Dolgotrajna oskrba – tretji steber socialne varnosti

V novi epizodi vladnega GOVSI podkasta, ki ga pripravlja Urad vlade za komuniciranje, se voditeljica Petra Prešeren Golob pogovarja z ministrom za solidarno prihodnost Simonom Maljevcem o sistemu dolgotrajne oskrbe, ki predstavlja tretji temeljni steber socialne varnosti, poleg pokojninskega in zdravstvenega zavarovanja.

Minister pojasnjuje, kako sistem temelji na solidarnosti, je dostopen vsem in omogoča, da pomoč prejmejo vsi, ki jo potrebujejo – ne glede na starost ali socialni status. Predstavi štiri temeljne pravice, ki jih dolgotrajna oskrba vključuje, med njimi tudi oskrbo na domu, e-oskrbo in denarni prejemek.

V pogovoru izpostavita tudi demografske izzive starajoče se družbe in pomen dolgotrajne oskrbe kot odziv nanje. Minister poudarja, da gre za največjo spremembo na področju socialnega varstva v zadnjih 50 letih in da je cilj sistema, da omogoči dostojno in samostojno življenje v domačem okolju čim več ljudem.

Vabljeni k poslušanju in ogledu! 

[ENGLISH VERSION]

Long-Term Care – The Third Pillar of Social Security

In the latest episode of the GOVSI government podcast, produced by the Slovenian Government Communication Office, host Petra Prešeren Golob speaks with the Minister for a Solidary Future, Simon Maljevac, about the long-term care system – now established as the third fundamental pillar of social security, alongside pension and health insurance.

The Minister explains how the system is based on solidarity, ensuring equal access for all, regardless of age or financial status. He outlines the four core rights within long-term care, including in-home care, e-care, and cash benefits.

The conversation also highlights the demographic challenges of an aging society and presents long-term care as a timely and essential response. The Minister emphasizes that this represents the biggest reform in social welfare in the past 50 years, with the aim of enabling as many people as possible to live independently and with dignity in their own homes.

Tune in and watch!

Transcript

Vladni podkast GOVSI

Voditeljica Petra Prešeren Golob: Lepo pozdravljeni v najnovejšem podkastu GOVSI, ki ga za vas pripravljamo na Uradu Vlade RS za komuniciranje. Z vami sem Petra Prešeren Golob. Današnja tema je vsegeneracijska in še kako aktualna. Govorili bomo o enem najpomembnejših korakov k bolj solidarni in vključujoči družbi - o dolgotrajni oskrbi. Po dolgih letih usklajevanj končno tudi dejansko vzpostavljamo tretji temeljni steber socialne varnosti, poleg pokojninskega in zdravstvenega zavarovanja še sistem dolgotrajne oskrbe.

Uvajanje je seveda zahtevno in obsežno, vendar korak za korakom postavljamo nov sistem, ki ga Slovenija nujno potrebuje. Danes je zato z nami minister za solidarno prihodnost Simon Maljevac, ki vam bo podrobneje predstavil, kaj vse vključuje dolgotrajna oskrba. Minister, lepo pozdravljeni.

Gost Simon Maljevac: Pozdrav vi vodite zahteven resor saj pokrivate področja, kjer je naša družba še posebej na preizkušnji, saj pride v ospredje vrednote, ki jo vaš resor nosi tudi v imenu solidarnost.

Voditeljica: Kje se prepletata solidarnost in dolgotrajna oskrba?

Gost: Ja, mislim, da je beseda 'solidarnost' en zelo dober opis tudi slovenske družbe. Ta teden sem bil namreč v Bruslju in med drugim sem se pogovarjal z novinarko, ki je pokrivala tudi poplave v Sloveniji. Je novinarka iz Nemčije in prva stvar, ki mi jo je rekla, je bilo, da je bila izjemno presenečena nad odzivom ljudi takoj po poplavah - koliko je bilo vzajemne pomoči in podpore, da je to nekaj neverjetnega, da ni tega še nikjer videla. Tako da ravno zaradi tega verjamem, da smo zelo solidarna družba. In kako je pa to prepleteno z dolgotrajno oskrbo? Celoten sistem dolgotrajne oskrbe smo želeli sestaviti na podlagi solidarnosti, torej dostopnosti za vse. Ne glede na to, kako globok je naš žep, da pomoč, ki jo potrebujemo na starejša leta ali pa tudi prej dobimo vsi. To je bilo naše osnovno vodilo.

Voditeljica: Če pogledava uradno definicijo - dolgotrajna oskrba je opredeljena kot sistem storitev in ukrepov namenjenih osebam, ki so zaradi bolezni, starosti, poškodb, invalidnosti, pomanjkanja ali izgube intelektualnih sposobnosti dlje časa ali trajno odvisne od pomoči drugih oseb pri opravljanju osnovnih in podpornih dnevnih opravil. To je dolga, malce zapletena definicija. Ali lahko morda poenostavite, razložite, kaj vse to konkretno pomeni?

Gost: Ja, zagotovo je zapletena in dolga definicija. Dve besedi smo slišali: podporna opravila. Na primer, kaj so ta osnovna opravila? Mislim, da je najboljše s plastično razlago pojasniti. Prvič, kot že izvira iz besede dolgotrajna oskrba govorimo o nekomu, ki rabi pomoč dolgotrajno, torej dlje časa. To ni to, če si na primer zlomimo nogo, pa potrebujemo pomoč samo 2 meseca, to ni dolgotrajna oskrba.

Če smo imeli eno poškodbo ali smo invalidni, ali smo starejši in potrebujemo pomoč skozi daljše časovno obdobje, to pomeni pri pitju, opravljanju osnovnih higienskih stvari, npr. tudi pri gospodinjskih opravilih, da nam gre kdo v trgovino in podobno. Celoten ta spekter je dolgotrajna oskrba, torej. Tisto, kar nam omogoča samostojno živeti, da živimo polno življenje.

Voditeljica: Že iz te vaše razlage gre razumeti, da dolgotrajna oskrba ni namenjena samo starejšim, ampak vsem starejšim od 18 let, in zaradi poškodbe, bolezni je to lahko že jutri vsakdo izmed nas?

Gost: Tako je, čisto vsakemu, ki je starejši nad 18 let in potrebuje podporo v svojem vsakdanjem življenju, je namenjena dolgotrajna oskrba. Uporabnikov bo vedno več, tudi tistih, ki so mlajši od 65 let, je pa glavnina seveda oseb, ki so vključeni v dolgotrajno oskrbo, starejših od 65.

Voditeljica: In ravno zato so te spremembe tako nujne. Ne vem, vsak peti prebivalec Slovenije je star 65 let ali več. Kakšne so demografske napovedi?

Gost: Zagotovo smo starajoča se družba. Omenili se, da je vsak peti že star nad 65 let. Ko pogledamo podatke iz leta 91, je bilo takih nekaj čez 10 %. Zdaj smo že čez 20 %, leta 2050 bo čez 30 % oseb starejših nad 65 let. In ravno to je osnova, zakaj potrebujemo sistem, kot je dolgotrajna oskrba. Postavljali smo ga tudi na podlagi teh podatkov, na podlagi demografske slike Slovenije in upam, da se bo v prihodnjih letih še nadgrajeval in nudi vso ustrezno oskrbo.

Voditeljica: Lovimo zadnji vlak, pravzaprav.

Gost: Ja, lovimo zadnji vagon, bi celo rekel, ne samo zadnji vlak. Ampak smo na vagonu in se premikamo zelo aktivno naprej. In to je tisto, kar je glavno.

Voditeljica: V uvodu sem omenila tretji temeljni steber socialne varnosti. Kaj pomeni, da vzpostavljamo ta steber? Kako se ta dolgotrajna oskrba razlikuje od zdravstvenega in pokojninskega zavarovanja?

