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Long-term care and the situation of social workers

Country

Czech Republic

Long-term care

Basic principles

Long-term care of citizens is not ensured by a single system, but it is partially included in the healthcare system, which is the responsibility of the Ministry of Health of the Czech Republic, and in the social services system, which is run by the Ministry of Labour and Social Affairs. Each of these systems has its own legal regulations, independent criteria of accessibility and quality, and a different method of financing. Apart from the state-guaranteed systems, long-term care and support is also provided by family members and other close persons and volunteers, mainly students.

The main source of funding of the healthcare system is public health insurance.

Social services have multi-source financing. They are financed from state, regional and municipal subsidies, from direct payments of clients, from own revenue of providers and from gifts. The main benefit of social care services is the ‘care allowance’, which is a state benefit paid to individuals dependent on care. The amount of care allowance corresponds to the degree of ‘dependence on care’ which is based upon an assessment of self-care capabilities (ADL, IADL). Family members of persons using the services may, but do not have to, provide the care. 

Long-term care

Field of application

The target group for long-term care consists of older persons, persons with disabilities and persons with chronic illnesses who are limited in self-care and independence (IADL criteria – Instrumental Activities of Daily Living – assistance with housework, preparation of food, shopping, transport and social activities, etc.) and those who need a higher level of care (ADL criteria – personal hygiene, getting dressed, eating, getting in and out of bed and chair, walking and orientation in the immediate surroundings, etc.).

Organisation of Long-term care

Informal caregivers and professional providers

Dependent people are cared for by professional providers either in institutions or at home with participation of informal carers (especally in home environment).

Informal caregivers (family members, neighbours, and friends) are registered only when they get a care allowance from the dependent person and the state pays their social and health insurance. Professional care is in some cases complemented by volunteers.

Professional providers are registered social services: legal entities established by regional and local authorities or private organisations, non-governmental organisations and natural persons.

Professional services are provided in households of users, in institutions or like outpatient services.

Long-term care

Benefits for the carer

Carers are not entitled to specific benefit. They receive the care allowance from dependent persons. The state pays health and social insurance contributions for those registered as informal carers. Periods of caring are taken into account for the purposes of old-age pension calculation.

Long-term care

User charges

Based on Social Services Act provisions, users of social services pay for board and lodging according to their income, thus the concrete sum of participation is calculated accordingly.
A social service provider can agree on cost sharing with a spouse, parents or children of user, should such person have no own income or such person’s income be insufficient to cover the costs.

Users pay for care from the care allowance which they receive from the state (depending on amount of allowance and type of services).

In addition to care allowance paid to the dependent person and financed from the state budget there are subsidies provided to registered social services in order to fund operational expenses (e.g. salaries, not investments e.g. in home improvement etc.). There is no ceiling; the amount depends on the availability of budget and other financial resources.