The representative of the Society of St. Vincent de Paul, Valdir Aparecido Alves, explained to the Human Rights Committee the drawbacks of the bill seeking to change how homes for older adults operate

On June 25, the Senate Human Rights Committee met with several organizations to discuss Bill 411/2024, which seeks to establish new guidelines, responsibilities, and operating standards for Long-Term Care Institutions for Older Adults—known in Brazil by the acronym ILPI—and referred to within the SSVP as homes or United Works. Senator Damares Alves, the bill’s rapporteur in the Committee, invited the organizations to participate in the discussion. Valdir Aparecido Alves, a member of Denor—the Department of Standards and Guidance—represented the SSVP at the meeting, taking part in the panel and presenting the organization’s point of view.

The proposal to change how ILPIs operate has already passed the Chamber of Deputies and is now under discussion in the Senate. It has been strongly criticized, particularly by organizations working in the sector, because the excessive increase in structural and financial requirements—such as strict health and sanitation rules and requirements concerning the purchase of medications—could jeopardize the care provided and lead to the closure of facilities.

Valdir addressed these concerns by drawing on the extensive experience of SSVP Brazil, which currently operates 476 ILPIs serving approximately 19,000 older adults in different parts of the country.

Valdir explained one of the most difficult aspects of the proposed bill. Under current regulations, an older adult who requires ongoing medical care cannot be admitted to residential institutions such as the SSVP’s ILPIs, or homes for older adults. The proposed legislation would change this rule.

“Under the bill, healthcare would become the responsibility of the ILPIs. This would completely change their purpose and would require them to care for older adults who are currently referred to a hospital or geriatric clinic, where they can receive care from trained, licensed, and qualified professionals,” he explained.

According to Valdir, the bill is unconstitutional because Brazil’s Federal Constitution establishes that healthcare is the responsibility of the State.

“If this proposal is approved, it will remove a responsibility from the State and transfer it to us, the ILPIs, even though we are already struggling to fulfill our social assistance mission. Our mission is very clearly stated in our bylaws and in the mission of the Society of St. Vincent de Paul in Brazil. We provide social assistance; we are not healthcare providers. A Long-Term Care Institution for Older Adults is not a geriatric clinic,” he argued.

Results

During the hearing, Senator Damares was moved by the statements made by the representatives of the organizations and came to understand that the bill, as currently written, would be harmful to Long-Term Care Institutions.

“She wants to introduce an amendment to adapt the bill to the reality of these organizations. To accomplish this, we created a working group, which also includes members of the senator’s advisory staff, so that we can develop a proposal that meets the needs of our homes,” Valdir explained.

In addition to Valdir, the SSVP is represented in the working group by Ivaldo de Moura Evangelista, Denor’s national coordinator.

“The idea is for this group to prepare a proposal—an amendment to this bill—so that Senator Damares can then call another public consultation,” he explained.

The voices of the organizations working with ILPIs were genuinely heard by the Senate Human Rights Committee. A few days after the consultation, the rapporteur’s office informed the participants that it had concluded that the matter required further examination before a final report could be issued, given the complexity of the legal, social, care-related, regulatory, and financial implications involved.

In this context, the following steps were established: obtaining a new opinion from the Legislative Consulting Office; conducting a strategic review of related legislative proposals; examining in greater depth the issues that emerged as central during the public hearing, particularly those concerning funding, the financial sustainability of ILPIs, health and sanitation regulations, integration between Brazil’s Unified Health System—SUS—and Unified Social Assistance System—SUAS—and the national long-term care policy; and expanding the debate within the Joint Parliamentary Front for the Defense of Older Adults.

According to the rapporteur’s office, the goal is to ensure that its future position is supported by the broadest possible technical dialogue and reflects legislative solutions that are feasible, legally sound, and compatible with the challenges posed by the aging of Brazil’s population.

“Our greatest victory was that we managed to stop the original text of the bill and gain a place at the table with the senator so that we could express our opinion. We are working directly in this field, welcoming older adults into our homes in several Brazilian states. I believe it was extremely important that we were able to speak and, above all, that our appeal was heard so that the bill would not be brought to a vote in the form in which it was drafted and approved by the Chamber of Deputies,” he concluded.

Written by Marina Prado
Source: https://www.ssvpbrasil.org.br/