Gost: Vsi poznamo pokojninsko in zdravstveno zavarovanje. In ko govorimo o vzpostavljanju sistema dolgotrajne oskrbe, je najbolj plastično si predstavljati, kakor da bi zdravstveni sistem postavljali iz nule. To je tisto, kar počnemo ta trenutek. Glavna sprememba, ki se je zgodila na tem področju, pa je, da ravno tako kot zdravstvo, temelji na zavarovanju. In to je tudi ta prispevek, ki ga vsi plačujemo. Ampak ravno zaradi tega so storitve, ki jih nudi dolgotrajna oskrba, dosegljive in dostopne vsem. Ne glede na to, koliko imamo v žepu ali koliko ima kdo od naših bližnjih. Torej, s tem, ko postaja tretji steber, postaja steber, ki je dosegljiv vsem prebivalcem in prebivalkam Slovenije, ne glede na to, kakšen je njihov status. S tem postaja to osnovni steber naše družbe.

Voditeljica: In ker ga postavljate praktično od temeljev navzgor, je tudi tako zahtevno, bom rekla, in se tudi najde kakšna ovira na poti, ne?

Gost: Ovir je kar nekaj na poti, ampak nikoli se ne predamo. Vedno pogledamo in postavljamo sistem naprej. Dostikrat slišim besedo, da dolgotrajna oskrba ne živi. Dolgotrajna oskrba še kako živi. Je tudi že prej, ampak tudi po zakonu živi intenzivno. Zadnje leto pa pol prvo pravico, o kateri bova kasneje tudi verjetno malce več govorila, govorimo o oskrbovalcu družinskega člana, je tako že skoraj 2000 torej, 2000 novih oseb je vključenih v sistem dolgotrajne oskrbe, imajo oskrbo, ki je prej niso imeli.

To je kot da bi v letu in pol zgradili, napolnili 20 domov za starejše s po 100 osebami, da si malo bolj plastično to predstavljamo.

Voditeljica: … In predvsem so olajšali toliko življenj oziroma naredili lažje življenje za svojce in za ljudi, ki pomoč potrebujejo.

Gost: Tako je. Predvsem za celo družino in konec koncev smo jo omogočili, da živijo tam, kjer želijo, torej, da so ostali doma. 

Voditeljica: No, in ravno to je ena od štirih temeljnih pravic, ki jih dolgotrajna oskrba vsebuje oziroma prinaša. Vi ste že omenili pravico do oskrbovalca družinskega člana, velja od januarja 2024, torej, in po novem so lahko to tudi upokojeni družinski člani. Kaj prinaša potem ta pravica?

Gost: Ja, tu smo razširili pravico v letošnjem letu, in sicer s 1. julijem bodo lahko oskrbovalci družinskega člana postali tudi upokojenci. To smo storili predvsem na poziv združenj in po pregledu terena in mislim, da je super, da smo to izvedli.

Ko govorimo o oskrbovalcih družinskega člana, je to tista oseba, ki z nami živi na istem naslovu in skrbi za nas. Kako pridemo do tega? Prvič, vlogo je treba oddati na center za socialno delo. Ker gre vsaka oseba, ki bi želela prejemati podporo, skozi ocenjevanje in če je uvrščena v 4. ali 5. kategorijo - to sta dve »tavišji« kategoriji dolgotrajne oskrbe -  lahko prejme pomoč s strani oskrbovalca družinskega člana. Moram pa poudariti, da tudi tisti naš družinski član, ki naj bi skrbel za nas, je preverjen. Torej, se preverja, ali je sposoben nuditi ustrezno skrb in to opravi invalidska Komisija v okviru ZPIZ-a. Tako da je zagotovljeno tudi, da je oskrba ustrezna.

Voditeljica: Je pri upokojencih pridobitev tega statusa oskrbovalca kaj drugačna, morajo biti še na kaj posebej pozorni?

Gost: Ne, postopek je enak za vse. Razlika je v tem, da lahko vlogo za oskrbovalca družinskega člana dajo tudi upokojenci. Zato bodo prejeli isto nadomestilo plačila DDV-ja v višini 1,2 minimalne plače, če skrbijo za eno osebo. Če skrbijo za 2 osebi pa 1,8 in pa seveda odstotek svoje pokojnine, ki jim pripada po zakonu o invalidskem in pokojninskem zavarovanju.

Voditeljica: Pa tudi izobraževanje, ne?

Gost: Tudi izobraževanje, tako. Ko hodim po terenu, je to zelo veliko vprašanje. Točno to, kako bomo preverjali samo izvajanje na terenu. Prvič, vsak oskrbovalec družinskega člana mora iti skozi izobraževanje, koordinator dolgotrajne oskrbe, ki bo zaposlen pri izvajalcih, bo pa tudi preverjal, kako se to izvaja na terenu. Ne želimo si negativnih zgodb na terenu, tako da lahko tudi izgubiš status oskrbovalca družinskega člana, če oskrba na terenu ne bo ustrezna.

Voditeljica: Torej, nadzor vsekakor bo?

Gost: Nadzor zagotovo mora biti.

Voditeljica: Vpeljali ste tudi dodatne storitve. E-oskrba, ta že obstaja - na terenu se že izvaja tudi po »starem sistemu« - in storitve za ohranjanje in krepitev samostojnosti. Kaj to pomeni?

Gost: E-oskrbo, mislim, da zdaj pa kar dobro poznamo. To je tista zapestnica ali ogrlica ki jo imamo ves čas s sabo. Torej, če bi bil jaz starejši in bi bila možnost, da vem, da lahko padem ali sem rahlo dementen (kakšne dneve se mi tako že zdi, da sem), je to tisto, kar mi nudi: prvič - meni osebno varnost, da vem, da če se mi kaj zgodi, se bo alarm takoj sprožil in klical v klicni center. Drugič pa mislim, da je to predvsem varnost za celotno družino. Torej, če sem sam in imam e-oskrbo, so lahko moji bližnji, ko so v službi, mirnejši, ker vedo, da če bom slučajno padel, se bo alarm sprožil, da bodo tudi oni obveščeni in bo stekla ustrezna oskrba. Ko govorimo pa o storitvah za ohranjanje samostojnosti, so pa te predvsem preventivne, ker mislim, da je nujno, da tudi to naslovimo. V preteklosti se je sicer na žalost čakalo predolgo in je nekdo vstopil sistem šele, ko je potreboval zdravstveno oskrbo. To so storitve psihofizične podpore - fizioterapija, delovna terapija, ki se izvaja na domu. Vsakemu pripada glede na to, v katero kategorijo smo uvrščeni, koliko ur na leto, in to je predvsem namenjeno temu, da ljudem omogočimo, da čim dlje živijo tam, kjer želijo. Torej, če sem jaz doma in želim biti doma, živimo pa v hiši, ki ima 10 stopnic, da lahko pridem do svojega stanovanja, bom s svojim fizioterapevtom vadil, kako vsak dan uspešno premagati teh 10 stopnic. To se mi zdi tudi zelo pomembno, da je storitev prilagojena dejanski situaciji na terenu.

Voditeljica: In kot ste rekli delujete preventivno. Torej, ohranjate ljudi aktivne in sposobne, da živijo doma, kar si večina pravzaprav želi čim dlje – ostati doma, a ne?

Gost:  Točno tako, kot že samo ime pove.

Voditeljica: In tudi naslednje pravica omogoča, da ljudje čim dlje ostanejo doma. To je pravica do dolgotrajne oskrbe na domu. Kako se razlikuje od pomoči na domu? To pravico poznamo že vrsto let. In kaj ta pravica do dolgotrajne oskrbe na domu vse vključuje?

Gost: Ja, pomoč na domu, mislim, da vsi poznamo. Prvič mogoče pojasnilo: pomoč na domu ostaja, se ne ukinja. Mislim, da je zelo pomembno, da vsak, ki jo ima, jo bo lahko imel še naprej, in vsak, ki jo bo potreboval ravno tako. Osnovna razlika je v tem, da je dolgotrajna oskrba na domu brezplačna. Torej, tisti, ki jo bo prejel, ne bo rabil zanjo doplačevati čisto nič, prejel pa jo bo na podlagi ocene na centru za socialno delo. Torej, koliko ur dolgotrajne oskrbe pripada. To je pa pomoč - spet sva pri tistih osnovnih in podpornih opravilih – torej, pomoč pri pitju, oblačenju, negi, ko gremo zvečer spat,  pa tudi pri gospodinjskih opravilih, obrokih, kuhanju obrokov in podobno. To je vse tisto, kar se potem dogovorimo z izvajalcem, ko dobimo obseg ur. Torej, če bi jaz dobil 80 ur dolgotrajne oskrbe na mesec, bi potem šel do izvajalcev dolgotrajne oskrbe in se z njimi dogovoril, ob katerih dnevih kaj in kaj je tisto, kar jaz potrebujem. To je ta osnovni nabor. Tu je tudi del zdravstvenih storitev, kot npr. deljenje zdravil in podobno. Najbolj enostavno se mi zdi opisati, da gre za storitev, ki smo jo do zdaj prejemali predvsem v okviru domov za starejše, v domovih za starejše, zdaj pa jo lahko prejmemo tudi doma.

