Long-Term Care
(Jersey) Law 2012
A LAW to make provision for the
long-term health care of Jersey residents.
Adopted by the
States 21st July 2011
Sanctioned by
Order of Her Majesty in Council 10th July 2012
Registered by the
Royal Court 27th
July 2012
THE STATES, subject to the sanction of Her Most Excellent Majesty in Council, have
adopted the following Law –
part 1
introductory
1 Interpretation
In this Law, unless the context otherwise requires –
“approved care home”
shall be construed in accordance with Article 6;
“approved care package”
shall be construed in accordance with Article 7;
“benefit” shall be
construed in accordance with Article 4;
“determining officer”
means a person appointed as determining officer under Article 8;
“Fund” means the
Long-Term Care Fund established under Article 2;
“long-term care”
means such care as a person is assessed as needing under Article 5;
“Minister” means the
Minister for Social Security;
“prescribed” means
prescribed by Order;
“registered person”
means a registered medical practitioner under the Medical Practitioners
(Registration) (Jersey) Law 1960[1] or a person in a registrable
occupation under the Health Care (Registration) (Jersey) Law 1995[2];
“Social Security Law”
means the Social Security (Jersey) Law 1974[3];
“tribunal” means the
Social Security Tribunal established under Article 33A of the Social
Security (Jersey) Law 1974 or the Medical Appeal Tribunal established
under Article 9 of the Income Support (Jersey) Law 2007[4], as the case requires.
part 2
source of funds
2 Long-Term
Care Fund
(1) For
the purposes of this Law, there shall be a fund called the “Long-Term
Care Fund” which shall be under the control and management of the
Minister.
(2) There
shall be paid into the Fund –
(a) the
appropriate Long-Term Care Fund allocation specified in Article 30 of the
Social Security Law; and
(b) such
other sums as the States may by Regulations determine.
(3) There
shall be paid out of the Fund –
(a) benefits
payable under this Law;
(b) such
expenditure as the Minister may determine related to the cost of long-term
care, including the purchase and maintenance of equipment for long-term care;
and
(c) all
expenses of whatever nature incurred by the Minister in carrying this Law into
effect, including any Regulations and Orders made under this Law.
(4) Draft
Regulations to be made by the States under this Article may be lodged only by
the Minister.
part 3
entitlement to benefits
3 Persons
entitled to benefits
(1) Subject
to the provisions of this Law, every person who has attained the age of 18 years
and who, after the date this Article comes into force, meets the conditions set
out in paragraph (2) is entitled to such benefit under this Law as may be
determined in accordance with the provisions of this Law.
(2) Those
conditions are that –
(a) the
person has been assessed as being in need of long-term care under Article 5;
(b) the
person –
(i) is a resident of
an approved care home, or
(ii) is in receipt of
an approved care package,
and the person would incur a charge imposed by the approved care
home or provider of the approved care package were it not for any benefit
payable to the person under this Law;
(c) the
person meets any such conditions as may be prescribed with respect to the
person making a payment towards the costs of long-term care;
(d) the
person is not subject to any proceedings (whether civil or criminal) brought
against the person under the Social Security Law or under this Law; and
(e) the
person meets such other conditions as are applicable to the person, including
conditions as to residency, that the States may specify by Regulations.
(3) An
Order under paragraph (2)(c) –
(a) shall
make provision for –
(i) determining,
whether generally or by description or with reference to some other matter, the
persons required to make a payment,
(ii) determining the
amount of any payment that may be required with reference to such of a
person’s means as may be specified in the Order,
(iii) determining the times
at which such a payment must be made,
(iv) determining the
circumstances in which such payment may be deducted from such benefits payable
under the Social Security Law as may be specified in the Order;
(b) may
make such provision as the Minister thinks necessary or expedient relating to
the extent to which the divesting of a person’s assets may be taken into
account for the purpose of determining a person’s means where the
purpose, or a primary purpose, of the divesting was to obtain a benefit payable
under this Law or to increase the amount of such a benefit; and
(c) shall
not, in specifying a person’s means for the purposes of
sub-paragraph (a)(ii), specify any means of such description as the States
may specify in Regulations.
(4) In paragraphs (3)(a)(ii)
and (3)(b) –
(a) “person”
means the person entitled to benefit and may include the person’s spouse
or any individual living in a marriage-like relationship with the person
(whether or not of different sexes); and
(b) “means”
includes any assets, financial or otherwise, available to a person.
