Written answers

Wednesday, 18 November 2009

Department of Health and Children

Nursing Homes Support Scheme

9:00 pm

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 177: To ask the Minister for Health and Children, with regard to private nursing homes approved under the nursing homes support scheme, if the €190 licensing fee per designated place in a nursing home was included in the detailed costing that formed part of the negotiations on the cost of care with the National Treatment Purchase Fund; and if she will make a statement on the matter. [42077/09]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 178: To ask the Minister for Health and Children the amount of funding she will make available to the nursing homes support scheme in 2010; and if she will make a statement on the matter. [42078/09]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 179: To ask the Minister for Health and Children the role the county registrar will play in approving care representatives to the nursing homes support scheme; if county registrars have been briefed on the processes and procedures with regard to this; and if she will make a statement on the matter. [42079/09]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Question 180: To ask the Minister for Health and Children if patients registered under the nursing homes support scheme in public hospital care who do not have a medical card will be charged additional moneys for care services such as physiotherapy, occupational therapy, speech therapy, special incontinence wear, special bandages and so on; and if she will make a statement on the matter. [42080/09]

Photo of Áine BradyÁine Brady (Kildare North, Fianna Fail)
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I propose to take Questions Nos. 177 to 180, inclusive, together.

Under the new Nursing Homes Support Scheme, the National Treatment Purchase Fund (NTPF) has agreed a price with each private nursing home provider wishing to partake in the scheme. This price forms the maximum agreed price for "long-term residential care services" provided under the scheme. A resident who avails of the scheme should not be charged any additional fee over and above this price, except where he or she chooses to obtain additional services (i.e. any services not coming within the definition of "long-term residential care services") such as hairdressing or delivery of daily newspapers.

In addition, the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009 specify that the registered provider shall agree a contract with the resident within one month of their admission, included in which are details of the services to be provided for that resident and the fees to be charged.

The €190 annual fee is payable by the registered provider and residents should only be charged those fees set out in their agreed contract with the provider. The Minister for Health and Children has indicated that she would anticipate that the registration fee should factor into negotiations with the NTPF in the context of agreeing a price for the purposes of the Nursing Homes Support Scheme. I also understand that the NTPF has endorsed this by accepting that the fee should be included as part of the reasonable day to day running costs associated with the provision of long-term residential care services.

The Deputy has also raised the issue of charging for a number of services which fall outside of the definition of "long-term residential care services". The Nursing Homes Support Scheme Act 2009 defines "long-term residential care services" as maintenance, health and personal care services. The legislation further provides for the details of the goods and services which constitute "long-term residential care services" to be specified in writing. In the case of approved private nursing homes, the details are stipulated within the agreement with the NTPF while, in the case of public nursing homes, they are set out in a document laid before the Houses of the Oireachtas by the Minister for Health and Children.

In stipulating the goods and services that constitute "long-term residential care services", it was imperative that both the care recipient and the taxpayer would be protected, and that the scheme would not facilitate double-counting. Medications and aids that are prescribed for individuals under an existing scheme, such as the medical card or drugs payment scheme, are not included in the cost of long-term residential care services as this would involve the tax payer and the care recipient effectively paying on the double. Accordingly, a person's eligibility under these other schemes remains unaffected. In particular, the Deputy has asked about specialised dressings and I wish to confirm that non-Medical Card holders who are eligible for the Drugs Payment Scheme can avail of specialised dressings in accordance with the terms of that scheme. Furthermore, existing arrangements with regard to the provision of incontinence wear to residents in public and private nursing homes will also remain in place.

The issue of therapies extends much more widely than nursing homes. It is a subject that is currently being examined comprehensively across all care settings in the context of eligibility legislation. With regard to the funding available for the scheme, Budget 2009 provided €55 million for the introduction of the scheme this year. In advance of the introduction of the scheme, a dedicated subhead for long-term residential care was established within the Health Service Executive's Vote (Subhead B16 in Vote 40). The total funding in Subhead B16 currently stands at €909 million. This represents the total State funding available for long-term residential care in 2009. Planned expenditure levels for the Health sector will be considered as part of the Estimates and budgetary process for 2010. Deliberations by Government on the expenditure allocations for next year are likely to continue until the Budget.

Finally, as regards the role of County Registrars in the Care Representative process, an application for appointment as a care representative must be made to the County Registrar in any county in the Circuit in which the person requiring a care representative now lives or in which he or she has lived at any time during the past three years. Where an application is not contested, the order appointing a care representative may be made by a County Registrar. All of the County Registrars have been briefed on the Care Representative process and the President of the Circuit Court has issued a Practice Direction.

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