Regional Government creates regime for patients discharged for social reasons

Ordinance no. 157/2026 has been published, establishing the adaptation to the Autonomous Region of Madeira of the inter-institutional coordination regime for the reception of people who, after clinical discharge, remain hospitalized for social reasons and do not meet the criteria for integration into the Regional Network of Integrated Continuing Care (RRCCI).

This measure aims to combat the delay of hospital discharges, ensuring that patients without family support or autonomy receive appropriate referral. The operationalization of the regime is based on the collaboration between the Social Security Institute of Madeira, IP-RAM (ISSM, IP-RAM) and the Health Service of the Autonomous Region of Madeira, EPERAM (SESARAM, EPERAM).

Main responsibilities defined:

• ISSM, IP-RAM: Responsible for public financial co-payment, social assessment, referral, monitoring, and management of vacancies in social responses.
• SESARAM, EPERAM: Responsible for clinical assessment, definition of the individual care plan, and provision of additional healthcare in intermediate units.

Tripartite funding model:

The funding of vacancies will be ensured through a model that includes:

• Social Security co-payment: Supported by ISSM, IP-RAM through budgetary allocations.
• Family co-payment: Calculated according to the rules of Residential Structures for the Elderly (ERPI).
• Additional healthcare: Costs supported by SESARAM, EPERAM, through autonomous invoicing and clinical validation.

The diploma enters into force the day after its publication, and the coordination between the entities will be formalized through specific protocols.