Long-Term Care (Jersey)
Law 2012
A LAW to make provision for the long-term health care of Jersey
residents.
Commencement [see endnotes]
part 1
introductory
1 Interpretation[1]
In this Law, unless the context otherwise requires –
“approved care home” shall be construed in accordance
with Article 6;
“approved home care service” shall be construed in accordance
with Article 6A;
“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;
“home care service” has the
same meaning as in paragraph 5 of
Schedule 1 to the Regulation of Care (Jersey)
Law 2014;
“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 or a person in a registrable
occupation under the Health Care (Registration)
(Jersey) Law 1995;
“Social Security Law” means the Social Security (Jersey)
Law 1974;
“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, 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
civil partner, or any individual living in a marriage-like relationship or
civil partnership-like relationship with the person; and
(b) “means”
includes any assets, financial or otherwise, available to a person.[2]
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.
6A Approved
home care service[3]
(1) A home care service may
be approved by the Minister for the purposes of this Law (an “approved
home care service”).
(2) The Minister shall, by
Order, make provision as respects all such matters as he or she thinks fit
concerning approval under paragraph (1) 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 shall
be prepared in accordance with the accounting
standards referred to in the Public Finances Manual
issued under the Public Finances (Jersey)
Law 2019.[4]
(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) [5]
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 3 on the standard scale.[6]
(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 Citation
This Law may be cited as the Long-Term Care (Jersey) Law 2012.