Jim O'Keeffe (Cork South West, Fine Gael)
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Question 293: To ask the Minister for Health and Children the basis for payment of the different levels of nursing home subvention; the different rates of payment; when it is expected that the legislation providing for the new system will be circulated; and the proposals in this regard. [14697/08]

Máire Hoctor (Tipperary North, Fianna Fail)
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The Nursing Home Subvention Scheme was introduced in 1993. The aim of this scheme is to provide financial assistance to older people towards the cost of maintenance in a private nursing home. As of January 2007, there are no longer three separate rates for subvention. Persons who apply may receive any amount up to a maximum of €300 per week. Additional funding of €55 million was provided for this purpose in Budget 2007. A subvention may be paid where a person has been assessed as needing nursing home care by the Health Service Executive and where the person has satisfied a means test.

In addition to the increased rate of basic subvention, additional funding of €30 million was made available in 2007 for enhanced subvention. This is a supplementary subvention, which may be paid by the HSE, to a person in or entering private long-term care. The amount of enhanced subvention paid is at the discretion of the HSE and varies according to the cost of care and the circumstances of the applicant.

The Bill providing for the Fair Deal scheme is being finalised by the Office of the Attorney General at present. My colleague, the Minister for Health and Children, intends to publish the Bill as soon as possible following finalisation by the Attorney General and Government approval, and to bring the legislation through the Houses of the Oireachtas thereafter.

Under the Fair Deal, individuals will apply to the HSE for an assessment of care needs. There will be a common assessment process throughout the country and the assessment will be carried out by a multi-disciplinary team of healthcare professionals. The assessment will be flexible and will recognise that some people may require more assessment by a wider range of health care professionals than others.

Individuals who are assessed as needing long-term residential care, can apply to the HSE for financial support. The new scheme will ensure that the State continues to fund the largest part of care costs overall. Furthermore, a person's family will not have to contribute towards the cost of their care.

Individuals who require long-term residential care will contribute a maximum of 80% of their net assessable income whether for public or private nursing home care. In calculating an individual's net assessable income, it is proposed that account can be taken of specified items of expenditure.

Depending on the amount of a person's assessable income, there may also be a contribution of up to 5% of a person's assets. The State will meet the balance of cost thereafter in public or private nursing homes. An individual can choose any approved nursing home subject to a) its ability to meet their care needs and b) availability.

The payment of the portion of the contribution relating to assets can be paid at the time when care is received, or may be deferred until the settlement of the individual's estate if they so wish. If an individual opts to defer this portion of the contribution, the Revenue Commissioners will collect it upon settlement of their estate.

Where the contribution is based on the principal private residence, it will be capped at a maximum of 15%, or 7.5% in the case of one spouse going into long-term residential care while the other remains in the home. This means that after three years in care, an individual will not be liable for any further deferred contribution based on the principal residence.

Where a spouse or certain dependants are living in the principal residence, the contribution may be further deferred until after the death of that spouse or dependant, or until such time as a person previously qualifying as a dependant ceases to qualify as such.