PLAN FOR PARTICIPATION AND QUALITY OF LIFE OF PEOPLE WITH DISABILITIES IN BIZKAIA/BISCAY 2016 -2019

PLAN FOR PARTICIPATION AND QUALITY OF LIFE OF PEOPLE WITH DISABILITIES IN BIZKAIA/BISCAY 2016 -2019 PROMOTER: PROVINCIAL COUNCIL OF BIZKAIA. DEPT. OF SOCIAL ACTION

DRIVER TEAM: OLGA MAIZ, ELENA ITURRIZAGA, IMANOL MADARIAGA & SERGIO MURILLO (PROVINCIAL COUNCIL OF BIZKAIA)

TECHNICAL SUPPORT: YOLANDA FILLAT (ALTER CIVITES)

ACKNOWLEDGEMENTS: ADEMBI (MULTIPLE SCLEROSIS ASSOCIATION OF BIZKAIA) AFA (ASSOCIATION OF FAMILIES OF ALZHEIMER’S SUFFERERS IN BIZKAIA) APNABI (ASSOCIATION OF PARENTS OF CHILDREN WITH AUTISM AND OTHER AUTISM SPECTRUM DISORDERS IN BIZKAIA). ASPACE BIZKAIA (CEREBRAL PALSY ASSOCIATION OF BIZKAIA) ATECE (ACQUIRED BRAIN DAMAGE ASSOCIATION OF BIZKAIA) AVIFES (ASSOCIATION OF MENTAL ILLNESS SUFFERERS AND FAMILIES IN BIZKAIA) BIDAIDEAK. EUSKAL GORRAK (BASQUE FEDERATION OF ASSOCIATIONS FOR THE DEAF) FEKOOR (FEDERATION FOR THE COORDINATION OF PERSONS WITH PHYSICAL AND/OR ORGANIC DISABILITIES IN BIZKAIA) ARGIA FOUNDATION. ERAGINTZA FOUNDATION. BASQUE DOWNS SYNDROME FOUNDATION FUTUBIDE (LEGAL GUARDIANSHIP FOUNDATION) GORABIDE (ASSOCIATION FOR PERSONS WITH LEARNING DISABILITIES IN BIZKAIA) LANTEGI BATUAK. ONCE (SPANISH NATIONAL ASSOCIATION FOR THE BLIND) ULERTUZ (ASSOCIATION OF FAMILIES AND FRIENDS OF DEAF CHILDREN IN BIZKAIA) URIBE COSTA (URIBE COSTA DISTRICT ASSOCIATION FOR PERSONS WITH LEARNING DISABILITIES) IFAS (PROVINCIAL SOCIAL ASSISTANCE INSTITUTE) ITB (LEGAL GUARDIANSHIP INSTITUTE OF BIZKAIA)

PUBLISHED BY: PROVINCIAL COUNCIL OF BIZKAIA. DEPT. OF SOCIAL ACTION. UGASKO 3, 2ª PLANTA. 48014 BILBAO

GRAPHIC DESIGN BY: LOGORITMO. PLAN FOR PARTICIPATION AND QUALITY OF LIFE OF PEOPLE WITH DISABILITIES IN BIZKAIA/BISCAY 2016 -2019

PLAN FOR PARTICIPATION AND QUALITY OF LIFE OF PEOPLE WITH DISABILITIESIN BIZKAIA/BISCAY 2016 -2019

INTRODUCTION 7

CONTEXTUALISATION AND DIAGNOSIS 9

1. ELEMENTS OF CONTEXTUALISATION AND BACKGROUND 9

2. PEOPLE WITH DISABILITIES IN BIZKAIA 13

3. THE CURRENT RANGE OF SERVICES OFFERED BY THE REGIONAL SOCIAL 19 SERVICES SYSTEM FOR PEOPLE WITH DISABILITIES AND THEIR FAMILIES

4. MAIN ACHIEVEMENTS AND CHALLENGES IN THE MODEL FOR 21 PARTICIPATION AND QUALITY OF LIFE IN THE COMMUNITY

VISION, OBJECTIVE, PREMISES AND STRATEGIC FRAMEWORK 25

AXES, STRATEGIC OBJECTIVES AND PRIORITY LINES OF ACTION 29

SYSTEM FOR THE APPLICATION AND EVALUATION OF THE PLAN 35

APPENDIX 1. METHODOLOGY 37

APPENDIX 2. STATISTICS ON PEOPLE WITH DISABILITIES BY SEX 39

APPENDIX 3. SOURCES AND REFERENCES 43

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PLAN FOR PARTICIPATION AND QUALITY OF LIFE OF PEOPLE WITH DISABILITIESIN BIZKAIA/BISCAY 2016 -2019

INTRODUCTION

The Model for Participation and Quality of Life in the Community is the reference model for the care and attention of people with disabilities and their families, and we are committed to advancing its full implementation and development in Bizkaia, with a shared commitment between the Department of Social Action and the region’s social institutions for disability. The Plan for Participation and Quality of Life of People with Disabilities in Bizkaia 2010-2013 has developed this model and its key points as a guide during its progressive implementation. With a focus on the long term, the aim is that its effective implementation will bring a cultural change in the agents and care mechanisms (services, procedures, tools and so on). It is a model that is aligned with scientific and legislative frameworks on the rights, quality of life, equal opportunities and participation of people with disabilities. In particular the United Nations Convention on the Rights of Persons with Disabilities, the International Classification of Functioning, Disability and Health, World Health Organisation (CIF 2001), and Person-centred Planning. It reflects a modern vision, both in understanding the social services system and in the interaction between the Third Sector and the Public Administration, as well as the role of those targeted, the primary causative agents in their own lives. This vision and model will be maintained and this new Plan aims to deepen its operational application for the time period 2016-2019. Indeed, in the coming years, it focuses on achieving a more practical application, operation and balance in the effective deployment of the five strategic axes of social transformation which were defined in the previous Plan and are ongoing in this new Plan. Historically, the Department of Social Action of the Regional Government of Bizkaia has, with the cooperation of social organisations, made a strong commitment to supporting and promoting the most vulnerable people of the area, including people with disabilities and their families. Its role of leadership and momentum in policies in this field in Bizkaia, as an institutional agent with public responsibility for the care, support and promotion of this group, reflects itsrecord of commitment to disability as well as the deployment of its powers, within the current legal framework. This commitment, laid out clearly in its plans, is to contribute to progress in conditions and qualitative, quantitative support in Bizkaia for the quality of life and participation of people with disabilities and their families, in their diversity, with full equality of opportunities in the exercise of all their rights. Within this context, the objective of this Plan 2016-2019 is to contribute to improving the performance of individuals, institutions and organisations involved in the care and promotion of these people in Bizkaia, progressively orienting them towards the Model for Participation and Quality of Life in the Community:

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• Both to achieve the progressive participation of all the key actors in Basque society whose involvement is necessary in a process of cultural change and social transformation towards an inclusive, diverse society. • And also to achieve continuous improvement, fairness, universality, quality and adaptation of the Regional Social Services to the current and emerging needs of these people. Developed with the participation of social organisations for disability in Bizkaia, the recipients of this Plan are all people with disabilities in Bizkaia and their families, both who require specialised support from the system of social services with regional responsibility1 and those who do not require or request this type of support, but whose real personal autonomy, development and equality requires decisive action and the involvement of multiple agents, as part of a social transformation towards a culture of equal opportunities. Therefore, the document presented below shows the following structure: a) Contextualisation and diagnosis: this includes the elements of contextualisation and background, the approach to the situation of people with disabilities and their families in Bizkaia, through the preparation of their profile, the main initiatives carried out for their care and attention and the identification of the main achievements and challenges to advancing the Participation and Quality of Life in the Community Model. b) Vision, purpose, assumptions and strategic framework for implementing the Model for Participation and Quality of Life in the Community. c) Central axes, strategic objectives and priority lines of action to implement the Model for Participation and Quality of Life in the Community. d) Indicators and work system for monitoring and evaluating the implementation of this Plan. e) Appendices: details of the methodology developed for the preparation of this Plan and list of sources and references used.

1  By “system of social services with regional responsibility” we mean a combination of aid, benefits and social services, with regional responsibility, mutually interdependent and making up an articulated, flexible and personalised network of resources, integrated in the Basque Social Services System and oriented, in this area, to the attention of people with life-long disabilities.

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CONTEXTUALISATION AND DIAGNOSIS

1. ELEMENTS OF CONTEXTUALISATION AND BACKGROUND The context for the development of this Plan for the Participation and Quality of Life of People with Disabilities in Bizkaia 2016-2019 is that it is part of the following priority elements of the regulatory and applicable scientific framework, background and context:

1.1. THE FRAMEWORK OF RIGHTS FOR PEOPLE WITH DISABILITIES AND GUARANTEES FOR THEIR EFFECTIVENESS People with disabilities are citizens with full rights. They have the same rights as all people, and it is necessary to guarantee them all conditions, support and positive action necessary – across the board in all areas of community involvement - to ensure their enjoyment and exercise of these rights without discrimination, with opportunities equal to those of other people and conditions of universal accessibility in all areas. In particular, the Social Services System, seen as a generator of conditions for effective equality and positive measures for participation, personal autonomy and quality of life, constitutes one of the basic instruments for ensuring that people with disabilities in need of support in this area have the effective exercise of and access to all their rights. In this regard, the United Nations Convention on the Rights of Persons with Disabilities, the Charter of Fundamental Rights of the European Union and the Treaty on the Functioning of the European Union, the Statute of Autonomy of the Basque Country and Law 12/2008 of the Social Services make up the priority regulatory reference framework for this Plan, offering guarantees of human rights and fundamental freedoms of people with disabilities and promoting conditions for their equality of opportunities and participation. Furthermore, this Plan takes the Europe 2020 Strategy approach towards smart, sustainable and inclusive growth as its benchmark. It is essential for its success for people with disabilities to participate fully in economic and social life in accordance with the European Disability Strategy 2010-2020: A renewed commitment to a barrier-free Europe. Accessibility, participation, equality, employment, education and training, social protection, healthcare and external action are the primary areas of this strategy. In particular, the Plan is launching a process to empower people with disabilities so they can fully participate in society on an equal playing field with the rest of the population.

