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Clients
Production
Personnel
Disability Care Core Data
Indexed Care Packages
Revenues

Clients
After many years of consistent growth the number of clients receiving disability care has been declining slightly since 2009. This can be attributed largely to the ‘package measures’ that were adopted as of 1 January 2009. As a result, clients with a minor disability whose care needs are restricted to supervision and participation in day-time programmes are no longer eligible for financial compensation through the Exceptional Medical Expenses
Act (AWBZ).

Figure 1 - Total number of clients receiving care for the disabled in 2002-2010

Figure 1 - Total number of clients receiving care for the disabled in 2002-2010. 2002: 103,000 | 2003: 105,000 | 2004: 120,000 | 2005: 130,000 | 2006: 140,000 | 2007: 145,000 | 2008: 160,000 | 2009: 155,000 | 2010 153,000 clients.

Source: Jaardocument maatschappelijke verantwoording (Annual Report of Social Responsibility)

Client numbers rose by an average of 6.3% per annum in 2007 and 2008. Figure 2 shows that the development in client numbers is contingent upon
the type of care provided. In 2007 and 2008 the number of clients needing extramural care rose by over 11%, the number of clients participating in day-time programmes rose by 5% and the number of clients needing intramural care rose by over 4%. As a result of the package measure the number of extramural clients began to drop in 2009. This concerns extramural clients with a mental disability or a sensory impairment. This decline continued in 2010 among extramural clients in the latter group, while the number of extramural clients with a mental disability began to grow once again.

Figure 2 – Number of clients per care category in 2007-2010

Figure 2 - Number of clients per care category in 2007-2010. Number of cliënts extramural care: 2007: 79,000 | 2008: 88,000 | 2009: 81,000 | 2010: 78,000 clients. Number of clients care with board: 2007: 67,000 | 2008: 70,000 | 2009: 72,000 | 2010: 75,000. Number of clients in day programmes: 2007: 49,000 | 2008: 52,000 | 2009: 55,000 | 2010: 53,000.
Source: Jaardocument maatschappelijke verantwoording (Annual Report of Social Responsibility)

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Production
In disability care the term ‘production unit’ is used to express the number of 24-hour periods a person spends at a care institution and the amount of time a client participates in a day-time programme (in half-days) or receives extramural care (in hours).

Figure 3 – Production units per care category in 2007-2010

Figure 3: Figure 3 - Production units per care category in 2007-2010. Number of care days in 2007: 24,000,000 | 2008: 24,500,000 | 2009: 25,000,000 | 2010: 25,500,000. Number of mornings or afternoon units of day-tine programmes: 2007: 14,000,000 | 2008: 15,000,000 | 2009: 14,000,000 | 2010: 13,500,000. Number of hours of extramural care: 2007: 10,500,000 | 2008: 11,000,000 | 2009: 10,500,000 | 2010: 9,500,000.
Source: Jaardocument maatschappelijke verantwoording (Annual Report of Social Responsibility)

In the 2007-2010 period the increase in the number of institutionalised care days (an average of 2.8%) was less than the increase in the number of clients, which rose by 3.8% per annum during this period. The number of mornings or afternoon units of day-time programmes fell by an average of 1% per annum, while the number of clients participating in day-time programmes rose by an average of 3.1%. The number of clients receiving extramural care and the number of hours of extramural care given fell by an average of 0.2% and 1.5% a year, respectively.

As client numbers have been expanding more rapidly than the number of hours of care given, the average amount of care a client receives has decreased slightly over the past four years. In 2010 an institutionalised client would, on average, receive 346 days of care a year, a client participating in day-time activities would spend 247 half-days a year in these programmes and an extramural client would receive an average of 128 hours of care.
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Personnel
Employee numbers in disability care have been growing in proportion to demand. Figures show that a sufficient number of professionals are attracted to long-term employment in disability care. This is substantiated by the fact that the average length of service has increased, coupled to a strong decrease in staff turnover since 2006. This implies that employees tend to stay with their employers for a longer period of time.

Table 1 – Core data for staffing in disability care

  2004 2005 2006 2007 2008 2009 2010
number of people working 147.928 - 151.320
158.940
167.300
-
 
of which on the payroll 135.831
140.614
141.730
148.250
152.790
158.700
163.340
number of posts 87.779 -
92.920
98.570
103.800
-
 
of which on the payroll 85.084 85.668
88.680
92.750
95.860
98.870
100.650
employees leaving
12,1% 11,2%
14,0%
12,8%
8,7%
6,8%
 

Sources: 2004-2008: Arbeid in Zorg en Welzijn, 2009 en 2010:  PGGM, CBS, Vernet.

