WLZ Assessment by CIZ: Application and Procedure in Delft
A WLZ assessment is an official evaluation by the Centrum Indicatiestelling Zorg (CIZ) determining whether residents of Delft are entitled to long-term care under the Long-Term Care Act (WLZ). This assessment is essential for individuals with chronic conditions or disabilities requiring continuous care in the Delft region. The CIZ evaluates whether ongoing and intensive care is necessary and advises on the scope and duration of care, taking into account local facilities such as nearby nursing homes.
What is a WLZ Assessment?
The Long-Term Care Act (WLZ) provides care for individuals in Delft who require permanent 24/7 intensive support, such as those with dementia, severe physical disabilities, or mental health challenges. A WLZ assessment is the formal approval for this care, which is reimbursed by the government through health insurers. Without this assessment, access to WLZ care—such as admission to a local nursing home or in-home assistance—is not possible.
The CIZ, as an independent body, handles the assessment process. They review the medical and social circumstances of applicants in Delft. Assessments cover various profiles, such as 'terminal care,' 'full home care package,' or 'residential care,' determining which local care options are available and where they can be provided.
The Role of the CIZ in WLZ Assessments
The Centrum Indicatiestelling Zorg (CIZ) manages the issuance of WLZ assessments for Delft residents. Applications are submitted by healthcare providers, general practitioners, or directly by citizens. The CIZ adheres to the Health Insurance Act (Zvw) and WLZ regulations. After evaluation, they send an assessment decision to the health insurer, which arranges financing.
In Delft, the process often begins with a general practitioner or district nurse in the region, who submits the application to the CIZ. The CIZ may send an officer for a home visit in Delft or analyze the case file. The procedure typically takes 6 weeks, but complex cases in the city may extend this timeline.
Legal Basis of the WLZ Assessment
The WLZ is governed by the Long-Term Care Act, which has been in effect since January 1, 2015, replacing the AWBZ. Key legal provisions include:
- Article 3.2 WLZ: Outlines eligibility criteria, such as a permanent need for 24-hour care.
- Article 3.3 WLZ: Defines assessment profiles, including six standard options such as 'Personal Budget for Home Care (PGB thuis)' or 'modular home care package.'
- Article 8.1 Zvw: Designates the CIZ as the authority responsible for assessments.
The Minister of Health, Welfare and Sport (Ministerie van VWS) establishes detailed evaluation rules through the Long-Term Care Regulation. The CIZ follows the Policy Rules for WLZ Assessments, which outline standards such as self-reliance and 24-hour supervision. You can object to a decision under Article 7:1 Awb (General Administrative Law Act), potentially appealing to the District Court of The Hague for Delft residents.
How to Apply for a WLZ Assessment?
The application process for a WLZ assessment in Delft follows a clear structure. Below is a step-by-step guide with local tips:
- Identify Care Needs: If you or a loved one in Delft requires ongoing care, consult your general practitioner or a local care provider. The Juridisch Loket Delft offers free advice on your options.
- Submit the Application: The referrer (general practitioner or specialist) completes the form on ciz.nl. Attach medical documents, and consult the Juridisch Loket Delft for assistance with preparation.
- CIZ Evaluation: The CIZ thoroughly reviews the application. In complex cases in Delft, they may arrange a home visit by an assessment officer.
- Receive the Assessment Decision: Within 6 weeks, you will receive the decision, which is binding for the health insurer.
- Organize Care: With the assessment, the health insurer selects a provider in the Delft region or arranges a personal contribution.
Practical Example: Consider Mrs. De Vries (68), a Delft resident with Parkinson’s disease who can no longer function independently. Her general practitioner from the district care service in Delft submits an application to the CIZ. After reviewing her file and visiting her home in the city center, she receives an assessment for 'full home care package.' She then receives intensive home care from a local provider, fully reimbursed minus her personal contribution.
Rights and Obligations in a WLZ Assessment
Rights:
- Right to a thorough and impartial evaluation by the CIZ, with support from the Juridisch Loket Delft.
- Right to input: You can provide additional information and lodge an objection to the decision, if necessary, through the District Court of The Hague.
- Right to care according to the assessment, including freedom to choose providers (in-kind care or Personal Budget) in the Delft area.
Obligations:
- Obligation to share accurate medical information.
- Payment of the personal contribution, determined based on income and assets (via the CAK).
- Report changes in health for reassessment; assessments can be temporary or permanent.
Without or with an insufficient assessment, you can apply for care in Delft through the Zvw or the Municipality of Delft under the Wmo, but this does not always cover 24-hour care.
Comparison of WLZ Assessment with Other Care Laws
| Act | Target Group | Assessment Authority | Example of Care |
|---|---|---|---|
| WLZ | Permanent 24-hour care needs | CIZ | Nursing home in Delft, intensive home care |
| Zvw | Medical care, not long-term | Health insurer | Short hospital stay in the Hague region |
| Wmo | Household assistance, not intensive | Municipality of Delft | Day activities or light support in the neighborhood |
The WLZ specifically targets long-term, intensive care; other laws, such as the Wmo via the Municipality of Delft, complement but do not fully overlap with WLZ coverage.
Frequently Asked Questions
Can I apply for a WLZ assessment myself?
No, in Delft, applications must be submitted through a referrer such as a general practitioner or specialist. They determine whether WLZ care is appropriate and complete the form. As a resident, you can discuss your needs, and the Juridisch Loket Delft provides guidance.
What if I disagree with the decision?
You can object within 6 weeks via the CIZ. For legal assistance in Delft, contact the Juridisch Loket Delft or the District Court of The Hague for appeals. They offer tailored support for local situations.