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1.2.THE SCIENTIFIC AND CONCEPTUAL FRAMEWORK OF DISABILITY At a scientific and conceptual level, the following references on how to understand a person with disabilities and the support model must be taken into account: • The International Classification of Functioning, Disability and Health (CIF 2001 of the World Health Organisation). This establishes a connection between the various (biological, personal and social) levels that support disability and affect each of them in a balanced and complementary way. The interactions that occur between all elements of these levels may affect the person positively in their ability to carry out activities and their participation in all areas of their life or negatively, in their disability or limitation for carrying out activities or for their participation. Within this new mode of understanding the phenomenon of disability and its implications, the social context is a prerequisite factor to enable or prevent the person from developing their full potential capacity and enjoying the same rights and opportunities as other citizens. In line with this new approach, the United Nations Convention on the Rights of Persons with Disabilities itself exceeds the rehabilitation model and incorporates social and diversity models. According to the social model it is not only individual limitations that are at the root of the problems of people with disabilities, but - above all - the limitations of society to provide appropriate services and to properly ensure that their needs are taken into account within the social organisation. Consequently, solutions should not only target the person individually, but must also be directed towards society. The model of diversity, related to the social model, requires the consideration of the disabled person as a valuable being themself for their diversity. They are a person who is different to another, so that their presence in society is a real enrichment factor2. In short, this model proposes profound changes in the way of conceptualising disability, in society’s vision and attitudes towards it, and in particular, the orientation of the policies and actions of the government, as responsible for establishing the necessary conditions for effective equality of opportunity and eliminating other conditions that prevent or hinder this equality.

• The Quality of life model, support system and person-centred planning. The most widely-used and agreed Quality of life model is that developed by Schalock and Verdugo. It covers eight essential dimensions: emotional welfare, interpersonal relationships, personal development, material welfare, physical welfare, self-determination, social inclusion and rights. It is based on the conviction that a proper application of support can improve the functional capabilities and personal autonomy of the people to whom it is addressed. In fact, the support is aimed at making a positive impact on living conditions and achieving positive personal outcomes. The support system is defined as a “set of resources and strategies designed to promote development, interests, quality of life and individual autonomy”, with various sources of support: the person themselves, their family and living environment, the general resources of the community and specialised support and services. The Model is aimed at achieving the appropriate conditions from those the environment must put in place and the implementation of all the supports and opportunities, involving all the systems across the board where the quality of people’s lives is at stake, in all of its dimensions.

2  Source: Report on the impact of the Convention on the Rights of Persons with Disabilities on the Spanish legal system. Human Rights Institute Bartolomé de las Casas of the Carlos III University, Madrid.

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This model also directs attention to the person, rather than to their disability or limitations, and to their powers; the empowerment and strengthening of people’s own capacities is essential to achieve the highest level of personal autonomy and independent life in the community throughout the course of their life (compared with more traditional models of rehabilitative or assisted care). This Model views the person as the protagonist of their own life project, participating with their desires, choices and decisions - taking into account the support they need in each case - in planning and energising all the sources of support and opportunities, evolving throughout the course of their life. The whole support system is structured through the coordination and streamlining of support, based on the methodology of person-centred planning (PCP). In this way, it provides results concerning the person, from the promotion of competence, training and strengthening of control over their lives and boosting their self-determination in order to achieve greater membership and participation in the community.

1.3. MODEL FOR PARTICIPATION AND QUALITY OF LIFE AS A BENCHMARK FOR THE CARE AND PROMOTION OF PEOPLE WITH DISABILITIES AND THEIR FAMILIES IN BIZKAIA The Plan for Participation and Quality of Life of Persons with Disabilities in Biscay 2010-2013 was developed with the participation of the Regional social organisations for disability and involved the consensus of key stakeholders in the shared model for care and attention of people with disabilities and their families — the Model for Participation and Quality of Life — which we plan to fully implement and develop. The Model is based on the legal and scientific framework laid out in the preceding paragraphs and is the result of the collaboration of the social organisations for disability in Bizkaia, based on the progress made by the organisations which represent, attend and serve people with disabilities and their families. Indeed, within the contextual framework, we must not forget that the organisations and networks of the Third Sector of Social Action and the Social Action Department have a long history of collaboration in the field of social services. As a result of the gradual maturing of the field of social services and the relationships between the parties, there has been progress in the dialogue with the third sector and in setting up a model for collaboration both in general activities and to provide services which have gradually been configured as services of regional responsibility. The main expression of this collaboration has been the creation and operation of the Round Table for Civil Dialogue3. The Model for Participation and Quality of Life in the Community is a commitment to transforming the neighbourhood community environment in which people with disabilities and their families can develop and advance within a culture of equality of opportunity in society as a whole, and in which they have the necessary support to maximize their capabilities so that they have maximum autonomy, inclusion and community development.4

3 Sources: “The collaboration of the Third Sector and the Regional Government of Bizkaia, in the social services area. To consolidate progress made and plan the future” and the Round Table for Civil Dialogue of Bizkaia. http://www.bizkaia.net/home2/Temas/DetalleTema.asp?Tem_Codigo=6860&Idioma=CA 4 Source: Plan for Participation and Quality of Life for People with Disabilities in Bizkaia 2010-2013.

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Also, as an integral model in addition to Quality of Life, it also incorporates Quality Management, based on an advanced management model and ethics in care, adding the ethical standpoint. The Plan, as well as identifying and validating this Model, establishes its key strategic priorities to advance its implementation. In the process of evaluating this Plan conducted with the participation of social organisations of disability, we have evaluated the validity of the Model and its axes, as well as the need to advance in its operability and practical application.

1.4. THE CONTEXT OF DEPLOYMENT AND CONSOLIDATION OF THE BASQUE SOCIAL SERVICES SYSTEM In late 2015, the Basque Government approved two basic instruments for the deployment of the Basque Social Services System (SVSS, from its acronym in Spanish), in development of Law 12/2008 on the Social Services: • Decree 185/2015, of 6 October, on the portfolio of benefit payments and services of the Basque Social Services System which includes the identification and content of benefits and services of the SVSS, as well as the requirements, criteria and procedures for access to its facilities and services. This specifies the content and defines the individual rights enshrined in Law 12/2008 and, at the same time, the obligations of the Basque government in relation to the provision of benefits and services of this Department. • The Strategic Plan of Social Services in the Autonomous Community of the Basque Country 2016-2019, whose aim is that in the coming years the Basque Country should have one single model of social services that guarantee access to the same benefits and services in the whole of the region, moving towards similar levels of coverage and prioritising the extension of benefits and services of the Department. The plan also provides a map of the social services — with the general criteria for minimum coverage to be achieved by 2017 — and the budget required to do so, with an economic report. The Regional Governments and local authorities should make a plan for the deployment of services and benefits within their jurisdiction, taking into account the general criteria set out in this Strategic Plan and the Map of Social Services of the Basque Country. Both instruments are aimed at consolidating the SVSS and moving towards its universalisation by 2020, as a universal system or network, in the hands of the Regional Government, composed of concerted benefits, services and teams of public and private ownership, with the prevalence of the public and social initiative. This Plan for the Participation and Quality of Life of People with Disabilities in Bizkaia 2016-2019 is presented in this context, in line with the application of these instruments for the development and consolidation of the Basque Social Services System.

1.5. THE CONTEXT OF PROMOTING PUBLIC HEALTH IN THE BASQUE COUNTRY This Plan also takes into account the ‘Strategic Lines of Social Healthcare for the Basque Country (2013-2016)’, aimed at promoting cross-sectional, intersectoral coordination among Government departments, Regional Governments and Town and City Councils, setting the action lines arising from this coordination and target groups as priorities for the legislature.

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2. PEOPLE WITH DISABILITIES IN BIZKAIA According to the Survey on Disabilities and Impairments and the Survey on Disability, Personal Autonomy and Situations of Dependency 2008 (with the Spanish acronym EDAD)5, in Bizkaia there were 92,200 people with disabilities - people in households who are over 6 years old with serious limitations in carrying out daily living activities -: 60% of them are female and 40% are male, and they represented 9.35% of the population of Bizkaia. 6 This is the group of people covered by this Plan, and the development of its strategy, objectives and lines of action is aimed at them, in particular through the transverse, transforming nature of its axes, relating to an independent life in the community, inclusion and active participation, universal accessibility, design for all and equal opportunity. From the perspective of the axes oriented to the continuous improvement of the regional system of social services (Equality and universality of social services, Quality and person- centred planning), the identification of the beneficiaries of the Plan requires consideration of those people who have an official recognition of disability, taking into account that a significant number of them may be users (current or potential) or applicants for services and benefit payments of the System. According to the database of the Department of Social Action (data from December 31, 2015), in Bizkaia there are 64,918 people with disabilities; 43% of them are women and 57% men.

TABLE 1. PEOPLE WITH DISABILITIES IN BIZKAIA BY SEX (2015)

Total WOMEN Women 27.633 43% 43% MEN Men 37.285 57% 57% Total 64.918 100%

Source: Regional Government of Bizkaia Department of Social Action Database.

The distribution of these people by Social Action Areas is shown in the following table according to the territorial zone division used so far by the Department of Social Action, which will have to be adapted to the zoning established when deploying the Map of Social Services in the Basque Country7:

5  Survey on Disability, Independence and Dependency Situations 2008, aimed at households, carried out by the National Institute of Statistics. This survey does not include information broken down by province relating to centres. It must be taken into account that this survey uses a broad definition of disability; it refers to people who have serious limitations in performing activities of daily life that have lasted or are expected to last more than a year and have their origin in a deficiency, i.e., it is not restricted to people who have a disability certificate but also includes other people who have activity limitations and participation restrictions.

6  Source: Review of the Municipal Register 2008. Data nationwide, from the autonomous community and province. National Institute of Statistics. Definitive results. Extracted 1 January, 2013 (17 January 2014). Bizkaia population in 2008: 986,043 people.

