Situation of Disabled People in Lithuania: Possibilities and Problems Lithuanian Association of People with Disabilities Ms Rasa Kavaliauskaitė, President Ms Ginta Žemaitaitytė, Vice-president Ms Jurgita Masiulionytė, Projects coordinator Regional North-East seminar Disability Rights and Reality October 2010, Vilnius

Disability Statistics In Lithuania, 7% of all residents are disabled. According to the Ministry of Social Security and Labour, in 2009, there were about 269 thousand disabled people receiving work incapacity pensions or benefits: –the majority of disabled, thousand (59.3 %), are people with established % capacity for work –34.7 thousand (12.9 %) people have the most severe form of disability –58.8 thousand (21,9 %) people have 45-55% capacity for work –Almost 16 thousand (5.9 %) are disabled children

Social Integration System for the Disabled The social integration system for the disabled consists of the following: Provision of medical services, Provision of vocational and social rehabilitation services, Meeting special needs with the help of the special assistive aids, Supporting the employment of the disabled, Provision of social support, Appropriation and payment of pensions and benefits from the State Social Insurance Fund Appropriation and payment of benefits from the Compulsory Health Insurance Fund, Provision of education services, Ensuring equal opportunities to participate in cultural events, sports, and other areas of social life.

Funding Social integration system for the disabled is funded by: State Budget, Municipal budgets, State Social Insurance Fund, Compulsory Health Insurance Fund, Employment Fund, EU structural funds, Other legally acquired funds.

Each person with established disability or vocational incapacity for work higher than 65 % is entitled to work incapacity pension or social assistance pension. Since 1 April 2004, three disability levels were set for children under 18 (with the exception of those covered the State Social Insurance): severe, moderate, and mild. Since 1 July 2005, the level of vocational incapacity for work for adults and persons under 18 if they are/were covered by the State Social Insurance, is established by taking into consideration medical, functional, professional, and other criteria aiming to assess the person’s capacity for work and employability. Lost capacity for work is expressed in percentage up to 100 %: –Complete incapacity for work is from 75 to 100 %; –Severe incapacity for work is from 60 to 70 %; –Partial incapacity for work is from 45 to 55 %.

Benefits for Children in 2009 children with disability Social assistance pension (15.8 thousand) severe – LTL 720 per month moderate– LTL 540 per month mild – LTL 360 per month Compensation of nursing expenses (1.3 thousand) Severe disability – LTL 765 per month Compensation of care (assistance) expenses (7.2 thousand) Severe - LTL306 per month Moderate - LTL153 per month

Possible financial benefits for adults with disability State social insurance pension Social assistance pension Target compensation for nursing expenses Target compensation for attendance (assistance) exp. Compensation for car purchasing and technical adjustment expenses Compensation for transportation expenses Special need has to be established for the disabled

Social assistance pension (23.8 thousand beneficiaries in 2009) Under 24 years old Over 24 years old Loss of % capacity for work – LTL 360 per month Loss of 60-70% capacity for work – LTL 324 per month For parents who nursed disabled children for over 15 years Loss of % capacity for work – LTL 540 per month Loss of 60-70% capacity for work and old- age pensioners – LTL 360 per month Loss of % capacity for work – LTL720 per month Loss of 60-70% capacity for work – LTL540 per month Loss of 45-55% capacity for work – LTL270 per month

Target compensation for nursing expenses People with severe disability LTL 765 monthly Target compensation for attendance (assistance) expenses Loss of % capacity for work Loss of 60-70% capacity for work Old-age pensioners LTL 306 monthly LTL 153 monthly Special needsEntitled to the benefit: Amount of the benefit Beneficiaries, thousands Number of beneficiaries increased by 1.5 times

Technical Aids Technical aids are given and repaired for free (for children, disabled with incapacity for work and disabled of group I); for other disabled it costs up to LTL Expenses for electrical wheelchairs are compensated once in 8 years – 95% of the price for electrical wheelchair. Repair – 80% of repair and battery change expenses are compensated. A person is entitled to a compensation for active wheelchair cost once in 4 years, but not more than LTL August 2005 Order No. A1-238, issued by the Minister of Social Security and Labour on the Approval of Procedure for Provision of Aids to the Disabled and for Compensation of Costs.

