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Mit 44:0 Stimmen wurde folgendem Beschlussesantrag zugestimmt:

1. Der Betrag von Fr. 400'000.- gemäss Voranschlag 2004 wird zu Lasten Konto 400.365.09 Beiträge an örtliche Institutionen freigegeben.

2. Der Stadtrat wird mit dem Vollzug beauftragt.\n","affair_title",295,1742773168000,"\"Sehr geehrter Herr Präsident
Sehr geehrte Damen und Herren

Der Stadtrat von Olten unterbreitet Ihnen folgenden Bericht und Antrag:

Spitex, Beitrag 2004/Genehmigung

1. Ausgangslage

In das Budget 2004 der Stadt Olten sind aufgrund einer Schätzung Fr. 400'000.-- als Subvention für die Leistungen des Spitex-Vereins Olten aufgenommen worden.

Aus Liquiditätsgründen wurde dem Spitex-Verein Olten im Hinblick auf die noch freizugebende und exakt zu beziffernde Subvention 2004 ein zinsloses Darlehen von Fr. 200'000.-- gewährt (Stadtratsbeschluss vom 26.01.2004).

Das vorliegende Budget 2004 des Spitex-Vereins Olten rechnet mit einer städtischen Subvention von Fr. 470'000.--. Um den Betrieb im Rechnungsjahr 2004 zu gewährleisten, ist der Spitex-Verein Olten auf die Freigabe der budgetierten städtischen Subvention angewiesen. Andernfalls müssten Mitarbeitende entlassen und Leistungen abgebaut werden.

Das gewährte Darlehen soll mit der Subvention verrechnet werden.

