The “Home Care and Assistance Services towards Independent and Dignified Life” Project (2012-2016) is currently implemented by the Bulgarian Red Cross in the capacity of an Executing Agency (EA) in partnership with the Ministry of Health, Ministry of Labour and Social Policy and the Swiss Red Cross. The Swiss Red Cross is also performing the role of a Swiss Intermediate Body (SIB). The goal of the project is to support the introduction in Bulgaria of a model for complex provision of health cares and social services at home as a form of long-term care for older people with chronic diseases and permanent disabilities drawing on the Swiss experience.
Except for provision of home care services to beneficiaries in the target region and improving of their quality of life, the project aims at establishing an institutional framework for sustainable provision of this type of services in Bulgaria, incl. proper legislative regulation, payment mechanisms, national quality standards and unified training programs for the staff. Among the main priorities of the project is to raise the awareness about home care services at all levels of the Bulgarian society in order to validate them as a form of integrated provision of health and social services to older people with chronic diseases and disabilities.
For the achievement of these tasks the experts from the Ministry of Health, the Ministry of Labour and Social Policy as well as from the Swiss Red Cross play a crucial role. Besides, in each area, the project envisages wide partnership with other competent institutions and stakeholders, among them Bulgarian Doctors’ Union, Bulgarian Association of Professionals in Nursing, National Health-Insurance Fund, municipal authorities, patients’ organizations, etc.
The main results achieved in 2012-2014 include:
- Elaboration of draft legislative changes - A draft proposal for changes in the Health Law regulating the integrated provision of health cares and social services at home was elaborated in 2012 with the active involvement of relevant institutions and stakeholders.
- Approbation of the home care model in the region of Vratza - Four Home Care Centres were established in the region of Vratza in the municipalities of Vratza, Byala Slatina, Oryahovo and Krivodol /December 2012/. Since then regular cares are provided to selected beneficiaries on the basis of the individual needs of each patient and in constant communication with their relatives, with the General Practitioners, other medical specialist, Social Assistance Departments, etc.
- Creation of workplaces - By establishment of the HC Centers 50 job positions were created in the region of Vratza – a total of 33 home-helpers and 17 nurses have been trained in the project and employed to work at the centers.
- Provision of the services - Provision of regular cares at home to 400 beneficiaries, selected by a joint committee, comprising the manager of the respective HC Center, a representative of the respective municipality as well as of the Regional Department for Social Assistance and the Regional Health Inspection. The beneficiaries have to respond to the criteria defined in the project in cooperation with the Ministry of Health and the Ministry of Labour and Social Policy.
- Continuous training of the staff - The nurses and the home-helpers employed at the HC Centers receive regular support and practical trainings by experts of the SRC with profound experience in home care. The trainings include different topics, among them: planning of cares, prophylaxis of decubitus, hygiene of the services provided at home, wound management, etc. These trainings raise the qualification of the staff and improve the quality of the cares provided leading to more adequate satisfaction of the needs of the beneficiaries.
- Inclusion of Roma into the home care services provision - A feasibility study with the objective to explore the specific needs and opportunities of the Roma community in terms of provision of home care services among them was performed. The study was implemented in the region of Vratza in the period June-August 2013 and the final report was published in December 2013. On the basis of the results from the study, eight additional job positions for Roma home-helpers were created, two in each HC Center. They were successfully trained in September, 2013 and employed at the HC Centers. Currently, the percentage of Roma working at the HC Centers reaches 25 % from the total number of job positions opened in the project.
- Introduction of a data and cost-management software in the HC Centers - With the support of the Technical Universities in Sofia a software programme was elaborated for data and cost-management of the home care services. It was introduced in the HC Centers in December 2013 and the staff was trained accordingly. The data gathered will serve as the basis for cost-pricing of the services and a minimal standard for a service catalogue will be elaborated.
- Presenting of the project at the SDC annual conference - The Home Care Project was presented at the SDC annual conference for Eastern Europe held on 31st May, 2013 in Bern. A selection of projects from several countries, among them Bulgaria, illustrated the activity of SDC how the projects for the implementation of the enlargement contribution are progressing. Government representatives and experts from Switzerland and abroad discussed the importance and the impact of these projects. Except for the Home Care Project, projects from Latvia, Poland, Czech Republic and Slovenia were presented.