The purpose of this Act is to—

This Act—

In this Act and in Schedules 1 to 3, unless the context otherwise requires,—

A reference in an enactment or a document to all or any of the provisions of sections 69FA and 132D, Part 4, and Schedules 27 and 30 of the Social Security Act 1964 (the former enactments) is to be interpreted as a reference to, or to the corresponding provisions of, this Act and Schedules 2 and 3, to the extent necessary to reflect sensibly the intent of the enactment or document.

Subsection (1) is subject to the consequential amendments in Schedule 10 of the Social Security Act 2018.

The provisions of this Act and Schedules 2 and 3—

Subsection (3) is subject to subsections (5) and (6) and section 7.

If the meaning of an enactment in this Act or Schedule 2 or 3 that comes into force on 26 November 2018 (the new law) is unclear or gives rise to absurdity, the wording of a law that is repealed by section 77(1) and that corresponds to the new law (the old law) must be used to ascertain the meaning of the new law.

Subsections (3) to (5) do not apply, if a new law is affected by an amendment made after the beginning of 26 November 2018, to that new law after the amendment commences.

The transitional, savings, and related provisions in Schedule 1 have effect according to their terms.

This Act binds the Crown.

This Act determines who pays for the cost of LTR contracted care.

Nothing in this Act affects the liability of a person to pay, under an agreement between that person and a provider, for any services provided to that person that are not contracted care services.

LTR contracted care is care that meets all of the following criteria:

The following key terms are used in the definition of LTR contracted care (and are also used elsewhere in this Act):

A qualifying person is a person who—

A person is funding eligible if the person belongs to a class of eligible people specified in regulations made under section 102 of the Pae Ora (Healthy Futures) Act 2022 or is eligible under a ministerial direction continued under clause 30 of Schedule 1 of that Act.

A person has been positively needs assessed if the person has been assessed under section 28 as requiring LTR care indefinitely.

No qualifying person is liable to pay more than the maximum contribution towards the cost of the contracted care services provided to that person.

The maximum contribution is the maximum amount that an individual may be required to pay towards the cost of LTR contracted care provided to the individual and that is set for each region under section 53.

Subsection (1) applies irrespective of the person’s assets or income.

A qualifying person whose assets as determined by a means assessment under section 34 are above the applicable asset threshold must contribute the maximum contribution for as long as that person’s assets are above the applicable asset threshold.

A qualifying person whose assets as determined by a means assessment under section 34 are equal to or below the applicable asset threshold must pay a contribution, based on income determined by a means assessment under section 37, towards the cost of that person’s LTR contracted care.

In relation to each qualifying person, the appropriate funder must pay the difference between—

This section applies to a person (P) who is a qualifying person except that—

P must pay the maximum contribution until P is means assessed.

There are 3 categories of special case person:

The definitions of funding eligible and positively needs assessed in sections 13 and 14 respectively apply also to special case persons.

A 50+ single person is a person who—

A 50+ single person (A) is liable to make only an income contribution (that is, a contribution based on income as determined by a means assessment under section 37) towards the cost of A’s LTR contracted care, that is, A must be treated as if A had been—

In relation to each 50+ single person, the appropriate funder must pay the difference between that person’s contribution and the cost of that person’s LTR contracted care.

An exempt person is a person who—

An exempt person is liable to contribute to the cost of that person’s LTR contracted care the amount of any benefit that P receives, less the personal allowance, and a funder must pay the balance of the cost.

Personal allowance, in this Act and Schedule 2, means an amount of benefit, specified in regulations made under section 74, that a person is not required to contribute to the cost of LTR contracted care provided to the person.

An elderly victim of crime is a person who—

A person who is an elderly victim of crime is not liable to contribute any amount to the cost of that person’s LTR contracted care and a funder must pay the whole of that cost.

A person may at any time apply for a needs assessment if the person is—

A person who is a special case person may at any time apply for a needs assessment.

Health New Zealand may at any time on its own initiative conduct a needs assessment of a person who could apply under subsection (1) or (2).