Voditeljica: In je res prilagojena vsakemu posamezniku, ne?

Gost: Čisto vsak posameznik naredi osebni načrt, kot temu rečemo, ki je potem podlaga za izvajanje.

Voditeljica: No, tisti, ki bodo potrebovali institucionalno oskrbo, torej, oskrbo v domu, pa pomeni, da bodo storitve, kot so pomoč pri prehranjevanju in pitju, pri osebni higieni, oblačenju in slačenju, gibanju pri jemanju zdravil, spremljanju zdravstvenega stanja in podobno. Vse te storitve bodo krite iz obveznega zavarovanja za dolgotrajno oskrbo, stanovalec pa bo plačal stroške prehrane in nastanitve. To se zdi nekako največja sprememba glede na trenutno obstoječi sistem?

Gost: Storitev bo potekala tako, kot poteka sedaj. Mogoče bo kvečjemu kdo dobil še malce več. Oziroma osnovna razlika je v tem, da bomo plačevali - mi temu rečemo t. i.  hotelski del, torej, to je nastanitev in prehrana. Konec koncev, to so tisti stroški, ki jih ima vsak izmed nas tudi doma. Vsak, da denar za stanovanje, za svoje položnice, za pranje oblačila in podobno. In to je vse, kar bomo po 1. 12. v domovih za starejše plačevali - ne glede na to, koliko oskrbe potrebujemo. Ali je potrebujemo bistveno več ali manj, plačamo samo ta del. In - to je še pomembno obvestilo - ta strošek v nobenem primeru ne bo višji od zagotovljene pokojnine za 40 let delovne dobe. Kar je v letošnjem letu 781 evrov. Torej, za standardno oskrbo v domovih za starejše po 1. 12. nihče ne bi smel prejeti položnice višje od tega zneska.

Voditeljica: Kar je ogromna razlika? Nekateri zdaj plačujejo 1.500-2.000 € za oskrbo v domu …

Gost: Tako, ker plačujemo celotno oskrbo. Torej, dajmo si čisto plastično predstavljati:  peta kategorija je najvišja, torej 110 ur. 110 ur socialne oskrbe mora nekdo ta trenutek plačati iz lastnega žepa, torej, da nam nekdo pomaga pri prehranjevanju, da nas preobleče, da nas umije in podobno. Zdaj pa bo vse to krito iz zavarovanja. Torej, to je vse tisto, kar je brezplačno – enako kot pri dolgotrajni oskrbi na domu.

Voditeljica: Omenili ste že, da bo ta pravica uveljavljena s 1. 12. letos. Kdaj morajo oziroma zainteresirani morajo vloge oddati od 1. 11. dalje oziroma lahko jih oddajajo. Je treba gledalce in naše poslušalce še na kaj opozoriti pri tem?

Gost: Ja, mogoče predvsem obvestilo, da tistim, ki so ta trenutek v domovih za starejše, ni treba čisto nič skrbet. Oni bodo avtomatično prevedeni, torej glede na to, v kateri oskrbi so trenutno, bodo prevedeni v sistem dolgotrajne oskrbe s soglasjem. Torej, ni jim treba oddajat nobene vloge in nič podobnega in ti bodo obveščeni od meseca oktobra naprej. Tisti, ki bi pa želeli iti v dom za starejše, pa lahko oddajo vlogo po dolgotrajni oskrbi od 1. 11. naprej in to je to. To je edina razlika. Oni bodo pa seveda ponovno kot vsi ostali, ki dajo vlogo za dolgotrajno oskrbo, najprej ocenjeni na centru za socialno delo, koliko ur dolgotrajne oskrbe jim pripada.

Voditeljica: Kaj pa če tisti, ki so zdaj že v domovih za starejše, če se kdo izmed njih odloči, da pa ne bi želel biti preveden v nov sistem. Kaj to pomeni zanj? Ali bo prav tako plačeval prispevek za dolgotrajno oskrbo?

Gost: Ja, seveda se lahko kdo odloči, da ostane po starem sistemu, ki se tudi ne ukinja, torej po zakonu o socialnem varstvu.  Mogoče to: tudi če nisem upravičen do dolgotrajne oskrbe dam vlogo za dolgotrajno oskrbo, grem skoz postopek ocenjevanja in seveda zaključek, da dolgotrajne oskrbe trenutno še ne potrebujem, ampak jaz bi pa vseeno želel iti v dom za starejše. To še vedno lahko storim. To ni izključeno, in sicer po zakonu o socialnem varstvu. Ta podlaga še vedno ostaja, prispevek pa bomo seveda vsi plačevali, tako jaz kot tisti, ki so tudi ta trenutek v domu za starejše, ker temelji na solidarnosti. 

Tista največja pridobitev celotnega sistema je, da omogoča dostopnost za vse in v obsegu oskrbe, kot je vsak potrebuje. Jaz sem prepričan, če jo mi ta trenutek ne potrebujemo, jo zagotovo nekdo izmed naših bližnjih. Slej kot prej pa bomo verjetno vsi potrebovali dolgotrajno oskrbo.

Voditeljica: In zdaj sva prišla še do četrte pravice. To je pravica do denarnega prejemka. Kakšna je vloga te pravice, kdaj in komu bo na voljo? Pa seveda od česa bo odvisna višina tega denarnega prejemka?

Gost: Ja, denarni prejemek je pravica, ki stopa v veljavo s prvim 1. 12. Lahko ga primerjamo mogoče z dodatkom za pomoč in postrežbo, ampak to je še ena v segmentu pravic, za katero se lahko odločimo. Mogoče je pomemben tudi poudarek, da je odločitev, katero storitev želimo prejemati, čisto na vsakemu izmed nas.

/../ Torej, če bi moja mama potrebovala dolgotrajno oskrbo, bi dala vlogo na center za socialno delo, ta bi jo potem kontaktiral in prišel k njej na obisk, opravil razgovor in oceno. Na podlagi tega bi prejela odločbo, v kateri bi pisalo, koliko ur dolgotrajne oskrbe na meseci ji pripada. In potem na podlagi tega bi šla do izvajalca in se odločila, katero pravico izmed njih hoče. Ena izmed njih je denarni prejemek. Torej, če bi se moja mama odločila: ne želim v dom za starejše, ne želim prejemati dolgotrajne oskrbe na domu, bi pa želela prejemati denarni prejemek, pa bom potem si sama poskrbela za oskrbo, to lahko dobi in prejme znesek glede na kategorijo, v katero je uvrščena. Zakaj je denarni prejemek pomemben? To je tudi tisti znesek, ki ga bo vsak prejemal v času, ko bi na primer čakal na dom za starejše. Odločil bi se, da gre v dom za starejše, pa bo mogoče malo počakati 2 meseca, preden bo prosta postelja v tem vmesnem obdobju bo prejemal denarni prejemek. Torej ni, da nam v tem tekočem času ne pripada nobena pravica.

Voditeljica: Tukaj je vprašanje tudi, ali se te pravice med seboj izključujejo ali jih je morda mogoče med seboj kombinirati? Morda tudi na ta način, ko ste rekli, ko ena pravica še ni dostopna zaradi nekih zunanjih okoliščin, pa potem lahko v vmesnem času dobimo neko drugo pravico?

