Strategische Sozialberichterstattung 2015 - Deutschland - 2015 Strategic Social Reporting - Germany - 2015 Strategic Social Reporting - Germany - 1 2015 Strategic Social Reporting Germany Table of Contents 1. Introduction ..................................................................................................................... 4 Macroeconomic context and social security ...................................................................... 5 Key social protection reforms ............................................................................................ 6 2. Contributions to delivering on the goals of the Europe 2020 strategy in tackling poverty and social marginalisation ............................................................................... 8 3. Most recent reforms and political initiatives in the field of social inclusion ........... 10 3.1 Access for all to resources, rights and services; preventing and combating exclusion and all forms of discrimination; supporting entry into the labour market ................................ 10 Career entry support for young people ........................................................................... 11 Improving the participation of people with disabilities ..................................................... 14 3.2 Investing in children.......................................................................................................... 19 Early assistance .............................................................................................................. 19 Expansion and quality of child day care facilities ............................................................ 20 3.3 Homelessness .................................................................................................................. 21 3.4 Inclusive living .................................................................................................................. 21 3.5 Fighting discrimination...................................................................................................... 22 4. Recent reforms to achieve appropriate and sustainable pensions .......................... 26 Raising the retirement age and current reform measures ............................................... 26 Pension adjustment......................................................................................................... 27 Contribution rate.............................................................................................................. 28 5. Recent reforms in the health care system .................................................................. 29 Accessible, high-quality and sustainable health care ...................................................... 29 Provision of health services and preventive health care ................................................. 30 Medical care for people suffering from dementia ............................................................ 31 2 6. Recent reforms in long-term care ................................................................................ 32 Accessible, high-quality and sustainable long-term care provision ................................. 32 Further development of social long-term care insurance ................................................ 32 Securing the supply of skilled labour in the caring professions ....................................... 33 Reconciling family, care and work commitments ............................................................ 33 Development of expenditure in social long-term care insurance .................................... 34 Annex .................................................................................................................................... 35 Overview of indicators ............................................................................................................ 35 3 1. Introduction Within the Open Method of Coordination in the field of social affairs (social OMC), EU member states report annually as part of Strategic Social Reporting on new national developments, reforms enshrined in law or pending in Parliament, and actions towards the common objectives in the OMC areas of social inclusion, pensions, health and long-term care. The reporting period is from 1 July 2014 to 30 April 2015. In addition, details are also given of some activities that are planned for the near future. Measures that were implemented by 30 June 2014 have already been reported and will not be detailed again in this report. The reports from the member states form the basis to the report of the Social Protection Committee (SPC) to the Council on structural social protection reforms. In Germany, reporting is synchronised with the National Reform Programme (NRP) and the European Semester process. With regard to their content, the Strategic Social Reporting, the NRP and the report entitled “Information from Germany on progress in the implementation of the report concerning the EU Framework for National Roma Integration Strategies up to 2020 - Integrated packages of measures to promote the integration and participation of Sinti and Roma in Germany” are complementary, and the reports make reference to one another at the relevant points. The social dimension and social issues are dealt with comprehensively in the Strategic Social Reporting. Within the Federal Government, the Federal Ministry of Labour and Social Affairs (BMAS) has primary responsibility for Strategic Social Reporting, with the Federal Ministry of Health (BMG), the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (BMFSFJ), the Federal Ministry of Education and Research (BMBF) and the Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety (BMUB) also making a significant contribution. Seeking to obtain a high level of transparency and encourage the broad-based participation of all stakeholders, the Federal Ministry of Labour and Social Affairs involved the social partners, welfare and social organisations, as well as the Länder and municipal levels in the entire process surrounding the 2015 Strategic Social Reporting. At the beginning of this process, the stakeholders formulated opinions on possible topics and priority areas of the report. These, in turn, were taken into consideration by the line ministries when drafting the expert contributions. This was followed by exchange between all the stakeholders and the line min- 4 istries, after which the stakeholders received the opportunity to state their position regarding the draft 2015 Strategic Social Reporting. In Germany, the social partners, welfare organisations and social organisations, as well as the Länder and municipal level, make a key contribution to delivering on the goals of the social OMC and the Europe 2020 strategy, particularly in the areas of social integration and poverty prevention. The 2015 Strategic Social Reporting was approved in the Federal Cabinet on 25 March 2015. Macroeconomic context and social security The German economy is still in good shape. While economic growth weakened significantly last year after a strong first quarter, with investment lagging behind expectations due to disappointing global economic development and insecurity from heightened geopolitical risks, a recovery could be witnessed in the last few months of 2014, driven by strong developments in employment and strong consumer spending. According to the provisional annual results of the Federal Statistical Office, Germany's price-adjusted gross domestic product increased overall by 1.6% on an annual average in 2014. This positive development is likely to continue in 2015. The Federal Government is expecting real GDP growth of 1.5% for the annual average, which will be driven almost exclusively by the domestic economy. The German labour market emerged largely unscathed from the temporary economic slowdown. Gainful employment and employment in jobs subject to social security contributions have continued to increase. There were 43.0 million individuals in gainful employment in Q4 2014, translating to 412,000 more individuals (+1.0%) than in the same period in 2013. In February 2015, the number of unemployed persons had dropped by 14,600 to 3.02 million compared with the previous month. Compared against February 2014, 121,000 fewer individuals were registered as unemployed (-3.9%). The national rate of unemployment stood at 6.9% in February 2015 (10.2% eastern Germany; 6.2% western Germany) and was thereby 0.4 percentage points below the rate of the previous year. Average unemployment in 2014 stood at 2.9 million, which is equivalent to a drop of 2% compared with the previous year and, together with 2012, is the lowest level since 1991. In 2014, the number of beneficiaries of basic security benefits for jobseekers fell slightly once again to 6.1 million, or by 0.4%. In 2013, 6.13 million people were claiming basic security 5 benefits for jobseekers (with a 0.3% drop compared with 2012). Therefore the number of beneficiaries expressed as a share of the population of the same age has largely remained constant (9.5% in 2014; 9.6% in 2013). In contrast, standing at roughly 962,000 the number of persons entitled to basic security benefits in old age and in the event of reduced earning capacity at the end of 2013 was 6.9% higher than at the end of 2012 (900,000 persons). At roughly 499,000 persons, beneficiaries aged 65 and over as a share of the population in this age bracket rose to 3.0% (compared with 2.8% at the end of 2012). Even though the specific share of the population has increased slightly in recent years, old-age poverty is still not a widespread issue. Key social protection reforms The Federal Government has taken action in the reporting period to further improve the social situation in Germany. A general statutory minimum wage of €8.50 per hour entered into force on 1 January 2015, guaranteeing a reasonable wage floor for workers. In designing the minimum wage, the Federal Government sought to make it as employment-friendly as possible. On the basis of industry-specific minimum wages under the Posted Workers Act (Arbeitnehmer-Entsendegesetz), some industries can continue to pay less than the minimum wage through to the end of 2017 but industry-specific minimum wages must be at least €8.50 by 1 January 2017. Improvements have also been rolled out to benefits under pension schemes. Since 1 July 2014, individuals who have been insured for a particularly long time, and have paid into the statutory pension insurance system for at least 45 years, have been entitled to receive their retirement pension at 63 without any pension deductions. This age limit for a full pension will be gradually increased to the current pension age of 65 for insured individuals born in 1953 and after. Further to this, the "mother pension" ensures better recognition under the pension system of the child-rearing work of parents whose children were born before 1992. The benefits under the pension for reduced earning capacity have also been improved. With retroactive effect to 1 January 2014, in future the annual adjustment to the rehabilitation budget will factor in demographic developments in addition to anticipated wage developments. The Federal Government's aim has been and remains to be that of organising the social security systems such that the insured continue to receive high-quality, appropriate social benefits should the need arise, while also guaranteeing the sustainability of the social security systems and public finances, providing incentives for decent and fair work, facilitating participation and preventing poverty. In addition, sensible and sustainable investment must be made in the social sector, education and social inclusion. 