2. Aktuelle Situation im Spitex-Verein Olten

Der Bereich Infrastruktur ist derzeit gut ausgebaut. Ein weiterer Ausbau ist vorerst nicht geplant. Mit dem Bezug von neuen Räumlichkeiten ist das Platzproblem gelöst. Die Voraussetzungen für effizientes Arbeiten sind auf absehbare Zeit gegeben. Im Jahr 2005 wird die Einführung des Bedarfsermittlungssystems RAI-Homecare ca. Fr. 20'000.-- Gesamtkosten (Software, Ausbildung) verursachen. Die Einführung wird vom Bund zwingend verlangt. Ein möglicher zusätzlicher Mittelbedarf könnte durch einen allfälligen nötigen Ersatz der bejahrten Dienstfahrzeuge entstehen. Allenfalls könnte durch den Einsatz von kostenloser Open-Source Software (Linux, Open Office) Geld gespart werden. Auf dem Gebiet Datenbank ist mit MySQL bereits kostenlose Software im Einsatz!
Der Personalbestand im Overhead Bereich konnte wesentlich gestrafft werden. Der Stellenplan weist ein Minus von 20% aus. Gegenüber dem Stellenplan 2003 sind Lohneinsparungen von Fr. 30'000.-- zu verzeichnen. Dennoch sind die Leistungen ausgebaut worden:
· Alle Geschäftsführungsaufgaben erfolgen heute vollumfänglich vom Zentrum aus. Der Miliz-Vorstand hat nun wie vorgesehen nur noch strategische Aufgaben zu erledigen.
· Professionalisierung der Führungsinstrumente. Ausbau der Führungsaufgaben. Stichworte: Mitarbeiterförderung, Reporting, Rapportwesen, Wirkungsanalyse.
· Das Kader verfügt heute über die qualitativen Ressourcen, alle im Leistungsauftrag vereinbarten Aufgaben zu erfüllen. Stichworte: Controlling, Qualitätssicherung, Organisationsentwicklung.
· Nebst ihren Führungsaufgaben sind alle Einsatzleiterinnen neu auch operativ im Einsatz. Dies verstärkt den Bezug zur Basis und erhöht die allgemeine Flexibilität in der Planung. Gleichzeitig kann die Qualität direkt vor Ort überprüft werden.
· Die Betreuung der IT-Infrastruktur (Netzwerkbetreuung, Wartungsarbeiten, Installati-onen, Security) kann intern abgedeckt werden.
Im gesamten operativen Bereich sind die Personalkosten 2003 im Vergleich zu den erbrachten Leistungen unterdurchschnittlich gewachsen. Der Zuwachs an Dienstleistungen konnte weitgehend durch Effizienzsteigerungen kompensiert werden. Dieses Ziel, im speziellen die Reduktion nicht verrechenbarer Zeit, wird 2004 weiterverfolgt. Der zu erwartende Spareffekt wird aber schwächer ausfallen, weil andererseits mehr Zeit für Qualitätssicherung (Reporting, Fallbesprechungen) und Personalentwicklung (Coaching) eingesetzt werden muss. Diese Bereiche wurden in der Vergangenheit vernachlässigt.
Allgemein lassen sich zwei statistisch belegbare Haupttendenzen feststellen. Die Klienten/Klientinnnen werden immer älter. Dadurch steigt der Bedarf an Grundpflegeleistungen bei den über 80-jährigen überdurchschnittlich. In der Folge entwickelt sich der Bedarf weg von freiwilligen, teilweise eigenfinanzierten Dienstleistungen (Haushilfe) zu kassenpflichtigen, gesetzlich reglementierten Leistungen (Pflege). Der unternehmerische Spielraum und Flexibilität nimmt im gleichen Masse ab. Gleichzeitig erhöhen sich der Bedarf an qualifiziertem Pflegepersonal und damit die Personalkosten.
Das Dienstleistungsvolumen im Reinigungsdienst hat zugenommen. Reinigungsarbeiten im Bereich Hauspflege wurden in den Reinigungsdienst ausgegliedert. Dadurch konnten Personalkosten gespart werden, da im Reinigungsdienst die tiefsten Löhne bezahlt werden. Die Bereiche Hauspflege und Reinigungsdienst sollen bezüglich Angebot, Adressatenkreis und Tarifierung 2004 neu positioniert werden. Ein diesbezügliches Projekt wird nächstens gestartet.
Hauswirtschaftliche Leistungen haben 2003 drastisch abgenommen. Die Gründe dafür sind vielfältig. Sicherlich führt die finanziell angespannte Situation bei vielen Kunden zu einer Zurückhaltung. Hauswirtschaftliche Leistungen sind nicht kassenpflichtig. Die Leistungen werden in der Folge von Angehörigen oder gar nicht mehr erbracht.
Zugenommen haben die Grundpflegeleistungen, welche in einfacheren Fällen vom Hauspflegepersonal erbracht werden können. Dies sind erste Auswirkungen der demographischen Entwicklung: Die Menschen werden älter. Die Phase der Pflegebedürftigkeit verlängert sich. Jedoch sind berufstätige Menschen nicht mehr in der Lage oder willens, tägliche, lebensnotwendige Verrichtungen für ihre Angehörigen selber zu leisten.
Die Nachfrage nach hauswirtschaftlichen Dienstleistungen wird sich stabilisieren oder je nach wirtschaftlicher Entwicklung wieder leicht zunehmen. Die Nachfrage nach einfachen Grundpflegeleistungen wird weiter zunehmen. Beides sind unverzichtbare Basisdienstleistungen für das längere Verbleiben in den eigenen vier Wänden.
Am meisten zugenommen haben Grundpflegeleistungen mit erhöhten Anforderungen. Die Pflegefälle werden immer komplexer. Die eigentliche Pflege wird erschwert durch familiäre und psychosoziale Faktoren. Deutlich zugenommen haben Demenzen und psychische Erkrankungen. Dies stellt sehr hohe Anforderungen an die pflegende Person. Der Bedarf an qualifiziertem Personal, verbunden mit einem professionellen Umfeld, nimmt deshalb stetig zu. Die höheren Lohnkosten im Budget sind Ausdruck des qualitativen Personalausbaus. Qualifiziertes Personal hat seinen Preis.
Im Bereich Krankenpflege besteht ein gesetzlicher Auftrag. Der Leistungskatalog ist durch das KVG gegeben. Spitäler schicken Patienten aus Kostengründen immer früher nach Hause und lassen die Nachbehandlung ambulant durchführen.
Ab 2004 werden im Kanton Solothurn die ersten Lehrlinge im neuen Berufsbild Fachangestellte Gesundheit (FAGE) ausgebildet. Spitex Olten hat bisher ihre Verantwortung im Bereich Ausbildung wahrgenommen, indem Praktikumsplätze für Krankenpflege und Hauspflege angeboten wurden. Neu werden keine Praktikantinnen der Berufsschule für Hauspflege in Aarau mehr aufgenommen. Der Vorstand hat sich entschlossen, sich neu auf die FAGE Ausbildung des Kantons Solothurn auszurichten und zwei Lehrstellen anzubieten. Diese Aufgabe absorbiert vermehrt Personalressourcen, da die Anforderungen seitens der Schule an den Lehrbetrieb hoch sind. Dazu kommen Kosten im Rahmen der Ausbildung von Lehrmeistern und Lehrbegleitungen. Die entstehenden Mehrkosten lassen sich momentan noch schwer einschätzen, weil die Basisdaten fehlen.
Für 2004 wurden folgende Ziele gesetzt:
· Verbesserungen im Bereich Reporting (Aktenführung, Zusammenarbeit). Dadurch kann die Effizienz verbessert werden.
· Periodische Bedarfsabklärungen. Nur dadurch kann professionell abgesichert werden, dass unsere begrenzten Mittel zweckdienlich und sachgerecht eingesetzt werden. Dafür fehlte Spitex Olten bisher Personal und Mittel.
· Reduktion der unverrechenbaren Zeit, dadurch höhere Produktivität.
Der gültige Leistungsauftrag mit der Stadt Olten weist Mängel im Bereich Finanzierung auf. Zwischen der Einreichung des Budgets Mitte Jahr und der Bewilligung der Subvention im ersten Quartal des Folgejahres verstreicht viel Zeit. Für Planungen und Entscheidungen gilt der Generalvorbehalt der Bewilligung der Subvention durch das Parlament. Jahresziele und die damit verbundene Planung erfolgen in der Regel in den Monaten November/Dezember. Der Bedarf an Dienstleistungen kann sich kurzfristig ändern. Dies hat Auswirkungen auf Saldo und auf Einzelpositionen des Budgets. Ein effizientes, flexibel und schnell reagierendes Management ist dadurch erschwert.
Die Finanzierungsseite des Leistungsauftrages sollte deshalb überarbeitet werden. Dabei sind folgende Punkte zu beachten:
· Leistungsumfang und -ziele sind durch den Leistungsauftrag klar definiert und eingegrenzt und können durch die vorhandenen Reporting- und Controllinginstrumente überprüft werden. Die Stadt Olten hat über ihren Vertreter im Vorstand unmittelbar Einfluss und Kontrolle über die laufenden Geschäfte. Es soll neu ein jährlicher Leistungsbericht verfasst werden.
· Die Finanzierung ist an ausgewiesene Leistungen zu knüpfen. Dabei können verschiedene Systeme zur Anwendung kommen: Sockelbetrag und Leistungsanteil oder total leistungsabhängige Finanzierung. Es können Maximalmengen definiert werden. Durch ein leistungsabhängiges System wird ein Anreiz zur Effizienzsteigerung geschaffen.
·Reserven zur Liquiditätssicherung sollen definiert werden
Mit der Ausarbeitung eines neuen Leistungsauftrages wird im laufenden Jahre begonnen. Sobald der Entwurf vorliegt, wird er dem Stadtrat und danach dem Gemeindeparlament zum Entscheid vorgelegt.

3. Spitex-Budget 2004

Das Spitex-Budget 2004 liegt diesem Bericht und Antrag als Beilage bei. Daraus sind auch die Zahlen 2003 und die Differenzbeträge zu ersehen.

Der Finanzbedarf des Spitex-Vereins Olten wächst im Jahr 2004 erneut. Dafür sind im Wesentlichen folgende Gründe zu nennen:
· Von Jahr zu Jahr sinkende Lohnsubventionen aus Art. 101 bis AHVG. Diese wurden von ursprünglichen 33% auf aktuelle 25 % der Gesamtlohnsumme reduziert.
· Steigender Bedarf an Dienstleistungen, insbesondere in personalkostenintensiven Dienstleistungsbereichen (Grundpflege/Behandlungspflege). Folge: Steigende Personalkosten.
· Umsetzung von Qualitätsnormen und Vorschriften mit gesetzlicher Grundlage und gemäss Vorgaben des Leistungsauftrages. (Personalkosten)
· Umstrukturierung der Spitex-Organisation gemäss Auftrag des Gemeindeparlamentes der Stadt Olten (siehe unten)
Der Beitrag der Stadt Olten erhöht sich deshalb gegenüber 2003 um Fr. 70'000.--, was 3.3% des budgetierten Umsatzes entspricht. Darin eingeschlossen sind der Mehraufwand Miete von Fr. 16'695.--. Der zu erwartende Personalmehraufwand wird also 2004 wiederum durch Effizienz- und Produktivitätssteigerungen teilkompensiert werden müssen. Das Potential hierfür wird nicht grösser.

