The Fair Deal Scheme – How Does it Affect You?

What is it?

The Fair Deal Scheme is a government scheme set up to support and assist people in paying for their long term residential care. Through the means of a care assessment, it is established what degree of care you require. With a financial assessment, the HSE decide how much a patient can afford to pay and how much they will contribute. You will contribute 80% of your weekly income to the home care monthly bill, the state will pay the balance.

Frequently Asked Questions

• What is the Fair Deal Scheme?
• The Fair Deal Scheme is a scheme set up by the HSE to provide financial support for people considering long term nursing home care.

• What facilities does the scheme cover?
• The scheme covers public and voluntary care homes; it also covers a selection of private homes, a list of which can be found on the HSE website.

• Who can apply?
• Any ordinary resident of Ireland can apply, regardless of age. An ordinary resident is anybody who has been living in Ireland for the previous year or intends to live in Ireland for a year.

• What services are covered by the scheme?
• All nursing and personal care required by the person as well as basic aids and appliances necessary to help the person with the activities of everyday life are all included in the scheme. Bed, board and laundry services are also covered by the scheme. It is worth checking with the care home as to what is not included as there are often additional charges.

• How do I apply?
• To apply, an application must be made in your local nursing home support office. A three step process is then followed, firstly, an application for a care assessment must be made, then an application for a financial assessment, and finally, if required, an application for a nursing home loan can be made. More details can be found on the HHHHHHHJHHHHHSE website or in your local nursing home support office.

HSE Website: http://www.hse.ie/eng/

List of Nursing Home Support Offices: https://www.hse.ie/eng/services/list/4/olderpeople/nhss/support-offices/

• Can I apply for somebody else?

Yes, if the person in question has a diminished mental capacity, a “specified person” can carry out the first two steps of the application process. Only a court appointed care representative can carry out the third step on behalf of another person. This person is usually your next of kin or a family member.

• Who constitutes a “specified person”?

With regard to this issue, a “specified person” is:

• In the case of a ward of court, their committee.
• A person appointed under a valid, registered enduring power of attorney who is not restricted from applying for the scheme.
• A care representative appointed under the Nursing Homes Support Scheme Act.
• A person’s spouse/partner.
• A relative who is 18 years or older.
• A next friend appointed by a court.
• A legal representative.
• A registered medical practitioner, nurse/social worker.

People from groups one to three take precedence over people from groups four to eight.

• Where does my care assessment take place?

It can be carried out in a hospital, at your home or any other communal setting of your choosing.

• What does the assessment involve?

During the assessment, the health care professional will look at the help available to you from family members or close members of your community; they will also test and consider your ability to carry out certain day to day tasks such as cooking, cleaning and washing. Health issues and your own personal wishes are also taken into account.

• If my request for this scheme is denied, is there any form of appeals process?

Yes, if you wish to challenge the outcome of either of the two assessments, an appeal process is available to you.

• How is the contribution that is to be made by the state calculated?

The way the contribution is calculated depends on whether it is a single person enquiring or a couple. If it is a person enquiring alone, the assessment will calculate his/her assessable income, the person will then contribute 80% of this income to the cost of the care, the remainder of the cost is the contribution made by the state. 7.5% of the value of the persons’ assets is due each year. If a couple is enquiring, the 80% is based off half of the couples combined income. The 7.5% annual bill is still due. A review is currently underway by the government as to how assessments will be made in the future.

• Will my house be taken into account?

Your house will be part of the assets billed at the 7.5% for the first three years only, after three years; the value of the principal residence will not be added to the value of your assets in this regard.

• Are there any allowances or deductions taken into account?

Certain “allowable deductions”, can be taken into account during the financial assessment. The applicant must request them and provide the HSE with any information required. Some of these deductions include some health expenses or any interest on loans related to principal residence.

• Are farms and businesses excluded from my assets for the 7.5% to be calculated with my principal residence?

Depending on the circumstances, a farm or business can be excluded alongside the principal residence. If a person requires long term nursing home care because of a sudden illness or disability, if his/her partner was actively involved in the day to day management of the farm or business up to the time of the sudden illness, or if a family successor certifies that he/she will continue the management of the farm or business. This measure is intended to ensure the financial sustainability of family farms and businesses in cases where a person suffered a sudden illness and did not have an opportunity to put appropriate succession arrangements in place. Currently this is an area of contention and it is being reviewed by the government.

• If I transferred my assets prior to making my application could I avoid costs?

No, when carrying out the financial assessment, any assets transferred in the previous five years are taken into account. Some people plan for the scheme by transferring assets five years before applying for the scheme to minimise costs and to distribute their assets in their lifetime. The state assesses your contribution at 80% regardless of the size of your income.

• What do I need to do to apply for a Nursing Home Loan?

In order to set up a Nursing Home Loan, you must consent to a charging order against an asset. If a couple is enquiring, both people must consent to the order. It is similar to putting a mortgage on your house.

• Am I charged interest on my Nursing Home Loan?

No, if the loan is repaid on time there is no interest due on the loan. The loan is however connected to the Consumer Price Index, so the amount due can increase, but only at the same rate as inflation.

• What do I have to do if I want to apply for a Nursing Home Loan for someone else?

You can only apply for a Nursing Home Loan for someone else if you are a court appointed care representative, the committee of a ward of court or an attorney appointed under an Enduring Power of Attorney, for that person. A care representative can be any of the following people once they have reached the age of 18:

• Spouse/Partner
• Parent
• Child
• Brother/Sister (Half or Full)
• Niece/Nephew
• Grandchild
• Aunt/Uncle
• A person who appears to the court to have a good and sufficient interest in your welfare.

There are two people who cannot become your care representative, they are an owner of a nursing home in which you are intending to stay at or are likely to stay at; or a medical practitioner who examined you and prepared a report for the court in relation to your capacity.

• Is there anything that I should watch for?

Yes, it is important you be aware of the cost of your contribution and any extras payable as you or a family member needs to be in control of that. Sometimes there can be adjustments or errors in billing just as there can be in hotels. Help the care home help you by being clear of the costs, extras and deductibles.

• Can my pension be paid directly to the care home?

Yes, the care home can become your agent to receive your state pension. The care home will deduct the cost of your care and hold the balance on your behalf for your bill for extras, incidentals, personal care and hygiene.