6 Social policy and the social state must be flexible in responding to social change and shape such change reliably so that social security and economic dynamism continue to interact in a viable and appropriate manner. This is because a strong social fabric is the backbone to both a modern society based on the principle of solidarity and a resilient, successful and effective economic system. At the same time, incentives to work and perform must not be weakened. After all, only an efficient and competitive economic system will be able to organise social equity and participation appropriately in the long term. 7 2. Contributions to delivering on the goals of the Europe 2020 strategy in tackling poverty and social marginalisation Long-term unemployment presents a substantial risk of individuals experiencing poverty and social exclusion. For this reason, the Federal Government has defined its quantitative goal in the fight against poverty and the promotion of social inclusion based on the number of individuals living in households affected by long-term unemployment. The aim is to reduce the number of long-term unemployed (unemployed for more than one year according to the ILO definition) by 20% by 2020 (measured against the annual average in 2008). This is equivalent to a drop of around 320,000 long-term unemployed (2008 annual average: 1.62 million). With conservative estimates of two persons per workless household, this reduces the number of people at risk of poverty by 640,000. Germany already clearly exceeds this goal. Given the extraordinarily positive employment trends in Germany, long-term unemployment declined significantly in recent years with numbers down to roughly 865,000 persons in Q3 2014. Benchmarked against the figures for Q3 2008, this equates to a drop of around 44%, or 674,000 people (data on the basis of the Eurostat labour force survey). The fight against long-term unemployment remains a priority of the Federal Government's labour market and social policy. While long-term unemployment has been trending downwards in recent years, the long-term unemployed benefit less from the positive developments on the labour market. On account of complex, individual problems, sustained integration into work is often only possible with major effort from all parties involved over an extended period. The Federal Government therefore continues to pursue the goal of placing more low-skilled and long-term unemployed individuals in work that guarantees a livelihood, to qualify these individuals so that their skills fit market needs, coach them and, where necessary assist them – even once they have been successfully integrated into the labour market – and create the necessary framework to make this happen. To this end, the Federal Government has presented the plan for "Opening Opportunities - Safeguarding Social Participation" to reduce long-term unemployment. The plan encompasses a variety of measures, programmes and approaches aimed at improving the opportunities of the long-term unemployed and facilitating social participation. Funding from the European Social Fund (ESF) makes a key contribution in this respect. The Regulations on Structural Funds for the 2014-2020 programming period specify that at national level at least 20% of ESF funding must be invested in the priority areas of promoting social integration and combating poverty. In the joint ESF/Federal programme for the 20148 2020 programming period, this goal will be achieved particularly by combating long-term unemployment through the permanent integration of the long-term unemployed in jobs subject to social security payments; support for migrants and the lasting placement of migrants in jobs and training; and improved access to employment, training and education for disadvantaged persons (including young people and young adults at the margins of the labour market and out of reach of the educational process). A lower-threshold approach is enabled by the Fund for European Aid to the Most Deprived (FEAD), which is being rolled out in Germany in 2015. The FEAD promotes the social inclusion of persons not reached by the advisory and support services of the regular system of assistance. This includes some EU migrants and their children, as well as homeless persons and people at risk of being homeless. While the aim is to bring the adult EU migrants, homeless persons and people at risk of being homeless into the regular system of assistance comprising language courses or targeted advice, for example, the migrants' children are to be offered better access to early childhood education and social inclusion, such as child day care facilities. Germany’s qualitative goals in the reduction of poverty and social marginalisation continue to centre primarily on the following target groups: children, young people, women, single parents, individuals from a migrant background, people with disabilities and older people. Over the past year, the Federation and the Länder have developed various strategies and programmes in this respect with the aim of improving the opportunities of the disadvantaged groups to partake at a social and economic level. Everyone must be given the opportunity to realise their individual potential at every stage of life. To this end, the aim is to improve the opportunities for education, social participation and integration both into society and the labour market, and to avoid poverty in old age. The goal of increasing the employment rate of women to 73% by 2020 has already been reached, having risen to 73.4% in Q3 2014. The employment rate of older workers (55 to 64year-olds) also continued to rise to 66.1% in Q3 2014, thereby already clearly exceeding the national goal of a 60% employment rate by 2020 as also set down in the National Sustainability Strategy. 9 3. Most recent reforms and political initiatives in the field of social inclusion 3.1 Access for all to resources, rights and services; preventing and combating exclusion and all forms of discrimination; supporting entry into the labour market Ensuring the appropriateness of welfare benefits The reform of the Asylum Seekers Benefits Act (Asylbewerberleistungsgesetz, AsylbLG) implemented the Federal Constitutional Court ruling of 18 July 2012 (1 BvL 10/10, 1 BvL 2/11, Federal Constitutional Court Ruling 132, 134-179) on 1 March 2015, and restructured monetary benefits under this Act in a manner than complies with the German Constitution. This reform redefined monetary benefits under the Asylum Seekers Benefits Act, making them transparent and in keeping with needs, and significantly raised the benefit rates compared with the previous levels. From now on, the monetary benefits for claimants of basic benefits under this Act will also be determined on the basis of the statistical model of sample surveys of income and expenditure - as defined in Book II and Book XII of the Social Code - and will also be updated according to the same update mechanism as defined in Book XII of the Social Code. At the same time, the length of time individuals claim basic benefits under the Act has been shortened significantly from 48 to 15 months, such that eligible persons will be able to receive benefits under Book XII of the Social Code after 15 months in future. Individuals with a residence permit on certain humanitarian grounds were not included in the scope of the Asylum Seekers Benefits Act. If they are in need of assistance, such individuals will in future receive benefits under Book II or Book XII of the Social Code. At the same time, an education package regulation was also introduced under which all children, youths and young adults within the scope of the Asylum Seekers Benefits Act are entitled from the outset to education and participation benefits in accordance with Book XII of the Social Code. This seeks to provide these individuals with opportunities for education and participation early on and improve their situation. In November 2014, conditions surrounding access to the German labour market were eased for asylum seekers and for foreigners whose deportation has been temporarily suspended. Entering into force on 6 November 2014, the Act on the Classification of Additional Countries as Safe Countries of Origin and to Facilitate Labour Market Access for Asylum Seekers and Foreigners whose Deportation has been Temporarily Suspended uniformly reduced to three months the time asylum seekers and persons whose deportation has been temporarily suspended are required to wait before they can take up employment. After this three-month waiting period, employment is possible with the approval of the Federal Employment Agency. Approval is granted if no German jobseekers or applicants from the EU, having priority sta10 tus, are available for the job (labour market test) and employment conditions match those of German workers. With the amendment to the Employment Regulation which entered into force on 11 November 2014, the labour market test does not apply to qualified skilled professionals who would otherwise not be subject to priority placement testing, or if the individual's stay in Germany has already been permitted, tolerated or authorised for a continuous period of 15 months. As before, the requirement to obtain approval no longer applies once the individual has been in the country for four years. Degree of coverage by social protection systems 0.06% of the population in the 15-24 age bracket claim subsistence allowances outside institutions under Book XII of the Social Code. The same applies for 0.13% of the population in the 25-29 age bracket. 