Róisín Shortall (Dublin North West, Social Democrats)
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1921. To ask the Minister for Health if he plans to change the HSE model for commissioning homecare; and if he will make a statement on the matter. [2464/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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As this is a service matter, I have asked the Health Service Executive to respond to Deputy Róisín Shorthall directly.

Róisín Shortall (Dublin North West, Social Democrats)
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1922. To ask the Minister for Health the status of plans to introduce a statutory right to homecare as committed to in the Programme for Government; the timescale he is working towards; and if he will make a statement on the matter. [2465/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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In accordance with the Programme for Government agreed in 2020, the Department of Health is committed to introducing a statutory scheme to support people to live in their own homes, with 'equitable access to high-quality, regulated home care'.

Consequently, work is on-going within the Department to progress the development of the new statutory scheme for the financing and regulation of home-support services. Taking place within the broader context of the Sláintecare reforms, this work encompasses the development of the regulatory framework for the new scheme; the examination of the options for the financing model for the scheme; and the development of a reformed model of service-delivery.

The aim is to ensure that all service-users are provided with a standard, high-quality level of care which is safe, effective, and person-centred. The regulatory framework will comprise: (i) primary legislation for the licensing of public and private home-support providers; (ii) minimum requirements (i.e., regulations); and (iii) HIQA National Standards for Home Support Services.

Last year, Government gave approval to draft a General Scheme and Heads of a Bill to establish a licensing framework for home-support providers. This is being progressed by the Department with a view to bringing it through the Houses of the Oireachtas at the earliest opportunity. It is expected that the primary legislation will give the Minister for Health the power to make regulations in respect of minimum requirements which will form the criteria against which a provider’s eligibility to hold a licence will be determined. The Department recently commenced a targeted stakeholder consultation on these draft minimum requirements. A public consultation will take place in 2022. In addition, HIQA recently ran a public scoping consultation to inform the development of their National Standards for Home Support Services. A regulatory impact analysis will be undertaken by the Department in 2022 to ensure effectiveness and mitigate risks.

In parallel to this, the Department is working with the Economic and Social Research Institute (ESRI) to investigate the projected demand for and cost of home-support service-provision across a range of models for the financing of the new scheme. The first report from this research, published in March 2021, focused on the potential demand for such a scheme. The findings contained in the report indicate that there will be a significant increase in the demand for home-support in the coming years and that, relative to a baseline provision of 24.7 million hours in 2019, between 3.5 and 8 million additional hours will be required across a range of policy scenarios. Building on this work, the ESRI is currently undertaking research on the potential cost of introducing such a scheme across a range of funding scenarios. This report is scheduled for publication in Q1 2022. The Department will seek Government approval in due course on any proposed legislation to provide for a funding model for the new home-support scheme, taking into consideration the cost associated with the various options. 

In parallel, work is ongoing in relation to the development of a reformed model of service delivery for the new scheme. In 2021, funding was secured for the Health Service Executive (HSE) to: (i) progress the roll-out of interRAI as the standard assessment tool for care-needs in the community; (ii) pilot a reformed model of service-delivery for home-support; and (iii) establish a National Office for Home Support Services.

The testing of the reformed model of service delivery for home-support commenced in November 2021 in the first of the four pilot sites, which is in CHO 8. It is envisaged that the three other sites, in CHOs 2, 4 and 7, will be fully operational by the end of January. Funding has been approved for 128 interRAI Care Needs Facilitators to progress the national rollout of interRAI as the standard assessment tool for care-needs. A National Home Support Office is in the process of being established. A comprehensive and robust operational model for the roll-out of the interRAI has been developed which will facilitate effective, efficient, fair and transparent care needs assessments and planning and appropriate service delivery. The interRAI outputs and pilot site evaluation will be critical to the development of the new home-support scheme.