1. Development of Comprehensive Long-term Care System in Thailand
RESTITUTION
Technical Meeting on the System Design on 26 March 2013, at the Amari Watergate Hotel

2. LTC RISK DEFINITION SKOPE PROPOSED DURING THE SEMINAR
LONG TERM HEALTH CARE
LONG TERM INTERMEDIATE CARE
LONG TERM SOCIAL CARE
INDEPENDANT
HELPED
DEPENDANT
PHYSIOLOGICAL DECREASE
LOST OF AUTONOMY
DEMENTIA/ ALZHEIMER
AGE 60 65 80

4. JURIDICAL FRAME AND BENEFICIARIES
FEATURES OF THE SYSTEM, QUALIFYING CONDITIONS
LTC BENEFIT A) UNIVERSAL (in term of economic status)
B) MEANS TESTED (TARGETED)
CRITERIA FOR ELIGIBILITY
A) DISABILITY LEVEL, Health status certified by doctor ex Severs – lower level of care/needs
B) AGE 60 years and above
C) INCOME LEVEL regardless to the economic status, all dependant of and above.

5. BENEFIT AND BENEFICIARIES
DIRECT OR FINAL BENEFICIARIES
ALLOWANCE right
PROVIDERS OR INDIRECT BENEFICIARIES
ALLOWANCE payment
OPS, DEPENDANT ELDERLY
Depandency allowance
FAMILY
RESPITE care
RESPITE allowance
CARERS
ORGANISATIONS AND SERVICES PROVIDERS

6. CONCEPTUAL FRAME ORGANISATION.
National level
To define policy in the field of :
- Finances,
-HR
-KM
-R&D
-STD
-ICT for LTC
Laws and regulation
Regional level
Assessment of LTC Needs
Technical back stoping
Capacity building
M&E
Planification of services
Provincial level
Area based Control regulation and quality and finances
Payments
Capacity Building
Local authorities
Implementation (care management)
Coordination of providers
Feed back to the National
(Futur purchasers)
Data base for LTC
Bottom Up

7. STAKE HOLDERS RUN BY GOVERNMENT
Old People : self assisted
Family GO/private support system, Home visits by volunteers, older person association (friends to friends)
Local administration office Nursing Home, paid care givers (HHC)
Respite care funded by LOA and community health promotion center , OPA
Community based Referal system in cooperation with comminuty and district hospital and Hot Line
Community Health Center for primary care
District hospital Secondary care:
- Training informal careers and volunteers
- Sub-system intermediate care (post acute care)(over 45 days they are in LTC)
Provincial for Tertiary , high level of care specialist care, R&D
Day care center (Thai context..)

8. PRIVATE STAKE HOLDERS PRIVATE STAKE HOLDERS
PROFITABLE Need regulation and law to complete and standardise the nursing home services, care givers,
NON PROFITABLE
B.1 Service provider face bas organisation (bhudism, NGO, charity Old person, club)
B.2 Part pf the official services agreed could receive the reimbursement
Consider including qualified private nursing home to serve as part of the service system (agreement and control)
OTHER STAKE HOLDERS
INSTRUMENTAL SUPPORT (for the case of IADL)
Funds needed for instrumental as governement ; institution others

9. DEVELOPMENTOF COMPREHENSIVE LONG-TERM CARE SYSTEM SERVICES
THIS CHAPTER OF THE POLICY DESIGN SHOULD BE DEVELOPPED IN ACCORDANCE WITH THE PREVIOUS DIAGRAM OF THE LTC SKOPE :
Social care, intermediate care and health care

10. HR SUPPORT A-PROFESSIONAL
1 Medical Doctors (lack of geriatric specialists at the national level)
2 Managers Care managers
Evaluateur for assessment of needs
3 Specialists : They should have a degree level
Gerontology, Anthropology
Medico sociologist
4 Physicians
5 Ergotherapists
6 Nurses, 6.b Assistant nurses
7 Psychologists
8 Nutritionists,
9 Dentists
10 SocialWorkers
B-SKILLED PERSONNEL (certificate)
1 Assistant therapists
2 Assistant nurses (one year training- not yet approve from the Nurses Council)
3 Trained care givers 420 hours training 70 Hours plus expérice
(MOL, MOI, MOPH, MSDHS,Private company at the moment thetraining course reference of MOPH curriculum not in action ; Need to regularise and quality control for HR System)
C-OTHER CATEGORIES LOW SKILL
Volunteers (MOPH, MSDHS, in charge of the volunteers) recommend to train them to upgrade their capacity
Family members (need support after regular assessment of their needs)

11. OTHER PRINCIPLE COLLECTED IN OUR MEETINGS AND FIELD VISITS

12. OUR FUTUR INVESTIGATIONS
To design the suitable costing model and link with the selected policy
To develop the description of services and standards
To prepare the main processus to be able to fulfill the requirement of shaping a IT
To develop the HR policy and Capacity Building
To reinforce the coordination for a shared view of the LTC policy
Selected on thes featutres the moste suitable scenario
To prepare recomendations for implementation