0.56% of the population in the 15-24 age bracket claim standard benefits under the Asylum Seekers Benefits Act. The same applies for 0.62% of the population in the 25-29 age bracket. Basic security benefits under Book II of the Social Code are claimed by 8.6% of the population in the 15-24 age bracket. Career entry support for young people The Federation, the business community, trade unions and the Länder sealed the "Alliance for Training and Continuing Education" on 12 December 2014, making a key contribution to securing the supply of skilled labour in Germany. Within the context of the Training Guarantee articulated in the Coalition Agreement, anyone interested in vocational training will receive a "roadmap" of the fastest track to obtaining the vocational qualification. In-company training is given priority here. Among their aims, the partners to the Alliance wish to strengthen Germany's dual system of vocational training, reduce the regional and vocational mismatch between applicants' qualifications and business needs on a lasting basis, and promote parity between vocational and academic education. The Federal Government, the Federal Employment Agency, trade unions and the Länder have committed to making specific contributions (for example, measured against the number of training positions reported to the Federal Employment Agency in 2014, the business community intends to make 20,000 additional training places available in 2015; the partners to the Alliance want to introduce a new assisted training instrument - to this end the Federal Employment Agency will finance up to 10,000 places in the 2015/16 training year and the partners will make a joint decision in 2015 on the expansion and funding of the assisted training instrument from the 2016/17 training year onwards). The Alliance replaces the previous "National Pact for Training and Skilled Manpower Development" and will run through to the end of 2018. 11 Legislative changes to introduce assisted training and extend assistance during training are underway. Assisted training is to be implemented for the entire duration of the Alliance for Training and Continuing Education, i.e. for a total of four entry cohorts. Lower-attaining pupils often have difficulty obtaining a school-leaving qualification and are therefore also at risk of not making a successful transition to working life. To minimise this risk, career start coaches seek to provide intensive career entry mentoring and coaching to lower-attaining pupils at lower secondary schools and special needs schools. The career entry support model has been trialled at selected schools since 2009. The current pilot model is to be supported and developed further, and expanded within the framework of the budget funding available. For the academic years between 2014/2015 and 2018/2019 there are plans to co-finance career entry support with ESF funding. In terms of financing, the joint ESF/Federal Programme to Co-finance Career Entry Support is the strongest ESF programme to be launched by the Federation in the 2014-2020 programming period. Altogether, roughly €1 billion are available, with €530 million coming from ESF funding and the same amount from the integration budget (Eingliederungstitel) of the Federal Employment Agency. This makes it possible to finance career entry support measures for five entry cohorts for the academic years between 2014/2015 and 2018/2019 at 2,550 schools, with a total of roughly 115,000 programme participants. The measure is scheduled to commence on 16 March 2015. The Federation developed the Education Links Initiative to help strengthen equality of opportunity in vocational training. The aim is to work with the Länder to interlink structures and offerings for vocational training through to the completion of training and final qualification, and thereby make it easier for disadvantaged young people, in particular, to transition to working life. With the 25th Act to Amend the Federal Educational Assistance Act (BAföGÄnderungsgesetz), the Federation provides full funding for the monetary allowances under the Federal Educational Assistance Act as of 2015, thereby granting the Länder annual relief of roughly €1.17 billion on a lasting basis to give them more latitude for the funding of education, particularly in the field of third-level education. Further to this, BAföG entitlements and income allowances will both be increased by 7% starting in the 2016/2017 academic year or the 2016/2017 winter semester. These measures will raise the levels of financial support provided and increase the number of BAföG recipients by around 110,000 on an annual average in 2017 - the first year the measures fully come into effect. Due to the additional above-average increase in the housing supplement for students not living at home, the levels 12 of support for this demographic will even increase by around 9.7%. This specifically factors in the increase in rental costs that have been witnessed even for student accommodation. The child care supplement will also be raised and standardised to ensure individuals can even better combine family commitments and education. Previous gaps in support in transitioning between Bachelor's and Master's programmes are largely closed. With simpler procedures and less bureaucracy, the BAföG assistance system will also become far more user friendly. This BAföG reform is a decisive step towards greater participation in learning and equal opportunities in the education system. As a result, pupils and students dependent on BAföG assistance can continue to rely on a solid system of education funding in the future. In the transitional field, the wide range of services and programmes are to be better aligned to enable as smooth a transition as possible to working life for young people, particularly lower-achieving individuals. Under the umbrella of "Youth and Vocation Work Alliances" these efforts are already taking shape in a wide range of projects to improve collaboration in the transition from school to working life and at the points where responsibilities under Books III, II and VIII of the Social Code intersect. Currently there are 186 such work alliances in Germany that are run as agencies for youth employment and vocational training, youth job centres or similar, and offer solutions that are tailored to regional circumstances. The aim is to take young people "by the hand" in the figurative sense and help them transition from school to a career. The collaboration efforts are to be extended nationwide and existing partnerships and alliances are to be developed further. Individual continuing vocational education and training (CVET) is supported by two modules under the "continuing education grant" programme launched by the Federal Ministry of Education and Research. For one, anyone interested in continuing education can receive a continuing education voucher worth a maximum of €500 every two years if their annual taxable income does not exceed €20,000 (or €40,000 if taxes are assessed jointly) and they bear half the costs of the CVET measure. Furthermore, individuals in receipt of the grant must be in gainful employment for at least 15 hours a week on average. A new condition is that the voucher recipient must be aged 25 or over and that the cost of the supported CVET measure must not exceed €1,000. Furthermore, to receive a CVET voucher, applicants must first consult with a continuing education grant advisory point. The further training savings plan constitutes the second component of the continuing education grant. Following a legislative amendment to the Fifth Capital Accumulation Act (Fünftes Vermögensbildungsgesetz), it is now possible to withdraw funds - equivalent to the training cost incurred - from savings deposits accrued through an employee savings programme to finance a continuing education course before the end of the lock-in period. Cumulative application of the two components is 13 possible. Since the programme commenced in autumn 2008, approximately 270,000 continuing education vouchers have been issued. The issuance of a further 280,000 vouchers is now made possible with the new funding period. Currently anyone interested in CVET measures can receive advice at around 500 advice centres nationwide and - if the prerequisites are met - be issued a voucher. On average, €360 was paid out per voucher in the second stage of funding. The demographics of those participating in the continuing education grant programme have hardly changed since the programme was rolled out. In the current third funding phase also, the majority of voucher recipients work in the field of "health and social work" (42%), followed by the field of "education" (11%) and "business activities" (10.5%). The programme continues to achieve higher-than-average outreach to demographic groups with below-average involvement in in-company CVET measures: this is true for women (77%), workers in SMEs with a maximum of 250 workers (90%), part-time workers (42%) and freelancers (23%). By way of CVET guidance, a telephone service for informed continuing vocational training and education advice has been trialled since the start of the year, helping individuals to identify their particular CVET needs and put their plans for CVET in concrete terms. The service offers those seeking guidance uniform, easy access to neutral advice on CVET, and provides answers to all questions surrounding vocational, political and specialised further training. This service helps individuals to actively and independently shape their own education and career paths and thereby contributes to delivering equal opportunities and participation in society. The free service is available on weekdays between 10 a.m. and 5 p.m. at 030 2017 90 90. In addition, the "Work and Live in Germany" hotline at the Federal Office for Migration and Refugees (BAMF) provides initial guidance on getting professional qualifications obtained abroad recognised in Germany. Improving the participation of people with disabilities The Federal Government adopted the National Action Plan to Implement the UN Convention on the Rights of Persons with Disabilities in June 2011. With the National Action Plan (NAP), the Federal Government has created an instrument with which it wishes to systematically drive forward the implementation of the UN Convention in a ten-year period. In this, the Federal Government underlines its commitment to "disability mainstreaming", i.e. factoring disability into all proposed legislation, every project and every measure. The 200-plus projects, programmes and actions demonstrate that inclusion is a process that encompasses all areas of life. The aim of inclusion is a task for the whole of society and requires the involvement of people both with and without disabilities. The Federal Government commissioned an external 14 scientific assessment of the Action Plan, which was performed on the understanding that evaluators were to closely scrutinise the NAP in every legislative term. On the basis of the assessment report presented in autumn 2014, the Action Plan is now to be developed further, again with the broad participation of civil society and particularly of persons with