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Common European Guidelines on the Transition from Institutional to Community-based Care & Toolkit on the Use of EU Funds
Jamie Bolling
European Network on Independent Living – ENIL
European Expert Group on the Transition from Institutional to Community-based Care (EEG)
Barcelona
14 February 2017
ENIL
European Network on
Independent Living
www.enil.eu
Jamie Bolling
Executive Director
What is ENIL?
European wide network of disabled people
Forum for independent living
Cross-disability organization
Strasbourg 1989 - 80 persons 20 countries
ENIL Freedom Drive
Lobby EU and National level
ENIL Youth
29 years later
- Members in more than 40 countries;
- Members from Finland to Spain, Bulgaria
to Iceland;
- European Day for Independent Living –
May 5th
- General Assembly every other year
EEG - European Expert Group on
DI • The European Expert Group on the Transition from
Institutional to Community-based Care (EEG)
• Broad coalition
• Stakeholders representing people with care or support needs
and their families, including children, people with disabilities,
homeless people, people experiencing mental health
problems; as well as service providers, public authorities and
intergovernmental organisations.
• Promoting models of services that are: person-centred, with
good quality and empowering and developing formal and
informal care that fully respect the human rights of all people
with care or support needs.
DI: Legal framework
– UNCRPD- Article 19.-LIVING INDEPENDENTLY AND
BEING INCLUDED IN THE COMMUNITY (ratified by
EU and 25 Member States)
– UNCRC - Articles 7, 9, 18, 20, 23 - Right to family
environment and support to families, right to substitute
family care.
– European Structural and Investment Funds regulations:
2 relevant ex ante conditionalities requiring measures
for shift from institutional to community-based care
• DI strategy or anti-poverty strategy (Thematic 9.1)
• General – Admin Capacity in line with CRPD
Key reference documents on DI
• Published by the European Expert Group on the Transition from Institutional to Community-based Care in 2012
• Preceded by the Ad Hoc Expert Group Report
• Endorsed by Commissioners Andor and Hahn
• Translated into 9 languages
• Toolkit revised in 2014
Why focus on children?
• Poor physical development and motor
skills
• Psychological consequences
• Detrimental effect on formation of
emotional attachments
• Poor development for intellect and
language
• Suppression of brain development
Key elements • “Common” means children, people with disabilities,
incl. people with mental health problems, and older people
• Can be used at different stages in the process of transition & based on best practice
• 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
Holistic approach to DI
- high-quality, individualsed
services in community (incl.
prevention)
- transfer of resources
- closure of long-stay residential
institutions
- moratorium on the building of new
institutions
accessible and
available mainstream
services
Why the Guidelines?
“Though governments increasingly recognise the inevitability of deinstitutionalisation, there is less clarity with regard to the mechanisms that replace institutionalisation and what would constitute a human rights-based response.”
COE Human Rights
Commissioner, 2012
Hammerberg
Trying to improve institutions by making additional investments – building and renovation.
Keeping the two systems running in parallel.
Developing services in the community which preserve institutional culture.
Closing institutions without developing services in the community.
Common risks
1 - Making the case for developing community-based alternatives to institutions
2 - 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
Making the transition – 10 chapters
How can EU funds support DI?
• Supporting structural change in the health and social care systems
• Facilitating the implementation of the European Quality Framework for Social Services
• Combining investments into infrastructure with workforce development and the improvement of mainstream services
• Supporting sustainable reforms
• Promoting social innovation
Legal basis for supporting DI
• ESI Funds Regulations 2014 – 2020
o Ex ante conditionalities
• Draft Thematic Guidance Fiche for Desk Officers – Transition from Institutional to Community-based Care
• EC Guidance on ensuring the respect for the Charter of Fundamental Rights of the EU when implementing the ESI Funds
• CRPD Committee Concluding observations on the initial report of the EU
• European Code of Conduct on Partnership
Funding transitional costs
Old system
New system
Examples of measures
• Infrastructure – housing (building, purchase and rental), home adaptations
• Training of staff to work in the new services
• Creating employment opportunities in the community
• Making mainstream services accessible to all (training, infrastructure)
• Technical assistance – assessment of the needs and the coordination of management of the change process
• Building the capacity of NGOs – to take part in the process, provide peer support etc.
• Personal assistance
ESF Output indicators
• Number of children re-integrated in their family, placed in a foster family, or in a family-type environment
• Number of children placed in small group homes
• Number of school leavers with special educational needs receiving careers advice
• Number of young people receiving support when leaving the care system
• Number of family support measures
ESF Result indicators
• Decrease in the percentage of children entering alternative care
• Of children in alternative care, the change in the ratio of those in residential care to those in family care
• Improvements in health and development
• Reduction of challenging behaviour
• Increase in the number of children with disabilities educated in mainstream schools
• Improved school results for all children moved from institutions
ERDF Output indicators
• Number of family-like placements for children (e.g. small group homes)
• Capacity of supported childcare or education infrastructure
ERDF Result indicators
• Increased percentage of children accessing high quality early-childhood services
• Increased percentage of children with disabilities or at risk of disabilities accessing universal maternal and child health systems
• Increased percentage of children with developmental delays and disabilities accessing early education and childcare services
• Reduced percentage of children placed in the alternative care system
• Decreased levels of morbidity and mortality of children with disabilities in the care system
• Increased numbers of children with disabilities educated in mainstream inclusive schools
• Improved school results for children with disabilties
Checklist for the selection of projects
• Information about the process
• Information about the target groups
• Information about the legal and regulatory framework
• Information about the services
• Information about the resources (financial and human)
• Information about user involvement
• Monitoring and evaluation
Concluding remarks
•Investments preceded by needs assessment
•Social inclusion as end goal
•User involvement, incl. those most marginalised
•Good overall coordination and monitoring systems
Thank you!
www.enil.eu
www.deinstitutionalisatioguide.eu
ENIL Brussels Office
Mundo J, Rue de l’Industrie 10, 1000 Brussels, Belgium
Tel: 0032 (0)2 893 25 83
