Social Security and Long-Term Care Dependency in Switzerland

Bischofberger, Iren; Landolt, Hardy

doi:10.1007/978-3-319-70081-6_14

Iren Bischofberger³ &
Hardy Landolt⁴

430 Accesses

Abstract

Since the founding of the Swiss Federal State in 1848, a very complex coexistence of laws has been developed with refined legal foundations, procedures and allowances, providing social protection against the risks of old age, illness and accident. As a result, there is an increased need for coordination between legislations and the consistent use of terms and concepts.

For more details, in particular on jurisprudence see: Bischberger/Landolt, Absicherung der Pflegebedürftigkeit in der Schweiz, Zeitschrift für ausländisches und internationals Sozialrecht (ZIAS) 2013, 105–168 (in German language).

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Notes

1.
Cf. Lieberherr et al. (2010).
2.
See Art. 7 Para. 2 lit. a KLV.
3.
Cf. Wingenfeld et al. (2011) and Landolt (2001b, 2002a, b, 2003, 2009).
4.
Cf. Höpflinger and Hugentobler (2005), p. 48.
5.
Cf. Höpflinger et al. (2011), p. 10.
6.
Cf. Lieberherr et al. (2010), p. 23 ff.
7.
Cf. Schön-Bühlmann (2005). These numbers are based on the Swiss Labour Force Survey [Schweizerische Arbeitskräfteerhebung, SAKE] or, where applicable, taken from the “Unpaid Work” module. This report distinguishes between long-term care and assistance on the one hand, and informal care provision and services provision on the other.
8.
Cf. Perrig-Chiello and Höpflinger (2012), Bischofberger (2011).
9.
Cf. Höpflinger et al. (2011).
10.
Cf. Swiss Conference of the Cantonal Healthcare Directors [Schweizerische Konferenz der kantonalen Gesundheitsdirektoren, GDK] (2009).
11.
Cf. Swiss Observatory on Healthcare [Schweizerisches Gesundheitsobservatorium, Obsan] (2009).
12.
See on this also the 2020 health policy priorities (Prioritäten Gesundheit 2020) of the Swiss Federal Council (http://www.bag.admin.ch/gesundheit2020/ – last viewed on 23/07/2013).
13.
Cf. Art. 41 Para. 1 lit. b BV.
14.
Cf. Art. 41 Para. 3 BV.
15.
Cf. Art. 41 Para. 4 BV.
16.
Cf. judgment BGer of 17.06.2005 (2P.73/2005) E. 5.
17.
See e.g. Art. 59 Para. 5 BV and Art. 112 ff. BV.
18.
Cf. Art. 112 f. BV.
19.
Cf. Art. 117 BV.
20.
Cf. Art. 114 Para. 4 BV and Art. 115 BV.
21.
Cf. e.g. Art. 111 Para. 3 BV.
22.
E.g. old age (Art. 8 Para. 2, 41 Para. 2 and 111 BV), disability or, respectively, disabled persons (Art. 8 Para. 2 and 108 Para. 4 BV), very old persons (Art. 108 Para. 4 and 112 Para. 4 BV), persons in need (Art. 108 Para. 4 and 115 BV), invalidity or, respectively, invalids (Art. 41 Para. 2, 111 and 112 Para. 6 BV), illness or, respectively, mental illness (Art. 41 Para. 2, 117, 118 Para. 2 lit. b, 119 Para. 2 lit. c and Art. 136 Para. 1 BV), accident (Art. 41 Para. 2, and 117 BV) as well as the need for subsistence support (Art. 112 Para. 2 lit. b BV and 10th transitory provision [Übergangsbestimmung] BV).
23.
Cf. Art. 25a KVG and infra margin No. 21 ff; Landolt (2010a).
24.
Cf. Art. 74 IVG and Art. 17 Para. 1 ELG.
25.
Cf. Art. 13 Para. 2 ELG.
26.
Cf. Art. 25a Para. 5 KVG.
27.
Art. 39 Para. 1 KVG.
28.
Art. 39 Para. 2 KVG.
29.
According to Art. 3 IFEG, the following are considered as institutions supporting the inclusion of persons with disability:
- facilities which employ on-site or at decentrally located workplaces invalids who could, under normal circumstances, not exercise any gainful activity,
- residential homes and other assisted forms of collective living for persons with disability,
- daycare centres where persons with disabilities spend their time in a community and can participate in leisure and gainful activity programmes.
30.
Art. 25a ELV does not distinguish between the terms ‘long-term care home’ and ‘facility for persons with disabilities’. A care home is considered to be any facility which is recognised by a canton as a home or which has obtained cantonal approval for operation. If—in connection with the granting of helplessness allowance—the IV authority grades an insured person as a care home resident within the meaning of Art. 42ter Para 2 IVG, this grading is also valid for claims to supplementary services as are deliverable to care home residents.
31.
Cf. Art. 51 KVV.
32.
Cf. Art. 49 KVV.
33.