disabilities and their representative organizations - within the sense of Article 4 Paragraph 3 of the UN Convention on the Rights of Persons with Disabilities. This process was started at the end of 2014 and will continue into 2015. Apart from "work and employment" and "prevention, rehabilitation, health and care", key action areas of the NAP also include "children, young people, family and partnerships", "women" and "the elderly", as well as "building and housing", "mobility" and "social and political participation". In the past few years, people with a severe disability did not benefit from the positive developments on the labour market to the same extent as people without a disability. For this reason, a principle focus of the NAP is the vocational participation of people with disabilities. The Federal Government has set itself the goal of improving the employment situation of people with disabilities on a lasting basis. To this end, the aim is to further sensitize and advise employers so that they recognise the workforce potential of people with disabilities and employ them. Last year, we reported on the "Inclusion Initiative for Training and Employment" as an active measure of labour market policy for people with disabilities which centres specifically on this objective. The measures agreed with the key labour market partners, and geared towards bringing about the necessary change in attitude among the business community, have been set in motion. The funding programme to step up the integration of people with severe disabilities and enhance advisory services was increased by up to €30 million in November 2014. This means that funding of up to €80 million is now available to implement plans of employment service providers that are geared towards stabilising existing employment relationships, creating new ones and promoting in-company training of young people with disabilities. The Inclusion Initiative for Training and Development is complemented by the "Inclusion Initiative". With a total of €140 million from the national rehabilitation fund, this Inclusion Initiative is geared towards the promotion of career orientation for young people with severe disabilities, the training of young people with severe disabilities, the employment of older people with severe disabilities and the inclusion skills of the Chambers of Commerce. 15 Reducing gender-specific segmentation in the labour market and facilitating female labour force participation To reduce vertical gender-specific segregation, the Federal Cabinet adopted the bill for the equal participation of men and women in executive positions in the private sector and in public service on 11 December 2014. With the help of the new legal regulations, the Federal Government seeks to increase the proportion of women in executive positions in Germany. From 2016 onwards, a 30% gender quota will apply for all new appointments to supervisory boards of publicly listed companies and businesses with obligations for full employee codetermination. Starting in 2015, publicly listed companies or businesses with obligations for employee co-determination are to be required by law to set targets for increasing the share of women on executive boards, supervisory boards and in top-level management positions, and set dates by which these targets will be reached. This information is to be disclosed publicly. Furthermore, such businesses must report on implementation regularly, thereby providing transparency on progress towards the targets. The Appointment to Federal Bodies Act (Bundesgremienbesetzungsgesetz) of 1994 and the Federal Act on Gender Equality (Bundesgleichstellungsgesetz) of 2001 are also to be amended within the context of the bill. In keeping with the new rules for the private sector, a gender quota of at least 30% will apply from 2016 for all new appointments to government seats on supervisory boards on which the Federation is entitled to at least three seats. The aim is to increase this proportion to 50% from 2018 onwards. A 50% quota is planned for key federal bodies. This quota can also be gradually reached by 2018. The amendment to the Federal Act on Gender Equality particularly seeks to increase the percentage of women in leadership positions in federal service. For supreme federal authorities, progress towards this goal will, in future, be recorded in the form of an equality index and published annually. Public awareness of the issue of equal pay is raised through the “Equal Pay Day" campaign, which was already discussed in the 2012-2014 Strategic Social Reports. The motto of the current 2014/2015 campaign is "Putting the cards on the table: what do women and men earn?", which culminated on Equal Pay Day on 20 March 2015. Transparent assessment methods and remuneration structures in businesses are a key prerequisite to closing the gender pay gap, which currently still stands at 22% in Germany. With transparency a priority topic in 2015, the Equal Pay Day public campaign supports the measures for the promotion of equal pay that were agreed in the Coalition Agreement. Accordingly, the Federal Government plans to present a law that ensures greater wage transparency. In their management reports according to the German Commercial Code, large businesses with 500 or more employees will be required to state their position on the promotion of women and equal pay in 16 accordance with legal criteria. Building on this, male and female employees will be granted an individual right to information. The aim is to encourage businesses to set binding procedures to identify differences in pay, and to sit down with workers and stakeholders to eliminate on their own responsibility any pay discrimination that has come to light in the company. The "Collective Bargaining & Equal Pay" research project looks at the effects of collective wage bargaining on the wage gap and seeks to gain an insight into collective bargaining processes. The results of the overall project will be presented at the end of 2015. "What do Women Earn? Economic Independence!" is a project of the German Trade Union Confederation implemented in collaboration and consultation with the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth and running from September 2014 to August 2016 that wishes to strengthen the economic independence of women and thereby also contribute to closing the gender pay gap. Targeting young women and mothers in particular, the project seeks to specifically illustrate the interconnection between economic independence, the wage gap and jobs that secure a livelihood, and to explain what women can be mindful of and watch out for in their professional lives. In implementing the project, the German Trade Union Confederation takes advantage of its access to women and disseminators in business enterprises and trade unions. The project particularly focuses on women at junctures in their lives, transitioning from training to working life, or coping with work and motherhood. The ESF program entitled "Changing Careers – Men and Women in Child Day-Care Centres" aims to reduce horizontal gender segregation on the labour market. It promotes the qualification of individuals who are changing careers to become educators in child day-care centres. Due to the training structures, such career change proves very difficult at present. The programme is trialling new, paid, adult-appropriate training courses for this target group, thereby helping to further open this field to men (as men, in particular, often tend to choose this career later in life) and increase staff diversity in child day-care centres. The "Gender-Responsive Career and Study Programme Orientation" initiative of the Federal Government ties in with the experience gathered over many years from the New Paths for Boys/Boys’ Day and Girls’ Day programmes. These programmes will be continued and a group of experts will identify existing gaps in research and develop recommendations for action. The research gaps are then to be closed and the recommendations for action implemented with the participation of the relevant stakeholders. 17 To assist parents in combining work and family commitments, new regulations surrounding parental allowance were developed and the new "parental allowance plus" (Elterngeld Plus) introduced. Parental allowance plus creates the best possible framework for parents to be able to receive parental allowance in conjunction with a part-time job, thereby making it easier for parents to return to work. Parents who return to part-time work shortly after the birth of their child lose some of their parental allowance entitlements on account of the part-time income. Parental allowance plus compensates for this by providing longer-term financial support beyond the first 14 months of the child's life. One previous month of parental allowance has now been made into two months of parental allowance plus. Further to this, the parental allowance is complemented by a partnership bonus that seeks to promote the sharing of family and work responsibilities among both partners. If both the mother and the father simultaneously work part-time for 25-30 hours per week for four consecutive months, they each receive four additional months of parental allowance plus. The new regulations are applicable to co-habiting parents and single parents. Parents can avail of the new service in the early family phase, choosing a set-up that is right for them, and thereby enter a situation in which family and work responsibilities are shared among both partners. In addition, new regulations surrounding parental leave are to give parents more flexibility in returning to work and in their plans to combine work and family commitments. Parental leave of up to 24 months which has not been taken can now be taken when the child is aged between two and seven. The approval of the employer is no longer required. In future, parental leave can also be split into three blocks (previously it was two). The third block can be denied by the employer for pressing business reasons if it is between the child's third and eighth birthday. In addition, the concept of "presumption of approval" is also introduced: if the employer does not respond to an application for part-time work by a parent entitled to parental leave within a certain time, approval is deemed to be granted. The new rules for parental allowance plus, the partnership bonus and parental leave apply to parents whose children are born on or after 1 July 2015. The ESF model programme "Return to Work – Unlock Potential" (Perspektive Wiedereinstieg - Potenziale erschließen) commences in 2015. The aim of the programme is to help men and women who have taken a multi-year career break for family reasons return to work with good prospects. The programme builds on the experience of the last programming period (see 