4. Reorganisation Spitex, Umsetzung der Massnahmen, Information Gemeindeparlament

An der Sitzung vom 10. Dezember 2002 fasste das Gemeindeparlament mit 40:0 Stimmen den Beschluss, den Überprüfungsbericht und die eingeleiteten Massnahmen zu dessen Umsetzung zur Kenntnis zu nehmen.

Bis heute sind folgende Teilaufträge umgesetzt bzw. eingeführt worden:

· Anstellung eines Geschäftsleiters, neue Führungsstruktur
· Schaffung von Grundlagen der Führung und Organisation (Organigramm, Stellenbeschreibungen, Funktionendiagramm, Arbeitsverträge)
· Einführung und Einsatz von Controllinginstrumenten
· Bildung zweier polyvalenter Teams per 1.11.03
· Einführung einer Kostenrechnung; erster Abschluss für das Jahr 2003
· Einführung eines Qualitätsmanagements und Durchführung von Qualität sichernden Massnahmen auf verschiedenen Ebenen. Einführung von Mitarbeitergesprächen, Betriebsordner, Coaching, Leitbild (April 2004). Qualitätssicherung als Prozess ist niemals abgeschlossen!
Noch nicht umgesetzt bzw. eingeführt ist folgender Teilauftrag:
· Einführung RAI-Home Care. Diese ist für 2005 geplant. Momentan laufen Pilotprojekte in anderen Organisationen. Wenn möglich werden bereits 2004 RAI-Home Care kompatible Elemente eingeführt (Bsp.: Neuer Bedarfsplan)

5. Erwägungen

Spitex Olten steht am Ende des Betreuungssystemes und sozialen Netzes:
· Spitex Olten ist die Alternative zu teuren, stationären Betreuungsformen.
· Spitex Olten unterstützt den Wunsch vieler älterer Menschen, länger in ihrer vertrauten Umgebung bleiben zu können.
· Spitex Olten begleitet und entlastet betreuende Angehörige.
· Spitex Olten entlastet Vormundschaftsämter in der Sicherung des Lebensbedarfs von Menschen mit körperlichen und psychischen Problemen.
· Mitarbeitende der Spitex Olten sind in vielen Fällen die einzigen konstanten Bezugs-personen von einsamen, kranken Menschen.

Die Aufrechterhaltung eines Spitex-Dienstes ist grundsätzlich unbestritten. Diskutiert werden Menge und Qualität der Leistungen. Die Frage nach der geeigneten Organisation ist in den letzten Jahren wiederholt gestellt worden. Auf Grund von Überprüfungen ist eine neue Führungsstruktur aufgebaut worden, die sich nun bewähren soll. Der freizugebende Kredit dient der Aufrechterhaltung eines in der Bevölkerung verwurzelten Betriebes.

Der Steuerungsanspruch der Stadt soll über den Leistungsauftrag und über den Einsitz im Vorstand der Spitex erfolgen. Mit der in den Vorstand delegierten Person soll ein Reporting-System erarbeitet werden. Diese Person soll nach politischen Vorgaben Einfluss auf die Tätigkeit der Spitex nehmen.

Die städtische Kommission für Alters- und Gesundheitsfragen unterstützt diesen Antrag einstimmig.

Ohne die Subvention der Stadt lässt sich der Spitex-Betrieb nicht aufrechterhalten. Personal müsste entlassen, Leistungen abgebaut werden. Der Leistungsauftrag mit der Stadt müsste gekündigt werden.

6. Wirtschaftlichkeit

Spitex-Leistungen sind in der ganzen Schweiz grundsätzlich unbestritten. Momentan steht dazu keine Alternative zur Verfügung, die ernsthaft in Betracht gezogen werden kann. Deshalb können hier nicht die finanziellen Folgen verschiedener Varianten einander gegenüber gestellt werden.

Diskutieren und Steuern lassen sich jedoch Menge und Qualität der Dienstleistungen. Das Instrument dazu ist für die Stadt der Leistungsauftrag und der Einsitz im Spitex-Vorstand. Der Leistungsauftrag soll überprüft und neu ausgehandelt werden. Die Sozialdirektion hat geplant, im Rahmen eines Projektes Spitex- und Alterspolitik Grundlagen für die Steuerung und das Engagement der Stadt zu erarbeiten und danach einen neuen Leistungsauftrag auszuhandeln. Der entsprechende Projektkredit ist vorerst aus finanziellen und personellen Gründen zurückgestellt worden.

Eine Einschränkung des Spitex-Angebotes hätte unmittelbare Folgen struktureller, sozialer und finanzieller Natur:
· Ausbau von stationären, medizinischen Einrichtungen
· Schaffung von kostenintensiven Pflegeplätzen für schwer Pflegebedürftige
· Schaffung von geeigneten, stationären Einrichtungen für Demente

7. Realisierung

Das bereits gewährte Darlehen von Fr. 200'000.-- wird mit der städtischen Subvention verrechnet. Mitte Jahr wird der Restbetrag von Fr. 270'000.-- überwiesen.

Beschlussesantrag:

I.

1. Ein Nachtragskredit von Fr. 70'000.-- wird zu Gunsten Konto 400.365.09 bewilligt

2. Fr. 470'000.-- werden zu Lasten Konto 400.365.09 freigegeben.

3. Der Stadtrat wird mit dem Vollzug beauftragt.

II.

Ziff. I./1. des Beschlussesantrages untersteht dem fakultativen Referendum.\"\n",868,"15525","Mit 40:0 Stimmen wurde Eintreten beschlossen.