E.g. in the canton of Zurich: Long-Term Care Act [Pflegegesetz] of 27/09/2010 (855.1) and the Regulation on Long-Term Care Provision [Verordnung über die Pflegeversorgung] of 22/11/2010 (855.11), as well as the Act regarding Facilities for Adult Invalids [Gesetz über Invalideneinrichtungen für erwachsene Personen (IEG)] of 01/10/2007 (855.2) and the Regulation on Facilities for Adult Invalids [Verordnung über Invalideneinrichtungen für erwachsene Personen (IEV)] of 12/12/2007 (855.21).
34.
Cf. Art. 10 Federal Act of 6 October regarding Institutions Supporting the Inclusion of Invalids [Bundesgesetz vom 6. Oktober 2006 über die Institutionen zur Förderung der Eingliederung von invaliden Personen (IFEG)].
35.
Art. 7 I.E. reads (translated):
1. 1.
  The cantons bear part of the expenses incurred for a stay in an approved facility to the extent that no invalid needs to claim social assistance due to such a stay.
2. 2.
  If an invalid cannot find placement in a facility approved by the canton of residence that adequately meets the needs of the invalid, the latter is—in line with Para. 1—entitled to claim contributions from the canton to costs incurred for placement in a different institution which meets the conditions according to Art. 5 Para. 1.
36.
The Intercantonal Agreement on Social Institutions [Interkantonale Vereinbarung für soziale Einrichtungen (IVSE)] of 13 December 2002 http://www.sodk.ch/ueber-die-sodk/ivse.html has the purpose of facilitating without impediments the intercantonal placement of persons with special requirements regarding assistance and support in appropriate institutions outside their canton of residence.
37.
Cf. Art. 7 Para. 1 IFEG.
38.
Cf. Art. 8 IFEG.
39.
Cf. Art. 2 and 7 IFEG.
40.
Cf. Art. 28 Para. 3 IVSE.
41.
Nursing and medical care not only include care treatment but also the general and socio-psychiatric basic nursing care (cf. Art. 7 Para. 2 KLV).
42.
Cf. Art. 39 Para. 3 KVG.
43.
Cf. judgment EVG of 19/12/2001 (K 77/00) E. 3b.
44.
Cf. RSKV (1979), p. 277.
45.
Cf. 107 V 54 E. 2a and RSKV (1979), p. 277.
46.
See on this BGE 115 V 38 E. 9b/aa and 107 V 54 E. 1 and 2.
47.
Cf. Art. 39 Para. 3 KVG.
48.
Cf. Art. 25a Para. 1 KVG. The care home tariff, valid as of 1 January 2011, provides for 12 needs levels or, respectively, a monthly allowance of CHF 270.– (tariff level 1: daily long-term care needs of up to 20 min) through to CHF 3240.– (tariff level 12: daily long-term care needs of more than 220 min) (cf. Art. 7a Para. 3 KLV).
49.
Cf. Art. 25a Para. 5 KVG.
50.
Cf. e.g. § 9 Para. 2 Long-Term Care Act [Pflegegesetz] of 27/09/2010 (Canton of Zurich).
51.
Cf. Art. 25a Para. 2 KVG.
52.
Cf. Art. 49a Para. 2 KVG.
53.
See BBl 1899 IV 61.
54.
Similarly, Art. 24 Para. 9 and Art. 29 Para. 2 Federal Act regarding the Insurance of Military Persons against Illness and Accidents [Bundesgesetz betreffend Versicherung der Militärpersonen gegen Krankheit und Unfall] of 28 June 1901 = BBl 1901 III 65.
55.
Cf. BBl 1911 III 523.
56.
See BBl 1915 I 45.
57.
Cf. BBl 1949 II 509.
58.
Art. 42 Para. 2 aIVG (1967).
59.
Amendment to the Federal Act regarding Pension and Survivors’ Insurance [Änderung des Bundesgesetzes über die Alters- und Hinterlassenenversicherung] of 4 October 1968.
60.
Cf. Art. 43bis Para. 2 AHVG.
61.
Cf. Art. 77 Para. 2 IVG.
62.
Cf. Art. 43bis Para. 1 AHVG and Art. 42 Para. 1 IVG.
63.
Cf. Art. 13 Para. 1 ATSG.
64.
Cf. Art. 13 Para. 2 ATSG.
65.
Cf. on this BGE 132 V 423.
66.
Cf. Art. 42 Para. 4 IVG.
67.
Cf. Art. 42bis Para. 3 IVG.
68.
Cf. Art. 9 ATSG and e.g. Art. 37 IVV and Art. 38 UVV.
69.
With further references BGE 121 V 88 E. 3a.
70.
Cf. BGE 117 V 146 E. 2. The need for assistance is regarded as considerable, for instance, if the insured person cannot cut his/her meals into small pieces or if he/she cannot hold the eating utensils him−/herself, cf. BGE 106 V 158 E. 2b; Landolt (1995).
71.
