Dáil Éireann Debate, Tuesday - 3 October 2023
632. Deputy Richard Bruton asked the Minister for Health the system of assessing contribution by patients from their income and from their assets towards the cost of nursing home care under the fair deal scheme, that will be in place from the start of 2024; and if there are particular changes being made. [42421/23]
View answerThe 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. The primary legislation underpinning the scheme is the Nursing Homes Support Scheme Act 2009. Participants in the NHSS 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 nursing home care is accessible and affordable for everyone, and that people are cared for in the most appropriate settings.
Participants in the Nursing Homes Support Scheme contribute a proportion of their income and the value of their assets towards their cost of care. Couples are assessed jointly but the value of their assets and income that is assessed is halved: participants 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 in assets (€72,000 if part of a couple) is excluded from assessment. Participants in the scheme who own property/land-based assets in the State also have access to Ancillary State Support, or the Nursing Home Loan, which is an optional feature of the Nursing Homes Support Scheme. It is a loan advanced by the HSE to help people meet the portion of their contribution to the cost of care that is based on property/land-based assets, most typically against the personal residence. If an individual secures Ancillary State Support, they will not need to contribute against the value of the relevant property during their time on the scheme, unless the property is sold during that time. It should be noted that 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.
The Department of Health has 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.
Effective from 1 November 2022, the amount of rental income that nursing home residents can retain under the Fair Deal from renting their principal private residence increased from 20% to 60%.
Prior to the change being implemented, participants under the Fair Deal scheme were able to rent out their homes or other assets, with rental income was subject to assessment at 80% like all other income (such as pension income).
The rate of assessment for rental income from a principal residence is now reduced from 80% to 40%. This means that for someone renting out their principal residence, they retain 60% of the income and 40% is assessed under Fair Deal. This measure allows residents in Fair Deal to keep more of their income and will also help address pressures on the rental market. It is important that residents who choose to rent out their homes do so in a safe and supported way. This policy change is currently under review.
The Department of Health has also announced plans to amend the Nursing Homes Support Scheme to broaden the definition of who could act as the family successor, to improve the viability and sustainability of family farms and businesses. The amendment also provides for the withdrawal or lapsing of an application to address unintended outcomes in relation to the provision for transferred assets.