2012-2014 Strategic Social Reports). In particular, this includes individual support management for women in the "hidden reserve", targeted pitching to employers, and the involvement of partners or support from household-related services. The programme scope is extended 18 with the "returning to work and care needs" and the "potential of women in mini-jobs" modules. The "Return to Work" (Perspektive Wiedereinstieg) parent programme of action communicates the topics of the model programme to the public and is continued with its various modules, such as the advisory portal (www.perspektive-wiedereinstieg.de), XING group, public relations work and the return-to-work calculator tool. In the Coalition Agreement and within the context of the Digital Agenda 2014-2017, the Federal Government has adopted measures to improve the framework for parents to reconcile work and family commitments. The Federal Government seeks to ease the burden on families balancing career and child-rearing responsibilities, create more time for families and careers, and contribute to increasing labour market participation among women. Householdrelated services constitute one instrument for delivering on these goals. For this reason, the Federal Government will set up an information portal for household-related services. By providing enhanced transparency and information, the portal aims to improve access to the legal household-related services market, promote professionalisation on the supply side by providing information on quality standards, and channel and increase demand on the whole. Moreover, the Coalition Agreement also calls for the facilitation of the transition from marginal employment to regular employment subject to social security contributions. This would benefit women, in particular, as the percentage of women in marginal employment clearly outweighs that of men. In local pilot projects, the Federal Employment Agency has already tested out how it can support beneficiaries who are fit for work in making the transition from marginal employment to employment subject to social security contributions. Both the Federal Employment Agency and regional project executing agencies - such as "Joboption" in Berlin - are pursuing interesting approaches in this respect. 3.2 Investing in children Early assistance (Expectant) parents with infants and toddlers need reliable support structures. Therefore the "early assistance" service and network structures that already been developed thus far in the Länder and municipalities will be firmly established by the Early Assistance Fund, which is regulated in the Federal Child Protection Act (Bundeskinderschutzgesetz). The aim of the fund is to safeguard the early assistance networks on a lasting basis and guarantee the nationwide provision of comparable, quality-controlled psychosocial services for families with infants and toddlers up to the age of three (early assistance). The Federal Government is 19 currently examining the impact of the Federal Child Protection Act. Pursuant to Article 4 of the Federal Child Protection Act, the Federal Government is required to present a report on the evaluation results, which has been agreed with the Länder, to the German Bundestag by 31 December 2015. The Federal Government will develop child protection further on the basis of these results. Expansion and quality of child day care facilities Good child day care services that are in line with demand are a central contribution to promoting equal opportunities and educational equality for all children, and thereby also to preventing poverty. At the same time, they are a prerequisite for ensuring the equal participation of fathers and mothers in the labour market. With the introduction of a legal entitlement to early childhood education for all children aged one and over from 1 August 2013 onwards, the Federation set a milestone for needsoriented child day care. The major increase in the number of childcare places for children under three (U3) can be attributed, in particular, to the financial support of the Federation and the expansion efforts of the Länder. The number of under-threes attending child day care facilities more than doubled between 2007 and 2014, with 661,965 children under three in child day care on 1 March 2014. The Federation made a total of €5.4 billion available for the expansion of child day care services for the under-threes through to 2014 and will provide permanent support of €845 million annually from 2015 onwards. In this legislative term, the Federation will add €550 million to the special fund with the result that €1 billion will be available through this fund for the further expansion of child day care facilities. The legal basis was created with the entry into force of the "Act for Further Relief for Länder and Municipalities as of 2015 and for the Quantitative and Qualitative Expansion of Day Care for Children" (Gesetz zur weiteren Entlastung von Ländern und Kommunen ab 2015 und zum quantitativen und qualitativen Ausbau der Kindertagesbetreuung) on 1 January 2015. Further to this, the Länder and municipalities will receive additional support towards operating costs in the form of €100 million each year for 2017 and 2018. In addition, the Federation is to push ahead with the further improvement in the quality of child day care services. The Federation is promoting language teaching work with children and collaboration with the families in roughly 4,000 focus centres for child day care services. The "Lernort Praxis" federal programme supports child day care facilities in optimally preparing child care trainees for their future career in the practical phases of their training programme. Furthermore, with the Child Day Care programme of action, the Federation has 20 been furthering the expansion of child day care and skills development in this field since 2008. A Federal/Länder conference held on 6 November 2014 addressed the system of early childhood education and care overall, and in a communiqué initiated a process of communication between the competent line ministers of the Federal Government and the Länder about quality in child day care, which is to take place with the participation of local authority central organisations. A first progress report will be presented at the end of 2016. 3.3 Homelessness From mid-2015, the Fund for European Aid to the Most Deprived (FEAD) will enable homeless persons or persons at risk of being homeless to claim assistance and provide them with access to services in the regular system of assistance (e.g. homeless assistance, medical advice, job centres, addiction counselling). Contact is to be established through lowthreshold services that are geared to the individual needs of the persons concerned and take multiple problems into consideration. On the one hand this will involve comprehensive advice centres in the form of drop-in centres (day centres, homeless centre-points) but can also involve outreach work in facilities (emergency shelters, charity organisations) or places where the homeless congregate. 3.4 Inclusive living The Federal Government supports the creation of more housing that caters to the elderly and meets intergenerational needs. On 1 October 2014, it reintroduced grant-funding with a new loan programme from KfW, Germany’s state-owned development bank, entitled "SeniorFriendly Conversion" (Altersgerecht Umbauen) not least because this enables more senior citizens and people with a disability to live independently in familiar surroundings for as long as possible. Funding totalling €54 million through to 2018 has been set aside in the 2014 federal budget for the new phase of the programme. The support will particularly benefit owner-occupiers who do not wish to take out another loan or would not qualify for a loan on account of their age. The new federal programme therefore suitably complements the existing KfW programme that incorporates a loan and own funds. Furthermore, under the terms of the Coalition Agreement a special bonus is to be provided within the framework of the CO2 building improvement programme for additional measures to 21 convert buildings into senior-friendly space. Forms of community living for the elderly will be supported and model projects promoted. 3.5 Fighting discrimination A blanket statutory minimum wage of €8.50 has applied in Germany since 1 January 2015. Roughly 3.7 million workers in the low-wage sector are affected by this new regulation and their wages are due to rise since the introduction of the minimum wage on 1 January 2015. The statutory minimum wage sets a wage floor and wages may not fall below this level. In this way, the minimum wage prevents unreasonably low wages and can reduce the number of workers who depend on welfare benefits despite being in full-time employment. An interim regulation eases the transition to the minimum wage for all industries in which wages are currently far below the €8.50 level. With the introduction of a general statutory minimum wage, workers in Germany are effectively protected for the first time ever against unreasonably low wages. Therefore, the statutory minimum wage also makes a key contribution to fair competition while at the same time ensuring greater stability in the systems of social security. The statutory minimum wage is a key component of the Act to Strengthen Free Collective Bargaining (Tarifautonomiestärkungsgesetz) adopted in 2014, which also contains rules to facilitate the extension of wage agreements under the Collective Agreements Act to noncontracting parties and to extend the Posted Workers Act (Arbeitnehmer-Entsendegesetz) to all industries. This strengthens the free collective bargaining position of all parties to collective wage agreements with the aim of securing reasonable working conditions for workers. In Germany, free collective bargaining enjoys special protection that is guaranteed by the German Constitution. However, in recent years the collective bargaining partners were unable to prevent the fact that some workers were employed at unreasonably low wages and therefore relied on welfare benefits to top up their income in some cases. The Act to Strengthen Free Collective Bargaining therefore safeguards the organisational responsibility of the collective bargaining partners but also sets a wage floor. In contrast to collective bargaining agreements, the minimum wage does not aim to secure the comprehensive protection of workers. Rather, the minimum wage can and ought to merely prevent the employment of workers for an unreasonable wage. Other than this, employers and workers are still called upon to safeguard reasonable working conditions through organisation in employers' associations and trade unions and the conclusion of collective bargaining agreements. The Federation is implementing the complementary labour market