Cf. e.g. BGE 133 V 472 E. 5.1, 121 V 88 E. 3c as well as 107 V 145 E. 1c and 136 E. 1b; Landolt (2004).
72.
Cf. Art. 37 Para. 1 IVV and Art. 38 Para. 2 UVV.
73.
Cf. Art. 37 Para. 3 lit. b IVV and Art. 38 Para. 4 lit. b UVV.
74.
Cf. Art. 37 Para. 1 IVV.
75.
Cf. Art. 37 Para. 3 IVV and Art. 38 Para. 4 UVV.
76.
Cf. Art. 37 Para. 3 IVV and Para. 38 Para. 4 UVV.
77.
Cf. Art. 38 Para. 3 UVV.
78.
Art. 37 Para. 2 lit. b IVV bzw. Art. 38 Para. 3 lit. b UVV.
79.
Cf. BGE 107 V 145 E. 1d.
80.
Art. 37 Para. 1 IVV and Art. 38 Para. 2 UVV.
81.
Cf. judgment BGer of 05/03/2009 (8C_912/2008) E. 3.2.3 and furthermore BGE 107 V 136 E. 1b and ZAK 1990, 44 E. 2c. The need for permanent care services does not mean that the cargiver is tied exclusively to the person dependent on help, and it neither means 24-hour-care, but is rather to be understood in terms of care services that are not of a temporary nature.
82.
Cf. judgment BGer of 19/06/2007 (U 595/06) E. 3.2.2.
83.
Cf. judgment EVG of 03/09/2003 (I 214/03) E. 4., also qualifies in terms of the need for supervision, cf. judgment BGer of 23/09/2003 (I 360/03) E. 4.1.
84.
Cf. judgment EVG of 03/09/2003 (I 214/03) E. 4, not, however, in the case of a roughly 15-minute long supervision of the taking of daily medication, cf. judgment EVG of 21/11/2006 (H 4/06) E. 4.2.
85.
Cf. Art. 37 Para. 1 IVV.
86.
Cf. Art. 37 Para. 3 IVV and Art. 38 Para. 4 UVV.
87.
Cf. BGE 116 V 48 E. 6b.
88.
Cf. margin No. 8057 KSIH.
89.
Cf. judgments BGer of 31.05.2005 (I 565/04) E. 4.2.1 and of 07/11/2001 (I 633/00) E. 1.
90.
Cf. Art. 42ter Para. 3 IVG and Art. 39 IVV.
91.
Cf. Art. 42ter Para. 3 IVG.
92.
Cf. Art. 39 Para. 2 IVV.
93.
Cf. Art. 39 Para. 2 IVV.
94.
Cf. Art. 39 Para. 3 IVV.
95.
Cf. Art. 42ter Para. 3 IVG.
96.
BGE 133 V 450 E. 9.
97.
Cf. judgments BGer of 23/10/2007 (I 317/06) E. 4.3.2, of 23/07/2007 (I 211/05) E. 2.2.3 and of 17/10/2005 (I 528/05) E. 1.
98.
Cf. Art. 42 Para. 3 IVG.
99.
Cf. Art. 42bis Para. 5 IVG and Art. 38 Para. 1 IVV.
100.
In accident insurance and for old-age pensioners (cf. BGE 133 V 569 E. 5.3 and 5.5) no allowance is paid for life skills assistance. If the helplessness status is only partly due to an accident, the insuree may claim from AHV or from invalidity insurance (IV) the amount incurred for helplessness allowance which these insurances would pay out to the insuree if he had not had an accident (cf. Art. 38 Para. 5 UVV).
101.
Cf. Art. 38 Para. 1 IVV.
102.
Cf. BGE 133 V 450 E. 10.2.
103.
Cf. BGE 133 V 472 E. 5.3.2.
104.
Cf. BGE 133 V 450 E. 9.
105.
Cf. BGE 127 V 115 E. 1d.
106.
Cf. Art. 37 Para. 1 IVV.
107.
Cf. Art. 37 Para. 2 IVV.
108.
Cf. Art. 37 Para. 3 IVV.
109.
See, inter alia, judgment SozVersGer of the Canton of Zurich of 29/06/2009 (AB.2009.00020) E. 3.1 (regarding an insuree born in 1942 who has been suffering from advanced Parkinson’s disease in combination with dementia and hallucinations for over 20 years, and who has been living in an elderly home since July 2007).
110.
Cf. Art. 64 Para. 1 ATSG.
111.
Cf. Art. 64 Para. 2 ATSG.
112.
Long-term care compensation under military law is not referred to in the following.
113.
Cf. Art. 7 ff. UVG; Landolt (2010b, c).
114.
Cf. Art. 21 Para. 1 UVG and further Subpara. 3 of the recommendation of the ad hoc Damages Commission UVG on the application of UVG and UVV, No. 7/90 in-home care [Empfehlungen der AD-HOC-Kommission Schaden UVG zur Anwendung von UVG und UVV, Nr. 7/90 Hauspflege], dated 27/11/1990, revised on 29/03/2005.