A needs assessment must determine whether the person assessed requires LTR care indefinitely.

If Health New Zealand receives an application under section 27(1), it must arrange for the needs assessment to be conducted as soon as practicable.

The date of a person’s needs assessment is the date shown as such on the assessment.

For the purposes of a needs assessment (and, in particular, consent to a needs assessment), the Code of Health and Disability Services Consumers’ Rights (made under section 74 of the Health and Disability Commissioner Act 1994) applies as if—

Health New Zealand must provide a copy of the result of a needs assessment as soon as practicable to—

Health New Zealand must at the same time inform the person assessed (P) of the following:

This Act provides for 2 stages of a means assessment, as follows:

A person who has been positively needs assessed may apply to MSD for a means assessment.

An application for a means assessment must be made on a form provided for the purpose by MSD and the applicant must supply any supporting evidence or information that is reasonably required by MSD to complete the assessment.

MSD must arrange for a means assessment to be conducted as soon as practicable after receiving an application.

The first stage of a means assessment is an assets assessment.

An assets assessment must be conducted in accordance with Part 2 of Schedule 2.

This section does not apply to a special case person (who, under section 22(1), 24(1), or 26, is not liable to contribute from that person’s assets).

An assets assessment must assess the value of the non-exempt assets of a person as at the date of means assessment and must determine whether those assets are above, equal to, or below the applicable asset threshold.

An income assessment is required if an assets assessment has determined that a person’s assets are equal to or below the applicable asset threshold.

An income assessment must be conducted in accordance with Part 3 of Schedule 2.

An income assessment of a person (P) must—

In subsection (1), 90-day period means the period of 90 days before the date of means assessment.

This section is subject to sections 24(1) and 26.

This section applies where MSD is satisfied that a person who has applied for a means assessment (P), or P’s spouse or partner, has directly or indirectly deprived himself or herself of any income or property.

In conducting P’s means assessment, MSD may include the income or property as if the deprivation had not occurred.

In this section, property does not include an exempt asset.

This section applies where MSD is satisfied that a person who has been means assessed (P), or P’s spouse or partner, has directly or indirectly deprived himself or herself of any income or property.

In conducting a review of P’s means assessment, MSD may include the income or property as at the date of the means assessment as if the deprivation had not occurred.

In this section, property does not include an exempt asset.

MSD must ensure that every means assessment is recorded in writing, whether the means assessment is a first assessment or a subsequent assessment on review, and whether or not the assessment relates only to assets or to assets and income.

MSD must ensure that a copy of the record of the means assessment is provided to the person to whom it relates.

MSD must ensure that the provider, the funder, and the Ministry of Health are advised of the following in respect of every person (P) who is means assessed or whose means assessment is reviewed:

A person (A) listed in subsection (2) must advise MSD of any change in the financial or other circumstances of a person who has been means assessed (B), or of B’s spouse or partner, if A—

For the purposes of subsection (1), A is any of the following:

Subsection (1) does not apply if—

A funder must take all practicable steps to ensure that a person who has undergone a means assessment (P)—

For the purpose of a means assessment under this Act, MSD may make a determination to regard as single a person (P) who is married or in a civil union, but is—

However, MSD cannot under subsection (1) determine that P is single by reason only that P or P’s spouse or partner—

A determination under subsection (1) may include a date, determined by MSD, on which the spouses or partners must be taken for the purposes of the determination to have commenced to live apart.

Every determination under this section also applies for the purposes of every debt-recovery or offence provision in, under, or for the purposes of, this Act.

For the purpose of a means assessment under this Act, MSD may make a determination to regard as a party to a de facto relationship any 2 people who, not being legally married or in a civil union, have entered into a de facto relationship.

A determination under subsection (1), for the purposes of the assessment, may include either or both of the following dates:

Every determination under this section also applies for the purposes of every debt-recovery or offence provision in, under, or for the purposes of, this Act.

MSD must review a means assessment of a person (P) if—

This section applies if a person (P) has been means assessed and been found to have assets above the applicable asset threshold.