Gost: Vedno se vse pravice uveljavlja na podlagi osebnega načrta, osebni načrt pa lahko vedno spremenimo. Ta trenutek se lahko odločim za dolgotrajno oskrbo na domu, čez eno leto pa lahko odidem v dom za starejše. Neprimerljive pravice so tu e-oskrba … E-oskrbo imamo lahko, ko prejemamo dolgotrajno oskrbo na domu, ne pa, ko smo v instituciji. Enako velja za storitve za ohranjanje samostojnosti. Zelo veliko je vprašanj glede dodatka za pomoč in postrežbo. Ta prav tako ne bo nikomur ukinjen. Tisti, ki ga prejema ta trenutek, bo dodatek ohranil do vstopa v sistem dolgotrajne oskrbe. Torej šele, ko poda vlogo, je ocenjen in začne koristiti pravice iz dolgotrajne oskrbe, se mu dodatek preneha izplačevati, ker ima drugo serijo pravic, ki mu pripadajo, med drugim tudi denarni prejemek, če se za njega odločil.

Voditeljica: In se sam uporabnik odloči, kdaj želi vstopiti v sistem dolgotrajne oskrbe?

Gost: Seveda, tako je, To je lahko letos, drugo leto ali pa čez 3 leta.

Voditeljica: Nekako ste že opisali ta postopek pridobivanja pravic kategorije 5, od 20 ur pa do 110 ur pomoči na mesec. In ko pride nekdo iz centra za socialno delo, kaj vse recimo pogledajo oz. kaj vse upoštevajo pri dodeljevanju te pomoči? Tudi ali imamo, ne vem, stopnišče ali dvigalo? Tudi take stvari?

Gost: Vse se pogleda, ne samo zdravstveno stanje, ampak tudi celotna socialna situacija. Torej, kje živimo, s kom živimo, kakšno je okolje, kakšno imamo trenutno podporo. To so vse elementi, ki se upoštevajo pri samem ocenjevanju. A nam je bilo zelo pomembno, da se to ocenjevanje ne dela v pisarni in na podlagi papirjev, ampak da se dela dejansko na terenu, ker mislim, da šele takrat vidimo realno sliko. Torej ni nujno, da bo nekdo, ki ima enako zdravstveno diagnozo kot drugi, prejel isto število ur dolgotrajne oskrbe. Cilj dolgotrajne oskrbe je, da nam omogoča samostojnost in na ta način bo tudi potekalo ocenjevanje.

Voditeljica: Ali lahko rečete, ali je prehod v novi sistem dolgotrajne oskrbe, smiseln in priporočljiv za vsakogar?

Gost: Mislim, da za zelo veliko večino ja. Zagotovo. Predvsem za tiste, ki so v institucionalnem varstvu, pa tudi tiste, ki so že dlje časa vključeni v pomoč na domu. Če družinski člani vedo, da bodo pomoč na domu potrebovali dolgoročno, torej ne samo za omejeno obdobje … Nekaj drugega je, na primer, kot sem omenil prej zlom noge ali pa zlom kolka in vemo, da bomo pomoč na domu potrebovali zgolj nekaj mesecev. Če pa je nekdo prejemal pomoč že dlje časa, pol leta ali leto ali več, je zagotovo smiseln prehod v dolgotrajno oskrbo na domu, v sistem dolgotrajne oskrbe, ker bomo to podporo potrebovali dolgoročno.

Voditeljica: Imate morda izračune, ocene koliko ljudi, koliko uporabnikov bo koristilo te pravice iz dolgotrajne oskrbe?

Gost: Izračune seveda imamo. To je vedno podlaga za celotno načrtovanje. Uvodoma sem omenil, da imamo že ta trenutek skoraj 2000 oskrbovalcev družinskega člana. Že ta trenutek je skoraj 20.000 oseb v sistemu institucionalnega varstva, torej v domovih za starejše. Kar nekaj tisoč jih v letošnjem letu pričakujemo, da se bodo vključili v sistem dolgotrajne oskrbe na domu in pa tudi e- oskrbe. Pričakujem, da bo že v letošnjem letu konec leta v sistem dolgotrajne oskrbe vključenih vsaj 30.000 oseb. Dolgoročno pa so neke ocene okrog 70.000 oseb. Torej, zelo velik del našega prebivalstva.

Voditeljica: Centri za socialno delo od 1. junija letos sprejemajo vloge za dolgotrajno oskrbo na domu. Malo sva že omenila, na kakšne načine, je mogoče oddati to vlogo?

Gost: Lahko jo oddajo seveda fizično na vseh enotah centrov za socialno delo, lahko jo oddamo pa tudi elektronsko ali po telefonu. Torej, možnosti je več, ne bojte se poklicati in vprašat na center za informacije in sem prepričan, da vam bodo svetovali.

Voditeljica: Odločbe pa lahko ljudje, ki so zdaj oddali vloge, pričakujejo šele jeseni?

Gost: Ja, sam postopek, kot sem ga omenil,  traja nekaj časa. Torej, odločbe je treba najprej pregledati, ali je v vlogi je vse ustrezno izpolnjeno. Potem pa je treba izpeljati še obisk na terenu, ki je podlaga za oceno. Centri za socialno delo so zdaj kadrovsko popolnjeni. Torej, že samo ta postopek do odločbe traja nekaj časa, zato predvidevamo, da bodo do takrat odločbe znane. Do takrat bo tudi pripravljen informacijski sistem, o katerem se zelo veliko govori v javnosti. Ta trenutek manko informacijskega sistema ne ovira nobenega postopka. Ko ga bomo potrebovali, ga bomo imeli. Kot rečeno, pa lahko prve odločbe pričakujemo jeseni.

Voditeljica: Torej delo teče nemoteno dalje, kljub temu da informacijski sistem še ni dokončno vzpostavljen?

Gost: Delo poteka nemoteno, celotna vzpostavitev sistema dolgotrajne oskrbe ravno tako.

Voditeljica: Večkrat ste omenili tudi osebni načrt. Kaj to pomeni? Nam lahko dodatno pojasnite? Takrat verjetno začnejo potem tudi veljati te pravice, ne?

Gost: Tako je. Osebni načrt je tista točka, ko smo prejeli odločbo in gremo do izvajalca ali dolgotrajne oskrbe na domu ali institucionalnega varstva, torej, tistega, ki nudi storitve dolgotrajne oskrbe v naši občini. To bo vse objavljeno. O tem vas bodo tudi obvestili na centru za socialno delo in z njim se dogovorimo, katere so tiste storitve, ki jih sam želim prejemati. Torej, dolgotrajno oskrbo na domu, na primer, ja, v bistvu živim sam, potrebujem še e-oskrbo, dogovori se tudi za storitve in ohranjanje samostojnosti. Torej, na papir se zapiše, kako si sam želim prejemati storitve dolgotrajne oskrbe in to je podlaga za izvajanje in kasneje za plačilo izvajalcev s strani zavoda za zdravstveno zavarovanje.

Voditeljica: S prvi julijem letos je začela veljati obveznost plačevanja prispevka za dolgotrajno oskrbo. Dejansko ga bomo prvič plačali pri julijski plači, torej avgusta. Kako je v celoti financirana dolgotrajna oskrba?

Gost: Prvič, zagotovo iz prispevka. Uvodoma sem povedal, da sistem temelji na solidarnosti – torej, vsi prispevamo, da lahko naši najbližji zagotovijo in dobijo storitve, ki jih potrebujejo. Drugi pomemben vir je proračun. Seveda, proračun je samo v lanskem letu že zagotovil 170 milijonov evrov za zagotavljanje dolgotrajne oskrbe, tako da velik del sredstev prihaja in bo prihajalo tudi iz proračuna poleg prispevka, tako da to sta trenutno dva glavna vira. Za financiranje dolgotrajne oskrbe v prihodnosti, če bi bilo kdaj teh sredstev premalo, pa lahko nastopi tudi točka osebnega doplačila, ampak sistem dolgotrajne oskrbe predvideva tudi finančno spremljanje na tri leta. Kako se odvija, kako se razvija in to so tudi tiste točke, ko bomo lahko videli, ali je potrebno tudi sistem financiranja prilagoditi.

