The Republic Centre for Support of Persons with Intellectual Disability – PORAKA in cooperation with the European Association of Service Providers for Persons with Disabilities (EASPD), on 7th of June 2019 in Hotel Holiday In in Skopje, held a Forum of Service Providers for Persons with Disabilities on the topic: THE NEW CHALLENGES AND PERSPECTIVES IN SOCIAL SERVICES PROVISION FOR PERSONS WITH DISABILITIES.
The Forum was attended by relevant representatives from institutions working in the disability rights area and organizations providing services for persons with disabilities in our country, with presentations related to the current developments and challenges in the reform processes and social service delivery on local level.
Dr. Vasilka Dimoska, Secretary General of the Republic Centre – PORAKA, opened the forum, followed by welcoming speeches by Mr.Chedomir Trajkovski, President of the Republic Centre – PORAKA, Mr.Gjonul Bajraktar, Deputy-Minister of Labour and Social Policy, who presented the Ministry’s current policies referring to advancing the opportunities, services and standard of living for persons with disabilities and their families. Mr.James Crowe, President of EASPD, also welcomed the participants and wished them successful work.
The current developments in social services provision for persons with disabilities were presented by Mr.Vladimir Lazovski, representative of the Ministry of Labour and Social Policy. He presented the situation regarding deinstitutionalization on our country, the process which in the past year, as well as the following years, will be one of the key activities in the country.
In the further course of the Forum, the participants discussed the situation on the filed regarding the transition from institutional to community-based services for persons with disabilities. The key issues addressed by the participants were:
– Planning the future social services (type, scope, methodologies, target groups);
– Concerns in designing support services (personalised approach vs. small group homes);
– Challenges in implementation of transformation plans (ongoing and future);
– Coordination and provision of sustainability.
Presentations of the representatives from residential institutions were next on the agenda. Ms.Aleksandra Velkovska, Director of the Special Institute – Demir Kapija, Mr.Fatmir Ejupi, Director of the Institute for Rehabilitation of Children and Youth – Topansko Pole, and Ms.Stojanka Izova, Director of the Institute for protection and Rehabilitation – Banja Bansko. They presented the transformation plans of the institutions they manage, as well as the challenges they face in the implementation of these plans.
The President of EASPD, Mr.James Crowe, shared the European experiences regarding the transition from institutional to community-based care for persons with disabilities. He underlined that according to the lessons learned from the experiences of certain EU countries, the cash spent on institutional services gives NO meaningful benefit. We should seek co-production with persons with disabilities to build better services and to move away from a “one size fits all” approach. To form a spectrum of community-based services and put person centred planning at the heart of all service planning. Also, to install Quality Assurance mechanisms. The recommendations arising from past experiences are as follows, providing sufficient resources to ensure services are available, accessible, affordable and acceptable for persons with disabilities. To strengthen the national and municipal capacity to implement deinstitutionalization with comprehensive planning approach, to create wide range of decentralized support services and create monitoring arrangements of all processes.
The forum continued with discussion regarding the current trends and perspectives in social services provision for persons with disabilities and the perspectives of the non-governmental sector. The following key issues prevailed in the discussion:
– Sustainability of the existing support services;
– Developing a network of different types of support services;
– Reform of the social protection system – personalized services and personalized budgets;
– Development of regulatory mechanisms (gate keeping procedures, quality standards, accreditation and licensing, procedures for evaluation and monitoring, financing) in the services delivery process;
– Establishing partnership between service providers from the civil sector and the Government – equal treatment for all service providers.
– Decentralisation.
The discussion of the participants imposed several recommendations that should be addressed with the aim of the deinstitutionalization process and the social service provision for persons with disabilities in the community:
• Develop and plan the implementation of the transition from institutional to community-based care, especially in the field of support services that would provide for independent living for persons with disability.
• Following the human rights approach while creating community-based support services for persons with disabilities.
• Personalised services, such as personal assistance or home assistance, should be available to anyone who needs such an assistance.
• The State should provide adequate human, financial and technical resources for full implementation of deinstitutionalisation, especially for implementation of the transition towards independent living, to allocate sufficient resources, to provide personal assistance and to ensure that community-based services are available, accessible, acceptable and with high quality, in order to provide for persons with disability to practice their right to live independently and to be included in the community.
We present the introductory speech of the President of the Republic Centre – PORAKA, Chedomir Trajkovski.
Respected Mr.Bajraktar, Deputy-Minister of Labour and Social Policy, respected Mr.James Crow, President of the European Association of Service Providers for Persons with Disabilities, respected representatives of relevant institutions involved in the disability rights area, respected parents and representatives of the civil sector.
It is a great honour to open this Forum, on a topic that is current especially on this period of reforms in our country. The deinstitutionalisation process began in 2000 for the first time, with direct commitment of the current minister at that time. It started with great enthusiasm, and to us as parents’ organization it represented a sign that the state would begin to work on opening alternative community-based services for persons with disability, as a replacement of the residential institutions.
The Special Institute in Demir Kapija stopped admitting new persons, but new services did not open with the needed intensity and again the entire burden fell on the families of persons with disabilities.
I believe you all know, and it has been noted by the Ombudsman as well, that the living conditions in these institutions are very poor.
Finally, it is visible that everybody in the state has a firm determination to deal with this decade’s problem and to take down the shame that we carry as a society because of the injustice that we have been doing to these innocent people for years.
The new Strategy for Deinstitutionalization 2018-2027, that has been adopted last year, foresees total transformation of these institutions in the near 2025. The first good news is that there aren’t any persons younger than 18 in the institutions. The activities are directed towards resettling persons younger than 26 from residential institutions, and by the end of 2025 the institutions should be completely closed.
I am positive that it will happen! I would like to emphasize that there is no longer room for questions such as, whether we can, but when and how to do it best.
We will look for answers to these and other questions, during these and similar forums and other types of cooperation, in order to implement the reform in the right direction. If we all work together as partners, the state and its institutions, and we as a civil sector together with our friends and supporters from the EU countries, I believe that the success is inevitable. But I must remind you that the wish for prompt resolution of the problem must not retreat in a direction of any improvisation which would mean going back and therefore we must be very careful.
Having in mind the previous experience in this process, I will emphasize several concerns:
• There is a huge concern regarding the implementation of transition from institutional to community-based care, especially in the field of support services that should provide for independent living for persons with disabilities.
• Despite the obvious lack of support services in the community, the existing services not always follow the human rights approach.
• The personalised services such as personal assistance, are lacking or are in initial pilot phase.
• Lack of adequate human and technical resources for implementation of the transition towards independent living, resources to provide personal assistance and to ensure that community-based services are available, accessible, acceptable and with high quality, in order to provide for persons with disabilities to practice their right to live independently and to be included in the community.
