Overview
- The royal decree operationalizes Law 3/2024 by extending 24-hour care and a monthly allowance nearing €10,000 to patients with irreversible, high‑complexity conditions beyond ALS.
- It defines four cumulative criteria for access: life expectancy under three years, lack of therapeutic response, continuous complex home care with support devices, and rapid negative progression shown by recent deterioration or repeated unplanned urgent admissions.
- An annex lists indicative conditions—progressive muscular atrophy, primary lateral sclerosis, transmissible spongiform encephalopathies, locked‑in syndrome from pontine stroke, and nonresponsive spinal muscular atrophy type I—while confirming eligibility is not diagnosis-based.
- The treating physician must complete a standardized questionnaire and issue a report within one month, authorities have up to three months for a nationwide-valid decision, and the decree takes effect 20 days after BOE publication.
- Funding creates a new III Plus dependence grade with up to about €9,868 per month for care, with €4,930 covered by the central government and the rest by regions; Galicia and patient groups decry restrictive thresholds and estimate limited access, while Andalusia unveils a separate subsidy of up to €14,000 per patient per year for an initial group.