New curbs to hit homecare for the elderly, disabled
Thousands of people who are elderly or disabled look set to be turned down for home help in the coming months as strict new financial curbs are enforced.
The HSE admitted that tough spending rules will mean the demands of many new applicants for home help cannot be met.
The existing 53,000 people who are getting around 17.9 million home support hours will not be affected - but apart from efforts to prioritise some patients who are occupying hospital beds and need to be discharged, there is little chance of the service being extended.
The restrictions were met with dismay by the Alzheimer's Society of Ireland and Age Action, who warned it is false economy as vulnerable people who are not supported at home may have to enter a nursing home and are more prone to accidents.
The weekly cost of supporting a person in a nursing home can be three times higher than providing homecare.
It is understood the drive to keep A&E trolley numbers at a certain level in the run-up to the local and European elections, as well as avoiding a winter spike, has already drained much of this year's homecare funding.
But from now there will also be a slowdown in transferring patients who are taking up a hospital bed and cannot be discharged without home support.
A HSE spokesman said: "Throughout the winter period, additional home support was provided to support early hospital discharge and prevent hospital admission.
"Managers now need to ensure their level of service provision is in line with their budget, their delivery plan and the National Service Plan.
"To achieve this, local managers must ensure that the total number of hours being provided does not exceed targeted levels. This may impact on their ability to provide new hours into the system."
Managers are putting some of the blame on the extra funding needed to pay around 8,000 home helps who are directly employed by the HSE.
For the first time, they are to be paid for their time travelling to and from homes, and not just for the duration of the visit as was previously the case.
Paul Bell, of Siptu, said the Government knew before the last Budget that this was coming down the tracks.
The HSE said additional funding to cover the cost of paying home helps when travelling was included in the 2019 Budget.
But it declined to say how much of the homecare budget will be allocated to the extra payments to home helps.
A spokeswoman for the Alzheimer's Society said nursing home care "is not only expensive, it is often inappropriate for people with dementia, the majority of whom want to live at home, in a familiar environment linked to their communities, for as long as they can.
"Where homecare services do exist they are often not responsive or flexible enough to meet the often complex and individualised care and support needs of people with dementia.
"Given the funding for dementia intensive homecare packages has come to an end, there is an urgent need for current homecare support services to be enhanced with increased funding.
"Homecare gets an allocation of around €408m a year - much lower than the Fair Deal nursing home's funding of around €1bn."
A spokeswoman for Age Action Ireland said there is always a waiting list of around 6,200 for HSE homecare, but this is an underestimate because many do not apply.
"The levels of unmet need are horrifying," she added.