115.
Cf. Art. 10 UVG in connection with Art. 15 ff. UVV.
116.
Cf. Art. 18 Para. 1 UVV.
117.
Cf. Art. 18 Para. 1 and 2 UVV.
118.
The UVG wage agreement can be downloaded from http://www.sbk-asi.ch/webseiten/deutsch/8dokumente/freiberufliche/Tarifvertrag-Sozialw.pdf (last viewed on 16.10.2017).
119.
Cf. Art. 18 Para. 2 UVV.
120.
See http://www.koordination.ch/fileadmin/files/ad-hoc/archiv/07-90-alt-08.pdf (last viewed on 16.10.2017).
121.
The International Council of Nurses (ICN) defines the task of professional caregivers as follows: “Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles” (see http://www.icn.ch/about-icn/icn-definition-of-nursing/ – last viewed on 16.10.2017).
122.
On this see infra margin No. 97 ff.
123.
Cf. Art. 7 Para. 2 lit. b Subpara. 1 ff. KLV.
124.
Cf. BGE 136 V 172 = Pra 2010 No. 135 E. 4.3 and judgment BGer of 21/12/2010 (9C_702/2010) E. 4.2.2.
125.
Cf. Art. 21 Para. 1 lit. c and d UVG.
126.
On this see supra margin No. 32 ff. and infra margin no. 102 ff.
127.
Cf. Art. 12 ff. IVG.
128.
Cf. Art. 12 and 13 IVG.
129.
Cf. Art. 14 Para. 1 IVG.
130.
Cf. Art. 14 Para. 3 IVG.
131.
Accessory basic care means basic care measures which are required or become necessary in connection with the performance of long-term care services. Accessory care involves, for instance, basic care services related to body hygiene or, respectively, body cleansing (cf. Art. 7 Para. 2 lit. c Subpara. 1 KLV) after bowel evacuation as may be necessary in line with long-term care treatment (cf. Art. 7 Para. 2 lit. b Subpara. 11 KLV), cf. also BGE 120 V 280 E. 3b.
132.
Treatment of the disease includes, in particular, the treatment of injuries, infections, as well as of internal and parasitic diseases (cf. Art. 2 Para. 4 IVV).
133.
Cf. Art. 12 Para. 1 IVG.
134.
See on this Annex of the Regulation of 9 December 1985 regarding birth defects [Verordnung vom 9. Dezember 1985 über Geburtsgebrechen (GgV)].
135.
Cf. Art. 13 IVG; BGE 136 V 209 ff.
136.
Cf. on this supra margin No. 46 ff.
137.
Cf. Art. 39 Para. 2 and 3 IVV.
138.
Cf. Art. 1a Para. 2 lit. b KVG.
139.
Cf. judgments BGer of 10/06/2011 (9C_886/2010) E. 4.5.
140.
Cf. Art. 25 Para. 2 lit. a KVG.
141.
Necessity of hospitalisation is the case if the necessary diagnostic and therapeutic measures can be performed in a purposeful way only in a hospital, or if all possibilities of outpatient care have been exhausted, or if it is only by means of a hospital stay that there is still any prospect of success with regard to treatment. The health insurance may also be obliged to cover the costs of a hospital stay in cases where the state of health of an insuree does not necessarily require such a stay, but where—due to particular personal circumstances—the patient can receive medical treatment nowhere else but in a hospital (cf. BGE 126 V 323 E. 2b and 120 V 206 E. 6a).
142.
For patients with chronic psychiatric problems—even if their state of health is subject to changes—the rules applicable to care home patients are generally valid, unless temporary deterioration of the illness requires acute hospital treatment (cf. BGE 120 V 200 E. 6a and judgment EVG of 20/10/2006 [K 20/06] E. 3.1).
143.
Cf. Art. 26a Para. 2 KVG.
144.
Cf. Art. 25a Para. 2 KVG.
145.
Cf. Art. 7 Para. 3 KLV. Acute care and temporary long-term care are remunerated pursuant to the hospital financing regulations (Regeln der Spitalfinanzierung (see Art. 49a KVG)) and not according to the otherwise applicable long-term care tariffs (cf. Art. 25a Para. 2 KVG).
146.
Art. 39 Para. 3 KVG.
147.
Cf. Art. 50 KVG.
148.
Cf. Art. 25a Para. 1 KVG and Art. 7 Para. 1 lit. c KLV.
149.
Cf. Art. 25a Para. 3 and 4 KVG.
150.
Cf. Art. 25a Para. 4 KVG.
151.
Cf. Art. 25a Para. 1 KVG and Art. 7 Para. 2bis KLV.
152.
Professional carers are approved if they hold a diploma from a school for health care and nursing care (since the education reform in the healthcare system of 2004 referred to as “higher vocational school / Höhere Fachschule” or “senior technical college / Fachhochschule”), as well as an approval for exercising the profession in the respective canton, and practical experience in the field of long-term care of a minimum of 2 years. A certificate issued by the Swish Red Cross confirming the attendance of an “assistant caregiver (Pflegehelfer/in)” training does not count as a professional nursing care diploma (120 h of theory, 12 days of practical training) (cf. judgment EVG of 05/09/2000 [K 62/00] E. 2).
