Tuesday, 22 November 2016
Department of Health
Long Stay Residential Units
418. To ask the Minister for Health if he will review the section of the long stay contribution scheme that allows a person to retain only €33 per week; and if he will make a statement on the matter. [35911/16]
Legislation to commence residential support services maintenance and accommodation contributions (long stay contributions) will come into operation on 1 January 2017 under sections 67A to 67D of the Health Act 1970 and the Health (Residential Support Services Maintenance and Accommodation Contributions) Regulations 2016. From that date, long stay contributions will replace the existing system of long stay charges for in-patient services (under section 53 of the Health Act 1970 and associated regulations).
The long stay contributions framework requires that affordable contributions be made towards maintenance and accommodation costs by service users in residential settings where services are provided directly by the HSE or by agencies funded under Section 38 of the Health Act 2004 to provide services on behalf of the HSE. The framework reflects modern residential support models (primarily in the disability, mental health and care of older people sectors).
From 1 January 2017, long stay contributions will apply to the further provision of residential support services (other than acute in-patient services and nursing home services provided to those supported under the Nursing Homes Support Scheme/Fair Deal), to persons who have already received at least 30 days of such services during the immediately preceding 12-month period, irrespective of where those 30 days of residential support services have been received.
Long stay contributions will be contributions towards the maintenance and accommodation costs associated with providing residential support services (similarly, charges under the existing long stay charges system are charges in respect of the maintenance element of the in-patient services provided).
The Health (Residential Support Services Maintenance and Accommodation Contributions) Regulations 2016 provide for three different classes of income-based long stay contributions towards accommodation and maintenance costs in three accommodation categories:
- Category A (to which this question relates) refers to accommodation where 24-hour nursing and/or medical care is provided, subject to a maximum of €175 per week for a person whose income is €208 per week or more. These rates are identical to the rates which currently apply under the existing long stay charges system.
- Category B relates to contributions payable by those in accommodation where part-time nursing and/or medical care is provided and is subject to a maximum of €130 per week for a person whose income is €194 per week or more. Again, these rates are unchanged from the current system.
- Category C relates to all other non-nursing settings (such as independent living settings), subject to a maximum of €70 per week for a person whose income is €188 per week or more.
In all three accommodation categories, contribution rates will be on sliding scales, with proportionally lower contribution rates applying to those on lower incomes.
Affordability and the avoidance of financial hardship are built-in features of the long stay contributions provisions (as with the existing long stay charges system):
- Firstly, section 67C of the Health Act 1970 caps the maximum contribution amount that may be set at 80% of the non-contributory State Pension weekly rate.
- Secondly, the relevant Regulations are structured to ensure that those making long stay contributions will retain income for personal use of at least €33 per week for Category A residents (in full-time nursing settings), at least €64 per week for Category B residents (in part-time nursing settings) and at least €118 for Category C residents (non-nursing settings).
- Thirdly, section 67D of the Health Act 1970 provides that the HSE may reduce or waive a contribution where appropriate, in order to:
- avoid undue financial hardship on the part of the service user and/or on the part of the service user’s dependants,
- advance a service user’s identified needs (e.g. care plan objectives), or
- take account of separate contributions (if any) made by a service user towards his or her maintenance or accommodation costs.
To assist in the fair application of the framework, the HSE has developed national guidelines for the correct determination of long stay contributions and comprehensive waiver guidelines (approved by the Ministers for Health and Public Expenditure and Reform) on the individual circumstances where such contributions may need to be reduced or waived. The guidelines specify that service providers must have regard to the individual circumstances of each service user and his or her dependants. The guidelines ensure that the applicable contribution may be reduced or waived where appropriate, taking account of each person’s income and necessary outgoings, including reasonable regular financial commitments, with a view to ensuring there is no unfair burden on the service user or on his or her dependants.
I am satisfied that the long stay contribution scheme which will commence on 1 January 2017 and the existing long stay charges scheme are reasonable and fair and ensure that each service user's contributions are based on what he or she can afford, taking account of the service user's individual circumstances.