Goverment draft act

1. -1
in accordance with the draft act on
clients’ freedom of choice
21 December 2016
What does
freedom of
choice mean
to me?
Draft act on clients’ freedom of choice, 21 December
2016

2. -
Freedom of choice is part of the health and
social services reform
The objective of the reform is to ensure equal and
modern health and social services at reasonable costs.
As part of the reform, freedom of choice will be
improved for clients of health and social services.
The objective is to give clients faster access to care
and improve their opportunities to influence the
services they use in different life situations.
The reform is due to come into force on 1 January
2019 but the services will be reformed gradually – not
everything changes at once.
21 December 20162
Draft act on clients’ freedom of choice, 21 December
2016

3. -
Clients can choose more individually than today
If you want to choose your services yourself, you can choose them from
a county-owned company, private enterprise or organisation. The
service provider must be registered, fulfil the requirements set by the
county and have an agreement with the county.
• From a health and social services centre you can get basic-level health services
and guidance on social services. The services will become even more
comprehensive in the future.
• You can also choose a unit for oral health services.
• The health and social services centre and the unit for oral health services are
responsible for all services assigned to them. They can grant you primary
vouchers for buying a particular service from other providers.
21 December 20163
Draft act on clients’ freedom of choice, 21 December
2016
You will get support
for your choices
online, through a
telephone helpline or
from service
counsellors. If you
don’t want to choose
yourself, the county
will direct you to
suitable services.
The array of services mentioned above is supported by county companies
that offer, for example, many kinds of social services and specialised
medical services.
When necessary, the county company carries out an assessment of your
need for services and care. Based on the assessment, you can receive an
extended voucher or personal budget to buy services included in your
client care plan. You can choose a service provider anywhere in the
country. The client fee will be the same, it does not depend on the service
provider.

4. -
Draft act on clients’ freedom of choice, 21 December 2016
4
Health and social services centre, unit for oral
health services, primary voucher
- GP and nurse, social services guidance
- Basic services by dentists and dental hygienists
- Later also other health and social services
- Responsible for the client’s services as a whole
- The client can be given a primary voucher for buying a
particular service or measure from other providers.
County’s own service provision
– Other services within the freedom of choice which are
not offered by the health and social services centre, for
example social services, 24-hour services and specialised
medical care.
– The client can choose a public sector service unit
amongst all public units in the country.
– The public care facility for specialised medical care will be
chosen together with the referring GP.
Extended voucher
– When necessary, the county company grants an
extended voucher for carrying out the client care plan.
– The county decides on the services and the client
chooses a service provider amongst the registered service
providers around the country.
– The county is responsible for the costs and the client
pays the client fee, which is the same for all providers.
Personal budget
- With the help of personal budget, elderly clients and
persons with disabilities, for example, can influence the
content of their support and choose their service provider.
- The client can decide, within the limits of his/her care
plan, for which services the money is used and who is the
service provider. The services can include, for example, a
personal assistant or transport services.
Clients have more freedom of
choice than today
The client chooses a health
and social services centre
and a unit for oral health
services and makes a one-
year commitment with these
service providers.
If the client needs other
services, he/she will
receive them from the
county company.

5. -
Counties have the overall responsibility for the services. Health and social services centres and units for oral health
services have the corresponding responsibility for providing the services within the scope of wide freedom of choice.
1. Choosing a health and
social services centre
and unit for oral health
services
2. Primary voucher granted
by the health and social
services centre or the unit
for oral health services
3. Choosing a county
company
4. Extended voucher or
personal budget granted
by the county company
Choices in different life situations
The client can choose a county
company and its unit from all
over Finland.
The client can use his/her
extended voucher or personal
budget to buy services provided
by any approved service
provider in Finland.
The client can choose a county-
approved service provider and its
unit from all over Finland. Money
follows the client.
The service provider is responsible
for and pays the costs of the
services the client receives against
his/her primary voucher.
The client chooses
and makes a
commitment for one
year
Assessment of the client’s need
for care and services
21 December 2016
Draft act on clients’ freedom of choice, 21 December
2016
5

6. -
Clients’ right to choose
from 1 January 2019
6
TO CHOOSE A HEALTH
AND SOCIAL SERVICES
CENTRE AND A UNIT
FOR ORAL HEALTH
SERVICES FROM THE
WHOLE COUNTRY
TO RECEIVE A PRIMARY
VOUCHER, IF YOU NEED
ONE, FROM A HEALTH
AND SOCIAL SERVICES
CENTRE OR FROM A
UNIT FOR ORAL
HEALTH SERVICES
TO CHOOSE A
COUNTY COMPANY
UNIT
TO RECEIVE AN EXTENDED
VOUCHER OR PERSONAL
BUDGET, IF YOU NEED ONE,
FROM THE COUNTY
COMPANY
TO SEEK NON-URGENT
CARE ABROAD
TO EXPRESS YOUR
WISHES REGARDING
THE ATTENDING CARE
PROVIDER. YOUR WISH
WILL BE FOLLOWED AS
FAR AS POSSIBLE
TO RECEIVE CARE IN A
TEMPORARY PLACE OF
RESIDENCE
11
2You will always have access to
emergency care offered by
public healthcare services in
Finland and abroad.
Draft act on clients’
freedom of choice, 21
December 2016

7. -
Service needs and costs
in clients’ different life situations
21 December 20167
Draft act on clients’ freedom of choice, 21 December
2016
The need for services and the costs per unit decrease
approx. 10% of
the population
(estimate)
30% of the
population
(estimate)
60% of the
population
(estimate)
100%
High need for
care or services
Wider need for
care or services
Occasional need for
care or services
Supporting health
and wellbeing
approx. 80% approx. 20%

8. -21 December 2016 Draft act on clients’ freedom of choice, 21 December
20168
Different practices in different life situations
Supporting population’s health and
wellbeing (whole population)
• Broad-based cooperation between interest
groups
• Supporting health and wellbeing, prevention,
early intervention
• Increasing awareness of choices affecting health
and wellbeing
• E-services for self-management of health,
telephone services, and information, advice and
guidance received from county service offices
Occasional need for care or services
(approx. 60% of the population)
• Services from a health and social services centre and
from a unit for oral health services, use of primary
vouchers when necessary
• E-services, client’s self-assessment of health, advice
by phone
• Swift care needs assessment and access to services
• Cooperation with units of the county company when
necessary but no need for deeper integration
Wider need for care or services
(approx. 30% of the population)
• Services from the health and social services
centre, unit for oral health services and county
company as defined in the client care plan.
• E-services supporting self-management of health.
• When necessary, extended vouchers or personal
budget granted by the county company.
• The county can decide that the health and social
services centre or the unit for oral health services
has the right to provide more services than those
defined nationally.
High need for care or services
(approx. 10% of the population)
• High need for individual integration, coherent
treatment and service chains, multiprofessional
cooperation, continuity of care
• The county company is responsible for assessing
care needs, making an extensive client care plan
and carrying it out in practice.
• High costs per unit, small number of clients
• The care package will be carried out in close
cooperation between the concerned health and
social services centre or unit for oral health
services.

9. -21 December 2016
Draft act on clients’ freedom of choice, 21 December
2016
9
Thank you!
regionalreform.fi
MINISTRY OF SOCIAL AFFAIRS AND HEALTH ● MINISTRY OF FINANCE