Nursing reform - the changes in 2015
Ingrid Müller is a chemist and medical journalist. She was editor-in-chief of for twelve years. Since March 2014 she has been working as a freelance journalist and author for, among others, Focus Gesundheit, the health portal ellviva.de, the publishing house living crossmedia and the health channel of rtv.de.
More about the experts All content is checked by medical journalists.More and more people in Germany are getting older and the number of people in need of care is increasing. The new long-term care reform has been in force since July 1, 2008. In January 2015 these were further supplemented. The core of the current changes are the improved services for people in need of care and their relatives. All in all, all long-term care insurance benefits will be increased by four percent.
The most important changes in a nutshell:
“Extra money for care levels
From 2015 all contributions will increase. For example, the care allowance for care level I will be increased from 235 to 244 euros. In the case of outpatient care, the care benefits in kind increase from 450 to 480 euros. Those who have to be accommodated in a nursing home receive an additional payment of 1,064 euros from the nursing care insurance fund in care level I instead of 1,023.
Care benefits in kind provided by outpatient care services are reimbursed up to an amount of 1,612 euros (care level III) instead of the previous 1,550 euros. In the case of inpatient care, from January 1, 2015, people in need of care of care level III will receive 1,612 euros from the care insurance fund instead of the previous 1,550.
“Nursing leave
Anyone who is employed and has to organize or provide acute care for a relative can take ten days off from their employer from the beginning of the year - without having to forego their salary. The new long-term care support allowance is paid by the long-term care insurance with around 90 percent of the net wage (from wages subject to contributions).
In addition, the already legally anchored six-month nursing leave can now be financed with an interest-free loan from the Federal Office for Family and Civil Society Tasks (BAFzA). The loan is repaid in installments at the end of the nursing leave.
»More money for help in the household and in everyday life
People in need of care with care levels I to III will also receive an additional care allowance of 104 euros per month from next year. This money is currently only reserved for people with significantly limited everyday skills. In the future, everyone is entitled to the obolus - for example, for accompanying doctors on visits to the doctor by volunteers, for support with shopping or housekeeping. In the future, low-threshold care and relief offers can also be used instead of part of the care benefit in kind. The new "reallocation option" applies up to 40 percent of the respective outpatient care benefit amount.
»More flexible design of preventive and short-term care
Preventive and short-term care offers caring relatives or those in need of care, for example after a hospital stay, the opportunity to take a short break. From 2015 there will also be more money for this: Regardless of the level of care, people in need of care will now receive 1,612 euros (previously 1,550 euros) per year for each of these services.
As of January 2015, replacement maintenance is possible for up to six weeks per calendar year. In addition, up to 50 percent of the benefit amount for short-term care (806 euros) can also be spent on preventive care in the future - with corresponding deduction from the entitlement to short-term care. Up to now, up to 1,550 euros per year was available for preventive care, in future it will be up to 2,418 euros per year.
Instead of four weeks, up to eight weeks of short-term care per year will be possible in the future; the nursing care fund will then pay up to 3,224 euros for this; so far it is up to 3,100 euros. This can be achieved because money that was not used in preventive care can also be used for short-term care from the new year onwards. The increased amount used for short-term care will then be offset against the benefit amount for preventive care. In addition, day and night care can in future be used in full alongside outpatient cash benefits and benefits in kind.
»Improvements for people with significant impairment of everyday skills
Dementia sufferers with recognized significant limitations in everyday skills, provided they are not classified in care levels I to III, are assigned to care level 0. At the turn of the year, you will receive access to all outpatient long-term care insurance benefits for the first time. They are entitled to day / night care as part of inpatient care as well as short-term care.
As of January 2015, dementia patients in outpatient care residential communities will for the first time be entitled to a group surcharge of 205 euros per month. This is paid to each resident to finance a support worker. This should organize social activities there or, for example, accompany walks. The start-up financing of 2,500 euros per resident for setting up an outpatient care group is now also available in care level 0.
