The Health Service Executive says it needs over €250 million in funding to rehouse thousands of people with disabilities in smaller units and meet standards set by the health watchdog.
The HSE has sent the Department of Health a costed submission setting out the work already done on moving people with disabilities from so-called "congregated settings" to a community-based model of care.
The document also outlines the significant challenges still faced in meeting the standards laid down by the Health Information and Quality Authority, whose inspectors have repeatedly criticised quality standards in the sector.
The HSE wants to accelerate implementation of the 2011 congregated setting report which recommended thousands of people with disabilities be moved from large institutional units to smaller scale care in the community.
The plan comprises four strands, starting with a priority 11 projects where 237 people with disabilities live in large institutional, congregated settings and which have the most significant compliance issues with Hiqa. This involves capital and once-off costs of €22.4 million.
The first three stands, covering 992 residents, require funding of €89.4 million in capital costs and once-off costs, and the HSE hopes to start the first two strands this year.
The fourth strand covers a total of 1,863 residents currently living in 55 settings. The re-accommodation costs here are estimated at about €163 million but this figure has yet to be validated.
The HSE has also told the Department its social care/disability division will incur a €15 million deficit this year as a result of significant service pressures caused by the non-compliance of many centres identified by Hiqa inspectors. It says the corrective actions which caused the overspend were necessary to mitigate the risks identified in Hiqa inspection reports and to assure quality and safe services for residents.
Hiqa, which began inspecting residential homes for the disabled in 2013, has threatened up to 20 centres with closure over persistent non-compliance with standards.
The HSE is also seeking funding of about €250 million to upgrade accommodation at State-run nursing homes so they can meet new standards overseen by Hiqa.
