"The biggest social reform in decades" comes to dependency and disability with more rights and fewer waits

Spain faces a new stage in its public care system. Congress closed this Wednesday the definitive approval of the largest reform of dependency and disability laws since 2006, a change that expands benefits, reduces waiting times and grants greater decision-making capacity to those who need support to carry out their daily lives.

The text places the will of each person at the center of the system. Those who have a recognized situation of dependency will be able to participate in the choice of the aid they receive, decide where they want to live and combine services that until now were incompatible in a large part of the country. Care will no longer be concentrated almost exclusively within homes and residences to also extend to neighborhoods and community life.

The Plenary ruled this Wednesday on the amendments incorporated during the processing in the Senate. The reform had been approved in Congress last July with 179 votes in favor, 33 against from Vox and 137 abstentions from the Popular Party. Of the more than 60 modifications subsequently approved in the Upper House, around twenty have been incorporated into the final text.

The Minister of Social Rights, Consumer Affairs and Agenda 2030, Pablo Bustinduy, has presented the law as a "refoundation" of the care model and "the greatest social reform in decades". His department maintains that the system is beginning to abandon a rigid structure, marked for years by incompatibilities and long administrative procedures, to move towards more personalized and close care.

Choosing how and where to receive care

One of the most relevant changes will be the possibility of combining benefits and services. A person who attends a day center will also be able to receive help at home, while the autonomous communities must progressively adapt their regulations and eliminate incompatibilities before 2030.

Home help can be used to accompany the person outside the home, go to the doctor, do shopping or participate in activities in their environment. Personal assistance is also expanded, support product loan services are created, such as wheelchairs, articulated beds or walkers, and the door is opened to new housing formulas with care for those who need intense support.

Telecare will become a universal right within the dependency system and may include geolocation devices and other tools aimed at preventing risk situations. Day centers will also expand their functions and may offer meals, activities, and care to people who continue to live in their homes.

The reform also recognizes a reality that for years remained outside the law. The primary caregiver may be a family member, a partner with whom there is no marriage, or someone from the emotional environment who assumes that responsibility. The State will cover the contributions of those who care, and the system must guarantee the continuity of care when the caregiver falls ill or is hospitalized.

The individual care program will have to be built by listening to the preferences of the dependent person. It will also be possible to combine employment with benefits, the right to receive care free from physical or pharmacological restraints will be recognized, and urgent procedures will be enabled for situations of special vulnerability.

Administrative simplification is another pillar of the law. The maximum period to recognize a situation of dependency and resolve the corresponding aid drops from six to three months. The reform also creates a single window to prevent families from having to submit the same documentation multiple times.

The change comes with more than 255,000 people awaiting some procedure and waits that average more than 300 days. Bustinduy has set the goal of reducing that list by half during 2027 and eliminating it in 2028. "Our commitment is total, and now it's up to all autonomous communities to work together to make it a reality," he defended from the rostrum.

The law also establishes that the General State Administration must assume 50% of the financing certified by the autonomous communities, a historical demand from the territories that manage the system. In 2024, the state contribution was around 27%. The Government plans to reach the new percentage in 2027 and has approved an additional injection of 6.2 billion euros for the years 2026 and 2027.

Accessibility becomes an enforceable right

The second part of the reform updates disability legislation and develops the mandate of the new article 49 of the Constitution. People with a Grade I dependency will automatically obtain recognition of a 33% disability, while Grades II and III will grant access to 65%. This equivalence will avoid parallel procedures and years of duplicated paperwork.

Universal accessibility is recognized as a right that can be claimed before administrations. Homeowners' associations will have to apply for public aid to adapt buildings when requested by a disabled neighbor or one over 70 years old. The State will launch a specific program to finance interventions in homes, public services, and other spaces.

The measure directly affects the approximately 100,000 people who remain trapped in their homes due to the absence of elevators, ramps, or other adaptations. Stations, airports, and other public transport infrastructures must also incorporate bathrooms prepared for people with ostomy.

Early intervention for children up to six years old with developmental disorders or at risk of suffering from them becomes a subjective right, regardless of budgetary availability or the number of existing places in each territory. Insurers will also not be able to apply different prices due to disability, and judicial procedures must have facilitators when a person needs support to understand and participate in the process.

The Director General of the Rights of Persons with Disabilities, Jesús Martín Blanco, has described the approval as a "great achievement of democracy" because it restores people's ability to decide on their own life project. The CERMI Women Foundation has spoken of a "historic day" and highlighted the mandate to prepare a future reparation law for women with disabilities subjected to forced sterilizations or performed without their consent.

Entities that provide dependency services have received the reform with satisfaction, although they demand that funding truly reach the centers and professional care. The Business Federation of Dependency considers the new framework an "important step" and calls for public contracts adjusted to the cost of services, better working conditions, and a national strategy against the lack of workers.

The processing has left pending the extension of the benefit for caring for children with cancer or other serious illnesses beyond 26 years of age. The Government vetoed the amendments that eliminated this limit due to their budgetary impact, while some 300 people gathered before Congress. The Minister of Inclusion, Social Security and Migration, Elma Saiz, has announced an "imminent" legislative initiative to review the maximum age and strengthen the protection of these families.