File #2446: "2018_Book_Long-TermCareInEurope.pdf"

2018_Book_Long-TermCareInEurope.pdf

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1|Preface|5
1|Contents|7
1|Contributors|9
1|Long Term Care in Europe: An Introduction|10
2|1 Introduction|10
2|2 Specificities of LTC Benefits|12
3|2.1 Care, Cure and Disabilities|12
3|2.2 LTC Dependency as a New Social Risk?|14
2|3 Organisation of LTC Benefits|15
3|3.1 Concept of Social Protection|15
3|3.2 Systematisation of Social Protection Systems|17
3|3.3 Mixed Systems and the Need for Coordination|19
2|4 Provision of LTC|20
3|4.1 Professional Care and the `Social Delivery Triangle´|20
3|4.2 Non-professional Care|23
3|4.3 Mixed Provision and the Need for Coordination|24
2|5 On the Outline of the Project|24
2|References|26
1|Benefit Structures for Persons Dependent on Long-Term Care in Austria|28
2|1 Synopsis|29
2|2 Specific Benefit Systems for Persons Dependent on Long-Term Care in Austria|33
3|2.1 Long-Term Care Allowance|34
4|2.1.1 General Eligibility Requirements|34
4|2.1.2 The Definition of Long-Term Care Dependency|35
4|2.1.3 Seven Levels of Care Allowance|38
4|2.1.4 Special Provisions|40
4|2.1.5 Procedure and Granting of Benefits|41
4|2.1.6 Competent Funding Entities|42
3|2.2 Benefits in Kind|43
4|2.2.1 Overview|43
4|2.2.2 Structural Commonalities|45
3|2.3 Other Services and Arrangements|48
4|2.3.1 General Issues|48
4|2.3.2 Protection of Caregivers Under Social Security Law|48
4|2.3.3 24-Hour Care|51
2|3 Fundamental Aspects Regarding an Appraisal|54
3|3.1 An Independent Social Risk Covered by Benefits and Services of a Universal Nature|55
3|3.2 Cash Benefits and Benefits in Kind Coming from Different Sources|56
3|3.3 Still More Dissociation than Coordination|57
3|3.4 Framework Conditions for Professional Long-Term Care|58
3|3.5 Framework Conditions for Informal Long-Term Care|60
3|3.6 More Self-Determination for Persons in Need of Long-Term Care|61
2|4 Attempts of an Appraisal after almost 25 Years|62
2|References|63
1|The Czech Republic: No Promised Land for Carers and Persons Dependent on Long-Term Care|65
2|1 Overview|66
2|2 Specific Systems (Benefits Systems)|69
3|2.1 Long-Term Care Allowance: A Basic Benefit Paving the Way to Autonomy|69
4|2.1.1 Level of Dependence on Assistance from Another Person and Determination Thereof|70
4|2.1.2 Decisions Concerning the Granting of Care Allowance|71
4|2.1.3 Brief Assessment of Care Allowance|73
3|2.2 Social Care Services as a Means of Assistance to Facilitate Autonomous Living|74
3|2.3 Health Care Services Provided to Persons Dependent on Long-Term Care in Their Own Social Environment|75
3|2.4 Services for Persons with Disability|76
4|2.4.1 Mobility Allowance|77
4|2.4.2 Allowance for a Specific Therapeutic Appliance|78
4|2.4.3 Granting of Benefits or Services|78
3|2.5 Legal Status and Protection of Caregivers|79
4|2.5.1 Privileges for Caregivers According to Labour Law and Labour Policy|79
5|2.5.1.1 Business Trips|80
5|2.5.1.2 Job Transfers|81
5|2.5.1.3 Reduction of Working Hours|81
5|2.5.1.4 Unemployment Benefits|83
4|2.5.2 Support Measures with Regard to Pension Insurance|83
2|3 Conditions Relating to Health Service Delivery|86
3|3.1 Contract on the Provision of Social Services|87
3|3.2 Registration of Social Service Providers and Inspection of Social Service Provision: Increased Protection for Persons Depe...|88
3|3.3 Quality Assurance Regarding Services Provided to Persons in Need of Long-Term Care|90
3|3.4 Financing Social Services|91
3|3.5 The Status of Social Workers and Employees in the Field of Social Service Provision|94
2|4 Concluding Remarks|97
2|References|99
1|Long-Term Care Benefits under the French Social Protection System|101
2|1 Overview|102
2|2 On the Concept of ``Long-Term Care Dependency´´|103
3|2.1 Long-Term Care Dependency in the Current French System|103
3|2.2 Necessity to Differentiate from Other Cases|103
2|3 First Measures to Protect Against the Risk of Long-Term Care Dependency|104
3|3.1 General Background Information|104
