South Karelia moves to prevent older care clients falling into debt

South Karelia’s regional wellbeing services authority is stepping in earlier to prevent older people receiving home care or living in service housing from falling into debt, Yle reports. More than 507,000 social and healthcare customer charges were sent to debt enforcement in Finland last year.

The authority introduced its new approach in August after finding that payment difficulties were particularly common among older people in the region. The model brings its customer payments team into assessments of whether an older person needs home care or service housing.

The team, led by Mika Piiroinen, assesses whether the client or their family can afford the charges and whether the client needs help managing bills. It monitors whether payments are made on time and contacts clients or relatives as soon as it notices problems, aiming to stop unpaid bills from piling up.

As part of the assessment, the team also checks whether clients have applied for all the financial benefits they are entitled to. It can prepare applications for relatives or representatives to submit and, when needed, alert social services if a client may need a legal guardian.

Local and Regional Government Minister Anna-Kaisa Ikonen wants wellbeing services authorities to address payment problems sooner and has praised South Karelia’s approach. The effects of the new model are not yet known, Piiroinen said. A few notifications of concern have been made.

Anne Perälahti, advocacy director at Soste, the umbrella organisation for social and health sector groups, said the approach should be adopted elsewhere in Finland. She said the ability to pay should be assessed automatically as part of service needs assessments, rather than depending on clients to raise the issue themselves.

Under Finnish law, wellbeing services authorities must reduce or waive customer charges if they threaten a person’s livelihood. But applications for reductions are relatively few compared with the number of charges sent to debt enforcement, Perälahti said. Many people do not know they can apply, and some avoid seeking services because they fear the charges or take out short-term loans to pay them.

South Karelia’s model also tracks whether clients in home care and service housing apply for reductions and directs them to do so when necessary.