in content lists or on the content page.A service project for the elderly in Tampere funded by Sitra’s service voucher project has created a totally new approach for those taken care of by close relatives – a personal budget. The goal is to make the daily life of the caretakers and those taken care of easier by giving decision power, autonomy and freedom of choice in service procurement. This would apply to approximately 38,000 people who are taken care of by close relatives and two-thirds of whom are 65 years of age or older.
With a personal budget, the person taken care of receives money from the municipality for the services he or she needs and finds useful. The services may be public or private.
A personal budget in Tampere was formed through a support package for those taking care of their close relatives. It includes compensation for taking care of a close relative, the services defined in the service and care plan and the required support for the care.
“The money spent on the personal budget is not new, but is taken from the same allowances from where the services have been paid so far,” says Mari Patronen, Project Manager, City of Tampere.
A price tag for taking care of close relatives
Through examples in Tampere, all services currently received by a person taken care of and the caretaker have been described and calculated in euro.
The compensation for taking care of a close relative varied from 0 to 20,000 euro per year. The annual cost of services for close relative care family services varied from 0 to 21,000 euro. At the annual level, an average of 12,500 euro was spent on support services. The services included domestic care services, accessories, day activities and short-term care in a housing service unit, for example. To compare, the annual cost of intensive service housing is 40,000 euro.
In Tampere, some close relative care families did not want any other municipal support than the compensation for close relative care. Some families received a lot of services supporting the care. A solution with services but without compensation was suitable for some families.
Customers should also be mutually equal
“We have had to consider whether our service, with good intentions, is such where demanding customers are served and the quieter ones have to cope on their own,” says Eeva Päivärinta, Procurement Manager for services for the elderly in the city of Tampere.
The same question has also been considered by Olli Valtonen, vice chair of the social committee of the city of Helsinki, and Director of HelsinkiMissio.
”Undersized services are stressful for the caretakers, whereas oversized services mean that those in need of services do not get them. The caretakers are motivated to continue taking care of their close relative and even a small amount of support will help them cope better and for longer,” says Valtonen.
”The duty of the municipality is to arrange the necessary services and supervise the quality, but the municipality of course does not have to provide all services on its own. A personal budget reinforces an experience of personal choice. However, it must not be used as a tool for cutting the benefits that the person otherwise would be entitled to,” says Valtonen.
Customer support and guidance through customer counselling
The person taken care of is the focus of the personal budget model. An employee of the municipality reviews the service need together with the person taken care of and the caretaker. The required services are defined and planned together. The close relative care family procures the services independently.
The family is encouraged to take responsibility. For this, they get services that are more suitable for them. In case of problems, the family may consult the municipality.
”A close relative care family must not be left on their own with their budget because the care coverage may become insufficient. Based on international experiences, we know that particularly the aged need support at the beginning to benefit from using their budget,” says Patronen.
The Service Voucher Act opens up an opportunity for progress
The personal budget may be implemented through the Service Voucher Act or the Social Welfare Act. In the approach based on the Service Voucher Act, the service voucher would cover the service package approved in the care and service plan. The services would be obtained using a payment card.
The municipality would manage the bank accounts related to the payment card and the customer would be entitled to use the payment card. The payment card would enable digital monitoring and reduce bureaucracy. The services could be obtained from approved service providers.
”If implemented through the Social Welfare Act, the personal budget would require detailed preparations and impact assessments because the concept of a personal budget is not included in the Act. However, the Service Voucher Act provides the opportunity for rapid progress by means of regional piloting, for example,” says Eija Koivuranta, Director, Ministry of Social Affairs and Health.
“One opportunity to speed up the preparations and introduction of the personal budget in social services is to include the issue in the Government Programme,” says Koivuranta.
Sitra initiates a public debate concerning the implementation of the personal budget
The present proposal for a personal budget is a way to get public debate going on the issue of service vouchers.
”We want people to voice their views on the content of the personal budget and its applicability for different customer groups. The personal budget is a spot-on example of a new operating approach which reinforces the position of citizens as developers of their services and as the best experts of their own lives,” says Tuomo Melin, Leading Specialist, Sitra.
For the public debate, go to the Facebook/Service voucher page http://www.facebook.com/palveluseteli
More information
Tuomo Melin, Senior Lead, Municipal Programme, Sitra, phone +358 40 183 4158, firstname.lastname@sitra.fi
Mari Patronen, Project Manager, Sitra’s Municipal Programme, service project for the elderly, City of Tampere, phone +358 40 801 6008, firstname.lastname@tampere.fi
Appendices (in Finnish)
• Mari Patronen, Proposal by the service voucher project’s old-age service project for a personal budget in close relative care support
• Mari Patronen, Personal budget in close relative care support, a presentation on Service Voucher Day, 17 March 2011
Video content (in Finnish)
Olli Valtonen, Director, HelsinkiMissio
Eija Koivuranta, Director, Ministry of Social Affairs and Health
Eeva Päivärinta, Procurement Manager, City of Tampere
Mari Patronen, Project Manager, City of Tampere