The concept of inclusion is a major criterion in the further development of structures and systems in the fields of prevention, health, long-term care and rehabilitation.
The Federal Government is endeavouring to ensure accessible, universal prevention, health, rehabilitation and long-term care services for people with and without disabilities that should be provided near to where they live. Instead of simply being next to one another, it is necessary to enable both the interlinking of all stakeholders and benefits and the information and advice on existing services.
The right to rehabilitation, as set out in the Ninth Book of the Social Code (SGB IX), is being refined with a view to an inclusive approach. Problems in implementation, such as with the inter-institutional personal budget or in the joint service agencies, are to be solved amongst other things through modern information and communication technologies. The vocational rehabilitation system will be equipped to face the challenges of the future by means of the “Reha Futur” initiative.
At the same time, Germany is confronted as a result of demographic development with insured parties who remain in gainful life for longer, so that the demands in terms of benefits to participate in pensions insurance will also continue to increase in future. A fundamental decision has been adopted in pensions policy that increases in expenditure in the pensions insurance system are not to be at the expense of justice between the generations, nor should they endanger the statutory upper limits for the contribution rate. In this context, the Federal Government will also be examining the need to increase the ceiling on rehabilitation costs.
We want to provide barrier-free access to rehabilitation services for persons with disabilities. This takes place on the basis of a study which investigates what is done in practice.
The Federal Government is examining the possible content of a Patients Rights Act to enhance the rights of persons with disabilities when it comes to questions of healthcare.
The reorientation of integration assistance for persons with disabilities from a largely institutionally-related towards a person-centred participation contribution is being discussed in a Federation-Länder working party. A uniform, comprehensive procedure for the planning of participation, in which the individual case is comprehensively investigated at a level spanning the financing entities, is also under discussion.
The principle of “rehabilitation before long-term care” is being systematically implemented to reduce and postpone the need for long-term care.
In future, long-term care is to be orientated closer still to the needs of those in need of long-term care, for instance, through greater transparency in the price and quality of benefit offered. This enables those in need of long-term care and their relatives to select benefits and benefit-providers more flexibly.
As well as a better portrayal of the need for benefits, forms of housing and care must be available which are orientated towards the requirements of those in need of long-term care, such as shared accommodation for people with dementia.
In order to enable people in gainful employment to engage in the long-term care of their relatives, the Federal Cabinet already adopted the draft Act on Reconciliation of Long-term Care and Work (Gesetz zur Vereinbarkeit von Pflege und Beruf) on 23 March 2011, the primary component of which is the Act on Care-giving Leave for Families (Familienpflegezeitgesetz). Relatives providing long-term care are hence to be able to maintain a financial livelihood and avoid interruptions in their working biographies.
The approach for a new, more differentiated definition of need for long-term care, as well as its impact on the future design of long-term care insurance and also the links with other benefit systems, are currently being examined with the aim in mind of guaranteeing that implementation will be as seamless as possible.
The basic and further training of long-term care staff is to consider more carefully the specific needs of women and men with disabilities in future.