DEINSTITUTIONALISATION IN LATVIA EXPERIENCES AND NATIONAL STRATEGY Tallin

General information on Latvia 2 Capital Riga State’s governing body members Parliament,100 Area 64,589 sq.km Population (urban: 68%, rural: 32%) Administrative units 5 regions, 9 republican cities, 110 local authorities

Responsibilities of the National and Local Governments in Social Service Provision 3 Local governments should ensure: operation of Municipal Social Service, providing at least 1 social work specialist per 1000 inhabitants assessment of the living conditions and needs of the person seeking support possibility to receive social services and social assistance corresponding to ones needs funding for social services and social assistance not granted by the state National government finances and ensures particular services defined in the Law on Social Services and Social Assistance

Social Services by Source of Funding NATIONAL BUDGET: Technical aids Vocational rehabilitation Particular social rehabilitation services for addicts, victims of violence or human trafficking, etc. Assistants for persons with functional impairments Long-term care institutions for: – orphans and children left without parental care until 2 years of age – children with functional impairments up to 4 years of age – children with mental disabilities up to 18 years of age – Adults with mental disabilities and visual impairments co-finances establishment of group homes, half-way homes and day care centres for persons with mental disabilities MUNICIPAL BUDGET: Community-based services according to the needs of the inhabitants Long-term care institutions for: – orphans and children left without parental care after age of 2 – persons with disabilities except mental disabilities – old-age persons 4

Guidelines on Development of Social Services DEINSTITUTIO NALISATION COMMUNITY- BASED SOCIAL SERVICES EFFICIENT SOCIAL SERVICE MANAGEMENT Approved by the government on MAIN DIRECTIONS:

The main priorities of DI in Latvia - shifts in disability policy Measures: Services: Human ability: Person-cetred: 6 From passive medical to human rights and inclusion From institutional to community-based services; From disability to functionality Person’ s needs as priority - not infrastructure

7 Community-based care for persons with mental disabilities in 2014 Source: Summary of State statistical reports on social services, social assistance and long-term social care and social rehabilitation services * Data on No of clients No of institutions No of municipalities Group houses (8%) Day care centers (19%) Home care (81%) Assistants (86%) The Number of Clients in State Long-term Care Institutions (as on the 1st of January of every year)

Major Gaps in Service Provision at Community Level 8 Unavailable housing for persons with disabilities Inappropriate infrastructure for community-based service provision Insufficient complementarity of social and health care services Low availability of mental health care services at a community level Low skills and willingness of specialists working with clients to deliver social services in a person-centred way Negative public attitude towards persons with mental disabilities living in the neighborhood

Target Groups of DI in Latvia in the Planning Period Adults with mental disabilities (psychosocial and intellectual disabilities), living in municipality or state social care institution Children in out- of-familial care, up to 18 years old, living in child care institutions Children with disabilities, living in families

Expected Results (2020) 10 CHILDREN Reduction by 60% of children placed in long- term care institutions longer than 3-6 months Number of children in institutions reduced to 720 (1799 in 2012) Social services provided for 3400 children with disabilities ADULTS WITH MENTAL DISABILITIES Social services provided for 1400 persons preventing institutionalising 700 clients have left long- term care institutions At least 3 branches of long- term care institutions closed Places in long-term care institutions reduced by 1000 Proportion of community- based services increased from 20 to 45%

EU Funding for DI Activities in the Planning Period European Social Fund EUR including state co- financing (15%) Complementary EUR Efficiency of Municipal Social Service and professional social work practice European Regional Development Fund EUR including local governments co-financing (15%)

Distribution of Competences in the implementation of DI (1) Ministry of Welfare Horizontal regulatory framework of policy reforms Methodological management and supervision of DI activities Planning Regions Final beneficiaries, implementing projects in cooperation with the local authorities and long-term care institutions: Mapping of community-based services and elaboration of regional DI plans, including reorganization plans for long- term care institutions Carrying out individual assessments of the target group Compensating the project-based costs for service delivery to the local authorities Organizing training on delivery of community-based services in a person-centered way Implementing of communication strategy for changing public attitude 12

Distribution of Competences in the implementation of DI (2) Local Authorities The main partners of the Planning Regions Planning development of community-based services for target groups of DI Taking part in elaboration of regional DI plans Providing mentoring for former clients of long-term care institutions Reorganising the long-term care institutions for children Providing and pre-financing community-based services and receiving monthly compensation of the costs 13

Individual Needs Assessment of the Target Groups and Planning of DI in ESF Projects,

Provision of Social Services in ESF Projects,

Intenational conference on DI under the Presidency - considerable response from the public ( ) Adoption of the Regulations of the Cabinet of Ministers on implentation of ESF projects on DI ( ) Adoption of Action Plan of Ministry of Welfare on implementation of DI ( ) Call for project proposal announced ( ), project appraisal close to completion Majority of local authorities have signed letters of intent for partcipation in the DI projects 16 Progress so far

Municipalities Planning to Participate in the ESF Projects on DI 17 92% of the total 2 big cities not involved

The Main Challenges in Implementation of DI Ambiguous public attitude to DI - although positive changes have taken place, resistance still exits Pressure from some stakeholders to open ERDF investments before individual assessments of the clients and regional DI plans are ready Choice of methodology for individual needs assessment of clients of each target group General belief that long-term care institution is a good place to live for persons with mental disabilities and they prefer living there is widespread Political decision on closing reasonable amount of concrete long-term care institutions is being postoned Legal regulations to strengthen the gate-keeping for entry to long-term care institutions 18

To be done until the end of 2015 Start implementation of ESF projects on DI Promote closer cooperation of the stakeholders Finalize the guidelines for individual needs assessment of the target groups Agree the unit-cost methodology for community-based services for persons with mental disabilities Develop the communication strategy for changing public attitude 19

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