»New long-term care provision fund
A long-term care provision fund is being set up in order to be able to keep the contributions to long-term care insurance as stable as possible from 2035 - the year from which the baby boomers enter the long-term care age. From next year, payments of 0.1 contribution points (around 1.2 billion euros) are planned. The fund is administered by the Bundesbank.
“Family care leave
From January 1, 2015, all employees are entitled to family care leave of 24 months if they care for a close relative in need of care in their home environment. However, the new law only applies under two conditions:
- Employees continue to work at least 15 hours a week and
- the company has more than 15 employees.
For financial security, employees can apply for an interest-free loan from the Federal Office for Family and Civil Society Tasks (BAFzA) during the leave of absence during family care leave.
During the family care leave, employees enjoy special protection against dismissal. The family care leave insurance, which is currently still compulsory, is no longer applicable.
The employer must be informed of the family care leave eight weeks in advance. The legal entitlement also applies to the care of a minor child in need of care. Family care leave and care leave can be combined with one another, provided that 24 months of leave or part time are not exceeded. If a care leave is to be followed by a family care leave, this must be announced to the employer at least three months in advance.
In 2009 there were already serious changes that are still valid:
»Care rates: The care rates were gradually increased until 2012. In the future, the amount of the benefits will be checked every three years and further adjusted if necessary.
»People with significantly limited everyday skills: The services in the outpatient area have been improved. This applies, for example, to people with dementia, the mentally handicapped and the mentally ill. In future, these people will receive benefits of up to EUR 100 per month (basic amount) or up to EUR 200 per month (increased amount), depending on their care needs. These are grants of up to 1,200 euros or up to 2,400 euros annually. For the first time, people with significantly restricted everyday skills who have not yet reached one of the care levels receive these benefits (care level 0).
»Preventive care: Since 2009, carers have been entitled to a substitute after just six months (previously twelve) if they need vacation or fall ill. The costs for the substitute carer are covered for up to four weeks per year (since 2010: 1510 euros, from 2012: 1550 euros). The nursing care fund continues to pay the carer's pension insurance contributions for the duration of the vacation leave.
»Care leave for employees: Caregiving relatives are entitled to care leave of up to six months during which they do not receive a salary but remain insured. The return of the family carers to their employer is guaranteed. During this period, you will usually remain insured through the long-term care insurance. The entitlement to unemployment insurance is retained.If necessary, the contributions to health and long-term care insurance are covered by the long-term care insurance up to the amount of the minimum contribution.
»Care TÜV: Outpatient and inpatient care facilities receive grades from the inspection service of the health insurance companies. They are checked annually and generally unannounced. The quality reports are published in an understandable form on the Internet and must also be posted in the homes in a clearly visible manner. The aim is to promote quality competition and transparency.
»Receive care benefits faster: Those who have paid in for at least two years or who have family insurance receive benefits from long-term care insurance. The previous insurance period will be reduced from five to two years.
»Evaluation deadlines: The long-term care insurance fund must report the result no later than five weeks after an application for long-term care has been submitted. In emergencies, the deadline is shortened to two or even one week.
»Care assistants: Care assistants can be employed in homes for people who need special care. They are financed by the nursing care funds, and the additional staff should also have a positive effect on the nursing staff.
»Case manager: There is a legal right to individual and comprehensive care advice (case management) from the health insurance company. So-called case managers provide information on benefit entitlements and financial aid from the health insurance companies. The care advisors are central contacts who not only provide advice, but also coordinate the entire service process for those in need of care.
»Care support points: Care and health insurance companies set up care support points if the individual federal states decide to set up care support points. Advisory services from various providers and the municipalities are to be bundled in the bases. This includes: advice on all aspects of care, benefits for the elderly, assistance for the handicapped or basic security or the involvement of voluntary work.
If a need for care suddenly occurs, employees can stay away from work for up to ten days at short notice in order to ensure care during this time or to organize needs-based care.
»Low-threshold offers (for example care groups, day care, groups of helpers to relieve caring relatives on an hourly basis) as well as voluntary structures and self-help in the care sector are also promoted.