The rise in staff numbers can also be attributed to the increasing number of work placement positions made available by various institutions. The total number of work placement positions rose from 12,676 in 2007 to 17,425 in 2009: almost a 37% increase.
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Disability Care Core Data
Table 2 offers a comprehensive overview of disability care core data. Approximately 95% of clients participating in day-time programmes also receive other forms of care.

Table 2 – Core data for disability care

    2007 2008 2009 2010
Clients Residential 66.795 70.143 72.842 74.658
Day programmes 48.749 52.097 55.116 53.282
Extramural
79.033 87.868 81.703 77.847
Production
Residential days 23.790.000 24.193.000 25.622.000 25.808.000
Day programmes half-days
13.547.000 14.660.000 13.932.000 13.151.000
Hours extramural care 10.440.000 10.592.000 10.377.000 9.968.000
Personnel
People 145.855 150.510 152.235 157.626
FTE 90.456 94.724 94.582 97.663

Expenses

(x € 1.000.000,-)

Budget 5.331 5.856 6.352 6.518
Other income
351 426 418 469
Total 5.687 6.290 6.767 6.985

Source: Jaardocument maatschappelijke verantwoording (Annual Report of Social Responsibility)

Core data per sub-sector
Disability care comprises three categories: care provided to the physically disabled, care given to people with a mental disability and care for people with a sensory impairment (auditory or visual). As a number of institutions provide care to both the mentally and physically disabled, these are presented as a separate sector.

Core data for the physical disabilities sector
The ‘PD sector’ includes institutions that provide care to the physically disabled.

Table 3 – Core Data PD Sector 2007-2010

    2007 2008 2009 2010
Clients Residential 1.525 1.529 1.564 1.639
Day programmes 2.927
3.310 3.280 3.440
Extramural 1.132 1.350 1.539 2.138
Production Residential days 543.000 547.000 560.000 581.000
Day programmes half-days 661.000 741.000 779.000 698.000
Hours extramural care 449.000 360.000 377.000 411.000
Personnel
People 4.024 4.043 4.109 4.191
FTE 2.556 2.631 2.750 2.759

Expenses

(x € 1.000.000,-)

Budget 166
174 188 191
Other income 7 10 13 11
Total 173 183 201 201

Source: Jaardocument maatschappelijke verantwoording (Annual Report of Social Responsibility)

Core data for the physical and mental disabilities sector
The institutions in this category provide care to persons with multiple disabilities and persons with both mental and physical disabilities.

Table 4 – Core Data PD/MD Sector 2007-2010

    2007 2008 2009 2010
Clients Residential 7.178 8.044 8.538 8.596
Day programmes 8.519
8.255 8.457 7.499
Extramural 6.005 6.497 5.894 6.413
Production Residential days 2.644.000 2.757.000 2.880.000 2.963.000
Day programmes half-days 2.073.000 2.049.000 2.107.000 2.014.000
Hours extramural care 1.226.000 1.239.000 1.170.000 1.102.000
Personnel People 16.721 17.300 17.166 17.388
FTE 9.763 10.025 10.317 10.592

Expenses

(x € 1.000.000,-)

Budget 600 668 698 702
Other income 34 38 38 48
Total 634 707 736 750

Source: Jaardocument maatschappelijke verantwoording (Annual Report of Social Responsibility)

Core data for the mental disabilities sector
The ‘MD sector’ comprises institutions that provide care to persons with a mental disability.

Table 5 – Core Data MD Sector 2007-2010

    2007 2008 2009 2010
Clients Residential 55.349 57.869 59.927 61.656
Day programmes 35.332
38.510 41.292 40.158
Extramural 32.607 35.589 33.926 37.061
Production Residential days 19.680.000 19.950.000 21.209.000 21.352.000
Day programmes half-days 10.372.000 11.476.000 10.619.000 10.128.000
Hours extramural care 7.432.000 7.342.000 7.181.000 6.893.000
Personnel People 117.165 120.000 121.971 127.076
FTE 72.982 76.287 75.827 78.788

Expenses

(x € 1.000.000,-)

Budget 4.340 4.660 5.090 5.240
Other income 295 332 323 371
Total 4.540 5.000 5.410 5.610

Source: Jaardocument maatschappelijke verantwoording (Annual Report of Social Responsibility)

Core data for the sensory impaired sector
The ‘SI sector’ is composed of ten institutions whose primary task is to provide care to the sensory impaired.

