Persons entitled to institutional care can choose a home care assistant over the daily institutional care, subject to requirements provided for by the Social Security Act and in cases stipulated therein. The institute of home care assistant plays an important role in maintaining the quality life in advanced years of persons with disabilities. It is primarily intended to persons with disabilities who believe that institutions cannot offer adequate intimacy, individuality, solidarity, personal communication, homeliness and heartiness.
 
The institute of home care assistant is a right pertaining to persons entitled to institutional care: in cases and under conditions stipulated by the Social Security Act, the beneficiary can choose a home care assistant, who provides help in domestic environment, over the daily institutional care.
 
The institute of home care assistant brings about a changed understanding of care for persons with disabilities: from being a problem of individual family members and specialized institutions to becoming part of the overall system of care for such persons. The right to choose a home care assistant is based on social care for persons with disabilities provided in domestic environment. 

In accordance with the Rules on conditions and procedure for exercising the right to choose a home care assistant, a person with disability is defined as:

• a person suffering from a severe mental development disorder
• severely physically impaired persons.

Pursuant to the Social Security Act (Article 18a), the right to choose a family assistant pertains to persons:

• who had been nursed by one of the parents receiving partial payment for lost income in accordance with regulations governing parental protection before the right to choose a home care assistant was enacted
• with disabilities pursuant to the Social Care for Mentally and Physically Handicapped Persons Act who need attendance in their basic daily activities or
• identified by the Commission for establishing the entitlement to choose a home care assistant as persons suffering from a severe mental handicap who need assistance in all basic daily activities or as persons with severe physical impairment who need assistance in all basic daily activities.

The person with disability exercises his/her right to choose a home care assistant with a competent social work centre. The decision on the right to choose a home care assistant is taken by the Disability committee with the Pension and Disability Insurance Institute. The status of a home care assistant and related rights and obligations, in particular the obligation to carry out the care required by the person with disability, is established by the decision on granting the right to a home care assistant and on the choice of a home care assistant. 
 
Home care assistants are persons providing the required help to a person with disability. An assistant can be a person who lives in the same permanent residence as a person with disability or one of his/her family members (father or mother, son or daughter, brother or sister, uncle or aunt, grand father or grand mother…). Under conditions stipulated by the act, a person with disability can choose a home care assistant other than his/her parent.
 
A home care assistant can be a person who, in order to become a home care assistant, de-registered from the register of unemployed persons or left the labour market. A home care assistant can also be a person employed part-time.
 
A home care assistant providing care to a person with disability in domestic environment must have an appropriate attitude to a person with disability, must have skills to communicate and be qualified to work with such a person. A home care assistant contributes to the adequate care or appropriate satisfaction of the wishes and needs of a person with disability by carrying out the following tasks:

• personal care
• medical care
• social care and organization of leisure activities 
• housework assistance.

A home care assistant is entitled to:

• partial payment for lost income amounting to the minimum wage (EUR 538,53 gross) or to the proportionate part of the payment for lost income (if in addition to being a home care assistant, he/she remains in part-time employment)
• pursuant to the provisions of Article 44 of the Act Amending the Social Assistance Act (ZSV-B), a home care assistant is covered by the compulsory pension insurance, insurance against unemployment and parental protection (pending the adoption of regulations governing pension and disability insurance, health insurance, insurance against unemployment and parental protection of home care assistants and regulations governing the payments of contributions thereof and determining the amounts of contributions for social security).

The period of performing tasks of a home care assistant is considered as insurance period or pensionable service; other specific insurance features are also granted.
 
A home care assistant must report to a competent social work centres about the provision of help to a person with disability at least once a year. If circumstances change and the rendering of home care assistance becomes impossible, a home care assistant must inform the competent social work centres thereof without delay. A home care assistant must participate in training programmes as required by the Social Chamber.

Statistics: 

• the number of persons with disabilities having the right to choose a home care assistant (as at 2 February 2007): 1.245
• the number of persons with disabilities, per causes (Article 18a of ZSV):
  • severely physically impaired persons: 848 (68%)
  • persons suffering from a severe mental development disorder: 45
  • persons suffering from a severe mental development disorder and severe physical impairment: 41
  • persons with disabilities pursuant to the Social Care for Mentally and Physically Handicapped Persons Act who need attendance in their basic daily activities: 273
  • persons with disabilities who had been nursed by one of the parents receiving partial payment for lost income in accordance with regulations governing parental protection before the right to choose a home care assistant was enacted: 38
• Structure of the disabled population with a right to choose a home care assistant: 
  • by gender:
    • male: 473 (38%)
    • female: 773 (62%)
  • by age:
    • from 18 to 24: 147
    • from 25 to 34: 120
    • from 35 to 44: 49
    • from 45 to 54: 77
    • from 55 to 64: 107
    • over 65: 746 (59,9%)
• The number of home care assistants (as at 2 February 2007): 1.349
• The number of home care assistants as to their relation to the person with disability: 
  • family members of the person with disability: 981 (78,8%)
  • other persons living in the same permanent residence: 264 (21,2%)