MSD may review P’s means assessment at any time if MSD considers that P’s assets have fallen, or are about to fall, to a level below or equal to the applicable asset threshold.

This section applies if a person (P) has been means assessed and been found to have assets equal to or below the applicable asset threshold.

MSD—

Nothing in section 48 or 49 obliges MSD to conduct a review of a means assessment following a change in the tests used in means assessments (such as an increase to applicable asset thresholds or a change to the personal allowance (as defined in section 24(2))) unless the person to whom the means assessment relates applies for a review under section 47.

A review must review the person’s means assessment as to assets and, if necessary, the person’s means assessment as to income unless subsection (2) applies.

A review must review the person’s means assessment as to income only (and not the person’s means assessment as to assets) if the review is conducted under—

A review is conducted as at the date of means assessment.

Section 38(1)(c) applies if a review determines that, as at the date of means assessment, the assets of the person were equal to or below the applicable asset threshold.

In this Act and Schedule 2, date of means assessment means,—

The Director-General of Health must, by written notice, determine the maximum contribution that applies in each region.

By way of explanation, the maximum contribution that applies in a region is the amount agreed at a national level between funder representatives and provider representatives as being the amount that funders in that region are to pay to providers in that region for providing rest-home-level care services.

However, if the amount identified under subsection (2) for a region is less than $636, the maximum contribution for that region must be set at $636.

A notice given under this section—

A notification in the Gazette for the purpose of subsection (4)(a)(ii) does not have to include the text of the notice.

In respect of the cost of an exempt person’s LTR contracted care, the funder must pay the amount determined under the following formula:

In respect of the cost of an elderly victim of crime’s LTR contracted care, the funder must pay the full cost.

If the assets of a qualifying person (P) have been means assessed and determined to be above the asset threshold, the funder’s liability for the difference between P’s maximum contribution (under section 16) and the cost of P’s LTR contracted care begins—

If the assets of a qualifying person (P) have been means assessed and determined to be equal to or below the asset threshold, the funder’s liability for the cost of P’s LTR contracted care (less any income contribution that P must pay under section 17) begins on the day during the 90-day period when P’s assets were first equal to or below the asset threshold.

In this section, 90-day period means the period of 90 days before the relevant date of means assessment.

A funder’s liability for the cost of the LTR contracted care of an exempt person or elderly victim of crime arises—

A funder’s liability for the cost of the LTR contracted care of a 50+ single person arises on the later of the following dates:

This Part applies to a person who—

For the purposes of this Part and Schedules 1 and 3, home-based disability support services means disability services that are supplied to a person, and that are services—

For the purposes of this Part and Schedules 1 and 3,—

MSD may, from time to time, on application by or on behalf of a person to whom this Part applies, assess in accordance with Schedule 3 the weekly amount that person is required to pay towards the cost of the home-based disability support services provided to that person.

The person is required to pay that amount in accordance with the assessment.

MSD’s information-gathering powers under clauses 1 to 7 of Schedule 6 of the Social Security Act 2018 can (in line with clause 3(e) of that schedule) be used for determining, under this Part,—

For the purposes of this Part and Schedules 1 and 3,—

For the purposes of this Part and Schedules 1 and 3,—

This section applies to assets that—

MSD may for the purposes of this Part treat the assets as cash assets.

This section applies if—

MSD may assess, or revise the assessment of, the person’s ability to pay for that person’s home-based disability support services as if that deprivation had not occurred.

Each assessment made by MSD under this Part—

MSD may supply the details of an assessment under this Part to Health New Zealand.

MSD—

A revised assessment under subsection (1)(b)(iii) takes effect from a date MSD determines (being a date that is, or is after, the date on which the change of circumstances concerned may reasonably be held to have occurred).

A person who has received an assessment under this Part must advise MSD without delay of any change in circumstances that affects that person’s ability to pay for that person’s home-based disability support services.

MSD may, by notice given under clauses 2 to 7 of Schedule 6 of the Social Security Act 2018, obtain information for all or any of the following purposes:

This section is by way of explanation only.

