WLZ Assessment by CIZ: Application & Procedure in The Hague
A WLZ assessment is an official evaluation by the Centrum Indicatiestelling Zorg (CIZ) determining whether residents of The Hague and surrounding areas are entitled to care under the Long-Term Care Act (WLZ). This assessment is essential for individuals with chronic conditions or disabilities requiring continuous, intensive support. The CIZ evaluates whether there is a need for ongoing, high-level care and advises on the scope and duration of the required support. Residents of The Hague can seek guidance on this process through the Juridisch Loket Den Haag.
What Is a WLZ Assessment?
The Long-Term Care Act (WLZ) provides care for individuals requiring continuous 24/7 assistance, such as those with dementia, severe physical disabilities, or mental health challenges. A WLZ assessment is the formal approval needed to access this government-funded care through an insurer. Without this assessment, residents of The Hague cannot access WLZ care, such as nursing home admission or in-home personal assistance.
The CIZ, an independent body, processes these assessments by reviewing medical and social circumstances. Approvals include profiles like 'terminal care,' 'full home care package,' or 'residential care,' determining the type and location of care available in the The Hague region.
The Role of the CIZ in WLZ Assessments
The Centrum Indicatiestelling Zorg (CIZ) issues WLZ assessments based on applications submitted by healthcare providers, GPs, or directly by residents of The Hague. The CIZ applies the Health Insurance Act (Zvw) and WLZ regulations. After evaluation, they send a decision on eligibility to the insurer, which arranges financing.
In The Hague, the process often begins with a GP or district nurse submitting the application to the CIZ. The CIZ may dispatch an officer for a home visit or dossier review. Processing typically takes 6 weeks, though complex cases in the region may extend this timeline.
Legal Framework of the WLZ Assessment
The WLZ is governed by the Long-Term Care Act, which replaced the AWBZ as of January 1, 2015. Key legal provisions include:
- Article 3.2 WLZ: Outlines eligibility criteria, such as a permanent need for 24/7 care.
- Article 3.3 WLZ: Defines assessment profiles, including six standard options like 'Personal Budget for Home Care (PGB thuis)' or 'modular home care package.'
- Article 8.1 Zvw: Establishes the CIZ’s role as the assessment authority.
The Ministry of Health, Welfare and Sport (VWS) sets detailed evaluation rules via the Long-Term Care Regulation. The CIZ applies the WLZ Assessment Policy Rules, focusing on criteria like self-sufficiency and 24/7 supervision. Disputes can be challenged under Article 7:1 Awb (General Administrative Law Act), with The Hague residents able to appeal to the District Court of The Hague.
How to Apply for a WLZ Assessment
The WLZ assessment process in The Hague follows a clear structure. Below is a step-by-step guide with local insights:
- Identify Care Needs: If you or a loved one in The Hague requires long-term support, consult a GP or local care provider.
- Submit the Application: The referring party (GP or specialist) completes the form on the CIZ website ([ciz.nl](https://www.ciz.nl)) and attaches medical documents. The Juridisch Loket Den Haag can assist with preparation.
- CIZ Evaluation: The CIZ thoroughly reviews the application. Complex cases in The Hague households may involve a home visit by an assessment officer.
- Receive the Assessment Decision: Within 6 weeks, you’ll receive a binding decision from the CIZ, communicated to your insurer.
- Arrange Care: With the assessment, your insurer selects a provider, or you may receive a personal budget via the CAK. The Hague offers diverse local care institutions.
Local Example in The Hague: Mrs. De Vries (68), a resident of Schilderswijk with advanced Parkinson’s, had her GP in The Hague submit a WLZ application to the CIZ. After reviewing her file and visiting her home, she received approval for a 'full home care package.' She now receives intensive in-home care from a Hague provider, largely covered minus her personal contribution.
Rights and Obligations in WLZ Assessments
Rights:
- Right to a thorough, objective evaluation by the CIZ.
- Right to participate: You can submit additional information and lodge objections to the decision, with support from the Juridisch Loket Den Haag.
- Right to care as per the assessment, with freedom to choose providers (in-kind care or personal budget).
Obligations:
- Duty to provide accurate medical information.
- Payment of the personal contribution, based on income and assets (via CAK).
- Report health changes for reassessment; assessments may be temporary or permanent.
Without or with an insufficient assessment, residents of The Hague can apply for care under the Zvw or Wmo via the Municipality of The Hague, though this does not always cover 24/7 needs.
Comparison: WLZ Assessment vs. Other Care Laws
| Law | Target Group | Assessment Body | Example of Care |
|---|---|---|---|
| WLZ | Permanent 24/7 care needs | CIZ | Nursing home admission, intensive home care in The Hague |
| Zvw | Medical care, non-long-term | Insurer | Short hospital stay |
| Wmo | Household support, non-intensive | Municipality of The Hague | Day activities, basic local assistance |
The WLZ specifically targets severe, long-term care; other laws like the Wmo (via the Municipality of The Hague) complement but do not fully overlap with these needs.
Frequently Asked Questions
Can I apply for a WLZ assessment myself?
No, applications must be submitted by a referrer, such as a GP or specialist in The Hague. They determine if WLZ care is appropriate and complete the form. As a resident, you can still raise the care need, and the Juridisch Loket Den Haag offers free advice.
What if I disagree with the decision?
You can object within six weeks via the CIZ. If unresolved, the case escalates to the District Court of The Hague. The Juridisch Loket Den Haag assists with the process.