7  BILBAO; EZKERRALDEA- ENKARTERRIAK (Margen Izquierda, Barakaldo, Zona Minera and Encartaciones); IBAIZABAL- NERVIÓN (Durangaldea, Arratia, Basauri- Etxabarri- Galdakao, Nerbioi); BUSTURIA- URIBE (Uribe, Busturialdea, Mungialde-Txorierri, Lea-Artibai). This distribution will be adapted to areas to be established within the forthcoming Map of Social Services in the Basque Country.

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TABLE AND FIGURE 2. PEOPLE WITH DISABILITIES BY SOCIAL ACTION ZONE AND SEX. BIZKAIA (2015).

Social Action Zone W M Total BUSTURIA- BILBAO 9.109 11.424 20.533 32% URIBE; 21% BILBAO; 32% EZKERRALDEA-ENKARTERRIAK 7.758 10.745 18.503 29% IBAIZABAL-NERBIOI 5.006 7.371 12.377 19% IBAIZABAL- BUSTURIA-URIBE 5.746 7.716 13.462 21% NERBIOI; 19% OUTSIDE BIZKAIA (*) 14 29 43 0,1% EZKERRALDEA- Total 27.633 37.285 64.918 100% ENKARTERRIAK; 29%

(*) People with disabilities registered in the database of the Department whose residence address is outside Bizkaia.

Source: Regional Government of Bizkaia Department of Social Action Database. By age, 41% of people with disabilities in Bizkaia are 65 or older (for the whole population of Bizkaia this percentage is 21%8). In addition, 29% of these disabled people are aged between 50 and 64 years.

TABLE AND FIGURE 3. PEOPLE WITH DISABILITIES IN BIZKAIA BY AGE GROUP AND SEX (2015).

95 and 0ver Age group W M Total 90 to 94 85 to 89 0 to 6 324 517 841 1% 80 to 84 75 to 79 7 to 15 594 1.322 1.916 3% 70 to 74 65 to 69 16 to 21 422 691 1.113 2% 60 to 64 55 to 59 22 to 49 6.252 9.190 15.442 24% 50 to 54 45 to 49 50 to 55 2.880 4.165 7.045 11% 40 to 44 35 to 39 56 to 64 4.574 6.907 11.481 18% 30 to 34 25 to 29 20 to 24 65 to 74 4.995 7.501 12.496 19% 15 to 19 10 to 14 w 75 and over 7.592 6.992 14.584 22% 5 to 9 M 0 to 4 Total 27.633 37.285 64.918 100% Source: Regional Government of Bizkaia Department of Social Action Database. Divided into the type of disability these people have (physical and/or organic, intellectual, mental or sensory, according to the first disability identified or prevalent disability9), 52% have physical and/or organic, 21% are people disabled by mental illness, 16% have sensory disability, and 9% intellectual disability:

TABLE AND FIGURE 4. PEOPLE WITH DISABILITIES IN BIZKAIA BY TYPE OF DISABILITY AND SEX (2015).

Unspecified Type of disability W M Total 2% Physical and/or organic Mental 13.366 20.540 33.906 52% Illness disability 21%

Intellectual Disability 2.395 3.167 5.562 9% Physical disability Sensory Disability 5.201 5.142 10.343 16% Sensory 52% disability Mental Illness 6.153 7.773 13.926 21% 16% Intellectual Unspecified 518 663 1.181 2% disability Total 27.633 37.285 64.918 100% 9%

Source: Regional Government of Bizkaia Department of Social Action Database.

8  Source: National Institute of Statistics. Statistics from the Continuous Register. Interim data to 1 January 2014. Total population in Bizkaia in 2014: 1,152,041 people; population aged 65 and over in Bizkaia in 2014: 245, 611 people. 9  Note: people with cerebral palsy are included with people with physical disabilities or people with intellectual disabilities, according to the disability first identified or prevalent.

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The following tables and charts show their distribution depending on the degree of disability they have (<33%; Slight - between 33% and 44.5% Moderate - between 45% and 64.5%; Serious - between 65% and 74.5% and Very Serious - 75% or more),:

TABLE AND FIGURE 5. PEOPLE WITH DISABILITIES IN BIZKAIA BY DEGREE AND SEX (2015)

<33% Very Degree W M Total 3% serious < 33% 945 1.210 2.155 3% 15% Slight 10.004 15.158 25.162 39% Slight 39% Moderate 4.919 7.030 11.949 18% Serious 24% Serious 6.721 8.980 15.701 24% Very Serious 5.044 4.907 9.951 15% Moderate Total 27.633 37.285 64.918 100% 19% Source: Regional Government of Bizkaia Department of Social Action Database.

TABLES AND FIGURE 6. PEOPLE WITH DISABILITIES BY TYPE OF DISABILITY AND DEGREE (BIZKAIA 2015)

Type of disability < 33% Slight Moderate Serious Very Serious Total

Physical and/or organic 1,558 5% 15,179 45% 7,098 21% 5,828 17% 4,243 13% 33,906 52%

Intellectual 5 0% 1,466 26% 864 16% 1,867 34% 1,360 24% 5,562 9%

Sensory 252 2% 4,451 43% 1,758 17% 1,287 12% 2,595 25% 10,343 16%

Mental 144 1% 3,642 26% 2,067 15% 6,444 46% 1,629 12% 13,926 21%

Unspecified 196 17% 424 36% 162 14% 275 23% 124 10% 1,181 2%

Total 2,155 3% 25,162 39% 11,949 18% 15,701 24% 9,951 15% 64,918 100%

Física Intellectual Sensory Mental Unspecified

<33% Slight Moderate Serious Very serious

Source: Regional Government of Bizkaia Department of Social Action Database.

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TABLES AND FIGURES 7. WOMEN AND MEN WITH DISABILITIES BY TYPE OF DISABILITY AND DEGREE (BIZKAIA 2015)

WOMEN WITH DISABILITY Type of disability < 33% Slight Moderate Serious Very sarious Total Physical and/or 665 5% 5.685 43% 2.638 20% 2.376 18% 2.002 15% 13.366 48% organic Intellectual 3 0% 538 22% 393 16% 819 34% 642 27% 2.395 9% Sensory 112 2% 2.068 40% 883 17% 662 13% 1.476 28% 5.201 19% Mental 78 1% 1.528 25% 940 15% 2.743 45% 864 14% 6.153 22% Unspecified 87 17% 185 36% 65 13% 121 23% 60 12% 518 2% Total 945 3% 10.004 36% 4.919 18% 6.721 24% 5.044 18% 27.633 100%

MEN WITH DISABILITY Type of disability < 33% Slight Moderate Serious Very sarious Total Physical and/or 893 4% 9.494 46% 4.460 22% 3.452 17% 2.241 11% 20.540 55% organic Intellectual 2 0% 928 29% 471 15% 1.048 33% 718 23% 3.167 8% Sensory 140 3% 2.383 46% 875 17% 625 12% 1.119 22% 5.142 14% Mental 66 1% 2.114 27% 1.127 14% 3.701 48% 765 10% 7.773 21% Unspecified 109 16% 239 36% 97 15% 154 23% 64 10% 663 2% Total 1.210 3% 15.158 41% 7.030 19% 8.980 24% 4.907 13% 37.285 100%

TABLES AND FIGURES 8. PEOPLE WITH DISABILITIES ACCORDING TO TYPE, AGE GROUP AND DEGREE (BIZKAIA 2015) – SEE DETAIL BREAKDOWN BY SEX IN APPENDIX 2 PEOPLE WITH PHYSICAL AND/OR ORGANIC DISABILITY Age group < 33% slight Moderate Serious Very serious Total 0 to 6 226 164 34 55 15 494 7 to 15 74 179 74 49 81 457 16 to 21 17 126 53 42 72 310 22 to 49 408 2.814 892 911 779 5.804 50 to 55 195 1.592 644 586 382 3.399 56 to 64 292 3.159 1.399 995 606 6.451 65 to 74 249 3.552 1.837 1.430 804 7.872 75 and over 97 3.593 2.165 1.760 1.504 9.119 Total 1.558 15.179 7.098 5.828 4.243 33.906

0 to 4 5 to 9 10 to 14 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 94 95 to 100 0ver 100

<33% Slight Serious Moderate Very serious

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PEOPLE WITH INTELLECTUAL DISABILITY Age group < 33% slight Moderate Serious Very serious Total 0 to 6 12 4 1 2 19 7 to 15 108 46 61 44 259 16 to 21 138 52 91 67 348 22 to 49 4 829 446 996 704 2.979 50 to 55 196 110 258 221 785 56 to 64 1 137 128 289 163 718 65 to 74 32 49 126 111 318 75 and over 14 29 45 48 136 Total 5 1.466 864 1.867 1.360 5.562

0 to 4 5 to 9 10 to 14 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 94 95 to 100 0ver 100

<33% Slight Moderate Serious Very serious

PEOPLE WITH SENSORY DISABILITY Age group < 33% slight Moderate Serious Very serious Total 0 to 6 6 34 7 3 9 59 7 to 15 9 64 33 15 34 155 16 to 21 5 40 11 10 29 95 22 to49 80 624 230 310 431 1.675 50 to 55 37 436 118 123 240 954 56 to 64 59 806 306 215 371 1.757 65 to 74 40 1076 406 266 491 2.279 75 and over 16 1371 647 345 990 3.369 Total 252 4.451 1.758 1.287 2.595 10.343

0 to 4 5 to 9 10 to 14 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 94 95 to 100 0ver 100

<33% Slight Moderate Serious Very serious

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PEOPLE WITH MENTAL DISABILITY Age group < 33% Slight Moderate Serious Very serious Total 0 to 6 11 217 16 23 2 269 7 to 15 13 753 144 94 37 1.041 16 to 21 9 178 51 77 35 350 22 to 49 51 962 692 2668 380 4.753 50 to 55 14 300 242 1113 129 1.798 56 to 64 26 569 364 1194 196 2.349 65 to 74 15 434 296 769 208 1.722 75 and over 5 229 262 506 642 1.644 Total 144 3.642 2.067 6.444 1.629 13.926

Source: Regional Government of Bizkaia Department of Social Action Database.

