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Officials in Finland warned for fast-tracking wealthy candidates for elder home services

The practice of prioritising affluent seniors over cash-strapped elders for places in private homes was deemed unlawful.

Nainen työntää vanhusta pyörätuolissa.
Image: Henrietta Hassinen / Yle

The Southern Finland regional administrative authority (Avi) has warned the southeastern city of Hamina for allowing more well-to-do candidates to bypass lower-income seniors in queues for care home accommodation.

According to Avi, the practice of prioritising affluent over cash-strapped older people for accommodation in private care facilities was unlawful.

The regional authority was alerted to the practice two years ago when it received complaints over queue-jumping in elder care housing services.

Hamina city council’s welfare board acknowledged in a statement on the matter that wealthier customers paying out of pocket or with service vouchers for care home placements had been given places quicker than poorer clients.

The board justified the practice by arguing that lower-income customers wouldn't necessarily be able to pay for private homes. The municipality claimed in the statement that when necessary, officials exercised discretion with respect to customer charges to ensure that as many seniors as possible could get into private facilities.

Previous director did not remember

Sanna Niskanen, a former director of elder care services in Hamina, declined to comment on why seniors’ incomes influenced their access to care facilities while she worked there.

"I cannot comment because I have not seen the Avi decision. I don’t even remember the matter. I haven’t worked there for years," she stated.

Since the beginning of the year, care home services have been managed by Kymsote, the Kymenlaakso municipal health cooperative. According to service manager Mervi Takala, wealth no longer plays a role in getting placement in a care home.

"Solvency is not a factor in receiving a care placement; rather it is the customer’s need for service that determines it. We provide care places the same way for Ingrian Finns, who usually have not accumulated much pension," she explained.

The regional authority has called on the city of Hamina to take note of the issue and also issued a caution on the subject.

Placement based on need, not ability to pay

Officials found that Hamina elder care services’ way of operating and its practice of fast-tracking affluent customers into care homes were in every way unlawful. They noted that the provision of care home places should be based on an individual’s need for assistance and support and not on their ability to pay.

"Care home fees are based on the customer’s income. However the municipality or municipal cooperative must charge customers the same fee for both private and municipal care homes," said Maria Borg, chief inspector of the local Avi office.

Borg noted that she was not aware of similar cases elsewhere in Finland.

"The ability to pay is not mentioned as a criterion for receiving a care placement, at least not generally. Nothing like that has been publicly stated," Borg added.

However she said that from time to time, people have spoken about how wealth might affect allocation of care home spots. She said this could be attributed to the fact that some seniors foot the bill for their care homes themselves.

"Not all customers seek placement via public services. Some wealthy pensioners do not get a placement from the municipality based on their means so they want to pay themselves and apply to homes on their own. Of course this is a minority of customers," she explained.

Legal waiting time exceeded

The regional administrative authority also criticised the fact that in many cases, seniors in Hamina who met the criteria for enhanced service housing did not receive a placement in a care home within three months of the decision to accommodate them.

Current laws require municipalities to provide customers their approved services without delay and without compromising an aged person’s right to immediate care. Elderly people have the right to receive approved non-urgent social services without undue delay, but within three months of the decision to provide the service.

The authority asked the city to provide a waiting list showing applicants for round-the-clock services for 2015, 2016 and 2017. During that time Hamina regularly had elderly folk who were not able to get the services they had requested within the three months specified by the Elderly Services Act.

"There were months when things worked smoothly and months when the time frame was exceeded," Borg commented.

On top of that, Avi deemed that social care expertise in the city was inadequate since there were no social workers employed in Hamina’s elder care services unit. The authority said that the customer’s right to have their service needs evaluated had not necessarily been satisfied according to social care laws.

Tabloid Iltalehti first reported on the fast-tracking of wealthier seniors in the Hamina elder care system.

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