3|3.2 Experimental Long-Term Care Provision: First Specific Protection Against the Risk of Long-Term Care Dependency|106
3|3.3 Specific Dependency Benefit: prestation spécifique dépendance|107
2|4 Current Long-Term Care Provision: Personalised Autonomy Benefit (allocation personnalisée d´autonomie-APA)|108
3|4.1 Overview and General Remarks|108
3|4.2 Eligibility for Benefits|109
4|4.2.1 General Requirements|110
4|4.2.2 Long-Term Care Dependency: Determination of the Degree of Long-Term Care Dependency on the Basis of the AGGIR Evaluation...|110
3|4.3 Provision of Long-Term Care Services|111
4|4.3.1 APA Benefit/Service Provision in the Person´s Home|111
4|4.3.2 APA Benefit in the Event of Accommodation in a Care Facility|113
2|5 Other Forms of Long-Term Care Assistance|114
3|5.1 ``Action sociale´´|114
3|5.2 Social Assistance|115
3|5.3 Residential Homes for Elderly Persons Dependent on Long-Term Care|116
3|5.4 Domestic Help for Persons Depending on Long-Term Care|116
4|5.4.1 Long-Term Care and Medical Services|116
4|5.4.2 Domestic Care Services (service de soins à domicile, SSAD)|117
4|5.4.3 General Issues|118
4|5.4.4 Domestic Nursing|118
3|5.5 Other Open Help Services|119
3|5.6 Semi-Inpatient Assistance|120
2|6 Organisation and Financing|120
3|6.1 Organisation|120
3|6.2 Financing of the APA Benefit/Service|121
3|6.3 Remuneration of Benefits and Services|121
4|6.3.1 Accommodation Costs|121
4|6.3.2 Long-Term Care Costs|122
4|6.3.3 Costs for Medical Services|123
2|7 Statistical Data (Tables 2, 3, 4 and 5)|123
2|8 Monitoring of Benefits and Services|124
2|9 Long-Term Care Insurance as an Independent Insurance Branch?|125
3|9.1 Stages Leading to an Independent Social Security Branch and the Main Obstacles Regarding the Establishment of an Independe...|125
3|9.2 Protection Against the Risk of Long-Term Care Dependency Via Private Insurance?|125
3|9.3 A Law for Maintaining One´s Personal Autonomy?|126
2|References|127
1|Long-Term Care in Germany|128
2|1 Overview|129
2|2 Long-Term Care and SGB XI|134
3|2.1 General Principles|134
4|2.1.1 Social Insurance|134
4|2.1.2 Competences|135
4|2.1.3 Objective of Long-Term Care Insurance|135
4|2.1.4 Gender and Cultural Aspects|136
4|2.1.5 Self-Determination|136
4|2.1.6 Primacy of Care at Home|136
4|2.1.7 Type and Extent of Benefits|137
4|2.1.8 Prevention|137
4|2.1.9 Self-Responsibility|137
4|2.1.10 Information and Advice|138
5|2.1.10.1 General Obligations|138
5|2.1.10.2 Provision of Advice on Long-Term Care (Pflegeberatung)|138
5|2.1.10.3 Vouchers for Advice Services (Beratungsgutscheine)|140
4|2.1.11 Obligations of Stakeholders|140
5|2.1.11.1 Long-Term Care As a Duty of Society As a Whole|140
5|2.1.11.2 Tasks of the German Federal States (Länder)|141
5|2.1.11.3 Obligation to Report|141
5|2.1.11.4 Rights and Obligations of the Institutions Providing Long-Term Care (Pflegeeinrichtungen)|141
5|2.1.11.5 Duties of the Long-Term Care Insurer (Pflegekassen)|142
5|2.1.11.6 Connection Between Long-Term Care Benefits and Other Social Security Benefits|142
3|2.2 Personal Scope of Application|142
4|2.2.1 Public System|142
4|2.2.2 Mandatory Private Insurance|143
3|2.3 Formal Requirements for Benefits|144
4|2.3.1 Application|144
4|2.3.2 Waiting Period|144
4|2.3.3 Time Limits|145
4|2.3.4 Exclusion from Benefits|145
4|2.3.5 No Benefits Abroad|145
4|2.3.6 Benefits in Kind|146
4|2.3.7 Expiry of Entitlement to Benefits|146
3|2.4 Concept of Long-Term Care Dependency (Begriff der Pflegebedürftigkeit)|146
4|2.4.1 Former Concept (Until End of 2016)|147
4|2.4.2 New Concept (As from 1 January 2017)|148
3|2.5 Levels of Long-Term Care Dependency (Stufen der Pflegebedürftigkeit)|149
4|2.5.1 Former Classification (Until End of 2016)|149
4|2.5.2 New Classification (As from 1 January 2017)|150
3|2.6 Assessment Procedure|151
4|2.6.1 Public System|151
4|2.6.2 Mandatory Private System|152
3|2.7 Benefits|153
4|2.7.1 Overview|153
4|2.7.2 General Principles|153
4|2.7.3 Benefits for Care at Home|153
5|2.7.3.1 Benefits in Kind|153
5|2.7.3.2 Cash Benefits|154
