More than 3,700 people from Tarragona are waiting for help from the agency
More than 3,700 people in Tarragona are on the waiting list to be able to access help from the dependency. This includes citizens who are pending the initial assessment of their degree of dependency and also those who, once resolved, remain waiting for the PIA, the individual care program that establishes the services and the economic benefit to be received by of the beneficiary.
As of October 28, there were 1,808 citizens awaiting their assessment1,277 of them in Camp de Tarragona and 531 in Terres de l'Ebre. But the number of people who have passed the first step but are still in process for definitive access to aid. In Camp de Tarragona there are 1,269 appraisals with pending PIA agreement. Of these, 1,127 are pending closure by the basic areas of social services in the territory and 142 in calculation phase of economic capacity by the Department.
In the Ebre, there are 690 PIA approvals in progress, of which 548 await the closure of the basic areas and 142 in that calculation phase, passages prior to being able to receive the money and, basically, a kind of limbo. in Camp de Tarragona, half of those waiting still have to pass the assessment while in Terres de l'Ebre the figure drops to 43%. All these figures show a more or less persistent delay in the deployment of the dependency law. "In recent times not much has changed, there has not been a substantial improvement. The average waiting time is 575 days between when you enter the system and they give you the place, when the law speaks of a limit of 180 days, ”explains Cinta Pascual, the president of the Catalan Association of Assistance Resources (ACRA).
“Financing is very short and the waiting list is very long. We have not improved”, says Cinta Pascual, president of the Catalan Association of Assistance Resources (ACRA)
The head of the Catalan employers' association of residences believes that delay multiplies its negative effects by beneficiary profile. “In these cases we speak many times of a extreme dependency and so must be given top priority. In people who have such a short life expectancy, a benefit that takes a year to arrive can be a lot, too much, it should be a maximum of three months. It is something that we have been denouncing for a long time, ”says Pascual, who is also very critical of the amounts and the allocation: "Obviously it falls short, more financing is needed."
Sheila Adam is a social worker at the Associació de Familiars d'Alzheimer de Tarragona, located in Sant Pere i Sant Pau and recently reactivated: «From the time you apply until they take the test to see your grade, a long time passes. And to that we must add more, the entire interval in which lown family is not aware that there is a dependency, and then start the process of requesting it from your GP.”
Families without the resources
This battle against the clock does not concern only the elderly, but also the sick. “There are families that perhaps see an insignificant dependency and do not consider it necessary to start the process, but some diagnoses can be rapidly aggravated and then it really starts to urge,” says Adam.
The Government admits the delay and asks to rethink the law so that the co-payment between administrations is viable
This mismatch is what causes the greatest conflicts in a home. “Everything depends on the economic situation, but sometimes it is impossible to face expenses such as a day center or a caregiver. Many families do not have those resources.», indicates Adam, who demands more speed in the processes. "It's a long way to go, more quickly, because depending on the diagnosis and the course of the disease, sometimes it's too late," admits Adam. The most extreme case is die while being at the gates of receiving that help. "It is true that there are cases in which at the time of the assessment the person was no longer there," adds the social worker.
The general impression is that the situation has hardly progressed after a pandemic that raged precisely against the most vulnerable. Some recently known data are convincing in this regard: Every 40 minutes a Catalan dependent on the waiting list dies21 a day, 7,827 a year.
"It is scandalous"
It was disseminated in the Social Rights Commission of the Parliament of Catalonia by the president of the Association of Directors and Managers of Social Services, José Manuel Ramírez, who was very critical in his appearance. That every half hour a person dies in the bureaucratic labyrinth of dependency is something scandalous", he pointed out. Ramirez added that “we must improve the economic benefits, 300 euros to care for a dependent person all year is not ideal. He fundamentally called for "undertaking reforms above all that speed up procedures, not only in Catalonia but throughout Spain."