Voditeljica: Slišali smo kritike, da bomo plačevali prispevek, še preden bomo pravzaprav prišli do storitev. Ampak to ni res? Omenili ste, da je že lani proračun dal sredstva za to. Lahko še malo bolj pojasnite?

Gost: Tako je. Omenil sem pravico oskrbovalca družinskega člana, prav tako institucionalno varstvo v domovih za starejše že ta trenutek poteka. V letošnjem letu bomo dali več kot 60 milijonov iz proračuna, da držimo oskrbnine v domovih za starejše bistveno nižje. Okrog 40 milijonov je tudi pravica oskrbovalca družinskega člana, ki se bo letos in tudi prihodnje leto plačevala iz proračuna. Proračun znatno prispeva k dolgotrajni oskrbi in je bil edini vir do sedaj za celotno dolgotrajno oskrbo.

Voditeljica: Na ena strani ne gre brez denarja, na drugi strani pa seveda ne brez zaposlenih, torej, kadrov, ljudi, ki skrbijo v domovih za starejše ali pa doma za ljudi, ki potrebujejo pomoč. V domovih za starejše že danes manjka od 300 do 400 zaposlenih. Domovi imajo nekje celo proste postelje, ampak zaradi kadrovskega primanjkljaja ne morejo sprejeti novih stanovalcev. Koliko in kakšen dodaten kader bi potrebovali, da bi lahko vsi, ki to potrebujejo, koristite pravice iz dolgotrajne oskrbe?

Gost: Ja, z domovi za starejše smo redno na vezi. Mogoče še podatek uvodoma iz lanskega leta, ko smo izvedli anketo. Dobili smo podatek, da je prostih postelj zaradi manjka kadra 440. Če pogledamo to na celotno kapaciteto, ki je čez 20.000,  je to manj kot 2 %. Torej, zagotovo je kadrovski problem velik, ampak sistem deluje in teh prostih postelj spet ni tako zelo veliko. Toda aktivno delujemo na področju zagotavljanja kadrov, na ministrstvu in kot vlada smo sprejeli že serijo ukrepov. Tudi poseben kadrovski zakon lansko leto, ki vključuje od štipendij do sofinanciranja prostovoljstva do dodatnega izobraževanja, segmenta ukrepov s področja zaposlovanja tujcev. Imamo tudi – jaz rečem že kar famozni 125. člen zakona o dolgotrajni oskrbi, ki zagotavlja, da v celoti krijemo vse dvige plač v domovih za starejše, ki izvirajo iz plačne reforme. V zadnjih mesecih je bilo zelo veliko govora o plačah v domovih za starejše. Lahko povem, da smo kot ministrstvo tudi pozvali vse direktorice in direktorje, da v okviru plačnega zakona, ki omogoča dvig plačnih razredov, torej dvig plač zaposlenim, to tudi storijo. Če to lahko storijo za 10 % zaposlenih in da bo to krila država in to tudi počnemo. Tako da ukrepov je kar nekaj, zadnji med njimi, pred nekaj tedni razširjen dodatek za demenco, ki je bil do zdaj zamejen samo na tiste, ki delajo na zaprtih oddelkih za demenco. Zdaj bo lahko prejemalo ta dodatek vsi tisti, ki so v stiku z osebami z demenco in teh je več kot polovica trenutno zaposlenih na področju socialnega varstva. Tako da ukrepov za kadre imamo kar nekaj in jih aktivno razvijamo še naprej. Tu sem zelo na vezi tudi z izkušnjami iz tujine, ki nam pri tem pomagajo.

Voditeljica: Seveda denar je pomemben vidik v tej zgodbi, ampak pomembno je tudi, da v tem delajo ljudje, ki so empatični, sočutni, srčni … Kaj še lahko omenite za izboljšanje kadrovskih pogojev, morebitne investicije tudi, da se sami delovni pogoji izboljšajo, da je delo za te zaposlene lažje.

Gost: Prvič, delo, pa tudi mislim, da izkušnja. Mislim, da je vedno večja potreba vsakega izmed nas, da bi imel malo več samostojnosti, intimnosti, večje sobe v domovih za starejše, zato v tem mandatu zelo intenzivno gradimo nove domove, jih prenavljamo. Zato smo namenili v zadnjih 3 letih več kot 300 milijonov evrov. To je res ogromen znesek. Investicij je vse skupaj več kot 60. Kar nekaj novih domov se gradi trenutno, samo do sredine prihodnjega leta bo ta novih domov več kot 16. Povečujemo kapacitete domov za starejše, predvsem pa izboljšujemo pogoje tudi v starejših. Vsi poznamo zgodbe Izole, doma, ki je v zelo slabem stanju. Deli stavbe so iz leta 1936 in mi smo zagrizli tudi v to kislo jabolko. Ravno pred enim tednom je prišla na mojo mizo rešitev, torej, kako bo nov dom zgledal in ta domov bo šel v prihodnjih mesecih v gradnjo.

Voditeljica: Spodbudne novice, torej. 

Gost: Tako je. 

Voditeljica: Na številna vprašanja ste že odgovorili, minister. Verjamem, da pa čisto na vsa ne in da imajo ljudje še dodatno vprašanje. Kje lahko dobijo naši gledalci, poslušalci dodatne informacije? Klicni center na številki 114 že deluje, kaj ljudi najbolj zanima in kako boste te informacije naredili čim bolj dostopne starejšim, ki jih to najbolj zanima. 

Gost: Predvsem je največ informacij vezanih na to, kako prejeti dolgotrajno oskrbo, komu pripada, kaj je treba narediti. Zelo sem vesel, da je bil klicni center vzpostavljen Tam je bilo v zadnjih tednih že več čez 3000 klicev. Tako da vsakega, ki rabi še dodatne informacije, mu svetujem, da pokliče na telefonsko številko 1 1 4. Tam mu bodo svetovalke in svetovalci nudili vse, kar potrebuje. Tako da super, da je bil ta center izpostavljen in vzpostavljen in zagotovo pomaga pri informiranju. 

Veliko sva govorila tudi midva oziroma nekaj besed o prispevku … Me je pa presenetilo, da je zelo malo vprašanj o prispevku, ker večina ljudi razume, zakaj bo prispevalo v ta solidarnostni sistem.

Voditeljica: Je tisti odstotek nekako manj, kot so plačevali, denimo, zdaj v domovih za starejše …

Gost: Položnica za dom za starejše ni bila breme samo tistega, ki je bil v domu, ampak breme za celotno družino in jaz verjamem, da se marsikdo v preteklosti tudi ni odločil, da bi šel v dom za starejše, ravno zaradi tega. In če bomo s tem vsaj nekaterim omogočili tudi ta manjši čustveni pritisk na stara leta, ljudem, ki so konec koncev gradili našo državo, jo postavljali, in bodo z lahko vestjo šli v dom za starejše, ko so starejši in  potrebujejo podporo in se ne bodo čutili kot breme svojim otrokom ali svojim bližnjim, je to zelo velika sprememba, ki smo jo naredili v družbi.

Voditeljica: Za konec samo še vprašanje, kakšen je vaš pogled v prihodnost sistema dolgotrajne oskrbe? Kaj si želite, da bi čez 10 let lahko rekli o tem, kako smo kot država poskrbeli za starejše in ranljive skupine?

Gost: Stavek … mislim, da ga zdaj že vsi poznajo, ki ga vedno izrečem je, da je dolgotrajna oskrba živa in živa mora ostati še v prihodnje. Mora ostati živ sistem, ki se bo prilagajal demografskim spremembam, ki se bo prilagajal situaciji na terenu, da bomo v prihodnje nadgrajevali storitve, najprej pa zagotovili njihovo izvajanje. Govorimo o največji spremembi na področju socialnega varstva od 70. let. To me je presenetilo, to so mi rekli profesorji s Fakultete za socialno delo, ali se zavedamo, kako veliko spremembo delamo na tem področju. Da je tako velike spremembe ni bilo vse od sprejetja zakona o socialnem varstvu. 

Voditeljica: In razvoj družbe se kaže tudi v tem, kako družba poskrbi za tiste najranljivejše skupine.

