Ministry of Social Protection, Family and Child Open Society Mental Health Initiative Soros Moldova Foundation The Development of Community-based Services for People with Mental Disabilities – deinstitutionalization pilot project Need and strategic options assessment - Summary of the study made by CREDO -

The Purpose of the Evaluation To ensure a comprehensive database with the situation of the children and youngsters with mental disabilities from the Republic of Moldova in order to help planning the deinstitutionalization activities

The Purpose of the Evaluation The study aims at answering the following questions: ► What is the situation of the children with disabilities, in general, and of the residents of the Orphanage from Orhei, in particular? ► What are the present public policies and programs? Are they efficient? ► Is the present legislation favourable to start the deinstitutionalization program of the residents from Orhei and to develop programs of social inclusion, in general, for this group?

The Structure of the Study ► Chapter 1 describes and draws conclusions regarding the situation of the children with disabilities from the Republic of Moldova and shows specific data regarding the residents from the Orphanage from Orhei ► Chapter 2 presents the national legal framework ► Chapter 3 analyzes the number and type of community based services and their geographical distribution in relation to Orhei

The Structure of the Study ► Chapter 4 analyses the offer of specialists in the field of disabilities (graduates and professionals) ► Chapter 5 discusses the different mechanisms and funding models for social services ► Chapter 6 presents the conclusions of the studies under the form of some recommendations regarding the strategic options for deinstitutionalization

Chapter 1 Children with disabilities from Moldova ► 13,000 children with disabilities ► 10-12% benefit of services

Chapter 1 Orphanage from Orhei Motive for placement parents incapable to raise children, 11, 2% divorced mother, 30, 6% family poverty, 1, 0% health problems of parents, 6, 1% orphan, 29, 6% parents disappeared, 2, 0% parents in detention, 1, 0% parents divorced, 33, 8% not specified, 1, 0% absence of house to live, 2, 0% parents went abroad, 6, 1% other causes, 32, 8% severe educational needs, 85, 19% severe disability, 224, 49%

Chapter 1 Orphanage from Orhei

Capitolul 1 Casa de Copii Orhei

Chapter 1 Orphanage from Orhei

Most of the children are years old meaning that there is a high risk for them to be transferred in the next years in institutions for adults with disabilities (e.g. psycho-neurological boarding house)

Chapter 1 Orphanage from Orhei

Chapter 2 Policies and Legislation The children with disabilities, as a social group, benefit of 4% of the total expenditures from the state budget for social services

Capitolul 2 Politici si Legislatie ► Bugetul pentru servicii sociale al autoritatilor locale se constituie in proportie de aproximativ 50% din venituri locale si 50% din bugetul de stat si surse speciale ► Capacitatea bugetara redusa a autoritatilor locale are un impact negativ asupra capacitatii de a sustine servicii fara o contributie suplimentara de la bugetul de stat

Capitolul 2 Politici si Legislatie Programe sociale pentru copii cu dizabilitati: Social policies for children with disabilities, mln MDL 1. Social allocations for disability; ; 69% 3. Community- based services; ; 13% 2. Residential services; ; 18%

Chapter 2 Policies and Legislation Types of social benefits/services: ► Allowances ► Subsidies ► Rehabilitation services ► Nominative indemnities (compensation of the expenditures regarding the utilities during winter) ► Benefits for taking care a person with disabilities ► Residential and non-residential services  The Ministry of Education: services for children with light disabilities  The Ministry of Social Protection: services for children with severe disabilities ► Indemnities for transportation ► Fiscal benefits for adopting children who are in the social protection system ► Community based services ► Medical services ► Fiscal facilities

Chapter 3 Social services Types of existing services Day centersPlacement centers Rehabilitation centers Mixed centers for families with children with disabilities for children at risk

Chapter 3 Social services The offer for social services: Diverse social groups (including children/youth with disabilities): ► 3 day centers financed from the budget of the Ministry for Social Protection, Family and Child ► 15 day / rehabilitation centers financed from the local budget (plus contribution from the state budget?) Children with disabilities: ► 7 day / rehabilitation centers ► Protected houses ► Adoptions 13 centers are in the area of town of Orhei

Chapter 4 The offer of specialists

Some conclusions: ► The number of social workers is increasing, but it’s still under the average of EEC countries ► Considering the demand-offer ratio, there are enough specialists, however the professional quality is to be taken into consideration ► The payment system, reputation and dignity of being a social worker are not attractive for many youngsters ► The professional training is focused excessively on theory without emphasizing the practicality ► Isolated existence of good practices regarding social services Chapter 4 The offer of specialists

Chapter 5 Funding Models Present stipulations on funding the social services: 2 types of arrangements for contracting social services: ► Direct funding from the state budget ► Funding from the budget of the local authorities

Chapter 5 Funding Models The expenditures from the state budget for social services are made under 3 programs: ► Create the policies and the management in the field of social protection ► Organizing the summer holiday and the social- medical protection of children who are in state care ► Organizing the social-medical support for the old, people with disabilities and the victims of human trafficking

Chapter 5 Funding Models

The social services, organized as community centers, represent a small priority in the local budget, with an average of under 10% from the total budget for social services. In general, the funding for services for children and adults with disabilities do not exceed 18 M MDL.

Chapter 5 Funding Models Standards and Accreditation TACIS/TRANSTEC (2007) and UNICEF (2006) elaborated minimum standards and accreditation procedures for social services, in general, and for services for children with disabilities, in special. FISM submitted standards to MPSFC’s approval which will become operational in FISM submitted standards to MPSFC’s approval which will become operational in 2008.

Recommendations Policy level: ► Benefits in cash ► Fiscal policies (tax exemptions) ► Deinstitutionalization policies (preference for community based services) ► Funding the social services ► Mechanisms for accreditation and standards ► Professional capacity

Recommendations Deinstitutionalization strategic elements that capitalizes on the existing legal framework: ► Benefits in cash ► Fiscal benefits ► Models of services in partnership with the local authorities

Recommendations The orphanage from Orhei: ► Capitalization on fiscal benefits and allowances in case of the families with medium/high income who get their child/children back to their families ► The partnership with existing services in the community in order to assist the children who returned to their families ► Social adoptions ► Develop new services in the community