A service voucher for intensive assisted living

If you come to a point in your life where you are no longer able to live at home, Espoo’s Nestori – Guidance and Service Counselling for Senior Citizens will help you and your loved ones determine the type of services you require. You will receive a written decision on the services that you have been granted. A nursing home is an option if you need care and attention round the clock and can no longer live at home. The official name of the services provided at nursing homes is intensive assisted living.

You can choose whether you want to move into a nursing home, where you will pay for the care and meals to the City based on the Act on Client Charges in Healthcare and Social Welfare, or use a service voucher, if you meet the financial criteria. The care and meals tend to cost more to service voucher clients, but on the other hand you will have more freedom in choosing your nursing home and may even receive a place in one faster. Accepting a service voucher is not compulsory. A service voucher allows you to choose your nursing home from amongst operators approved to provide service voucher services. Plenty of nursing homes are located in Espoo and elsewhere around Finland. All the nursing homes in Espoo also provide intensive assisted living for service voucher holders. The nursing homes approved as service voucher operators, their service fees and rental charges can be found at parastapalvelua.fi(extrernal link) (in Finnish and Swedish) by selecting ‘paikkakunta Espoo / hoiva-asumisen palveluseteli’.

If you are unable to find a suitable nursing home from this list, you can ask a service provider to contact the City of Espoo’s services for the elderly unit and apply to become an approved voucher service provider.

By granting a service voucher, the City agrees to pay for a portion of the overall care and meal costs at a private nursing home equal to the value of the voucher. Any excess costs you must pay for yourself. You must pay for the excess on a monthly basis to the nursing home. In addition you must pay for the rent, your medication and other personal expenditures and materials.

The value of a service voucher for long-term intensive assisted living depends on your income and is determined based on a table of values. When deciding on a voucher’s value, the income assessment will include all continuous and regular income after tax, earnings and capital income, income from forest, pensions and all similar continuous benefits. The medication costs, rent or other similar outgoings of service voucher clients are not considered as a reduction of a client’s overall income. However, you can apply for Kela housing allowance and care allowance for pensioners. These will not be taken into account when calculating the value of a service voucher.

Once we have received your income statement, we will determine the value of your voucher and send you the decision that you have been granted one. The value of a voucher may not exceed the true cost of services and meals. 

You can request an amendment to the service voucher decision by the Individual Matters Subcommittee of the Welfare and Health Committee. You will receive instructions on this with your service voucher decision.

Once you have found a suitable nursing home and agreed with it on moving there, we will notify the nursing home of the value of your service voucher and pay that amount every month directly to the service provider.

Your service voucher will be valid from your moving day onwards, if you move there after you have been granted a voucher. On the other hand, if you have already moved to a nursing home of your choice before receiving a service voucher, the voucher will become valid on the date specified in the service voucher decision.

The City of Espoo annually reviews the values of service vouchers it has granted and will therefore ask you for an income statement. If your income level changes significantly over the course of a year, you must notify the Welfare and Health Sector’s client fee team.

When you are granted a service voucher, the necessary information about you will be recorded in the Health and Social Services’ client database.

As a service voucher client, you will sign a written service agreement with your service provider about the services you will receive. The agreement must specify the terms of invoicing, the service and meal fees as well as the rent, the excess, the term of notice and the rules for terminating your agreement. Additionally, the agreement parties must agree on the invoicing during temporary absences. The service provider must notify you of any changes to your excess three months in advance.

If you are temporarily away from the nursing home, e.g. on holiday or in hospital, the City of Espoo will make the following payments to the service provider, based on your service voucher:

• 1–5 days’ absence: 100% payment based on the voucher
• 6–15 days’ absence: 50% payment based on the voucher
• over 16 days’ absence: 0% payment based on the voucher.

The City of Espoo has specified the minimum requirements for intensive assisted living provided by nursing homes. You can read more about these requirements in the service concept of the intensive assisted living services for the elderly(extrernal link) (in Finnish and Swedish).

The intensive assisted living services (monthly fee) do not include: 

• apartment rent
• medication 
• personal clothing or hygiene and care materials 
• personal mobility assistance equipment
• cost of buying or fixing a dental prosthesis or glasses 
• public healthcare costs 
• personal physiotherapy costs 
• hairdresser’s/barber’s fees, chiropodist’s services, travel costs incurred from use of services, costs incurred from managing personal banking or hobbies 
• newspaper or magazine subscriptions, phone bills 
• cost of buying or fixing personal equipment. 

You should check with the nursing home you have selected what their policy is regarding medical and other healthcare services when it comes to service voucher clients. We recommend that clients who move outside of Espoo change their health centre to a local one near their nursing home, which will make it easier to manage matters related to health care.

https://www.espoo.fi/en/health/health-centres/switching-health-centres(extrernal link)

When it comes to services provided in exchange for a service voucher, you as the client and your service provider will be the agreement parties and none of the commitments and obligations of the service agreement will apply to the City of Espoo. If you are unhappy with the services your nursing home has provided in return for your service voucher, we ask that you discuss the matter with the nursing home’s staff, director or their supervisor. You can also send feedback to the nursing home via parastapalvelua.fi. Where necessary, you can also give feedback to the City of Espoo about the service provider’s operations (easiointi.espoo.fi/efeedback/en(extrernal link) or pitkaaikaishoito@espoo.fi). Additionally, you have a right to issue a notification to the person in charge at your nursing home or the City of Espoo, or lodge a claim with the Regional State Administrative Agency or Valvira about your treatment. If necessary, the City of Espoo’s Social and Patient Ombudsman (sosiaali.potilasasiamies@espoo.fi) can help you submit a notification or a complaint.

When making a complaint, you as a service voucher client have a right to legal protection, in accordance with the Consumer Protection Act. The potential sanctions include a right to refuse to make a payment, a correction of the error, a discount, termination of the agreement and payment of damages. You can also submit the case to the Consumer Disputes Board, in accordance with the Act on the Consumer Dispute Board.