Timmy Dooley (Clare, Fianna Fail)
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470. To ask the Minister for Health the entitlement that older persons that satisfy the means test and clinical assessment criteria to respite care in a public hospital or nursing home; the number of free days respite they are entitled to in every 12 month period; and if he will make a statement on the matter. [48311/18]

Simon Harris (Wicklow, Fine Gael)
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Respite care is an essential component to ensuring older people with care needs in the home, including those with dementia, can be cared for in their community and close to their carers. Respite beds offer additional assistance to families and carers thus helping to alleviate the ongoing stress associated with providing care. The provision of respite can often assist with avoidable acute hospital admissions.

There are in the region of 2,000 “short stay” public beds nationally with a budget of €212 million approximately. This includes step-up, step-down care, intermediate care, rehab and respite care comprised of a mixture of the following categories:

- Palliative

- Respite

- Rehab Specific

- Convalescent

- Dementia Respite

- Assessment beds

- Transitional care beds.

These beds are interchangeable for use depending on demand in the centres and so the number of specific respite beds in any one month can fluctuate up and down.

The Health Act 1970 (as amended) provides that all persons ordinarily resident in the country are eligible, subject to certain charges, for public in-patient services. In-patient services are defined as institutional services provided for persons while maintained in a hospital, convalescent home or home for persons suffering from physical or mental disability or in accommodation ancillary thereto.

Within this overall definition of in-patient care, a person may be eligible for acute in-patient care in circumstances where in-patient services are provided in a hospital for the care and treatment of patients with acute ailments to a person requiring medically acute care and treatment. 

The definition of “in-patient services” covers a range of services which may include respite care provided or funded by the HSE in residential accommodation (other than in the person’s own home).  

In this context, whether respite care services for older persons falls within the definition of in-patient or acute in-patient services depends on the setting in which the service is provided and the type of service provided.

A person in receipt of acute in-patient services is liable, subject to a number of exemptions, for the statutory acute in-patient charge, currently €80 per day for a maximum of 10 days in any period of 12 consecutive months.

In non-acute residential support service settings, an obligation to pay contributions towards maintenance and accommodation costs applies under section 67C of the Health Act 1970.  This includes non-acute residential respite care services provided by the HSE or by agencies funded to provide such services on behalf of the HSE under section 38 of the Health Act 2004. These contributions apply to the maintenance and accommodation elements only of such services. There is no provision for free days in each 12 month period. However, a threshold provision means that contributions are payable on a given day if the person has received 30 or more days of residential support services during the immediately preceding 12-month period.

A waiver system is in place to ensure that each service user's maintenance and accommodation contribution is based on what he or she can afford, taking account of the service user's individual circumstances.

The HSE publishes detailed supporting documentation in relation to long stay residential support services maintenance and accommodation contributions on its website at  www.hse.ie/longstaycontributions.