‘Means test’ is preferred option for first home care scheme
MEANS-TESTING people who need home care has emerged as the preferred option for the first national scheme following a public consultation.
However, the Government has been warned not to view elderly people as a “soft target” when determining the fees people will have to pay towards care.
A report due to be published on the consultation, which heard from more than 2,600 respondents, found that 57pc believe that people should make a contribution towards the cost of home care based on their ability to pay.
The report, which is the next step in the Government’s plan to introduce the scheme, comes against a backdrop of an estimated 120pc increase in the demand for home care services by 2031. In 2018, around €408m will be spent on providing some 17,000 care hours.
A “wide range” of views were given on how means-testing should be implemented, the report compiled by the Institute of Public Health in Ireland, noted.
Among these are proposals such as introducing a minimum income threshold that would mean individuals earning below a certain amount would not be required to pay for services.
Another suggestion was the introduction of a maximum spend threshold – so that a person would not be required to pay further once they had paid out the maximum amount.
Seeking contributions only from those “in the highest tax bracket” is another suggestion included in the document.
A number of respondents felt that the Fair Deal programme could be extended beyond nursing home support to cover home care services.
The introduction of meanstesting could only be legitimately introduced if the scheme provides a high-quality and comprehensive service and if service users retained a choice over who their carer is and the services provided, it said.
Submissions also noted the need for any contributions to be set at an affordable level, with one organisation warning that “older people should not be seen as a soft target”.
However, those who opposed the suggestion of a contributory model – most of whom favoured a universal free scheme – raised concerns that to do so would increase poverty or it would create a two-tier system.
Various options for financing of home care were proposed, including a social insurance model, increased general taxation or increased corporation tax.
The Government will now consider the submissions in the report. It is understood Minister for Older People Jim Daly’s preference would be the State co-financing home care based on need and the ability of the service user to pay.
Home care services need to be standardised and significant investment is needed according to those who contributed.
Ireland is also set to regulate the industry for the first time. Person-centred model of care is earmarked as a key tenant for any overhaul of the services, with calls to protect the role of voluntary carers. Licensing for home care providers and a streamlined complaints system are recommended.