No one is waiting for the nationwide care reform in Burgenland. Since 2019, the federal state has been going its own way with the employment of caring relatives and, as the state audit office has now also determined, not quite cost-effective.
Together with Provincial Governor Hans Peter Doskozil, Social Provincial Councilor Leonard Schneemann – both SPÖ, after all they have governed Burgenland alone since the beginning of 2020 – are now presenting a new care concept: in the future, nine full-time or correspondingly more part-time employees will be responsible for mobile long-term care and support at 70 care bases , who provide care in day centers for senior citizens and assisted living in a region that is home to around 4,000 people.
Snowman: “Remedies don’t fall from the sky”
One has “a responsibility towards the older population to ensure that one can age with dignity,” said Governor Doskozil when presenting the concept. It is the task of politics “as care financiers” to “achieve the greatest possible effect for those affected with the available funds”.
As a country, you don’t want to be a mobile care provider, the current ones remain, including Volkshilfe, Caritas, a relief organization, the Red Cross and Diakonie. “We want to free them from the property factor,” says Doskozil. Because the bases are close to where you live, you can save money on travel times. “The current financing model converted to full-time equivalents results in nine employees per base, which is cost-neutral,” the governor calculates. Social Provincial Councilor Leonard Schneemann says in an interview with the “Wiener Zeitung” that the “funds don’t just fall out of the sky”.
When it comes to the exact costs, however, he wants to keep a low profile at first, so that he can finally name at least part of them when asked: the state real estate company has named around two million euros as a necessary investment for a new care base, “if you set it up completely new on the green field “Snowman says. However, 20 to 30 of the planned 70 bases are not about that, but about adaptations or existing buildings.
Care and support
Do not disconnect
Schneemann finds it easier to formulate the social goal: It is about fulfilling the wish of 98.5 percent of Burgenland residents, which was surveyed, and namely “to spend the old age as much as possible in their own four walls”. It is therefore clear that none of the 44 stationary nursing homes will be expanded into a base: “We don’t want a giant nursing temple, we want to expand, into the communities, close to the people.”
Governor Doskozil sees the bases as “a village square where older people also meet.” Schneemann also wants to organize volunteer and neighborhood help. The state will determine which professional groups are active in the bases, from community nurses to nursing and care, in discussions with the providers. Payment above the minimum wage and accounting for jobs instead of individual services are fixed, says Schneemann.
The tenders for the 70 bases combined into 28 regions will only follow after these talks at the beginning of 2023. If necessary, there could also be an apartment for a 24-hour supervisor who then looks after four people, says Schneemann, “because each only a few hours, but there is no alternative now”. The employment of caring relatives should also continue.
Court of Auditors: “Dynamic change” in costs
the State Court of Auditors has in its current report analyzes these jobs, inpatient care and the costs in general and sees a “dynamic change” of plus 56 percent since 2015 to 145 million euros in 2019. “Yes, we had 46 percent more costs in inpatient care with an increase in supply of eight percent for the beds,” says the Social Provincial Councilor. He cites the abolished care recourse and the value adjustment for wages and salaries as reasons, “that alone explains a good 15 percent of the additional costs”.
The Court of Audit cites the government decision of September 2019 to finance family caregivers: “The annual costs for the employment model will be around 13 million euros when fully expanded with 600 employment relationships.” In fact, the Court of Auditors now lists that the state paid personnel costs of 3.08 million euros for a total of 222 employed relatives by the end of 2020. In addition, those in need of care contributed a further EUR 1 million as a deductible for the employment of their relatives. However, the state paid an additional 1.47 million euros in operating costs to Pflege Service Burgenland GmbH, which organizes the model.
For Schneemann, the around 300 jobs still make sense: “We have helped three hundred families to look after their relatives close to home. Who knows how many of them would otherwise have ended up in old people’s homes?” asks the provincial councillor. “And at 130 euros per day and patient, the home is definitely the most expensive solution.”