programme "Education, Economy and Employment in the Local Neighbourhood (BIWAQ)" with funding from the ESF 22 and the Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety (BMUB). The focus here is on disadvantaged, structurally weak urban areas and districts within the framework of the "Socially Integrative City" urban development assistance programme. A special characteristic of this programme is that it is oriented to social space and interlinks instruments of urban development assistance with employment promotion measures, thereby specifically improving the skills development and social situation of the local population and strengthening their prospects on the labour market. ESF funding of up to €90 million is available for BIWAQ in the entire 2014-2020 programming period. With cofinancing from the BMUB budget (up to roughly €64.5 million), the own contribution required from the project executing organisations can be reduced to 10%. A new departure in the new ESF programming period is the joint implementation of an ESF project by two Federal Ministries, namely the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (BMFSFJ) and the Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety (BMUB). The joint local youth empowerment programme - "JUGEND STÄRKEN im Quartier" - strengthens outreach youth social work in the local area and addresses the transition of young people from schooling to work in disadvantaged districts. Financial resources and professional expertise are specifically directed at these districts and urban areas that fall within the scope of the "Socially Integrative City" programme, or are comparable socially deprived areas, to lend even more efficient support to young people in the areas concerned. With the "ESF Integration Guidelines of the Federation" programme, which was made public on 21 October 2014, the Federal Ministry of Labour and Social Affairs is supporting the gradual and lasting integration of individuals experiencing particular difficulty in entering the labour market with the help of collaborative alliances of education providers, companies and employment agencies/job centres in the 2014-2020 ESF programming period. The programme specifically targets youths and young adults under 35, as well as people not holding a long-term residence permit and with at least secondary access to the labour market. In addition to tailored advice, skills development and placement services, the projects supported by the programme also offer periods of work abroad in European countries. The "Work Abroad" programme module is implemented in collaboration with labour ministries and ESF administration and implementing authorities in other European member states and regions within the framework of a European ESF mobility network. Growing demands in the working world - even for "simple tasks" - increasingly require workers to have better and more comprehensive knowledge. Therefore it is important for all adults 23 to have a sufficient level of literacy and basic education. To support such individuals, the Federation and the Länder have joined forces with other partners to form the "National Strategy for Adult Literacy and Basic Education," which seeks to anchor this issue in society on a lasting basis and bring stakeholders together at federal level. The joint agreement comprises measures and actions of the individual partners at several levels, initially through to 2016. In addition coordination centres are also set up at Land level, serving as points of contact for education providers and business enterprises. To shine a light on this problem, which affects society as a whole, the Federal Ministry of Education and Research (BMBF) continued the national information campaign, "Reading and Writing – My Key to the World" in August 2014. The campaign aims to break the taboo of illiteracy in German society, reach the private and professional lives of the individuals affected and mobilise them. As part of the campaign, TV spots, cinema adverts and billboards drew attention to the issue, making it clear to the public that it is worthwhile learning to read and write even as an adult. In parallel to the media campaign, 17 regional events were held up to the end of 2014 to raise public awareness of illiteracy and basic education at local level. "Literacy in the Workplace and Basic Education for Adults" is another funding priority within the context of this strategy. The focus of action of the projects supported is on encouraging companies to set up literacy and basic education services in the workplace, sensitising contact persons in the affected parties' working environment and personal life, and the further development of continuing and further training programmes for educational staff at adult education organisations, in interim employment and job creation companies, and in business enterprises. With regard to literacy skills and basic education for adults, male and female Muslim migrants constitute a specific target group. Culturally-aware access to and dealings with this demographic must focus on the place of contact and learning. The mosque as the centre of religious and social life of the Muslim community offers ideal points of contact. Initial results demonstrate that literacy and basic education services at the three mosques selected for a trial in Berlin are welcomed, particularly by individuals who so far have not considered adult education centres to be a suitable place of learning for them. The Programme to Promote Vocational Language Skills for People from a Migrant Background (ESF/BAMF programme) will continue to support the improvement of job-related German language skills in the new 2014-2020 ESF programming period. The first courses commenced at the start of 2015. The core focus of the programme remains that of increasing the opportunities of people from a migrant background to be integrated into the primary la24 bour market and thereby also of contributing to social participation. To this end, German lessons are linked to elements of continuous vocational training. The education providers cooperate locally with companies and education centres to place individuals in internships, but also with a keen eye to the integration of the individuals into employment, training or further education measures. The plan is to enable the participation of roughly 80,000 individuals in the 2015-2017 funding period. With the "Work Strong" (Stark im Beruf) ESF programme, the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth is committed to improving the opportunities of mothers from a migrant background on the labour market. Roughly 80 project centres nationwide are sponsored with the aim of securing better accessibility to existing services and supporting the target group with specific offerings, such as those focussing on the reconciliation of work and family life. The approaches specific to the target group are complemented by the structural integration of the relevant stakeholders and the involvement of the business community. The programme will be co-financed by ESF funding from 2015 to 2020. Pursuant to Article 23 of the UN Convention on the Rights of Persons with Disabilities, the legal entitlement to advice on all questions surrounding pregnancy and family planning must also be specifically implemented for people with disabilities and impairments. To this end, since January 2013 the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth has been supporting a three-year pilot project at the donum vitae federal association entitled "I also want to marry! – Implementing tailored advisory services for general pregnancy and pregnancy in conflict situations for individuals with a learning disability". This project aims to incorporate the concept of inclusion into the work of the association at the central federal level by professionalising advice in the context of the Act on Pregnancies in Conflict Situations (Schwangerschaftskonfliktgesetz) and sex education for people with learning difficulties, and making this information and advice available in an accessible format. Based upon this, a nationwide network of tailored services is to be created in conjunction with partnerships with a wide range of institutions serving people with disabilities. The creation of accessible, easy-to-understand educational materials and accompanying public relations work are also planned. The project is overseen by an advisory board and the measure appraised to guarantee the quality and the long-term nature of the project. 25 4. Recent reforms to achieve appropriate and sustainable pensions In recent years the Federal Government has successfully set the course for a viable system of old-age security that is aligned with demographic developments. Alongside this, the priority must be to take processes of change in employment histories and the working world into consideration in the old-age security system, and to continue to develop and modernise the pension system appropriately beyond the successful reforms of recent years. Raising the retirement age and current reform measures German law-makers have long resolved to raise the statutory age of retirement gradually to 67 by 2029. For 2014 (those born in 1949), the statutory retirement age was therefore 65 and 3 months. Over the course of the coming years it will be raised by one month per birth year up to the age of 66, and as of 2024 (those born in 1959) by two months per birth year up to the age of 67 (those born in 1964 and after). Appropriate increases will be implemented for other age limits. The retirement age for individuals insured for a particularly long time has been lowered since 1 July 2014 on the basis of a time-limited special regulation. Since 1 July 2014, insured parties with 45 years of mandatory contribution payments (including periods of unemployment) and born before 1953 can receive their retirement pension at 63 without any pension deductions on account of the contribution they made to stabilising the statutory pension insurance system. In the years that follow, the retirement age will be gradually increased to the previous age of 65, a process that will be completed with insured parties born in 1964. This is because demographic changes, which prompted the retirement age rise in the first place, must also be given due consideration even by those who have been insured for a very long time. The child-rearing work of all mothers or fathers of children born before 1992 has been recognized with an additional earning point (“mother pension”) in the old age security system since 1 July 2014. This gives additional recognition to the child-rearing work of these parents who reared their children in a time when sufficient childcare services were still not available. Finally, two measures have provided greater security to people with reduced earning