Dem Antrag des Stadtrates wurde mit 39:0 Stimmen zugestimmt.\n",833,"15359","\"Sehr geehrter Herr Präsident
Sehr geehrte Damen und Herren

Der Stadtrat unterbreitet Ihnen folgende Erwägungen und Anträge:

1. Ausgangslage

In das Budget 2004 der Einwohnergemeinde der Stadt Olten wurden Fr. 400'000.-- provisorisch als Subvention für die Leistungen des Spitex-Vereins Olten aufgenommen. Das erst nach dem Budgetierungsprozess vorliegende Budget 2004 des Spitex-Vereins Olten wies einen Subventionsbedarf von Fr. 470'000.-- aus. Der Stadtrat unterbreitete dem Gemeindeparlament einen Bericht und Antrag, der von der Geschäftsprüfungskommission (GPK) der Stadt Olten am 16. März 2004 geprüft wurde. Die GPK schlug vor, über den beantragten Nachtragskredit von Fr. 70'000.— an der Septembersitzung des Gemeindeparlamentes beim Vorliegen weiterer Grundlagen zu befinden und vorerst den Betrag von Fr. 400'000.- gemäss Voranschlag 2004 zu Lasten Konto 400.365.09 „Beiträge an örtliche Institutionen“ freizugeben. Das Gemeindeparlament beschloss am 25. März 2004, dem Vorschlag der GPK zu folgen.

2. Leitbild

Das Projekt „Spitex- und Altersleitbild“ der Sozialdirektion wurde vom Stadtrat aus finanziellen Gründen zurückgestellt. Die Sozialdirektion schlägt für das Budget 2005 die Aufnahme eines entsprechenden Budgetpostens vor. Erst im Rahmen dieses Projektes kann eine umfassende Auslegeordnung und Grundlagenbeschaffung in den Bereichen Alter und Gesundheit erfolgen. Neben den Spitex-Dienstleistungen werden auch die Baukostenbeiträge an Heimprojekte Thema sein.
Um diese Lücke zu füllen und den Forderungen der GPK zu entsprechen, hat die Sozialdirektion ein isoliertes Spitex-Leitbild erarbeitet, das diesem Bericht und Antrag beiliegt.

3. Kennzahlen

Der Spitex-Verein Olten stellt folgende Kennzahlen zur Verfügung, die diesem Bericht beiliegen:
· Vergleich Solothurn-Grenchen-Olten
· Umstrukturierung Kosten
· Tarifvergleich
· Prognose Leistungsentwicklung bis 2007
· Budget 2004
· Quartalsbericht 1. Quartal 2004.
· Budgetentwicklung bis 2007

4. Leistungsauftrag

Der Leistungsauftrag ist überarbeitet worden. Darin wird eine Maximalmenge an zu erbringenden Leistungen definiert. Pro geleistete Stunde wird ein Subventionsbeitrag fällig. Aus diesen beiden Grössen lässt sich der maximal fällige Subventionsbeitrag rechnen.

Der Leistungsauftrag liegt diesem Bericht und Antrag bei.

5. Tarife

An seiner Sitzung vom 24.05.2004 besprach der Vorstand des Spitex-Vereins Olten die Ergebnisse des Projektes \"\"Neupositionierung Hauspflege und Reinigungsdienst\"\". Die für beide Dienstleistungsbereiche neuformulierten Leistungsbeschriebe wurden genehmigt. In diesem Zusammenhang wurden auch die Tarife geprüft. Der Vorstand folgte den Empfehlungen einer Arbeitsgruppe und beschloss, diese gestaffelt anzuheben.

Per 1.7.2004 wurden – nach Rücksprache mit der Sozialdirektion - folgende Anpassungen eingeführt:
Dienstleistung neu/bisher/Differenz
Reinigungsdienst 35.40/30.--/5.40
Hauspflege (Normaltarif) 30.--/25.80/4.20
Hauspflege (Sozialtarif) 28.20/25.80/2.40

Die Anhebung der Hauspflege-Tarife erfolgte u.a. aus folgenden Gründen:
Teuerung
· Quervergleich zu vergleichbaren Leistungen im Gesundheitswesen: Zu günstige Tarife schaffen unerwünschte Anreize. Aus finanziellen Gründen wird auf sinnvollere Lösungen verzichtet, z.B. ein notwendiger Heimeintritt aufgeschoben
· Der tiefe Grundtarif ist nur dank hohem Subventionsanteil möglich
· Mit der Erhöhung der frei gestaltbaren Tarife soll der subventionierte Anteil an den Kosten abgebaut werden.

Der Reinigungsdienst soll nur noch bei Bezügern weiterer Spitex-Leistungen angeboten werden. Übergangsbestimmungen sind vorgesehen. Der Reinigungsdienst ist nicht Kerngeschäft der Spitex, sondern ein begleitendes Angebot. Es bestehen alternative Angebote von Pro Senectute und Sprungbrett. Die Entwicklung soll deshalb in die Richtung kostendeckender Tarife gehen. Die Kundschaft wurde schriftlich durch den Geschäftsleiter über die Tariferhöhung informiert

6. Quervergleich (Benchmarking)

Unter Punkt 3, Kennzahlen, wird als Beilage der Vergleich Solothurn-Grenchen-Olten aufgeführt. Hier handelt es sich um einen Vergleich mit Gemeinwesen ähnlicher Grösse und städtischen Charakters. Auf Grund dieses Quervergleiches muss nüchtern festgestellt werden, dass die Leistungserbringung durch den Spitex-Verein Olten effizient erfolgt. Wir verweisen dazu auf die Beilage.