4 Benefits
(1) The
Minister shall, by Order, determine the rate for –
(a) a
benefit in respect of the costs of long-term care, to be known as a “long-term
care benefit”;
(b) a
benefit to meet all or part of the cost of a payment prescribed under Article 3(2)(c);
(c) any
other benefit as may be prescribed.
(2) An
Order may provide –
(a) for
different rates of benefit to be payable in respect of different types or levels
of long-term care;
(b) for
the minimum and maximum rates of benefit;
(c) for
the rate of any benefit to be subject to such of a person’s means as may
be specified in the Order.
(3) For
the purposes of paragraph (2)(c), “person” and “means”
have the same meaning as in Article 3(4).
5 Long-term
care assessment
(1) A
person may be assessed as being in need of long-term care if the person needs
permanent help with activities that are an essential part of normal daily
living (such as bathing, dressing, grooming, eating).
(2) An
assessment under this Article must be carried out by a registered person.
(3) The
Minister shall, by Order, make provision as respects all such matters as he or
she thinks fit for assessments including, without limiting the generality of
the foregoing –
(a) specifying
the descriptions of registered person who may make assessments for the purposes
of this Article or Article 7, or both;
(b) the
appointment and removal of such persons;
(c) the
criteria to be taken into account in making assessments;
(d) procedures
for assessments, including subsequent reviews;
(e) provisions
for appeals against removal of registered persons from appointment and appeals
against assessments.
(4) The
Minister may require the needs of a person assessed as being in need of long-term
care under this Article to be reviewed at any time.
(5) In
this Article “permanent” means continuing, or likely to continue,
for the rest of the person’s life.
6 Approved
care home
(1) This
Article applies to an establishment for the residence and care of persons who
are or may be assessed as being in need of long-term care.
(2) An
establishment to which this Article applies may be approved by the Minister for
the purposes of this Law, such establishment being known as an “approved
care home”.
(3) The
Minister shall, by Order, make provision as respects all such matters as he or
she thinks fit concerning approval under paragraph (2) including, without
limiting the generality of the foregoing –
(a) conditions
subject to which approval may be given;
(b) procedures
for approval and subsequent reviews;
(c) the
form and manner of an application for approval, including any application fee;
(d) revocation
or suspension of approval;
(e) provision
for appeals against revocation or suspension of approval.
7 Approved
care package
(1) This
Article applies to arrangements for providing care for a person assessed as
being in need of long-term care under Article 5, such care being provided
in the person’s home or in other premises not being an approved care
home.
(2) Arrangements
to which this Article applies may be approved by a registered person for the
purposes of this Article, such arrangements to be known as an “approved
care package”.
(3) The
Minister shall, by Order, make such provision as he or she thinks fit
concerning approval under paragraph (2) including, without limiting the
generality of the foregoing –
(a) descriptions
of registered persons who may give approval;
(b) conditions
subject to which approval may be given;
(c) procedures
for approval and subsequent reviews;
(d) revocation
or suspension of approval;
(e) provision
for appeals against revocation or suspension of approval.
part 4
claims and payment of benefits
8 Procedures
in relation to claims and payment of benefits
(1) A
claim for benefit, or any question or matter arising in relation to such a
claim, shall be determined by one or more persons, to be known as
“determining officers” appointed by the Minister.
(2) If
a person in respect of whom a claim is made is dissatisfied with any
determination of a determining officer under this Law, the matter shall be
redetermined by a second determining officer.
(3) The
Minister shall, by Order, make such provision as he or she thinks fit in
relation to consideration by a determining officer or a tribunal of any matter
concerning a claim and payment of a benefit, including without prejudice to the
generality of the foregoing, provisions for –
(a) procedures
for claims, including forms to be used, the evidence which is required and the
circumstances in which any official record or certificate is to be sufficient
or conclusive evidence;
(b) when,
by whom and in what circumstances notice must be given of any change of
circumstances affecting the continuance of entitlement to a benefit or to a
particular rate of benefit;
(c) determining
the frequency and manner of payment of benefits;
(d) the
appointment of a person (which may include the Minister) to act on behalf of a
person making a claim or for the receipt of benefits, including provision for
determining when benefits shall be made directly to a person acting for an approved
care home or providing an approved care package;
(e) the
procedure for appeals to a tribunal;
(f) time
limits for any claim or appeal or for producing any evidence or other
information;
(g) the
reference to the Royal Court for a decision of any question of law arising in
connection with the determination of a question by a determining officer or by a
tribunal;
(h) appeals
to the Royal Court from a decision of a tribunal on any question of law;
(i) summoning
persons to attend and give evidence or produce documents and for authorizing
the administration of oaths to witnesses;
(j) for
the representation of one person, at any hearing of a case, by another person,
whether or not that other person has professional representation;
(k) for
adjustment of benefit following a determination or appeal and for repayment
where necessary.
