Long-Stay Contributions for Residential Support Services

If your accommodation or your daily living costs are provided by the Health Service Executive (HSE), or by another provider on behalf of the HSE, you may pay a Long-Stay Contribution towards these costs. (Long-Stay Contributions replaced long-stay charges from 1 January 2017.)

Long-Stay Contributions also apply to mental health and disability residential support services provided by, or on behalf of, the HSE in accommodation without a nursing or medical service. A lower rate of Contribution applies in such accommodation.

You are being provided with Residential Support Services if your accommodation or your daily living costs are provided by the HSE, or on behalf of the HSE (but the Contributions described here don't apply if you are covered by the Nursing Home Support Scheme or are receiving acute in-patient care).

You will generally have to pay a set amount towards these maintenance and accommodation costs. This is called a Long-Stay Contribution (also known as the Residential Support Services Maintenance and Accommodation Contribution).

The Long-Stay Contribution applies if you have been getting Residential Support Services for more than 30 days in the last 12 months. You only pay for days when you get Residential Support Services from your provider (a day is counted if you receive the services overnight, that is, at midnight).

The Contribution goes towards your accommodation and maintenance costs such as heating, electricity, groceries or meals.

If you already pay rent or pay towards groceries, for example, into a household fund, this can continue and be taken into account as part of your Long-Stay Contribution.

If some or all of your daily living costs – food, utility bills and so on – are provided for by the HSE, or on behalf of the HSE, but your accommodation is not, your Contribution will be reduced by the amount of rent you pay or by €30 a week, whichever is more.

If you have a medical card, you pay the Long-Stay Contribution towards your food, utilities and accommodation as these are not covered by your medical card.

Your service provider will help you figure out how much you have to pay. You will have an individual assessment to make sure that the amount you pay is correct. You can be assisted by a family member or other advocate who can also attend meetings with you.

Income assessed

The income that is assessed is the amount you have left after deductions such as tax and PRSI.

Income assessed includes:

• Department of Social Protection payments — except for the payments listed below under 'Excluded income'
• Income from your job, self-employment, trade, farming, profession or vocation
• Earnings above €120 a week from a rehabilitative job (for example, if you earn €130 a week, €10 a week will be included in the income assessment)
• Income from your pension including an occupational pension or overseas pension
• Rental income from property and land
• Income from fees, commissions, dividends, interest or income of a similar nature
• Payments under a legal settlement, a covenant or a will
• Maintenance payments
• Interest or dividends earned on savings (but only if your savings are over €15,000)
• Income from holding an office or directorship
• Income from royalties and annuities

Excluded income

Income that is not taken into account in assessing your Contribution is called excluded or disregarded income.

Income that is not your own is excluded (for example, the income of your partner, spouse or other family member).

The first €120 a week of earnings from a rehabilitative job is also disregarded.

For savings up to €15,000, any interest or dividends you earn are not taken into account.

The following payments are disregarded:

• Family Income Supplement
• Child Benefit
• Carer's Allowance
• Domiciliary Care Allowance
• Rent supplement or accommodation subsidy
• Weekly supplements paid under the Supplementary Welfare Allowance scheme
• Increase for a Qualified Adult or Qualified Child
• Fuel, Island, and Living Alone Allowances
• Guardian's Payments
• Foster care allowance
• Mobility Allowance
• Third-level education maintenance grants
• Rehabilitation training allowance

The following compensation payments are disregarded (along with any income that comes from the payment):

• Any payment under the Redress for Women Resident in Certain Institutions Act 2015 (for women who worked in, for example, Magdalen Laundries)
• Any ex-gratia payment under the Lourdes Hospital Redress Scheme 2007 or the Lourdes Hospital Payment Scheme
• Any ex-gratia payment under the Symphysiotomy Payment Scheme
• Certain payments for disability caused by Thalidomide

When your assessment is finished, you will get a letter that tells you the amount of your Long-Stay Contribution.

If your circumstances change, you should tell your service provider, who will arrange an assessment to see if your Contribution should change.

The amount you contribute depends on:

• Your income.
• Your essential expenses. You may qualify for a waiver to ensure that what you pay will be within your means (see below).
• What type of accommodation you live in.

There are 3 types of accommodation:

• Category A accommodation where there is full-time (24-hour) medical or nursing care
• Category B accommodation where there is part-time (less than 24-hour) medical or nursing care
• Category C accommodation (other accommodation, such as independent living settings)

There is a maximum rate of Contribution. If your income is over a certain amount you pay the maximum rate. If your income is lower you pay less. The Contribution rates for each income band are set out in the tables in Statutory Instrument No. 106 of 2019.

If you know your income is over the amount at which you have to pay the maximum Contribution and you do not wish to seek a waiver (see below), you can choose to agree to pay the maximum Contribution without having to submit your income details or go through the assessment process.

You are entitled to have a minimum amount of money left for your personal use after paying the Long-Stay Contribution.

Example

If your only income is Disability Allowance of €220, the table of Contribution rates shows that the most you will have to pay each week is:

• €171 if you are in Category A accommodation
• €136 if you are in Category B accommodation
• €86 if you are in Category C accommodation

You can apply for a waiver if you have essential expenses and would find it difficult to afford the standard Contribution rate for your income. If you have a waiver it is an agreement that you will pay a reduced Long-Stay Contribution or no Long-Stay Contribution. Your financial circumstances and the needs set out in your care plan will be considered.

The waiver assessment takes into account:

• Payments you already make for your maintenance and accommodation.
• Expenses to meet your medical, therapeutic, rehabilitative or health-related needs (including needs set out in your care plan).
• Your essential expenses. This includes the reasonable expenses of your dependants. It also includes your financial commitments such as rent or mortgage payments for the family home, maintenance payments or repayments on existing loans.

Your service provider will tell you what documents you need to provide with your request for a waiver, such as bills, receipts, bank statements and pay slips. However, if you do not have all these documents with you during your individual assessment, you can provide any outstanding documents as soon as possible afterwards so that your service provider can finish the assessment.

When your assessment is finished, you will get a letter that tells you the amount of the Long-Stay Contribution you have to pay, whether you have a waiver or not, the amount of the waiver (if any), and an explanation.

If your circumstances change, you can ask your service provider to update your assessment.

If you think a mistake has been made in your assessment, you can ask your service provider to correct it.

If you are unhappy with the amount of your Long-Stay Contribution, you can appeal the decision.

If you wish to make an appeal you can write to the HSE National Appeals Office, An Clochar, Ballyshannon Health Campus, College Street Ballyshannon, Co Donegal F94 TPX4, or by email to: nationalappeals@hse.ie

Explain why you are dissatisfied with the decision and the reasons you want it to be reconsidered. Include a copy of the decision letter and any other relevant documents.

If you are still unhappy after you have made an appeal you can write a letter of complaint to the Office of the Ombudsman.