Claire Kerrane (Roscommon-Galway, Sinn Fein)
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633. To ask the Minister for Health if fees paid by families under the fair deal scheme will be reviewed given the high costs for families; and if he will make a statement on the matter. [49535/22]

Claire Kerrane (Roscommon-Galway, Sinn Fein)
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634. To ask the Minister for Health the rules that are in place concerning costs under the fair deal scheme after the person has been in nursing care for three years; and if he will make a statement on the matter. [49536/22]

Mary Butler (Waterford, Fianna Fail)
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I propose to take Questions Nos. 633 and 634 together.

The Nursing Homes Support Scheme (NHSS), commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term residential care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.

All participants within the NHSS contribute up to 80% of their income (40% if part of a couple) and 7.5% per annum of the value of their assets (3.75% if part of a couple). The first €36,000 (€72,000 if part of a couple) is excluded from assessment.

Assets assessed include cash assets as well as non-cash assets such as the principal private residence, other property and land, including farmland.

For the purposes of financial assessment, income includes:- Earnings, including income from farming or business activities- Pension income- Social welfare benefits/allowances- Rental income- Income from holding an office or directorship- Income from fees, commissions, dividends or interest

Transferred assets and income, defined as assets or income transferred to another person up to five years before a person's application to the scheme, are also assessed.

The capital value of an individual’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, which is intended to protect the value of a principal private residence.

Last year, the Department of Health introduced the Nursing Homes Support Scheme (Amendment) Act 2021, which became operational in October 2021. This introduced a three-year cap on contributions from family farm and business assets, provided that a family successor is appointed to run the asset for at least 6 years. The Act also extended the three-year cap to the proceeds of sale of a principal residence, which means that, from the fourth year in care onwards and provided the house was sold while the person is in care, a nursing home resident may sell their principal private residence without incurring additional costs.

In addition, the Government has made a policy change to the NHSS to remove a disincentive for participants in the Scheme to rent out their principal residence after they have entered long term residential care. The rate of assessment on rental income from the principal residence will be reduced from 80% to 40%. This will be reviewed after six months of operation, with the potential for further amendment after that point. This policy change addresses the commitments made under Housing For All Action 19.8.

The change was made through Committee-Stage amendment to the Regulation of Providers of Building Works and Building Control (Amendment) Bill 2022. The Bill was approved by the Oireachtas on 30th June and signed into law by President Higgins in July. It is expected that the necessary administrative and operational changes will soon be in place and the amendment will become fully operational shortly thereafter.

It should be noted that the NHSS covers the cost of the standard components of long-term residential care which are: - Nursing and personal care appropriate to the level of care needs of the person - Bed and board - Basic aids and appliances necessary to assist a person with the activities of daily living - Laundry service - A person's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home. In determining the services covered by the NHSS it was considered very important that the care recipient and the taxpayer would be protected and would not end up paying for the same services twice. For this reason, medications and aids that are already prescribed for individuals under an existing scheme are not included in the services covered by the NHSS, as this would involve effectively paying twice for the same service.

Although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, such as social programmes, newspapers or hairdressing. In recognition of this, anyone in receipt of financial support under the NHSS retains at least 20% of their income. The minimum amount that is retained is the equivalent of 20% of the State Pension (Non-Contributory). An operator should not seek payment from residents for items which are covered by the NHSS, the medical card or any other existing scheme.