0 to 4 5 to 9 10 to 14 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 94 95 to 100 0ver 100

<33% Slight Moderate Serious Very serious

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3. THE CURRENT RANGE OF SERVICES AND BENEFITS OFFERED BY THE REGIONAL SYSTEM OF SOCIAL SERVICES FOR PEOPLE WITH DISABILITIES AND THEIR FAMILIES The following tables show information relating to the places in the regional services and other benefits managed by the Department of Social Action (data from 31 December, 2015):

TABLE 9. SERVICES AND BENEFITS OF THE DFB (REGIONAL GOVERNMENT OF BIZKAIA) DEPARTMENT OF SOCIAL ACTION IN THE FIELD OF DISABILITY. 2015.

Daytime, occupational and residential secondary care services (*) Nº PLACES Occupational centres 1.277 Day centres 1.034 CRI (Resource Centre for Inclusive Education of Students with Visual Impairment) 104 Special Employment Centre (**) 113 Residential centres 16 hours 463 Residential centres 24 hours 575 Sheltered housing/protected flats 169 (*) This records all places within Bizkaia, including those provided through agreements managed by the Centre Service, and also those funded through the Benefits and Subsidies Service. No places outside Bizkaia are included. (**) Residual places being phased out.

WELFARE BENEFITS BENEFITS UNDER LAW 1/2013 (PREVIOUSLY LAW Nº PEOPLE RECEIVING TOTAL FOR THE INTEGRATION OF THE DISABLED, LISMI) BENEFITS AT 31/12/2015 Healthcare and pharmaceutical assistance 19 - Subsidy for minimum income guarantee 146 313.807 € Subsidy for aid to a third person 9 7.367 € Subsidy for mobility and transportation costs 12 9.086 € NON-CONTRIBUTORY PENSIONS Non-contributory disability pension 3.842 20.359.506 € Non-contributory retirement pension 2.881 13.633.527 € Pension supplement for housing rental 446 (*) 237.150 € SAAD10 WELFARE BENEFITS Welfare benefit for care in the home environment 12.769 (**) 45.896.449 € Welfare benefit for personal assistant 68 221.918 € Nº PEOPLE WHO HAVE BEEN PAID TOTAL A MONTHLY SUM IN 2015 Welfare benefit linked to the service 1.362 2.918.376 € INDIVIDUAL AID Early support 1.643 2.183.761 € SUPPORT PRODUCTS SERVICE (GIZATEK) Single payment support (Gizatek) 1.381 1.381.501 € (*) Nº of people who have claimed rent supplement during 2015. (**) 3.258 are people under 65 who have been received this welfare benefit for care in the home environment at 31/12/15.

10 Welfare benefit from the System for Autonomy and Attention for Dependence.

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Nº ACTIONS ANNUAL BUDGET OTHER SUBSIDIES/AID GRANTED RESERVED Subsidies regulated by Regional Decree (association activity, A leisure time, awareness and outreach, intervention and specialised 179 1.210.193 € support, institutional care and cultural promotion). Nº ANNUAL BUDGET AGREEMENTS RESERVED OR CASES Registered subsidies for the implementation of Programmes B (association activity, leisure time, specialised intervention and 19 3.401.541 € support and adapted transport. ANNUAL BUDGET Nº GRANTS RESERVED Registered subsidies for the development of programmes for the C 7 1.192.147 € promotion of personal autonomy. D Registered subsidies for investments. 2 550.000 € Source: Information from the Department of Social Action of the Regional Government of Bizkaia. The distribution of places in day and residential care for people with disabilities in Bizkaia according to their situation by Social Action Areas11 and the type of disability of recipients (data from 31 December 2015) is shown below:

TABLE 10. REGIONAL DAY AND RESIDENTIAL CARE CENTRES AND PLACES FOR PEOPLE WITH DISABILITIES IN BIZKAIA. 2015.

TARGET COLLECTIVE People with People with CENTRES AND PLACES People with People with People autism and physical and/ DAY CARE SERVICES intellectual cerebral with mental Total developmental or organic disabilities palsy illness disorders disabilities Social Action Areas C P C P C P C P C P C P BILBAO 3 114 7 170 2 69 2 100 2 106 16 559 BUSTURIA-URIBE 11 245 2 34 1 45 2 118 1 15 17 457 EZKERRALDEA- 5 71 4 51 4 109 13 231 ENKARTERRIAK IBAIZABAL-NERVIÓN/ 4 49 1 30 5 115 10 194 NERBIOI TOTAL 23 479 10 234 7 165 13 442 3 121 56 1.441

TARGET COLLECTIVE CENTRES AND PLACES People with People with People with People with People RESIDENTIAL CARE autism and physical and/ intellectual cerebral with mental Total SERVICES developmental or organic disabilities palsy illness disorders disabilities Social Action Areas C P C P C P C P C P C P BILBAO 9 77 1 5 2 65 4 93 16 240 BUSTURIA-URIBE 9 141 3 39 1 30 2 140 15 350 EZKERRALDEA- 10 274 4 34 1 11 1 18 1 24 17 361 ENKARTERRIAK IBAIZABAL-NERVIÓN/ 5 240 1 16 6 256 NERBIOI TOTAL 33 732 9 94 2 41 5 223 5 117 54 1.207

Source: Information from the Department of Social Action of the Regional Government of Bizkaia. Centres and places funded through agreements managed by the Centres Service. No places outside Bizkaia are included.

11  BILBAO; EZKERRALDEA- ENKARTERRIAK (Left Bank, Barakaldo, Mining Towns and Encartaciones); IBAIZABAL- NERVIÓN (The Durango area, Arratia, Basauri- Etxabarri- Galdakao, Nerbioi); BUSTURIA- URIBE (Uribe, Busturialdea, Mungialde-Txorierri, Lea-Artibai). This distribution will have to be adapted to the new zones laid out in the Basque Map of Social Services.

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4. MAIN ACHIEVEMENTS AND CHALLENGES IN THE MODEL FOR PARTICIPATION AND QUALITY OF LIFE IN THE COMMUNITY.

The approval of the Plan for Participation and Quality of Life of Persons with Disabilities in Bizkaia 2010-2013 constituted a milestone, by establishing a vision and model shared by the Department of Social Action and the Social Organisations. It was a model in line with new scientific and policy frameworks on the rights, quality of life, equal opportunities and the participation of people with disabilities, in particular, the International Classification of Functioning, Disability and Health of World Health Organisation (CIF 2001), Person-centred Planning12 and the United Nations Convention on the Rights of Persons with Disabilities. Its approval made it possible to identify and validate the keys to this Model, using advanced strategic axes within the framework of social policies, in which move in its progressive incorporation; in particular, in the axes of Quality and person-centred planning (axis D) and the Partnership and dialogue with the Third Sector (axis E). It lays the foundation and the road map, setting a long-haul framework towards full incorporation of this Model. It is a plan that is still in force, in its Model and Axes, covering a broad time period for its development. The main challenges for the period 2016-2019 are to achieve greater balance in the development of its axes and progress in turning its care model into concrete actions. It also has to improve the systematisation of monitoring its implementation. In the process of evaluating the Plan 2010-2013, these developments have been noted, as well as the main challenges for the coming years in relation to each of the axes: In the transversal Axes (axes A and B) directed at the whole of Basque society for independent living in the community, inclusion and active participation, in conditions of universal accessibility and equal opportunities:

AXIS A: AUTONOMOUS COMMUNITY LIFE, INCLUSION AND ACTIVE PARTICIPATION: There has been progress in the development of programmes for personal autonomy and in support for volunteering, as well as the consolidation of the model of independent living through innovative responses to the new needs of people with disabilities in independence, autonomy and participation in the community on an equal basis. There has also been progress in the bid to promote activation and employment opportunities for people with disabilities, and it has been recognised that the mixed occupational-employment model is the key to this in the Basque Country. Further progress must be made in services and support programmes with varying intensities of support as needed, tailored to the specific nature of the heterogeneous needs of people with disabilities and their life cycle, favouring personal autonomy and participation in the community.

12  References about the scientific framework of Person-centred Planning: Buntinx, W. H. E. and Schalock, R. L. (2010) Models of Disability, Quality of Life, and Individualized Supports: Implications for Professional Practice in Intellectual Disability. Journal of Policy and Practice in Intellectual Disabilities Volume 7 Number 4 pp 283–294.

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AXIS B: UNIVERSAL ACCESSIBILITY, DESIGN FOR ALL AND EQUAL OPPORTUNITIES: Progress has been made in Gizatek, as a service that meets the needs of a significant proportion of disabled people in their diversity, and as a catalyst and coordinator in the field of accessibility, support products and as a reference centre for promotion activities for personal autonomy. Further progress must be made in this axis, as one of the conditions for autonomy and independent life, from the transverse perspective, i.e. effectively involving other systems (employment, health, education, housing, transport, etc.) in the care and promotion of people with disabilities and also, in the elimination of situations of discrimination and social stigma, as well as conditions for achieving effective equality of opportunities. Social organisations must also be encouraged to deploy their essential role in motivating and empowering their social base in the knowledge and exercise of their own rights. In the internal Axes centred on the Regional Social Services system (Axes C, D and E), aimed at their continuous improvement:

AXIS C: UNIVERSALITY OF SOCIAL SERVICES AND EQUAL ACCESS: There have been significant advances in the expansion and consolidation of the network of services and support for people with disabilities and their families in recent years (in the allocation of resources, diversification and adaptation to the needs of people through promotion and support for leisure and free time, support services for families, programmes for personal autonomy and independent living and so on). Moreover, a range of resources has continued to evolve, aligned with the Model for Participation and Quality of Life in the Community, which is capable of responding equally to the needs of all people with disabilities and the systematisation of objective criteria of methodologies and tools: • Moving towards a better balance between demand and supply of resources for the various groups as well as towards a better extension of services and supports for people with disabilities and their families, from criteria of rationality, equality, efficiency and sustainability. • Deploying an appropriate answer to the diversity of people’s needs, throughout their life (childhood, youth, adulthood, old age). • Improving the system of access, transition and mobility between resources based on the changing needs of individuals, ensuring that the person is at all times supported by the most appropriate resource. In particular, there has been an increase in demand for services by people with mental illness and there is a need to improve the response for this group through better care coordination.

