Niall Collins (Limerick County, Fianna Fail)
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124. To ask the Minister for Health the status of the fair deal scheme and the way such scheme applies to farmers (details supplied); and if he will make a statement on the matter. [31034/16]

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 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.

When the Nursing Homes Support Scheme (NHSS) commenced in 2009, a commitment was made that it would be reviewed after three years. The Report of the Review was published in July 2015. Arising out of the Review, a number of key issues have been identified for more detailed consideration across Departments and Agencies, including the treatment of business and farm assets for the purposes of the financial assessment element of the Scheme. In advance of the Review, submissions were sought from groups or bodies who wished to make a contribution, and the Irish Farmers' Association (IFA) made a submission in this context on which they expanded at a subsequent meeting with officials of the Department of Health.

An Interdepartmental/Agency Working Group has been established to progress the recommendations contained in the Review. This group is chaired by the Department of Health and includes representatives from the Department of the Taoiseach, the Department of Public Expenditure and Reform, the HSE, the Revenue Commissioners and, when required, the National Treatment Purchase Fund. I have recently met with the IFA and invited them to present their submission at the next meeting of the Working Group. The Working Group met on the 11 of October and the IFA gave a verbal presentation to the Group. The issue is currently being considered.

The Programme for a Partnership Government has committed to reviewing the NHSS to remove any discrimination against small business and family farms.