On 4 April, the Irish government announced the introduction of the COVID-19 Financial Support Scheme (Scheme) to assist the residential elderly care home sector in Ireland. Following lengthy engagement between the Department of Health and key stakeholders details of a recalibrated version of the Scheme were released by the Department of Health on 27 April. Whilst the Scheme will evolve further over the coming weeks, we explore the key aspects which will be relevant to those active in the Irish care home sector.
What’s changed since 4 April?
The updated Scheme now contains details of the types of cost that care home operators will be able to claim. Moreover, the calculation metrics have also been recalibrated together with the process for claiming under the Scheme which now includes an independent review/appeal process. Additionally, the Scheme will be administered by the Health Service Executive (HSE), rather than the National Treatment Purchase Fund (NTPF) who will instead process the applications.
For how long is the Scheme available?
The latest guidance from the HSE indicates that the Scheme will be available for a three month period from April to June 2020 (inclusive).
What costs can be claimed for under the updated Scheme?
The HSE has now provided guidance on the types of cost which care home operators can claim for under the Scheme. In broad terms, costs incurred by the care home which would not have been incurred but for the impact of COVID-19, can be claimed. It would therefore appear that additional staffing and equipment costs that flow directly from COVID-19, can be claimed. The Scheme also contains a non-exhaustive list of costs which cannot be claimed and this includes items such as capital costs, loss of income, interest payments, rent, tax and payments to the HSE for support staff and supplies.
What forms of assistance are available under the updated Scheme?
The updated Scheme now comprises two forms of assistance payment:
Standard Assistance Payments. On a monthly basis, care homes may apply prospectively for a Standard Assistance Payment, based on an estimate of the allowable additional costs that are expected to be incurred during that month. On or before, the fifteenth of each month, the care home must then submit a statement of the various costs on a retrospective basis which will be reviewed by the NTPF who will then advise on the amount of Standard Assistance Payment to be paid, subject to the Standard Assistance Payment Cap and the Overall Payment Cap (see below). This may result in a balancing payment which can be made in either direction. For example, any difference owed to the HSE from a care home, may be deducted from future payments to the care home, under the Scheme or normal Fair Deal Scheme payments.
Outbreak Assistance Payments. No details have yet been released on the terms of the Outbreak Assistance Payment with further information being anticipated from the NTPF in May.
How is the Standard Assistance Payment calculated?
The maximum amount of Standard Assistance Payments which a care home can claim each month (the Standard Assistance Cap) is calculated by reference to following sliding scale:
- €800 per resident, per month, for the first 40 Fair Deal Residents;
- €400 per resident, per month, for the second 40 Fair Deal Residents; and
- €200 per resident, per month, for the eighty-first Fair Deal resident and above.
The level of financial support will be calculated by reference to the average number of Fair Deal residents in the relevant care home in the month that is two months preceding the month to which the claim relates. For example, an April claim will be based on the February average occupancy of Fair Deal residents.
Are non-Fair Deal residents included when calculating the Standard Assistance Payment?
No, and one of the main criticisms of the Scheme is that all of the calculations are based solely on Nursing Home Support Scheme (Fair Deal) residents such that private residents are not taken into account. Whilst this remains unchanged following the updates to the Scheme, it is understood that Nursing Homes Ireland (the national representative body for Ireland’s 460 private and voluntary care homes) are continuing to seek an extension of the Scheme to include non-Fair Deal residents.
Does an overall payment cap apply?
Yes, the maximum aggregate amount that a care home can receive in any given month (for both Standard Assistance and Outbreak Assistance) is capped at the lower of:
- €75,000; or
- the amount which is twice the amount of Standard Assistance Payments Cap.
Can claims under the Scheme be reviewed?
Yes, the HSE and NTPF may carry out formal audits of claims with the assistance of professional auditors and so care home operators will be required to provide vouched evidence of relevant costs. This can result in a change in payments to be made to care homes under the Scheme.
How do care homes submit an application under the Scheme?
Care homes wishing to make a prospective Standard Assistance claim for April should submit their applications to the NTPF by 30 April. The relevant application forms can be accessed here.
What’s next?
The exact details of the Outbreak Assistance Payment are to be released in May. Discussions between the Department of Health and Nursing Homes Ireland on nuances to the Scheme remain ongoing with the key question being whether the Scheme is extended to non-Fair Deal residents. It is also likely that the interim period will see further fine tuning of the Scheme.
See our Coronavirus (COVID-19) feature for more information generally on the possible legal implications of COVID-19.