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AXIS D: QUALITY AND PERSON-CENTRED PLANNING: Progress has been made on case coordination for access to the most appropriate resources for the needs of the individual, and on the joint work of social organisations with technical team from the Centres for People with Disabilities Section. Also progress has been made on greater flexibility and personalisation in the allocation of resources and the joint search for solutions to complex or urgent situations. The challenge that we face in the coming years is to put into practice this person-centred planning; it is necessary to develop strategies that confirm and consolidate this plan, not only within the theoretical framework, but the development of specific actions that allow this framework. This development also has to ensure that people can express themselves and be addressed in the language they wish to use. Moreover, further progress must be made in the line of work shared between the Department and the social institutions, by establishing better systematisation and methodology. Progress must also be made in promoting quality and excellence in the management of the System agents, in promoting an integrated management model focused on quality of life, ethics of care, quality management, organisational transparency, gender equality and normalisation of the use of Basque.

AXIS E: COLLABORATION AND DIALOGUE WITH THE THIRD SECTOR: We recognise the significant progress made by the Round Table for Civil Dialogue. Progress is needed in an operational development of this Axis with concrete actions that make this shared dialogue a reality by facilitating the participation of organisations in the planning of activities, new initiatives, identifying needs, identifying answers and the design, by the Department, of work processes that influence them.

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PLAN FOR PARTICIPATION AND QUALITY OF LIFE OF PEOPLE WITH DISABILITIESIN BIZKAIA/BISCAY 2016 -2019

VISION, OBJECTIVE, PREMISES AND STRATEGIC FRAMEWORK

The Model for Participation and Quality of Life in the Community is the reference model for the care and attention of people with disabilities and their families, and we want to advance towards its full implementation and development in Bizkaia, with the participation of all key actors. Using this model will help aim the transformation of the system towards a scheme that is increasingly person-centred, in terms of participation and quality of life in the community. The vision, objectives, premises and strategic axes of change and transformation around which we must continue to progress in the construction of this Model are:

Vision: Getting people and society to evolve towards a culture of personal autonomy and independent living in the community to enable everyone, without exclusion or discrimination of any kind, to make their own choices and to live in suitable conditions of quality of life and self-fulfilment. Objective: To be able, over the next four years, to significantly improve the coverage, quality and effectiveness of the Regional system of social services, aimed at people with disabilities and their families, as well as to enhance their ability to influence those areas of transverse social transformation that would advance towards the achievement of the main goal: participation and quality of life in the community of people with disabilities and their families. The focus towards this vision and the achievement of this aim are indispensable prerequisites so that people with disabilities can have: Ÿ quality of life, Ÿ personal satisfaction in all areas, Ÿ fulfilment of their personal life project.

For this we need to:

• Empower and support people so that FIGURE 1. AREAS OF ACTIVITY OF they develop the widest possible range THE SOCIAL SERVICES SYSTEM of powers for personal autonomy and (AND OTHER SOCIAL SYSTEMS AND AGENTS). participation in the community. • Transform environments, guaranteeing

universal accessibility (removal of Equality of barriers and design for everyone) in all opportunityes areas. • Promote and facilitate effective equality of opportunity by taking precise positive actions and removing discriminatory situations. PERSON • Promote the active participation of individuals and representative ENVIRONMENT

organisations. Universal Active accessibility participation • Adapt supports available (resources, SERVICES ORGANISATION services, conditions) and organisations CONDITIONS in line with this new paradigm, the quality model (quality of life, quality of management and ethics).

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Making an impact on each of these elements requires a necessary process of cultural change and social transformation, and requires the involvement of all key actors in the system; the people with disabilities and their families, the bodies that represent them and/or provide them with support, the public authorities, the professionals, volunteers, other care systems, social media, companies, social partners and Bizkaia as a whole. It is a process of change with five strategic axes of social transformation:

Two transverse axes, which will include the actions that the Regional system of social services should aim at the whole of Bizkaia, based on the premise that cultural change involves predisposing society (institutions, governments and public authorities, economic and social partners, companies, schools, health centres, etc.) towards the inclusion of diversity and involving this society effectively in the processes of change:

A. AUTONOMOUS LIFE IN THE COMMUNITY, INCLUSION AND ACTIVE PARTICIPATION: Promoting the right conditions for people with disabilities in Bizkaia to reach their maximum autonomy, inclusion and active participation in the community.

B. UNIVERSAL ACCESSIBILITY, DESIGN FOR ALL AND EQUAL OPPORTUNITIES: Promoting effective universal accessibility and design for all, as well as equal opportunities and appropriate and non-discriminatory treatment of people with disabilities.

Three axes of an internal nature centred on the Regional social service system and oriented to continuous improvement, with the involvement of all key actors (the Department of Social Action itself, people with disabilities and their families, entities that represent them and/or provide services, professionals, and volunteers):

C. UNIVERSALITY OF SOCIAL SERVICES AND EQUALITY OF ACCESS: To promote sufficient, appropriate conditions to ensure universality and equal access to Regional benefits and services aimed at people with disabilities and their families.

D. QUALITY AND PERSON-CENTRED PLANNING: To progress in implementing the model of participation and quality of life in the community and the person-centred planning methodology within the system’s intervention model.

E. COLLABORATION AND DIALOGUE WITH THE THIRD SECTOR: To promote the cooperation of the social initiative bodies in orienting and deploying civil dialogue and other activities of general interest by social initiative bodies by the Regional social services (service delivery, planning, innovation and continuous improvement).

The challenges on the road towards the deployment of an adequate, sufficient and comprehensive network of social resources, consistent with the Model of participation and quality of life in the community, require the commitment and consequent involvement of its various agents. Specifically, they will require further progress towards: • Citizens who are active and promote social initiatives. • The professionalization of the sector. • A public administration that is responsible and aware of the importance of their role in ensuring equal rights and opportunities for citizens. • A lively volunteer sector.

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• The progressive empowerment of people with disabilities and their families, viewing themselves as subjects with rights and obligations within a social context that is gradually integrating the value of diversity as a social engine. This deployment should be accompanied by the maintenance of political commitment and social initiative, by collaboration and by improvement in both the services and the administrative processes that support them. The pulling power of a model when it comes to changing the care for people with disabilities will depend on the commitment of all actors to work within the framework defined by it. As a result, we understand that it is important to reflect in the Plan for the participation and quality of life of people with disabilities in Bizkaia a framework that draws the Regional system of social services and their agents towards criteria of quality of life and of person-centred planning, within a model of participation and quality of life in the community. The following diagram is designed to express the necessary interaction between the system’s agents to push the incorporation of this Model forward, structured in four dimensions:

This covers the set of cross-cutting strategies for social transformation and Model approach for participation and quality of life in the community. This means that the third sector and public administration are not separate compartments, but interrelated systems, which through multiple interfaces System are coordinated and work together to create support systems for people and create a rich, pluralistic society. This covers the activity oriented towards social change needed to create a Society culture of equal opportunity and diversity. The person who receives the set of services and programmes aimed at Person benefitting people with disabilities and their families and takes responsibility, as far as they can, for their own lives.

FIGURE 2. AGENTS, MODEL AND INTERACTIONS OF THE REGIONAL SOCIAL SERVICES SYSTEM

Inclusion, participation, autonomous life in the community

SOCIETY PERSON

Model for participation and quality of life in the community:

A) Inclusion, participation and independent Culture of life in the community. Complete diversity, B) Universal accessibility, design for all and specialised universal access equal opportunities. support and equal C) Universality of social services and network opportunities equality of access. (secondary care) D) Quality and person-centred planning. E) Collaboration and dialogue with the courts.

SYSTEMA

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PLAN FOR PARTICIPATION AND QUALITY OF LIFE OF PEOPLE WITH DISABILITIESIN BIZKAIA/BISCAY 2016 -2019

AXES, STRATEGIC OBJECTIVES AND PRIORITY LINES OF ACTION

A. AUTONOMOUS LIFE IN THE COMMUNITY, INCLUSION AND ACTIVE PARTICIPATION: To promote good conditions for people with disabilities in Bizkaia to reach their maximum autonomy, inclusion and active participation in the community.

STRATEGIC OBJECTIVES PRIORITY LINES OF ACTION S.Obj. A.1. To advance services, Ÿ Develop services and programmes for personal autonomy programmes and support and for the prevention of dependency and disability, for personal autonomy and tailored to specific support needs, depending on the independent living, aligned diversity and heterogeneity exhibited by people with with the model of quality of life disabilities and their families, throughout their life cycle and and participation. in all areas of their life. Ÿ Consolidate services and programmes for independent living for people with disabilities, extending and improving personal assistance as a figure of cross-disciplinary support for the individual. Ÿ Innovate in support programmes with varying intensities of support as needed, aimed at keeping people with disabilities at home and in their natural environment. S.Obj. A.2. To promote the Ÿ Support the associative movement of disability in empowerment of people with mobilising and empowering their social base. disabilities to exercise self- Ÿ Develop programmes, services and activities that improve determination and freedom of the skills and empowerment of people with disabilities. choice, and to participate and exercise their rights. S.Obj. A.3. To progress in Ÿ Consolidate and further develop the activity of Gizatek. integrating and innovating Ÿ Improve the coordination and complementarity of Gizatek support products and technical with the Ortho-prosthetic catalogue of the public health support. service Osakidetza. Ÿ Work on R&D&I, both in intervention processes, and support products; in the latter, with technological developments and application of new technologies, with the participation of social organisations. S.Obj. A.4. To promote social Ÿ Promote volunteering in the field of disability as a transformation through social transforming agent of society. participation Ÿ Develop programmes that promote the use of community resources and community involvement.

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B. UNIVERSAL ACCESSIBILITY, DESIGN FOR ALL AND EQUAL OPPORTUNITIES: To promote effective universal accessibility and design for all, as well as equal opportunities and appropriate and non-discriminatory treatment of people with disabilities.

