Overview
- ConELA’s mid‑June report shows six autonomous communities — Valencia, Basque Country, La Rioja, Catalonia, Castilla y León and Madrid — have approved Grado III+ cases and begun disbursing payments and services to beneficiaries.
- The Ley ELA and Real Decreto‑ley 11/2025 created a new Grado III+ within the Dependencia system and set a state reference maximum of about €9,850 per month for guaranteed 24‑hour home supports.
- Many families are refusing or delaying uptake because the sociosanitary classification makes the new aid incompatible with existing cash payments such as the complemento por gran invalidez, which can reduce their net income.
- Regional rules that allow large copayments, require families to advance costs or offer limited hourly options are making the law unaffordable in places such as Castilla‑La Mancha and the Balearic Islands, with reported family outlays ranging from roughly €1,500 to €4,000 a month.
- Political and clinical actors are pushing for fixes: Catalonia’s parliament unanimously asked Congress to reclassify ELA care as health care and secure minimum cash support, while neurologists and providers warn rising demand and high per‑patient costs (over €50,000 a year) require multidisciplinary units and stable funding.