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LONG - TERM CARE POLICIES AND REFORM IN SLOVENIA

LONG - TERM CARE POLICIES AND REFORM IN SLOVENIA. LJUBLJANA , November 2013. EUROPOP 2010 - Slovenia. Present System of Long-Term Care in Slovenia.

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LONG - TERM CARE POLICIES AND REFORM IN SLOVENIA

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  1. LONG - TERM CARE POLICIES AND REFORMIN SLOVENIA LJUBLJANA, November 2013

  2. EUROPOP 2010 - Slovenia

  3. Present System of Long-Term Carein Slovenia Slovenia does not have a uniformsystem of long-term care for elderly, chronically ill, disabled and other persons who need help in performing ADL and IADL.

  4. LTC is currently provided in different ways Services within the social (care) system:different forms of institutional care, home care services, the right to a home care assistant, care in sheltered housing, various forms of personal assistance for disabled. Services within the health care system:non-acute hospital treatment for intermediate care (nursing departments and prolonged hospitalisation), long-term care at home is provided within the community nursing care. Different cash benefits for LTC to be used for informal help or to (co)pay the formal services. Entitled are: beneficiaries of old-age and disability pensions, beneficiaries of social assistance, persons who are unemployed due to high disability, war-disabled persons and war veterans (all in cases of need), but not all who are in need of LTC.

  5. Current financing of the LTC services and benefits Partly from taxes(from the national and municipal budgets). Partly from social security contributions (provided from compulsory health insurance and compulsory pension and disability insurance). Partly from the users(private) contribution (long-term care services are covered fully by public sources only if the user or his/her relatives are unable to pay obligatory contribution).

  6. Formal LTC services in Slovenia -2011

  7. LTC benefits - 2011

  8. Structure of expenditure for LTC in RS 2003-2011 Source: SORS 2013

  9. What is hindering accessibility of LTC? Inadequate financing of LTC. The existing services and benefits are not integrated into an uniform system. A lack of co-ordination between social and health service providers. Inadequate regional distribution and lackof providers of LTC (urban versus rural). Relativelyundevelopedservices in home (local) environment. Undeveloped prevention, rehabilitative care and use of IT.

  10. Starting point of the LTC reform Recognition of the need for LTC as a new social risk that people should be protected against. Proposal for the introduction of a new compulsory insurance scheme, similar to theprotection of entire population against sickness or injury, disability and old age (pension insurance), unemployment and other social risks.

  11. The main elements of the Draft Act on LTC Integration of health and social part of the long-term care in to an uniform system Introduction of one entrance point (one-stop-shop) for claiming all long-term rights (independent bodies at the local- regionallevel) Introduction of anuniform system of needs assessment Free choice of the type of service by the users More individualised treatment of users and emphasis on services in home and local environment (community forms of LTC have priority to institutional forms)

  12. Financing according to the Draft Act on LTC Solidarity financing according to the principles of social insurance by introduction of the compulsory social insurance for LTC. OPTION: Introduction of private insurance to cover part of the costs, (personal payment, higher standard and »hotel costs within institutional care«) Part of expenses would be covered through compulsory insurance and part through private insurance or out-of-pocket.

  13. KEY DILEMMAS The keyquestion is what type of private founding ? Out-of-pocket payment? Obligatory or voluntary private insurance? Co-payment or additional payment? Private insurance combined with health insurance? Independent private insurance?

  14. Planned activities regarding preparation of the new LTC ACT Starting points adopted by theSlovenian government in September 2013 Proposal of the NEW LTC ACT beginning of 2014 Adoption in the Parliament mid-2014 Implementation of the new LTC Act 2016

  15. THANK YOU! davor.dominkus@gov.si

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