5|2.7.3.3 Combination of Cash Benefits and Benefits in Kind|155
5|2.7.3.4 Additional Benefits for Persons Living in Supervised Groups (Ambulant betreute Wohngruppen)|155
5|2.7.3.5 Care at Home in Cases Where a Carer Is Not Available|155
5|2.7.3.6 Auxiliary Means for Care (Pflegehilfsmittel) and Measures to Improve the Domestic Environment (wohnumfeldverbessernde ...|156
4|2.7.4 Semi-Inpatient Care (Teilstationäre Pflege) and Short-Term Care (Kurzzeitpflege)|156
5|2.7.4.1 Day Care and Night Care|156
5|2.7.4.2 Short-Term Care (Kurzzeitpflege)|156
4|2.7.5 Full Inpatient Care (Vollstationäre Pflege)|156
5|2.7.5.1 Benefits in General|156
5|2.7.5.2 Benefits for Persons Living in Special Facilities for the Disabled|157
4|2.7.6 Benefits for Family Carers|157
5|2.7.6.1 Contributions to the Social Security System|157
5|2.7.6.2 Additional Benefits for Care Leave and Short-Term Impediment to Work|158
5|2.7.6.3 Care Training Courses for Next-of-Kin and Volunteers|158
4|2.7.7 Benefits for Insurees with a Substantial General Need for Care|158
5|2.7.7.1 Beneficiaries|158
5|2.7.7.2 Additional Benefits for Care and Relief Care|158
5|2.7.7.3 Development of Care Structures|159
5|2.7.7.4 Promotion of Volunteer Structures and Self-Help|159
3|2.8 Promotion of New Forms of Living Together|159
3|2.9 Financing|159
3|2.10 Relationship Between Long-Term Care Insurers and Benefit Providers|160
4|2.10.1 General Principles|160
4|2.10.2 Relationship to Care Facilities|160
4|2.10.3 Relationship to Other Benefit Providers|162
3|2.11 Payment for Care|163
4|2.11.1 General Rules|163
4|2.11.2 Payment for Inpatient Care|164
4|2.11.3 Payment for Outpatient Care|164
3|2.12 Integrated Care (Integrierte Versorgung)|165
3|2.13 Care Support Centres (Pflegestützpunkte)|165
3|2.14 Quality Assessment|165
3|2.15 State Subsidies for Private Long-Term Care Provision|166
3|2.16 Long-Term Care Provision Fund|166
2|3 Long-Term Care As a Social Assistance Benefit (Hilfe zur Pflege)|166
2|4 Long-Term Care Benefits Under Other Systems|169
3|4.1 Federal Relief Act (Bundesversorgungsgesetz, BVG)|169
3|4.2 Workers´ Compensation Act (Arbeitsunfallversicherung)|171
2|5 Rights of Family Carers|171
3|5.1 Labour Law|172
3|5.2 Social Security|175
4|5.2.1 Pension Insurance|175
4|5.2.2 Health Insurance and Long-Term Care Insurance|176
4|5.2.3 Work Accident Insurance|177
4|5.2.4 Unemployment Insurance|177
3|5.3 Civil Law (Inheritance Law)|178
2|6 Conclusion|179
2|References|180
1|Long Term Care in Hungary|183
2|1 Overview|184
3|1.1 Hungary in the Light of Some Statistical Data|185
3|1.2 The General Situation of Long-Term Care in Hungary|185
3|1.3 What Makes Care a Risk?|186
2|2 Specific Systems|197
3|2.1 Hungarian Definition of Long-Term Care|197
4|2.1.1 Concept of Care|197
4|2.1.2 Concept of ``Long-Term´´|198
3|2.2 System of Benefits|199
2|3 Details of the Provision of Benefits|200
3|3.1 General Benefits for Various Groups|200
4|3.1.1 Domestic Care and Domestic Care Due to Signal (Hzi segítségnyújts és Jelzorendszeres hzi segítségnyújts)|200
4|3.1.2 Day Care (Nappali ellts)|201
4|3.1.3 Family Services (Csaldsegítés)|202
4|3.1.4 Home Medical Care (Otthoni szakpols)|202
4|3.1.5 Household Maintenance Subsidy (Laksfenntartsi tmogats)|203
4|3.1.6 Public Health Care Aid (Közgyógyellts)|203
4|3.1.7 Provision of Meals (Étkeztetés)|204
4|3.1.8 Regular Social Assistance (Rendszeres szocilis segély)|205
4|3.1.9 Sickness Benefit (Tppénz)|206
3|3.2 Social Support Service (Tmogató szolgltats)|206
4|3.2.1 Temporary Social Assistance (Átmeneti segély)|206
4|3.2.2 Temporary Widow(er)´s Pension (Ideiglenes özvegyi nyugdíj)|207
4|3.2.3 Village Caretaker and Farm Caretaker Service (Falugondnoki és tanyagondnoki szolgltats)|208
3|3.3 Specific Benefits for Child Care and Families|210
4|3.3.1 Birth Grant (Anyasgi tmogats)|210
4|3.3.2 Breast Milk Supply (Anyatejellts)|210
4|3.3.3 Childcare Grant (Gyermekgondozsi díj)|211
4|3.3.4 Child Home Care Allowance (Gyermekgondozsi segély)|211
4|3.3.5 Child-Raising Support (Gyermeknevelési tmogats)|212
