Notice Type
Departmental
1997 Direction of the Minister of Health Relating to Eligibility for Publicly Funded Personal Health and Disability Services in New Zealand Pursuant to section 25 of the Health and Disability Services Act 1993, the Minister of Health, after consulting as required by that section, hereby gives the following direction to the Transitional Health Authority established under section 32 of that Act. 1. Title and commencement (1) This direction may be cited as the Health and Disability Services Eligibility Direction 1997. (2) This direction shall come into force on the 1st day of July 1997. 2. Interpretation (1) In this direction, unless the context otherwise requires ``Acute admission'' means an unplanned admission on the day of presentation at the admitting health care facility. Admission may have been from the emergency or outpatient departments of the health care facility or a transfer from another facility; ``Acute services'' means the following secondary or tertiary services: (a) an acute admission; or (b) unplanned accident and emergency services provided within 24 hours of the person presenting for treatment; or (c) outpatient services associated with services provided under (a) or (b); or (d) outpatient services not associated with services provided under (a) or (b), which are provided within 24 hours of the person being referred for those services by a medical practitioner; or (e) community services associated with (a), (b), (c) or (d); and for the avoidance of doubt does not include disability support services; ``Arranged admission'' means a planned admission where the admission date is less than 7 days after the date the decision was made by a specialist that the admission was necessary; ``Arranged services'' means the following secondary or tertiary services: (a) an arranged admission; or (b) outpatient services associated with an arranged admission; or (c) outpatient services provided less than 7 days after the date the person is referred for those services by a medical practitioner; or (d) Community services associated with (a), (b), or (c); and for the avoidance of doubt does not include disability support services; ``ARCI Act'' means the Accident Rehabilitation and Compensation Insurance Act 1992 and includes any regulations made or continued under that Act; ``Community services'' means services (other than disability support services) provided in a community setting outside a health care facility; ``Disability services'' has the same meaning as in section 2 of the H & DS Act; ``Disability Support Services'' include (a) services which provide information on Disability Support Services to people with disabilities and/or their caregivers in a suitable form; and (b) needs assessment services; and (c) service co-ordination services; and (d) personal care services including assistance with daily activities such as dressing, personal hygiene, assistance with eating, supervising medication, seating, positioning and toileting; and (e) household management services for people with disabilities including assistance with domestic functions such as meal preparation, cooking, cleaning, laundering and shopping; and (f) caregiver support services that provide relief to primary informal care givers; and (g) residential care services that provide short and long term care; and (h) rehabilitation and habilitation services; and (i) environmental support services which supply people with disabilities with (i) equipment and aids to meet a range of needs including mobility, household management, communication, personal care needs; and (ii) consumables related to continence, personal care and mobility. ``Eligibility'' means the right to be considered for receipt of publicly funded services, but does not equate to an entitlement to receive those services; ``Eligibility criteria'' means the criteria set out in section 5 of this direction, any of which, as a minimum, must be satisfied before any person may receive any publicly funded service purchased by the THA; ``Funding agreement'' means an agreement within the meaning of section 21 of the H & DS Act entered into by the THA; ``H & DS Act'' means the Health and Disability Services Act 1993; ``Health care facility'' means a hospital, or other facility for the provision of services operated by a hospital (whether or not located in that hospital); ``Minister'' means the Minister of Health; ``New Zealand citizen'' means a person who has New Zealand citizenship under the Citizenship Act 1977 or the Citizenship (Western Samoa) Act 1982; ``Ordinarily resident in New Zealand'' means an individual who is lawfully present in New Zealand at the time of seeking services and who (a) Is a New Zealand citizen who, immediately prior to seeking services, has remained in New Zealand for a period equal to or exceeding 2 years, whether or not that person has been temporarily absent from New Zealand; or (b) Is a New Zealand citizen who (i) has his or her usual place of abode in New Zealand; and (ii) can demonstrate a reasonably based intention to remain in New Zealand for a period that, together with the time that person has already been in New Zealand, equals or exceeds 2 years; or (c) Holds a permit issued under the Immigration Act 1987 (including a residence permit) entitling that person to remain in New Zealand for 2 years or more, or (d) Holds a student permit issued under section 26 of the Immigration Act 1987 entitling that person to remain in New Zealand for a period of not less than 12 months, where that individual can demonstrate a reasonable expectation of having a further student permit issued for a period that (together with the duration of the first permit), allows that person to remain in New Zealand continuously for 2 years or more; or (e) Holds a permit (including, without limitation, a work permit) issued under the Immigration Act 1987 entitling that person to remain in New Zealand for a specified period which, together with any period of time that person has already been lawfully in New Zealand immediately prior to obtaining the permit, equals or exceeds 2 years; or (f) Is a citizen of Australia who is exempt from holding a permit to remain in New Zealand through regulations issued pursuant to section 12 (1) of the Immigration Act 1987 who (i) has his or her usual place of abode in New Zealand; and (ii) can demonstrate a reasonably based intention to remain in New Zealand for a period that, together with the time that person has already been in New Zealand, equals or exceeds 2 years; or (g) Is an individual under the age of 2 years who was born in New Zealand and has remained in New Zealand since birth, whether or not that person has been temporarily absent from New Zealand; ``Outpatient services'' means personal health services (including treatment, therapy, advice, diagnostic or investigatory procedures or pre-admission assessment) provided in a health care facility to a person who is not admitted to that facility at the time of receiving those services ``Partner'' means (a) where the parties are legally married, either the husband or the wife, as the case requires; (b) where the parties (whether of the same or opposite gender) are not legally married but are living together in a relationship in the nature of marriage, either of the parties, as the case requires; ``Personal health services'' has the same meaning as in section 2 of the H & DS Act; ``Prison'' includes a Gazetted police jail, or corrective training institution; ``Publicly funded services'' means personal health and disability services purchased by the THA using funds provided by the Crown under a funding agreement, and does not include services purchased by the THA using funds provided by any person or agency other than the Crown, whether or not the purchasing of those services results in a part charge to the person receiving the services; ``Services'' means personal health services or disability services or both; ``THA'' means the Transitional Health Authority established by Order in Council under section 32 of the H & DS Act; (2) Words importing the singular include the plural and vice versa. 