The contents of this article are subject to change due to the government proposal on 8 March 2018. This article will be updated as soon as possible.
The purpose of social services is to support people and families in their independent life and participation and to prevent exclusion. The aim of the health and social services reform is to integrate social services with other services. From the point of view of clients, services are more useful if their life situation is considered as a whole.
The objective of the health and social services reform is that health and social services would be as well integrated as possible. Service chains need to function well from the point of view of the clients. Services are not effective if people need to deal with many experts, none of whom has a general picture of the client’s situation. It is necessary to take into account the client’s whole life situation, particularly when the person or the family have many kinds of difficulties which they need support for. The health and social services reform will transfer the duty to organise health and social services from municipalities to counties in 2020.
Freedom of choice in social services
Even in future, public, private and third-sector operators can provide publicly funded social services for clients. However, clients would have more freedom than at present to choose their services providers. When using services provided by the county, clients can choose which unincorporated county enterprise and which of its service units they will use. They can choose for example a social services clinic. Clients can also choose the professional they wish to see if it is possible and appropriate with regard to the activities.
Health and social services voucher and personal budget
Unincorporated county enterprises can grant their clients health and social services vouchers. Clients can then choose a service provider and buy the agreed service from that provider against the services voucher. A services voucher can be granted if the unincorporated county enterprise has assessed and verified the client’s need for services. Clients can get services vouchers for buying home services, for example. In that case the client can choose a service provider that best suits him or her.
The client can also be granted a personal budget. Personal budget is a sum of money for buying a service package defined in the client care plan. Older people and people with disabilities in need of continuous and broad-based support must be offered a personal budget.
Clients can themselves decide where to buy the services defined by the client care plan, and they can also influence the content of their services. In this way clients will receive services that best suit their individual situation.
Social welfare professionals working at health and social services centres
According to the draft bill on freedom of choice, advising clients in matters relating to social welfare services would be taken care of by the new health and social services centres as far as possible. Social welfare professionals working at health and social services centres will give guidance and advice on social welfare services and activities and on social security.
According to the draft bill, some staff from the county’s own social services will also be working at health and social services centres. Counties must have one or several groups working at health and social services centres, including a social worker, other social welfare professionals and even healthcare professionals, when necessary. County staff working at health and social services centres would offer social services and make needs assessments. Clients would not need to separately visit a service unit of the unincorporated county enterprise in order to get social services.
However, clients will be referred to the unincorporated county enterprise if they need more extensive social services or if the service they need requires an official decision. Health and social services centres are not authorities and thereby do not have the power to make official decisions. The client may also be referred to receive peer support from a third-sector operator if there is no need for actual health and social services.
Assessment of need for services, and client care plan
Some clients need more health and social services than others. In that case, an individual client care plan will be drawn up for the person, and the support measures and means used to respond to the client’s needs will be documented in the plan. The details will be specified in the new Act on Freedom of Choice.
A client care plan would be the central tool for coordinating the services individually for each client. The client care plan would include all health and social services planned for the client, irrespective of service provider. One operator (the unincorporated county enterprise or the health and social services centre) would be responsible for drawing up the plan in accordance with the client’s need for services. The plan would be drawn up in cooperation with the client’s other service providers. All service providers would have to follow the client care plan.
Role of social guidance will become stronger
Even in future social workers shall integrate services and support in order to deliver the client the service package they need. In the model with several service providers, social work and social guidance is carried out in broad-based networks. The primary social workers, as referred to in the Social Welfare Act, play an important role in securing that their clients receive the services they need, in accordance with the assessment of need for services and the client care plan.
In addition, centralised service coordination is necessary in order to give the clients the information they need for making choices, to maintain an overview of the situation and to keep information flowing through the process.
Local services will remain close to home
A part of social services are local, home-delivered or mobile services or given by services units close to home. Local services include, for example, home care, family work and child protection. Even regarding social services, electronic services can be offered more often to clients who can use digital devices.
Counties would decide how to organise health and social services in an appropriate way in their region, in cooperation with other counties if necessary. Services that require special skills can be centralised or gathered together to a few localities. Examples of services that could be centralised include certain social welfare services for the disabled and a part of the child protection services, both requiring special skills. Clients should primarily get even these services in their own living environment.
The Government’s programme to address child and family services is developing particularly those health and social services that require most demanding special skills and specialisation. The programme also examines how the services could be centralised into centres of expertise and support. This would improve the quality and availability of the services, and they would serve the whole region. The centres would be located in unincorporated county enterprises in five collaborative catchment areas.
Kirsi Varhila, Director-General, tel. +358 295 163338
Virva Juurikkala, Senior Specialist, tel. + 358 295 163204
Elina Palola, Ministerial Adviser, tel. + 358 295 163595