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Potentials for Development of Community Based Services in the Transition from Institutional Care

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Potentials for development of community based services in the transition from institutional care Authors: Dr. Vito Flaker Vlado Krstovski Technical assistance support for the deinstitutionalisation process in social sector EuropeAid/132633/C/SER/MULTI Specific contract number 2017/384095 A project implemented by the A.E.S.A. Consortium in partnership with Alternative Consulting CONTENTS LIST OF ACRONYMS AND ABBREVIATIONS ..........................................................................................................5 Introduction ............................................................................................................................................................6 ASSESSMENT AND IDENTIFICATION OF POTENTIAL LOCATIONS FOR NEW COMMUNITY BASED SERVICES .......... 7 1.1 Regional differences ...................................................................................................................................8 1.2 Geographical variance of institutionalisation rate ...................................................................................10 1.2.1 Factors of institutionalisation based on regional differences ........................................................13 1.3 Regional distribution of the services ........................................................................................................14 1.4 Impact of transforming institutions ..........................................................................................................16 1.5 Interest for development on specific location ...........................................................................................17 1.5.1 Brief profiles of potential locations ................................................................................................18 1.6 Conclusions and recommendations .........................................................................................................21 1.6.1 Deinstitutionalisation framework propositions..............................................................................21 1.6.2 Economic development rate ..........................................................................................................22 1.6.3 Institutionalisation rate ..................................................................................................................23 1.6.4 Missing services..............................................................................................................................23 1.6.5 Transformation of institutions as a generator of the services .......................................................25 1.6.6 General recommendations for structuring development initiatives .............................................25 1.6.7 Recommendations regarding the specific projects and geographic locations ..............................26 IDENTIFICATION OF POTENTIAL FUTURE COMMUNITY BASED CSO SOCIAL SERVICE PROVIDERS AND ASSESSMENT OF THEIR CAPACITY AND TRAINING NEEDS ............................................................................................ 28 2.1 Legal framework and background ............................................................................................................28 2.2 Overview of the CSO service providers .....................................................................................................29 2.3 Capacity of the CSO service providers .....................................................................................................34 2.4 Training needs ...........................................................................................................................................36 2.5 Conclusions ..............................................................................................................................................36 2.6 Recommendations ...................................................................................................................................37 ESSENTIAL SUPPLIES AND WORKS FOR ADAPTATION AND MODERNISATION/REFURBISHMENT OF POTENTIAL LOCATIONS FOR NEW COMMUNITY BASED LIVING/HOUSING SERVICES, PLUS THE ESTIMATED COSTS WITH PARTICULAR ATTENTION TO THE ACCESS NEEDS FOR PERSONS WITH DISABILITIES ............................................. 39 3.1 Overview ....................................................................................................................................................39 3.2 Options for resolving housing needs ........................................................................................................40 3.3 Social housing apartments provided by MoLSP .......................................................................................41 3.4 Overview of possible costs in securing accommodation in the resettlement process ............................42 RECOMMENDATIONS FOR DEVELOPMENT INITIATIVES .................................................................................................. 46 APPENDICES ........................................................................................................................................................................... 49 5.1 Development indicators and Institutionalisation rate per region .................................................................50 5.2 Tentative allocation of funds by regions, locations and activities .................................................................51 Technical assistance support for the deinstitutionalisation process in social sector Disclaimer The content of this Report is the sole responsibility of the Contractor (AESA) and can in no way be taken to reflect the views of the European Union. 4 | Potentials for development of community based services in the transition from institutional care Technical assistance support for the deinstitutionalisation process in social sector LIST OF ACRONYMS AND ABBREVIATIONS AD adults under 65 CE Centre for counselling and advice CH children CO counselling service CRPD UN Convention on the Rights of Persons with Disabilities CSO Civil Society Organisations CSW Centres for Social Work DC Day centre EU European Union FC Foster care GE general: awareness raising, advocacy, education and information GH Group home HH Home help IPA Instrument for Pre-Accession Assistance IR Institutionatisation rate (number of residents in institutions per capita) MH Mental health MIHB Mothers’ and infants’ home Bitola MoLSP Ministry of Labour and Social Policy NGO Non-Governmental Organisation OA Old age adults OAH Old Age Home RI Residential Institution RIMH mental hospital TC tele-counselling UNICEF United Nations Children Fund Potentials for development of community based services in the transition from institutional care | 5 Technical assistance support for the deinstitutionalisation process in social sector INTRODUCTION The following report has been developed under the EU funded project Technical Assistance support for the deinstitutionalisation in the social sector. This report provides a cumulative text of the outputs grouped around the second component of the project, notably: - Output 2.1: Assessment and identification of potential locations for new community based services - Output 2.2: Identification of potential future community based CSO social service providers and assessment of their capacity and training needs - Output 2.3: Essential supplies and works for adaptation and modernisation/refurbishment The data provided here have been collected following an extensive consultation with the institutional stakeholders, notably the Ministry of Labour and Social Policy, the residential institutions, the centres for social work, the CSO in the area of community based care, as well as through interviews and presentations with a group of municipality representatives, including mayors within a workshop held under the auspices of the project. Each Output is presented in a separate chapter followed by brief recommendations for future development initiatives as currently discussed among the Ministry for Labour and Social Policy (MoLSP), service providers and the European Union Delegation to Skopje. It has to be noted that this report presents only suggestions and recommendations and that the decisions on the amount and type of support for the future development activities lies with the entire body of deinstitutionalisation (DI) stakeholders, namely the Ministry of Labour and Social Policy in coordination with the local municipal administration affected. In addition, it needs to be clear that this document does not present all the actions which need to be performed for the transition from institutional to community care – for this ‘The Deinstitutionalisation Strategy with the Action Plan’ and ‘the Common European Guidelines on the Transition from Institutional to Community Based Care’ have to be consulted. 6 | Potentials for development of community based services in the transition from institutional care Technical assistance support for the deinstitutionalisation process in social sector ASSESSMENT AND IDENTIFICATION OF POTENTIAL LOCATIONS FOR NEW COMMUNITY BASED SERVICES For the implementation of the National Strategy for Deinstitutionalisation, in addition to and in line with its Action Plan, it is important to identify locations and design mechanisms for how diverse actors will collaborate on and about the chosen locations in transforming the institutions and establishing a new response in the community; both – in the immediate environment of the residential
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