A proposal for a systemic arrangment of long-term care

Magistrska diplomska naloga obravnava aktualno tematiko, tj. sistem dolgotrajne oskrbe. Predmet raziskovanja je pravna ureditev dolgotrajne oskrbe v Sloveniji. Trenutno se dolgotrajna oskrba v Sloveniji izvaja zgolj projektno. Decembra 2021 je bil na področju dolgotrajne oskrbe sprejet Zakon o dolgotrajni oskrbi, ki to področje sistemsko ureja. Obstoječ sistem se je namreč izkazal za pomanjkljivega, saj je zaradi razkropljenosti pravic po različnih zakonih prihajalo do odstopanj pridobljenih pravic med upravičenci s primerljivimi položaji. Novo sprejet zakon se je začel uporabljati 18.01.2022 z izjemo nekaterih členov, ki se bodo začeli uporabljati 1. januarja 2023 oz. 1. julija 2024. Zakon pravico do storitev dolgotrajne oskrbe podeljuje osebam starejšim od 18 let (pod določenimi pogoji tudi mlajšim), ki izpolnjujejo z zakonom določene pogoje. Do odstopanj pridobljenih pravic bo prihajalo zgolj med upravičenci, ki bodo uvrščeni v različno kategorijo DO, vendar bo s tem poskrbljeno, da bodo tisti z enakimi oz. podobnimi potrebami obravnavani enako. O pravicah bo odločal Zavod za zdravstveno zavarovanje Slovenije, storitve dolgotrajne oskrbe pa bodo izvajali izvajalci dolgotrajne oskrbe v obliki DO v instituciji ali DO na domu. Zakon opredeljuje zgolj začasne vire financiranja storitev DO, in sicer iz deležev prispevkov za obvezno zdravstveno zavarovanje in prispevkov za pokojninsko in invalidsko zavarovanje. Del sredstev bo kril državni proračun. Dolgoročno financiranje storitev dolgotrajne oskrbe bo urejeno šele s sprejetjem Zakona o obveznem zavarovanju za dolgotrajno oskrbo v letu 2025. Slovenija je s sprejemom Zakona o dolgotrajni oskrbi končno naredila korak v smeri integriranega sistema dolgotrajne oskrbe. Kljub temu je zakon precej pomanjkljiv in ga bo v prihodnjih letih potrebno spremeniti in dopolniti.This master\u27s thesis deals with a topical subject of long-term care. The research object is a legal regulation of long-term care in Slovenia. It is currently carried out on a project basis. In the field of long-term care, the Long-Term Care Act was adopted in December 2021, which systemically regulates this field. The existing system proved to be deficient, as the dispersion of rights under various laws caused deviations in acquired rights among the beneficiaries with comparable positions. The newly adopted law came into force on 18 January 2022 with the exception of certain articles, which will take effect on 1 January 2023, i.e. 1 July 2024. The law grants the right to long-term care services to persons over 18 years of age (and under certain conditions to younger people as well), who meet the conditions defined by the law. Deviations of acquired rights will only occur between the beneficiaries, classified in a different long-term care category, but this will enable the ones with the same or similar requirements to be treated equally. Health Insurance Institute of Slovenia will decide on the rights, whereas the services of long-term care will be carried out by the long-term care providers in the institution or in the home of a dependent person. The law defines only temporary financial resources of long-term care services, which are namely being covered from compulsory health insurance contributions and from pension and disability insurance contributions. A part of the funds will be covered by the state budget. Long-term funding of long-term care services will only be regulated when the Compulsory Insurance Act on Long-Term Care will be adopted in 2025. With the adoption of the Long-Term Care, Slovenia has finally taken a step towards reaching the integrated system of long-term care. The law, however, is still deficient in many respects and will have to be amended in the following years