Provision of Technical Aids for the Disabled Technical aids in total Electrical wheelchair Other wheelchairs Wheelchair accessories Transport means (crawling aid and moving panel) 6125 Tri-walker Walking aid for one hand Walking aid for both hands Walking aid accessories Toileting Aids for washing and bathing in bath and shower Furniture for sitting Table Anti-decubitus system Motion, power, and equilibrium training system Movement aid System helping perform and/or replacing functions of a hand and/or palm and/or finger Other aids (for putting on socks, cutlery, stairs, etc.) Source: Centre of Technical Aid for Disabled People

Orthopedic Equipment and Prothesis The whole price of the basic orthopedic equipment is compensated. 31 March 2006 Order No. V-234, issued by the Minister of Health on the Approval of Organisation Procedure for State Support for Purchasing Technical Orthopedic Equipment The lowest price of the relevant group endoprothese, purchased during the period of surgery is compensated by the National Health Insurance Fund (NHIF). 28 September 1999 Order No.3/4, issued by the Compulsory Health Insurance Board on the Procedure for Compensation the Joint Endoprotheses Purchasing Expenses

Home Adjustment Municipalities spend 80% of the state budget and 20% of the municipal budget revenue for people with very severe and severe movement and self-servicing impairment for adjusting their homes. Municipalities spend 50% of the state budget and 50% of the municipal budget revenue for people with moderate movement and self-servicing impairment for adjusting their homes. 28 June 2006 Resolution No.638 issued by the Government of the Republic of Lithuania on the Approval of the Programme on Home Adjustment for the Disabled

Programme on Home Adjustment for the Disabled In 2009, the Programme was implemented by 57 cities and district municipalities. 262 homes were adjusted, including 154 homes for people with very severe movement and self-servicing impairments, 99 homes for people with severe movement and self-servicing impairments and 9 homes for people with moderate movement and self-servicing impairments. Within the total number of adjusted homes, 26 were for the disabled children and young people, 26 were for disabled students, and 3 homes were for working disabled. The adjustment of homes included 57 pcs of expensive equipment (hoists or lifts). The majority of homes were adjusted in the municipalities of Vilniaus (21 homes), Kaunas (15), Visaginas (16), Biržai (11), Plungė (9) and Šakiai (9). In 2009, under the Programme, LTL thousand (LTL thousand from the state budget and LTL thousand from municipal budget) was spent.

Accommodation (1) State support for purchasing home and for adjusting it for the needs of the disabled is provided for: –People with established severe or moderate level of disability; –Families where a family member has established severe or moderate level of disability. Law on State Support for Purchasing or Renting Housing and for Modernisation of the Blocks-of-flats (Article 4) Families with a disabled child, which received loans under privileged conditions before 31 December 2002 and families with disabled child after 01 January 2003 have 20 % of the provided loan residue covered. Law on Implementation of State Support for Purchasing or Renting Housing (Article 2-1)

Accommodation(2) A family with disabled child which resides in a home rented by municipality with the floor space less than 10 square meters or 14 square meters per family member is entitled to improved social housing (Article 8 and 9). A family with disabled child and entitled to social housing is included into the list based on the date of application registration in municipality. The list contains families with disabled child. Law on Provision Housing to Residents

Special Cars and Compensation for Transportation Costs Disabled with impaired movement are entitled to a compensation amounting to 32 minimum monthly wages (LTL 4000) for purchasing special car and making technical adjustments, if the disabled can drive the car. A person with disability can benefit from this privilege once in 6 years. People with disability with impaired movement are entitled to a monthly compensation for transportation expenses; the compensation amounts to 0.25 of the minimum monthly wages (LTL 32.50). Law on Transport Privileges

Education Financial assistance for disabled students: 1) 50 % of the basic pension paid by the State Social Insurance (LTL 180) for meeting special needs – monthly targeted benefits; 2) amount equal to 3.2 of the minimum monthly wages, set by the Government of the Republic of Lithuania (LTL 400) for students, studying in partially state funded or not funded places - monthly targeted benefits Resolution issued by the Government of the Republic of Lithuania on the Approval of the Description of Procedure for Supporting the Disabled Students at Higher Schools Persons with special needs are supplied with educational assistive technology in educational institutions and at home. Law on Special Education (Article 25)

Growth of the Number of Disabled Students In the academic year of , as many as 1026 disabled students studied at Lithuanian universities. Since 2005, the number of students at universities and colleges doubled. During the first quarter of 2010, the Department of Disabled Affairs under the Ministry of Social Security and Labour received applications for financial assistance from 36 higher schools (26 state and 10 non state higher schools). During the above period, 864 disabled students received support (in total LTL thousand absorbed): –864 disabled students received benefits for meeting their special needs (LTL thousand absorbed), –333 students received target benefits for partial coverage of study related expenses (LTL thousand absorbed).