4|3.3.6 Family Allowance (Csaldi pótlék)|212
4|3.3.7 Midwife and Health Visitor Service (Védonoi szolglat)|213
4|3.3.8 Nursing Grant (Ápolsi díj)|214
4|3.3.9 Orphan´s Allowance (Árvaellts)|215
4|3.3.10 Pregnancy-Confinement Benefit (Terhességi-gyermekgyi segély)|216
3|3.4 Disabled Persons|217
4|3.4.1 Financial Support for Severely Disabled Persons (Fogyatékossgi tmogats)|217
4|3.4.2 Care Homes for Persons with Disabilities (Fogyatékos személyek gondozóhza)|218
4|3.4.3 Disability Benefit (rokkantsgi ellts)|218
4|3.4.4 Homes for Persons with Disabilities (Fogyatékos személyek Otthona)|219
4|3.4.5 Rehabilitation Benefit (rehabilitciós ellts)|220
4|3.4.6 Rehabilitation Institutes for Persons with Disabilities (Rehabilitciós intézmény fogyatékkal élo személyek szmra)|221
3|3.5 Elderly Persons|221
4|3.5.1 Care Homes for the Elderly (Idoskorúak gondozóhza)|221
4|3.5.2 Homes for the Elderly (Idosek Otthona)|222
4|3.5.3 Hospice Service at Home (Otthoni Hospice)|223
2|4 Other Aspects|224
3|4.1 Modern Ideas of Management (e.g. Budget)|224
3|4.2 Integration Within the LTC System|224
3|4.3 Demand and Supply|225
3|4.4 Policy Goals|225
3|4.5 Case Management|226
3|4.6 Personal Budget Concept|228
3|4.7 Targeting|228
4|4.7.1 Recent Situation|228
4|4.7.2 A New Experts´ Draft: ``The National Social-Political Concept for the Years 2011-2020|229
2|5 Summary|229
2|References|233
2|Fundamental Law of Hungary|233
1|Long-Term Care Benefits and Services in Italy|235
2|1 Overview|237
3|1.1 Systems Involved|240
4|1.1.1 Monetary Benefits|240
4|1.1.2 Inpatient and Outpatient Services|241
4|1.1.3 Public Support for Family Caregivers|242
4|1.1.4 Regional Legislation|242
3|1.2 Concepts and Definitions of Long-Term Care Dependency|243
4|1.2.1 Definitions at National Level|244
5|1.2.1.1 National Attendance Allowance|245
5|1.2.1.2 Social Insurance Schemes|245
5|1.2.1.3 Disability Law|246
5|1.2.1.4 Private Insurance Law|246
4|1.2.2 Definitions in Regional Legislation|246
3|1.3 Statistics|248
2|2 Monetary Benefits|250
3|2.1 National Attendance Allowance|250
4|2.1.1 Entitlement Criteria|250
4|2.1.2 Benefit Amount|252
4|2.1.3 Assessment of Long-Term Care Dependency|253
4|2.1.4 Organization and Financing|254
3|2.2 Pensions and Allowances for the Civilian Disabled and Invalids|254
4|2.2.1 Special Benefits for Adults with Reduced Earning Capacities|254
4|2.2.2 Special Benefits for Children and Adolescents with Disabilities|255
4|2.2.3 Benefits for Particular Forms of Disability|255
3|2.3 Allowances Under Privileged Social Protection Schemes|256
4|2.3.1 Statutory Work Accident Insurance|256
4|2.3.2 Statutory Pension Insurance|257
4|2.3.3 Indemnization Schemes for Victims of War and Other Victims|257
3|2.4 Fiscal Benefits|258
3|2.5 Monetary Benefits Under Regional Legislation|259
4|2.5.1 Entitlement Criteria and Benefit Amounts|259
4|2.5.2 Organization and Financing|262
2|3 General Legal Framework of Long-Term Care and Social Services|263
3|3.1 Legislative Powers of the State and the Regions|263
3|3.2 Definition of Core Levels of Benefits (livelli essenziali)|263
4|3.2.1 Healthcare|264
4|3.2.2 Social Services|266
3|3.3 Administration of Healthcare and Social Services at National, Regional and Local Level|268
4|3.3.1 Healthcare Services|269
4|3.3.2 Social Services|270
4|3.3.3 Integrated Social Healthcare Services|271
3|3.4 Planning of Long-Term Care Services at the National and Regional Level|272
3|3.5 Participation of Private Subjects in the Provision of Healthcare Services|273
4|3.5.1 Authorization|274
4|3.5.2 Accreditation|274
4|3.5.3 Contractual Agreements|275
3|3.6 Participation of Private Subjects in the Provision of Social Services|275
4|3.6.1 Authorization and Accreditation|276
4|3.6.2 Contractual Arrangements for the Purchasing of Social Services|277
3|3.7 Financing of Long-Term Healthcare and Social Services|278
2|4 Formal Home Care Services|280
3|4.1 Typology of Services|280
3|4.2 Access to Home Care Services|282
4|4.2.1 Integrated Home Healthcare Services (ADI)|282
