For Written Answer on : 15/11/2022
Question Number(s): 591 Question Reference(s): 56717/22
Asked by: David Stanton T.D.
To ask the Minister for Health if it is possible for monies to be refunded following the death of the applicant if it is discovered that social welfare non-contributory pension payments had been overpaid over a number of years which had resulted in a higher amount under the financial assessment carried-out under the fair deal scheme; and if he will make a statement on the matter.
The 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 NHSS is the Nursing Home Support Scheme Act 2009.
Participants contribute to the cost of their care according to their means, while the State pays the balance of the cost. Under the rules of the scheme, 80% of a person’s income (including pensions) and 7.5% per annum of the value of their assets is contributed towards the cost of their care.
The Department understands from the HSE that there are a small number of cases in which the HSE has received claims from the Estates of deceased clients previously supported by Fair Deal for a recoupment of client contribution, on the basis of a review and subsequent determination by DEASP that a non-contributory pension was incorrectly claimed in part or whole.
The issue arises because the HSE establishes the level of client contribution based on the information and evidence provided by applicants on the Fair Deal application form, including details of DEASP allowance. If NHSS-funded residents over-claim DEASP allowance this can result in a situation where their NHSS contributions are higher than they would be if they claimed the correct amount (typically 80% of the amount over-claimed). The Department understands that the DEASP routinely reviews payments when an individual has passed away; where an over-payment has been made by the DEASP, the overpaid amount is recouped by the DEASP from the individual’s Estate. In certain cases, the Estates of deceased NHSS-funded clients have contacted the HSE to seek a re-calculation of the client contribution based on the fact that the Estate has had to make a repayment of over-claimed DEASP allowances.
To date the HSE has not allowed such claims, with no basis in legislation (NHSS Act 2009) for such repayments to be made. However, noting a small number of recent cases, cross-governmental engagement is currently taking place on this issue in order to establish a long-term position.