153.
Cf. Art. 9 Para. 2 KLV.
154.
Cf. BGE 111 V 324.
155.
Cf. BGE 126 V 330 = RKUV 2000, p. 288 E. 1b.
156.
Cf. BGE 133 V 218 E. 6, judgment BGer of 10/05/2007 (K 141/06 and K 145/06) E. 5.2.
157.
Cf. judgment EVG of 21/06/2006 (K 156/04) = RKUV 2006, p. 303 E. 4.
158.
Cf. Art. 9a Para. 1 lit. a and b KLV, as well as judgments EVG of 25/08/2003 (K 60/03) E. 3.3 and VersGer Kanton St. Gallen of 18/08/2006 i. S. L. = SGGVP 2006 No. 18.
159.
Cf. judgment BGer of 19/12/2007 (9C_597/2007) E. 5.1.
160.
Art. 7 Para. 2 KLV.
161.
Cf. Rex et al. (2013).
162.
The recognised treatment and nursing care services are listed in Art. 7 Para. 2 lit. b KLV.
163.
Cf. BGE 136 V 172 = Pra 2010 No. 135.
164.
The conceptual term “basic and treatment care (Grund- und Behandlungspflege)” was introduced to the German-speaking area in 1967 by hospital economist Siegfried Eichhorn. The terms “basic care” and “treatment care” in this context were the results of translations from an essay in English written in 1954, cf. Friesacher (2008), p. 192 f. The dualism in long-term care practise arising from this distinction between relatively undemanding (basic) care measures and activities requiring a higher qualification and medical expertise was abandoned for the benefit of a more holistic approach in the course of the change in professional attitude and the emergence of the nursing science, cf. Müller (1998), Mittelstaedt (1998).
165.
Cf. Art. 7a Para. 1 KLV.
166.
Cf. judgment BGer of 12/07/2012 (9C_43/2012) E. 4.1.1.
167.
Cf. Art. 7 Para. 2 lit. c Ziff. 2 KLV.
168.
Cf. Art. 7 Para. 2 lit. c Subpara. 1 KLV.
169.
Cf. Art. 7 Para. 2 lit. c Subpara. 2 KLV.
170.
Cf. BGE 131 V 178 E. 2.2.3.
171.
BGE 131 V 178 E. 2.2.3.
172.
Cf. decision of the Swiss Federal Council of 09/03/1998 = RKUV 1998 KV No. 28 p. 180 E. II.
173.
Cf. BGE 136 V 172 E. 5.3.2. Accompaniment of a care-dependent person from the bedroom to the dining room does not count as a care measure according to KVG/KLV either.
174.
Cf. Art. 7 Para. 2 lit. c Subpara. 1 KLV and infra Rz 182 f.
175.
Cf. Art. 42quater ff. IVG, Art. 39a ff. IVV and Circular on the Assistance Contribution [Kreisschreiben über den Assistenzbeitrag (KSAB)], valid as of 1 January 2013, as well as explanatory notes on the regulation regarding invalidity insurance [Erläuterungen zur Verordnung über die Invalidenversicherung] of 16/11/2011 (hereinafter referred to as Explanatory Notes Assistance Contribution/Erläuterungen Assistenzbeitrag); available online at http://www.bsv.admin.ch/themen/iv/00025/index.html?lang=de – last viewed on 16. Oktober 2017).
176.
Cf. Art. 1a lit. c IVG.
177.
The Swiss Federal Council Bundesrat expects 400 withdrawals from care homes and 700 avoidable care home admissions in the next 15 years, cf. Botschaft 6. IV-Revision, 2010, p. 1922.
178.
Cf. Art. 42 quater Para. 1 IVG.
179.
Cf. Art. 26 f. UVG.
180.
Cf. Art. 20 MVG.
181.
Cf. Art. 43bis AHVG.
182.
Cf. Art. 42 Para. 6 IVG; Botschaft 6. IV-Revision, 2010, p. 1900.
183.
Accordingly, dependent persons are not entitled to assistance services that are provided by inpatient (care homes, hospitals, psychiatric clinics) or semi-inpatient institutions (sheltered workshops, daycare centres and integration centres); or by organisations and other legal entities (exception: advisory and support services).
184.
Cf. Art. 42 quinquies lit. a and b IVG.
185.
Cf. Botschaft 6. IV-Revision, 2010, pp. 1867 and 1902 f.
186.
Cf. Art. 328 ZGB.
187.
Cf. Art. 163, 276 f. ZGB.
188.
Cf. Art. 39d IVV.
189.
Cf. Art. 39c lit. a IVV and Botschaft 6. IV-Revision, pp. 1904 f.
190.
Cf. Art. 39c liA t. b IVV and Botschaft 6. IV-Revision, pp. 1904 f.
