Health (Amendment) Act 2013

PART 1 Preliminary and General

1. Short title.

1.— This Act may be cited as the Health (Amendment) Act 2013.

2. Commencement.

2.— (1) Subject to subsection (2), this Act, other than Part 1 and sections 5,6, 7 (but not including paragraph (e)(ii) of section 7) and 14, shall come into operation on such day or days as the Minister may appoint by order or orders either generally or with reference to any particular purpose or provision, and different days may be so appointed for different purposes and different provisions.

(2) Sections 13,15,16and17shall come into operation on 1 January 2014.

3. Definitions.

3.— In this Act—

“Act of 1970” means the Health Act 1970;

“Act of 2009” means the Nursing Homes Support Scheme Act 2009;

“Minister” means the Minister for Health.

PART 2 Amendment of Nursing Homes Support Scheme Act 2009

4. Amendment of section 5 of Act of 2009.

4.— Section 5 of the Act of 2009 is amended by the substitution of the following for subsection (3):

“(3) (a) It shall be a function of the Executive to operate and administer the Scheme.

(b) The Executive may enter into an arrangement with a person under which that person may perform any part of the Executive’s function arising under paragraph (a) on behalf of the Executive.”.

5. Amendment of section 10 of Act of 2009.

5.— Section 10 of the Act of 2009 is amended by the substitution of the following for subsection (2):

“(2) The financial assessment shall be carried out—

(a) in the case of a person who is not a member of a couple, in accordance with the provisions of Part 1 or Part 1A, as appropriate, and Part 3 of Schedule 1, and

(b) in the case of a person who is a member of a couple, in accordance with the provisions of Part 2 or Part 2A, as appropriate, and Part 3 of Schedule 1.”.

6. Amendment of section 13 of Act of 2009.

6.— Section 13 of the Act of 2009 is amended—

(a) in subsection (3), by the insertion of “(3A),” after “Subject to subsections”, and

(b) by the insertion, after subsection (3) of the following subsection:

“(3A) Subsection (3) shall cease to have effect as respects a person who makes an application for State support after the coming into operation of section 6 of the Health (Amendment) Act 2013.”.

7. Amendment of Schedule 1 to Act of 2009.

7.— Schedule 1 to the Act of 2009 is amended—

(a) in Part 1, by the substitution of the following for paragraph 1:

“Assessment of means of a person who is not a memberof a couple where the application for State support is madeprior to the relevant day

(b) This Part applies to applications for State support made prior to the relevant day.”,

(b) by the insertion, after Part 1, of the following Part:

“PART 1A

Assessment of means of a person who is not a member ofa couple where the application for State support is madeon or after the relevant day

1.(a) The means of a person who is not a member of a couple shall, subject to Part 3, be assessed on the basis of the rules in this Part.

(b) This Part applies to applications for State support made on or after the relevant day.

Assessment of income

A. Establish the annual income of the person using the definition of ‘income’.

B. Deduct allowable deductions.

C. Divide amount produced by step B by 52 to establish net weekly income.

D. Take 80 per cent of amount produced by step C (net weekly income) which amount, unless step E applies, is the weekly assessed income.

E. Where applying the rule in step C produces a result whereby 20 per cent of net weekly income is less than the minimum retained income threshold, the weekly assessed income is the amount established by step C less the minimum retained income threshold.

Assessment of cash assets

A. Establish all the cash assets of the person being assessed using the definition of ‘cash assets’ and value each cash asset on the basis of the estimated market value.

B. Deduct from the estimated market value of each cash asset the amount of allowable deductions relating to that cash asset to produce the net value of each cash asset.

C. Aggregate all net values of cash assets established under step B.

D. Deduct general assets deductible amount from the amount produced by step C to produce annual assessed cash assets.

E. Take 7.5 per cent of the amount produced by step D to establish the amount of the annual assessed cash assets.

F. Divide amount produced by step E by 52 to produce weekly assessed cash assets.

Assessment of relevant assets

A. Establish all assets which are relevant assets using the definition of ‘relevant assets’ of the person being assessed and value each relevant asset on the basis of the estimated market value.

B. Deduct from the estimated market value of each relevant asset the amount of allowable deductions relating to that relevant asset to produce the net value of each relevant asset.

C. Aggregate all net values of relevant assets to produce total net value of relevant assets.

D. If the general assets deductible amount has not been fully used in connection with the cash assets assessment apply unused balance by deducting the unused amount from total net value of relevant assets produced by step C.

E. Take 7.5 per cent of the amount produced by step D or, if step D does not apply, by step C to produce the annual assessed relevant assets amount.

