WLZ Assessment by CIZ: Application and Procedure for Leiden Residents
A WLZ assessment by the Centrum Indicatiestelling Zorg (CIZ) is a critical evaluation determining whether residents of Leiden qualify for long-term care under the Long-Term Care Act (WLZ). This assessment is essential for accessing care due to chronic conditions or disabilities and facilitates entry into local services in the region. The CIZ evaluates whether there is a continuous and intensive need for care, advising on the scope and duration of care tailored to Leiden’s specific circumstances.
What Does a WLZ Assessment Mean for Leiden Residents?
The Long-Term Care Act (WLZ) provides support for Leiden residents requiring 24/7 intensive care, such as those with dementia, severe physical disabilities, or mental health challenges. A WLZ assessment serves as the official approval for this care, funded by the government through your health insurer. Without this assessment, residents of Leiden cannot access WLZ services, such as admission to a local nursing home or personal home care.
The CIZ, as an independent body, processes the assessment by reviewing the medical and social circumstances of the applicant. Assessments are categorized into profiles like 'terminal care,' 'full home care package,' or 'residential care,' determining which care options are available in the Leiden region, including nearby care facilities.
The Role of the CIZ in WLZ Assessments in Leiden
The Centrum Indicatiestelling Zorg (CIZ) is responsible for issuing WLZ assessments. Applications are submitted by healthcare providers, general practitioners in Leiden, or directly by citizens. The CIZ adheres to the Health Insurance Act (Zvw) and WLZ regulations. After evaluation, the CIZ sends an assessment decision to the health insurer, which arranges the funding.
In Leiden, the process often begins with a local general practitioner or district nurse submitting the application to the CIZ. The CIZ may dispatch an officer for a home visit in the city or analyze the case file. The procedure typically takes 6 weeks, though complex cases in the region may extend this timeline.
Legal Basis of the WLZ Assessment
The WLZ is outlined in the Long-Term Care Act, which replaced the AWBZ as of January 1, 2015. Key legal provisions include:
- Article 3.2 WLZ: Establishes eligibility criteria, such as a permanent need for 24-hour care.
- Article 3.3 WLZ: Describes assessment profiles, including six standard options like 'PGB at home' or 'modular home care package'.
- Article 8.1 Zvw: Defines the CIZ’s role as an assessment body.
The Minister of Health, Welfare, and Sport sets detailed assessment rules via the Long-Term Care Regulations. The CIZ follows the WLZ Assessment Policy Rules, which address aspects like self-reliance and 24-hour supervision. If you disagree with a decision, you can appeal to the Leiden District Court, in accordance with Article 7:1 Awb (General Administrative Law Act). For free advice, contact the Leiden Legal Helpdesk.
How to Apply for a WLZ Assessment in Leiden
The procedure for obtaining a WLZ assessment is structured and accessible for Leiden residents. Below is a step-by-step guide:
- Identify the Care Need: If you or a loved one in Leiden requires ongoing care, consult a local general practitioner or healthcare provider, such as the city center’s medical practice.
- Submit the Application: The referrer (general practitioner or specialist at LUMC) completes the form on the CIZ website (ciz.nl) and attaches medical documents.
- CIZ Evaluation: The CIZ reviews the application; complex cases in Leiden may involve a home visit by an assessment officer.
- Receive the Assessment Decision: Within 6 weeks, you will receive the ruling, which is binding for your health insurer.
- Arrange the Care: With the assessment, your insurer selects a provider in the Leiden region or arranges your personal contribution.
Practical Example: Consider Mrs. De Vries (68), a Leiden-Noord resident with Alzheimer’s who can no longer live alone. Her local GP submits the application to the CIZ. After reviewing her file and conducting a visit, she receives an assessment for 'institutional residential care.' She moves into a nursing home in the Leiden area, with care largely covered minus her personal contribution.
Rights and Obligations in a WLZ Assessment for Leiden Residents
Rights:
- Right to a thorough and impartial evaluation by the CIZ.
- Right to input: You can provide information and file an objection, with support from the Leiden Legal Helpdesk.
- Right to care as per the assessment, with options for in-kind services or PGB, including local choices via the Municipality of Leiden.
Obligations:
- Obligation to share accurate medical information.
- Payment of the personal contribution, based on income and assets (via the CAK).
- Report changes in health for reassessment; assessments can be temporary or permanent.
Without or with insufficient assessment, you can apply for care through the Zvw or Wmo via the Municipality of Leiden, though this does not always cover 24-hour care.
Comparison of WLZ Assessment with Other Care Laws in the Leiden Context
| Law | Target Group | Assessment Body | Example of Care |
|---|---|---|---|
| WLZ | Permanent 24-hour care needs | CIZ | Nursing home in Leiden, intensive home care |
| Zvw | Medical care, not long-term | Health insurer | Short-term admission at LUMC |
| Wmo | Household assistance, non-intensive | Municipality of Leiden | Day activities, basic local support |
The WLZ specifically targets long-term, intensive care; other laws complement it but overlap is limited, with local adjustments via the Municipality of Leiden.
Frequently Asked Questions for Leiden Residents
Can I apply for a WLZ assessment myself in Leiden?
No, the application must be submitted by a referrer, such as a general practitioner or specialist in Leiden. They determine if WLZ care is appropriate and complete the form. As a resident, you can discuss the need and seek support from the Leiden Legal Helpdesk.
What if I disagree with the decision?
You can file an objection within six weeks with the CIZ. For legal advice in Leiden, contact the Leiden Legal Helpdesk or the Leiden District Court for a hearing.