3. Disputes and payments If any question or dispute arises as to whether or not (1) Any person satisfies any of the eligibility criteria for receipt of a service; or (2) Any other criteria or any terms or conditions, set out in a funding agreement, for receipt of a service, are satisfied; that question or dispute shall be determined by the Minister. 4. Amendment, revocation and term of direction (1) The Minister may from time to time, by notice under section 25 of the H & DS Act, amend or revoke this direction. (2) The Health and Disability Services Eligibility Direction 1994 is hereby revoked. (3) This direction (together with any amendments to it made under clause (1) of this section), shall remain in force until it is revoked by the Minister. 5. Eligibility Criteria A person shall be eligible for publicly funded services if he or she is in New Zealand at the time of seeking services and (1) Is ordinarily resident in New Zealand; or (2) Is a New Zealand citizen who is temporarily resident in New Zealand and who has at some time had his or her usual place of abode in New Zealand for a period equal to or exceeding 2 years whether or not that person has been temporarily absent from New Zealand during that period; or (3) Is a citizen of New Zealand whose usual place of abode is in the Cook Islands, Niue, or Tokelau, who for the time being is temporarily resident in New Zealand; or (4) Has refugee status in New Zealand or is in the process of applying for such status; or (5) Is a student receiving funding under the Ministry of Foreign Affairs and Trade Official Development Assistance Programme, or is the partner, or child under the age of 18 years of such student; or (6) Is a participant in the Ministry of Education's Foreign Language Teaching Assistantship Scheme; or (7) Is a community services cardholder; or (8) Is (a) a person having their usual place of abode (other than unlawfully) in a country or territory from time to time specified by the Minister by notice in the Gazette, being a country or territory where in the opinion of the Minister individuals who are citizens of New Zealand or ordinarily resident in New Zealand are or will be, while in that country or territory, eligible for services that substantially correspond to services that the THA is obliged by its funding agreement to purchase in respect of those individuals; and (b) not of a class of persons specified by the Minister in that notice as being individuals who may not receive services purchased by the THA; or (9) Is a resident of Australia who is in New Zealand on a temporary basis (in respect of services required to be provided for that individual while in New Zealand by the agreement set out in the Schedule to the Health Benefits (Reciprocity with Australia) Act 1986); or (10) Is recognised by the Government of the United Kingdom as a national, and has his or her usual place of abode in the United Kingdom, and is in New Zealand on a temporary basis, provided that the services are required to be provided for such national while in New Zealand by the agreement set out in the Schedule to the Health Benefits (Reciprocity with the United Kingdom) Act 1982); or (11) Is a child (who is not otherwise eligible) under the age of 16 years who is lawfully in New Zealand and is for the time being in the care and control of a person meeting any of the eligibility criteria specified in clauses 1, 2, or 3; or (12) Is an individual receiving compulsory services under the Tuberculosis Act 1948, the Health Act 1956, the Alcoholism and Drug Addiction Act 1966, the Mental Health (Compulsory Assessment and Treatment) Act 1992, or any regulations made under such legislation, in respect only of services under those enactments, provided that any such individual may be considered for eligibility for those services only in terms of this clause 12; or (13) Is a prison inmate, including an individual on remand in prison custody, in respect only of services not available through the prison health services, provided that any such individual may be considered for eligibility for those services only in terms of this clause 13; or (14) (a) Is an individual who, in respect only of eligibility for acute or arranged services required by that person for a personal injury for which that person has cover under the ARCI Act (i) Is ``ordinarily resident in New Zealand'' within the meaning of the Accident Rehabilitation and Compensation Insurance (Ordinary Residence Definition) Regulations 1992, and has any type of personal injury; or (ii) Is not ``ordinarily resident in New Zealand'' in terms of clause 14 (a) (i), and the personal injury is a work injury or motor vehicle injury within the meaning of the ARCI Act; or (iii) Is not ``ordinarily resident in New Zealand'' in terms of clause 14 (a) (i), and is an earner (within the meaning of the ARCI Act), and has any type of personal injury; (b) In respect only of eligibility for disability support services, is an individual who requires those services for a personal injury for which the person has cover under the ARCI Act, but no entitlement to those services pursuant to regulations made, or a contract entered into, under that Act, and who (were it not for the proviso (c) to this clause 14) would satisfy any of the criteria in clauses 111 of this section in respect of such services; (c) Provided that any individual within subclause (a) or (b) above may be considered for eligibility for publicly funded services, the need for which arises directly from that injury, only in terms of this clause 14. 6. General (1) Eligibility according to the eligibility criteria is to be assessed at the time the service is sought. (2) A person may, unless otherwise stated, be eligible under one or more of the eligibility criteria. (3) No payment shall be made by the THA in respect of the receipt of a service by an eligible person who was not within New Zealand at the time of that receipt, unless such payment is authorised in a funding agreement. Dated at Wellington this 1st day of July 1997. Hon. BILL ENGLISH, Minister of Health.
Publication Date
24 Jul 1997

Notice Number

1997-go5079

Page Number

1850