Huge increases on charges for people with disabilities

Thousands of people with disabilities living in long stay accommodation are facing substantial increases in charges, as a direct result of the Health Regulations, 2005 rushed through the Dail by Mary Harney on 15 June 2005.

The Health (Charges for In-Patient Services) Regulations 2005 was introduced to legalise charges in nursing and long stay homes – previously these charges were imposed illegally and the Supreme Court found earlier this year that the attempt to legalise this retrospectively was unconstitutional.

Under the new regulations, residents are required to pay more than they paid when charges were illegal. It means these people are worse off now than they were prior to December 2004, when they paid the illegal changes.

Up to 10,000 people with intellectual disabilities are living in residential centers. The numbers of people with physical and sensory disabilities in residential centers or in need of residential care is not known. Most of these now are subjected to the increased charges.

Twenty four residents living with disabilities in the Cara Cheshire Home in the Phoenix Park have been required to pay Ä389 per month, a 130 per cent increase in charges from July to August 2005. Residents previously paid Ä165 per month. Accommodation and meals are provided by the centre but residents are expected to pay for personal items such as toiletries, clothes and travel.

Most of the residents are living on Disability Allowance, pensions, or some other form of social welfare allowance. Disability Allowance is Ä148 per week. The new payments mean that residents can pay up to Ä90 per week in charges, leaving a Ä58 per week for all other costs. Two of the residents in the Cara center are working. Residents were asked to set up direct debit accounts for the Ä389 which left their accounts on 15 August.

Residents in Cara Cheshire Home in the Phoenix Park have launched a campaign of protest against the charges. They are objecting to the increase in charges and calling for clarification on what the charges are paying for and the mechanisms to seek a waiver for the charges. No such procedure is in place at the moment.

On 25 August, they received notification that they will not receive the Ä2,000 back payment which is being paid out in lieu of the illegal charges.

Residential centers like the Cheshire Homes promote independent living for people with disabilities. There are 330 residents in Cheshire Homes in Ireland. The residents in the Richmond Cheshire Home in Monkstown have also launched a campaign and have refused to pay the increased charges. These new charges directly mitigate against independence.

Niall Byrne of the Cheshire Homes said that they support their residents to have their voices heard and to advocate for fairness in charges for people in long term accommodation.

Brian O'Donnell of the Federation of Voluntary Organisations for People with Intellectual Disability has asked its 61 member organisations who provide services for 20,000 people not to deduct charges until there is clarity on to whom is charges are being made and consideration is given to the implication of these charges. He expressed concern that these charges significantly mitigate independent living and social inclusion.

Cliona NÌ Chual·in of the National Association of Mental Handicap in Ireland (NAMHI) called for clarification on what the charges are covering and a transparent and standardised system of charging and waivers for the charges. This is not the case at the moment. There is confusion about the charges and reducing the incomes of people in long stay care is not conducive to a supportive living model. NAMHI believe that residents should contribute something to the centres they are living in but these payments should not reduce their quality of life and ability to participate in society.

Questions put to the Department of Health and the Health Services Executive on the increase in charges, their impact on residents in long stay homes, clarification of mechanism of payment and waiver system were ignored by the Department of Health. The following response came for the HSE

ìThe HSE has convened an Expert Group that is engaged in a consultation process with all the voluntary providers about guidelines/criteria for the imposition of long stay charges for residents receiving nursing care in mental health and disability settings. The HSE is aware that there are some issues . It has recommended that charges should be recommenced where the situation is straightforward or uncomplicated ie where there is nursing care – where there is no substantial increase or undue hardship. A waiver can apply where the charge will result in undue hardship for any individual – looking at it on case by case basis

sara burke