Germany - Services within the framework of statutory social insurance

Description

(1)Basis of the qualification module "MAKS® - M" are: MAKS® is an effective psychosocial intervention for the therapy of dementias (in case of mild o. moderate severity). In two methodically high-quality scientific studies it could be shown that in cases of mild or moderate dementia during the period of application of MAKS® the cognitive and everyday practical abilities remained on average at the initial level, whereas they significantly decreased in the control groups. The content of the MAKS® training is defined by a curriculum and includes 9 training units. In the methodical design and practical implementation of the curriculum, attention is paid to an interactive learning environment in which skills and abilities are trained. This is based on the following principles: reflection on professional practice, action-oriented and the use of a variety of methods.
The nursing care insurance funds of the AOK in Hessen and the BAHN-BKK intend to conclude non-exclusive agreements within the framework of a so-called open house procedure with suitable companies for the purpose of promoting preventive measures in the sense of the regulation of § 5 SGB XI. The companies carry out:- qualification measures on the subject of "MAKS® - M" in the partial and full inpatient care facilities- distribute a so-called handout and a certificate of participation to the participants- carry out quality assurance after the implementation on the basis of a feedback form the overall evaluation of the feedback sheets is sent to the long-term care insurance fund of the AOK in Hesse.It should be noted that the expenditure of the long-term care insurance funds for the performance of their tasks for the purpose of promoting preventive measures in accordance with § 5 Para. 2 SGB XI amounts to a total of € 0.30 in 2016 for each of their insured persons. The expenditure shall be adjusted in subsequent years in accordance with the percentage change in the monthly reference figure pursuant to section 18(1) of Book IV. The reference value is determined by the estimation circle and announced by the Federal Ministry of Health once a year in the month of September/October. Consequently, the amount of expenditure (financial resources that may be used in this context for the purpose of promoting preventive measures) is limited by law in accordance with the provisions of § 5 Paragraph 2 of the Social Code Book XI. The nursing care insurance fund of the AOK in Hesse is required, on behalf of the nursing care insurance funds, to monitor the amount of financial expenditure legally stipulated for prevention services according to § 5 paragraph 2 SGB XI and to use it exclusively for the promotion of the tasks legally stipulated in § 5 SGB XI. For this purpose, the nursing care insurance fund of the AOK in Hesse has set up a controlling mechanism in your company. The financial support ends with immediate effect upon written notification by the nursing care insurance fund of the AOK in Hesse if it is determined within the scope of the controlling to be carried out that the available and legally limited financial resources could be exceeded or have been used up. In order to ensure that there is no overspending, contractual regulations provide for the following procedure within the framework of the provision of services: The nursing facilities that would like to participate in the qualification measure first notify the nursing care insurance funds of their interest. Only after receipt of a positive response from a nursing facility by the nursing care insurance funds is it possible for a nursing facility to participate in the qualification measure that is the subject of the contract. The respective company is then informed by the nursing care insurance fund by means of a written notification that it may now carry out the qualification measure. The care facilities select a company from a so-called provider directory that carries out the underlying qualification measure for the care facility. The nursing care insurance fund has no influence on this. The provider directory is made available to the care facilities by the AOK care insurance fund in Hesse. The companies agree that their data will be included in the aforementioned directory and made available to the care facilities in Hesse after conclusion of the contract. The provider itself is not entitled to be considered for the qualification measure. Consequently, it may happen that the provider has the underlying contract but does not come into play even once during the term of the contract; consequently, in this case, the provider also has no claim to remuneration.

Opportunity closing date

31 May 2023

Value of contract

to be confirmed