STRATEGIC OBJECTIVES PRIORITY LINES OF ACTION

S.Obj. B.1. To promote cross- Ÿ Reinforce the impact of the Department of Social Action involvement of all sectors on other areas and departments to advance universal and key actors for effective accessibility, equal opportunities and participation and equality of opportunity, non- inclusion of people with disabilities in mainstream and discrimination and universal community resources. accessibility. • Study appropriate formulas and better coordination with other Areas or departments in situations of double discrimination. S.Obj. B.2. To progress in • Progress in conditions of universal accessibility to the conditions of universal Regional social services. accessibility • Promote conditions of universal accessibility and design for all people (both in relation to architectural barriers, and with communication, understanding and attitudinal barriers) in all areas of the community environment. • Analyse ways to solve transport in occupational centres for people with disabilities or without the autonomy to access centres on their own. • Continue to participate on the Basque Government Accessibility Committee. S.Obj. B.3. To advance in • Promote initiatives against discrimination based on disability raising awareness in society and social stigma. about equal opportunities • Promote initiatives to raise social awareness about disability, and universal access. equal opportunities and universal accessibility.

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C. UNIVERSALITY OF SOCIAL SERVICES AND EQUALITY OF ACCESS: To promote sufficient, appropriate conditions to ensure universal, equal access to Regional benefits and services aimed at people with disabilities and their families.

STRATEGIC PRIORITY LINES OF ACTION OBJECTIVES • Progress with a better balance between current supply and demand S.Obj. C.1. To of resources, depending on various needs. progress in getting • Undertake the specific development of a response for people with better conditions mental illness as a target group for the strategic social healthcare and coverage by the lines, based on the need to promote better services for them13. social services system for the universality • Carry out analysis and projection of current, emerging and future of social services needs of people with disabilities and their families considering, and equality of among other points, changes in their life cycle (childhood, youth, access, contributing adulthood, and old age). to a better balance • Develop and implement a Portfolio of Benefits and Social Services of between demand the DFB (Regional Government of Bizkaia) in the field of disability, and supply of providing the precise mechanisms for their constant adaptation to resources and a new requirements. better extension of services and support • Conduct a sectored, functional programme of the Regional social for people with services system benefits and services, adapted to the needs of each disabilities and their specific disability and their evolution in the person’s life cycle, and to families, progress on each zone. criteria of rationality, • Promote decentralisation and bring resources closer to people, equity, efficiency valuing partnerships with local authorities and other organisations so and sustainability, that they can reach everyone. always subject to the proper application • Lay out objective criteria for determining the costs of services and of the model for subsequent public-private legal frameworks, suited to the different participation and needs and supports that are required in each case. Among other quality of life. issues, review and improve the conditions of supply, including the specifics of co-financing the social healthcare space. • Develop better communication about the criteria and guidelines used in public-private legal frameworks. • Study the best response formulas to meet investments needs for maintaining the existing infrastructures.

S.Obj. C.2. To adapt • Continue to diversify and offer more flexible services and support services to the programmes taking into account the characteristics, needs and changing needs demands of people and, consistent with the model of participation of people with and quality of life in the community, rolling out support that disabilities and encourages autonomy and independent living and participation in their families, in line the community. with the model of quality of life and • Promote and diversify support for families and carers, considering participation. the new needs that families present, with new models and makeup of units of cohabitation. • Develop services for the legal protection of people with disabilities in cases when necessary.

13  People with mental disorders are one of the target groups for the strategic social healthcare lines for the Basque Country (2013-2016) and the Basque Country Strategic Social Services Plan (2016-2019) reflects the need to promote services for people with Mental illness. 31 PLAN FOR PARTICIPATION AND QUALITY OF LIFE OF PEOPLE WITH DISABILITIESIN BIZKAIA/BISCAY 2016 -2019

• Innovate in programmes and services to enable people to have a good range of opportunities to access and develop in the work environment, considering, among other things, the challenges of ageing. • Consolidate and develop housing support services specialising in community environment and independent living in the home. • Continue to develop and promote leisure and free time activities that are inclusive and specialised for people with disabilities. • Innovate in support programmes that prevent situations of depen- dency or worsening of support needs. • Increase availability of places in temporary accommodation for people with disabilities aimed at urgent cases as well as attention for tempo- rary situations. S.Obj. C.3. To improve the system • Innovate and improve the adaptation of specialised responses to the of assessment, emerging needs of people with disabilities in their life course; in old orientation, access age, childhood, youth or adulthood. and transit between services, so that • Improve methodologies and assessment tools and guidance for the each person with proper allocation of resources and services according to the needs disabilities can find, presented by each person. in every moment • Analyse and identify ways to improve the transition and mobility from of their evolution one resource to another, as well as their compatibility and flexibility of and itinerary in the use. resource that best suits their needs. S.Obj. C.4. To • In matters of Housing, get the involvement and commitment of the reinforce the impact Housing Areas of the different competent Authorities in the field, to on other areas and adapt their response to the needs of people with disabilities and their departments, from families, and achieve greater involvement and commitment to the the perspective of a provision of resources and solutions to support their needs in this area. transverse approach • In Health, bring about better coordination with the Health Department to disability policies of the Basque Government for a better social healthcare response to to achieve greater people with disabilities and their families in Bizkaia. involvement and commitment to • In Education, bring about greater coordination to provide a compre- resourcing and hensive response for children and young people with disabilities. solutions for the • In Employment, bring about greater coordination to improve the support of people response in the social-employment area. with disabilities and their families.

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D. QUALITY AND PERSON-CENTRED PLANNING: To progress in implementing the model of participation and quality of life in the community and the methodology of person-centred planning within the intervention model of the system.

STRATEGIC OBJECTIVES PRIORITY LINES OF ACTION

S.Obj. D.1. To progress • Advance in the work shared with the social organisations of in putting into practice disability on methodologies and tools for implementing person- the principles of person- centred planning and the individualisation of support, taking centred planning. advantage of the knowledge generated in social bodies. • Advance further in the shared work between the technical team of the Department and the entities in case coordination, ensuring proper coordination and streamlining of all sources of support and ensuring the participation of the disabled person. • Continue to ensure that people can express themselves and be addressed in the language, communication and comprehen- sion system, technique or code they wish to use (systems for alternative communication, easy reading, interpreting and video interpreting in sign language etc.). S.Obj. D.2. To promote an • Promote the implementation and consolidation of models or integrated management systems of quality management and continuous improvement model centred on the in organisations. quality of life, ethics of • Promote ethical commitment in care and the implementation care, quality management, of systems of transparency and good governance between the organisational transparency, system agents. gender equality and the normalisation of the use of • Promote gender equality between the agents of the system. Basque. • Promote the normalisation of Basque in the System.

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E. COLLABORATION AND DIALOGUE WITH THE THIRD SECTOR: To promote the cooperation of the social initiative bodies in the orientation and deployment of the Regional social services system (in service delivery, planning, innovation and continuous improve- ment) in terms of civil dialogue and other activities of general interest to social initiative bodies.

STRATEGIC OBJECTIVES PRIORITY LINES OF ACTION

S.Obj. E.1. To strengthen • Strengthen the cooperative relationship with the Third Sector collaboration between the of disability in both the provision of public services and in Public Authorities and the Third relation to other general activities (raising awareness, advo- Sector in the care and attention cacy, research, innovation ....) of people with disabilities and • Develop better collaboration between the Public Authorities their families. and the third sector aimed at harnessing knowledge, inno- vation, methodologies and tools, etc. generated from social organisations in the care and promotion of people. • Ensure that collaboration in the management of the services in the Social Services System is carried out with entities that agree with the model for participation and quality of life, reaching a consensus on objective criteria linked to its deployment. • Systematise objective criteria based on the social value provided by the Third Sector in line with the implementation of the quality of life model. • Study the feasibility of developing the concept of “Framework Agreements” under the Social Services Act or other similar laws, getting funding formulas and working together in a more stable way. S.Obj. E.2. To progress in the • Establish and implement a work plan and programme for the operation and enhancement of Round Table for Civil Dialogue. cooperation between the Public • Define the criteria for participation in the Round Table for Authorities and the Third Sector Civil Dialogue and, if applicable, new formulas and working in the care and promotion of groups, assessing the participation of other social entities people with disabilities and involved, depending on the topics discussed and including all their families. those representing the social bases. • Facilitate the participation of organisations in the planning of activities, new initiatives, detection of needs, identification of answers and design, by the Department, of work processes that affect them.

34 PLAN FOR PARTICIPATION AND QUALITY OF LIFE OF PEOPLE WITH DISABILITIESIN BIZKAIA/BISCAY 2016 -2019

SYSTEM FOR THE APPLICATION AND EVALUATION OF THE PLAN

In order to facilitate the practical implementation and operation of the Plan for Participation and Quality of Life of People with Disabilities in Bizkaia 2016-2019, as well as monitoring and evaluating the plan, we expect to set up four Working Groups with a diverse composition and work methodology. The Department is expected to participate in all the Working Groups, as well as the social organisations for Disability in Bizkaia and IFAS and ITB, as autonomous bodies attached to the DFB. Each Group will have the task of looking into one of these focus areas with these objectives:

WORKING GROUP WORK OBJECTIVES

• Identify the most relevant indicators related to the implementation of the 1. Monitoring and Plan. evaluation of the • Develop and establish guidelines, methodology and tools for regular monito- implementation of ring and evaluation of the Plan. the Plan. • Carry out regular monitoring and evaluation of the implementation of the Plan. • Specify current demand for benefits and services for people with disabilities as well as their projection in future scenarios, taking into account, among other references: - the new zoning established in the Map of Social Services in the Basque 2. Response Country, framework for - coverage projections in the Map of Social Services in the Basque Country, current and future - data available from the Department on people with a recognized disability, needs. - demand expressed in the various services, - available data and estimates from social organisations on the present and future demand of their collective. • Use this information to define the response framework (benefits and services) for people with disabilities in Bizkaia and their projections in future scenarios, with appropriate sectorised and regional planning. • Identify the basic procedure for individual intervention (steps, actors involved and functions). 3. Basic procedure • Propose improvements in the method of individual intervention and coordi- for individual nation of the case. intervention and • Identify transit routes in the supply of resources in response to changing transition between needs. resources • Identify areas for improvement in the system of access and transit between services, in response to changing needs. • Analyse and define formulas that will help improve transition and mobility between resources, as well as deinstitutionalisation.

