Catherine Martin (Dublin Rathdown, Green Party)
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210. To ask the Minister for Health his plans to lower the premium placed on land and property assets of persons availing of the nursing homes support scheme from 7.5% to its previous level of a 5% premium; and if he will make a statement on the matter. [7512/17]

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 income and assets 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.

The Scheme was amended by the Health (Amendment) Act 2013 which increased the level of asset contribution from 5% to 7.5% per annum. This applied to new entrants to the Scheme after the enactment of the amendment and was required in order to ensure the sustainability of the Scheme in light of the increasing population of older people in Ireland. There are no plans to change the level of asset contribution back to 5% per annum.

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. It is important to note that a person'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 other 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 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. A number of key issues have been identified for more detailed consideration across Departments and Agencies, including recommendations relating to the treatment of business and farm assets for the purposes of the financial assessment element of the Scheme.

This work is currently underway and the IFA has made a submission in this context to the Interdepartmental Group which is overseeing the implementation of certain recommendations contained in the Review. The proposals put forward by the IFA are currently being considered. Once all of the relevant Review recommendations have been considered, any amendments required to the Scheme will be identified.