Nun gibt es in der Umgebung Oltens kleinere Gemeinwesen mit weniger städtischem Charakter, die Spitex-Dienstleistungen mit geringerem Subventionsanteil erbringen. In der politischen Diskussion ist wiederholt Trimbach erwähnt worden. Ein Vergleich der Leistungserbringung in Olten mit derjenigen in Trimbach ist aufschlussreich. Wir betrachten die Organisationen unter den Aspekten Aufgabe, Struktur und Kultur:

Aufgabe:
Die Spitex Trimbach erbringt mit 12'000 Einsatzstunden etwa die Hälfte der Leistungen des Spitex-Vereines Oltens. Die Leistungen werden sowohl in Trimbach als auch in Olten von Fachpersonal erbracht. Die Aufgaben sind in etwa dieselben.
Trimbach ist verkehrstechnisch gut erschlossen. Die durchschnittlichen Wegzeiten betragen maximal 5 Minuten. Die Mitarbeiterinnen des Spitex-Vereines Olten haben hingegen durchschnittliche Wegzeiten von 15 – 20 Minuten während und von 5 – 10 Minuten ausserhalb der Stosszeiten. Diese sind nach der verbindlichen Tarifordnung nicht verrechenbar. Löhne und Spesen für nicht verrechenbare Wegzeiten betragen in Olten Fr. 220'000. Sollte das Verkehrsproblem in Olten in Zukunft gelöst werden, hätte dies positive Auswirkungen auf die Kosten der Spitex. Umgekehrt wirkt sich das Verkehrsproblem auf die Leistungserbringung der Spitex in Form von mehr nicht verrechenbaren Stunden aus.
Der Spitex-Verein Olten bietet momentan 4 Personen Ausbildungsmöglichkeiten an. Die Spitex Trimbach hatte zusammen mit einem Heim einen Ausbildungsplatz. 2004 befindet sich jedoch keine Person in Ausbildung. Ausbildung ist mit Aufwand und nicht verrechenbaren Kosten verbunden. Der Spitex-Verein Olten budgetiert diesen Aufwand für das Jahr 2005 mit Fr. 62'520.
Die Spitex Trimbach budgetiert dieses Jahr Fr. 42'000 Gemeindesubvention, der Spitex-Verein Olten Fr. 470'000.
Struktur:
Der Vorstand der Spitex Trimbach übernimmt ehrenamtlich u.a. folgende Aufgaben: Qualitätsmanagement, Finanzen inklusive Abschluss, Budget, Lohnbuchhaltung, Controlling, Kundenumfragen, Bearbeitung von Kundenreklamationen. Der Vorstand rechnet damit, in Zukunft Mühe zu haben, Vorstandsmitglieder zu rekrutieren, die freiwillig operative Tätigkeiten ausüben werden. Im Spitex-Verein Olten ist ein Geschäftsführer angestellt.
In Trimbach genügt ein Team, in Olten sind zwei Teams im Einsatz. Entsprechend ist der Führungsaufwand etwas grösser.
Kultur:
Beide Leistungsanbieter legen Wert auf Teambildung, Identifikation mit der Arbeit und dem Arbeitgeber sowie auf die Qualität der erbrachten Leistungen.
Zusammenfassend lässt sich folgendes sagen: Spitex-Leistungen werden in einem Kontext erbracht. Dabei spielen die Grösse der Organisation, die damit verbundene Struktur, die verkehrsmässige Erschliessung der Umgebung aber auch die ehrenamtlich und ohne Entgelt erbrachte Leistung eine Rolle. Würde Trimbach die Leistungserbringung auf ein grösseres Gebiet erweitern, liesse sich der Verein nicht mehr ehrenamtlich führen und gingen die Vorteile (kurze Wegzeiten, schlanke Struktur) verloren. Somit wird Spitex Trimbach kaum als Zweitanbieter im Raum Olten mit günstigeren Angeboten auftreten. Umgekehrt könnte der Spitex-Verein Olten mit der bestehenden Struktur ohne grossen Mehraufwand im Führungsbereich ein weiteres Team beispielsweise für die Leistungerbringung in der Umgebung von Olten führen.

7. Erwägungen

Leitbild, überarbeiteter Leistungsauftrag und Kennzahlen liegen vor. Insbesondere besteht ein Vergleich mit Gemeinwesen vergleichbarer Grösse. Die Beschaffung umfassender Grundlagen ist im Rahmen des Projektes „Spitex- und Altersleitbild“ geplant, das die Sozialdirektion im Budget 2005 berücksichtigen will.

Der Spitex-Verein Olten hat seine Hausaufgaben erledigt: Der Bericht Schiess ist wie von Stadtrat und Parlament gewünscht mit Ausnahme des für 2005 geplanten RAI-Home Care umgesetzt. Die wenigen Freiräume in der Tarifgestaltung sind genutzt, Reinigungs- und Hauspflegetarife sozialverträglich erhöht worden.
Der überarbeitete Leistungsauftrag enthält die Möglichkeit, Maximalmengen an zu erbringenden Dienstleistungen zu definieren. Dabei sollte allerdings nicht zu weit vom tatsächlichen Bedarf abgewichen werden. Sonst würde sich das Problem stellen, wer unter welchen Bedingungen Spitex-Dienstleistungen beziehen darf und wer nicht. Eine solch heikle Frage sollte nur abgestützt auf umfassende Grundlagen behandelt werden, wie sie beispielsweise im Rahmen des Projektes „Spitex- und Altersleitbild“ erarbeitet werden können. Die Verantwortung für eine Mengenbeschränkung und die damit verbundenen Probleme darf nicht dem Leistungserbringer aufgebürdet werden sondern ist von den politischen Entscheidungsträgern zu tragen. Die Sozialdirektion empfiehlt deshalb, die im Finanzplan eingesetzten Beiträge zu übernehmen und den Nachtragskredit von Fr. 70'000 für die Budgetperiode 2004 zu genehmigen.

8. Stellungsnahmen

Leistungsauftrag und Leitbild wurden im Vorstand des Spitex-Vereines Olten diskutiert. Das Leitbild wird einstimmig begrüsst und unterstützt.

Die Kommission für Alters- und Gesundheitsfragen unterstützt den Bericht und Antrag. Sie nimmt das Leitbild und die Leistungsvereinbarung zustimmend zur Kenntnis.

9. Wirtschaftlichkeit

Die übergeordnet festgelegten Tarife sind nicht kostendeckend. Die Fehlbeträge werden auf Grund des geschätzten Dienstleistungsbedarfs hochgerechnet. Die Prognosen bis in das Jahr 2007 liegen diesem Bericht und Antrag bei. Die entsprechenden Beträge sind in den Finanzplan aufgenommen worden.

Beschlussesantrag:

I.

1. Vom Leitbild und vom Leistungsauftrag wird Kenntnis genommen.

2. Zu Gunsten Konto 400.365.09 wird ein Nachtragskredit von Fr. 70'000.- bewilligt.

3. Der Stadtrat wird mit dem Vollzug beauftragt.

II.