• Understand the management systems and models used by organisations in 4. Management the regional services. System aligned • Identify improvements to incorporate the priorities of the Department with the Model for towards an integrated management model centred on quality of life, ethics of Participation and care, quality management, organisational transparency, gender equality and Quality of Life and normalisation of the use of Basque. the priorities of • To specify the actions and the time scales required for the gradual align- the Department. ment of systems and management models to the model of participation and quality of life and the Department’s priorities.

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PLAN FOR PARTICIPATION AND QUALITY OF LIFE OF PEOPLE APPENDIX WITH DISABILITIESIN BIZKAIA/BISCAY 2016 -2019

APPENDIX 1. METHODOLOGY

The preparation of this Plan for Participation and Quality of Life of People with Disabilities in Bizkaia 2016-2019 has been developed by the Department of Social Action, with the participation of the following social disability organisations in Bizkaia:

• Adembi, Multiple Sclerosis Association of Bizkaia. • Afa, Association of Relatives of Patients with Alzheimer’s disease in Bizkaia. • Apnabi, Association of parents affected by autism and other disorders on the autism spectrum in Bizkaia.

• Aspace Bizkaia, Cerebral Palsy Association of Bizkaia. • Atece, Acquired Brain Injury Association of Bizkaia. • Avifes, Bizkaia Association of Families and People with Mental Illness. • Bidaideak. • Euskal Gorrak (Basque Federation of Associations for the Deaf) • Fekoor, Coordinating Federation for People with Physical and/or Organic Disabilities in Bizkaia.

• Argia Foundation • Eragintza Foundation • Down’s Syndrome Foundation of the Basque Country. • Futubide, Care Foundation. • Gorabide, Bizkaia Association for Persons with Intellectual Disability. • Lantegi Batuak. • Once, Spanish National Organisation for the Blind. • Ulertuz, Association of Families and Friends of Deaf Children Bizkaia. • Uribe Costa, Uribe Costa Association for People with Intellectual Disability.

Also participating in drafting this plan are the following autonomous entities or bodies attached to the Regional Government of Bizkaia:

• IFAS, Regional Institute of Social Welfare. • ITB, Bizkaia Care Institute.

37 PLAN FOR PARTICIPATION AND QUALITY OF LIFE OF PEOPLE APPENDIX WITH DISABILITIESIN BIZKAIA/BISCAY 2016 -2019

Specifically, for the preparation of the plan, the following activities were carried out between 2013 and 2016:

1) Evaluation of the Plan for Participation and Quality of Life of People with Disabilities in Bizkaia 2010-2013 September 2013-September 2014

Face-to-face meetings and interviews with social disability organisations that manage Regional services.

Contribution of ideas and content to the script of questions on the assessment of the Plan by the social disability organisations via e-mail.

Meetings of the Department of Social Action Team.

Drafting of the report on the findings and conclusions of the assessment of the Plan for Participation and Quality of Life of People with Disabilities in Bizkaia 2010-2013

Discussion of the draft and contributions from social disability organisations.

2) General closing discussion session on the assessment of the Plan for Participation and Quality of Life of Persons with Disabilities in Bizkaia 2010-2013 and November – December 2014 evaluation of the priority areas of work for the coming years.

3) Preparation of the Plan for Participation and Quality of Life of People with Disabilities in Bizkaia 2016-2019 January 2015 – January 2016

Meetings of the Department of Social Action Team.

Preparation of the first draft of the Plan for Participation and Quality of Life of People with Disabilities in Bizkaia 2016-2019

Discussion of the first draft and contributions from social disability organisations.

Writing of the first draft of the Plan for Participation and Quality of Life of People with Disabilities in Bizkaia 2016-2019

Discussion of the first draft and contributions from social disability organisations and drawing up of final document of the Plan

4) Public communication and dissemination of the Plan for Participation and Quality of Life of People with February 2016 Disabilities in Bizkaia 2016-2019

38 PLAN FOR PARTICIPATION AND QUALITY OF LIFE OF PEOPLE APPENDIX WITH DISABILITIESIN BIZKAIA/BISCAY 2016 -2019

APPENDIX 2. STATISTICS ON PEOPLE WITH DISABILITIES BY SEX TABLES AND FIGURES 11. PEOPLE WITH DISABILITIES BY SEX, TYPE, AGE GROUP AND DEGREE (BIZKAIA 2015)

WOMEN WITH PHYSICAL AND/OR ORGANIC DISABILITY AGE GROUP < 33% SLIGHT MODERATE SERIOUS VERY SERIOUS TOTAL 0 to 6 102 72 14 18 7 213 7 to 15 25 74 28 24 32 183 16 to 21 5 53 20 23 24 125 22 to 49 150 1.191 367 390 339 2.437 50 to 55 80 556 228 249 144 1.257 56 to 64 134 1.034 437 384 235 2.224 65 to 74 109 1.148 568 498 321 2.644 75 and over 60 1.557 976 790 900 4.283 Total 665 5.685 2.638 2.376 2.002 13.366

0 to 4 5 to 9 10 to 14 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 95 to 0ver 94 100 100

<33% Slight Moderate Serious Very serious

MEN WITH PHYSICAL AND/OR ORGANIC DISABILITY AGE GROUP < 33% SLIGHT MODERATE SERIOUS VERY SERIOUS TOTAL 0 to 6 124 92 20 37 8 281 7 to 15 49 105 46 25 49 274 16 to 21 12 73 33 19 48 185 22 to 49 258 1.623 525 521 440 3.367 50 to 55 115 1.036 416 337 238 2.142 56 to 64 158 2.125 962 611 371 4.227 65 to 74 140 2.404 1.269 932 483 5.228 75 and over 37 2.036 1.189 970 604 4.836 Total 893 9.494 4.460 3.452 2.241 20.540

0 to 4 5 to 9 10 to 14 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 95 to 0ver 94 100 100

<33% Slight Moderate Serious Very serious 39 PLAN FOR PARTICIPATION AND QUALITY OF LIFE OF PEOPLE APPENDIX WITH DISABILITIESIN BIZKAIA/BISCAY 2016 -2019

WOMEN WITH INTELLECTUAL DISABILITY

AGE GROUP < 33% SLIGHT MODERATE SERIOUS VERY SERIOUS TOTAL 0 to 6 7 1 1 9 7 to 15 43 17 23 9 92 16 to 21 51 34 44 25 154 22 to 49 2 315 200 425 334 1.276 50 to 55 63 43 113 117 336 56 to 64 1 41 56 129 86 313 65 to 74 10 27 57 45 139 75 and over 8 15 27 26 76 Total 3 538 393 819 642 2.395

0 to 4 5 to 9 10 to 14 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 95 to 0ver 94 100 100

<33% Slight Moderate Serious Very serious

MEN WITH INTELLECTUAL DISABILITY AGE GROUP < 33% SLIGHT MODERATE SERIOUS VERY SERIOUS TOTAL 0 to 6 5 3 2 10 7 to 15 65 29 38 35 167 16 to 21 87 18 47 42 194 22 to 49 2 514 246 571 370 1.703 50 to 55 133 67 145 104 449 56 to 64 96 72 160 77 405 65 to 74 22 22 69 66 179 75 and over 6 14 18 22 60 Total 2 928 471 1.048 718 3.167

0 to 4 5 to 9 10 to 14 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 94 95 to 0ver 100 100

<33% Slight Moderate Serious Very serious

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WOMEN WITH SENSORY DISABILITY AGE GROUP < 33% SLIGHT MODERATE SERIOUS VERY SERIOUS TOTAL 0 to 6 4 17 0 2 2 25 7 to 15 2 34 16 6 19 77 16 to 21 2 21 5 4 12 44 22 to 49 40 316 97 141 189 783 50 to 55 14 187 58 68 109 436 56 to 64 23 352 139 95 190 799 65 to 74 18 451 196 134 291 1.090 75 and over 9 690 372 212 664 1.947 Total 112 2.068 883 662 1.476 5.201

0 to 4 5 to 9 10 to 14 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 95 to 0ver 94 100 100

<33% Slight Moderate Serious Very serious

MEN WITH SENSORY DISABILITY AGE GROUP < 33% SLIGHT MODERATE SERIOUS VERY SERIOUS TOTAL 0 to 6 2 17 7 1 7 34 7 to 15 7 30 17 9 15 78 16 to 21 3 19 6 6 17 51 22 to 49 40 308 133 169 242 892 50 to 55 23 249 60 55 131 518 56 to 64 36 454 167 120 181 958 65 to 74 22 625 210 132 200 1.189 75 and over 7 681 275 133 326 1.422 Total 140 2.383 875 625 1.119 5.142

0 to 4 5 to 9 10 to 14 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 95 to 0ver 94 100 100

<33% Slight Moderate Serious Very serious

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WOMEN WITH MENTAL DISABILITY AGE GROUP < 33% SLIGHT MODERATE SERIOUS VERY SERIOUS TOTAL 0 to 6 3 58 6 9 1 77 7 to 15 4 162 29 26 18 239 16 to 21 1 43 13 27 11 95 22 to 49 29 376 259 892 116 1.672 50 to 55 7 151 112 474 54 798 56 to 64 20 322 162 550 88 1.142 65 to 74 12 268 178 440 95 993 75 and over 2 148 181 325 481 1.137 Total 78 1.528 940 2.743 864 6.153

0 to 4 5 to 9 10 to 14 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 95 to 0ver 94 100 100

<33% Slight Moderate Serious Very serious

MEN WITH MENTAL DISABILITY AGE GROUP < 33% SLIGHT MODERATE SERIOUS VERY SERIOUS TOTAL 0 to 6 8 159 10 14 1 192 7 to 15 9 591 115 68 19 802 16 to 21 8 135 38 50 24 255 22 to 49 22 586 433 1776 264 3.081 50 to 55 7 149 130 639 75 1.000 56 to 64 6 247 202 644 108 1.207 65 to 74 3 166 118 329 113 729 75 and over 3 81 81 181 161 507 Total 66 2.114 1.127 3.701 765 7.773

0 to 4 5 to 9 10 to 14 15 to 19 20 to 24 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 to 69 70 to 74 75 to 79 80 to 84 85 to 89 90 to 95 to 0ver 94 100 100

<33% Slight Moderate Serious Very serious

Source: Regional Government of Bizkaia Department of Social Action Database.

