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Closing healthcare gap

The first congress of medical centers for adults with disabilities had its focus on urgently required healthcare for disabled persons. So-called MZEBs might be the answer.

he first congress of medical centers for adults with disabilities was staged in Rummelsberg near Nuremberg on March 1 and 2 of this year. Actually an unobtrusive designation, which somewhat conceals the significance of this matter. That this congress had its premiere only this year is owed to the fact that the first so-called MZEBs (medical treatment centers for adults suffering from mental disability or severe multiple disabilities) were installed only after German lawmakers in 2015 passed a bill on improving medical care. Prior to that date, healthcare for adults with severe disabilities had been absolutely inadequate.

"Persons with complex impairments require complex medical care meeting their very specific health requirements," said congress chairman Dr. Martin Winterholler. "But while children and adolescents up to age 18 are given this healthcare in specialized socio-pediatric centers, adults needing such care in Germany must usually turn to general practitioners for medical support." And that is not at all easy for either side, because these treatments frequently require a high degree of specialization – as mentally disabled persons can often not accurately describe the symptoms of their illness – and a great deal of time as well.

Enactment of §119c SGB V finally provided the legal basis for establishing these MZEBs. Passing this bill also marked the occasion for founding the federal association of medical centers for adults with disabilities (BAG-MZEB), which is designated to drive the process of establishing, promoting, conceptually advancing and integrating the MZEBs into regional healthcare structures. The BAG-MZEB hosted the congress jointly with the German society for healthcare to persons suffering from mental disability (DGMGB).

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The first congress of medical centers for adults with disabilities: A significant event.

"New medical centers for persons suffering from multiple or mental disabilities are currently opening at a rate of almost one per month," Winterholler told the approximately 300 attendees in his welcome address. "But the MZEB program is yet only in its starting phase." He pointed out that this successful development is the result of the decades of hard work put in by many dedicated colleagues and experts in the DGMGB, the trade associations active in care for persons with disabilities and other organizations, who had consistently advocated the need for specialized healthcare for persons with severe disabilities.

"These new centers are a challenge on all of us, and they offer good prospects as well: this is the first time in Germany that a multi-disciplinary approach will allow us to provide improved diagnostics and treatment for persons with disabilities on a larger scale irrespective of their particular living arrangements," said Winterholler. "This congress is aimed at covering the spectrum from more technical scientific issues over organizations concerns all the way to design and operation of the new centers."

The organization of these new treatment centers was accordingly one of the main congress topics. A series of lectures was dedicated specifically to the structures of these MZEBs with the presentation themes including transdisciplinarity, teambuilding and conflict management, and there were workshops on "Expeditions to unchartered territories". Other keynotes and workshops were titled "Communication with persons suffering from severe mental disabilities" and "Down-Syndrome in adulthood: guidelines for therapies", just to name a few.

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The social evening was staged at the Germanisches Nationalmuseum in nearby Nuremberg.


Intercongress GmbH is one of the leading Professional Congress Organisers (PCO) in Germany. The company specialises in medical and scientific congresses since 1992 with offices in Berlin, Düsseldorf, Freiburg and Wiesbaden. Intercongress supports and organises some 50 congresses a year with up to 12,000 participants per congress.

"Of course the congress is also a platform for presenting new scientific findings or the products of research programs," said Winterholler. "However, we are primarily anticipating to fundamentally strengthen medical care for persons with mental disabilities, increase public awareness and as a consequence to establish more of these centers."

Congress chairman Winterholler is head physician of the neurological department at the Rummelsberg hospital, where an MZEB was opened on March 5 of this year. "With this §119c SGB V, we finally have a legal basis upon which to establish these MZEBs being opened all over Germany. We are delighted that one of these centers has been set up here in Rummelsberg.“ The hospital is also one of the congress venues. The lecture hall is situated in the adjacent vocational training facility; both venues are barrier- free. "That was of course one of our major concerns in preparing for this event," said Winterholler. The interdisciplinary approach of this event includes all those working or scheduled to work at the new centers, irrespective of their particular profession: therapists, physicians as well as MZEB organizational and administrational staff.

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Congress chairman Winterholler: “Important event for the persons in our focus!”

From Winterholler's point of view, his hospital is ideally suited for hosting the first congress on this topic: "Rummelsberg benefits from decades of experience in medical treatment and support of persons with disabilities." The venue has all facilities required for an interdisciplinary approach: a diaconal institution, a vocational training facility, a support center, a workshop for persons with disabilities (WfbM), facilities for persons suffering from mental or physical disabilities as well as an orthopedic and a neurological clinic. The social evening was staged at the Germanisches Nationalmuseum in nearby Nuremberg. The congress chairman considered this another matching puzzle piece: "Nuremberg once took pride in being known as the city of Nazi party rallies, and the infamous Doctors' Trails were held here, while in our times Nuremberg has progressed to a City of Human Rights, making it just the right place for commemoration and a new beginning."

This congress was supported by Intercongress. "Owing to the fact that hospitals and vocational training facilities are not your standard congress venues, organization was in fact a bit of a challenge. We needed to input a lot of coordination effort," is how Alisa Ganter with the Freiburg PCO (Professional Congress Organizer) summed up her impression of the congress. In context with planning and coordinating the congress, she had to interact a lot with trainees at the Berufsbildungswerk Rummelsberg. These are youths and adolescents with disabilities, impairments, learning disabilities or psychic disorders. The trainees were also involved in activities at the congress events, for example in technical support, and that opened up entirely new dimensions for Ganter. "Our colleagues were extremely helpful and committed to their work. It was really remarkable how likeable and grateful these people were in interacting with us. I will certainly keep these impressions in very fond memory."

Dr. Winterholler is certain to appreciate these considerations, as increasing awareness is one of the primary purposes of this congress . "I personally was delighted with the response and the quality of visitors," he confirmed. "As a matter of fact, attendance reflected the `Who is Who´ of all those concerned with healthcare for persons with disabilities in Germany. And that's why this event is so important to us as clinic, for work in the associations and not the least also for the persons in our focus."  CHRISTIAN FUNK