The varying level of charges for residential care.
There are a number of aspects to this:
• The Maximum Contribution
• Additional services
• Those receiving a subsidy
• ‘Top up’
The ‘Maximum Contribution’
Those who have had their needs assessed and been found to be eligible for residential care and who reside or will reside in a DHB contracted facility need pay no more than the ‘Maximum Contribution’. The ‘Maximum Contribution’ is the maximum amount that any resident should have to pay for their ‘basic’ care.
The amount varies between ‘local body’ regions and is adjusted annually. Further information and the weekly rate per region can be found via the Ministry of Health website section ‘Maximum Contribution’.
Fully subsidised residents costs are covered by the residential care subsidy.
Where confusion seems to creep in is around ‘Additional services’.
Additional Services are those services over and above the ‘basic’ District Health Board contracted services. You will have to pay for any additional services yourself. Additional services may be purchased by any resident whether privately paying or subsidised and can range from a personal copy of the daily newspaper through to items such as a personal phone line, Sky TV or luxury accommodation.
The definition as to what constitutes a ‘basic service’ varies from facility to facility. For example a number of providers define an ensuite as an ‘additional service’ (i.e. separate from the DHB contract). In those facilities you could therefore be asked to pay more for an ensuited room. As you can imagine there is a ‘grey area’ around what constitutes ‘additional services’.
All residents should be given an admission agreement to consider and sign before taking up residency. Amongst other things the admission agreement should tell you what you will and will not have to pay for. It is wise to take it away before signing so that you can look at it more carefully at your own pace and in your own time. You may also like to get a legal opinion. Always ensure that any additional services you agree to are itemised on this agreement.
Note: If you are at the stage of deciding on your choice of facility and you are facing costs over and above the ‘basic’ service that you are not willing or able to pay for then you need to be aware that if the service does not have another option for you, you will probably have to go elsewhere.
Those receiving a subsidy
If you receive a Residential Care Subsidy and are residing in a District Health Board contracted facility all your essential ‘basic’ costs must be provided for.
In general the subsidy covers: food services, laundry, nursing and care services, continence products, GP visits, health care that is ordered by the GP, prescriptions and transport to health services.
Examples of what the subsidy does not cover include: specialist visits, hairdresser and personal toiletries, transport and recreational activities beyond the usual day to day activities incorporated into the programme, private phone, satellite TV, personal reading material, spectacles, hearing aids and dental care. Further information and examples can be seen on the Ministry of Health website in the section ‘Questions and Answers on Residential Care’.
As a subsidised resident you may also be offered additional services which you can either agree to or decline. If you do agree to additional services make sure these are itemised on your agreement and that you include these in your budget.
If you do not meet the asset threshold (i.e. privately paying) and you require care that in reality costs more than the Maximum Contribution e.g. dementia or hospital care, then the DHB pay a ‘top up’ price (up to the DHB contract price).
You will not be asked to pay this amount.
For other information relevant to this subject see the Seniorline website section 'Moving into Care'.
© Eldernet 2014