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International Caregiving Legislation

The Netherlands

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Revision of Long-Term Care Insurance (AWBZ)

Type of legislation:  Long-term care insurance reform

For more information contact:

Annelies Scheepens

Policy Officer LOT (Dutch Carers Association)

a.scheepens@mantelzorg-lot.nl

Marja Pijl

Board member LOT, pijl.ma@tref.nl

Description of legislation:

Revising the AWBZ has been among the major projects of the government in the period 1998-2002.  After intensive consultations consensus has been reached on a number of changes that will be implemented in January 2003. Many of them still have to be worked out in further detail. Some of these changes are expected to have an impact on carers. 

Whereas entitlement to provisions financed on the basis of the AWBZ used to be defined rather precisely in terms of the kinds of care to be provided, in the new system entitlements will be defined in terms of functions.

These functions are: domestic care, personal care, nursing, supporting supervision, activating supervision, stay and treatment.

The assessment, which is the gate to all AWBZ financed provisions, will not only indicate the functions to which the applicant will be entitled, but also the classes. The classes determine the intensity of the care and will be expressed in time units. The classes still need to be defined.

Applicants will have a choice between care in kind or an amount of cash (i.e. a care allowance, in Dutch usually referred to as PGB), corresponding to the functions and their intensity as stated in the assessment. A care allowance is only possible for the first five functions.

If the applicant opts for care in kind, he will choose one or more providers, contracted by the insurance office, and negotiate with them for the best possible solutions on the basis of his entitlements (Klanten kiezen. VWS 2002. www.opkopzorg.nl, in Dutch).

It is expected that the new system will have certain indirect and direct advantages for carers. 

·        There will be greater freedom for the care recipient to determine how the care will be given and by which provider.

·        The care allowance plan will be available for anyone who opts for it.

·        There are three functions which are expected to open up new possibilities which are relevant for carers.  In particular:

o       The two kinds of supervision mean that attendance, which is often a very burdensome task for carers, can be covered by the AWBZ.

o       The same is true of stay. This will not only concern a permanent stay in an institution but also a temporary stay of the cared for person outside his/her own home, to give the carer a break (i.e., respite care).

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