Ziff. I.2. dieses Beschlusses unterliegt dem fakultativen 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Tile size shows how often a word is used.","topics_all_time","All time","topics_last_4y","Last 4 years","topics_last_8y","Last 8 years","topics_from","topics_to","topics_speeches","speeches","topics_words","words (filtered)","topics_distinct","distinct words","topics_uses","uses","topics_alt","Treemap of the {count} most-used words, sized by how often each is used. {ctx}","topics_table_alt","Table of the {count} most-used words and how often each is used. {ctx}","topics_table_toggle","Show as table","topics_table_word","Word","topics_empty","No speeches with usable text in this period. Try widening the range.","loyalty_title","Party loyalty","loyalty_subtitle","Share of a member's votes cast against their group's majority line (higher = more independent). Abstentions count as a position.","loyalty_axis","Dissent rate: share of votes against own group","loyalty_dissent","dissent","loyalty_ballots","votes","loyalty_empty","No votes in this period meet the thresholds for a loyalty score. Widen the range.","loyalty_chart_alt","Beeswarm plot of the dissent rate of {count} members, one dot per member, coloured by party. {ctx}","loyalty_table_alt","Table of {count} members with their votes, dissents and dissent rate. {ctx}","loyalty_col_member","loyalty_col_party","loyalty_col_group","loyalty_col_ballots","loyalty_col_dissents","Against","loyalty_col_rate","Dissent","loyalty_from","loyalty_to","loyalty_scale","Scale","loyalty_scale_log","Log","loyalty_scale_linear","Linear","loyalty_filters","Filters","cohesion_title","Group cohesion","cohesion_hint","mean Agreement Index (1 = unanimous)","section_alignment","Voting alignment","no_alignment","Not enough shared votes to compare.","view_all_alignment","View full alignment","alignment_agreed_of_shared","agreed on {agreed} of {shared} shared votes","sort_agreement","Agreement","sort_shared","Shared votes","facet_min_shared","Min. shared","min_shared_10","≥ 10","min_shared_20","≥ 20","min_shared_50","≥ 50","min_shared_100","≥ 100","section_body_alignment","body_alignment_subtitle","How members of this chamber vote relative to one another, from the votes they have in common. In the map, members who vote alike sit close together and opponents far apart. Colours are parties, so blocs and coalitions show up as clusters. The grid gives the average agreement between each pair of parties (the diagonal is each party's own internal cohesion).","alignment_from","alignment_to","alignment_view","View","alignment_view_scatter","Map","alignment_view_heatmap","Party grid","alignment_empty","Not enough votes in this window to build the model.","alignment_window_note","Most meaningful within a single legislative period: the model compares members from the votes they have in common. If the window spans an election or a change in composition, members with different terms barely overlap and positions become less comparable.","alignment_no_parties","No party groups to compare in this window.","alignment_scatter_alt","Scatter plot of {count} members placed by how similarly they voted, coloured by party. {ctx}","alignment_pairs","pairs","alignment_heatmap_note","Each cell is the average agreement between members of the two parties (diagonal = a party's internal cohesion). ± is the 95% confidence range and n the number of member-pairs behind it. A small range over many pairs means the alignment is well-established; a wide range means it's only suggestive.","alignment_heatmap_alt","Grid of the average voting agreement between {count} parties. {ctx}","alignment_members_heading","Members","alignment_members_table_alt","Table of {count} members with their agreement with the chamber and with their own party. {ctx}","alignment_col_member","alignment_col_party","alignment_col_votes","alignment_col_chamber","Aligns with chamber","alignment_col_party_align","Within party","alignment_zoom_in","Zoom in","alignment_zoom_out","Zoom out","alignment_zoom_reset","Reset zoom","alignment_filters","section_lobby","Lobby network","lobby_subtitle","The organizations members of this chamber declare in their register of interests, and where those ties overlap. In the network, members are dots (coloured by party) and organizations shared by two or more members are squares. Members who share the same organizations pull together. The breakdown shows how many mandates are paid versus unpaid, and who holds the most.","lobby_empty","No declared interests for this chamber in this window.","lobby_no_shared","No organizations are shared by two or more members here. See the breakdown.","lobby_network_alt","Network graph of {members} members and the {orgs} organizations they share, linked by declared interests. {ctx}","lobby_mandates","mandates","lobby_members_tied","members","lobby_unknown","Unknown","lobby_org_node","Organization","lobby_payment_heading","Paid vs unpaid mandates","lobby_top_orgs","Most-shared organizations","lobby_top_members","Members by mandates","discussion_title","Speech profiles","discussion_intro","Where members sit on a latent axis derived purely from the words they use in their speeches (Wordfish scaling).","discussion_calculating","Scaling speeches…","lobby_calculating","Computing lobby network…","discussion_error","The speech scaling could not be computed.","discussion_converged","Model converged","discussion_not_converged","Model did not fully converge. Read positions with extra caution.","discussion_members_scored","Members scored","discussion_vocab","Vocabulary","discussion_window","Window","discussion_show_all","discussion_show_reliable","Reliable only","discussion_methodology","How this is computed","discussion_range_label","Time range","discussion_range_1y","1 year","discussion_range_2y","2 years","discussion_range_4y","4 years","discussion_range_8y","8 years","discussion_plot_alt","Beeswarm plot of {count} members placed along a word-choice axis, one dot per member. {ctx}","discussion_plot_caption","Each dot is one member, placed by the words they use in their speeches. Members who reach for the same distinctive words sit close together; members who talk very differently sit far apart. So a member's spot isn't assigned by us; it comes out of how they actually speak. For example, someone who keeps saying “tax”, “budget” and “spending” lands far from someone who mostly says “asylum”, “border” and “integration”. Hover any dot for its details. Filled dots have enough speech to place reliably; hollow rings spoke too little, so read their position with caution.","discussion_empty","No