(4) Where,
in any proceedings for an offence under this Law or for the recovery of any
sums due to the Fund, any question arises that is required to be determined in
accordance with an Order under this Article, provision may be made by Order –
(a) that
the decision relating to that question shall be conclusive for the purpose of
those proceedings;
(b) for
obtaining such a decision when it has not been given; and
(c) for
adjourning the proceedings until such a decision has been given.
9 Expenses
of persons required to attend proceedings
(1) The
Minister may pay such travelling and other allowances, including compensation
for loss of remunerative time, as the Minister may determine to any member of a
tribunal in connection with any reference or appeal to the tribunal under this
Law.
(2) The
Minister may also pay to any such member of a tribunal any other expenses
incurred in connection with the member’s work as appear to the Minister
to be reasonable.
10 Offences
in relation to claims for benefit
If a person for the purpose of obtaining any benefit, whether for
the person or some other person –
(a) knowingly
makes any false statement or false representation or withholds any material
information;
(b) produces
or furnishes, or causes or knowingly allows to be produced or furnished, any
document or information which the person knows to be false in a material
particular; or
(c) fails
to notify a change of circumstances as required by an Order under this Law,
the person shall be liable to imprisonment for a term of 7 years
and to a fine.
part 5
administration of the fund
11 Accounts
(1) Annual
accounts of the Fund shall be prepared in such form, in such manner and at such
times as the Minister may determine, and the Comptroller and Auditor General
shall examine and certify every such account, and copies thereof (together with
the report of the Comptroller and Auditor General thereon) shall be laid before
the States.
(2) Any
monies forming part of the Fund may from time to time be paid over to –
(a) the Treasurer of the
States; or
(b) an investment manager,
and may, by either of them, be invested in accordance with such
directions as may be given by the Minister for Treasury and Resources.
(3) The
Minister for Treasury and Resources may, after consultation with the Minister,
appoint one or more investment managers.
(4) The
Minister for Treasury and Resources shall not appoint an investment manager
under paragraph (3) unless, having considered the value of the fund monies
from the Fund to be managed by such investment manager, he or she is satisfied
that such value will not be excessive having regard to –
(a) proper advice;
(b) the desirability of
securing diversification of management of the Fund; and
(c) the value of the Fund.
(5) The
terms of appointment of an investment manager shall –
(a) provide for its
termination without notice;
(b) require the investment
manager to provide the Minister for Treasury and Resources, at least once every
3 months or such other period as may be specified in the terms of
appointment, with a report setting out the action taken by the investment
manager under the appointment;
(c) require the investment
manager to comply with such instructions as the Minister for Treasury and
Resources may give;
(d) require the investment
manager to have regard to the need for diversification of investment of monies
from the Fund and to the suitability of investments of any description.
(6) The
Minister for Treasury and Resources, on consideration of each report provided
to him or her under paragraph (5) and any other information he or she
thinks relevant, shall, having regard to –
(a) the need for
diversification of investment of monies from the Fund;
(b) the suitability of
investments of any description; and
(c) proper advice,
consider the desirability of continuing or terminating the investment
manager’s appointment.
(7) In
this Article –
(a) “investment
manager” means a person or persons reasonably believed by the Minister to
be suitably qualified by ability in, and practical experience of, financial
matters to make investment decisions on his or her behalf;
(b) “proper
advice” means the advice of a person or persons reasonably believed by the
Minister for Treasury and Resources to be qualified by his or her ability in,
and practical experience of, financial matters to give such advice.
(8) Regulations
made under the Public Finances (Jersey) Law 2005[5], if and to the extent that
they apply to any monies paid over under paragraph (2), are subject to
this Article.
12 Actuarial reports
(1) An
actuary, appointed for the purpose by the Minister, shall review the operation
of this Law during the period ending 31st December in the year following
the year that this Article comes into force and thereafter during the period
ending with 31st December in every 3rd year and, on each such review, make a
report to the Minister on the financial condition of the Fund and the adequacy
or otherwise of the contributions payable to the Fund to support the benefits under
this Law having regard to its liabilities under this Law.
