The following persons residing in the Republic of Latvia have the right to receive long-term social care and social rehabilitation service (hereinafter - service):
- citizens and non-citizens of Latvia;
- third-country nationals who have received a permanent residence permit or who have been granted the status of a permanent resident of the European Union in the Republic of Latvia;
- citizens of the European Union Member States, European Economic Area states and the Swiss Confederation who:
- have obtained the right of permanent residence;
- are entitled to reside in the Republic of Latvia and who have stayed in the Republic of Latvia for at least three months;
- who have stayed in the Republic of Latvia for at least six months if entering into employment relationships in the Republic of Latvia has been the purpose of their stay, and their attempt to find a job is attested by registration thereof in the State Employment Agency;
- family members of these persons.
The aforementioned service is provided by long-term social care and social rehabilitation institutions, which ensure accommodation, comprehensive care, and social rehabilitation for persons who, due to age or health conditions, are unable to care for themselves, as well as for orphans and children deprived of parental care.
To determine care needs, a home visit is usually conducted by the social service. The assessment of care needs is increasingly based on a functional evaluation, using a scale that defines the level of care dependency. In accordance with the Law on Social Services and Social Assistance (hereinafter — the Law), social services are provided only on the basis of an assessment of an individual’s needs and resources, carried out by a social work specialist in cooperation with a general practitioner (GP). The assessment protocol consists of six sections: (a) basic needs; (b) mobility; (c) self-awareness, cognitive functioning, and safety; (d) behaviour and social interaction; (e) personal hygiene; and (f) assistance with household tasks.
A specific dependency threshold is set for each type of long-term care (LTC) service.
The types of social services, the principles for their provision, and the procedures for accessing them in Latvia are regulated by the Law. The Law establishes the division of responsibilities between the State and local governments in ensuring the provision of social services to residents.
The state finances long-term services for:
- adult persons who are blind and adult persons with severe or very severe mental disorders (disability groups I and II) whose degree of functional impairment and required level of care (level 3 or 4 of care) necessitate receiving services in a long-term social care and social rehabilitation institution;
- children with severe or very severe intellectual disabilities, children with severe or very severe physical disabilities, as well as children with combined severe or very severe intellectual and physical disabilities up to four years of age, for whom, due to functional impairments, care cannot be provided in a family environment, by a legal guardian, or in a foster family;
- children aged four to 18 with severe or very severe mental disorders for whom, due to the severity of functional impairments, care cannot be provided in a family environment, by a legal guardian, or in a foster family;
- orphans up to two years of age — temporarily, until care by a legal guardian or in a foster family is arranged, but for no longer than six months in total; this period does not include the child’s adoption process if it has been initiated within the first six months following placement in a long-term social care and social rehabilitation institution;
- children deprived of parental care up to two years of age — temporarily, until the child returns to the family or care by a legal guardian or in a foster family is arranged, but for no longer than six months in total; this period does not include the child’s adoption process if it has been initiated within the first six months following placement in a long-term social care and social rehabilitation institution.
Local governments shall provide services to adult persons with severe functional impairments (care levels 3 or 4), as well as to orphans and children deprived of parental care (aged 2 to 18), until the child can return to the family or, if this is not possible, until guardianship is established, the child is placed in a foster family, or the child is placed for adoption.
Local governments finance long-term services for persons with low income. Other persons, with the exception of children, are required to pay for the services received in accordance with the established service price and the payment procedures determined by the local government, unless the local government has set more favourable payment conditions for the individual.
If a person residing in an institution has insufficient income and has no spouse or child who is legally obliged to provide financial support, the municipality covers the care costs in part or in full.
The State determines the minimum amount of income that must remain at a person’s disposal after payment for services: this amount is equal to the monthly minimum wage (EUR 780) for the first household member and half of the minimum wage for each additional household member. Municipalities may adjust payment arrangements within their competence.
In practice, most local governments assess the income of the service recipient when pension income is insufficient and determine the amount of municipal co-payment on a case-by-case basis. Where there are no relatives able to contribute, or where their income is too low, the municipality covers the difference between the person’s pension and the actual cost of institutional care.
In order to receive a service, a person or his or her legal representative (if the service is required for a child) shall apply to the local government social service office and submit the following:
- an application describing the problem and the requested solution;
- information and documents regarding the income of the person and, where applicable, of persons legally responsible for their maintenance;
- a statement from a general practitioner regarding the person’s health status, indicating the type of functional impairments and the presence (if any) of acute infections (for example, active pulmonary tuberculosis or other acute infectious diseases) that may affect the provision of social services; the statement shall also include recommendations for care and preventive measures;
- an opinion from a psychiatrist regarding the person’s mental health status and any specific psychiatric contraindications to receiving social services (applicable only to persons with mental disorders).
Citizens of other European Union Member States who meet these conditions, with the exception of children, may receive the service on a fee-paying basis.