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in accordance with the draft act on clients’ freedom of choice21 December 2016

What does freedom of choice mean to me?

Draft act on clients’ freedom of choice, 21 December 2016

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Freedom of choice is part of the health and social services reformThe objective of the reform is to ensure equal and modern health and social services at reasonable costs. As part of the reform, freedom of choice will be improved for clients of health and social services.

The objective is to give clients faster access to care and improve their opportunities to influence the services they use in different life situations.

The reform is due to come into force on 1 January 2019 but the services will be reformed gradually – not everything changes at once.

21 December 2016 Draft act on clients’ freedom of choice, 21 December 2016

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Clients can choose more individually than todayIf you want to choose your services yourself, you can choose them from a county-owned company, private enterprise or organisation. The service provider must be registered, fulfil the requirements set by the county and have an agreement with the county.• From a health and social services centre you can get basic-level health services

and guidance on social services. The services will become even more comprehensive in the future.

• You can also choose a unit for oral health services. • The health and social services centre and the unit for oral health services are

responsible for all services assigned to them. They can grant you primary vouchers for buying a particular service from other providers.

21 December 2016 Draft act on clients’ freedom of choice, 21 December 2016

You will get support for your choices online, through a

telephone helpline or from service

counsellors. If you don’t want to choose yourself, the county

will direct you to suitable services.

The array of services mentioned above is supported by county companies that offer, for example, many kinds of social services and specialised medical services. When necessary, the county company carries out an assessment of your need for services and care. Based on the assessment, you can receive an extended voucher or personal budget to buy services included in your client care plan. You can choose a service provider anywhere in the country. The client fee will be the same, it does not depend on the service provider.

-Draft act on clients’ freedom of choice, 21 December 2016

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Health and social services centre, unit for oral health services, primary voucher- GP and nurse, social services guidance - Basic services by dentists and dental hygienists- Later also other health and social services- Responsible for the client’s services as a whole- The client can be given a primary voucher for buying a particular service or measure from other providers.

County’s own service provision – Other services within the freedom of choice which are not offered by the health and social services centre, for example social services, 24-hour services and specialised medical care.– The client can choose a public sector service unit amongst all public units in the country. – The public care facility for specialised medical care will be chosen together with the referring GP.

Extended voucher– When necessary, the county company grants an extended voucher for carrying out the client care plan.– The county decides on the services and the client chooses a service provider amongst the registered service providers around the country.– The county is responsible for the costs and the client pays the client fee, which is the same for all providers.

Personal budget- With the help of personal budget, elderly clients and persons with disabilities, for example, can influence the content of their support and choose their service provider.- The client can decide, within the limits of his/her care plan, for which services the money is used and who is the service provider. The services can include, for example, a personal assistant or transport services.

Clients have more freedom of choice than today

The client chooses a health and social services centre and a unit for oral health

services and makes a one-year commitment with these

service providers.

If the client needs other services, he/she will

receive them from the county company.

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Counties have the overall responsibility for the services. Health and social services centres and units for oral health services have the corresponding responsibility for providing the services within the scope of wide freedom of choice.

1. Choosing a health and social services centre

and unit for oral health services

2. Primary voucher granted by the health and social

services centre or the unit for oral health services

3. Choosing a county company

4. Extended voucher or personal budget granted by the county company

Choices in different life situations

The client can choose a county company and its unit from all over

Finland.

The client can use his/her extended voucher or personal budget to buy services provided by any approved service provider in Finland.

The client can choose a county-approved service

provider and its unit from all over Finland.

Money follows the client.

The service provider is responsible for and pays the costs of the services

the client receives against his/her primary

voucher.

The client chooses and makes a commitment for one year

Assessment of the client’s need for care

and services

21 December 2016 Draft act on clients’ freedom of choice, 21 December 20165

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Clients’ right to choosefrom 1 January 2019

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TO CHOOSE A HEALTH AND SOCIAL SERVICES CENTRE AND A UNIT FOR ORAL HEALTH

SERVICES FROM THE WHOLE COUNTRY

TO RECEIVE A PRIMARY VOUCHER, IF YOU NEED ONE, FROM A HEALTH

AND SOCIAL SERVICES

CENTRE OR FROM A UNIT FOR ORAL HEALTH SERVICES

TO CHOOSE A COUNTY COMPANY

UNIT

TO RECEIVE AN EXTENDED VOUCHER OR PERSONAL

BUDGET, IF YOU NEED ONE, FROM THE COUNTY

COMPANY

TO SEEK NON-URGENT CARE ABROAD

TO EXPRESS YOUR WISHES REGARDING

THE ATTENDING CARE PROVIDER. YOUR WISH WILL BE FOLLOWED AS

FAR AS POSSIBLE

TO RECEIVE CARE IN A TEMPORARY PLACE OF

RESIDENCE

112You will always have access to

emergency care offered by public healthcare services in

Finland and abroad.

Draft act on clients’ freedom of choice, 21

December 2016

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Service needs and costsin clients’ different life situations

21 December 2016 Draft act on clients’ freedom of choice, 21 December 2016

The need for services and the costs per unit decrease

approx. 10% of the population

(estimate)

30% of the population

(estimate)

60% of the population

(estimate)

100%

High need for care or services

Wider need for care or services

Occasional need for care or services

Supporting health and wellbeing

approx. 80% approx. 20%

-21 December 2016 Draft act on clients’ freedom of choice, 21 December 20168

Different practices in different life situationsSupporting population’s health and wellbeing (whole population)

• Broad-based cooperation between interest groups

• Supporting health and wellbeing, prevention, early intervention

• Increasing awareness of choices affecting health and wellbeing

• E-services for self-management of health, telephone services, and information, advice and guidance received from county service offices

Occasional need for care or services (approx. 60% of the population)

• Services from a health and social services centre and from a unit for oral health services, use of primary vouchers when necessary

• E-services, client’s self-assessment of health, advice by phone

• Swift care needs assessment and access to services• Cooperation with units of the county company when

necessary but no need for deeper integration

Wider need for care or services (approx. 30% of the population)

• Services from the health and social services centre, unit for oral health services and county company as defined in the client care plan.

• E-services supporting self-management of health.• When necessary, extended vouchers or personal

budget granted by the county company. • The county can decide that the health and social

services centre or the unit for oral health services has the right to provide more services than those defined nationally.

High need for care or services (approx. 10% of the population)

• High need for individual integration, coherent treatment and service chains, multiprofessional cooperation, continuity of care

• The county company is responsible for assessing care needs, making an extensive client care plan and carrying it out in practice.

• High costs per unit, small number of clients• The care package will be carried out in close

cooperation between the concerned health and social services centre or unit for oral health services.

-9 21 December 2016 Draft act on clients’ freedom of choice, 21 December 2016

Thank you!

regionalreform.fiMINISTRY OF SOCIAL AFFAIRS AND HEALTH ● MINISTRY OF FINANCE