CSAIO6

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CSAIO6 Long Term Care The Situation in The
Food And Agriculture Organization Of The United
Nations (FAO), WFP and IFAD
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The Provision of Long Term care for Staff and
their dependants in FAO is defined by a general
staff rule and the Provisions of the Manual
Section on health protection and medical
insurance plans STAFF REGULATION The
Director-General shall establish a scheme of
social security for the staff, including
provisions or health protection, sick leave, and
maternity leave...
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The (FAO) Basic Medical Insurance Plan .........
provides world-wide insurance for expenses that
are medically necessary, reasonable and customary
for the treatment of sickness, accident or
maternity. BENEFITS Expenses incurred by the
staff member or family members for medical
treatment prescribed by physicians and given by
persons qualified to treat patients are
reimbursed as shown below Convalescence in
sanatoria or institutional care for persons,
including the aged, with permanent ailments, when
prescribed by a physician
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• Present Practice
• The claims processor is continually attempting to
  narrow down coverage to clearly defined medical
  conditions
• Reimbursement of the costs of long term care for
  handicapped children of staff members
• Reimbursement of the costs of long term care for
  the elderly but only when there is a specific
  medical condition (i.e. no coverage just because
  a person is frail or cannot look after
  themselves)

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• At the moment the Joint Advisory Committee on
  Medical Coverage (JAC/MC) is considering the
  definition of Institutional Care. What is being
  proposed by Van Breda is the following

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Present Definition Convalescence in sanatoria,
or institutional care for persons including the
aged, with permanent ailments, when prescribed by
a physician. Proposed Definition (by the Claims
Processor Van Breda) Institutional care for
persons including the aged, suffering from
permanent ailments, which require constant and
primarily medical care. The care is to be
prescribed by a physician and is to be provided
in a specialized medical facility by staff
carrying a recognized (para)medical degree.
Care that is primarily custodial in nature,
i.e. representing assistance with activities of
daily living, is not reimbursable.
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• Irreversible mental diseases if treated with
  non-medical therapies will be reimbursed in the
  following way
• Care made up of services and supplies that
• are furnished mainly to train or assist in
  personal hygiene or other activities of daily
  living, rather than to provide medical treatment,
  or
• can adequately be provided by persons who do not
  have the technical skills of a covered healthcare
  professional.

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• What is going happen about long term care for the
  elderly (i.e. those too infirm to be able to look
  after themselves but not necessarily ill) ??
  Particularly if they cannot obtain long term care
  provisions under their national social security
  system. Should long term care be
• Included in the present medical plan?
• or
• Do we need a separate long term care plan?
• or
• Do we need a long term care plan at all?

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• Note however
• Pensioners can only continue with after service
  medical coverage if they (and their families)
  have completed 10 years or more membership of the
  medical plan
• Pensioners can only continue with after service
  medical coverage if they are receiving a pension
  under the UN pension scheme

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• Some Questions
• Should a long term care plan be compulsory??
• If it is not then will another separate (new)
  plan be viable??
• Should pensioners contribute to the costs of
  their care?
• Should such a plan be system wide??
• Would it not be more efficient to have only one
  medical plan instead of having the administrative
  costs of two separate ones??