Legislative reform develops services provided at home and housing services for older people
The second phase of the reform concerning services for older people will improve particularly services provided at home and housing services. The reform will, for the most part, enter into force on 1 January 2023 simultaneously with the health and social services reform. The amendments will also apply to other client groups of social services.
The aim of the new legislation on services provided at home is to ensure that older people can live in their homes safely and have the services they need provided at home. The reform also aims to ensure the sufficiency of home care personnel and improve the implementation and management of home care.
In future, services provided at home will be divided into support services and home care, which can also include home nursing needed by clients. The term ‘home services’ will only be used to refer to home services for families with children, which will be a separate service in future.
Home care can be provided around the clock if necessary. The legislation now includes new provisions on planning house calls and providing home care, addressing personnel shortages and securing adequate staffing levels, as well as provisions on self-supervision and management, for example.
The legislation also contains provisions specifying the role of support services as the first services older people need to support their functional capacity. Support services can include cleaning and meal services and help with other affairs.
Housing services that change according to clients’ needs
The reform of housing services will make it possible to create diverse housing and service packages so that older people can be provided with such flexible and communal housing and service solutions supporting their functional capacity that are intermediate solutions between living at home and current service housing with 24-hour assistance.
In future, the housing services under the Social Welfare Act will be communal housing, 24-hour service housing, temporary housing and supported housing.
Communal housing will replace the current ordinary service housing. Communal housing includes suitable housing for clients and services that promote social interaction. What is new compared to the current ordinary service housing is that housing and services will be organised separately based on clients’ individual needs. 24-hour service housing and services will be organised in the same way as in the current service housing with 24-hour assistance. Personnel must be available around the clock, and the statutory staffing levels will be complied with in services for older people.
Communal housing and 24-hour service housing can be provided in facilities that belong to the same building complex, and the complex can also include other apartments. The idea is to make it less necessary for clients to move when their need for services increases. If clients’ circumstances change so that it is justified for them to move from communal housing or ordinary housing to 24-hour service housing, the change must, if possible, be implemented in a way that does not involve moving to another apartment just to receive the services they need. If it is in the best interests of clients to move to another apartment, efforts must be made to provide housing at least in the same living environment, for example in a service housing block, while ensuring stronger services for them.
The reform will amend the Social Welfare Act and also the Act on Client Charges in Health and Social Services and the Act on Private Social Services. The provisions of the Act on Client Charges will be amended not only regarding technical integration but also regarding the maximum amount of fees for long-term service housing with 24-hour assistance, family care and institutional care for clients who have been married or lived in a cohabiting partnership. The amendment will ensure that the fee which is determined on the basis of the combined monthly income of the spouses is not more than it would be if calculated on the basis of the client’s own monthly income.
Preparation of provisions on the use of technology continues
The use of technology in home care and care alarm services that was discussed during the preparation process was not included in the reform but will be addressed during further preparations. Further preparations will take account of not only the previous work but also the fundamental rights of clients as a whole.
Technology is used increasingly in practical development work, for example to help plan house calls and provide home care. The legislation in force includes provisions on client processes and provisions on ensuring data protection and privacy protection. By complying with these provisions, for example, it is possible to make use of technology in practical work and to develop new working methods.
Although the detailed regulation on care alarm services is not be implemented at this stage, both municipalities and future wellbeing services counties can organise security services as other services supporting housing under the Social Welfare Act, just as before.
Act on Care Services for Older Persons amended as part of the reform
The second phase of the reform concerning services for older people also includes amending the Act on Care Services for Older Persons. One of the most important amendments to the Act would be to improve the monitoring of the quality of services for older people. In future, the Finnish Institute for Health and Welfare would conduct a national client survey every two years.
Another significant amendment would be to abolish the long-term institutional care for older people within social welfare by the end of 2027. In future, more demanding services would, as a rule, be organised as 24-hour service housing, which would make it possible to increase clients’ self-determination and meet their individual needs. Long-term institutional care could be organised at health centre wards, if there were medical grounds or grounds related to patient safety for doing so.
The amendments to the Act on Care Services for Older Persons will also encourage wellbeing services counties to organise and provide services promoting the wellbeing of older people as advisory services, as part of the package of client assistance and service coordination, as many areas already do.
The bill for amending the Act on Care Services for Older Persons will be resubmitted to Parliament for further consideration because of the technical errors. If Parliament passes the bill in this way without any material alteration and with the correction of these technical errors, it will enter into force without needing approval.
On Thursday 25 August, the Government proposed that the bills for amending the Social Welfare Act, the Act on Client Charges in Health and Social Services and the Act on Private Social Services be approved. The President of the Republic is to approve the bills on Friday.
The reform concerning services for older people will enter into force on 1 January 2023 simultaneously with the health and social services reform. The above-mentioned section 7c, subsection 5 of the Act on Client Charges in Health and Social Services will enter into force on 1 October 2022.
Jaana Huhta, Director
Satu Karppanen, Ministerial Adviser
Kaarina Tuokko, Specialist
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