This section applies to decisions or determinations of MSD made under any of the provisions of—

Part 7 of the Social Security Act 2018 gives rights of review and appeal in respect of the decisions or determinations (see, for example, row 1 of the table in section 391(1), and section 397(1)(d), of that Act).

This section is by way of explanation only.

A qualifying person (P) who has been means assessed as to assets under section 34 may apply for a loan under the residential care loan scheme operated by the Ministry of Health if—

A notice given under this section is secondary legislation (see Part 3 of the Legislation Act 2019 for publication requirements).

Regulations may be made under section 74 that provide for payment of a clothing allowance to either or both of the following classes of person:

A person (P) commits an offence if—

A person (P) commits an offence if—

In this section, advantage means—

A person who commits an offence under this section is liable on conviction to a penalty that is either or both of the following:

This section does not limit sections 290 and 291 of the Social Security Act 2018.

The limitation period in respect of an offence against this Act ends on the date that is 12 months after the date on which the facts alleged in the charging document are brought to the knowledge of any officer concerned in the administration of this Act.

Subsection (1) overrides section 25 of the Criminal Procedure Act 2011.

The Governor-General may, by Order in Council, make regulations for all or any of the following purposes:

The purpose of exemption regulations made under subsection (1)(a) is to specify a class or classes of persons who, because of their circumstances (for example, a requirement to undergo compulsory treatment), should be liable to contribute to the cost of their LTR care only the amount of any benefit that they receive, less the personal allowance (see sections 23 and 24 and subsection (1)(j)).

Exemption regulations made under subsection (1)(a) may be made only on the recommendation of the Minister.

The Minister must, before making a recommendation that particular exemption regulations be made under subsection (1)(a),—

Regulations published under the Legislation Act 2019 under subsection (1)(i), (l), or (m) have effect in respect of any amounts or types of cash assets, income, or amounts of certain types of income, or defined terms to be excluded as cash assets, specified in the regulations on and after a date that is—

Regulations made under this section are secondary legislation (see Part 3 of the Legislation Act 2019 for publication requirements).

The applicable asset thresholds set out in Part 1 of Schedule 2 must be increased on 1 July 2019, and on every following 1 July, by an amount that reflects the upwards movement (if any) in the index number of the Consumers Price Index (all groups) for the year ending on the previous 31 March.

The income-from-assets exemption (as defined in Part 3 of Schedule 2) must be increased on 1 July 2019, and on every following 1 July, by an amount that reflects the upwards movement (if any) in the index number of the Consumers Price Index (all groups) for the year ending on the previous 31 March.

The adjustments (by any percentage movement in the index number of the Consumers Price Index (All Groups)) required under subsection (2) as at 1 July in any year from 2019 to 2021 (inclusive) for the income-from-assets exemption must, despite subsection (2), be calculated,—

If the adjusted amount of an applicable asset threshold or, as the case requires, of the income-from-assets exemption is not a whole number of dollars,—

This section does not limit section 452 of the Social Security Act 2018 (about orders making discretionary increases to specified amounts in Schedule 2 of this Act).

In this section, Consumers Price Index (all groups) means the Consumers Price Index (all groups) published by Statistics New Zealand or, if that index ceases to be published, any measure certified by the Government Statistician as being equivalent to that index.

The Director-General of Health must, as soon as practicable after 1 July in each year, give written notice of the current amount of the income-from-assets exemption.

A notice under this section must, as soon as practicable after it is given, be published on an Internet site administered by or on behalf of the Ministry of Health and be notified in the Gazette.

A notification in the Gazette for the purpose of subsection (2) does not have to include the text of the notice.

Sections 69FA and 132D, Part 4, and Schedules 27 and 30 of the Social Security Act 1964 are repealed.

All regulations made by Order in Council, or other Orders in Council made under those provisions of that Act, and in force on the commencement of this section, are revoked by this subsection.

Subsection (2) does not revoke orders saved by Schedule 1.