Gost: Najranljivejše skupine, sploh v času negotovosti v času, ko je varnost v ospredju,  mislim, da se ravno takrat pokaže, kakšna družba smo. Ne samo, da verjamem, ampak tudi vem, da smo Slovenci in Slovenke zelo solidarni in nam je zelo mar, kako je poskrbljeno za ljudi, tako da sem prepričan, da nikogar ne bomo pustili zadaj.

Voditeljica: Minister, najlepša hvala za vsa pojasnila uspešno delo. Seveda še naprej.

Gost: Hvala. 

Voditeljica: Hvala, pa tudi vsem našim gledalcem in gledalkam, poslušalcem in poslušalkam. Spremljate nas lahko na našem YT kanalu ali pa na aplikacijah za podkaste? No, po poletnih počitnicah pa bomo ponovno z vami z utripom blejskega strateškega foruma.

[ENGLISH VERSION]

Government Podcast GOVSI

Host Petra Prešeren Golob: A warm welcome to the latest GOVSI podcast, produced for you by the Communication Office of the Government of the Republic of Slovenia. I’m Petra Prešeren Golob. Today’s topic is intergenerational and very timely. We will be discussing one of the most important steps toward a more supportive and inclusive society – long-term care. After many years of coordination, we are finally establishing the third essential pillar of social security: in addition to pension and health insurance, the long-term care system.

Of course, the implementation is complex and extensive, but step by step, we are building a new system that Slovenia urgently needs. That’s why today we are joined by the Minister for a Solidary Future, Simon Maljevac, who will explain in more detail what long-term care includes. Minister, welcome.

Guest Simon Maljevac: Thank you. You are leading a challenging department, as you cover areas where our society is especially put to the test, bringing to the forefront the value that your ministry also carries in its name – solidarity.

Host: Where do solidarity and long-term care intersect?

Guest: Well, I think the word “solidarity” is a very good descriptor of Slovenian society. Just this week I was in Brussels, and among other meetings, I spoke with a journalist who had also covered the floods in Slovenia. She’s a journalist from Germany, and the first thing she told me was how extremely surprised she was by the public response after the floods – the amount of mutual help and support, something she had never seen before. That’s why I believe we are indeed a very solidaristic society. And how is that connected to long-term care? We wanted to build the entire system of long-term care based on solidarity – meaning accessibility for everyone. No matter how deep our pockets are, everyone should receive the support they need in their old age, or even earlier. That was our core guiding principle.

Host: Let’s look at the official definition – long-term care is defined as a system of services and measures for persons who, due to illness, age, injury, disability, or loss of intellectual abilities, are long-term or permanently dependent on the help of others in performing basic and supportive daily tasks. It’s a long and somewhat complex definition. Can you perhaps simplify or explain what that means?

Guest: Yes, it is certainly a long and complex definition. We heard two words: “supportive tasks.” What are those basic tasks? I think the best way is to explain with a concrete example. First, as the term “long-term care” implies, we are talking about someone who needs help over an extended period. So, it doesn’t apply if you, for example, break a leg and need help for two months – that’s not long-term care.

If you’ve had an injury, are living with a disability, or are elderly and need assistance over a longer time – with drinking, basic hygiene, or even domestic tasks like grocery shopping – that entire spectrum is long-term care. It includes everything that allows us to live independently and lead a full life.

Host: From your explanation, it's already clear that long-term care isn't intended only for the elderly, but for everyone over the age of 18. Due to injury or illness, any of us could find ourselves needing it as soon as tomorrow?

Guest: That's exactly right. Long-term care is intended for anyone over the age of 18 who needs support in their daily life. The number of users will continue to grow, including those under 65, but of course, most people included in long-term care are over the age of 65.

Host: And that’s precisely why these changes are so urgent. As I understand, every fifth resident of Slovenia is 65 or older. What are the demographic projections?

Guest: We are undoubtedly an aging society. As you mentioned, every fifth person is now over 65. Looking back to 1991, just over 10% of the population were that age. Now we’re already above 20%, and by 2050, more than 30% of people in Slovenia will be over 65. And that’s the key reason why we need a system like long-term care. We designed it based on these figures – on Slovenia’s demographic picture – and I hope it will continue to be upgraded in the coming years to provide appropriate care.

Host: We’re really catching the last train, so to speak.

Guest: Yes, I’d even say we’re catching the last car of the last train. But we’re on it, and we’re moving actively forward. And that’s what matters.

Host: In the introduction, I mentioned the third pillar of social security. What does it mean that we’re establishing this pillar? How does long-term care differ from health and pension insurance?

Guest: We all know health and pension insurance. When we talk about setting up the long-term care system, the most illustrative way to think of it is like creating the health care system from scratch. That’s essentially what we’re doing right now. The key shift is that, like the health system, it is based on insurance. That’s also the contribution we all pay. But precisely because of that, the services provided by long-term care are accessible to everyone – regardless of how much money we or our loved ones have. So by becoming the third pillar, it becomes one that is accessible to every resident of Slovenia, regardless of their status. This makes it a foundational pillar of our society.

Host: And since you’re building it practically from the ground up, I’d imagine it’s also quite demanding – with some obstacles along the way?

Guest: There are certainly obstacles, but we never give up. We always look ahead and keep building the system. I often hear people say that long-term care “doesn’t exist.” But long-term care is very much alive. It existed before, and now, under the law, it is taking shape intensively. Over the past year and a half, we've already implemented the first right that we’ll probably discuss further – the right to a family caregiver – and almost 2,000 new individuals have already been included in the system. That’s 2,000 people who now have care they didn’t have before.

To put it into perspective, it’s like having built and filled 20 elder care homes, each with 100 residents, in just a year and a half.

Host: And most importantly, the lives of all these people – and their families – have been made easier.

Guest: Exactly. It improves the lives of entire families. In the end, we’ve made it possible for people to live where they want – to remain in their homes.

Host: And this is exactly one of the four fundamental rights that long-term care includes or introduces. You already mentioned the right to a family caregiver – in effect since January 2024 – and now retired family members can also take on this role. What does this right entail?

Guest: Yes, this year we’ve expanded this right. Starting July 1, retired persons can also become family caregivers. We did this in response to appeals from associations and based on insights from the field. I think it was the right decision.

When we talk about family caregivers, we mean a person who lives at the same address as the one needing care and looks after them. How does someone access this right? First, an application must be submitted to the local Centre for Social Work. Every applicant undergoes an assessment. If they are categorized in the 4th or 5th level – the two highest categories in long-term care – they can receive care from a family caregiver.

I must emphasize that the family member who is to provide care is also assessed. It is checked whether they can provide adequate care, and this is done by the Disability Commission within the Pension and Disability Insurance Institute (ZPIZ). That ensures the care is appropriate.

Host: Is the process any different for retirees? Do they need to pay special attention to anything?

Guest: No, the process is the same for everyone. The only difference is that retired persons can now also apply to become a family caregiver. They will receive the same tax-free compensation – 1.2 times the minimum wage for caring for one person, or 1.8 times for two persons – plus a percentage of their pension, in line with the pension and disability insurance law.

Host: And they also must undergo training, right?

Guest: Yes, training is required. When I’m on the ground, I often get questions about how the caregiving will be monitored. Every family caregiver must undergo training. A long-term care coordinator, who will be employed by service providers, will also monitor how care is being delivered. We want to prevent negative experiences, so it’s also possible to lose caregiver status if the care provided is inadequate.

Host: So, monitoring will be in place?

Guest: Yes, monitoring is essential.

Host: You’ve also introduced additional services. E-care already exists – it has been provided in the past under the “old system” – as well as services for maintaining and strengthening independence. What do those mean?

Guest: E-care is something most people are already familiar with. It’s that bracelet or necklace we wear all the time. So, if I were elderly and knew that I might fall or was experiencing mild dementia (some days I already feel like that myself), it would give me: first – personal safety, knowing that if something happens to me, an alarm will immediately be triggered and call the response center; and second – it offers security to my entire family. If I’m home alone with e-care, my loved ones can go to work with peace of mind, knowing that if I fall, they’ll be notified and proper care will follow.

