Clare Daly (Dublin Fingal, Independent)
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386. To ask the Minister for Health the policy implemented under the fair deal scheme by which residents in nursing homes are allocated a daily allowance of €6.34 per day; and if he will make a statement on the matter. [28193/16]

Helen McEntee (Meath East, Fine Gael)
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The Nursing Homes Support Scheme (NHSS) is a system of financial support for those in need of long-term nursing home care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings. A financial assessment is carried out by the HSE to determine how much a participant in the Scheme will contribute to the cost of their care.

Participants in the Scheme contribute up to 80% of their assessable income and a maximum of 7.5% per annum of the value of assets held. In the case of a couple, the applicant’s means are assessed as 50% of the couple’s combined income and assets. 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. The capital value of an individual’s principal private residence is only included in the financial assessment for the first three years of their time in care. This is known as the three year cap.

The NHSS covers the cost of the standard components of residential care which are:

- Nursing and personal care appropriate to the level of care needs of the person;

- Bed and board;

- Basic aids and appliances necessary to assist a person with the activities of daily living;

- Laundry service.

The Scheme has a number of important safeguards built into the financial assessment which ensures that:

- Nobody will pay more than the actual cost of care;

- An applicant will keep a personal allowance of 20% of his/her income or 20% of the maximum rate of the State Pension (non-Contributory), whichever is greater. This is in recognition of the fact that, although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, such as social programmes, newspapers or hairdressing;

- If an applicant has a spouse/partner remaining at home, he/she will be left with 50% of the couple’s income or the maximum rate of the State Pension (non-Contributory), whichever is greater;

- If both members of a couple enter nursing home care, they each retain at least 20% of their income, or 20% of the maximum rate of the State Pension (non-Contributory), whichever is greater;

- Certain items of expenditure, called allowable deductions, can be taken into account for the financial assessment, including health expenses, payments required by law, rent payments and borrowings in respect of a person’s principal private residence;

- A person’s eligibility for other schemes, such as the Medical Card Scheme or the Drug Payment Scheme, is unaffected by participation in the Nursing Homes Support Scheme or residence in a nursing home.

In addition to these safeguards, where an applicant’s assets include land and property held in the State, the contribution based on such assets may be deferred and collected from their estate. This is known as the Nursing Home Loan (Ancillary State Support), the purpose of which is to ensure that a person does not have to sell their home during their lifetime to pay for long-term nursing home care. A nursing home resident can apply for this deferral at any stage.

A person’s financial assessment can be reviewed, at their request, if 12 months have passed since the initial financial assessment or the most recent review, or if the HSE is satisfied that there has been a material change to the person’s financial circumstances.