1. Experiences from Sweden - Jyväskylä 2 february 2016 2/2/2016 Karin Flyckt

2. Punktlista nivå 1: Century Gothic, bold 19pt Nivå 2: Century Gothic normal 19pt Rubrik: Century Gothic, bold 33pt The National Board of Health and Welfare... 7/10/2016 … follows up, evaluates, investigates and examines … structures, develops and disseminates knowledge … develops norms based on legislation and knowledge … performs other public authority tasks. 2

3. Our history 7/10/2016 The National Board of Health and Welfare was formed in 1968 through a merger of the Royal Medical Board and the Royal Board of Social Affairs. The history of the Royal Medical Board could be traced back to the Collegium Medicorum, which was founded in 1663. In time it developed into an administrative board with overall supervision of the nation’s health care and medical care. The Royal Board of Social Affairs came into being in 1912 as an authority dealing with “the labour issues”. Over time, social policy developed and the tasks of the Board focused more on social services, care of the elderly, disability issues, etc. 3

4. How Sweden is governed 7/10/2016 National level The Riksdag (Parliament) Represents the people. Is elected every four years. Has the legislative power. The Government Enforces the decisions of the Riksdag and develops proposals for new laws or amendments to legislation. It is assisted by the Government Offices, a number of ministries and government agencies. Government agencies Shall practically implement the decisions made by the Riksdag and Government. Act independently pursuant to Government guidelines. However, the Government may not intervene in the ongoing work (unlike many other countries). National level Regional level Local level 4

5. How Sweden is governed 7/10/2016 Regional level County administrative boards Sweden is divided in 21 counties. In each county there is a county administrative board that acts as the Government’s regional representative. The duties of the county administrative boards include regional social planning as well as general administrative tasks. County councils At the county level, there is also a county council*. The decision-makers are elected by the population of the county every fourth year. The council is responsible for health care and medical care. Activities are financed primarily from county council taxes and to some extent from fees and government grants. *exceptions are the counties of Västra Götaland, Skåne and Gotland National level Regional level Local level 5

6. How Sweden is governed 7/10/2016 Local level Municipalities Sweden is divided in 290 municipalities. The decision- making body, the municipal council, is elected every fourth year. The council appoints the municipal executive board which conducts the daily activities. A municipality is responsible for schools, preschools, care of the elderly and disabled persons, individual and family services, roads, water supply and sewage system etc. Activities are financed primarily from municipal taxes and partly through government grants and fees. National level Regional level Local level 6

7. A few words on rehabilition x/x/20xx Many actors –National social insurance agencies –The swedish public employment service –Health care/county council –Municipalities 1 000 000 of 9 800 000 people have disability A couple of houndred thousand receive rehabilition measures

8. Financial Coordination Through coordination agencies (Law 2003:1210)

9. ”Collaboration is not a condition that can be reached at any given moment but a continuous living process that every day has to be conquered, established and constantly nourished.” (Report from the Commission of Collaboration SOU 2000:114)

10. A few numbers The law came into effect on the first of January 2004 560 million crowns (SEK) from state, municipalities och county councils 2015 80 collaboration agencies in 241 of Sweden´s 290 municipalities, and many more to be started About 600 activities targeted towards individuals 2014 (39 000 participants)

11. FINSAM – Law of Financial Coordination Coordination Agency – Organisation for financing activities to support individuals Financial coordination – Allocation of resources Collaboration – Between organisations Cooperation – Between professionals Concept

12. The Swedish Social Insurance Office, Försäkringskassan 50%, includes the Swedish Public Employment Service, Arbetsförmedlingen Municipalities 25% County Council 25 % Financing

13. Individuals in need of coordinated services from two or more of the organisations involved in the coordination agency There can be physical, psychiatric, social and/or vocational needs Identified locally Individuals between 16-64 years old Target group

14. The individual should reach or improve work ability Avoid unnecessary vicious circles or grey areas between authorities Develop well-functioning collaboration between authorities Achieve a more effective use of resources in the hole system. Purpose

15. The organisation of public welfare is done through silos Sometimes individuals needs solutions that demand a more comprehensive view Authorities have different goals and missions Responsibility is sometimes muddled There are no economic incentives to collaborate Why Collaboration Agencies

16. A comprehensive view on the needs of the individual Competencies to work and communicate over professional och organisational boundaries Knowledge and understanding of each other´s targets and professional competencies Mutual trust and respect A supportive leadership Success Factors

17. It´s own statutory body Is lead by a board where every member organisation is representented The board is comprised of both politicans and civil servants Coordinating managers fascilitate and support Collaboration Agencies

18. Decide how the resources are to be used Joint steering and joined-up budget Point of departure are the needs of the individual and the benefits for society as a whole Collaboration Agencies

19.  Decide upon goals and broad outlines for the financial coordination  Support and fascilitate collaboration between the member organisations  Finance such activities as accounted to in the Law of Financial Coordination as well activities whithin the area of responsibility of the member organisations as a whole  Decide in which way the allocated resources for financial coordination are to be used  Account for following-up and evaluation the rehabilitation activities  Set up a budget and an annual financial report The board should….

20. Inventories and mapping of target groups locally Indentify bottle-necks and obstacles in the system Finance structurally directed activities that fascilitate collaboration between authorities Finance operative activities targeted towards individuals Activities

21. Rehabilitation to work or studies Supporting, activation, motivation (a pre-phase before rehabiltiation) Activities toward individuals

22. Has a comprehensive view on the issues that the collaboration agency has to decide upon Has the ability to rise above a silo-ised way of thinking and look beyond the purpose and motivations that lie behind the financial coordination Board members

23. For the individual - Met with respect and kindness - Adequate treatment - Participation in the rehabilitation process For the staff - Meaningful work - Lessened frustration - Higher levels of qualification and competency For society - Shortened rehabilitation processes - Shortened waiting time - Clearer boundaries of responsibility What is the result of collaboration?

24. 2011-2014: 30 % of the participants continued to work or studies. 2014: 34 % of the men and 32 % of the women continued to work or studies. 23 % of the participants became a part of the labor force (registrated at the employment office). More follow ups are on their way… Some results in numbers

25. Thank you for your attention! 2/2/2016