5|4.2.1.1 Request of Intervention|283
5|4.2.1.2 Assessment of Care Needs|284
5|4.2.1.3 Definition of an Individual Medical and Social Care Plan|285
4|4.2.2 Domestic Aid and Personal Care Services (SAD)|285
3|4.3 Availability and Intensity of Home Care Services|286
4|4.3.1 Providers of Home Care Services|286
5|4.3.1.1 ADI Services|286
5|4.3.1.2 SAD Services|287
4|4.3.2 Integration of ADI and SAD Services|287
3|4.4 Planning and Organization|288
4|4.4.1 General Criteria|288
4|4.4.2 Case Manager|289
4|4.4.3 Voucher Models|289
3|4.5 Principles of Service Provision|290
3|4.6 Financing and Cost Participation of Beneficiaries|291
2|5 Semi-Residential Care Facilities: Day Care Centres and Services|292
3|5.1 Types and Objectives|292
3|5.2 Access and Availability|293
3|5.3 Financing and Cost Participation|294
2|6 Nursing Homes and Residential Care|294
3|6.1 Typology and Objectives|295
3|6.2 Access to Residential Care and Availability|297
3|6.3 Residential Care in RSA Homes|298
4|6.3.1 Features of RSA Services|298
4|6.3.2 Quality Standards and Quality Assessment|299
3|6.4 Planning and Organization|300
3|6.5 Financing and Cost Participation|301
4|6.5.1 Cost Sharing at the Institutional Level|301
4|6.5.2 Private Co-payment Obligations|302
2|7 Family Care and Support for Informal Care|303
3|7.1 Care Leave to Assist Severely Handicapped People|304
4|7.1.1 Care Leave to Provide Care for Adult Family Members|304
4|7.1.2 Extension of Parental Leave|305
4|7.1.3 Special Protection Under Labour Law|306
3|7.2 Social Services to Support Informal and Migrant Care|306
2|8 Conclusions and Future Prospects|307
2|References|309
1|Long-Term Care in the Netherlands|314
2|1 Introduction|315
3|1.1 Long-Term Care in the Netherlands: An Overview|315
3|1.2 The Concept of Long-Term Care from the International Perspective|317
3|1.3 Structure of the Chapter|318
2|2 Reforms of the Care System|318
3|2.1 The Introduction of Regulated Competition|318
3|2.2 Ongoing Reforms|319
2|3 Public Insurance for Long-Term Care|321
3|3.1 Development of the Long-Term Care Insurance|321
3|3.2 Personal Coverage|323
3|3.3 Entitlement to Care|323
3|3.4 Care Provided Under the Awbz and the Wlz|324
4|3.4.1 Different Kinds of Care|324
4|3.4.2 Personal Care|324
4|3.4.3 Nursing|325
4|3.4.4 Support|325
4|3.4.5 Treatment|326
4|3.4.6 Residence|326
4|3.4.7 Other Services|326
3|3.5 Indication of the Kind and Amount of Care|327
3|3.6 Wlz Care in Kind in an Institution, in Kind at Home, or as a Personal Budget|328
3|3.7 Personal Budget|329
3|3.8 Financing and Administration|330
4|3.8.1 Financing|330
4|3.8.2 Administration and Management|331
2|4 The Social Support Act 2015 (Wmo 2015)|332
3|4.1 Development of the Wmo 2015|332
3|4.2 Personal Coverage|334
3|4.3 Entitlement to Wmo 2015 Care|334
3|4.4 Services Provided Under the Wmo 2015|336
4|4.4.1 Policy Requirements|336
4|4.4.2 Tailor-Made Provisions: A Shift from Individual Entitlements to Municipal Policy Objectives|337
5|4.4.2.1 Provisions to Independently Keep a Household|337
5|4.4.2.2 Provisions to Move in and Around the Home|338
5|4.4.2.3 Provisions to Move Within the Municipality|338
5|4.4.2.4 Day Care and Day Activities|339
5|4.4.2.5 Provisions to Meet Other People and Enter into Social Associations|339
4|4.4.3 Indication of the Kind and Amount of Support Regarding Tailor-Made Provisions|339
4|4.4.4 General Provisions|340
3|4.5 Personal Budget|341
3|4.6 Informal Care and Volunteer Care|342
3|4.7 Financing and Administration|343
2|5 The Health Insurance Act (Zvw)|344
3|5.1 Development of the Zvw|344
3|5.2 Entitlement to Care|345
3|5.3 Services Relating to Long-Term Care|346
3|5.4 Financing and Administration|346
2|6 Care Providers: Eligibility and Quality Standards|348
3|6.1 Eligibility|348
3|6.2 Quality Standards|349
2|7 Supervision|351
3|7.1 Many Different Actors and Regulations|351
3|7.2 The Health Care Inspectorate|352
3|7.3 The Dutch Health Care Authority|353
2|8 Concluding Remarks|354
2|References|355
1|Long-Term Care Benefits and Services in Norway|358
