In future, only charges provided by law could be collected from clients of health and social services
The Government is proposing a new Act on Client Charges in Health and Social Services that would apply to health and social services organised by counties. In future, only service charges provided by the Act on Client Charges in Health and Social Services could be collected from clients.
The aim is that the service charges would be reasonable and not prevent people from using the health and social services they need.
The client's own county would charge the client. Counties could also charge less than the maximum fee, or let their residents use services free of charge. The client would always pay the same sum for the same service organised by the county, irrespective of who provided the service. The county would use the same client charges for services provided by the county itself and for services bought from other service providers against the client's health and social services voucher or personal budget. The service provider would be allowed to charge for unattended appointments that had not been cancelled.
As before, there would fixed client charges and client charges based on the client's ability to pay (income-related charges). When determining income-related charges, only the clients' continuous, regular income would be taken into account, not their property. Regulations concerning forest income would remain unchanged.
Scope of application of payment ceiling becomes broader
The aim is not to change the level of the current annual payment ceiling (EUR 683). In future, the following costs would be included when calculating whether the client's total costs reach the payment ceiling: appointment and processing charges for oral health services, charges for temporary home nursing and hospital at home, charges for prehospital emergency medical services, and charges paid from the person's income support.
Providers would be allowed to charge the same sums for distance services as for services received during traditional appointments. Charges for distance services would be included in the client's costs for the payment ceiling. Payment practices in primary services and specialised services would be harmonised. In future, each appointment to a doctor, nurse or therapist would be charged separately, as well as each appointment for serial treatment.
The obligation to monitor when the client reaches the payment ceiling would be transferred from the client to the county.
The provision obliging to reduce or waive a charge would be made more effective and the provision would be extended to cover even the charges for short-term institutional healthcare. Clients should be informed about the possibility to apply for payment reduction. Payment reduction would be preferred rather than granting income support.
Free-of-charge health services to minors and for preventive purposes
In future, health services to minors would always be free of charge. The change would also apply to institutional healthcare and specialised medical care.
As before, preventive services would mainly be free of charge. Appointments to outpatient care services relating to mental health and substance abuse problems would be free of charge.
Charging criteria for home care, service housing and institutional care will be harmonised
The Act on Client Charges in Health and Social Services would lay down charges for long-term service housing. In the same connection, the principles for income-related charges for long-term or continuous and regular services would be harmonised.
Continuous and regular home care would be comparable to ordinary long-term service housing because both arrangements bring services to the clients' homes and the clients do not need services 24 hours a day. The income limits for home care charges would be raised.
Long-term service housing with 24-h assistance would be considered equal to long-term institutional care as both service arrangements provide clients with intensive 24-hour care. The Act would require that a client shall have at least EUR 160 at his or her personal disposal in service housing with 24-h assistance. In institutional care, the sum is EUR 108.
The Act is scheduled to enter into force on 1 January 2021.
Marjo Kekki, Senior Specialist, tel. +358 2951 63675
Salla Kokko, Lawyer, tel. +358 2951 63212
Kari Paaso, Director, tel. +358 2951 63340