Community for All pilot project - Orhei Lucia Gavrilita, Deputy Minister MSPFC Chisinau-September, 22, 2008

Background of the project Memorandum of Understanding between Ministry of Social Protection, Family and Child (MSPFC) Open Society Mental Health Initiative (OSMHI)/ Soros Foundation Moldova (SFM) Hope and Homes for Children UK (HHC UK) Keystone Human Services International USA (KHSI) / Keystone Human Services International Moldova Association (KHSIMA)

Achievements Evaluation of Mental Health Opportunities Programs in Moldova (CReDO Case Study) Individual Assessments of Residents Consultancy Group Analysis of the Opportunities and Barriers regarding project implementation

Summary of Orhei Residents Evaluation  321 residents  Evaluation Period : March-June 2008  Multidisciplinary team: psychologists/psycho-pedagogues, social workers, psychiatrists, special educators  Evaluation approach: individual psycho- social and medical assessments, family assessments.

Orhei Residential Institution  The Home for Boys with Mental Disabilities in Orhei was founded in  It functions under the supervision of the Ministry of Social Protection, Child and Family who also funds it. Consequently, the decision of placement in is in most cases taken by the Ministry.  The recommendation for placement is based on the decision of the rayon-level specialized commissions (PMPCs) and approved by the Ministry.

Reason for placement

Residents’ Family Situation

Residents by age groups

Types of disabilities

Recommendations for Placement - Summary Placement with biological family Placement with extended family Specialized Foster Care Family Type Homes (with possible reintegra tion with family) Family Type Homes Semi- independent living arrangements (with possible reintegration with family) Semi- independent living arrangements

Chisinau, 59 residents Placement with biological family Placement with extended family Specialized Foster Care Family Type Homes (with possible reintegra tion with family) Family Type Homes Semi- independent living arrangements (with possible reintegration with family) Semi- independent living arrangements

Balti, 15 residents Placement with biological family Placement with extended family Specialized Foster Care Family Type Homes (with possible reintegra tion with family) Family Type Homes Semi- independent living arrangements (with possible reintegration with family) Semi- independent living arrangements

Southern Region, 33 residents (Basarabeasca, Cahul, Cantemir, Ciadir-Lunga, Cimislia, Comrat, Leova, Stefan-Voda, Taraclia, Vulcanesti) Placement with biological family Placement with extended family Specialized Foster Care Family Type Homes (with possible reintegra tion with family) Family Type Homes Semi- independent living arrangements (with possible reintegration with family) Semi- independent living arrangements

Central Region, 119 residents (Anenii-Noi, Cainari, Calarasi, Criuleni, Causeni, Hincesti, Ialoveni, Nisporeni, Orhei, Straseni, Telenesti, Ungheni) Placement with biological family Placement with extended family Specialized Foster Care Family Type Homes (with possible reintegra tion with family) Family Type Homes Semi- independent living arrangements (with possible reintegration with family) Semi- independent living arrangements

Northern Region, 44 residents (Donduseni, Drochia, Edinet, Falesti, Floresti, Glodeni, Ocnita, Rezina, Riscani, Singerei, Soroca, Soldanesti) Placement with biological family Placement with extended family Specialized Foster Care Family Type Homes (with possible reintegra tion with family) Family Type Homes Semi- independent living arrangements (with possible reintegration with family) Semi- independent living arrangements

Transnistria, 17 Residents (Camenca, Dubasari, Ribnita, Slobozia, Tiraspol) Placement with biological family Placement with extended family Specialized Foster Care Family Type Homes (with possible reintegra tion with family) Family Type Homes Semi- independent living arrangements (with possible reintegration with family) Semi- independent living arrangements

Abandoned or Orphaned, 33 residents Placement with biological family Placement with extended family Specialized Foster Care Family Type Homes (with possible reintegra tion with family) Family Type Homes Semi- independent living arrangements (with possible reintegration with family) Semi- independent living arrangements

Opportunities and Barriers Legal Framework Social Services Framework Human Resources Framework Financial Framework

Legal Framework The Law on Social Protection of People with Disabilities (No 821-XII / ) The Law on Social Assistance (No 547-XV / ) The Draft of the Social Integrated Services Strategy The Draft of the Social Inclusion of People with Disabilities Strategy The Draft of Social Services Law

Social Services Framework 37,2% of Orhei beneficiaries are adults; In 145 cases there are no social services; In 149 cases there are some support social services but not recommended by the evaluation team; In only 28 cases there are services that support deinstitutionalization process.

Human Resources Framework Capacity development of the local key professionals (social assistants, nurses, psychologists, teachers) that will work for / assist the replaced children integration in the community or family

Financial Framework (I) Annual Residential Care Cost per Child Type of expenditures (Orhei Institution budget) 2007, outturn2008, approved2009, draft Recurring costs24, , ,059.8 Administrative costs8,353.89, ,870.1 staff costs3,638.63,637.23,642.9 building maintenance680.71,076.61,519.0 operational costs1,233.91,195.61,308.9 utility costs2,800.63,561.15,399.4 Care costs15, , ,189.7 staff costs6,680.17,265.38,078.3 catering7,074.47,328.88,644.3 drugs1,119.31,186.41,839.2 inventory

Financial Framework (II) Community Based Services - Estimated Costs ServicesAnnual Amount per Beneficiary MDL Family, biological or extended10, Foster care23, Family type homes14, Community homes26, Supported living services24,590.00

Community Based Alternatives to Institutional Care (project model) Immediate Biological Family (Adults and Children) Extended Biological Family (Adults and Children) Adoption Services (Children) Foster Care Services (Children) Therapeutic/Specialized Foster Care Services (Children) Shared Living (Adults) Community Homes (Adults) Community Homes (Children) Supported Living Services (Adults)

What should be done for deinstitutionalization process National Program for Reforming the System of Care for People with Disabilities Regulatory frameworks for new community based services Quality standards for community based services The personal assistance scheme Information package/guidelines and training for communities

… Sometimes, it’s seems to be too much and hard work to get to a result, but if you do not target far you cannot achieve what you proposed…