191.
Cf. Art. 39c lit. c IVV and Botschaft 6. IV-Revision, pp. 1904 f.
192.
Cf. Art. 39c lit. d IVV.
193.
Cf. Art. 39c lit. e IVV.
194.
Cf. Art. 39c lit. f IVV and Botschaft 6. IV-Revision, pp. 1904 f.
195.
Cf. Art. 39c lit. g IVV.
196.
Cf. Art. 39c lit. h IVV.
197.
Cf. Art. 39c lit. i IVV.
198.
See Rz 4005 ff. KSAB.
199.
See on this Latzel and Andermatt (2007).
200.
Cf. Art. 42 ff. IVG.
201.
Cf. Art. 21ter Para. 2 IVG.
202.
Cf. Art. 25a KVG i.V.m. Art. 7 Para. 2 lit. c KLV.
203.
There is no need for coordination with regard to treatment care services, as these are not taken into the equation for assistance contribution (cf. Art. 42sexies Para. 3 IVG) and are exclusively covered by the health and accident insurance (cf. Art. 25a KVG and Art. 7 Para. 2 lit. b KLV and Art. 18 UVV). Margin no. 4110 KSAB, on the other hand, provides for a deduction of medical care measures pursuant to Art. 13 IVG.
204.
Cf. Art. 42sexies Para. 1 and 3 IVG.
205.
Cf. margin No. 4105 ff. KSAB.
206.
Cf. Art. 39f Para. 1 IVV.
207.
Cf. Art. 39f Para. 2 IVV.
208.
Cf. Art. 39f Para. 3 IVV.
209.
Annex 2 on KLV (available at http://www.bag.admin.ch/themen/krankenversicherung/00263/00264/04184/index.html – last viewed on 16.10.2017).
210.
Cf. Art. 21 f. IVG and HVI, Art. 11 UVG and HVUV, Art. 21 MVG.
211.
Cf. Art. 2 Para. 5 HVI.
212.
Cf. BGE 121 V 260 E. 2b and Art. 2 Para. 5 HVI.
213.
Cf. Art. 21 Para. 3 IVG.
214.
Cf. Art. 21bis Para. 1 and 2 IVG, as well as Art. 21 Para. 2–4 MVG.
215.
Cf. Art. 14 Para. 1 lit. f ELG. Most cantons have kept up the previous list of nursing aids issued by ELKV.
216.
Cf. Art. 21bis Para. 2 IVG. The rules of IV also apply accordingly for AHV (cf. Art. 4 HVU).
217.
Cf. Art. 21 Para. 4 MVG.
218.
Cf. 118 V 200 E. 3c.
219.
Cf. BGE 112 V 11 E. 1a and EVGE 1968, p. 272.
220.
Cf. margin No. 1042 KHMI and Annex 1 Subpara. 6.4.
221.
Cf. judgment EVG of 17/03/2005 (I 354/03) E. 3.4.
222.
Cf. BGE 112 V 11 E. 1b and 96 V 84.
223.
Cf. margin No. 1037 KHMI.
224.
See on this judgment BGer of 18/09/2009 (9C_493/2009) E. 5.2.2.3.
225.
Cf. Art. 21bis Para. 2bis IVG; Cf. judgment BGer of 25/01/2008 (9C_592/2007) E. 3.2 and Communication of 21/02/2001 on the 4th Revision of the Federal Act on Invalidity Insurance [Botschaft vom 21.02.2001 über die 4. Revision des Bundesgesetzes über die Invalidenversicherung] = BBl 2001, pp. 3205 ff., 3264.
226.
Persons entitled to helplessness allowance are granted supplementary benefits only once they have reached 18 years of age (cf. Art. 6 ELG); Landolt (2011).
227.
Cf. Art. 4 Para. 1 lit. c and d ELG.
228.
Cf. Art. 3 Para. 1 lit. a ELG.
229.
Cf. Art. 3 Para. 1 lit. b ELG.
230.
Cf. Art. 2 Para. 1 ELG.
231.
The allowable expenses of CHF 31340.– for a single person plus expenses as mentioned in Art. 10 Para. 3 ELG are higher than the subsistence minimum under social assistance as referred to in the SKOS guidelines.
232.
Cf., among others, e.g. judgment EVG of 23/01/2002 (P 72/01) E. 2.
233.
Cf. Art. 9 Para. 2 ELG.
234.
Cf. Art. 10 lit. b Subpara. 3 ELG.
235.
See Art. 16 ELV and Subpara. 4.3.9 of Circular No. 11 of 31/08/2005 on the deduction of expenses incurred for healthcare and accidents, as well as for costs incurred due to disability [“Abzug von Krankheits- und Unfallkosten sowie von behinderungsbedingten Kosten vom 31.08.2005”] of the Swiss Federal Tax Administration.
236.
Cf. Art. 10 Para. 2 lit. a ELG.
237.
Cf. Art. 13 Para. 2 ELG.
238.
