The Nursing Homes Support Scheme, 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.
As outlined in the HSE's National Service Plan for 2019, the NHSS is expected to support 23,042 people in 2019. The NHSS budget for 2019 is €985.8m which is an increase of €24.3m over its 2018 budget.
Over the last two years, an additional €45 million has been provided to NHSS budget for the continued provision of services in line with pricing and demand. As part of normal governance and performance management arrangements The Department and the HSE maintain regular service area engagements, which also form part of ongoing collaborative work on issues relating to older persons policy and service delivery.
The HSE have noted that the number of residents in nursing homes whom are supported by the NHSS to be ahead of forecast for the year to date. The latest available HSE data indicate that there are 23,090 people supported in the Scheme at the end of August this year. This is significantly more people than forecast and this creates a challenge. The HSE has also advised that the cost of care continues to rise and the average weekly cost per bed is higher in 2019 than anticipated.
Having regard to the available budget and the demand for support, the HSE releases funding in a managed way to ensure that the operation of the NHSS remains within the budgetary allocation. The HSE cannot legally fund clients beyond the determined funding allocation, and the appropriate mechanism relating to funding allocations is through the estimates and budgetary process. To manage the available funds throughout the year, a national placement list for the release of funding is operated by the HSE, to enable it to operate within budget. Funding issues to applicants in chronological order, to ensure equity nationally. Approved applicants are placed on the national placement list in order of their approval date and funding is released to applicants in order of their place on this list. The length of time spent on the placement list depends on the number of applicants currently receiving financial support and the number of new applications. Where demand is higher, the time spent on the waiting list may increase having regard for the prudent management of the Scheme's budget.
The HSE has put in place arrangements that a monthly analysis of performance of the Nursing Homes Support Scheme continues to ensure that the maximum number of new entrants are approved with the shortest possible waiting times while remaining on track to deliver a balanced budgetary position by year end. In the context of planning and preparing for the challenges of the winter period, the Department and the HSE have been considering a comprehensive approach to the current high-level of delayed transfers of care (DTOCs). However, recognising the urgency of the situation, approval was provided to the HSE to begin actions immediately to the value of €5m in 2019. As part of these measures the HSE released a significant number of funding approvals within NHSS this month bringing the waiting time for the release of funding back to 4 weeks.
As of 25 September I can confirm that 572 applicants to the Scheme are waiting for funding to be released.