speeches are available for this parliament, so its members can't be placed on the axis. This scaling reads the words members actually speak, and the data set only holds speech transcripts for a few parliaments: the federal chambers and a handful of cantons such as Bern, Basel-Stadt or St. Gallen. You can also try a longer time range above.","discussion_empty_sparse","There is too little speech transcript text for this parliament to place its members on the axis. Try a longer time range above.","discussion_pole_a","One pole","discussion_pole_b","Other pole","discussion_col_party","discussion_key_filled","Enough text (reliable)","discussion_key_ring","Below the word floor (low confidence)","discussion_align_title","Does the axis track party?","discussion_align_hint","How much of the spread in positions is explained by party membership (η²): 100% = parties are perfectly separated, ~0% = party tells you nothing.","discussion_align_strong","parties are clearly separated","discussion_align_moderate","parties are partly separated","discussion_align_weak","party barely explains the axis","discussion_poles_title","What the axis is made of","discussion_poles_hint","The words that most pull members towards each pole. The axis only means something once you read these. Its direction is arbitrary.","discussion_no_party","No party","discussion_col_name","discussion_col_position","Position","discussion_col_words","Words","discussion_col_speeches","discussion_low_confidence","low confidence","discussion_table_title","discussion_table_alt","Table of {count} members with their position on the word-choice axis. {ctx}","discussion_read_title","How to read this","discussion_read_direction","The axis direction is arbitrary: Wordfish finds the split, not which side is “left” or “right”. Read the word poles to see what each side means.","discussion_read_uncertainty","Positions are standardized, so the spread is a convention, not a real distance. Wider error bars (and hollow dots) mean less certainty, so don't over-read those members.","discussion_read_confound","Speech style reflects role as much as ideology: committee chairs, ministers and frequent speakers can land at a pole because of what they do, not only what they believe.","organizations_title","organizations_none","No organizations.","org_members","org_mandates","org_bodies","org_members_heading","org_members_table_alt","Table of {count} members with their party, body, role, payment and period. {ctx}","org_no_members","No members.","org_col_member","org_col_party","org_col_body","org_col_role","org_col_payment","Payment","org_col_period","sort_members","sort_mandates","Mandates","interest_unknown","lobby_panel_person","Declared organizations","lobby_panel_org","Members with this mandate","lobby_table_heading","Who is tied to what","lobby_table_explain","The full matrix marks every member against every shared organization: one dot per declared tie, the exhaustive view of who is tied to what.","lobby_table_large","For this chamber that is","lobby_table_cells","cells","lobby_table_show","Show table","lobby_table_alt","Table marking each of {count} members against the {orgs} organizations they are tied to, one dot per declared tie. {ctx}","lobby_select_hint","Select a member or organization to see its ties.","lobby_filters","lobby_error","The lobby network could not be computed.","lobby_clear_selection","Clear selection","close","not_found_person","Person not found","not_found_body","Parliament not found","not_found_affair","Affair not found","not_found_group","Committee or group not found","not_found_voting","Voting not found","not_found_meeting","Meeting not found","not_found_interest","Interest not found","not_found_organization","Organization not found","not_found_text","Text not found","not_found_doc","Document not found","not_found_speech","Speech not found","not_found_hint","There is no entry with the ID {id}. It may have been removed, or the link may be outdated.","not_found_back","Back to the overview","about","About","faq","FAQ","section_title","section_title_bodies","section_title_affairs","section_title_votings","section_title_texts","section_title_docs","section_subtitle_search","section_subtitle_discussion",{"_1600":1601,"_1617":783,"_1618":1619,"_1620":1621,"_1622":970,"_1301":544,"_1275":343,"_103":548,"_1623":551,"_1606":353,"_1624":1625,"_1626":754,"_1408":303,"_99":313,"_1603":455,"_19":323,"_101":554,"_106":333,"_1627":1080,"_1628":1214,"_1629":1250,"_1630":1214,"_1631":1632,"_1633":1214,"_1634":1635,"_1636":544,"_1637":722,"_1638":1214,"_1639":1621,"_1640":548,"_1607":422,"_1641":1642,"_1213":1214,"_1643":660,"_1226":1214,"_97":559,"_1644":1436,"_1645":1293,"_1646":1331,"_1647":1625,"_1648":1420,"_1608":363,"_1649":1412,"_1650":1214},"section_switcher",{"_1598":1599,"_1600":1601,"_1602":303,"_95":499,"_99":313,"_1603":455,"_1604":389,"_1275":343,"_106":333,"_1605":323,"_1606":353,"_1607":422,"_1608":363,"_1609":1610,"_1611":1612,"_1613":1614,"_1615":1616},"section_title_speeches","section_title_groups","section_title_interests","section_title_meetings","section_title_organizations","label_section","Section","home","Home","people","affairs","groups","documents","interests","meetings","organizations","group_parliament","Actors","group_proceedings","Proceedings","group_records","Records","group_lobbying","Lobbying","search","eyebrow","Data on {{name}}","overview","Overview","personal_data","memberships","access_badges","Lobby","images","texts_overview","text_details","docs_overview","doc_details","votings_overview","Voting","voting_details","voting_diagram","Diagram","voting_tally","speeches_overview","speech_details","groups_overview","contributions","interests_overview","Interest","meetings_overview","vocabulary","loyalty","alignment","lobby","discussion","organizations_overview","org_details",{"_1708":1709,"_1710":1711,"_1652":1712,"_254":1713},"intro",{"_1654":1655,"_1656":1657,"_1658":1659,"_1660":1661,"_1662":1663,"_1664":1665,"_1666":1667},"en",{"_1668":1703,"_1670":1704,"_1672":1705,"_1674":1706,"_1676":1707},"de",{"_1668":1698,"_1670":1699,"_1672":1700,"_1674":1701,"_1676":1702},"fr",{"_1668":1693,"_1670":1694,"_1672":1695,"_1674":1696,"_1676":1697},"it",{"_1668":1688,"_1670":1689,"_1672":1690,"_1674":1691,"_1676":1692},"es",{"_1668":1683,"_1670":1684,"_1672":1685,"_1674":1686,"_1676":1687},"pt",{"_1668":1678,"_1670":1679,"_1672":1680,"_1674":1681,"_1676":1682},"rm",{"_1668":1669,"_1670":1671,"_1672":1673,"_1674":1675,"_1676":1677},"cookie","Nus duvrain mo cookies essenzials e funcziunals. Nagina analitica, nagin