Bernard Durkan (Kildare North, Fine Gael)
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Question 140: To ask the Minister for Health and Children if he has examined the fair deal nursing homes support scheme as it applies to a patient suffering from dementia, who may be young and whose family may not be in a position to retain the family home for a spouse given the current terms of the scheme; if he will examine the best way to amend the scheme to alleviate hardship; and if he will make a statement on the matter. [11089/11]

Bernard Durkan (Kildare North, Fine Gael)
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Question 141: To ask the Minister for Health and Children if he will review the terms of the nursing homes support scheme in view of the fact that it particularly militates against the interest of younger patients and their immediate families who may be forced to sell the family home in order to maintain the patient; if he will undertake a full review of the scheme if necessary; and if he will make a statement on the matter. [11090/11]

Kathleen Lynch (Cork North Central, Labour)
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I propose to take Questions Nos. 140 and 141 together.

The Nursing Homes Support Scheme provides financial support to individual's in need of long-term nursing home care. Under the scheme, individuals contribute up to 80% of their assessable income and a maximum of 5% of the value of any assets per annum towards their cost of care. The first €36,000 of an individual's assets, or €72,000 in the case of a couple, is not counted at all in the financial assessment.

An individual's principal residence is only included in the financial assessment for the first three years of their time in care. This is known as the 15% or 'three year' cap. It means that individuals pay a 5% contribution based on their principal residence for a maximum of three years regardless of the time they spend in nursing home care. After 3 years, even if an individual is still in long-term nursing home care, they will not pay any further contribution based on the principal residence. This 'three year' cap applies regardless of whether an individual chooses to opt for the loan or not. The intention of this three year cap is to protect the family home.

There are several important safeguards built into the scheme which ensure that both the person entering long-term nursing home care and their partner are adequately provided for.

1. Nobody will pay more than the actual cost of care.

2. The first €36,000 for a person's assets, or €72,000 for a couple, is not taken into account during the financial assessment.

3. The principal residence will only be included in the financial assessment for the first three years of a person's time in care.

4. Individuals keep a personal allowance of 20% of their income, or 20% of the maximum rate of the State Pension (Non-Contributory), whichever is the greater.

5. If there is a spouse/partner remaining at home, he/she will retain 50% of the couples income, or the maximum rate of the State Pension (Non-Contributory), whichever is the greater.

6. There is a financial review mechanism which takes account of the fluctuating value of assets and the fact that cash assets will naturally deplete over time as payments are made to the nursing home etc.

7. Certain allowable deductions are taken account of during the financial assessment.

The allowable deductions taken account of during the financial assessment are:

health expenses,

interest on loans related to the principal residence,

rent payments (for individual's who live in rented accommodation, and

maintenance payments to another person.

In addition, the definition of 'allowable deduction' was expanded by the Nursing Homes Support Scheme (Allowable Deductions) Regulations 2010 which commenced on the 1st January 2011. The effect of these Regulations is to include borrowings in respect of a person's principal residence as an allowable deduction. This enables individuals to deduct the full value of mortgage repayments from their income prior to calculating their income-based contribution. Where an individual chooses to avail of this deduction, he/she cannot also seek to offset the same mortgage against the value of the asset concerned.

The Nursing Homes Support Scheme (Allowable Deductions) Regulations 2010 were introduced to take account of the situation referred to by the Deputy, i.e. a young person who may have an outstanding mortgage entering long-term nursing home care.