People with a personal budget (pgb) are increasingly unable to make ends meet financially, because the rates of self-employed persons in the care sector have risen sharply. Per Saldo, an association for people with a personal budget, sees this. In the first months of this year, the association received more than 250 reports about too high costs, as a result of which PGBs are not covering.
About 120,000 Dutch people have a personal budget (pgb), an amount that is used to purchase care or home help themselves.
The problem occurs with Nynke Koelma, for example. She has a progressive muscle disease and depends on help with washing and dressing. She sees that a “kind of lopsided growth” has arisen in what insurance pays and what nurses charge for care.
For example, she recently spoke to a nurse who has a lot of experience, but who will not work for Koelma because of the price difference. “She was 10 euros per hour above the amount that my insurance reimburses.” Koelma receives 35 euros per hour for a care provider. “Then she said she wouldn’t do it for that amount. That was a shame.”
Sarike de Zoeten needs help with the care of her son Bram. She has the feeling that some self-employed care providers now mainly choose this work because of the increased rates. “Caring for a child is really different from a boy like Bram.”
Director Aline Molenaar of Per Saldo sees harrowing cases. She cites the example of a man who had to stay in his wheelchair at night because there was no one to take him to bed.
Due to the large schedule gaps in healthcare, self-employed people are desperately needed to get the teams around. And hiring a new help is therefore too expensive in some cases.
Someone with a personal budget must pay a healthcare provider the minimum wage anyway. The maximum amount a professional may earn per hour or part of a day is determined by the municipality or health insurer. If, for example, the rate of a self-employed person is higher than that maximum, the client must pay the extra.
Rates down or reimbursement up?
SoloPartners is a branch organization for self-employed professionals in the healthcare sector. The sector recognizes that the budgets for personal budgets via the Wmo and Zvw are lagging behind the rates. A spokesperson for the organization explains that the rates differ because, according to him, both the healthcare system and the market are not functioning properly.
“But is that because the rates of the self-employed are too high or because the budgets are based on too low rates? A self-employed person must be able to pay his business expenses and have an income left over,” says the spokesperson.
Sometimes professional care providers are satisfied with less, sees Aline Molenaar of Per Saldo: “You have very loyal self-employed people who have been working for a budget holder for years. They find the work so important that they take into account the rate they charge. But we know also a lot of self-employed people who ask far above the rate that the budget holder receives to purchase care.”
Budget holder Nynke Koelma is worried about the future, because she will need more and more help due to the course of her muscle disease. “I don’t know if I can find the right people for that,” she says. “I don’t know what a solution could be either. Should self-employed people lower their rates or is it the insurance company that has to reimburse more? Who’s up?”
Minister Helder for Long-Term Care and Sport refers to the Health Insurance Act and the Long-Term Care Act, which set rates that insurers are allowed to reimburse as a maximum. She says that her ministry has no influence on what self-employed people ask for care and support. In collaboration with municipalities and Per Saldo, the ministry is working on a guideline for calculating adequate personal budget rates that municipalities use to determine a personal budget.
Per Saldo thinks this is not enough and wants guidelines for municipalities to be converted into obligations, which should also apply to health insurers, which also set personal budgets. “Only if the same fixed rates apply to all personal budget laws that are reimbursed at the maximum, you can improve the negotiating position of the budget holder against the self-employed,” says Per Saldo director Molenaar.
- From now on, home care help is also entitled to social security schemes