Date: April 15, 2020

In the virtual meeting of March 26, the ASD discussed and debated the Youth Assistance Regulation 2020 for the municipality of Nuenen. Based on this memorandum and the discussions, the ASD formulated some recommendations.

Summary

The Youth Assistance Ordinance Nuenen Municipality 2020 has been improved. Mutual responsibilities are now more clearly indicated, without impeding access for necessary help. Besides two questions, the ASD gives a positive opinion on the regulation.

Analysis problems in youth assistance

This section analyzes some problems and suggests possible solutions. We limit ourselves to the psychological problems. The physical ones are treated in another less youth-specific way. Psychological problems are a complex and unruly domain, at least for the following reasons:

• A child is part of his family and social environment. Problems in his family and social environment strike back at the child. By treating the child, his family and, if possible, his social environment together, the risk of relapse is reduced. With the family group plan, the regulation, rightly, seeks to do just that.

• Referrals outside the CMD remain possible. The analysis of the child and the subsequent treatment plan can then hardly be influenced by the municipality, but it does receive the bill. A good relationship with the general practitioners and the already created position of a POH at the CMD is valuable. The regulation strikes a better balance between free access but also better responsibility.

• The effect of treatment is difficult to measure, and if it is there is no guarantee that the problems have been solved for a long time. This seems inherent in the domain and difficult for the municipality to change.

• Classifying for single complaints is doable. Although it is challenging to make the right choice from 32 SPICs (segment profile intensity combination), the hundreds of DBCs (diagnosis treatment combinations) and PDCs (product services catalog). For multiple problems, virtually no standard treatment is possible or standard practitioner available. Customization is then the only solution. But who has the expertise to determine the correct diagnosis and treatment?

Regulation

The Youth Assistance Regulation has been amended. Access to help, via external referral or internally, is better defined. The improvements are mainly to even better record, arrange, control and evaluate agreements afterwards. It is enforced that it is better argued and documented for which treatments the municipality will pay. The fact that the process can be suspended if the parties do not cooperate sufficiently makes the agreements less non-committal. The ASD has two comments on the regulation:

• Article 8 uses the percentages 55, 75 and 100% for different groups of providers of PGB-funded assistance. The order of percentages is clear, the absolute choice is not. This choice is not explained. There should be a relationship between the quality, effectiveness and efficiency of the help provided and the percentage. It seems to discourage the use of self-employed, freelancers and help from the network, regardless of whether these providers meet the requirements of technical and professional competence. Excluding these providers does not reduce wait times. Question: Can the choice of these percentages be explained with an indication of their impact. Do other municipalities in the region use similar percentages?
• One of the problems with youth care is the privacy rules. It is advisable to ask the client's permission to inform their own family doctor at the start of a treatment program. Without privacy problems, he can then be kept informed of the medical developments of his patient. Advice: Include this action in the regulation.

Conclusion: The regulation is a clear improvement. Mutual responsibilities are now more clearly stated, without impeding access for necessary assistance. Like to pay attention to the 2 comments. The ASD advises positively.