As for the services aimed at maintaining independence, these are primarily preventive. I think it’s crucial to address this. In the past, unfortunately, people entered the system too late – only once they needed medical care. These preventive services include psychophysical support – such as physical and occupational therapy – delivered at home. Each person is entitled to a certain number of hours per year, based on their care category. The goal is to help people remain in their homes as long as possible. For example, if I live in a house with 10 stairs leading to my apartment, I’ll work with a physiotherapist to practice how to manage those stairs safely every day. It’s very important that the service is tailored to the person’s real-life situation.

Host: And as you said – this is prevention in action. It keeps people active and capable of staying at home, which is really what most people want: to remain at home as long as possible, right?

Guest: Exactly – the name says it all.

Host: And the next right also enables people to remain at home as long as possible – this is the right to long-term care at home. How is this different from home help? We’ve known that right for many years. What exactly does the right to long-term care at home include?

Guest: Yes, I believe everyone is familiar with home help. First, let me clarify: home help remains in place – it is not being abolished. It’s important to emphasize that anyone currently receiving it can continue to do so, and anyone who needs it in the future will still be able to access it.

The main difference is that long-term care at home is free of charge. Those who receive it will not have to pay anything out of pocket. The amount of care they receive will be determined by an assessment conducted by the Centre for Social Work.

So, what kind of help are we talking about? Again, we’re referring to basic and supportive daily tasks – assistance with drinking, dressing, personal hygiene, going to bed in the evening, but also household chores, meal preparation, and so on. Everything is arranged directly with the care provider once the number of approved hours is determined.

For example, if I were granted 80 hours of long-term care per month, I would then contact a long-term care provider and make arrangements about which services I need, on which days, and how they’ll be delivered. That’s the basic package. This also includes some healthcare services, such as administering medication.

The simplest way to describe it is that this is a service that people used to receive primarily in institutional settings – in nursing homes – but now they can receive it at home.

Host: And it’s truly tailored to everyone, right?

Guest: Yes, every individual develops what we call a personal care plan, which serves as the foundation for service delivery.

Host: Now, for those who will need institutional care – that is, care in a nursing home – this means that services like assistance with eating and drinking, personal hygiene, dressing and undressing, movement, taking medication, and monitoring health will all be covered by mandatory long-term care insurance. The resident will only pay for food and accommodation. That seems like the biggest change compared to the current system.

Guest: The care services will continue as they do now – if anything, some people may even receive a bit more. But the basic change is that we will only be paying what we call the “hotel portion” – accommodation and meals. After all, these are costs everyone has at home, too: rent, utilities, laundry, and so on.

And that’s all residents will pay after December 1 in nursing homes – regardless of how much care they need. Whether someone needs much more or much less care, they’ll pay only that portion.

And here's an important point: this cost will never exceed the guaranteed pension for someone with 40 years of work history. This year, that guaranteed amount is €781. So, for standard institutional care, no one should receive a bill higher than that after December 1.

Host: That’s a huge difference. Some people are currently paying €1,500–€2,000 for care in a nursing home …

Guest: Exactly, because right now people pay for all the care themselves. Let’s put it into perspective: the fifth care category is the highest, amounting to 110 hours. Currently, a person must pay for all those hours – help with eating, dressing, bathing, etc. But now, all of that will be covered by insurance. Just like with long-term care at home, it will be free of charge.

Host: You already mentioned that this right will take effect as of December 1. Applications can be submitted starting November 1. Is there anything viewers and listeners should be especially aware of?

Guest: Yes – mainly, I want to assure current residents of nursing homes that they don’t need to worry about anything. They will be automatically transitioned to the new long-term care system based on their current level of care, and this will be done with their consent. They don’t need to submit any application or do anything else. They’ll be informed starting in October.

As for those who want to move into a nursing home, they can apply for long-term care starting on November 1. That’s the only difference. Like all other applicants, they will first be assessed by the Centre for Social Work to determine how many hours of care they are entitled to.

Host: What if someone who is already living in a nursing home decides they don’t want to transition to the new system? What does that mean for them? Will they still be required to pay the long-term care contribution?

Guest: Yes, of course. Anyone can choose to remain in the old system, which isn’t being abolished – that is, the system under the Social Welfare Act. And another important clarification: even if someone is not entitled to long-term care, they can still apply, go through the assessment process, and if the conclusion is that they currently don’t need long-term care – but they still wish to move into a nursing home – that’s still possible. It’s not excluded. That can still happen under the Social Welfare Act, which remains in force.

As for the contribution – we’ll all be paying it. Me included, as well as those currently residing in nursing homes, because the system is built on solidarity.

The greatest achievement of this entire system is that it ensures accessibility for everyone and in the scope of care each person needs. I’m convinced that even if we don’t need long-term care right now, someone close to us certainly does. And sooner or later, we’ll all likely need it.

Host: And now we’ve come to the fourth right – the right to a cash benefit. What is the purpose of this right, who will be eligible, and what will determine the amount?

Guest: Yes, the cash benefit is a right that will take effect on December 1. You could compare it to the existing “assistance and attendance allowance,” but this is an additional option among the rights people can choose.

It’s important to emphasize that the choice of which service to use is entirely up to each individual.

Let’s say my mother needs long-term care. She would submit an application to the Centre for Social Work, which would then contact her and come for a home visit, conduct an interview, and make an assessment. Based on that, she’d receive an official decision stating how many hours of long-term care per month she is entitled to.

Then she would go to a provider and choose which right she wants to use. One of those rights is the cash benefit. So, if my mother were to say: I don’t want to go to a nursing home, I don’t want to receive long-term care at home, but I would like to receive the cash benefit and arrange care myself – she can do that. The amount she receives will depend on the care category she’s placed in.

Why is the cash benefit important? Because this is also the benefit people will receive while they wait – for example, for a spot in a nursing home. If someone applies and then must wait, say, two months for a bed to become available, they will receive the cash benefit during that time. So, it’s not like you’re left with no rights during that waiting period.

Host: And can these rights be combined? Or are they mutually exclusive? You mentioned that while one right might not be accessible due to circumstances, people can receive another in the meantime?

Guest: All rights are exercised based on a personal care plan, and that plan can always be updated. For example, right now I might choose long-term care at home, and in a year I might decide to move into a nursing home.

Some rights can’t be used together – like e-care. You can receive e-care while using long-term care at home, but not while in a nursing home. The same goes for services that help maintain independence.

There are a lot of questions about the “assistance and attendance allowance.” That benefit won’t be terminated for anyone. Those who currently receive it will keep it until they enter the long-term care system. Only once they apply, are assessed, and begin receiving long-term care services, will the existing benefit stop. At that point, they’ll be entitled to a new set of rights, including the cash benefit, if they choose it.

Host: And the user decides on their own when they want to enter the long-term care system?

Guest: Yes, exactly. That can be this year, next year, or even three years from now.

Host: You’ve already described the process for determining eligibility, with five care categories ranging from 20 to 110 hours of assistance per month. When someone from the Centre for Social Work comes for the assessment, what exactly do they look at? For example, do they also consider whether the person has stairs in their home or an elevator? Do such things matter?

Guest: Yes, everything is considered – not just the medical condition, but also the social situation. That includes where the person lives, with whom they live, what their home environment is like, and what kind of support they currently have.

What was very important for us is that this assessment is not done in an office, based on paperwork alone. It is done on site, because only then can we truly see the real picture. So, two people with the same diagnosis may receive a different number of hours of long-term care, depending on their actual situation.

The goal of long-term care is to support a person’s independence, and that’s how the assessments are structured.

Host: Would you say that switching to the new long-term care system makes sense – and is advisable – for everyone?

Guest: I’d say for the vast majority, absolutely. Especially for those who are already in institutional care, or those who have been receiving home help for a longer time.

If family members know they’ll need home help on an ongoing basis – not just for a limited time – then it makes sense to transition. It’s a different matter if someone breaks a leg or hip and only needs help for a few months. But if a person has already been receiving help for six months, a year, or longer, then transitioning to long-term care at home makes sense, because they will need support long term.

Host: Do you have any figures or estimates on how many people will use these long-term care rights?

Guest: Yes, of course. We always base planning on data. I mentioned earlier that we already have nearly 2,000 family caregivers enrolled in the system. Right now, nearly 20,000 people are in institutional care – that is, living in nursing homes.

