Fair Deal… a better deal

THE introduction of a new support scheme for people who need long-term nursing home care provides a more equitable and affordable mechanism for Clare families, according to Deputy Timmy Dooley.

Speaking at a public meeting in the West County Hotel, Ennis on Friday night, Deputy Dooley explained that the Government had decided to bring in the Fair Deal to help patients afford care in private nursing homes because the State is not in a position to provide enough public beds.
The Fianna Fáil deputy said it was felt the State should provide some funding in a careful and more equitable way to help families who were finding it increasingly difficult to pay for the cost of providing nursing home care for a loved one.
Under the Fair Deal, a patient will make a contribution towards the cost of their own care and the State will pay the balance. This applies whether the nursing home is public, private or voluntary.
Information was provided by Pascal Moynihan, HSE specialist for older people’s services and HSE community welfare officer for the Mid-West, Mary Frawley for the meeting, which was organised by Deputy Dooley.
Clarecastle and District Daycare chairperson, Mary Morrissey, expressed concern about the downgrading of St Joseph’s Geriatric Hospital, Ennis, which has provided a very high standard of care and said she felt sad to see wards and beds being shut only to be turned into offices.
At a time when the population in Clare is ageing, Ms Morrissey stressed that more public beds are needed. She also expressed concern that some private nursing homes may not have adequate levels of staff for patients compared to public facilities.
Mr Moynihan said people could be assured the same stringent standards administered by the Health and Information Quality Authority (HIQA) would apply to private and public facilities.
Patients currently receiving a nursing home subvention can opt to apply for the new scheme or continue with their existing arrangements but all new applicants can only apply for assistance under Fair Deal.
Applicants must be a resident of the State or at least living here for a year, require long-term care and reside in a private nursing home.
A care needs assessment must be carried out by an appropriate healthcare professional to assess a person’s ability to carry out daily duties, medical, health and social services being provided at the time and family support.
Where a person has reduced ability to make decisions, a specified person including the committee for a ward of court, power of attorney, care representative, spouse or partner, relative over 18, or a next friend appointed by a court, can apply for Ancillary State Support on behalf of an applicant.
An applicant can apply for a nursing home loan, which has to be paid back a year with consumer price index adjustments after the person dies by the sale of all or portion of their assets. There is also an option to pay back this loan without the sale of an asset once it becomes redeemable.
A person can also apply to defer paying back the loan in a number of circumstances no later than three months after it is due.
An applicant can choose their own nursing home except in exceptional circumstances where high dependency requirements may result in a requirement to use a specific facility.
All relevant information must be submitted to the HSE who may require further information.
Valuations of land and houses must be provided by an auctioneer and the HSE can request an independent quote if it believes the initial quoted value undervalues the property.
Details of the scheme were provided by Pascal Moynihan who explained that 80% of a person’s assessable income and 5% of the value of any assets per annum must be provided. However, up to €36,000 of savings will be disregarded. State support is only given when the assessable income is below the cost of the nursing home care.
Mr Moynihan also provided a number of examples to explain how this will affect Clare people.
John is an old-age pensioner, who wants to live in a private nursing home costing €800 a week. His income is €230, he has €15,000 in savings, which are disregarded, so he pays €184 a week and the HSE pays €616.
Mary requires care in a nursing home costing €800 weekly, She has an income of €520 weekly, has land valued at €50,000, which is rented for €800 and has a house valued at €250,000. She will pay €711 weekly, while the HSE will pay €89. If she opts for the nursing home loan, she will pay €428 a week and the HSE will pay €371.
The principal residence will only be included in the financial assessment for the first three years of time in care.
The three-year cap also extends for farms and businesses where the person has suffered a sudden illness or disability, which causes them to need long-term nursing home care; the person or their partner was actively engaged in the daily management of the farm or business up until the time of the sudden illness or disability a family successor certifies he or she will continue the management of the business.
Application forms can be downloaded from the HSE website or requested from HSE Nursing Homes Support Office, St Joseph’s Hospital, Mulgrave Street, Limerick.