Table 6 – Core Data SI Sector 2007-2010

    2007 2008 2009 2010
Clients Residential 2.743 2.701 2.813 2.767
Day programmes 1.971
2.022 2.087 2.185
Extramural 39.289 44.432 40.344 32.235
Production Residential days 923.000 939.000 973.000 912.000
Day programmes half-days 441.000 394.000 427.000 311.000
Hours extramural care 1.333.000 1.651.000 1.649.000 1.562.000
Personnel People 7.945 9.067 8.989 8.971
FTE 5.155 5.781 5.688 5.524

Expenses

(x € 1.000.000,-)

Budget 325 354 376 285
Other income 15 46 44 39
Total 340 400 420 424

Source: Jaardocument maatschappelijke verantwoording (Annual Report of Social Responsibility)
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Indexed Care Packages
Institutionalised care is provided as part of an Indexed Care Package (zorgzwaartepakket, ZZP). Twenty-five different packages were defined for disability care in 2010. Seven of these Indexed Care Packages were tailored to persons with a mental disability, another seven to the physically disabled, four to the hearing impaired, five to the visually impaired, one to persons with a minor mental disability and another to persons suffering from a minor mental disability paired with a behavioural disorder. Care providers set a fixed rate for each Indexed Care Package. A total of 26,633,247 production days were registered in 2010.

Figure 4 – Number of production days per Indexed Care Package in 2010

Figure 4 – Number of production days per Indexed Care Package in 2010. ZZP VG1: 759,564 | ZZP VG2: 1,973,469 | ZZP VG3: 4,446,145 | ZZP VG4: 3,140,209 | ZZP VG5: 4,893,548 | ZZP VG6: 3,477,530 | ZZP VG7: 2,957,436 | ZZP LVG: 1,226,147 | ZZP SGLVG: 87,018 | ZZP LG1: 218,896 | ZZP LG2: 367,300 | ZZP LG3: 386,056 | ZZP LG4: 602,864 | ZZP LG5: 266,598 | ZZP LG6: 679,841 | ZZP LG7: 312,050 | ZZP AUD1: 71,830 | ZZP AUD2: 83,051 | ZZP AUD3: 105,752 | ZZP AUD4: 45,872 | ZZP VIS1: 82,119 | ZZP VIS2: 118,493 | ZZP VIS3: 104,893 | ZZP VIS4: 71,602 | ZZP VIS5: 154,955.
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Revenues
From 2007 to 2010, the revenue generated by providers of disability care increased from nearly € 5.7 billion to almost € 7 billion. The total budget is composed of the statutory budget for acceptable costs and other revenue. 2008 saw a relatively strong growth resulting from the processing of an administrative backlog in the calculation of the capital burden of care institutions in this sector. This growth levelled off slightly in 2009.

Figure 5 – Disability care revenues 2007-2010 (x 1 million)

Figure 5 – Disability care revenues 2007-2010 (x 1 million). 2007: 5,331 (statutory budget) en 351 (other income) | 2008: 5,856 (statutory budget) en 426 (other income) | 2009: 6,352 (statutory budget) en 418 (other income) | 2010: 6,518 (statutory budget) en 469 (other income).
Source: College voor Zorgverzekeringen, Jaardocument maatschappelijke verantwoording

The graph below illustrates the revenue generated per Indexed Care Package in 2010. A total revenue of € 4,332,919,404 was derived from Indexed Care Packages in 2010.

Figure 6 – Revenue per Indexed Care Package in 2010

Figure 6 – Revenue per Indexed Care Package in 2010. ZZP VG1: 55,712,065 | ZZP VG2: 180,170,474 | ZZP VG3: 528,547,408 | ZZP VG4: 438,932,000 | ZZP VG5: 949,793,056 | ZZP VG6: 578,866,763 | ZZP VG7: 718,016,405 | ZZP LVG: 239,120,000 | ZZP SGLVG: 26,558,114 | ZZP LG1: 23,137,158 | ZZP LG2: 49,536,028 | ZZP LG3: 52,245,240 | ZZP LG4: 92,344,410 | ZZP LG5: 48,710,476 | ZZP LG6: 132,748,119 | ZZP LG7: 65,768,268 | ZZP AUD1: 9,059,887 | ZZP AUD2: 21,591,359 | ZZP AUD3: 33,225,350 | ZZP AUD4: 8,884,954 | ZZP VIS1: 7,067,884 | ZZP VIS2: 14,761,651 | ZZP VIS3: 16,478,947 | ZZP VIS4: 14,832,357 | ZZP VIS5: 35,810,031. 
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