1. Nursing Homes Support Scheme 2009

2. NHSS Application Process
NHSS offices are the central point of contact for all aspects of the application.
Assistance and guidance is provided to the applicants/nominated contacts
On the day the application is received
Care Need Assessment is requested from relevant Local Placement Forum (LPF)
If applicant applying for Ancillary State Support (Care Loan) Title Search is requested from National Co-Ordinating Unit

3. Application process continued
Application is examined to ensure all financial information and supporting documentation has been provided
Application is acknowledged
Any outstanding financial information is requested
Care Needs Assessment and Financial Assessment are performed con-currently

4. Ancillary State Support (Care Loan)
Option to borrow against asset to reduce weekly cost of care (may require care representative, REPOA, WOC)
3 year cap of charge for Principal private residence (Option to further defer collection of charge)
3 year cap on farms and relevant businesses subject to conditions
Payment of Care Loan creates a charge against relevant property

5. Care Needs Assessment
Applicant must require Long Term Care to qualify for State Support under the NHSS
Prior to LPF meetings the relevant NHSS office receive a list of clients to be discussed
Where possible the NHSS office completes the financial assessment pending receipt of the CNA approval

6. Care Needs Assessment
Care Needs are assessed by suitably qualified staff on applicants ability to carry out activities of daily living, including-
Cognitive ability, mobility, communication
Ability to dress, feed & bathe unaided, degree of continence
Availability of family/community support
Availability of medical, health and personal social services
If it is determined that the applicant does not require long-term care – applicant is informed and application closed

7. Determination of Application
When CNA and Financial Assessment is complete the application is determined
An application will be determined if Care Loan application is still pending – ensuring applicant is not disadvantaged
Client notified of outcome of CNA & Financial Assessment
Client is provided with a breakdown of the financial assessment and advised of the next steps e.g. choosing nursing home options

8. Common Causes of Delays
Obtaining statements from financial institutions where applicant has cognitive issues
Financial Information not provided
Applicants who have no next of kin and are unable to provide relevant information
Appointment of Care Representatives
Registration of Enduring Power of Attorney
Application for Ward of Court
Legal issues – usually relating to applicants property
Applicant/family not engaging in process

9. Funding Approval
The Scheme is budget controlled therefore a National waiting list for funding is in operation
Date application is determined is the date applicant placed funding waiting list - i.e. date Care Need & Financial assessment completed (waiting list currently 3 – 4 weeks)
Funding released weekly (numbers depend on budget availability)
Funding allocated STRICTLY by date of determination

10. Communications
To facilitate hospital discharges it is essential the NHSS offices and our partners in the Acute Hospitals have strong communication processes in place
Regular contact between Discharge Teams and the NHSS offices is important to ensure NHSS applications can be processed in an effective and efficient manner
Each NHSS office has developed strong relationships and processes with the hospitals in its area

11. Example of Communication process CHO DNCC/Acutes
NHSS office maintains a database for each hospital
Hospital advise the NHSS office of
Patients listed for long term care/Discharges/Deaths
NHSS office advise Hospital when
Application received/Assigned Case Officer/Application Determined/Funding released
A central address is in place to manage queries in relation to hospital applications

12. Transitional Care Funding
Transitional Care Funding facilitates discharge from the Acute hospital pending approval of NHSS funding
Hospital makes application to National TCF office
Client must meet criteria for approval i.e.
Geriatrician sign off
Assessed client contribution does not exceed cost of care
No legal issues that would prevent determination of NHSS application