tracking.","dataLang","La Svizra ha quatter linguas naziunalas, e questas datas datti en pliras da quellas. Intgins records èn plurilings, auters mo en ina lingua. Vus pudais tscherner en tge lingua ch'il cuntegn vegn mussà; sche vossa tscherna n'è betg disponibla per in record, vegnan duvradas las autras linguas en in urden da prioritad fix. Quai è independent da la lingua da l'interfatscha. As lascha reglar sut Configuraziuns › Lingua dal cuntegn (sura a dretga).","alt","Questa pagina è era disponibla per rumantsch.","switch","Mussar per rumantsch","dismiss","Betg pli mussar","Utilizamos apenas cookies essenciais e funcionais. Sem análises, sem rastreio.","A Suíça tem quatro línguas nacionais, e estes dados existem em várias delas. Alguns registos estão em várias línguas, outros apenas numa. Pode escolher em que idioma os conteúdos são apresentados; quando a sua escolha não está disponível para um registo, as restantes línguas são usadas por uma ordem de prioridade fixa. Isto é independente do idioma da interface. Configure em Definições › Idioma dos conteúdos (canto superior direito).","Esta página também está disponível em português.","Ver em português","Não mostrar novamente","Solo utilizamos cookies esenciales y funcionales. Sin análisis, sin seguimiento.","Suiza tiene cuatro lenguas nacionales, y estos datos existen en varias de ellas. Algunos registros están en varias lenguas, otros en una sola. Puede elegir en qué idioma se muestra el contenido; cuando su elección no está disponible para un registro, se utilizan las demás lenguas en un orden de prioridad fijo. Esto es independiente del idioma de la interfaz. 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Certaines entrées sont en plusieurs langues, d'autres dans une seule. Vous pouvez choisir la langue d'affichage du contenu ; si votre choix n'est pas disponible pour une entrée, les autres langues sont utilisées selon un ordre de priorité défini. Ceci est indépendant de la langue de l'interface. Réglable dans Paramètres › Langue du contenu (en haut à droite).","Cette page est aussi disponible en français.","Voir en français","Ne plus afficher","Wir verwenden nur essenzielle, funktionale Cookies. Keine Analyse, kein Tracking.","Die Schweiz hat vier Landessprachen, und diese Daten liegen in mehreren davon vor. Manche Einträge sind mehrsprachig, andere nur in einer Sprache. Sie können wählen, in welcher Sprache die Inhalte angezeigt werden; ist Ihre Wahl für einen Eintrag nicht verfügbar, werden die übrigen Sprachen in einer festen Prioritätsreihenfolge verwendet. Dies ist unabhängig von der Oberflächensprache. Einstellbar unter Einstellungen › Inhaltssprache (oben rechts).","Diese Seite ist auch auf Deutsch verfügbar.","Auf Deutsch anzeigen","Nicht mehr anzeigen","We use only essential, functional cookies. No analytics, no tracking.","Switzerland has four national languages, and this data comes in several of them. Some records are in multiple languages, some in only one. You can choose which language the content is shown in; when your choice isn't available for a record, the remaining languages are used in a set priority order. This is independent of the interface language. Set it under Settings › Content language (top right).","This page is also available in English.","View in English","Don't show again","settings",{"_1776":1777,"_1778":1779,"_1780":1135,"_1781":1782,"_1783":1137,"_1784":1139,"_1785":1786,"_1787":1788,"_1789":1790,"_1791":1792,"_1793":1794,"_55":610,"_1795":1796,"_1797":1798,"_1799":1800,"_1801":1802,"_1803":1804},"nav",{"_1600":1722,"_1723":1724,"_1725":659,"_1726":1727,"_1728":1729,"_1609":1610,"_1611":1612,"_1613":1614,"_1615":1616,"_1602":303,"_95":499,"_1604":389,"_1603":455,"_99":313,"_1607":422,"_1275":343,"_106":333,"_1605":323,"_1606":353,"_1608":363,"_1730":1715,"_1731":1732,"_1578":1579,"_1733":1734,"_1580":1581,"_1735":1736,"_1737":1738,"_1739":1740,"_1741":1742,"_1743":1744,"_1745":1746,"_1747":1748,"_1749":1750,"_1751":1752,"_1753":1754,"_1755":1756,"_1757":1758,"_1759":1760,"_1761":1762,"_1763":1764,"_1765":1766,"_1767":1768,"_1769":1719,"_1770":1771,"_1772":1773,"_1774":1775},{"_1668":1703,"_1670":1704,"_1672":1705,"_1674":1706,"_1676":1707},{"_1714":1715,"_1716":1717,"_1718":1719,"_1720":1721},"project.title","Project","project.desc","About parlhub: what the portal is, answers to common questions, and how the data fits together.","experiments.title","Experiments","experiments.desc","Experimental analyses and methodology showcases on parlhub, including the Wordfish scaling of parliaments from their speeches.","parlhub home","skip_to_content","Skip to main content","explore","start","Start here","start_desc","Quicklinks to chambers, cantons and communes","project","project_desc","The project at a glance","about_desc","What parlhub is and who is behind it","faq_desc","Answers to common questions","sustainability","Sustainability","sustainability_desc","How parlhub is hosted and what it costs the planet","accessibility","Accessibility","accessibility_desc","What works, what doesn't, and how to report a barrier","traffic_stats","Traffic statistics","traffic_stats_desc","Which parts of the site get requested, and by whom","imprint","Imprint","imprint_desc","Who runs parlhub, contact, and the licenses","github","GitHub","github_desc","The project's source code on GitHub","data_guide","Data guide","data_guide_desc","Every kind of data, in plain terms, with examples","data_map","Data map","data_map_desc","How the data fits together, at a glance","methodology","Methodology","methodology_desc","How each figure is calculated, with links to the code","experiments","experiments_desc","Experimental analyses and methodology write-ups","wordfish","Wordfish scaling","wordfish_desc","Placing members on an axis by the words in their speeches","menu_label","Settings","appearance","Appearance","theme","theme_system","System","theme_light","theme_dark","font_size","Font size","font_size_decrease","Decrease font size","font_size_increase","Increase font size","high_contrast","High contrast","grayscale","Grayscale","interface_language","Interface","content_language","Content language","content_language_auto","Auto (follow interface)","content_language_note","Language of the displayed data (names, titles, texts). Independent of the interface; when a record isn't available, the next language is used.","content_language_priority","Priority",{"_1780":1806,"_1785":1807,"_1808":178,"_1809":161,"_1810":161,"_1811":178,"_1812":-5},"system",100,"show_cookie_consent_message","ui_high_contrast","ui_grayscale","msg_lang_hint","content_lang"]