2|1 Overview|359
3|1.1 Municipal Health and Long-Term Care Services|359
3|1.2 Monetary Benefits from Social Insurance|361
2|2 Individual Services and Benefits|361
3|2.1 Benefits and Services in Municipal Health and Long-Term Care|361
4|2.1.1 Service Targets|362
4|2.1.2 Authorised Persons|362
4|2.1.3 Common Types of Assistance Offered|363
3|2.2 Municipal Care Wage|364
3|2.3 Benefits from Social Insurance|364
4|2.3.1 Grunnstønad|365
4|2.3.2 Hjelpestønad|366
4|2.3.3 Forhøyet Hjelpestønad|366
4|2.3.4 Omsorgs- and Pleiepenger|367
3|2.4 Basic Principles Concerning Service Provision|368
2|3 Conditions Relating to Health Service Delivery|369
3|3.1 Procedures of Application and Approval|369
3|3.2 Professional and Non-professional Service Providers|370
4|3.2.1 Family Carers|371
4|3.2.2 Benefits for Caregivers|371
5|3.2.2.1 Avlastningstiltak|372
5|3.2.2.2 Støttekontakt|372
5|3.2.2.3 Financial Support|373
4|3.2.3 Non-profit and Private Long-Term Care Providers|373
5|3.2.3.1 Freedom of Choice|373
5|3.2.3.2 Approval and Supervision|374
3|3.3 The Personal Budget as a Special Form of Management|375
3|3.4 Financing|376
4|3.4.1 Municipal Tax Revenues|377
4|3.4.2 State Subsidies|377
4|3.4.3 Co-payments by Beneficiaries|378
4|3.4.4 Expenses of the Communities|379
3|3.5 Quality Assurance|380
4|3.5.1 Quality Requirements|380
4|3.5.2 Documentation Requirements|381
4|3.5.3 National Supervision|382
2|References|383
1|The Legal Position of Persons Dependent on Long-Term Care in the Republic of Poland|385
2|1 Introduction|386
2|2 Health Care Services Provided by the Health Insurance|391
2|3 Social Assistance|396
3|3.1 Benefits in Kind|397
4|3.1.1 General and Professionally Provided Long-Term Care Services|397
4|3.1.2 24-Hour Care Services in Family Assistance Living Groups|398
4|3.1.3 Daytime Services in Support Centres|398
4|3.1.4 Long-Term Care Homes|399
4|3.1.5 Commercial Service Provision in Care Facilities|401
3|3.2 Cash Benefits|401
4|3.2.1 Benefits Granted for an Unlimited Period of Time|401
4|3.2.2 Benefits Granted for a Limited Period of Time|402
4|3.2.3 Targeted Benefits|402
4|3.2.4 Payment of Social Security Contributions|402
4|3.2.5 Long-Term Care Allowance|403
4|3.2.6 Long-Term Care Benefit|404
4|3.2.7 Social Pension|404
2|4 Social Security Benefits|405
2|5 Review|408
2|6 Project|411
2|7 Summary|415
2|References|416
1|Legal Aspects of Long-Term Care in Slovenia|418
2|1 Introductory Remarks|419
3|1.1 Historical Arguments|419
3|1.2 Aging of the Population|420
3|1.3 Proposals for the New Long-Term Care Insurance Scheme|422
3|1.4 Long-Term Care as a New Social Risk|423
3|1.5 Structure of the Present Paper|424
2|2 Overview of Long-Term Care Benefits|424
3|2.1 Current Legal Situation|424
4|2.1.1 Long-Term Cash Benefits|424
4|2.1.2 Long-Term Benefits in Kind|428
5|2.1.2.1 Non-acute Medical Care|428
5|2.1.2.2 Social Services|429
5|2.1.2.3 Domestic Care|430
6|2.1.2.3.1 Home Care (pomoč na domu)|430
6|2.1.2.3.2 Social Servicing (socialni servis)|431
5|2.1.2.4 Residential Care|432
6|2.1.2.4.1 Semi-Residential Care|432
6|2.1.2.4.2 Residential Care|432
3|2.2 Legislative Proposals|434
2|3 Defining Long-Term Care|435
3|3.1 Social Risk Definition|435
4|3.1.1 Defining the Concept|436
4|3.1.2 Characteristics of Reliance on Long-Term Care|437
5|3.1.2.1 Extended Period of Time|438
5|3.1.2.2 Reduced Autonomy in Performing Essential Activities of Daily Living|439
4|3.1.3 Long-term Cash Benefits|439
4|3.1.4 Long-term Cash Benefits in Kind|441
3|3.2 Proposed New Legislation|442
3|3.3 Delimitation from Other Social Risks|443
4|3.3.1 Delimitation from Occupational Disease or Injury|443
4|3.3.2 Delimitation from Sickness|445
4|3.3.3 Delimitation from Invalidity|447
4|3.3.4 Delimitation from Old Age|448
4|3.3.5 Delimitation from Having a Family|449
4|3.3.6 Delimitation from Assistance to Children in Schooling|449
2|4 Provision of Long-Term Care Benefits|451
3|4.1 Organisation and Financing of Long-Term Care|451
4|4.1.1 Organisation|451
4|4.1.2 Financing|453
