Written answers
Tuesday, 4 December 2018
Department of Health
Nursing Homes Support Scheme Review
Stephen Donnelly (Wicklow, Fianna Fail)
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471. To ask the Minister for Health the action that has been taken to implement each of the 32 recommendations in the review of the nursing homes support scheme 2015 on the administration of the scheme in tabular form. [50925/18]
Stephen Donnelly (Wicklow, Fianna Fail)
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472. To ask the Minister for Health the action that has been taken to implement each of the 13 recommendations in the review of the nursing homes support scheme 2015 on the cost of long-term residential care in tabular form. [50926/18]
Stephen Donnelly (Wicklow, Fianna Fail)
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473. To ask the Minister for Health the action that has been taken to implement each of the 12 recommendations in the 2015 review of the nursing homes support scheme 2015 for future service provision in tabular form. [50927/18]
Stephen Donnelly (Wicklow, Fianna Fail)
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474. To ask the Minister for Health the action that has been taken to implement each of the four recommendations in the review of the nursing homes support scheme 2015 on residential care capacity [50928/18]
Jim Daly (Cork South West, Fine Gael)
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I propose to take Questions Nos. 471 to 474, inclusive, together.
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.
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 (NTPF).
The following table provides the current status in relation to the consideration of the recommendations contained in the review.
Review of Nursing Homes Support Scheme - Progress in Actions
| No. | Recommendation – Administration of Scheme | Current Position |
|---|---|---|
| 1 | Centralise certain elements of the scheme where appropriate, with built in appropriate management and training processes to ensure customer service is maintained | This recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Review Group |
| 2 | Consolidate local NHSOs (from 17 to 4) | Work in Progress on moving to five Regional NHSO’s |
| 3 | Develop a web based form to enable nursing homes to submit invoices electronically | Work in Progress |
| 4 | Centralise the processing of invoices | This recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Review Group |
| 5 | Centralise the calculation of loan repayments | This recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Review Group |
| 6 | Clarify for how long the application form/documentation and the CSAR form remain valid without any new processes or medical checks | Implemented |
| 7 | Provide additional information regarding nursing homes to assist with the process of identifying one that is suitable | This recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Review Group |
| 8 | Review documents and application forms with advice from the National Adult Literacy Agency to ensure they are sufficiently user-friendly and informative and that they include clear guidance on where relevant information/documentation can be obtained | Implemented |
| 9 | Consider whether any additional questions should be included in the application form | Implemented |
| 10 | Make sample completed application forms available | Implemented |
| 11 | Include in the application form a mechanism for an applicant to authorise a representative to submit the application on their behalf | Implemented |
| 12 | Consider the need to establish an NHSS Best Practice Group (consisting of NHSO/national office staff) to share experiences and agree on best practice | Implemented |
| 13 | Consider splitting application form into two parts to avoid delaying the care needs assessment while financial information and documentation is being assembled | This recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Review Group |
| 14 | Standardise informal advice provided to applicants regarding the nursing home loan, including clarity re legal aspects | Implemented |
| 15 | Provide advice regarding the possibility of claiming tax relief for medical expenses/nursing home fees | Implemented |
| 16 | Review current letter templates and, where possible, replace with alternative, quicker forms of communication | Work in Progress. Updated versions agreed and in test on IT system. |
| 17 | Review content of correspondence to ensure it is as clear as possible | Work in Progress |
| 18 | Examine the possibility of scanning/electronic transmission of forms and documentation from NHSOs to the national office | This recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Review Group |
| 19 | Clarify that the involvement of a solicitor is not required in order to apply for the loan | Implemented |
| 20 | Consider making it a condition of availing of the loan that the required details, including the PPSN of the responsible person are provided | Implemented |
| 21 | Complete analysis of home ownership levels | Implemented |
| 22 | Establish what databases exist that may contain useful data for the financial assessment and establish the access by NHSOs to these, including standard operating procedures, requiring review, of such information sources | Work in Progress in liaison with DESP. |
| 23 | Develop a consistently applied standard operating procedure for the initial financial assessment based on available resources of information | Implemented |
| 24 | Introduce a policy of undertaking random spot checks of financial data | Implemented |
| 25 | Follow up with the Revenue Commissioners on the scope for improved validation of declarations of income/assets | Work in Progress |
| 26 | Consider the options to encourage realistic valuations of declared property assets | Work in Progress |
| 27 | Standardise procedures in relation to reviews across NHSOs and ensure that all available information is utilised and accessed | Implemented |
| 28 | Consider amending legislation to provide for fluctuating values of assets and incomes | Requires Legislative change. This may be considered as part of amendment planned for 2018 |
| 29 | Continue to operate the national placement list in chronological order | Implemented |
| 30 | Increase time for recovery of loan to 18 months | Requires Legislative change. This may be considered as part of amendment planned for 2018 |
| 31 | Amend definition of ordinarily resident to ‘those who have been living in Ireland for at least a year’ | Work in Progress |
| 32 | Consideration should be given to whether a cap should be applied to the charge for nursing home care based on non-residential productive assets which are passed on to a direct family member after, or in the five years prior to, the death of an NHSS participant, and where the new owner carries on the farm or other business as their principal livelihood | The changes to the Scheme will come into effect in 2019 subject to the legislative process. |
| No. | Recommendations on Residential Care Capacity | Current Position |
|---|---|---|
| 1 | The Department of Health continues to progress the project to identify and assess the various options available to encourage the provision, including the upgrading and refurbishment, of long-term residential care facilities for older people. | 5 year Capital investment programme for Community Nursing Units 2016-2021 is on-going |
| 2 | The implications for HSE residential facilities of the relevant standards should be clarified with a view to agreeing an approach that achieves the best achievable outcome for residents. | 5 year Capital investment programme for Community Nursing Units 2016-2021 is on-going |
| 3 | Detailed consideration should be given to whether there is potential for new models of collaboration between the public and private sectors. | 5 year Capital Investment programme for Community Nursing Units includes a number of CNU’s for Public Private Partnership |
| 4 | The potential of sheltered housing and assisted housing models should be considered in consultation with the Department of Environment, Community and Local Government. | Collaboration with the Department of Housing Planning and Local Government is on -going and includes the development of a demonstration project for supported living |
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