The National Confederation of ELA Entities (ConELA) has made clear, coinciding with the second anniversary of the ELA Law, the existence of a “serious asymmetry and territorial fragmentation” in the way that the autonomous communities are applying the standard.
The organization points out that the economic advances that households must assume, the incompatibility with certain family benefits, and the absence of public physiotherapy mean that the aid does not reach homes effectively.
According to the “2nd Evaluation Report on the Implementation of the ELA Law” presented in the Congress of Deputies, the state framework set a guaranteed floor of 4,930 euros per month and raised the aid earmarked for Grade III+ of extreme dependency up to 9,859 euros. However, the actual arrival of these resources is affected by “heterogeneous blockages” depending on the territory.
The document details that 35.29 percent of the autonomous communities require families to advance the cost of the services and wait for reimbursement once the invoices are submitted. This implies paying out between 3,200 and 9,859 euros per month from their own pocket before receiving the subsidy, an economic filter that, according to the report, excludes from the system households without savings. In contrast, 11 autonomies safeguard family liquidity through advance payments or by assigning the right to collect directly to the provider companies.
ConELA also warns that, in most territories, access to Grade III+ benefits is considered incompatible with the Economic Benefit for Care in the Family Setting (PECEF). This circumstance, it underlines, forces numerous households to give up the new aid in order to prevent the primary caregiver from losing her or his special agreement with Social Security and, with it, the contributions toward retirement.
The confederation also denounces the rigidity of the training requirements demanded of the figures of personal assistance, since most autonomous communities do not include grace periods for habitual caregivers to be accredited. The report highlights that many conventional home help companies do not have staff trained to handle invasive life-support devices, mechanical ventilation, or tube feeding, which, in numerous cases, forces the families themselves to train the auxiliary caregivers.
With regard to the co-payment, 11 of the 17 communities have formally eliminated this contribution in Grade III+, while territories such as Catalonia, the Canary Islands, Álava or Murcia maintain deductions linked to income or the ordinary scheme.
Finally, the entity reproaches the widespread failure to comply with the common portfolio of home physiotherapy in the National Health System. According to the data collected, Catalonia is the only community that provides regulated public coverage (two hours per week), while in the rest of the country families depend entirely on support from the associative sector.