Vocational Rehabilitation The Law on Social Integration of the Disabled defines vocational rehabilitation as restoration of person’s capacity for work, professional competence and ability to participate in the labour market or enhancement through educational, social, psychological, rehabilitation or other measures. Vocational rehabilitation services: –Professional counselling –Consulting –Assessment and restoration of professional skills or development of new skills –Requalification

Stages of Vocational Rehabilitation: 1)Disability and Working Capacity Assessment Office determines personal need for vocational rehabilitation services; 2)A person needs a conclusion on the vocational rehabilitation needs, issued by the Office to the Territorial Labour Exchange Office of the place of residence. 3)The Territorial Labour Exchange Office issues a licence to attend vocational rehabilitation establishment where a person will undergo vocational rehabilitation based on a personal plan. A disabled person will be paid vocational rehabilitation benefit of LTL April 2005 Resolution No.413 issued by the Government of the Republic of Lithuania on the Approval of Regulations for Provision of Vocational Rehabilitation Benefit and Payment. 4)Upon completion of vocational rehabilitation programme, the person returns to Disability and Working Capacity Assessment Office were the final assessment of the capacity for work is established. The average duration of vocational rehabilitation is 5.4 months.

Vocational Rehabilitation In 2008, the services of vocational rehabilitation were provided by 9 companies which offered to the disabled vocational training under 139 programmes. In 2008, LTL 12.9 million was spent on vocational rehabilitation programme, various services and benefits related to the implementation of this programme.

Employment of Disabled The main pieces of legislation, regulating the employment of the disabled in the Republic of Lithuania: Constitution, 1992 Labour Code, 2000 Law on Equal Opportunities, 2003 Law on Social Integration of the Disabled, 1991, 2004 Law on Social Services, 2006 Law on Support for Employment, 2006 Law on Social Enterprises, 2004

Labour Market Statistics As little as 15% (28–29 thousand) of the disabled take part in the labour market including 5% of those with the status of unemployed; Out of all registered unemployed as little as 2 % of the disabled found a job. Only 10.5% of potentially capable for work disabled had a job in 2009, according to Lithuanian Labour Exchange. In 2010, in Lithuania there were 107 social enterprises. There are over 70 social companies for the disabled. About 3600 people work in the social companies, including 1850 people with different disabilities.

LAW ON SUPPORT FOR EMPLOYMENT Subsidised Employment Target GroupRemuneration compensation percentage CompensationDuration 0-25 % capacity for work or severe disability 75 % from the calculated amount 2 minimum monthly wages (LTL 1600 ) During the entire term of employment % capacity for work or moderate disability 60 % from the calculated amount % capacity for work or mild disability 50 % from the calculated amount Up to 12 months

LAW ON SUPPORT FOR EMPLOYMENT subsidies for job creation Subsidies for job creation – irreclaimable funds for creating jobs or adjusting work places; without such funding the workplaces could not be created. Subsidy for job creation is provided for compensation costs of: work tools and technical aids, necessary for the functionality of the workplace, ensured through purchasing, assembling or adjusting; training when professional qualification or competence is needed for the created job and when such training is not provided by the Labour Exchange; Renovation and adjustment of owned premises when a work place has to be set up (50 % of the subsidy amount) Insurance of long-term tangible assets funded from the subsidy.

LAW ON SUPPORT FOR EMPLOYMENT Support for job creation Political tool for active labour market Subsidy beneficiaries Amount of reimbursement Target group for which job is created/work place is adjusted Own contribution Subsidies for job creation Employers, who are creating jobs/adjusting work places to the disability of the unemployed 40 minimum monthly wages (LTL 32000) The disabled with established % capacity for work or severe disability 20% The disabled with established % capacity for work or moderate disability 30% The disabled with established % capacity for work or mild disability 35% Support for entrepreneurship Disabled with established 0-40 % capacity for work or severe to moderate level of disability who are creating jobs for themselves The disabled with established up to 40 % capacity for work or severe to mild disability 0 %

LAW ON SUPPORT FOR EMPLOYMENT LAW ON SOCIAL ENTERPRISES LawState support Law on Support for EmploymentFor the disabled of working age Law on Social Enterprises For the disabled of working age and old age

LAW ON SOCIAL ENTERPRISES Types of State Aid Provided to a Social Enterprise : –partial compensation for wages and state social insurance contributions; –subsidy for the creation of workplaces, adaptation of workplaces to disabled employees and acquisition or adaptation of their work equipment; –subsidy for training the employees who are attributed to the target groups. Besides the above mentioned state aid, a social enterprise of the disabled may be allocated additional state aid for the following purposes: –Subsidy for the adaptation of work environment, production premises and recreation rooms to disabled employees; –Subsidy for the reimbursement of additional administrative and transport expenses; –Subsidy for the reimbursement of expenses on an assistant (sign language interpreter).

LAW ON SOCIAL ENTERPRISES partial reimbursement of wages and state social insurance contributions Target Group Remuneration compensation percentage Amount compensated Duration 0-25 % capacity for work or severe disability or high level of special needs 80 % from the calculated amount 2 minimum monthly wages (LTL 1600) During the entire term of employment Up to 12 months % capacity for work or moderate disability or moderate level of special needs 70 % from the calculated amount % capacity for work or mild disability or low level of special needs 60 % from the calculated amount