Cf. Art. 13 Para. 2 last Sent. ELG.
239.
Cf. Art. 10 Para. 2 ELG.
240.
Cf. BGE 138 V 481 = Pra 2013 No. 31 E. 4.
241.
Cf. Art. 10 Para. 2 lit. ELG.
242.
Ibid.
243.
Cf. BGE 138 V 481 = Pra 2013 No. 31.
244.
Cf. Art. 1c Para. 2 ELV.
245.
On this see infra Rz 142.
246.
Cf. Art. 11 Para. 1 lit. c ELG.
247.
Cf. Art. 11 Para. 2 ELG.
248.
Cf. Art. 11 Para. 1bis ELG.
249.
Cf. Art. 15b ELV.
250.
Cf. Art. 14 Para. 1 ELG.
251.
Cf. Art. 14 Para. 3 lit. b ELG.
252.
Cf. Art. 14 Para. 6 ELG.
253.
Cf. Art. 14 Para. 2 ELG.
254.
Cf. Art. 14 Para. 1 and 3 ELG.
255.
Cf. Art. 14 Para. 1 ELG.
256.
In the Canton of Aargau, for instance, currently a loss of income of 10% over a period of 4 weeks entitles caregivers to claim compensation, § 14 Para. 3 of the Regulation of 17 November 2010 on the reimbursement of costs of supplementary benefits (ELKV-AG) incurred for health care or due to disability [Verordnung über die Vergütung von Krankheits- und Behinderungskosten bei den Ergänzungsleistungen (ELKV-AG) vom 17. November 2010].
257.
Cf. judgment BGer of 25/04/2007 (P 18/06) E. 4 and SVR 1998 EL No. 10 p. 25.
258.
In the Canton of Bern, for instance, a maximum of CHF 9600.– per year may be paid, cf. Art. 15 Para. 3 EV ELG (BE).
259.
Cf. judgment BGer of 11/02/2009 (8C_773/2008) E. 5.2.
260.
Ibid. E. 5.2.
261.
Cf. Art. 14 Para. 2 and 3 ELG.
262.
Cf. Art. 14 Para. 4 ELG and Art. 19b Para. 1 ELV. The same increase is granted also to recipients of a helplessness allowance pursuant to AHV who had previously received helplessness allowance pursuant to IV, cf. Art. 14 Para. 5 ELG.
263.
Art. 3d Para. 2bis 2nd clause to Sent. 1 aELG and further judgment BGer of 10/08/2009 (9C_84/2009) E. 4.2.
264.
Cf. Art. 29sexies AHVG.
265.
Cf. Art. 29septies AHVG and Art. 52 g ff. AHVV, as well as Circular regarding bonuses for caretaking (KSBGS; as per: 01/01/2012).
266.
Cf. Art. 29septies Para. 1 AHVG.
267.
Cf. Art. 29septies Para. 2 AHVG, margin No. 1002 KSBGS.
268.
Cf. Art. 29septies Para. 1 AHVG.
269.
Cf. Art. 29septies Para. 4 AHVG.
270.
Cf. Art. 29septies Para. 6 AHVG.
271.
Cf. Art. 52i AHVV.
272.
Cf. Art. 29septies Para. 1 AHVG.
273.
Cf. BGE 126 V 435 ff.
274.
Cf. margin No. 1002 KSBGS.
275.
Cf. Art. 29septies Para. 1 AHVG.
276.
Cf. Art. 52 g AHVV, margin No. 3010.1 KSBGS.
277.
Cf. Art. 9 Para. 2 lit. Hbis StHG and Art. 33 Para. 1 lit. Hbis DBG.
278.
See e.g. § 42 I d StG AG (CHF 3000.–) and Art. 28 lit. g StG BE.
279.
Cf. § 24 lit. c SPG AG and § 21 lit. b SPV AG (care compensation to the amount of the maximum orphan’s pension pursuant to AHVG), § 11 SpitexG BS and §§ 6 ff. SpitexVO BS (for care services required starting from 1 h per day and amounting to a maximum of 35% of the highest AHV pension level) and Art. 4 HPflG FR (flat-rate compensation of CHF 25.– per day); Art. 14 Para. 1 ELG.
280.
Cf. http://www.skos.ch/store/pdf_d/richtlinien/richtlinien/RL_deutsch_2012.pdf (last viewed on 16.10.2017).
281.
Cf. Subpara. B.2.1 SKOS Guidelines [SKOS-Richtlinien] 2012.
282.
Cf. Subpara. C.1.1 SKOS Guidelines [SKOS-Richtlinien] 2012.
283.
Cf. Subpara. C.1.2 SKOS Guidelines [SKOS-Richtlinien] 2012.
284.
Cf. Subpara. C.2 SKOS Guidelines [SKOS-Richtlinien] 2012.
285.
Cf. Klie (1998), Müller (1998).
286.
Cf., inter alia, Juchli (1973).
287.
See e.g. Menche (2011), Schewior-Popp et al. (2012), Rosdahl and Kowalski (2011).