F. To establish assessed weekly value of relevant assets divide result of step E by 52.”,

(c) in Part 2, by the substitution of the following for paragraph 1:

“Assessment of means of a person who is a member of acouple where the application for State support is madeprior to the relevant day

1.(a)The means of a person who is a member of a couple shall, subject to Part 3, be assessed on the basis of the rules in this Part.

(b)This Part applies to applications for State support made prior to the relevant day.”,

(d) by the insertion, after Part 2, of the following Part:

“PART 2A

Assessment of means of a person who is a member of acouple where the application for State support is made onor after the relevant day

1.(a)The means of a person who is a member of a couple shall, subject to Part 3, be assessed on the basis of the rules in this Part.

(b)This Part applies to applications for State support made on or after the relevant day.

Assessment of income

A. Establish the annual income of the person and his or her partner using the definition of ‘income’.

B. From the annual income of each of those persons deduct allowable deductions applicable to that person’s income to establish net annual income of each member of the couple.

C. Aggregate the two net annual incomes established under step B.

D. Divide amount produced by step C by 52 to establish net weekly income.

E. Take 40 per cent of amount produced by step D and the amount established following that calculation is, unless step F applies, the weekly assessed income.

F. Where applying the rule in step E produces a result whereby 60 per cent of net weekly income is less than the minimum retained income threshold, the weekly assessed income is the amount established by step D less the amount which is the minimum retained income threshold.

Assessment of cash assets

A. Establish all the cash assets of the person to whom the assessment relates and his or her partner using the definition of ‘cash assets’ and value each cash asset on the basis of the estimated market value.

B. Deduct from the estimated market value of each cash asset the amount of allowable deductions relating to that cash asset to produce net value of each cash asset.

C. Aggregate all net values of cash assets established under step B.

D. Deduct general assets deductible amount from the amount produced by step C to establish total assessed cash assets.

E. Take 7.5 per cent of the amount produced by step D to establish the amount of the annual assessed cash assets of the couple.

F. Divide amount established by step E by 2 to establish the amount of the annual assessed cash assets of the person in respect of whom the financial assessment is being carried out.

G. Divide amount established by step F by 52 to produce the assessed weekly cash assets of the person in respect of whom the financial assessment is being carried out.

Assessment of relevant assets

A. Establish all assets which are relevant assets of the person in respect of whom the financial assessment is being carried out and his or her partner using the definition of ‘relevant assets’ and value each relevant asset on the basis of estimated market value.

B. Deduct from the estimated market value of each relevant asset the amount of allowable deductions relating to that relevant asset to produce the net value of each relevant asset.

C. Aggregate all net values of relevant assets established under step B.

D. If the general assets deductible amount has not been fully used in connection with the cash assets assessment then apply the unused balance by deducting the unused amount from the amount established by step C.

E. Take 7.5 per cent of the amount established by step D or, if step D does not apply, by step C to establish the annual assessed relevant assets amount.

F. Divide amount established by step E by 2 to establish the amount of the annual assessed relevant assets of the person in respect of whom the financial assessment is being carried out.

G. Divide the amount established by step F by 52 to produce the assessed weekly value of relevant assets of the person in respect of whom the financial assessment is being carried out.”,

(e) in paragraph 1 of Part 3—

(i) in the definition of “assessed weekly means” by the substitution of “Part 1, 1A, 2 or 2A of this Schedule” for “Part 1 or Part 2 of this Schedule”,

(ii) in the definition of “minimum retained income threshold” by the substitution of the following for paragraph (b)(i)(II):

“(II) is habitually resident in a relevant facility or a nursing home, the amount of any contribution required to be paid by the partner pursuant to section 67C(1) of the Health Act 1970,”,

and

(iii) by the insertion, after the definition of “relevant business” of the following definition:

“ ‘relevant day’ means the day following the enactment of the Health (Amendment) Act 2013;”,

(f) in paragraph 3 of Part 3 by the substitution of “Part 1, 1A, 2 or 2A,” for “Part 1 or Part 2,”,

(g) in paragraph 4 of Part 3 by the substitution of “Part 1, 1A, 2 or 2A,” for “Part 1 or Part 2,”, and

(h) in paragraph 10 of Part 3—

(i) in subparagraph (b) by the substitution of “subject to subparagraph (c), shall not exceed the amount which is 22.5 per cent of the estimated market value” for “shall not exceed the amount which is 15 per cent of the estimated market value”, and

(ii) by the insertion of the following subparagraph after subparagraph (b):

“(c) Where—

(i) the other member and the relevant person both applied for State support on or after 27 October 2009 and prior to the relevant day, the reference to 22.5 per cent in subparagraph (b) shall be read as a reference to 15 per cent, and

(ii) the other member applied for State support on or after 27 October 2009 and prior to the relevant day and the relevant person applied for State support on or after the relevant day, the reference to 22.5 per cent in subparagraph (b) shall be read as a reference to 18.75 per cent.”.

