Workshop 1.6 - Deutscher Verein für öffentliche und private Fürsorge

What is the overall chain of care for the budget holder of the man or woman who applies for it? First, there is need assessment, the
access ticket to care. At this stage, it’s still irrelevant whether a client wants care in kind or a personal budget. He needs care, and often
he needs it urgently, quite apart from where he receives it or from whom.
The next step in the process for the client is to make the choice between care in kind or a personal budget. He therefore has to be informed
about all the ins and outs. If a client chooses the personal budget, the regional health care office grants him a budget in accordance with
his need assessment. With his budget, the client can look for a provider in some way. Agreements have to be made, specifying working
hours, conditions, prices, etc. After the work has been done, the budget holder pays the care worker. The budget holder is obliged to
keep accounts in order to justify expenditure. The money has to be spent on insured care under the terms of the five functions. The health
care office decides whether the budget expenditure is OK or not. In exceptional cases, the personal budget may be withdrawn.
I’ll give some examples of the use of the personal budget by elderly people. The personal budget for home care is by far the most popular.
Almost 73 % of all budget holders receive a budget for home care. In 2001 Euro 313 million were spend on personal care budgets.
Of all the clients who receive home care, 43 % are over 65 years of age. With the help of the personal budget these elderly people are
able to stay in their own home or live independently for a longer time. They can manage their own demand for care. They receive care
from a person of their own choosing, within their own conditions, in a familiar environment.
The personal budget is an important instrument in the policy of changing from a focus on supply to a focus on demand. Care-provider
organisations therefore have to listen to the budget holders. Since the personal budget system is reformed by April the 1st of this year
in a non-bureaucratic sense we hope to reach even more people who are willing and able to take control of their own care.
2. Social activation
People with social allowances in the social activation target group typically have a combination of problems of a personal, financial or
social nature that impedes social participation. The overall target group includes:
• people who are so far removed from the labour market that no other labour market instrument is currently a real option;
• people who are, or are likely to become, socially isolated;
• people who are disadvantaged.
There are many types of social activation activities. The most important are voluntary work, group activities, other socially useful
activities, courses, work placement-type activities, guided learning and activities for specific target groups.
All activities that form part of a social activation programme have two important aspects in common:
- When participants are placed in a social activation programme, a case worker keeps in contact with the participant. The case worker
does not leave the volunteer with a social allowance to his or her own devices. This enables progress to be monitored (on behalf of the
‘client’). After all the social services department will almost always want to know how well the participant is performing and
progressing in the social activation programme.
- Some participants are very well able to pursue their activities independently, while others – especially at the start – require supervision.
In practice, the number of hours participants spend on these activities also varies considerably. This calls for a personalised approach
on the part of the supervisors and the institutions where the social activation activities take place. Within this framework, a ‘growth
model’ is particularly appropriate for social activation: a participant can begin with a limited number of hours and a high level of
supervision, and then ‘progress’ to more hours, less supervision and more difficult tasks.
Most of the different organisations involved did develop target group-specific activities and have various sources of funds available for
social activation. The most important sources are:
• the Local Authority Fund, which covers the normal implementation costs of the National Social Security Assistance Act and local
authority welfare policy;
• the Jobseekers Employment Act (WIW) training and activation budget, which can be used to finance social activation programmes;
• European Social Fund subsidies for specific projects;
• the Unemployment Insurance Act (WW) budget for social activation of the unemployed;
• the Occupationally Disabled (Re)integration Act (REA) budget for the social activation of the occupationally disabled; and
• the financial resources available under the so-called ‘comprehensive approach’ policy.
Close cooperation between the organisations involved and coordination of activities are essential if optimum use is to be made of these
resources.
Which success factors play a role? Many local authorities are actively promoting social activation; others are yet to make a start.
Surveying the developments in the social activation field, we can pinpoint the following success factors: integrated approach, strong
support base, good cooperation, a flexible range of services that are in keeping with participants’ personal qualities (customisation, in
fact), voluntary basis but not free of commitment and motivated consultants.
What still has to happen? Generally speaking, we can say that much has already been achieved in the area of social activation, but that
much more can still be done and must be done for the social activation target group. The following are some of the priorities for the
years ahead:
• The development of an overall vision for social activation at the local level. This means that local authorities, welfare organisations
and other organisations involved must work together to develop a vision for social activation. Only then an optimum range of services
can be developed for the target group.
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