Published: Wednesday, 2nd December, 2009 5:00pm

New nursing home finance support plan unveiled

by Michael Cryan

The new Nursing Homes Support Scheme will go a long way to alleviate money problems for people who will have to avail of the service, according to Cavan representative Gerry Murray at a recent meeting of the North East Health Forum.

Welcoming the new legislation, he urged people to take part and added that applications from patients were recommended. "There are some sections I have reservations with but overall it will provide financial support for people who need long-term nursing home care."

He made his comments following a presentation from Patricia McDermott, senior manager, Nursing Home Support Service on the proposed scheme entitled 'AS Fair Deal' where she outlined what the scheme was about.

"It replaces the Subvention Scheme, which has been in existence since 1993. Under the Nursing Homes Support Scheme, you will make a contribution towards the cost of your care and the State will pay the balance. This applies whether the nursing home is public, private or voluntary."

There are three steps to the application process, the first being an application for a Care Needs Assessment. The Care Needs Assessment identifies whether or not you need long-term nursing home care.

The second stage is an application for State Support. "This will be used to complete the financial assessment, which determines your contribution to your care and your corresponding level of financial assistance."

Ms. McDermott said step three was an optional step, which should be completed if one wished to apply for the Nursing Home Loan. The application form should be completed and signed by the person applying for nursing home care. However, in certain cases, another person may apply on their behalf, she added.

"The Care Needs Assessment identifies whether or not you need long term nursing home care. Its purpose is to ensure that long-term nursing home care is necessary and is the right choice for you. The assessment will consider whether you can be supported to continue living at home or whether long-term nursing home care is more appropriate." Continuing Ms. McDermott said the financial assessment looked at your income and assets in order to work out what your contribution to care would be. The HSE would then pay the balance of your cost of care. For example, if the cost of your care was €1,000 and your weekly contribution was €300, the HSE will pay the weekly balance of €700. This payment by the HSE is called State Support. The financial assessment looks at all of your income and assets.

"Income includes any earnings, pension income, social welfare benefits/allowances, rental income, income from holding an office or directorship, income from fees, commissions, dividends or interest, or any income which you have deprived yourself of in the five years leading up to your application."

Having looked at your income and assets, the financial assessment will work out your contribution to care, she added. "You will contribute 80% of your assessable income and 5% of the value of any assets per annum."

However, the first €36,000 of your assets, or €72,000 for a couple, would not be counted at all in the financial assessment. Where your assets include land and property in the State, the five per cent contribution based on such assets may be deferred and collected from your estate. This is an optional Nursing Home Loan element of the scheme which is legally referred to as "Ancillary State Support".

"Your principal residence will only be included in the financial assessment for the first three years of your time in care. This is known as the 15% or 'three year' cap." It means that you will pay a five per cent contribution based on your principal residence for a maximum of three years regardless of the time you spend in nursing home care. After three years, even if you are still getting long-term nursing home care, you will not pay any further contribution based on the principal residence. This 'three year' cap applies regardless of whether you choose to opt for the loan or not.

Mr. Murray said there should be clarity on patients in acute care who are not discharged would they be charged on a daily basis? He hoped the Department of Health and local health representative would have an open mind where farms were concerned.

Ms. McDermott said it would all depend in what beds patients were in. If patients were in acute beds they would be charged, however if they were in a public bed and were not discharged from acute care they would not be charged.

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