capacity since 1 July 2014: for one, these individuals are treated as if they had continued working for an additional two years, earning the previous average income (extension of the noncontributory supplementary period from age 60 to 62). Secondly, the last four years before the reduction in earning capacity occurred are not counted if they reduce the value of this 26 non-contributory supplementary period (e.g. by switching to part-time work or periods of illness before claiming the pension). To ensure that the statutory pension insurance system can continue to guarantee or restore the earning capacity of insured parties through the provision of integration services (medical and vocational rehabilitation) in the future, the rehabilitation budget – i.e. the amount of capped funds available to the pension insurance system each year precisely for this purpose - will be adjusted with retrospective effect to 1 January 2014. The introduction of a demographic component in the annual adjustment of the rehabilitation budget will ensure that the temporary additional funding needs, resulting from people born in high-birth years reaching an age (45+) where they require intensive rehabilitation services, is factored in when setting annual pension insurance expenditure on integration services. The demographic component is taken into consideration as a separate factor alongside the anticipated development in gross salaries and wages per employee. Pension adjustment Pensions under the statutory pension insurance system rose by 1.67% and 2.53% in the old and new Länder respectively with effect from 1 July 2014. The 2014 pension adjustment was based on a wage development of 1.38% in the old Länder and 1.78% in the new Länder, which is relevant for pension adjustment. Through the sustainability factor, the development of the ratio of pension beneficiaries to pension contributors had a bearing on the pension adjustment, reducing it by 0.19 percentage points from an arithmetical perspective with effect from 1 July 2014. In contrast, with 0.92 percentage points the factor of old-age provision payments had the effect of increasing pension adjustments from an arithmetical perspective because the contribution rate in the general pension insurance system dropped from 19.6% to 18.9% with effect from 1 January 2013. While compensation requirements (in eastern Germany) were fully eliminated with the 2012 pension adjustment, the remaining compensation requirements in the old Länder - reflecting pension cuts that were not implemented in the past - were fully eliminated with the 2014 pension adjustment. As a result, the calculated pension adjustment in the old Länder was reduced by 0.46 percentage points. The result was that the actual pension value was increased by 1.67% to €28.61 in the old Länder and by 2.53% to €26.39 in the new Länder with effect from 1 July 2014. Therefore the actual pension value (in eastern Germany) stands at around 92.2% that of the actual pension value applicable for the old Länder. 27 Contribution rate Thanks to the continuing favourable financial development in the pension insurance system, the contribution rate in the general pension insurance system was lowered to 18.7% on 1 January 2015. Compared with 2011 when the rate stood at 19.9%, the contribution rate has therefore been reduced for the third time – by 1.2 percentage points in total – and is currently at the lowest level ever since 1995. 28 5. Recent reforms in the health care system Accessible, high-quality and sustainable health care Within the field of health care and long-term care (see Section 6), the impact of demographic change presents the biggest challenge to policy-makers. The increasing proportion of older and very old people in the population tends to increase the demand for health and care services. The Federal Government is rising to these challenges with the latest reforms in the health care system. The Act to Further Develop the Financial Structure and Quality of the Statutory Health Insurance System (Gesetz zur Weiterentwicklung der Finanzstruktur und der Qualität in der gesetzlichen Krankenversicherung, GKV- FQWG) which entered into force on 1 January 2015 puts the finances of the statutory health insurance system (SHI) on a viable basis and strengthens competition in terms of price and quality in the interests of the members. With the reduction of the general contribution rate from 15.5% to 14.6% and the introduction of the possibility for health funds to levy individual, income-based additional contributions, the autonomy of the health insurance funds with regard to contributions has been increased. In future, different additional contribution rates will send important pricing signals as the funds compete for members. In order to remain attractive for members and avoid members changing providers, the health insurance funds must endeavour to deliver high-quality health care services and limit the amount of the additional contribution rate by making efficient use of resources. The introduction of full income equalisation for the additional contributions works against any inducement on the part of the health insurance funds to give priority to better earners in the competition for members so that they can levy lower additional contributions. The employer's share of the general contribution rate remains fixed at 7.3%. This ensures that the financing architecture continues to encourage employment and prevents any negative effects of increasing health care expenditure on growth and employment. The establishment of a quality institute specified in the Act to Further Develop the Financial Structure and Quality of the Statutory Health Insurance System creates the framework for a consistent focus on quality among the service providers and thereby strengthens competition in terms of quality in the statutory health insurance system. The aim is to give patients a set of transparent criteria which they can use to ascertain which specific hospitals offer the best quality for a specific treatment, for instance. Over the medium to long term, a better quality of service leads to the more efficient use of resources and improves the sustainability of the German health care system. 29 Provision of health services and preventive health care The Federal Government places a priority on improving the quality of medical care and the strengthening of health promotion and prevention. The health care supply chain begins with health promotion and prevention. On 17 December 2014, the Federal Government adopted the draft of an Act to Strengthen Health Promotion and Prevention (Gesetz zur Stärkung der Gesundheitsförderung und der Prävention). The Act is expected to enter into force in the second half of 2015. A particular aim of the Act is to strengthen individual-directed and environment-directed prevention and health promotion in all domains of life, particularly in childcare facilities, schools, businesses or nursing homes. To ensure an integrated, holistic approach, all social security institutions will be included with the participation of private health insurance and private compulsory long-term care insurance. With regard to out-patient health care, the waiting time for a doctor’s appointment is to be reduced significantly for individuals insured under the statutory health insurance system. In future they should be able to contact a central appointment service centre at the regional doctors’ association if being referred to a specialist. Patients should generally not need to wait more than four weeks for an appointment. If this is not possible, the appointment service centre will offer the patient an appointment for out-patient treatment in a hospital – except in cases that are not medically justified. Appropriate legal regulations are included in the draft of an Act to Strengthen Medical Care in the Statutory Health Insurance System (Gesetz zur Stärkung der Versorgung in der gesetzlichen Krankenversicherung, GKV-VS) which was adopted by the Cabinet on 17 December 2014 and is due to enter into force in mid-2015. The Federal Government has set up a Federal/Länder task force which has been developing the foundations for a hospital reform since March 2014 and presented key parameters of a hospital reform at the start of December 2014. These key parameters are to be implemented in legislation and regulations in 2015. On account of Directive 2013/33/EU of the European Parliament and of the Council of 26 June 2013 laying down standards for the reception of applicants for international protection (Reception Directive), amendments must be implemented in German law by mid-July 2015. With regard to the provision of health care to asylum seekers and refugees, this Directive makes provisions for improvements in benefits for people in need of protection (including 30 people with a disability, minors and victims of violence). The Federal Government will take this need to amend regulations into consideration within the context of the forthcoming reform of health-care benefits under the Asylum Seekers Benefits Act in 2015. Development of healthcare expenditure The sustainable financing of the healthcare system is of central importance. The financial situation of the statutory health insurance system (SHI) has enjoyed a favourable development in recent years. At the end of 2013, the statutory health insurance system had financial reserves of roughly €30 billion, with the liquidity reserve of the Health Fund claiming roughly €13.6 billion and the statutory health insurance funds roughly €16.8 billion. SHI expenditure amounted to €153 billion through to the end of Q3 2014, which equates to an increase of 5.1% per insured person compared with the previous year. Overall, the statutory health insurance funds ran a deficit of around €0.8 billion in the first nine months of 2014. The financial reserves of the health insurance funds continue to stand at around €16 billion. Medical care for people suffering from dementia Dealing with dementia presents one of the biggest challenges for health and social policy. Roughly 1.5 million people are currently suffering from dementia in Germany, with some 300,000 new cases reported each year. Forecasts suggest that over 3 million people will be affected by dementia in 2050. To improve the quality of life of dementia patients, the Federal Government created the "Alliance for People with Dementia" as the C.2 task force of the Demographic Strategy. The Alliance is to set up a network at federal level that brings together responsible parties to deliver lasting improvement to the situation of people affected by dementia and raise public awareness of dementia. By signing the "United for People with Dementia" agenda on 15 September 2014, which envisages over 150 specific measures in four action areas, the partners are committed to implementing the agenda in their specific areas of responsibility. Complementing this, local support networks are created for dementia sufferers with the funding programme of the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth to develop up to 500 local alliances. 