1. Common European Guidelines on the Transition from Institutional to Community-based Care and Toolkit on the use of European Union funding
Ines Bulic, Researcher
European Expert Group on the Transition from Institutional to Community-based Care (EEG)
27 November 2012

2. Overview of the presentation
Setting the scene
Common European Guidelines on the Transition from Institutional to Community-based Care
Toolkit on the use of European Union funds

3. Setting the scene: people with disabilities
29% of people with disabilities have a job (compared to 69% of all Europeans)
62% of people with disabilities are among the poorest in Europe
At least 1,2 million people with disabilities live in institutions in the European Union (in places with 30 + residents)
The majority of people in institutions do not work, some provide free labour

4. Setting the scene: children
1 million children in institutional and residential care in 30 European countries
Significant number of children with disabilities without access to formal education (especially those in institutions)
Within one country in CEE, nearly half of the children (45%) were admitted to institutions for educational purposes
In some countries, discrimination has led to systematic misdiagnosis of Roma children as having ‘special educational needs’
MDAC v. Bulgaria (2008) – European Committee on Social Rights held that segregated education is a violation of the right to education under European Social Charter

5. Although statistics are inadequate, we know that
The rate of children in institutional care in CEE and fSU is increasing, when the declining birth rate is taken into account
Children with actual or perceived disability have a higher chance of being institutionalised and for a longer period of time (many forever)
Among people with disabilities, people with intellectual disabilities and people with mental health problems are most commonly institutionalised
In some countries, there is an over-representation of Romani children in institutions
Institutionalisation is a Europe-wide problem

6. Case for DI Prevalence of institutional care in Europe
Political commitment at the European and international level
Social inclusion objectives of Europe 2020 Strategy – reducing poverty, extending employment, promoting active inclusion, providing decent housing and overcoming discrimination
Human rights violations in institutional care
Damaging effects of institutionalisation on children and adults (especially at age 0 – 3)
Better use of resources

7. Case for DI: Negative impact on children and adults
The majority of children, once they reach adulthood, are transferred to institutions for adults
The most common reason for leaving institutional care is death
Severely reduced life chances for adults who spent their childhood in institutions: 20% with criminal record, 14% in prostitution, 10% committed suicide (Russia)
Young women raised in institutions 10 times more likely to be trafficked (Moldova)

8. Objectives of the Guidelines
Offer expertise and impartial advice to Member States and EU institutions
Gather and promote practical examples of good practice
Raise awareness about the right to live in the community at EU level
Ensure that EU and national policies and funding mechanisms support DI
Encourage Member States to fully involve user groups

9. Common = Children (with and without disabilities)
Persons with disabilities
Persons with mental health problems
Older people

10. Key elements
Tailored to Member States at different stages in transition to community living
Links to Europe 2020 strategy
Guidance on how to ensure actions taken are in line with the CRPD, CRC and the ECHR
Key guidance outlining risks and challenges in the process
Case studies presenting good practice
Emphasis on management, cross-sectoral coordination and user involvement

11. Holistic approach to DI
Development of high-quality, individualised services in the community, including those aimed at preventing institutionalisation and the transfer of resources from institutions to the new services
Planned closure of long-stay residential institutions, including a moratorium on the building of new institutions
Making mainstream services accessible and available to individuals with a variety of support needs

12. Making the case for developing community-based alternatives to institutions
Assessment of the situation
Developing a strategy and an action plan
Establishing the legal framework for community-based services
Developing a range of services in the community
Allocating financial, material and human resources
Developing individual plans
Supporting individuals and communities during transition
Defining, monitoring and evaluating the quality of services
Developing the workforce

13. Using EU Structural Funds to support DI
MS can use the European Social Fund (ESF) to support:
Development of services, including early intervention, family support, foster care, personal assistance, rehabilitation, community-based residential support, independent living schemes and supported employment
Management of the change process
Development of a qualified workforce, including retraining institutional care staff

14. Using EU Structural Funds to support DI
MS can use the European Regional Development Fund (ERDF) to support:
Targeted investments in mainstream health and social infrastructure, education, housing and specialised services where necessary

15. Lessons learned
Lack of clear direction on developing alternatives to institutional care
Residential institutions reconstructed, expanded and built
Restrictive interpretations of the rules for Structural Funds
Barriers to the development of community services
Lack of transparency
Poor monitoring and evaluation
Barriers faced by smaller to mid-size NGOs when applying for SF

16. Toolkit: Programming stage
Indicative checklist for Partnership Contracts
Indicative list of actions for ESF Operational Programmes
ESF Output and Result Indicators
Indicative checklist for ESF Operational Programmes

17. Indicative checklist for Partnership contracts
Problem analysis
Key information on the care/support system
This will help establish where investments are needed and where the reform should start.
Expected results
The transition from institutional to community-based care is included as one of the main results expected for the objective “promoting social inclusion and combating poverty”
This will help ensure that the projects funded are part of a wider reform, that the ESF and the ERDF are used in a combined way, that attention is given to making mainstream services accessible, and that service users are consulted throughout the process.
Explicit ban on the use of Structural Funds for building new institutions, and renovating or resizing old ones, is included
Integrated approach
The specific needs of children and adults in institutional care, as a target group exposed to discrimination and social exclusion, are identified
This will help ensure that alongside infrastructure, funding is provided for staff training, management of the process, employment initiatives and so on.
Fulfilment of ex ante conditionality
Existence and implementation of a national strategy for poverty reduction
This will help ensure that deinstitutionalisation is a part of a wider anti-poverty strategy and that the process is properly planned, with a clear timetable and a budget.

18. Indicative list of actions for ESF OPs
Relevant to all user groups:
Needs assessment, including individual assessment of the needs and wishes of each child or adult involved in the transition process
Drawing up (local) action plans on transition to community-based care, including individual care/support and preparation plans for each child or adult involved in the plans
Activities to facilitate cross-sectoral coordination and management of the process of transition to community-based care
ESF Output indicators
Number of individual assessments carried out
Number of individual care/support plans developed and implemented
Number of individuals who have left institutional care
ESF Result indicators
Increased range of services in the community
Increased percentage of people leaving institutional care
Decrease in the percentage of new admissions into institutions

19. Indicative checklist for ESF Operational Programmes
Identification of needs
Key information on people in institutional care/other forms of care
This will show where there is the highest need for investment.
Identification of the choices of investment priorities
“Enhancing access to affordable, sustainable and high-quality services” is a chosen investment priority
This will ensure that deinstitutionalisation is not left out of the OP.
Deinstitutionalisation is included as a key action under this investment priority
Priority axis “Promoting social inclusion and combating poverty”
The transition from institutional to community-based care is included as one of the specific objectives
This will ensure that deinstitutionalisation is included in the OP. It will show what actions are planned and ensure that the actions planned are in line with the DI strategy (if in place); that outputs and results can be monitored and evaluated; and that there is good coordination between the ESF and the ERDF.
Key ESF actions to implement a deinstitutionalisation strategy are described
Involvement of partners
A list of actions taken to involve the partners in all stages of the programming and implementation of the OP is included
This will help ensure that all the partners are meaningfully involved in the preparation of the OP.

20. Implementation stage: Checklist for the selection of projects
Information about the process
Information about target groups
Information about the legal and regulatory framework
Information about the services
Living units
Access to other support services
Information about the resources (financial and human)
Information about user involvement
Monitoring and evaluation

21. Monitoring and evaluation stages
Checklist for monitoring
Checklist for evaluations

22. Further information www.deinstitutionalisationguide.eu
Thank you!