Making community-based services a reality.

Roadmap to deinstitutionalisation

Belgrade, 24 April 2015Sabrina Ferraina

Senior Policy Officerwww.easpd.eu

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EASPD

European Association of Service providers for Persons with Disabilities (EASPD)• Representing social and health support

services in the disability sector• Ensuring implementation of the CRPD

through high quality service systems• Accredited to the UN Conference of

State Parties to the CRPD

What is EASPD?

EU NGO in the disability sector

It represents over 10,000 social service provider organisations across Europe

Based in Brussels, established in 1996

EASPD plays a key role on a European level as a representative of disability service providers

Objective: Promote equal opportunities for people with disabilities through effective and high quality service systems in Europe

EUROPEAN ASSOCIATION OF SERVICE PROVIDERS

FOR PERSONS WITH DISABILITIES

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3 Pillars

INFORMATIONService provision

to members: networking,

exchange possibilities to

members at European,

national, regional and local level

INNOVATIONResearch and

Development: as basis for

innovation and improvement of service provision

IMPACT Policy-

influencing: voicing service

providers in Europe

( Political Representation

towards EU Institutions and

Council of Europe)

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Methods of operation

ICT & Assistive Technology

Arts

Early intervention

Human Resources and Staff Development

Education

Inclusive Living

Employment

Policy Impact Group

STANDING COMMITTEES

&

INTEREST GROUPS

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Areas of action

• Education• Employment

• Social Inclusion: 1/3 of EASPD’s members provide residential/daycare support

Standing Committee on Inclusive Living

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EASPD work on DI

• Standing Committee on Inclusive Living• Involvement in the European Expert Group on DI• Cooperation with other European networks• Cooperation with housing sector• Development of personal assistance schemes

(self-directed support, etc.)

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Standing Committee on Inclusive Living

To discuss strategic and practical ways to implement Art 19 UN CRPD in EASPD's member organisations•To collect and exchange models of good practice in the field of de-institutionalisation and (supported) housing•To support the development of instruments facilitating user involvement and independent living•To draft policy recommendation for authorities at all levels•To study the future challenges in social care, housing and support•To increase cooperation with other European networks on housing for vulnerable groups

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European Expert Group

• Set up in 2009• Includes:

– UN bodies (OHCHR, Unifec)– Institutions (European Union)– NGOs (EASPD, EDF, Mental Health Europe,

Eurochild, …)

• Organisation of seminars, trainings and lobby activities

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EASPD work on DI

• Strong commitment since the beginning

• Wide approach covering the whole of Europe

• 2009: EASPD becomes part of the European Expert Group on DI

• October 2011: Seminar on DI in Western EU countries

• May 2013: Seminar on DI in Europe• Dec 2013: EASPD DI roadmap

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EASPD’s position on DI & CBS

EASPD Declaration on Article 19: “Making community-based services a reality.Roadmap to deinstitutionalisation”• Adopted by the EASPD Board in

December 2013• EASPD’s strategy in this field

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Context DI Roadmap

Social model of disability of the UN CRPD:• society needs to respond to existing

barriers• inclusion and participation are the key

concepts enabling PWDs rights• positive measure are strongly encouraged

consequence

Change in the provision of long term and intense care is required

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Key articles Social Inclusion

• UN CRPD• Art 12: Equal recognition before the

law • Art 19: Living Independently and

being included in the community

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Art 19: Living Independently and being included in the community• Establishes the equal right of all persons with disabilities to

live in the community, with choices equal to others.

State Parties should ensure that:• Persons with disabilities have the opportunity to choose their

place of residence and with whom they live with on an equal basis with others

• Persons with disabilities have access to a range of in-home residential and community services, including personal assistance necessary to support living and inclusion in the community rather than isolation or segregation

• Community services and facilities for the general population are available on an equal basis to persons with disabilities and are responsive to their needs

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Key concepts

• Participation• Inclusion• Equality of opportunity• Non-discrimination

• Equal recognition before the law• Accessibility• Reasonable accommodation• Universal Design

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Long term/intense care today

• Mostly residential care settings have a protective (segregating) approach

• Wide array of quality level• Lack of participative, inclusive and

person-centred approach

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Segregating institutions

Choice• Any place in which persons are

isolated, segregated and/or compelled to live together

Control• Any place in which people do not

have, or are not allowed to exercise control over their lives and their day-to-day decisions.

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Segregating institutions

Inclusion• An institution is not defined merely

by its size:Segregating environments can be reproduced also in small-scale settings

Participation – Equal opportunities• Typically the requirements of the

organization tend to take precedence over the users' individualized needs.

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Support services

• Ensure person-centred inclusive approach• Long term complex process that poses

many issues to service providers• The transition from DI to CBS is complex

• Objective: Promoting community-based services, adapted to individual needs, that promote participation and inclusion

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Challenges

• Careful planning• People with complex needs• Innovative solutions to provide

choice and control• Funding is needed

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Expected result

Community-based services:• “spectrum of services that enable

individuals to live in the community and, in the case of children, to grow up in a family environment as opposed to an institution”

They include:• mainstream services: i.e. housing,

healthcare, education, employment, culture and leisure

• specialised services: i.e. such as personal assistance for persons with disabilities, respite care and others

• family-based and family-like care for children

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Social and health support services

Support services should:

• Facilitate full participation, inclusion and equal citizenship

• Be tailored to the individual needs and preferences

• Designed and delivered in coproduction with users

• Be community-based and rooted in society• Be set-up in and in close cooperation with the

mainstream sector

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Social and health support services

Support services should:

• Be provided by well trained staff• Respect the social network around

the person• Be based on stakeholder cooperation• Ensure security to all people with

support needs• Allow real and informed choices

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EASPD’s actions

• Promote correct implementation of the UN CRPD at national and EU level

• Monitoring policies & Support Members

• Promote networking between mainstream and specialised settings

• Ensure representation of services and PWD in the debate

• Research and data collection

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Recommendations to all stakeholders

• Involvement of all actors and services

• Planning and monitoring• Staff training and staff development• Establish cooperation between

mainstream and specialised services• Make use of EU funds

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Conclusions

• Involvement of all actors is essential (families, users, stakeholders, service providers) in all stages of the process

• Mainstreaming of services with all actors

• Quality of life is above quality of services

• Institutional culture can thrive also in community-based services

• Planning and monitoring is needed

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Follow-up & Monitoring

• What’s the state of play?• Did we miss something?• What should we focus on as a matter

of priority?• Have there been any step-backs?

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References

• EASPD DI Roadmap: http://easpd.all2all.org/sites/default/files/sites/default/files/Policy/easpd_di_roadmap_final.pdf

• European Expert Group: www.deinstitutionaliseguide.eu• EN (English) - Common European Guidelines on the

Transition from Institutional to Community-Based Care, available in Serbian here:http://deinstitutionalisationguide.eu/wp-content/uploads/2013/09/smernice_korigovane_priprema.pdf

• European Expert Group blog “From institutions to living in the Community”:http://deinstitutionalisation.com/

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Any questions ?

Thank you for your attention!

Sabrina FerrainaSabrina.ferraina@easpd.eu

www.easpd.eu

With support from the European Union Programme for Employment and Social Innovation “EaSI” (2014-2020)