Pará State to Recover SUS Costs from Domestic Violence Perpetrators
The Brazilian state of Pará has implemented a new measure requiring perpetrators of domestic and family violence to reimburse the state for the costs incurred by the Unified Health System (SUS) in treating victims. This policy, established by State Decree nº 5.507, is now in effect and mandates full reimbursement for consultations, exams, medications, hospitalizations, and other procedures provided in state health facilities. The collected funds will be directed to the State Health Fund (FES) and will be calculated based on official SUS pricing. The formal identification of the aggressor, supported by Civil Police reports or judicial decisions, will trigger this reimbursement process. The decree clarifies that this financial recovery is a patrimonial measure and does not replace criminal liability or other legal sanctions. Crucially, the state assures that victim care will not be delayed or restricted due to this reimbursement procedure, and victim contact information will be protected. The decree applies only to incidents and treatments occurring after its publication on Monday, June 6th, and is not retroactive. In 2025, Pará recorded an average of 28 daily cases of violence against women, with 1,655 reports made to the Ligue 180 helpline between January and July, leading to 6,072 recorded incidents of various forms of violence. During the same period, the state registered 31 feminicides.
This state decree introduces a novel mechanism for cost recovery within the public health system, directly linking the financial burden of domestic violence treatment to the perpetrators. By establishing a patrimonial claim against aggressors, the policy aims to alleviate pressure on the SUS budget while potentially serving as an additional deterrent. However, the effectiveness of this measure will depend on robust identification and enforcement processes, ensuring that the administrative recovery does not impede timely victim care or compromise their safety. The long-term impact may also involve shifts in how legal systems integrate financial accountability with criminal justice for domestic violence cases, particularly in regions with high incidence rates like Pará, where 31 feminicides were recorded in the first seven months of 2025. This approach could influence future public health funding models and domestic violence intervention strategies across Brazil.
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