THE SPANISH DEPENDENCE CARE SYSTEM 西班牙生活依靠人群照料体系 Valladolid, 28th June 2016 巴利阿多利德， 2016年6月28日

Index 目录 THE SPANISH DEPENDENCE CARE SYSTEM PRELIMINARY ISSUES LAW 39/2006 of December 14th BENEFICIARIES SERVICES AND ECONOMIC BENEFITS FUNDING OF THE SYSTEM INFORMATION SYSTEM APPLICATION IN CASTILLA Y LEÓN 西班牙生活依靠人群照料体系 前提问题 《2006年12月14日第39号法》 受益人 服务和经济福利 体系筹资 信息系统 卡斯提利亚和莱昂大区的体系实践

Distribution of competences 职权划分 AUTONOMOUS COMMUNITIES : Social Services sole competence STATE: competence to regulate the basic conditions that guarantee equal opportunities for all Spaniards in the exercise of rights Law 39/2006 of December 14th about Promotion of Personal Autonomy and Care for people in situation of dependence 各自治区： 社会服务独立职权 国家： 其职权系规范基础条件，以保障西班牙公民行使权力时机会均等； 《2006年12月14日第39号推进生活依靠人群个人自理和照料法》

Law 39/2006 of December 14th 《2006年12月14日第39号法》 Caring in situations of dependence before 2006 Law: Pension scheme Small amounts Small segment of population Public and private social services with public funding With limited means Other systems in the EU 《2006年法》之前的生活依靠人群照料 养老金制度 小额 少数人群 公、私社会服务，均为公共财政支撑 照料手段有限 欧盟其他体系

Law 39/2006 of December 14th 《2006年12月14日第39号法》 LAW 39/2006 of December guarantees the care to situations of dependence needs, as a subjective right Principles: Universal access of all people in situation of dependence Comprehensive, integrated and customised care Permanence in the environment Participation of person in situation of dependence and their family Inter-administrative cooperation… Public Administrations involved: The State Autonomous Communities Local Entities (muncipalities and provinces) Territorial Council of Social Services and the System for autonomy and dependence care (establishes common criteria: scale of assessing, intensity of services…) 《2006年12月14日第39号法》 保障生活依靠人群照料需求，视之为主人翁权利 原则： 生活依靠人群照料获取统一轨道 综合的、整体的、遵从实际条件的照料 使受照料人能长期居于其生活环境 生活依靠人群及其家庭参与过程 行政部门间合作 相关公共行政机关 国家 自治区 地方机关（市政府或省政府） 社会服务地方委员会和生活依靠人群自理和照料体系（建立共同标准、评定级别、服务频次）

Law 39/2006 of December 14th 《2006年12月14日第39号法》 Beneficiaries: People requiring other people care to perform basic activities of daily life (ABVD), due to age, illness or disability Requirements: To have a recognised degree of dependence Living in Spanish territory and having lived for a five years period, being two consecutive and immediately preceding to the filing date of the application 受益人 因年老、疾病或残障等原因，要求他人提供照料以进行日常生活基本活动的人（ABVD） 条件要求 须有生活依靠程度认证 居住在西班牙境内，并总体超过5年以上；在递交申请日期之前连续2年居住于西班牙。

Law 39/2006 of December 14th Procedure 《2006年12月14日第39号法》 规定之程序 Application Functional (social and economic assessment) Establishment of individualised care programme (PIA) Recognition of the degree of dependence and service/benefit 申请 功能评定（社会经济状况评定） 确立个性化照料方案（PIA） 认定生活依靠程度和服务/福利水平

Law 39/2006 of December 14th 《2006年12月14日第39号法》 Functional assessment (I): Scale of dependence assessment (BVD). After aged 3. Assesses the ability of the person to perform by theirself certain tasks: eating and drinking, personal hygiene, health maintenance, travel, taking decisions… 0-24 points: No dependence 25 – 49 points : Grade I 50 – 74 points : Grade II 75 – 100 points : Grade III From 0 to 3 year: specific assessment scale 功能评定（1） 生活依靠程度级别（BVD）：年满3周岁以后，评定自力完成确定的数项任务之能力，包括：食物饮水、个人卫生、健康保持、外出旅行、自我决断… 0-24分：无需依靠他人 25-49分：1级 50-74分：2级 75-100分：3级 0-3周岁：有另外专门评定级别