3|4.2 Freedom of the Beneficiary to Choose the Most Suitable Long-Term Care Arrangement|454
3|4.3 Cooperation Between a Beneficiary and Long-Term Care Providers|456
3|4.4 Inclusion of Family Members and Quality Control Mechanisms|457
4|4.4.1 Priority of Professional or Informal Care?|457
4|4.4.2 Mechanisms to Improve the Quality of Care|459
4|4.4.3 Reliance on Long-Term Care: Double Social Risk?|460
2|5 Concluding Thoughts|461
2|References|461
1|Social Protection Against the Risk of Long-Term Care Dependency in Spain|464
2|1 Introduction|465
2|2 Social Protection Against the Risk of Long-Term Care Dependency Prior to the Adoption of Law No. 39/2006|467
2|3 Social Protection Against the Risk of Long-Term Care Dependency Pursuant to Law No. 39/2006|469
3|3.1 History of the Law|469
3|3.2 Aim of the Law|470
3|3.3 Definitions|470
3|3.4 Principles of Law|474
3|3.5 Rights and Obligations of Dependant Persons|474
3|3.6 Entitled Persons|474
3|3.7 Level of Protection and Organisation|476
3|3.8 Benefits and Services Granted According to the Degree of Long-Term Care Dependency|476
4|3.8.1 Benefits in Kind (Services)|476
4|3.8.2 Cash Benefits (Prestaciones económicas)|478
3|3.9 Assessing the Degree of Long-Term Care Dependency|481
3|3.10 Services and Benefits in Detail|483
4|3.10.1 Services Directed Towards Prevention and Personal Autonomy|483
4|3.10.2 Services Directed Towards Prevention|483
4|3.10.3 Services Directed Towards the Promotion of Personal Autonomy|484
4|3.10.4 Services Concerning Home Assistance|484
4|3.10.5 Services Concerning External Support|484
4|3.10.6 Day-Care/Night-Care Centres (centros de día/noche)|485
4|3.10.7 Residential Care (atención residencial)|485
4|3.10.8 Financial Support Granted for Service Provision|485
4|3.10.9 Financial Support for Personal Assistance|485
4|3.10.10 Financial Benefits Granted for Long-Term Care Provided in the Family Setting and for Supporting Non-professional Careg...|486
3|3.11 Applications and Resolutions|486
3|3.12 Non Professional Carers|486
3|3.13 Financing of Benefits and Services|491
2|4 Securing Long-Term Care in Times of Financial Crisis|491
2|References|493
1|Long-Term Care Benefits and Services in Sweden|497
2|1 Overview|498
3|1.1 Social Services Offered by the Communities|499
3|1.2 Supplementary Social Security Benefits|500
2|2 Individual Services and Benefits|501
3|2.1 Services for the Elderly|502
4|2.1.1 Benefits and Services Pursuant to the Social Services Act|503
5|2.1.1.1 Individual Needs Assessment|503
5|2.1.1.2 Catalogue of Services Commonly Offered|504
5|2.1.1.3 Evaluative Overall Analysis|505
4|2.1.2 Benefits and Services Pursuant to the Swedish Health Care Law|506
3|2.2 Benefits and Services for Persons with Disabilities|507
4|2.2.1 Special Support and Services|507
4|2.2.2 Subsidy for an Assistant|508
3|2.3 Disability Allowance|509
3|2.4 Benefits and Services for Children and Adolescents|510
4|2.4.1 Care Allowance, Care Benefit (Child-Care Subsidy)|511
4|2.4.2 Temporary Parental Allowance|512
4|2.4.3 Basic Principles Concerning Service Provision|513
2|3 Conditions Relating to Health Service Delivery|514
3|3.1 Procedures of Application and Approval|514
3|3.2 Professional and Non-professional Service Providers|515
4|3.2.1 Family Carers|516
4|3.2.2 Benefits for Caregivers|517
5|3.2.2.1 Services Offered by the Communities|517
5|3.2.2.2 Social Security Benefits|519
4|3.2.3 Non-profit and Private Long-Term Care Providers|520
5|3.2.3.1 Freedom of Choice|520
5|3.2.3.2 Approval and Supervision|521
3|3.3 Special Forms of Management|522
3|3.4 Financing|523
4|3.4.1 Municipal Income Tax|524
4|3.4.2 Structural Compensation and State Subsidies|524
4|3.4.3 Participation of Beneficiaries|525
4|3.4.4 Expenses of the Communities and Provinces|526
3|3.5 Quality Assurance|527
4|3.5.1 Quality Requirements|527
5|3.5.1.1 Legal Provisions|527
5|3.5.1.2 Concretisation Via Regulations and Instructions|528
4|3.5.2 Documentation Requirements|529
4|3.5.3 National Supervision|530
2|References|530
