The Health Service Executive (HSE) has responsibility for the delivery of public health community and home care supports at local level, including the Home Care Package scheme.
The Home Care Package (HCP) scheme is an administrative scheme, operated by the HSE. It aims to help people who need medium to high caring support to continue to live at home independently. The Home Care Package scheme is not established in law; as it is an administrative scheme, you do not have an automatic right to the scheme, or to avail of services under the scheme.
The HSE operates national guidelines on how to qualify for the HCP scheme. The scheme is not means tested, and there is no charge or contribution to be paid for the services provided.
Each HSE Area has responsibility for the operation of the scheme within the resources allocated for it in that area. This means that the level of service or support you receive as part of a HCP may vary in different parts of the country depending on the local population, your individual needs, who is available to deliver services and the demand for the scheme. Check with your Local Health Office for more details on the scheme in your area.
Each support package is tailored to your individual needs. The package may include the services of nurses, home helps and various therapies including physiotherapy and occupational therapy services. You might also receive some respite care or aids or appliances as part of your HCP if these are needed to support you to stay in your own home. The services that are supplied will depend on your needs, as assessed by the HSE, and the levels of other supports available to you, such as family members or friends.
Your individual Package will vary according to your medical condition, the level of care required and the supports you already have available to you. For example, there might be a greater emphasis in some Packages on home help services (personal and/or domestic care) while other Packages may require a greater level of therapy and nursing, depending on individual need.
The HSE may provide a Home Care Package as a short-term arrangement, for example, when you are recovering following a stay in hospital, during an illness or while you are recuperating. A HCP may also be provided to help you with the activities of daily living over a longer term.
The main priority of the HCP scheme is older people living in the community or who are in-patients in acute hospitals and at risk of admission to long-term care.
Home Care Packages may also be available to those older people who have been admitted to long-term care and who can (with support), return to the community. Packages may also be offered to people who are already using existing care services, such as home helps, but who may need more assistance to continue to live in their community.
Home Care Packages may also be available occasionally for younger people whose needs would be best met by access to older people's services, for example, in the situation of early-onset dementia.
The type of Package available will depend on the needs of the individual concerned. The HSE is working on standardising a national needs assessment of all individuals.
In the meantime the HSE has implemented an interim approach to the standard assessment of the needs of people who apply for this scheme. In most cases, your public health nurse will do a Care Needs Assessment and will work out with you and your family how your needs would be most appropriately met.
The general rule is that if you need more than 5 hours' home help service per week, you can apply to be considered for a HCP. The number of hours and types of support or services approved by the HSE will again depend on your individual needs.Services may be provided by the HSE directly, or by certain non-HSE providers. These are voluntary (not for profit) and private (for profit) organisations that have been approved by the HSE to provide Home Care Packages. The non-HSE providers have been assessed by the HSE as demonstrating that they could achieve new minimum standards required on its behalf.
A Care Needs Assessment identifies your overall health needs and your level of dependency. It will be done by a health care worker, such as, for example, a public health nurse or physiotherapist etc. The assessment will look at your needs, including:
•Your ability to carry out the activities of daily living, for example, bathing, shopping, dressing and moving around
•Any medical, health and personal social services being provided to you
•Your family, social and community supports
•Your wishes and preferences.
The assessment may include a physical examination by a healthcare professional. A report will be prepared to record your care needs and a copy can be provided to you.
Home Care Packages are tailored to meet individual needs. This means that services vary. Typical packages of support available under the scheme may be worth between €350-500 per week in respect of each patient, depending on individual need. As outlined above, the Package may consist of:
However, if you arrange services or supports above the levels provided by the HSE or if you do not qualify for a Home Care Package you will have to pay for the cost of those services yourself. If you employ someone in your home (such as a private carer) funded from your own resources, you become their employer. As an employer, you have various duties and obligations. Revenue has a useful leaflet on the Domestic EmployerScheme (pdf).
There are tax
concessions if you pay part or all of the costs yourself.
Your Local Health Office will provide any further information you need.
You apply to the Home Care Package office in your Local Health Office. The HSE will then contact you to arrange to carry out a Care Needs Assessment.
If you have a question relating to this topic you can contact the Citizens Information Phone Service on 0761 07 4000 (Monday to Friday, 9am to 8pm) or you can visit your local Citizens Information Centre.