Hundreds paying for home help
Agencies breaching guidelines by accepting cash
HUNDREDS of people are paying fees for home-help support that should be free under Health Service Executive guidelines.
The Irish Independent has found evidence that client contributions -- totalling at least €300,000 -- were paid to a number of companies providing home-help services last year.
This is despite clear rules that such payments should not be accepted. The HSE pays not-for-profit companies more than €50m a year to provide home care to people around the country annually.
However, the Irish Independent has learned it has emerged that a minority of these firms continue to take additional contributions from clients. In one instance, a company takes a "contribution" of €4 from clients for each visit to their home, even though their care is being funded by the HSE.
Staff known as 'home helps' support older people and people with disabilities by visiting them in their own houses for a number of hours, and allowing them to continue to live independently.
The receipted payments from clients are termed "contributions" rather than charges and are paid to the company rather than directly to the home helps.
They have become an inbuilt part of the income of several of these organisations and are listed in their audited annual accounts. Companies that are known to accept contributions include the Drumcondra Home Help and Care Services Ltd and Donnycarney and Beaumont Home Help Service Ltd, both of which are based in Dublin.
Other companies that receive this income include the Arklow Home Help Service Ltd and Greystones Home Help Service Ltd in Wicklow.
Joan Malone, manager of Drumcondra Home Help and Care Services Ltd, told the Irish Independent: "All the contributions received are acknowledged with the HSE and receipted."
However, she refused to elaborate further despite one potential client being told the company accepts a contribution of up to €4 for each home-help visit. The latest accounts filed by the company listed contributions of €146,275 in 2008 and €144,563 in 2009. It got health service grants of around €1.2m in 2009.
The managers of Donnycarney and Beaumont Home Help services in Killester Health Centre in Dublin refused to clarify how much of the €86,246 it received in contributions last year came from clients. It got nearly €900,000 in grants from the HSE in 2010.
There was also no response from Arklow Home Help service in Arklow Health Centre, Wicklow, although its accounts noted €42,163 in contributions last year. It got €1.3m from the HSE last year.
Staff at Greystones Home Help Service, Wicklow, also refused to answer questions about the €29,983 in contributions that the company declared in its annual accounts in 2010. Grants from the HSE for 2010 amounted to €1.6m.
The industry remains unregulated and client contributions are still a "grey area". It is unclear what level of obligation is on people to contribute to the service they are getting.
The HSE has cut funding to all not-for-profit companies that it has contracted to do home-help work in recent years.
The knock-on effect is that the hours when clients can avail of a home help have been reduced.
Asked to comment on the practice of companies taking contributions, a spokesperson for the HSE said all companies it funded should not impose any charges or accept contributions for home-care services.
This instruction is set out in national guidelines governing home care and any "service provider funded by the HSE to provide home-care services are required to comply with this approach".
Dermot Kirwan, chief executive of the support organisation Friends of the Elderly, said he was disappointed to hear that older people were making these contributions.
"It should be made very clear to the client that the level of care they receive will in no way be affected if they don't make the contribution. It is essential everyone is clearly informed about how the contribution system works."