Law 39/2006 of December 14th 《2006年12月14日第39号法》 Social assessment : Intends to identify the most appropriate benefits for the person Economic assessment: Carried out to establish the specific amount of economic benefits or the contribution of the beneficiary to the cost of public services. 社会评定： 旨在确认受益人最宜福利 经济评定 旨在确定经济福利额度或确定受益人为公共服务成本而缴纳之费用

Law 39/2006 of December 14th 《2006年12月14日第39号法》 Services and economic benefits: Situations of need are assisted through services that traditionally were provided through the public system of Social Services and the private offerings: Promotion of personal autonomy Telecare Home help Daytime and night-time centres Residencial care 各项服务和经济福利 需求人群可通过服务扶助其生活；这些服务传统上通过公、私社会服务系统提供；包括： 个人自理提高服务 远地照料 入户帮扶 日间和夜间照料中心 住院照料

Law 39/2006 of December 14th 《2006年12月14日第39号法》 Service of personal autonomy promotion: activities of guidance, counseling, support, etc. helping the accomplishment of the basic activities of daily living: Enabling and occupational therapy Early care for children aged 0 to 6 years Cognitive stimulation Promotion, maintenance and recovery of functional autonomy Psychosocial enabling for people with mental disease or intellectual disability 个人自理提高服务：引导、抚慰、扶助等工作，帮助受益人完成日常生活的基本活动 能力提高和职业疗养 0-6岁儿童早期照顾 认知激发 恢复、保持和提高自理功能 精神病或智障患者社会心理能力提高

Law 39/2006 of December 14th 《2006年12月14日第39号法》 Telecare Service Care through the use of communication and information technologies, with the support of personal means. Immediate answer to emergency situations Home help service Actions carried out at home, related to personal care in performing the activities of daily living and with domestic or household needs. The service is provided by authorised entities or companies Daytime center, night-time center and residential care services Offer comprehensive care for dependent person during the day-time, night or both 远程服务 通过信息和沟通技术，通过个人设备，直接回答应急问题。 入户帮扶服务 入户进行的工作，帮助受益人根据居家需要，进行日常活动。该类服务由获得授权的机构或企业提供。 日理中心、夜理中心和住院照料服务 在日间、夜间或日夜为生活依靠人群提供全面综合的照料。

Law 39/2006 of December 14th 《2006年12月14日第39号法》 Economic benefits: To finance authorised private services: Promotion of personal autonomy, Telecare, Home help, daytime and night-time centres, Residencial care. Personal assistance Economic benefit for care of family setting. A spending proof is not required. Lower amount 经济福利 用于资助获得授权认证的民办服务 个人自理提高服务，远程照料，入户帮扶，日夜照料中心、住院服务 个人扶助 家庭设施照料福利金；无需开销证明；额度较低。

Law 39/2006 of December 14th 《2006年12月14日第39号法》 FUNDING OF THE SYSTEM: State funding: Minimum level of protection: amount per beneficiary, depending on their degree and type of service/benefit Agreed level with the Regional Communitites (according to the affected population, size, geographical dispersion…) Regional funding: Agreed level with the State Aditional level: in practice it is the highest level of funding Beneficiaries funding: According to their economic capacity. Information System (SISAAD) 体系筹资 国家拨款 最低保障水平：根据每一受益人评定级别、所受服务/福利类型提供不同金额 与大区政府协议确定福利拨款水平（根据该区人口、规模、地理分布状况等…） 大区拨款 与国家协议确定的拨款水平 增补拨款水平：在实际操作中术语最高水平拨款 受益人缴费 根据其受益人经济能力缴纳 信息系统（SISAAD）

