Home health care
FOUNDATIOM FOR ELDERLY CARE (FEC) started this project in January 1999, financed by Stichting Roemenie Committees – Belgium and “Something for Romania” – England, in the amount of 50,000.00 USD . To ensure continuity of care and social services at home, in 2000-2004 we obtained financing in the amount of 12,000.00 USD and 160,000.00 Euros from HealthNet International – Netherlands. From this funding we were able to develop not only services in Cluj-Napoca, but also within Cluj County, opening branches in three cities (Huedin, Turda, Dej) and 7 rural communities. To provide high quality services, we have qualified through professional classes, 30 nurses, 6 physiotherapists, 15 social workers and 35 caregivers.
In 2002 we opened four branches in neighboring counties of Cluj County, as follows: in Timisoara (Timiș county), in Bistrița (county Bistrița-Năsăud) in Oradea (Bihor county) and Zalău (Sălaj). Each workstation had a multidisciplinary team consisting of: two nurses, two social workers, a physiotherapist, a nurse.
By offering these health and social services at home, in a familiar environment, we wanted to prove to the local authorities the need and importance to develop these services, especially since these services are at least three times less expensive than institutional care.
Between 2005-2014, we have concluded contracts for offering health and medical care services at home with the County Health Insurance Cluj for financing health fund and for social assistance at home, we obtained a grant under Law no. 34/1998, from Cluj-Napoca City Council. Social services and nursing home services were granted only in Cluj-Napoca.
In 2014, we provided home health care services to a number of 153 patients, making over 1830 visits. These services were provided by our multidisciplinary team consist of: 1 manager of care, 2 nurses, 1 doctor, 2 carers, 1 physiotherapist.
Requests for home care services are increasing. These services should be developed, decision makers should give more importance to the budget allocation of public funds, being less expensive than hospital services, institutionalization.
In 2014, a rate of about 70% of home care recipients were found being in the palliative phase of the illness and the professionals from our Foundation’s team gave specific medical care, they having also the necessary qualification to perform palliative care at home.
Bureaucratic and financial problems:
1. Complex documentation to obtain the decision for medical care at home, financed by County Health Insurance House;
2. Length too large (about 10 days) after submitting the documents until the actual start of care at home;
3. Insufficient budget allocated from the National Health Insurance for home care services. According to the Framework Contract and Norms in order, a patient may receive 90 days of home nursing services in 11 months / year, services are provided, where needed, also on Saturday and Sunday or public holidays. Under the terms of the Framework Contract / 2014, established by the County Health Insurance House in Cluj, for a patient’s care, 10 days / month are paid, so more people receive care in the monthly budget allocated. The following 20 days of service / month must be covered by the provider’s funds or they can be charged. In such circumstances, to the benefit of patients, a Supplier should have sufficient funds, so that, even with the co-payment, he can be able to assure the continuity of services.
For 2014, the National Health Insurance House has agreed to pay 55 RON / 1 day of care. The tarrif includes the payment of necessary health care services and supplies (bandages, syringes, infusion kits, cannula, sterile gloves, bladder catheters, stoma bags for collecting, minimum 2 urine incontinence diapers) for different types of recommended services. This price, actually, covers about 55% of the total cost for one day of care, which should be covered by the supplier, the difference of about 45% must be paid by the provider by its own funds.