The idea of ​​Mental Health Centers across the country is being pushed back. The Ministry is extending the pilot

• The draft amendment to the regulation on the pilot programme in mental health centres has been sent for consultation
• It is to extend the period of providing benefits under the pilot program by half a year, i.e. until December 31, 2025.
• Its aim is also to prepare a mechanism that will enable the completion of the program in a manner that is safe for the functioning of the CZP.
• - When designing this pilot, its authors did not think about how to get out of it. There are practically no such provisions in the regulation - said Maciej Karaszewski, director of the Department of Medical Treatment in the Ministry of Health, during the Health Challenges Congress. Hence the need for changes
• A team appointed by Minister Izabela Leszczyna is working on solutions that will enable a smooth completion of the pilot, without limiting access to benefits provided by CZP.

The Ministry of Health has submitted a draft amendment to the regulation on the pilot program in mental health centers for consultation. It is to extend the period of providing services under the pilot by half a year, i.e. until December 31, 2025, and to prepare a mechanism for settling the last settlement period , which will enable the program to be completed in a manner that is safe for the functioning of CZPs while ensuring the continuity of the provision of services.

- Due to the ongoing work of the Team for Systemic Changes in Mental Health Centres , appointed on 4 December 2024, the deadline for completing the pilot programme, i.e. 30 June 2025, is relatively short for developing a strategy for implementing solutions resulting from the pilot programme - explains the Ministry of Health in the justification of the project.

As the ministry reminds, the aim of the team is to prepare proposals for solutions in the field of mental health care system, taking into account the method of organizing and financing mental health centers after the end of the pilot program, as well as to develop a strategy for implementing these solutions.

During the work, particular attention was paid to the fact that the existing mechanism for terminating the pilot project poses a threat to the financial liquidity of some of the facilities operating within it and their further operation.

The final deadline for completing the pilot program in mental health centers is December 31, 2025. Therefore, there is a need to amend § 21 of the regulation, concerning the reduction of the lump sum amount made by the National Health Fund in the last settlement period. - In the event of the end of the program, it is unjustified for mental health centers to plan expenses for subsequent settlement periods - indicate the project authors. The settlement of the last settlement period will be carried out on the basis of the amended § 24 of the regulation.

The proposed changes in § 21 and § 24 of the regulation will extend the settlement period of the last period of the agreement concluded with the Fund for the implementation of the pilot program, enabling entities to properly settle benefits. This solution is to ensure their financial liquidity in the last settlement period, in connection with the inclusion of the reduction of the last settlement period in the costs of implementing the agreement for the implementation of the pilot program.

- This change will reduce the risk of negative financial consequences resulting from the current double deductions made by the Fund - the bill's authors assume.

The issue of ending the pilot program stirred up a lot of emotions at the end of last year. At the beginning of December, a protest was held in defense of mental health centers (MHCs). The community gathered around these facilities – their charges, employees, co-creators of the reform – was concerned about their future in connection with the end of the pilot program that had been ongoing since 2018. For now, MHCs cover half of the population of Poland. The plan was that from July 1 this year, they were to be implemented systematically and ultimately function throughout the country as the dominant model of psychiatric care. However, this means changes – including in the financing of MHCs. Their details are to be developed by a team appointed by Minister Izabela Leszczyna.

Maciej Karaszewski, director of the Department of Therapeutics at the Ministry of Health and a member of the aforementioned team, assured during the Health Challenges Congress that the ministry wants to close the pilot, but not in order to close down the centres, but to implement them throughout Poland.

- However, when designing this pilot, its authors did not think about how to exit it. There are practically no such provisions in the regulation. That is why it is being extended. If we want to move from mental health centers to the universal system, the regulation must include provisions on how to exit the pilot - he explained, announcing work on the changes.

- The pilot should end at the end of June, but there is no such path there at all. Now, in fact, the National Health Fund should issue corrective invoices by 31 March, reducing the rate twice, which means that for these three months, entities implementing the pilot would be left without money for current operations - he added.

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