REPUBLIC OF SLOVENIA MINISTRY OF LABOUR, FAMILY AND SOCIAL AFFAIRS REPUBLIC OF SLOVENIA MINISTRY OF...

REPUBLIC OF SLOVENIAMINISTRY OF LABOUR, FAMILY AND SOCIAL AFFAIRS

REPUBLIC OF SLOVENIAMINISTRY OF LABOUR, FAMILY,SOCIAL AFFAIRS AND EQUAL OPPORTUNITIES

LONG - TERM CARE POLICIES AND REFORM

IN SLOVENIA

LJUBLJANA, November 2013



EUROPOP 2010 - Slovenia

Populationaged 0-14(%)

Populationaged 15-64 (%)

Population aged 65 or more(%)

Population aged 80 or more(%)

Old-agedependency ratio(%)

2010 14.0 69.4 16.5 3.9 23.8

2020 15.2 65.0 19.8 5.2 30.4

2030 13.7 62.2 24.2 6.3 38.8

2040 12.9 59.6 27.5 9.2 46.1

2050 13.9 55.5 30.6 10.9 55.0

2060 13.7 54.8 31.6 12.7 57.6



2010 2020 2030 2040 2050 20600.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

0-14 let 15-64 let 65 ali več let



Present System of Long-Term Carein Slovenia

Slovenia does not have a uniform system of long-term care for elderly, chronically ill, disabled and other persons who need help in performing ADL and IADL.



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.



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).


REPUBLIC OF SLOVENIAMINISTRY OF LABOUR, FAMILY,SOCIAL AFFAIRS AND EQUAL OPPORTUNITIES Formal

LTC services in Slovenia -2011

Type of long-term care service

Number of users

Institutional care of elderly 17.386

Institutional care of dissabled 3.486

Non-acute hospital treatment 6.138

Home care and personal assistance

6.618753

Home care assistant 779

Total 35.160


REPUBLIC OF SLOVENIAMINISTRY OF LABOUR, FAMILY,SOCIAL AFFAIRS AND EQUAL OPPORTUNITIES LTC benefits - 2011

Type of cash benefit for long-term care

Number of beneficiaries

Attendance allowance according to the PDI regulations

30.731

Attendance allowance to the CSA beneficiaries

343

Assistance and aid allowance according to the ACSCMPHP

4.011

Attendance allowance according to the regulations on war-disabled persons and war veterans

412

Total 35.497



Structure of expenditure for LTC in RS 2003-2011

Index 2011/2003

2003 2005 2007 2009 2011

Total costs (mil EUR) 255 317 351 437 477 187

public expenditure 193 247 272 333 355 183

private expenditure 62 70 79 104 122 198

Share of GDP (in %) 1,01 1,10 1,01 1,23 1,32 130

public expenditure 0,77 0,86 0,79 0,94 0,98 128

private expenditure 0,25 0,24 0,23 0,29 0,34 138

Share of total costs (in %) 100 100 100 100 100

public expenditure 76 78 77 76 74 98

private expenditure 24 22 23 24 26 106

Source: SORS 2013



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 lack of providers of LTC (urban versus rural).

• Relatively undeveloped services in home (local) environment.

• Undeveloped prevention, rehabilitative care and use of IT.



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 the protection of entire population against sickness or injury, disability and old age (pension insurance), unemployment and other social risks.



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 - regional level)

•Introduction of an uniform 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)


REPUBLIC OF SLOVENIAMINISTRY OF LABOUR, FAMILY,SOCIAL AFFAIRS AND EQUAL OPPORTUNITIES 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.



KEY DILEMMAS

The key question 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?



Planned activities regarding preparation of the new LTC ACT

•Starting points adopted by the Slovenian 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



THANK YOU!

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