On 21 July 2023 the National Assembly adopted the Long-term Care Act, replacing the Long-term Care Act (2021) (see “Long-Term Care Act adopted by Parliament in December 2021” https://eurohealthobservatory.who.int/monitors/health-systems-monitor/updates/hspm/slovenia-2022/long-term-care-act-adopted-by-parliament-in-december-2021).
In November 2022, the application of some of the provisions of the 2021 Act was postponed via a referendum, leading to a new Ministry of Solidarity-Based Future was established with, among others, responsibilities for LTC. The Ministry submitted the new 2023 Act in June 2023, keeping most of the main solutions foreseen in the previous Act, with a notable exception being the financing arrangements for LTC.
The provisions described refer to the 2023 Act:
Access to LTC is ensured via “compulsory insurance for long-term care”. The 2023 Long-term Care Act introduces a new nationally standardized instrument to assess individual needs for (and rights to) for LTC. The assessment instrument was piloted in several settings prior to the adoption of the Act. These assessments will be performed at so-called “entry points” in local Centres for Social Work and allocated a person to 1 of 5 LTC categories. The resulting category designated to an individual more specifically determines the level of need and the extent to which each of these services will be available to them.
The types of LTC support determined by the Act are:
- continuous LTC in institutions
- daily LTC in institutions
- LTC at home
- care provided by a family member, and
- right to monetary transfers.
Funds for LTC insurance will be collected from employers and employees similarly to health insurance contributions, whereby each (that is, employer and employee) will contribute 1% of the worker’s salary. Special provisions apply to particular employment arrangements, for example, self-employed persons. Additionally, €190 million (approximately 0.4% of Slovenia’s GDP) will be added annually from the national budget.
According to government estimates, the full set of services and the full costs of the new system will be apparent in 2026. Total LTC expenditure is estimated to increase from 1.45% of GDP in 2020 to 1.72% of GDP in 2026. Nominally, the private contribution to expenditure is expected to increase (from €164 million in 2020 to €244 million in 2026). However, given higher total spending on LTC, private expenditure as a share of total LTC expenditure is expected to decrease from 24.1% to 18.7%.
A major challenge to the implementation of the Act in full is the timely and effective upgrade or establishment of LTC services foreseen in the Act, especially strengthening capacity for home care.