Application of the system in Castilla y León: Application of the dependence system in Castilla y León 卡·莱大区生活依靠人群照料体系申请程序 Application of the system in Castilla y León: Full integration of dependence system care with traditional social services Objetives: Achieve the greatest rationalisation and efficiency of the comprehensive care of the person Avoid duplication of effort, Get better speed and quality, and Get the best efficiency as possible in the use of available resources. 卡·莱大区体系申请程序 生活依靠人群照料体系构建完整，并包含各项传统社会服务项目 目标： 以最合理、最有效的方式，实现对受益人的全面综合照料 避免重复工作 提高速度与质量，并 运用可控资源，尽可能取得最效益

LOCAL ENTITIES 地方机构 REGIONAL GOVERNMENT 大区政府 Application of the dependence system in Castilla y León 卡·莱大区生活依靠人群照料体系申请程序 LOCAL ENTITIES 地方机构 Monitoring 监测 INFORMATION 信息 TECHNICAL DECISION 技术性决策 SOCIAL ASSESSMENT 社会境况评定 FUNCTIONAL 功能评级 ECONOMIC 经济状况评定 Application 申请 Home care service 入户照料服务 Telecare 远程照料 ●Daytime center /日间护理中心 ● Promotion of personal autonomy service / 个人自理提高服务 ● Residential center / 住院场所 ENQUIRY 询问 DECISION 决定 RESOLUTION 解决方式 GUIDANCE 引导 REGIONAL GOVERNMENT 大区政府 Financial benefit for care in the family setting 家庭场所照料福利金 Financial benefit linked to the service 服务关联福利金 Monitoring 监测

Standardised application form for requesting: 统一申请程序 标准化申请形式 Application of the dependence system in Castilla y León 卡·莱大区生活依靠人群照料体系申请程序 UNIFIED APPLICATION Standardised application form for requesting: Assessment Financial benefits Public Services Previous applications for accessing to different resources have been unified 统一申请程序 标准化申请形式 评定 福利金 公共服务 过去面向不同资源的申请途径现已统一

Functional and social assessment (I) 功能评级与社会境况评定（1） Application of the dependence system in Castilla y León 卡·莱大区生活依靠人群照料体系申请程序 Functional and social assessment (I) Standardisation of scales. The scale that values dependence (BVD) is useful for Assessing dependence Ordering dependents access to the services Ordering access to the services of people with no degree of dependence Standardised social report: for all social benefits access arising from the lack of personal autonomy 功能评级与社会境况评定（1） 等级标准化；对应于生活依靠程度的等级（BVD）运用于： 评定生活依靠程度 安排生活依靠人员接轨不同服务 安排无生活依靠等级的人员接轨不同服务 标准化社会境况报告：所有无生活自理能力人员申请社会福利时作出

3周岁以下儿童 Functional and social assessment (II) Application of the dependence system in Castilla y León 卡·莱大区生活依靠人群照料体系申请程序 Functional and social assessment (II) The assessment is performed by the nearest professional and with better knowledge of the person: 功能状况与社会境况评定（2） 评定工作由距离最近的专业人士和对受益人了解更多的人士作出 社会工作基础团队，由当地机关（地方政府）决定 居家生活 省社会救助管理办公室专业人员（大区行政机关） 居住福利院 早期照顾团队（大区行政机关） 3周岁以下儿童 Basic social action teams, depending on Local Entities (Local Government) Living at home Professionals of the Provincial Management Office of Social Services (Regional Administration) Living in nursing homes Early care teams (Regional Administration) Children aged under 3

Functional and social assessment (III) Application of the dependence system in Castilla y León 卡·莱大区生活依靠人群照料体系申请程序 Functional and social assessment (III) Professional of Reference or case manager: For people living in private homes, they are professionals of the basic social action teams (Local Government) who, besides assessing, provide benefits information, guidance and follow up It is the gateway to the system, for both dependents and no dependents Economic assessment: It is centralised in the Regional Administration, and is valid for all financial benefits and public services, regardless of who provides them 功能状况和社会状况评定（3） 专业参考人员或个案管理人：对居家受益人，提供社会工作基础团队的专业人员（地方政府）；专业人员在评定工作之外，还提供福利信息、引导和跟进工作 这是所有生活依靠人员和非依靠人员的体系入口 经济状况评定： 由大区行政机关统一组织，涵盖所有福利金和公共服务，而无论其由何种资源提供。

