MIAMI, United States. – The Council of Ministers of Cuba authorized non-state economic actors to provide care services to older adults and people “in a situation of disability,” according to the Agreement 10249/2025published in the Official Gazette No. 23 (ordinary edition).
The norm provides that these services function as a complement to the state network (grandparents’ homes, nursing homes and similar centers), and imposes on new providers the obligation to reserve “at least 10%” of their capacities for vulnerable people considered “of social interest”, with rates comparable to those of certified state institutions and the possibility that the Social Assistance assume payments when there is proven insolvency.
The agreement indicates that the decision responds to the “accelerated aging process of the Cuban population” and the need to “expand the scope of social care services,” which is why “it is necessary to authorize the provision of such services by non-state economic actors.”
In its foundation, the text links the measure with the Decree 109 “National system for comprehensive life care”to which it attributes objectives such as “contributing to the redistribution of care among the different social and economic actors” and “promoting the autonomy and well-being of people who require temporary or permanent care.”
The authorization is specified in the first point of the agreement: “Authorize the provision by non-state economic actors of care services to older adults or people with disabilities, hereinafter, the beneficiaries.” To operate, interested parties must obtain approval “according to current legislation” applicable to the type of non-state actor and, in addition, present the endorsement of the Municipal Director General of Health, which certifies compliance with requirements “in accordance with what is regulated by the Ministry of Public Health”.
The approved framework defines three types of provision: “day care homes”, “permanent care homes” and a mixed modality of “day and permanent care homes”. The text emphasizes that these services “are distinguished” from existing state services (grandparents’ homes, nursing homes and centers for people with disabilities, “or other similar”), but at the same time presents them as part of a logic of institutional complementarity.
The most sensitive point of the design—due to its social and budgetary implications—is the mandatory reservation of capacities for vulnerable cases. The norm orders that the owners “offer at least 10% of the capacities authorized to grant to people of social interest, due to their vulnerable status.” For these beneficiaries, “the rate established by the Minister of Finance and Prices for state-certified grandparents’ homes and nursing homes” will be paid and, “in case of guaranteed economic insolvency,” the “total or partial” payment will be made by Social Assistance.
The agreement also requires that, if the provider decides to close and has those capacities occupied, it must notify the territory’s Health “no less than 30 days” so that social protection measures can be adopted.
The standard assigns the MINSAP a central role of regulation and control: it must “establish the requirements” of the residences, “guarantee medical and dental care” and “develop and control training and accreditation” through “schools for caregivers.” In addition, it must establish the “procedure for collection” of the mandatory course and “grant health licenses” for the premises.
In parallel, the Ministry of Finance and Prices is responsible for approving the course fee and for “evaluating and proposing tax benefits or other economic incentives” to stimulate these services, including bonuses linked to “the number of people of social interest” that the owner undertakes to serve, at the proposal of the municipal directorates of Work and Social Security.
The agreement also tasks governors and mayors with the active promotion of this type of services: identifying interested parties through calls, evaluating self-employed workers who already carry out similar activities, identifying properties with conditions and putting them out to tender for this purpose, and “facilitating the acquisition of necessary goods and supplies” for the provision. In a special provision, in addition, “the exemption from payment of the lease of the state premises” where the service is provided is established for “a period of two years, extendable up to three” if the economic situation requires it, and then it is planned to evaluate whether the premises are charged or delivered in usufruct.
Although the Government presents the opening as a mechanism to expand coverage and “favor social co-responsibility”, the text itself reveals underlying tensions: on the one hand, the expansion relies on incentives (including the exemption from rent) and the mobilization of material resources for non-state actors; On the other hand, part of the “social interest” scheme can transfer costs to the public budget through Social Assistance when the beneficiary cannot pay, while the State maintains health, training and tariff control over an activity that enables private individuals. The rule establishes that it will come into force “from 30 days after its publication” in the Gazette.