31 6. Recent reforms in long-term care Accessible, high-quality and sustainable long-term care provision The Federal Government has set itself the goal of improving the quality of life of people in need of care and their families. Further development of social long-term care insurance The Federal Government will increase the benefits under social long-term care insurance by around 20% (roughly €5 billion) in this legislative term by two Acts to Strengthen Long-Term Care. This is the biggest increase in benefits in this field since the introduction of long-term care insurance in 1995. The vast majority of people in need of care in Germany are still cared for by their relatives in the home environment. More support for home-based care is therefore a priority of the statutory improvements in benefits brought about by the First Act to Strengthen Long-Term Care (Erstes Pflegestärkungsgesetz) which entered into force on 1 January 2015. Care at home is strengthened, for example, by expanding the framework of possibilities to claim respite care and short-time care and making this framework more flexible, and by fully granting day care and night care in addition to out-patient benefits in cash and in kind. In addition, lowthreshold assistance services are complemented by respite services and are available to all those in need of care and not only to insured parties with a considerably limited ability to cope in everyday life. Furthermore, the maximum amounts for measures to improve the individual's living environment and for the use of certain nursing aids have been increased significantly. The framework for the complementary care of people suffering from dementia in care facilities by additional care staff is improved and the service is extended to everyone requiring care. In future, care facilities can hire more care staff so that the carer-to-patient ratio for this service is improved from 1:24 to 1:20 (one carer to 20 residents). A new definition of “need of long-term care” together with a new assessment procedure is to be introduced in this legislative term as part of a Second Act to Strengthen Long-Term Care (Zweites Pflegestärkungsgesetz). Given the general increase in prices, the vast majority of the benefit amounts under longterm care insurance in out-patient and in-patient care were increased by 4% on 1 January 2015. 32 Securing the supply of skilled labour in the caring professions The Federal Government is committed to securing the skilled labour base in the caring professions. The "Training and Skills Development Programme for Elder Care," which was started in December 2012 as a community initiative of the Federation, the Länder and associations, will be implemented through to the end of 2015. Through specific agreements, the aim is strengthen initial, further and continuing training in the field of elder care and make jobs and employment in this sector more appealing. In the second year of implementation of this training pact (2013/2014 academic year), there was a 14.2% increase on the previous year in the numbers enrolling for elder care training. Further to this, a fundamental reform of nursing training is set to take place in the 18th legislative term. A new Caring Professions Act (Pflegeberufegesetz) is to merge the current vocational training programmes for "elder care," "nursing and health care", and "nursing and paediatric care" into a general and standardised nursing training programme in order to meet future supply needs in the care sector. Reconciling family, care and work commitments The Act for the Better Reconciliation of Family, Care and Work Commitments (Gesetz zur besseren Vereinbarkeit von Familie, Pflege und Beruf) entered into force on 1 January 2015. As a result of this Act, the legal regulations of the Act on Long-Term Care Leave (Pflegezeitgesetz) and the Family Caregiver Leave Act (Familienpflegezeitgesetz) have become more closely aligned and have been developed further. The Act on Long-Term Care Leave gives workers the possibility of being released from work - either entirely or in part - for a period of up to six months. This entitlement does not apply to workers at businesses with 15 or fewer workers in general. Since 1 January 2015, workers have been entitled to family care-giver leave, i.e. partial release from work for up to 24 months with a minimum working week of 15 hours, for the care of a close relative requiring care in a home environment. This does not apply to workers at businesses with 25 or fewer workers in general, wherein workers in vocational training are not counted. Under the provisions of both Acts, the total length of time individuals are entitled to leave is 24 months. For the time they are released from work under the Act on Long-Term Care Leave, and partially released from work under the Family Caregiver Leave Act, workers are entitled to financial support in the form of an interest-free loan so they can better safeguard their livelihood during the time they have less or no income. The entitlement to support in the form of an interest-free loan also applies to workers at smaller businesses where the time off work was agreed on a voluntary basis. The loan is paid out in monthly instalments and generally covers half the net salary missing as a result of the reduction in work time. 33 Apart from the care of a close relative in a home environment, workers are also entitled to be released from work (fully or partially) for up to six months or for up to 24 months (partially) to care for an underage close relative who is in need of care, wherein the care environment can be both the individual's own home and a facility outside the home and can change at any time. Furthermore, workers are also entitled to be released from work fully or partially for up to three months to provide support to a close relative in the last phase of his/her life. Since 1 January 2015, workers who are temporarily unable to work for care reasons for a period of up to ten workdays can receive a care support allowance as an income replacement benefit. This allowance is limited to ten days. The amount of income replacement benefit is calculated along the same lines as the rules for child sickness benefit and is paid by the nursing insurance fund or the insurance company of the close relative requiring care. Development of expenditure in social long-term care insurance Social long-term care insurance remained on a sound financial footing in 2014. The fund volume of social long-term care insurance stood at over €6 billion for 2013 as a whole, and there are indications of a surplus of roughly €0.5 billion for 2014. To fund the first Act to Strengthen Long-Term Care (Pflegestärkungsgesetz), the contribution rate to statutory long-term care insurance was increased by 0.3 percentage points as of 1 January 2015. Of this, 0.1 contribution rate points will go towards building up reserves in a long-term care provident fund to cushion future contribution rate increases in light of demographic challenges. This is equivalent to revenues of roughly €1.2 billion per year. 0.2 contribution rate points will go towards financing the improvements in services. This equates to additional revenues of around €2.4 billion. To finance the second phase of the care reform in connection with the new definition of "need of long-term care", there are plans to increase the contribution rate to statutory longterm care insurance by a further 0.2 percentage points. 34 Annex Overview of indicators Year 2008 2012 2013 Employment rate in population (aged 20-64), expressed as a percentage EU28 70.3 69.0 68.5 68.5 68.4 Men 77.8 75.7 75.0 74.9 74.5 Women 62.8 62.3 62.0 62.2 62.4 68.4 74.3 62.6 Germany Men Women 77.1 81.9 72.3 74.0 80.1 67.8 2009 74.2 79.6 68.7 2010 74.9 80.1 69.6 2011 76.3 81.4 71.1 76.7 81.8 71.5 Employment rate among persons with a low level of education (aged 20-64), expressed as a percentage EU28 56.4 54.3 53.3 52.9 52.1 51.4 Germany 55.9 55.7 56.0 57.3 57.7 58.2 Note: A low level of education is defined as no higher than lower secondary school (without a vocational training certificate). Employment rate among older persons (aged 55-64), expressed as a percentage EU28 45.5 45.9 46.3 47.3 48.8 50.2 Germany 53.7 56.1 57.7 59.9 61.5 63.5 Unemployment rate of under 25s, expressed as a percentage EU28 15.6 19.9 21.0 21.4 Germany 10.6 11.2 9.9 8.6 22.9 8.1 23.4 7.9 Absolute long-term unemployed in thousands and ratio to all unemployed, expressed as a percentage Germany 1,623 1,447 1,380 1,189 1,043 1,009 Men 883 803 806 687 603 584 Women 740 644 574 501 440 425 Germany Men Women 52.5 53.2 51.7 45.5 44.4 46.9 47.3 48.1 46.3 48.0 49.3 46.2 45.5 46.8 43.7 44.7 45.5 43.8 At-risk-of-poverty threshold for single parents (60% of median annual income) Germany 10,986 11,151 11,278 11,426 11,757 11,749 35 At-risk-of-poverty rate (percentage of persons with less than 60% median income) EU28 16.5* 16.4* 16.5 17.0 16.9 16.7 Men 15.6* 15.5* 15.8 16.2 16.3 16.1 Women 17.5* 17.2* 17.2 17.7 17.5 17.2 Under 18 65 and older 20.4* 20.1* 20.8 20.8 20.7 20.3 18.9* 17.8* 15.9 15.9 14.6 13.8 Germany Men Women 15.2 14.2 16.2 15.5 14.7 16.3 15.6 14.9 16.4 15.8 14.9 16.8 16.1 14.9 17.2 16.1 15.0 17.2 Under 18 65 and older 15.2 15.0 17.5 15.6 15.2 14.7 14.9 15.0 14.1 14.2 15.0 14.9 Average median income in EUR/year and relative median ratio of income in old age (65 and older) EU28 12,935* 13,203* 13,527 13,738 14,344 14,719 Total 0.85* 0.86* 0.88 0.89 0.91 0.93 Men 0.88* 0.90* 0.92 0.93 0.95 0.96 Women 0.83* 0.84* 0.86 0.87 0.89 0.91 Germany Total Men Women 16,498 0.87 0.89 0.87 16,804 0.88 0.90 0.86 17,167 0.89 0.90 0.88 17,611 0.90 0.91 0.89 17,729 0.88 0.88 0.87 17,904 0.89 0.90 0.88 Note: Median net equivalent income of people aged 65 and older in comparison with persons under 65. *Values for EU27 Source: EUROSTAT Absolute dependents on minimum security in thousands and percentage of population Germany 7,646 7,761 7,537 7,258 7,249 7,384 Germany 9.3% 9.5% 9.2% 8.9% 9.0% 9.1% Note: Transfer payments of minimum social security systems denote financial assistance from the government that is paid out to entitled persons to secure a decent subsistence minimum. The legal bases are Books II and XII of the Social Code, the Asylum Seekers Benefits Act and the Federal War Victims Compensation Act. Absolute recipients of basic income support in old age in thousands and percentage of population aged 65 or above Germany 410 400 412 436 465 499 Germany 2.5% 2.4% 2.4% 2.6% 2.8% 3.0% Source: Federal Statistical Office 36
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