We expect several thousand more to join the long-term care system at home this year, as well as through e-care.

By the end of this year, I expect that at least 30,000 people will be included in the long-term care system. Long term, the estimates suggest around 70,000 users. That’s a very significant portion of our population.

Host: As of June 1 this year, Centres for Social Work are accepting applications for long-term care at home. You’ve already mentioned some of the ways people can apply – could you summarize again?

Guest: Applications can be submitted in person at any unit of the Centre for Social Work. But they can also be submitted electronically or by phone. So there are multiple options, and I encourage people not to be afraid to call and ask for information. I’m sure the staff will help guide them.

Host: But people who’ve submitted applications shouldn’t expect to receive a decision before autumn, right?

Guest: Yes, the process takes some time, as I’ve mentioned. First, the application has to be checked to make sure everything is filled in correctly. Then there must be an on-site visit, which forms the basis of the assessment. The Centres for Social Work now have sufficient staffing, but even so, just going through this process to reach a decision takes time.

That’s why we estimate that decisions will start coming out in autumn. By then, the information system that has been frequently discussed in public will also be ready. Now, the lack of this system is not delaying any procedures. When we need it, we’ll have it. As I said, the first decisions should be issued in the fall.

Host: So, the work is moving forward smoothly, even though the IT system isn’t fully established yet?

Guest: Yes, operations are continuing without disruption, and the entire system of long-term care is being established as planned.

Host: You’ve mentioned the personal care plan several times. What exactly does it mean? Could you explain it further? I assume that’s when the rights actually start to take effect?

Guest: Exactly. The personal care plan comes into play after the official decision has been issued. At that point, the person goes to the long-term care provider – either for home-based services or for institutional care – in their municipality. A list of all providers will be published. The Centres for Social Work will also inform users about them.

Then the person sits down with the provider and discusses which services they personally want to receive. For example, I might say: “I live alone, I’d also like e-care, and I’m interested in services that help maintain my independence.” Everything is written down in the personal care plan, and that document becomes the basis for both service delivery and later payment to providers by the Health Insurance Institute.

Host: As of July 1 this year, the mandatory contribution for long-term care comes into effect. In practice, this will be deducted from July’s salary, meaning in August. How is long-term care funded as a whole?

Guest: First and foremost, through the contribution. As I mentioned earlier, the system is built on solidarity – everyone contributes so that our loved ones can get the services they need.

The second key source is the state budget. In fact, just last year the budget provided €170 million for the long-term care system. So, a large share of funding already comes – and will continue to come – from the budget, alongside the contribution.

In the future, if those two sources are ever insufficient, there’s also a provision for co-payments. But the system also includes regular financial reviews every three years, to evaluate how the system is evolving. That gives us an opportunity to make adjustments to the funding model if necessary.

Host: We’ve heard some criticism that we’ll be paying the contribution before we actually get access to services. But that’s not really accurate, is it? You mentioned earlier that the state budget already allocated money for this last year. Could you elaborate?

Guest: That’s right. For instance, the right to a family caregiver is already being implemented. And institutional care in nursing homes is also already operating under the new system.

This year alone, we’ll be spending more than €60 million from the budget to keep nursing home fees significantly lower. Around €40 million will go toward paying family caregivers – this year and next – and all of that is coming from the budget.

So yes, the state budget has been the only source of funding so far. It’s made this entire launch possible.

Host: On one hand, none of this works without money – but on the other, we also need people: the workforce – those who care for the elderly, whether at home or in institutions. Currently, there’s a shortage of 300 to 400 staff in nursing homes. Some homes even have vacant beds but can’t accept new residents due to lack of staff. How many additional workers would we need to fully deliver long-term care?

Guest: We’re in regular contact with nursing homes. Let me share a figure: based on a survey we conducted last year, there were 440 vacant beds that couldn’t be used due to staffing shortages. If we compare that to the total capacity – over 20,000 beds – it’s less than 2%.

So yes, staffing is a serious issue, but the system is still functioning. The number of completely unused beds is not massive – but we’re actively working on strengthening the workforce.

As a ministry and government, we’ve already adopted several measures – including a special staffing law passed last year. It includes scholarships, co-financing of volunteer work, additional training, and provisions for hiring foreign workers.

We also have what I often call the famous Article 125 of the Long-Term Care Act, which ensures that all wage increases for staff in nursing homes – resulting from the public sector wage reform – are fully funded by the state.

In recent months, there’s been a lot of discussion about wages in the sector. I can say that the ministry has encouraged all directors of nursing homes to implement the wage reform and raise pay grades for staff wherever possible. If they do this for even 10% of employees, the state will cover the cost, and we are doing just that.

We’ve also expanded the dementia bonus – previously limited to employees working in closed dementia units – so that now it can be received by anyone in contact with persons with dementia. That’s over half of the current workforce in the field of social care.

So yes, we’ve adopted several measures to support staffing, and we’re continuing to develop and implement more. We’re also drawing from international experience to guide us.

Host: Of course, funding is one part of the equation. But it’s equally important to have compassionate, empathetic, dedicated people doing this work. What else can you tell us about improving working conditions or investing to make their work easier?

Guest: First, it’s about the job, but also about the experience. I think people increasingly want more independence, privacy, and larger rooms in care homes. That’s why we’re intensively building and renovating homes in this mandate.

In the past three years alone, we’ve allocated over €300 million for this – a huge amount. There are over 60 investment projects, and several new homes are under construction. By the middle of next year, there will be more than 16 new care homes.

We’re increasing capacity and improving conditions, especially in older buildings. Everyone knows about the case in Izola – a care home in very poor condition, with parts of the building dating back to 1936. But we’ve taken on that challenge too. Just a week ago, a final design for the new facility landed on my desk, and construction will begin in the coming months.

Host: That’s certainly encouraging news.

Guest: Yes, it is.

Host: You’ve answered many questions today, Minister. But I’m sure not all of them – people likely still have some. Where can our viewers and listeners find additional information? The hotline 114 is already operating – what do people ask most, and how are you making the info accessible to older adults, who are most affected?

Guest: Most questions are about how to access long-term care, who is eligible, and what steps to take. I’m very pleased the hotline was established – over the past few weeks, it’s handled more than 3,000 calls.

So, to anyone seeking more information, I encourage you to call 114. The advisors there will help with everything you need. It’s great that the center is up and running – it’s helping us inform the public.

We’ve talked a lot today about the contribution as well … and what surprised me is that there are very few questions about it. Most people understand why they are contributing to this system of solidarity.

Host: And the contribution is less than what people were paying out of pocket for care in nursing homes …

Guest: Exactly. A bill for care in a nursing home wasn’t just a burden on the resident – it was a burden for the whole family. I truly believe some people in the past chose not to go into a care home precisely because of that.

If this change helps ease the emotional burden for even a few elderly people – those who helped build and shape our country – allowing them to enter care without feeling like a burden to their children or loved ones … that’s a huge transformation in our society.

Host: One final question: what is your vision for the future of the long-term care system? What would you like us to be able to say in 10 years about how we care for older and vulnerable people in Slovenia?

Guest: The phrase I always say – and I think everyone knows it by now – is:
“Long-term care is alive – and it must stay alive in the future.”

It has to remain a living system, one that adapts to demographic changes and real-world needs. In the years ahead, we’ll need to upgrade services, but first and foremost ensure their delivery.

We’re talking about the biggest change in social care since the 1970s. I was surprised when professors from the Faculty of Social Work told me that this is the most significant reform in the field since the Social Welfare Act was passed.

Host: And the development of a society is reflected in how it cares for its most vulnerable members.

Guest: Especially in times of uncertainty and when safety is a major concern, that’s when a society shows who it truly is. I don’t just believe it – I know that Slovenians are deeply solidaristic and genuinely care about others. I’m certain we won’t leave anyone behind.

Host: Minister, thank you very much for all your explanations and best of luck with your ongoing work.

Guest: Thank you.

Host: Thanks also to all our viewers and listeners. You can follow us on our YouTube channel or on podcast platforms. After the summer break, we’ll be back with highlights from the Bled Strategic Forum.