Caregivers are more expensive: Neighborhood helpers call for help themselves

Created: 11/28/2022 13:36

By: Tobias Gmach

Since September, outpatient care services have only received money from health insurance companies if they pay according to the tariff.

© Jana Bauch/dpa

They have to pay their nursing staff more money, but they don't get more from the health insurance companies: That's why neighborhood aids like in Feldafing and Seefeld are facing major deficits.

In their financial distress, they turn to the communities.

District – The neighborhood help (NBH) Feldafing itself calls for help.

In order for the care team to be able to continue caring for around 70 elderly people in the village, the facility asked for donations in a letter in the community newspaper.

Due to a new legal regulation and the behavior of the long-term care insurance funds, the non-profit GmbH has a “considerable, unforeseeable financing gap”.

The deficit this year is 78,579 euros, despite the support of the association.

For this, the NBH also had to ask the municipality of Feldafing for financial support.

She is by no means an isolated case.

The instrument that is both a blessing and a curse for small outpatient care teams is called the Health Care Further Development Act.

Adopted by the Bundestag in mid-2021, it is intended to significantly improve the working conditions and remuneration of nursing staff, make the professions more attractive and counteract the nursing shortage.

The law states, for example, that after September 1, 2022, health insurance companies may only conclude pension contracts with institutions that pay their employees according to a recognized collective agreement.

Neighborhood aids like the one in Feldafing have not done that before.

Its chairman Walter Föhr says: "Payment according to collective agreements is urgently needed, there is no discussion about it.

But the refinancing must be ensured.” The money from the supply contracts with the health insurers is the main source of income – “without it we are not viable”.

The wages of employees have risen by 25 to 30 percent since September as a result of the law, plus weekend and public holiday bonuses, vacation and Christmas bonuses.

NBH Chairman: Health insurance companies refuse

But the health insurers would refer to current supply contracts and have so far refused to compensate for the increased costs.

Whether and when they will do so is uncertain, says Föhr.

So that the nursing service can continue to work for the foreseeable future, the community is making up for the deficit with funds from the former Lieberwirth Foundation.

The council made the decision at its most recent meeting.

But the endowment money is finite and the budget situation is tense in times of crises and unavoidable investments.

The background to the complex issue: In order to comply with the legal requirement, the NBH joined the Paritätische Tarifgemeinschaft (PTG) of the umbrella organization Paritätischer in Bavaria.

The latter bundles the interests of the carriers.

Föhr explains: The PTG is currently working with its member organizations - "also with the active participation of our neighborhood help" - the requirements for a framework and wage agreement, which is then to be negotiated and concluded with the Verdi services union.

A process that will probably last until mid-2023.

The new contract will come into effect in 2024 at the earliest.

In the meantime, the NBH pays according to the collective agreement for the public sector (TVöD).

NBH Seefeld does not want to be pushed into the collective agreement

According to the bookkeeper Sylvia Fischer, the neighborhood help in Seefeld tries to avoid "that we are pushed into the TVöD".

The collective agreement is so complex that the small institution would have to employ an extra employee.

"And we can't afford that," says Fischer.

When it comes to payment, the Seefeld companies are initially based on the regional level of pay, an option that the legislature grants.

They too are waiting for the collective agreement of the Paritätischer Wohlfahrtsverband.

Fischer: "We are hanging in the air." The amount of the deficit is not yet foreseeable - but the minus is certain.

"There have already been talks with the community." So Seefeld could also play the emergency anchor for their NBH.

Feldafing's mayor Bernhard Sontheim recently vented his displeasure in the municipal council:

“This is a sheer cheek from the legislature towards the social services.

He is once again relying on the municipalities.”

Sylvia Fischer from the NBH Seefeld is generally not enthusiastic about the tariff obligation.

Although the employees would get more money, they would have to adhere to schedules more strictly than before in order to be able to bill for services.

“They are driven and must also drive the patients.

Bringing something from the supermarket or taking the rubbish down on the way: We can no longer afford the friendly neighborly idea,” says the accountant.

Add to that the lack of staff.

For this reason, the NBH Hechendorf dissolved its nursing service in the summer of 2021.

A cautionary tale.

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