Application of the dependence system in Castilla y León 卡·莱大区生活依靠人群照料体系申请程序 Procedures （各项程序） 2007 – 30/04/2016 30/04/2016 Initial application – 初步申请 218.954 （例） Revisions and amendments – 复查与修订 118.488 （例） Total procedures – 申请案例总数 337.442 （例） Age groups N （数） % 年龄层 Under 18 years 2.728 3,3 18周岁以下 From 18 to 39 years 4.310 5,3 18-39周岁 From 40 to 64 years 10.695 13,1 40-64周岁 From 65 to 79 years 13.618 16,7 65-79周岁 From 80 years and over 50.259 61,6 80周岁及以上 Total 81.610 100,0 总数 Degree of dependence 生活依靠程度（等级） 30/04/2016 Grade III (great dependence) 3级（重度依靠） 27.618 （人） Grade II (severe dependence) 2级（高度依靠） 28.842 （人） Grade I (moderate dependence) 1级（重度依靠） 25.137 （人） Total dependents 生活依靠人员总数 81.597 （人） Persons assessed as no dependents 评定为无须依靠人员总数 25.539 （人） Female （女性） 65% 生活依靠人员

Services/Benefits (I): 各项服务/福利（1） Application of the dependence system in Castilla y León 卡·莱大区生活依靠人群照料体系申请程序 Services/Benefits (I): Priority services vs the economic benefit for care of family setting Benefit linked to services (I): It acts when the public service is not available or is not adjusted to the needs of the individual. Flexibility: it can be used for one or more services simultaneously or successively without submitting new applications. 各项服务/福利（1） 优先服务项目 vs 家庭设施照料福利金 服务补助金（1） 当公共服务无法获得实施时，或无法满足个人需要时，提供该福利金 灵活性：可以同时发放给一项或多项服务，而不需提交新的申请。

Services/Benefits (II): 各项服务/福利（2） Application of the dependence system in Castilla y León 卡·莱大区生活依靠人群照料体系申请程序 Services/Benefits (II): Benefit linked to services (II): Justification of expenses with invoices or certificates to make the payment The amounts are much higher than those for caring in family setting They are also higher than the maximum amounts set by the State Maximum price agreements with representatives of nursing homes 各项服务/福利（2） 服务补助金（2） 通过发票或支付凭据验证开销 其金额比家庭设施照料金额高很多 比国家拨款的最低福利金额也要高很多 与福利场所代表协商一致的最低价格

Application of the dependence system in Castilla y León 卡·莱大区生活依靠人群照料体系申请程序 Benefits- 各项福利 30/04/2016 Home care service – 入户照料服务 18.832 Telecare – 远程照料 6.111 Promotion of personal autonomy service 个人自理提高服务 12.127 Daytime center – 日理中心 8.035 Residential center – 入住照料中心 7.420 Financial benefit for care in the family setting 家庭设施照料福利金 22.408 Financial benefit linked to the service 服务补助金 23.449 Total benefits – 福利总数 98.382 Total beneficiaries – 受益人总数 77.253

SAUSS：整体程序支持应用软件，由全体专业工作人员实时接入（大区和基层行政机关） Application of the dependence system in Castilla y León 卡·莱大区生活依靠人群照料体系申请程序 SAUSS Software application that supports the entire procedure and accessible in real time for all professionals involved in it (from the Regional and Local Administration) STATISTICS SAUSS：整体程序支持应用软件，由全体专业工作人员实时接入（大区和基层行政机关） 各项统计数据 Estatistics – 31/03/2016 统计数据 España 西班牙 Castilla y León 卡·莱大区 Applications - 申请案例 1.611.196 115.266 Persons assessed – 获评人员 1.511.147 106.502 Persons entitled to benefits – 获得福利资格人员 1.202.427 81.134 Persons with benefits – 获取福利人员 802.269 75.551 Total benefits – 福利总数 987.205 96.426