Wednesday 18 March: Home and Community Care Ireland (HCCI) – the national membership organisation for companies that provide home care services – has today  published its COVID-19 home care action plan.  The plan sets out six urgent recommendations for government and the HSE to ensure home care providers can continue to provide essential care services to vulnerable people nationwide during the COVID-19 pandemic.

Background: Home and Community Care Ireland

Home and Community Care Ireland (HCCI) is the national membership body for home care providers in Ireland.  We have over 80 members across the country.  Key facts about HCCI:

• To date, 45 clients are self-isolating upon the advice of a medical professional. 836 clients of HCCI members are self-isolating voluntarily.
• To date, 53 carers are self-isolating upon the advice of a medical professional. 103 carers employed by HCCI members are self-isolating voluntarily.
• Our members care for 17,000 clients whose care is paid for via the HSE’s Home Support Scheme. They care for 3,000 clients who pay for their care privately.
• Our members employ 3,400 full time care staff and 9,500 part time care staff.
• Our initial estimates indicate that 1,000-2,000 of these clients are so vulnerable they will need to be admitted to hospital if they do not receive their regular home care calls.
• The majority of our members’ care services are provided to older persons, but a significant share is also given to people with disabilities and those with complex needs.

Context: COVID-19

We understand the full gravity of the national emergency that COVID-19 presents to the State.  All sections of our country need to play their part if Ireland is to successfully manage the threat.  As per page 18 of Ireland’s National Action Plan in response to COVID-19, we understand the importance of the home care sector continuing to deliver services to vulnerable clients.  Home care can also help to alleviate the pressure on the acute system by quickly taking non-COVID-19 clients out of hospital and back into the community.  Our hospitals will wish to discharge all non-urgent cases back into the community to focus on providing care to critical COVID-19 cases and other emergency cases as they are raised.  To do so, we urgently need to boost capacity in the existing home care system.

We are not currently proposing that home care providers treat COVID-19 patients in their own home.  We are available to discuss this should the Government feel this is a national priority.  HCCI members can also support the proposed cocooning policy that An Taoiseach, Leo Varadkar T.D. announced on last night’s televised address to the nation.

For now, our proposals aim to increase capacity in the health care system and to stabilise the home care sector.  We are concerned, if we do not move quickly, that there will be a serious threat to the viability of our industry which remains a necessary part of the fabric of our nation’s efforts to combat COVID-19.

Priority recommendations: To facilitate greater capacity in home care

1. Suspend the following social welfare rules to free up more working hours among current staff:
   • Suspend the requirement that limits employees on the Community Employment programme to 19.5 hours of work per week.
   • Suspend the rule that employees must earn €184 or less per week in order to retain their entitlement to a Medical Card.
   • Suspend the rule that limits employees from working over 38 hours in a two-week period if they wish to qualify for the Working Family Payment.
2. Suspend, for the duration of the COVID-19 emergency, the requirement for new carers to shadow an existing carer for five hours.

Priority recommendations: To stabilise the home care sector

3. Amend the current policy of paying providers for only two days if a client self-isolates voluntarily or upon the advice of public health authorities. We propose payment be extended from two days to up to six weeks, subject to monthly reviews.  The current limit unfairly penalises both clients (who may lose their home care package if they voluntarily self-isolate) and providers. Our proposed amended policy is more in line with Government announcements on the COVID-19 sick leave policy and COVID-19 Pandemic Unemployment Payment.
4. Issue more detailed national guidance for home care providers on caring for clients during the emergency. This should include detail for dealing with clients suspected to have COVID-19 and how to limit the risks to carers at this time.  In tandem, issue a national directive that, if the need arises, sufficient Personal Protective Equipment (PPE) will be issued to all home care providers with attendant training. HCCI will commit to streamlining the training to make it as simple as possible for the Government to deliver.
5. Expand Revenue guidance issued on 13^th March 2020 to include payments, interest and penalties on PAYE, USC and PRSI, and extend this until the COVID-19 emergency is over. Employers will continue to file all returns as normal.
6. HSE to immediately settle all outstanding invoices issued by HCCI members. HSE to put in place a robust invoice payments system that will operate efficiently throughout the period of the COVID-19 crisis.

We require the urgent engagement of Government and the HSE on these issues to allow us to assist in the overall national efforts during this crisis.