288.
See e.g. Wilkinson (2012).
289.
Cf. Art. 7 Para. 2 lit. a KLV.
290.
Cf. Bundesamt für Gesundheit (2009).
291.
Lawton and Brody (1969).
292.
E.g. Feinstein et al. (1986), Bennett (1999), Sikkes et al. (2009).
293.
14 ATL in Henderson (1960) and 6 in Lawton and Brody (1969).
294.
Cf. Katz et al. (1963), Lawton and Brody (1969).
295.
Cf. Wingenfeld et al. (2011).
296.
The eight categories for the assessment of long-term care dependency are: 1. mobility, 2. communicative and cognitive functions, 3. behaviour and psychological problem-situations, 4. (food) self-sufficiency, 5. ability to deal with illness/therapy-related challenges and strains, 6. management of everyday life and social contacts, 7. out-of-home activities, 8. household maintenance.
297.
World Health Organization, 2001 (see http://www.who.int/classifications/icf/en/ – last viewed on 16.10.2017).
298.
With a view to these two instruments, the Swiss legislator, authorities and expert committees can resort to mature solutions from abroad for a new definition of long-term care dependency and the categorisation of the specific need for help and care, cf. inter alia Schaeffer (2004) and Landolt (2001a).
299.
Cf. e.g. Art. 7 and Art. 7a KLV.
300.
Cf. Carpenter et al. (1997).
301.
E.g. Baur (2005).
302.
The Swiss association for domiciliary assistance and care services (Spitex Verband Schweiz) recommends it as the instrument to be chosen for Spitex (RAI Home Care). As for inpatient long-term institutions, it is the cantons that decide which instrument is to be used (RAI Nursing Home, among others).
303.
Cf. Art. 7a Para. 3 KLV.
304.
Cf. BGE 136 V 172 E. 4.3.3 and 124 V 351 E. 2e as well as judgment BGer of 21/12/2010 (9C_702/2010) E. 4.2.3.
305.
Cf. judgment BGer of 12/07/2013 (8C_1037/2012) E. 5.2.4.
306.
Cf. Vettori et al. (2007).
307.
Cf. OECD (2013).
308.
Cf. Bischofberger (2012c), Johnson and McCarthy (2013).
309.
E.g. Kickbusch and Haslbeck (2011).
310.
Cf. Haslbeck (2012).
311.
See on this cooperation at www.evivo.ch, a programme addressing multiple diseases with a view to the promotion of self-management in the case of chronic illness.
312.
Cf. Barkholdt and Lasch (2004), Bischofberger et al. (2009, 2013).
313.
Cf. Art. 36 Para. 1 ArG.
314.
Cf. Art. 329 Para. 3 OR.
315.
E.g. Bischofberger and Höglinger (2008), Escher Clauss (2011), Leis (2012), Derrer Balladore (2012).
316.
Cf. Bischofberger (2012a, b).
317.
Cf. Leu and Bischofberger (2012).
318.
Cf. King (2011).
319.
Cf. Weiss Zbinden (2011).
320.
A project on this is currently conducted by Kalaidos University of Applied Sciences (Kalaidos Fachhochschule Gesundheit) or, respectively, by Careum Research (Forschungsinstitut Careum F + E) in collaboration with Spitex Köniz in the framework of support measures by means of a KTI innovation cheque (KTI InnovationsScheck) (see www.careum.ch > Forschung > Patientensicherheit).
321.
Cf. van Holten et al. (2013).
322.
Cf. van Holten et al. (2013).
323.
Cf. Jähnke et al. (2012); see also the guide on the employment of a helper in the home, issued by the Office for Equality (Fachstelle für Gleichstellung) of the City of Zurich:: http://www.stadt-zuerich.ch/content/prd/de/index/gleichstellung/themen/erwerbsarbeit/haushalthilfe_im_alter/publikationen.html – last viewed on 21 June 2013).
324.
See on this supra margin No. 146.
325.
Cf. Latzel and Andermatt (2008a, b).
326.
Art. 13b aELKV provided for the payment of an allowance for costs incurred in the case of illness and disability for family caregivers and family assistants.
327.
Cf. Oesch and Künzi (2008).
328.
Cf. Jochum-Müller and Harringer (2011).
329.
See also http://www.stadt.sg.ch/home/gesellschaft-sicherheit/aeltere-menschen/zeitvorsorge.html (last viewed on 16.10.2017).
330.
See on this Stutz and Knupfer (2012), Colombo et al. (2011), OECD (2013).

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Kalaidos University of Applied Sciences, Zurich, Switzerland
Iren Bischofberger
Centre of Competence for Law on Long-Term Care, Glarus, Switzerland
Hardy Landolt

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Bischofberger, I., Landolt, H. (2018). Social Security and Long-Term Care Dependency in Switzerland. In: Becker, U., Reinhard, HJ. (eds) Long-Term Care in Europe. Springer, Cham. https://doi.org/10.1007/978-3-319-70081-6_14

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