The Programme for Government agreed in 2020 commits the government to ‘Introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high-quality, regulated home care’.
Consequently, work is on-going within the Department of Health to progress the development of the new statutory scheme for the financing and regulation of home-support services. Taking place within the broader context of the Sláintecare reforms, this work encompasses the development of the regulatory framework for the new scheme; the examination of the options for the financing model for the scheme; and the development of a reformed model of service-delivery.
In relation to the regulatory framework, Government gave approval to draft a General Scheme and Heads of a Bill to establish a licensing framework for homecare and support providers in April 2021. The framework will comprise: (i) primary legislation for the licensing of public and private home-support providers; (ii) minimum requirements (i.e., regulations); and (iii) HIQA National Standards for Home Support Services. Development of regulations are at an advanced level and public consultation is planned for Q2 2022.
On 24th February, the ESRI published a report on the demand for and cost of home support. This is the final output from a programme of research that the ESRI has undertaken to support the Department of Health to progress the development of the new home support scheme. This research will form an important part of the evidence base for the development of a sustainable funding model for home support services in the context of our ageing population. Government approval will be sought in due course on any proposed legislation to provide for a financial support scheme, taking into consideration the cost associated with the various options.
In addition, work is ongoing in relation to the development of a reformed model of service delivery for the new scheme. In 2021, funding was secured for the Health Service Executive to: (i) progress the roll-out of interRAI as the standard assessment tool for care-needs in the community; (ii) pilot a reformed model of service-delivery for home-support; and (iii) establish a National Office for Home Support Services.
The testing of the reformed model of service delivery Home Support Pilot is in progress in four pilot sites. Funding has been approved for 128 interRAI Care Needs Facilitators to progress the national rollout of interRAI as the standard assessment tool for care-needs. A National Home Support Office is in the process of being established. A comprehensive and robust operational model for the roll-out of the interRAI has been developed which will facilitate effective, efficient, fair and transparent care needs assessment and planning and appropriate service delivery. The interRAI outputs and pilot site evaluation will be critical to the development of the new home-support scheme.
Home Support services are delivered directly by the Health Service Executive (HSE) or through service arrangements with private providers. The HSE National Service Plan 2022 outlines that the proportion of public / private provision of home support hours will be maintained at a minimum of 40%, so that the provider balance is reflected in each area and any increases reflect the workforce requirements of the expected statutory home support scheme.
Additionally, work has begun on the 2023 HSE home-support tender. A joint working group involving the HSE, and the Department of Health is in the process of being established to prepare the tender and ensure that it is in place from 1st January 2023. As it is envisaged that the new tender will be in place before the statutory scheme comes into effect, the working group will consider options to accommodate this transition.
