1. Integration of social services in Belgium, in particular in Flanders European Conference on Integrated Social Services Council of Europe Warsaw, Poland, 14-15 June 2007 J. Mostinckx, former director of Social Services Ministry of Flanders Department Social Services, Public Health and Family. Belgium

2. Why goverment decided to integrate social services? 1. To avoid the overlapping and multiple use of social services 2. To deal more effectively with complex social problems 3. To facilitate access to social services and social rights, in particular for the most vulnerable social groups 4. To simplify and accelerate service delivery 5. To improve efficiency, effectiveness and client- friendliness of service provision

3. Social services were in Belgium initially developed by: 1. The Ministry of Justice 2. The Ministry of Public Health 3. The Ministry of Education 4. The Ministry of Employment 5. The Ministry of Culture => 15 different recognition systems and grant shemes

4. Three most important integration movements 1. 1980: Federal administrative reform 2. 1990-2004: The regions promoted mergers and co-operative ventures of social services by: recognition procedures subsidy decrees 3. 2004: Decentralisation of social services to the local level

5. 1. Federal administrative reform and integration The social services which depended till 1980 on different national ministries Were granted to the Flemish, French and German communities authority In Flanders the granted Welfare, Health and Family matters were brought together in one department: Department of Social Services, Public Health and Family

6. By bringing together different social services in one ministerial department It became easier to compare different welfare provisions and see the problems it was not clear to the clients what they could expect and where they could expect it => users couldn ’ t see the wood for the trees! overlaps and duplicated use became apparent problems with professionalism and quality

7. 2. Integration process after the state reform of 1980 1. [Federal: the 1980 Federal State reform law bringing together the welfare, health and family matters within one department of the two regions] 2. Regional: 1. 1991: Integration Acts on general social work 2. 1998: Integration Act of the school medical inspection and psycho-medical-social centres 3. 1999: Integration Act of mental health care 4. 2004: Act on integrated youth support 3. [Local: : Act of 2004 on integrated local policy => social house]

8. 2.1. The first Flemish Parliament Integration Act on general social work brought different forms of non-residential and residential social work together in 1991

9. Effect of integration plan 1980-90: general social work: 38 different decrees 15 different subsidy regulations or grant systems 1994: 355 different centres 1,025 FT social workers (sw) => an average of 2,8 social workers per centre 2003: 1 recognition system and 1 grant scheme 27 independent centres for social work 1,075 FT SW => an average of 40 sw per centre

10. The Parliament Integration Act of 1991 had four objectives : 1. Greater legal security for the private social work centres 2. A better position and profile for the sector within overall welfare and care. 3. Creating a coherent and integrated network of balanced, spread and accessible provisions. 4. Harmonisation of the regulatory framework for all the recognised provisions in general social work

11. 2.2.Integrated youth support The 7 May 2004 Flemish Parliament Act on integrated youth support provides a framework for intersectorial co- operation and co-ordination determines the aim and operating principles of integrated youth support determines which sectors participate proposes a number of concrete forms of co- operation and co-ordination establishes an intersectorial policy

12. The following “ sectors ” form part of integrated youth support  Public agencies:  Agency for Special Youth Assistance  Agency for the Social Integration of Disabled Persons  Agency for Child and Family  Private centres  General social work centres  Family Care Centres  Mental Health Care Centres  Pupil Guidance Centres

13. The operating principles :  Accessibility: well known, available, comprehensible and affordable  Demand-oriented  Subsidiarity: a preference for the least interventionist alternative  Client participation: dialogue  Acceptance: support is only provided if the client agrees, unless the juvenile court decides differently  Emancipation: aimed at increasing the possibilities to act independently.

14. 2.3. Integration of the school medical inspection and the psycho-medical-social centres  Merging of:  104 school medical inspection centres and  201 psycho-medical-social centres  to 75 pupil guidance centres  school doctors and nurses started to co-operate with psychologists, pedagogues and other experts  supporting schools and parents.  The pupil guidance centres (Act of Dec. 1998) started to work as on 1 Sept. 2000.

15. 2.4. Integration of mental health care Parliament Act of May 1999 was implemented in Dec. 1999 The objectives a broadening of scope more room for management a clear second line position emphasis on weaker groups, children and the elderly Integration: 84 centres in 1988 merged to 21 centres in 1998, evenly spread throughout Flanders The budget increased from 28.9 million euros in 1998 to 41 million euros in 2004. In 1998: 620 FT care workers were subsidised, and in 2003: 880.

16. 3. The social house Integration of social and care services by local social policy

17. The Local Social Policy project aims at: assigning a stronger coordinating role to the local authorities achieving more integration in a fragmented field of service provision continuing to work on an accessible, client- friendly social service provision providing more concrete possibilities for organisations, target groups and citizens to participate.

18. The following initiatives were introduced July 2001: The creation of a framework for local social policy The drawing up and implementation of a concrete action plan regarding local social policy The start-up of a number of pilot projects related to the social projects

19. Result: Social house Is a one-stop shop for citizens with regard to social service provision in their municipality Provides “integrated access” to the social service provision of both the municipality and the local public centre for social welfare Allows citizens to gain easier access to their social rights to be helped in an effective way

20. 4. Summary and conclusions The integration of social services was a reform that lasted 25 years Policy makers, managers of social services and social workers were initially demanding parties for integration Once the integration process was in full swing dissatisfaction arose Today there is a general contentment about the different integration processes.

21. Administrative reforms and integration of social services Administrative reforms, (e.g. State reform in Belgium) are ideal moments for starting integration processes => are preceded by social consultation and parliamentary debates The need to work together on a permanent or structural basis can be more easily achieved at lower administrative levels => decentralisation (Social House) It is necessary to work with different procedures at the different levels (federal, regional, and local) It is necessary to adopt both a ‘ bottom-up ’ and a ‘ top- down ’ approach.

22. Economies (cuts) and integration of social services Co-operative ventures (joint-working, partnership, collaboration, networking) are: sometimes a necessary transition to integration but are expensive and time consuming. Permanent and functional mergers: are more invasive but also more efficient are more client-friendly cost money in the short term are economical in the long term e.g. envelope-system (fixed amount) in the general social work

23. The budget increasing factors in the case of integration Harmonising salaries Mergers result in larger companies: A large company => more hierarchy higher salary costs more administrative and management costs In all sectors where integration was introduced there was a considerable increase in the budget in the first years

24. Access to social rights and integration of social services The most important results of integration in our experiences are: quality policy result-oriented management client-friendliness improving access to social rights => in particular for the most vulnerable groups adoption of a more holistic approach in meeting the needs of service users.