(2) The
Minister may at any time reduce the period to be covered by a review and report
under paragraph (1) and accelerate the making of that and subsequent
reviews and reports accordingly.
(3) A
copy of every report under this Article shall be laid before the States as soon
as practicable after it is made.
13 Civil proceedings
to recover sums due to the Fund
Proceedings for the recovery of sums due to the Fund may be
instituted by the Treasurer of the States and, notwithstanding any enactment or
rule of law to the contrary, any such proceedings may be brought at any time
within 10 years
from the time when the matter complained of arose.
14 Recovery of sums
due to Fund by deductions from earnings
(1) Where
judgment has been obtained for the payment of any sum due to the Fund by any
individual (in this Article referred to as the “judgment debtor”)
then, notwithstanding any enactment or rule of law to the contrary and without
prejudice to any other means of recovery, the sum payable under the judgment
together with the recoverable costs (in this Article referred to as the “judgment
debt”) may be recovered in accordance with the provisions of this Article.
(2) Where
it is desired to recover any judgment debt under this Article –
(a) the
Minister may serve notice on the employer for the time being of the judgment
debtor requiring the employer to furnish the Minister, within such time (not
being less than 7 days) as may be specified in the notice, with a
certificate of the amount earned by the judgment debtor in the employ of the
employer during such past period or periods as may be so specified; and
(b) subject
to paragraph (3), whether or not such a certificate as aforesaid has been
required to be furnished, the Minister may serve notice on the employer for the
time being of the judgment debtor requiring the employer to make such
deductions from the earnings of the judgment debtor as may, having regard to
all the circumstances of the case, appear to the Minister to be reasonable and
to pay the amounts so deducted to the Minister at such times as may be
specified in the notice, and the amount so paid shall be applied towards the satisfaction
of the judgment debt.
(3) Where
the judgment debt has been ordered to be paid by instalments, the Minister
shall not require such deductions to be made as would at any date reduce the
judgment debt by a greater amount than that by which it would have been reduced
had the instalments been paid.
(4) An
employer who refuses or without lawful excuse fails to furnish a certificate
which, under paragraph (2)(a), the employer is required to furnish within
such time as may be so required is guilty of an offence and is liable to a fine
of level 2 on the standard scale.
(5) An
employer who furnishes a certificate under paragraph (2)(a) which is false
in a material particular is guilty of an offence and is liable to a fine of
level 4 on the standard scale.
(6) Any
notice under paragraph (2)(b) may at any time be varied by a subsequent
notice under that sub-paragraph.
(7) A
copy of every notice served under paragraph (2)(b) or (6) shall be served
also on the judgment debtor.
(8) Where
an employer fails to deduct any amount which the employer is required by virtue
of paragraph (2)(b) to deduct, or to pay to the Minister any amount so
deducted, the amount may be recovered from the employer as a debt due to the
Fund.
(9) Service
of any notice under this Article may be effected by sending it by registered
post to the person on whom it is to be served at his or her usual or last known
place of abode or his or her principal place of business or, in the case of a
company, at its registered office.
15 Recovery in
bankruptcy, etc.
In the event of any dégrèvement,
réalisation, désastre,
bankruptcy or composition with creditors, any amount due to the Long-Term Care Fund
shall rank for payment pari passu with other
privileged debts and in priority to all other debts.
part 6
miscellaneous and closing
16 Regulations
and Orders
(1) The
States may, by Regulations, amend any enactment, including this Law, for the
purpose of making such transitional, consequential incidental, supplementary
and savings provisions as they consider necessary or expedient in respect of
any provision of this Law.
(2) The
Minister may, by Order –
(a) make
such transitional, consequential, incidental, supplementary and savings provisions
(other than amending any enactment) as he or she considers necessary or
expedient in respect of any provision of this Law; and
(b) prescribe
any matter that shall or may be prescribed under this Law.
(3) Any
Regulations or Order under this Law may contain such transitional,
consequential, incidental or supplementary provisions as appear to the States
or the Minister, as the case requires, to be necessary or expedient for the
purposes of the Regulations or Order.
17 Social
Security Law amended
The Schedule shall have effect.
18 Citation
and closing
This Law may be cited as the
Long-Term Care (Jersey) Law 2012 and shall come into force on such day or
days as the States may by Act appoint.
a.h. harris
Deputy Greffier of the States