1|Social Security and Long-Term Care Dependency in Switzerland|533
2|1 Introduction|534
2|2 Foundations of the Swiss Long-Term Care Insurance System|536
3|2.1 Constitutional Foundations|536
3|2.2 Dual Financing System|537
2|3 Subsidies Granted to Long-Term Care Facilities|537
3|3.1 General|537
3|3.2 Facilities for Persons with Disabilities|538
3|3.3 Nursing Homes|539
2|4 Care Benefits|540
3|4.1 Historical Development|540
3|4.2 Helplessness Allowance|541
4|4.2.1 General|541
4|4.2.2 Helplessness|542
5|4.2.2.1 General|542
5|4.2.2.2 Assistance with Carrying Out Activities of Daily Living|542
5|4.2.2.3 Need for Surveillance|542
5|4.2.2.4 Long-Term Care Dependency|543
6|4.2.2.4.1 Permanent or Particularly Intensive Long-Term Care|543
6|4.2.2.4.2 Intensive Long-Term Care Dependency|544
5|4.2.2.5 Life Skills Assistance|545
3|4.3 Degrees of Helplessness|546
4|4.3.1 Long-Term Care Allowance|547
5|4.3.1.1 General|547
5|4.3.1.2 Accident Insurance|548
6|4.3.1.2.1 General|548
6|4.3.1.2.2 Acknowledged Forms of Long-Term Care|548
6|4.3.1.2.3 Acknowledged Long-Term Care Services|549
5|4.3.1.3 Invalidity Insurance|550
6|4.3.1.3.1 General|550
6|4.3.1.3.2 Acknowledged Forms of Long-Term Care|550
6|4.3.1.3.3 Acknowledged Long-Term Care Services|550
7|Medical Rehabilitation Measures|550
7|Insurance to Cover Congenital Defects|551
7|Intensive Long-Term Care Supplements for Minors|551
5|4.3.1.4 Health Insurance|551
6|4.3.1.4.1 General|551
6|4.3.1.4.2 Acknowledged Forms of Long-Term Care|551
7|Hospital Care|551
7|Nursing Home Care|552
7|Spitex Care|552
7|Caregivers Caring for Relatives|553
6|4.3.1.4.3 Acknowledged Long-Term Care Services|553
7|General|553
7|Diagnosis, Advice and Coordination|553
7|Care Treatment|554
7|Basic Care|554
3|4.4 Assistance Allowance|555
4|4.4.1 General|555
4|4.4.2 Eligibility Requirements|556
4|4.4.3 Acknowledged Forms of Assistance|556
4|4.4.4 Acknowleged Assistance Services|556
2|5 Medical Aids|558
3|5.1 Provision of Medical Aids|558
3|5.2 Allowances for Third Party Services|559
2|6 Additional Allowances|560
3|6.1 General|560
3|6.2 Annual Supplementary Benefits|560
4|6.2.1 Expenditures Eligible for Coverage|560
5|6.2.1.1 Home Care|560
5|6.2.1.2 Nursing Home Care|561
5|6.2.1.3 Allowable Revenues|562
3|6.3 Reimbursement of Costs Incurred Due to Illness and Disability|563
4|6.3.1 General|563
4|6.3.2 Recognised Costs Incurred Due to Illness and Disability|563
4|6.3.3 Maximum Amounts|564
2|7 Care Credits|566
3|7.1 General|566
3|7.2 Eligibility Requirements|566
4|7.2.1 Recognised Family Carers|566
4|7.2.2 (Moderately) Severe Helplessness|566
4|7.2.3 Being within Easy Reach|567
2|8 Further Securities|567
3|8.1 Tax Deductions|567
3|8.2 Cantonal Support of Family Caregiving|567
3|8.3 Social Assistance|568
2|9 Critical Appraisal and Potential Future Remedies|568
3|9.1 Critical Appraisal|568
3|9.2 Developing New Solutions|569
2|References|577
1|Comparison|581
2|1 Introduction|582
3|1.1 Problem|582
3|1.2 Long-Term Care Dependency As a ``Janus-Faced´´ Social Risk|583
2|2 Legal Bases|584
3|2.1 Social Protection Against the Risk of Long-Term Care Dependency As an Independent Legal Basis|584
4|2.1.1 Historical Development|584
4|2.1.2 Independent Legal Protection Within the Context of an Integral System|584
3|2.2 Social Security and Long-Term Care Dependency Within the Scope of Health Care Law|586
3|2.3 Social Security for Persons Dependent on Long-Term Care via Entitlement to Social Services|586
3|2.4 Social Security for Persons Dependent on Long-Term Care via Entitlement to Social Assistance|587
2|3 Collaboration Among Different Institutions|589
2|4 Competences|589
2|5 Financing|591
2|6 Role of the Private Sector|591
2|7 Safeguarding the Rights of Persons Involved|592
2|8 Freedom of Choice|595
2|9 Service Delivery Structures|596
3|9.1 Assuring the Necessary Infrastructure|596
3|9.2 Professional Versus Informal Care|597
3|9.3 Incentives for Non-Professional Carers|599
2|10 Long-Term Care Dependency and Assessment|600
2|11 Long-Term Care Dependency and Migration|601
2|References|604