District health boards (DHBs) are responsible for funding residential care services for older people under the Social Security Act 1964. DHBs have a contract with rest home or hospital owners (‘providers’) to provide long-term residential care (‘contracted care services’) to residents who are eligible for government funding through the residential-care subsidy.
Only rest homes or hospitals that have achieved Certification under the Health and Disability Services (Safety) Act 2001 and comply with the Health and Disability Sector Standards 2001 can have a contract with DHBs. Rest homes and hospitals that have an Age Related Residential Care Contract with a DHB are referred to in these Questions and Answers as ‘DHB contracted care facilities’.
DHBs are responsible for ensuring that there are sufficient contracted care beds available to people assessed as requiring long-term residential care indefinitely.
To enter DHB contracted residential care
the person must be eligible for publicly funded health and disability services (a New Zealand citizen or permanent resident, or eligible under the Eligibility Direction made under the New Zealand Public Health and Disability Act 2000).
If a person believes they can no longer live at home even with support, the first step is to apply for a needs assessment from a DHB or local DHB funded Needs Assessment and Service Coordination Agency (NASC). Alternatively a person may be needs assessed by a specialist while a patient in a public hospital.
A needs assessment will determine the level of need the person has – very low, low, medium, high, or very high. During the service coordination process it will then be determined:
Not everyone is entitled to funding under the Social Security Act 1964.
A person must first have a needs assessment from a DHB or DHB funded Needs Assessment Service Coordination agency (NASC). If the needs assessment determines that the person requires long - term residential care indefinitely and the person wishes to apply for a Residential Care Subsidy, then the DHB or NASC will provide the person with a financial means assessment application form to complete.
The Ministry of Social Development (through Work and Income) then carries out a financial means assessment that considers the person’s assets and income, and any gifting that has occurred.
The financial means assessment has two components:
If the person has assets above the applicable asset threshold then the person is liable to pay for the costs of their care up to the maximum contribution.
If the person’s assets are equal to or below the applicable asset threshold, they qualify for Government funding (the residential care subsidy) to pay for most of the cost of their care. An income test will then determine what the person must contribute to the cost of their care. The level of subsidy will depend on the type of care the person is assessed as requiring.
A weekly personal allowance and an annual clothing allowance are paid separately to the person.
Refer to ‘Who is responsible for funding residential care services for older people?’ and ‘What are the criteria for entry into residential care?’ above.