“Aid is lacking speed because there are diseases that evolve quickly,” admits Sheila Adam, a social worker
The Generalitat itself recognizes the shortcomings and difficulties to address all requests. In that same commission, deputy David Saldoni (Junts) admitted “a very important saturation in the waiting lists”since “we have been experiencing these increases and these difficulties for a year”. Sources from the Department of Social Rights claim rethink the law so that it is feasible to apply the co-payment criteria that it provides for and that are not met, since the Government contributes much more than the State.
In a parliamentary response in September, the then Minister of Social Rights, Violant Cervera -relieved a month ago by Carles Campuzano after the remodeling of the Government-, indicated that “investment to reduce the waiting list in 2021 increased”. It went from 1,384 million in 2020 to 1,522 last year, and the dynamics in recent years is one of increase.
One of the problems is financing. The Generalitat contributes 81% and the State only 19%. The law establishes a contribution in equal parts
Beyond these data, the problem of financing goes back a long way, and we must look for it at the birth of the law, in 2006. The norm established that the autonomies and the central administration were going to contribute in equal parts. The 2008 crisis reduced the State contribution for several years. In 2021, the State increased its contribution by almost 46%, going from 194 to 283 million, according to Imserso figures. The Generalitat increased it by 4%, rising from 1,189 million to 1,238. The imbalance is palpable: the Generalitat contributes 81% and the Government only 19%.
“Valuations are very low”
Ramón, a resident of Tarragona over 90 years old, was recognized with a dependency degree I, the lowest. This level is approved in those people who need help at least once a day in basic activities or have intermittent help needs.
Ramón couldn't do anything alone: neither eat, nor cook, nor go to the bathroom. Two of his caregivers complained that the assessment had not recognized a higher degree of autonomy: «He needs help for everything, and you have to be on the lookout practically all day. We don't understand why the valuation is so low."
It is a common complaint in families. Sheila Adam, a social worker at the Associació de Familiars d'Alzheimer de Tarragona, laments a certain randomness in the examinations: «Alzheimer's is not as visible as a physical dependency. It happens that sometimes on a specific day the patient is better for whatever reason and that can condition the grade. Just with one visit you can't see reality."
These are some of the dysfunctions denounced by those who know well an area with more and more needs. In the last seven years requests have skyrocketed 50% and beneficiaries have grown by only 15% at Camp. In the Ebre, the requests have risen by 50% and the people who receive the aid by 28%.
To alleviate the situation, the Department has eliminated this year the suspensive period of the benefit for carers, an aid that can be received at the time it is processed without having to wait 18 months as happened before. Also the approval of the 3% increase in the rates of social services is finalizedwhich will have repercussions in an improvement of the conditions of the workers.
A URV study warns: "The model has many shortcomings"
The professor of social and cultural anthropology at the URV, Dolors Comas d'Argemir, participated in the last Committee on Social Rights of the Parliament to present the conclusions of a state study led by the University of Tarragona on the situation of dependency and the effects of the pandemic . The teacher was clear and forceful: «The care model has many deficits, public policies are weakI would even say unsatisfactory.
He even addressed the politicians present: “Would you like to go to a residence as they are now? We have made little progress and Catalonia has a particularly difficult situation. There are 71,000 people waiting for a benefit that has already been recognized. The teacher rated “insufficient services” and x-rayed the impact of the pandemic: «We are not aware of the extent to which families are important for dependency. The pandemic demanded extraordinary efforts from women. Little has been said. It was an impact from doors inside. Day centers were closed, there was no home care, services were suppressed, the network of the extended family was lost. It was a great suffering for the families and a cognitive and physical deterioration for people in a situation of dependency.
Another of his conclusions alluded to how «public aid does not arrive in a sufficient way, they did not do it before, there are many families who feel helpless. The situation is more serious." The study also diagnoses a "highly feminized" occupation, with a precarious problem, positions in the lower scales of the market, strong rotation, flight to other sectors, partiality and insufficient templates».