1. Luk Zelderloo, EASPD Secretary General info@easpd.eu www.easpd.eu

2. Differences in the ‘cultures’ Institutional care  Isolation from broader community  Clients have not sufficient control over their live  Paternalistic relationship  Routine  Block treatment  Rules of the institution are more important the needs of the clients Community care (CBS)  Inclusion to the community  Involvements of the clients to all decisions  Partnership  Flexibility  Individual approach  Client in the centre I. What is it about

3. I. What is it about 10 key quality requirements 1.To facilitate full participation, inclusion and equal citizenship 2.To be built around people with disabilities and their changing needs: tailor made – person centred 3.To be community based and rooted in society 4.To be set up in, and in close cooperation with the mainstream 5.Holistic approach -> multi faceted approach

4. I. What is it about 10 key quality requirements 6. Be provided by well trained and managed staff 7. Keep the family together 8. Be based on stakeholder cooperation 9. Ensure security to all users 10. Allow real and informed choices

5. Over-investment in existing institutions Developing parallel services Alternatives with institutional culture (mini- institutions) Closure of institutions without community alternatives I. What is it about Risks during the transition process

6. II. Key Policy Issues From shaming and blaming towards a positive change:  Wording!  What do we want?  Involvement of all stakeholders  Persons with Disabilities  Families  Professionals  Trade unions  Authorities…

7. II. Key Policy Issues Re-training & valuing professionals :  Old medical defect model (defectology)  Traditional- industrial management models (standardisation, economy of scale)  Care professionals…working poor

8. 8 II. Key Policy Issues Scattered competencies=lack of coherence  Health, Justice, Education, Social Affairs, Employment….  Federal, regional, and municipal level  Societal consensus needed

9. 9 II. Key Policy Issues Funding (system)  Overlap funding needed  Reorganise the traditional triangle funding system  Reforming in times of crisis=losing

10. 10 II. Key Policy Issues Quality assurance systems  Traditionally: input focused  More up to date systems  Through put & process focus  Output & results

11. 11 II. Key Policy Issues Position of persons with disabilities (PwD), seniors…  PwD at the steering wheel  Facilitating support models  ‘’Co-production’’ of services

12. 1. The Frog Phenomenon So, needed is:  Focus on needs and needs assessment  Developing and showing alternatives (availability)  Explaining the importance of the change in paradigm  Training change management  Training new skills for first line staff  Identify bottlenecks in legislation and underlying frameworks  Alternative employment opportunities for staff III. Towards Community-based Living

13. So, needed is:  Socio-economic support mechanism for poor families  Communication support  Recognition of different roles: parents/brothers, sisters 2. Family Support III. Towards Community-based Living

14. So, needed is:  Available information services  Aware and trained staff in maternity hospitals  Early intervention and ambulant services  Personal assistants in day care and schools  Respite care services and temporary care  Family support combined with support for persons with disabilities  Focus on transition in life stages  Available support in mainstream education and health care 3. Service Spectrum III. Towards Community-based Living

15. 4. Develop Partnerships So, needed is :  Invest in stakeholder cooperation and involvement of people with disabilities  Recognition of different roles  Commitment of all partners  Mainstreaming III. Towards Community-based Living

16. So, needed is:  Flexible time frames for services (pre-school programs)  Identify the number of persons living in the institutes  Stop investment in the buildings  Agreed plans for breakdown  Legal ‘stop’ 5. Cut the Supply Line III. Towards Community-based Living

17. So, needed is:  Structural involvement of persons with disabilities  Identify perverting effects of not specific legislation  Include quality of life in quality of services instruments 6. Install Snowball Mechanism III. Towards Community-based Living

18. VI. The way forward Mainstream support  Networks of support around the client  Knowledge centres/expertise  Plug & Play  Training of mainstream support staff  …

19. VI. The way forward ICT and Assistive Technology  Distance support  Distance learning  Support through call centres  … Aiming at:  Employment  Inclusion  Full citizenship

20. VI. The way forward New types of services  Family support systems  Community support  Network & Community building  Provision of accessible information & legal advice  Respite care  Services for ageing people and their disabled family members  Early intervention

21. 21 V. Conclusions Reconfirmation policy objectives Positive message Societal consensus based on clear values & stakeholder involvement Re-training of professionals Empowerment through empowering support Investment approach! Allocated budget Leadership

22. 22 With the financial support from the European Union Programme for Employment and Social Innovation “EaSI” (2014-2020) Thank You! EASPD Av. d’Auderghem 63 / Oudergemlaan B – 1040 Brussels Tel +32 2 282 46 10 – Fax +32 2 230 72 33 www.easpd.eu info@easpd.eu