For the first time in the history of this country, families, people with disabilityand professionals from the area, joined in a measure of strength camping eleven days in front of Pink House. The claimwhich was repeated under different formats in various provinces of Argentina, was triggered by the abrupt cut in payments which normally have a 60 days late from the moment the service is provided and until the professionals collect their fees.
That gap of two months had been, until July, the usual. Disability experts consulted by NOTICIAS affirm that 60-day payments are “reasonable” because “it is the time it takes to settle a benefit.” However, this cut undressed other system problems.
How is the wheel? The Health Insurance Superintendency (SSS), the Federal Public Revenue Agency (AFIP) and the National Disability Agency (ANDIS) make up the circuit that involves compliance with the Law 24,901which regulates the “System of basic benefits in comprehensive rehabilitation in favor of people with disabilities”, more popularly known as disability law.
The disbursements required by the system so that each provider receives the money for their activity are financed through the Solidarity Fund that is nourished by the contributions and contributions of the workers (and for that reason, protected by law). It is out of the budget and subject to collection by the AFIP.
Normally, every first week of the month, the SSS sends a report to the AFIP to inform it how the transfers should be made. In this way, the AFIP releases the money between the 20th and 30th of that month and with those funds the providers and institutions that work within the disability system can pay the salaries and fees.
But something happened this time someone did not send the expected report to the AFIP in a timely mannerand since the social projects are not in a position to cover the shortfall because they do not have the money, there was an abrupt cut in the chain of payments.
“The The objective of the system is that all people with disabilities have coverage of one hundred percent and that everyone can access the benefits of the system. It is based on a basic principle, which is the equity“, Explain Andres Lopez Pelldirector of the Doctorate in Disability at Favaloro University.
The expected result is that the person who needs it (or their parents or guardians), goes to a disability provider and is treated for the same amount, because all providers charge the same. “It is a great law. Now, if the fairness of the system is touched, if the oiled functioning that it should have is altered, everything comes into bloom”, warns López Pell.
Health, education, mobility
All people with disabilities need a very diverse amount of support to be able to be inserted in social life and sometimes benefits have to be very tailored so that they are really useful to each child or adult with a disability. And disabilities can range from Down syndrome to Autism Spectrum Disorder (ASD) and partial or absolute motor difficulty.
The State cannot do this, design each person their tailored suit, and that is why the system that attends to disability in Argentina works on the basis of cooperation of public and private providers that complement each other.
The financiers Are the national and prepaid social works (through the contribution of its affiliates) and health programs that the national State may have (PAMI and Include Health cases). The provincial social works, the judicial and legislative powers, the Armed Forces and the National Universities are outside the orbit of the SSS.
In these cases, there are social works that then offer to pay the benefits provided by the specialists at less than what the national nomenclature indicates. That is when the person with a disability runs the risk of not being able to access the benefits to which they are entitled by law, because these professionals can choose not to work with certain social projects. This is one of the weak points of the system.
The second point of conflict is that all providers are categorized within the single system and there are very strict requirements to qualify specialized centers. But there are also non-categorized providers, independent professionals who do therapy at home or in private offices and do not meet the requirements that are asked of those who are categorized.
And if there are two problems, obviously there is also a third. “In recent years it has been seen that the incidence of disability benefits in this fund has been growingeach time it consumes more percentage of that Fund, which has something very good and transparent: the traceability of how the money is distributed”, explains López Pell.
What is the tension in this case? There are social projects that consider that the benefits corresponding to aspects related to the education and transportation are not health benefits. Why doesn’t the State do it?, is the request.
It is difficult to think that a transport to, for example, go to a place to perform a therapy is not part of a person’s health. Complicated, thinking of a boy who at school needs a companion inside the classroom so that he can function more safely does not affect the health of that child. Because health does not only include the physical and the biological. Y Law 24,901 says it very clearly: mentions educational therapeutic benefits (for example in the case of therapies to achieve self-help for the disabled), educational benefits (such as schooling), transportation, job training, psychophysical and motor rehabilitation, to mention just a few.
It’s all about health and improving life within the disabled community. Anything that messes this up leaves the person with a disability with a high degree of vulnerability.
The slogan of the most visible claim, which was the white tent in front of the Casa Rosada from August 29 to September 9, 2022, was “NO to disability adjustment”, however, from various areas of the Government denied that this adjustment existed. The Ministry of Economy denied that there will be cuts in the area.
“ANDIS never interrupted the payments of benefits that it pays monthly to more than 1,200 institutions throughout the country. At the beginning of our management we found a tremendous indebtedness with the sector that depended on our organization, which went back more than 7 months, “says Fernando Galarraga, executive director of the Agency.
Lenders see it from another angle. “Not paying is an adjustment,” says clinical educational psychologist Mariana Retamales. “The adjustment is not only about how much our work is worth, it is real that we had raises, but we did not receive the payments, and that is an adjustment,” she reaffirms.
“What triggered the force measures is that the chain of payments was brokenthey wait three or four months to collect and the deferred payment is naturalized, but this time, not receiving the payments exacerbated a lot of problems,” says Guillermo Kull, a reference for Precarious Providers in health and education.
“In addition to the interruption of payments, a naturalization of backwardness and the Non-recognition of basic treatment benefits such as: therapeutic companion, home caregivers, hydrotherapy and equine therapy”, described referents of the Disability Collective in the Disability Commission in the Chamber of Deputies on September 8, before SSS and ANDIS officials. For example, an activity such as therapeutic companionship is not under the national nomenclature and therefore each social or prepaid work decides the rate to be paid.
In recent years, there are more and more professionals who give up working in the area of disability according to data from the Precarious Health and Education Providers group, who ask for a 60% increase in the nomenclature, and that they be paid monthly defeated.
Meanwhile, the most vulnerable suffer the consequences of the banquinazos. “My son has autism and needs support to be able to go to school. But the social company did not pay May, June and July to the providers. Few of us families joined the mobilization of the white tent. They were more providers than fathers and those who violate their rights are our children – describes Nohely M. transit agent-. If they don’t receive their therapy, if they don’t have their transfer, if they don’t have their support at school, their day to day life becomes very difficult. This year my son was beaten in a bus. That made me understand how society is.”
López Pell calls for dialogue and the search for solutions, once the specific problem has been corrected. “You have to give a lot of preponderance to the Directory of the Single System of Basic Benefits (the space that administers the application of the law of basic benefits in disability) because it is the area where things can be discussed and consensus reached so that the system lasts. Law 24,901 is an advanced law and we can be proud, simply we must make things work according to how it is stipulated”.