John Lahart (Dublin South West, Fianna Fail)
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812. To ask the Minister for Health the steps that are being taken to ensure that older persons can age in their own home with dignity and independence as long as possible. [8096/22]

John Lahart (Dublin South West, Fianna Fail)
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816. To ask the Minister for Health the steps he is taking to analyse the need for home care in the State. [8100/22]

John Lahart (Dublin South West, Fianna Fail)
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817. To ask the Minister for Health the steps he is taking to equalise the inequity between different HSE regions with regard to provisions of home care and particularly with regard to the provision of travel expenses. [8101/22]

John Lahart (Dublin South West, Fianna Fail)
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818. To ask the Minister for Health the steps he is taking to tackle the level of unregulated care, including informal employment in a person's home in the home care sector. [8102/22]

Mary Butler (Waterford, Fianna Fail)
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I propose to take Questions Nos. 812 and 816 to 818, inclusive, together.

The Programme for Government agreed in 2020 commits the government to ‘Introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high-quality, regulated home care’.

Consequently, work is on-going within the Department of Health 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 in the State are provided with a standard, high-quality level of care which is safe, effective, and person-centred, thus allowing them to age in their own homes with dignity and independence for as long as is safely possible. 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 that 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 lately ran a public scoping consultation to inform the development of their National Standards for Home Support Services. A regulatory impact analysis is currently being undertaken by the Department to ensure effectiveness and mitigate risks.

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 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.

Recruitment of 128 interRAI Care Needs Facilitator posts has been approved. This will progress the national roll-out of interRAI as the standard assessment tool for care for older persons services. A comprehensive and robust operational model for the roll-out of interRAI has been developed which will facilitate effective, efficient, fair and transparent care needs assessment and planning and appropriate service delivery.

The testing of the reformed model of service delivery for home-support commenced in November 2021 in the first of the four pilot sites: East Westmeath in Community Healthcare Organisation (CHO) 8. The three other sites – Tuam, Athenry and Loughrea in CHO 2; Bandon, Kinsale and Carrigaline in CHO 4; and Ballyfermot and Palmerstown in CHO 7 – came into operation in January 2022. The interRAI outputs and pilot site evaluations will be critical to the development of the new home-support scheme. A National Home Support Office is in the process of being established.

In parallel, the Department is developing the evidence base to determine the optimal approach to a funding model for the scheme. As part of this work, the Economic and Social Research Institute (ESRI) is undertaking research on behalf of the Department on the potential demand for and cost of home-support. The first report from this research, published in March 2021, focused on the potential demand for such a scheme in a number of policy scenarios. 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 of the 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 modelled. 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. This work will complement the research already undertaken, including by the Health Research Board, in relation to the provision of home-support in other countries. 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 addition to the statutory scheme, the Minister for Mental Health and Older People, Mary Butler TD, has committed to establishing a cross-departmental Strategic Workforce Advisory Group to examine strategic workforce challenges in front-line carer roles in home-support and nursing homes. The work of this Group, the first meeting of which is expected to take place the week commencing 28th February, will centre on engagement with relevant stakeholders in the sector and will involve a structured programme of ongoing consultative engagements with key sectoral stakeholders to further explore and define the issues, listen to stakeholder views, and identify approaches to respond to strategic workforce challenges. Potential areas to be considered by the Group include recruitment, retention, training, and the career development of front-line carers in home-support and nursing homes into the future.  Provision of travel expenses to staff may also form part of these considerations.