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part iii achieving the change - Disability Monitor Initiative

part iii achieving the change - Disability Monitor Initiative

Beyond

Beyond De-institutionalisation: The Unsteady Transition towards an Enabling System in South East EuropeACHIEVING THE CHANGE: KEY STEPS AND SHARED RESPONSIBILITIESis no flexibility to allow for a safe reintegrationinto the labour force. However, considering that thelabour environment in South East Europe is virtuallyinaccessible for people with disabilities regardless ofthe type and severity of their disability and even ifdisability pension is not a real support for inclusion,there is a need for preserving it while proper andeffective income maintenance systems are created.An intermediate disability pension should be based onan individual's needs not on categories of disabilitiesto optimise its impact on social participation ofbeneficiaries.Initiatives for changeMany states have placed an emphasis on disabilitypension reform as a way of redirecting resources.Furthermore, influential agencies such as the WorldBank, stress the notion of reforming the pension andinsurance schemes as a priority for states within socialdevelopment programmes (Box 33).For many countries in the region, pension deficits areextremely high due to the collapse of the former socialwelfare system and the process of decentralisation. Asa result, governments in South East Europe are adoptingnew disability and pension benefits with strict eligibilitycriteria in order to redirect public finances and curb thepension deficit 110 . In 2003, the Serbian governmentadopted a bill tightening eligibility criteria for disabilitypension.These reform initiatives consist of not only tighteningeligibility criteria but in most cases they are draftedwithout comprehensive needs-based assessmentmechanisms and without specific measures forprofessional rehabilitation and employment inclusion.Looking aheadGovernments need to redefine the financial incentive touse residential care mainly because the current fundingstreams create an incentive for local governments torely on institutional care as higher levels of governmentfund them. The fiscal system needs to shift to a clientbasedfocus as Tobis suggests, where "money followsthe client" meaning that local authorities are granted oneallocation from the national budget to be used either forsocial services or residential care on a per client basis.Because community-based services are argued to beless expensive, this approach will create an incentivefor community care 111 . However, this strictly fiscalargument for redirecting resources can be a slippery oneas the number of beneficiaries would probably increasein a community-based service system, possibly makingit more costly than residential institutional care. Sincethere is limited research on the cost of disability it ishard to speculate either way. However, an evaluationand monitoring system can be established that willfollow pilot projects and community-based servicereforms in order to prove that the quality of life of aperson with disabilities improves with more choices,access to society and more opportunities to participate.It might as well reduce the reliance on social welfareif persons with disabilities have the opportunity tocontribute in the community.BOX 34Pension reform initiativesPension reform in Serbia and Montenegro has largely been in the form of reformulating the parametersof the Serbian Pension system, PAYGO, and this has included tightening the eligibility criteria fordisability pension. Within the reform rounds, benefit rules for disability were tightened so that a personwith disabilities can only receive pension if they are 100% incapable of working.Source: World Bank, Serbia and Montenegro: Recent Progress on Structural Reforms, November 2003,pg. 20-22In Bosnia and Herzegovina, in cooperation with the World Bank, the preparations have started for thereform of the pension system through the Social Insurance Technical Assistance Project (SITAP). Thepurpose of this project is to strengthen the effectiveness and efficiency of the health care and pensioninsurance system for future reforms of social insurance. The purpose of insurance schemes is to allowpeople with disabilities to be given the rights to manage their resources and benefits. In addition, theproject will support the competent ministries to build capacities in defining the strategic goals, businessand financial planning and effective implementation of the adopted reforms. The SITAP also calls for astate level disability pension fund to be created. The purpose of insurance schemes is to allow peoplewith disabilities to be given the rights to manage their resources and benefits. Within pension reform,the SITAP sets out a unified pension system for Disabled War Veterans including calls for building toolsand instruments to encourage the employment of veterans with disabilities.Source: Poverty Reduction Strategy Paper for Bosnia Herzegovina 2003, pg. 166-169.110 Interview with Bearing Point, Belgrade, 2004.111 Tobis, ibid, 54.126

Beyond De-institutionalisation: The Unsteady Transition towards an Enabling System in South East EuropeACHIEVING THE CHANGE: KEY STEPS AND SHARED RESPONSIBILITIES5. MOVING FORWARD: THE NEED FOR A NATIONAL DISABILITY STRATEGY ANDNATIONAL COUNCIL ON DISABILITYUN Standard Rule 14. Policy Making and Planning (extracts)States will ensure that disability aspects are included in all relevant policy-making and nationalplanning.• States should initiate and plan adequate policies for persons with disabilities at the national level,and stimulate and support action at regional and local levels,• States should involve organizations of persons with disabilities in all decision-making relating toplans and programmes concerning persons with disabilities or affecting their economic and socialstatus,• The needs and concerns of persons with disabilities should be incorporated into generaldevelopment plans and not be treated separately.A National Disability Strategy is a cross-sectoral policyplanningtool with comprehensive long-term objectivesfor building an enabling system underpinned by fullparticipation. It should accompany the decentralisationprocess and is important because it has the potentialto make comprehensive changes both in the legalframework and in practice, which is particularlyimportant because of the transitional position of thecare system in the region. It is also important to buildand empower a National Disability Council to contributeto the planning of a National Disability Strategy andmonitor its implementation.5.1 Key step: developing and implementinga National Disability Strategy andestablishing a National Council on Disability• A National Disability Strategy should be basedon the new disability paradigm using internationalstandards,• The plan or strategy should be reflective of differenttrends in the disability movement,• A National Council on Disability should head thisand monitor the implementation.BOX 35The characteristics of a good disability policy plan outlined by Agenda 22 LocalAuthorities: Disability Policy Planning Instructions for Local AuthoritiesBegin with using the UN Standard Rules as the underlying guideline for the plan while applyingthe concept of equal partnership with DPOs and people with disabilities in the development andimplementation of the plan.The steps include:• Long-term overarching objectives such as, "In our state, all citizens shall be able to participate incultural life on equal terms".• A summary of inventories indicating how the different social service activities in different regions ormunicipalities work in relation to the UN Standard Rules,• A summary of the social service needs of people with disabilities, critical information such as ageneral description of the total national service needs of people with disabilities disaggregated bymunicipality,• Long-term time table indicating the fields in which measures need to be taken and how thesemeasures are to be spread out over a specified year,• Objectives and concrete measures - description of targets and measures for each field to beaddressed within the period of the plan. The measures should be clarified in such a way as toindicate the steps to be taken, when they are to be completed, the agencies responsible for theirimplementation and how they are to be funded,• Evaluation and revision - procedures as to when and how the plan is to be evaluated and revised.Full text of Agenda 22 is available in the annex to this report.127

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