to fund formal care and, in a number of Northern and Continental European countries, arrangements exist to at least partially fund informal care as well. Some countries have had publicly organized funding arrangements in place for many years: the Netherlands adopted the Exceptional Medical Expenses Act (ABWZ) in 1967, and in 1988 Norway established a framework for municipal payments to informal caregivers (in certain instances making them municipal employees). Other countries have only recently put in place comprehensive national programs: in 2004, for example, France set up a specific insurance fund for dependent older people and in 2006, Portugal created a public funded national network for long-term care. Some countries (Spain and Italy in Southern Europe, Poland and Hungary in Central Europe) have not yet established comprehensive national programs, relying on informal caregivers combined with a fragmented mix of formal services that varies in quality and by location. In the 1980s, some Nordic countries began making payments to informal caregivers, with Norway and Denmark allowing relatives and neighbors who were providing regular home care to become municipal employees, complete with regular pension benefits. In Finland, informal caregivers received a fixed fee from municipalities as well as pension payments. In the 1990s, a number of countries with social health insurance (Austria in 1994, Germany in 1996, Luxembourg in 1999) began providing a cash payment to service recipients, who could then use those funds to pay informal caregivers. In Germany, funding for long-term care is covered through a mandatory insurance scheme (or Pflegeversicherung), with contributions divided equally between the insured and their employers. The scheme covers the care needs of people who as a consequence of illness or disability are unable to live independently for a period of at least six months. Most beneficiaries stay at home (69%). The country's LTC fund may also make pension contributions if an informal caregiver works more than 14 hours per week. Major reform initiatives in health care systems in Europe are based, in part on an extension of user-directed services demonstrations and approvals in the US (e.g., Cash and counseling demonstrations and evaluations). Clare Ungerson, a professor of Social Policy, together with Susan Yeandle, Professor of Sociology, reported on the Cash for Care Demonstrations in Nation-States in Europe (Austria, France, Italy, Netherlands, England, Germany) with a comparative USA ("paradigm of home and community care"). In addition, direct payment schemes were developed and implemented in the