PART 3 Amendment of Health Act 1970

8. Amendment of section 51 of Act of 1970.

8.— The Act of 1970 is amended by the substitution of the following for section 51:

“In-patient services.

51.— In this Part—

‘acute in-patient services’ means in-patient services provided—

(a) in a hospital for the care and treatment of patients with acute ailments (including psychiatric ailments), and

(b) to persons requiring medically acute care and treatment (including care and treatment in respect of motherhood);

‘in-patient services’ means institutional services provided for persons while maintained in a hospital, convalescent home or home for persons suffering from physical or mental disability or in accommodation ancillary thereto;

‘long-term residential care services’ means long-term residential care services within the meaning of the Nursing Homes Support Scheme Act 2009.”.

9. Amendment of section 52 of Act of 1970.

9.— Section 52 of the Act of 1970 is amended—

(a) in subsection (1A) by the deletion of “within the meaning of the Nursing Homes Support Scheme Act 2009”,

(b) by the deletion of subsection (2), and

(c) in subsection (3)—

(i) by the substitution of “Where,” for “Subject to section 54, where,”, and

(ii) by the substitution of “does not avail of or waives his or her right to avail of, some part of those services” for “does not avail of, some part of those services”.

10. Repeal of section 53 of Act of 1970.

10.— Section 53 of the Act of 1970 is repealed.

11. Amendment of section 53A of Act of 1970.

11.— Section 53A of the Act of 1970 is amended—

(a) by the substitution of the following for subsection (1):

“(1) This section applies where—

(a) in-patient services (not being long-term residential care services) are provided to a person in a hospital for the care and treatment of patients with acute ailments (including any psychiatric ailments) and a registered medical practitioner designated by the Health Service Executive has certified in writing that the person in receipt of such services does not require medically acute care and treatment in respect of any such ailment, or

(b) in-patient services are being provided to a person—

(i) who is a resident in a designated centre for older people (as defined in the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009 (S.I. No. 236 of 2009)) at which centre services are provided by or on behalf of the Health Service Executive,

(ii) who first began to receive those in-patient services on or after 27 October 2009,

(iii) who is not being provided with State support or ancillary State support under the Nursing Homes Support Scheme Act 2009, and

(iv) in respect of whom a registered medical practitioner designated by the Health Service Executive has certified in writing that long-term residential care services are required.”,

and

(b) in subsection (2)—

(i) by the substitution of “section 67C” for “section 53”,

and

(ii) by the deletion of “within the meaning of the Nursing Homes Support Scheme Act 2009.”.

12. Insertion of sections 53B and 53C in Act of 1970.

12.— The Act of 1970 is amended by the insertion, after section 53A, of the following sections:

“Charges for long-term residential care services.

53B.— (1) Charges shall be made for long-term residential care services in accordance with the Nursing Homes Support Scheme Act 2009.

(2) A reference in subsection (1) to long-term residential care services shall be construed as a reference to such services provided to a person who first began to receive those services on or after 27 October 2009.

(3) A person who is required by or under section 67C to make payment of a residential support services maintenance and accommodation contribution shall not be required to pay charges under this section.

(4) In any enactment—

(a) a reference to section 53(1A) shall be construed as a reference to subsection (1),

(b) a reference to section 53(1B) shall be construed as a reference to subsection (2),

(c) a reference to section 53(1C) shall be construed as a reference to subsection (3),

(d) a reference to section 53 other than subsections (1A), (1B) or (1C) shall be construed as a reference to—

(i) section 53C,

(ii) section 67C, or

(iii) to both sections 53C and 67C,

as the context requires,

(e) a reference to a charge under section 53 (other than subsections (1A), (1B) or (1C)) shall be construed as a reference to—

(i) a charge under section 53C,

(ii) a contribution under section 67C, or

(iii) to both a charge under section 53C and a contribution under section 67C,

as the context requires.

Charges for acute in-patient services.

53C.— (1) Charges shall be made for acute in-patient services provided by or on behalf of the Health Service Executive to a person who is a member of a class of persons specified in regulations made under subsection (3) for the purpose of this section.

(2) The daily rate of charge shall be €80 unless a different amount is prescribed in regulations made under subsection (4), in which case the daily rate of charge shall be that different amount.

(3) The Minister may, with the consent of the Minister for Public Expenditure and Reform, make regulations for the purpose of this section, which may—