Older adults in the Republic of Ireland could be asked to contribute €5 an hour towards their home care under a new home support scheme, the Economic & Social Research Institute (ESRI) has said.

A statutory scheme for the provision of home care support services is currently being developed by the Department of Health and is expected to be introduced in 2023 after a long day.

It is anticipated that demand for home support services may increase under this scheme, especially as the population ages, and so ESRI was tasked to look at funding options to meet this demand.

“Any increased demand would result in an increased cost,” the report said.

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 “One potential way to help fund an expanded scheme would be to introduce contributions from some home support recipients as is the case in countries like Germany, Sweden and the Netherlands,” the report said.

Among the funding options discussed by ESRI is a flat-rate contribution of €5 per home support hour, which would raise up to one-fifth of the total cost of the scheme.

However ESRI noted flat-rate contributions fall more heavily on those with low incomes, creating affordability problems for some individuals.

It found that means-tested contributions protect those on lower incomes, with contributions starting only when income is above a threshold, such as the living wage, and rising gradually in line with income.

ESRI suggested that designing recipient contributions with appropriate means-tested thresholds could help ensure minimal impacts on the poverty rate of those over 65.

It also said that caps on contributions could help ensure that those with high income support needs do not face large costs of care.

Dr Claire Keane, an author of the report and a Senior Research Officer at the ESRI, said: “While publicly funded home support is currently provided free of charge population ageing will lead to increased demand in the future. While the expansion of current schemes could help tackle this it will come at an increased cost for the state. User contributions taking account of ability to pay and need could help fund an expanded scheme and can be designed in a way as to protect those on lower incomes and with high care needs.”

Minister for Mental Health and Older People, Mary Butler, said: “This report is the final output from the programme of research that the ESRI is undertaking to support the Department of Health to progress the development of the new home support scheme. The scheme will provide equitable and transparent access to high-quality home care services to support people to stay well in their homes and communities.

“This research will form an important part of the evidence base for the development of a sustainable funding model for home support services in the context of our ageing population.”

Welcoming the report, Joseph Musgrave, CEO, Home and Community Care Ireland (HCCI), said: “It is the start of a conversation about how we pay for our care needs into old age. HCCI’s previous research indicated people were prepared to pay approximately 20% of the cost of a home care package. However, the report misses a significant issue – how we pay for care in rural areas. This is something Australia does well through a system that provides top-up payments to providers to cover the longer travel distances involved in rural home care.

“It is also imperative that all stakeholders are involved in the development of a home care scheme – advocacy groups representing people who need home care and those involved in the home care sector. HCCI is ready and willing to do all it can to help develop a sustainable model of care that works for everyone.”

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