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APPENDIX 3. SOURCES AND REFERENCES

NORMATIVE REFERENCES AT INTERNATIONAL LEVEL

• United Nations Convention on the Rights of • Charter of Fundamental Rights of the Persons with Disabilities. European Union. • Instrument of Ratification of the Convention • Treaty on the Functioning of the European on the Rights of Persons with Disabilities, Union (TFEU). adopted in New York on 13 December 2006. • Europe 2020 Strategy. BOE April 21, 2008. • European Disability Strategy 2010-2020: A • Instrument of ratification of the Optional renewed commitment to a barrier-free Europe Protocol to the Convention on the Rights of (COM (2010) 636 final). Persons with Disabilities, adopted in New York • Action Plan 2006-2015 of the Council of on 13 December 2006. BOE 22 April 2008. Europe for people with disabilities.

AT STATE LEVEL • Spanish Constitution. means of support for oral communication for • Law 26/2011 on legislative adaptation to the the deaf, those with hearing disabilities and Convention on the Rights of Persons with the deafblind. Disabilities. • Law 39/2006 for the Promotion of Personal • Legislative Royal Decree 1/2013 approving the Autonomy and Care for People in Situations Revised Text of the General Law on the Rights of Dependency. of Persons with Disabilities and its social • Law 19/2013, of 9 December on transparency, inclusion. access to public information and good • Law 27/2007 of 23 October recognising governance. Spanish sign languages and regulating the

AT THE LEVEL OF THE BASQUE COUNTRY • Organic Law 3/1979, of 18 December, Statute • Decree 64/2004 of 6 April approving of Autonomy of the Basque Country. the bill of rights and obligations of users • Law 12/2008 of 5 December, on the Social and professionals in the social services in Services of the Basque Country. the Basque Country and the system for suggestions and complaints. • Law 10/2000 of 27 December on the Charter of Social Rights. • Decree 68/2000 of 11 April, approving the technical standards on accessibility in urban • Law 8/2008 of 25 June, amending the Law environments, public spaces, buildings, and against Social Exclusion and the Charter of information and communication systems. Social Rights Act. • Law 20/1997, of 4 December on the promotion • Decree 185/2015, of 6 October, on the of accessibility. portfolio of benefit payments and services of the Basque Social Services System. • Decree 283/2012 of 11 December, which constitutes and regulates the Round Table for Civil Dialogue.

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AT THE LEVEL OF THE REGION OF BIZKAIA

• Regional Decree of the Regional Government • Regional Decree of the Regional Govern- of Bizkaia 3/2014, 28 January, modifying the ment of Bizkaia 87/2011 of 10 May, amending Organic Regulations of the Department of Regional Decree 210/2005, of 20 December, Social Action of the Regional Government of which regulates the access to Regional public Bizkaia, approved by Regional Decree of the service retirement homes and the conditions Regional Government of Bizkaia 70/2012, 3 for the provision of temporary stays in resi- April. dential services for the purpose of respite for families and carers. • Regional Decree of the Regional Government of Bizkaia 110/2013 of 30 July, on the modi- • Regional Decree of the Regional Govern- fication of the standard Application form ment of Bizkaia 65/2011 of 29 March, modi- for the Assessment, Review or Transfer of fying Regional Decree 90/2010, of 29 June, dependence provided for in Regional Decree as amended by the Regional Decree 117/2010, 162/2009 of 1 December laying down the of 9 November, regulating benefit payments procedure for recognition of the dependence linked to the Regional residential service for and amended by Regional Decree 93/2010, of dependent people. 20 July. • Regional Decree of the Regional Government • Regional Decree of the Regional Government of Bizkaia 117/2010 of 9 November, modifying of Bizkaia 103/2013 of 23 July, regulating Regional Decree 90/2010 of 29 June, regu- grants for personal assistance. lating benefit payments linked to the Regional residential service for dependent people. • Regional Decree of the Regional Government of Bizkaia 16/2013 of 12 February, amending • Regional Decree of the Regional Govern- the Regional Decree 179/2011 of 29 November ment of Bizkaia 93/2010 of 20 July, modifying the provision of care in the family environ- Regional Decree 162/2009, of 1 December of ment for 2013 for grade I dependents with 40 the Regional Government of Bizkaia, regu- to 49 points. lating the procedure for officially recognising a situation of dependency. • Regional Decree of the Regional Government of Bizkaia 121/2012 of 21 August, amending • Regional Decree of the Regional Government the Regional Decree 162/2009 of December 1 of Bizkaia 90/2010 of 29 June, regulating benefit payments linked to the Regional resi- of the Regional Government of Bizkaia, regu- dential services for dependent people. lating the procedure for recognition of the situation of dependency. • Decree of the Regional Government of Bizkaia 83/2010 of 14 June, amending Regional • Regional Decree of the Regional Govern- Decree of the Regional Government of Bizkaia ment of Bizkaia 116/2012 of 24 July, amending 197/2008 of 16 December, which creates and Regional Decree 210/2005, of 20 December regulates amending Technical Assessment of the Regional Government of Bizkaia, which Commission for Dependent People. regulates the access to the Regional Service for homes for the elderly and conditions for • Regional Decree of the Regional Government provision of residential service in temporary of Bizkaia 162/2009 of 1 December, regulating stays for the purpose of respite for families the procedure for officially recognising a situ- and carers. ation of dependence.

• Regional Decree of the Regional Government • Regional Decree of the Regional Government 70/2012, of 3 April, approving the Organic of Bizkaia 197/2008 of 16 December, which Regulations of the Department of Social creates and regulates the technical evaluation Action of the Regional Government of Bizkaia. committee for dependent people.

• Regional Decree of the Regional Govern- • Regional Decree 145/2001, of 22 August, of the ment of Bizkaia 179/2011 of 29 November Regional Government, regulating the system regulating the provision for care in the home of access to day centres for elderly depen- environment. dents owned by the Regional Government of

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Bizkaia, or to concerted places in day centres Regional Decree 24/2009 of 17 February, for elderly dependents and the granting of regulating access to the Regional Service individual financial assistance for the use for Orientation and Loan of support prod- of non-concerted places in day centres for ucts for the promotion of personal autonomy elderly dependents. (GIZATEK).

• Regional Decree of the Regional Government • Regional Decree 108/2006, of June 13, as of Bizkaia 84/2014, of July 1, regulating the amended by Regional Decree 38/2007, of access system for temporary stays in homes March 13, extended by the Regional Decree for dependent people. 94/07 of 12 June, regulating the general system of access to temporary stay places in • Regional Decree of the Regional Government the residential day care service for people with of Bizkaia 83/2014, of July 1, regulating the disabilities, provided in its own centres of the agreed application and the cost of the provi- Regional Government of Bizkaia, concerted or sion of short stays in Regional homes for as part of this institution. dependent persons. • Regional Decree 204/2003, of 28 October, • Regional Decree of the Regional Government agreeing the application and the regulation of Bizkaia 17/2014 of 25 February, regulating of public prices in concerted and contracted access to permanent stays in Regional homes Care Centres for People with Disabilities. for dependents and the conditions of service provision. • Regional Regulation 4/2001 of 30 May relating to the modification of the Statutes of the • Regional Decree of the Regional Government Regional Institute of Social Welfare of Bizkaia. of Bizkaia 177/2013 of 10 December, amending Regional Decree 103/2013, of 23 July, on • Regional Regulation 8/2005 of 24 October, benefit payments for personal assistance. amending Regional Law 4/2001 of 30 May, amending the Statutes of the Regional Insti- • Regional Decree of the Regional Government tute of Social Welfare of Bizkaia. of Bizkaia 178/2013 of 10 December, approving the amending Regional Decree 179/2011, of • Regional Regulation 9/2000 creating the Insti- November 29th regulating benefit payments tute of Bizkaia Tutelar amended by Regional for care in the home environment and Law 3/2003. extending the term of the Regional Decree 16/2013, of February 12 until July 1, 2015. • Regional Regulation 3/2003 of 13 March, amending Regional Law 9/200, on the • Regional Decree of the Regional Government creation of the Bizkaia Care Institute. of Bizkaia 179/2013 of 10 December, deter- mining in Bizkaia the maximum amounts of • Regional Decree 38/2008, of March 18, the benefit payments for care in the family envi- Regional Government of Bizkaia, approving ronment, personal assistance and linked to the Organic Regulations of the Department the residential service. of Social Action of the Regional Government of Bizkaia. • Regional Decree of the Regional Government 24/2009, of February 17, regulating Regional • Regional Decree 4/2003 of 28 January, laying service orientation and loan of support prod- down the creation rules for the Committee ucts for the promotion of personal autonomy for People with Disabilities in the Region of (Gizatek). Bizkaia.

• Regional Decree of the Regional Govern- • Regional Decree 119/2005 of 24 August regu- ment 82/2013, of 11 June, regulating access lating the suggestions and complaints service to the Regional Service for Orientation and of the Department of Social Action through Loan of support products for the promotion the customer attention unit. of personal autonomy (Gizatek) amending Regional Decree 24/2009. • Regional Decree 232/2006, of 26 December, the Regional Government of Bizkaia, regu- • Regional Decree of the Regional Govern- lating the creation of the Ethics Committees ment of Bizkaia 96/2012 of 22 May, amending in Social Intervention.

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PUBLICATIONS, BIBLIOGRAPHY AND OTHER REFERENCES DEPARTMENT OF SOCIAL ACTION (DFB) PUBLICATIONS/REFERENCES:

• Plan for Participation and Quality of Life of • Proceedings of the Department of Social People with Disabilities in Bizkaia 2010-2013. Action DFB. Years 2010-2013.. • Strategic Plan for the Elderly in Bizkaia (2013). • The needs of people with intellectual disabilities • Strategic Social Action Plan 2008-2011. in the ageing process. Regional Government Regional Government of Bizkaia. de Bizkaia (2007). • Strategic Plan for Accessible Transport in Bizkaia (2009).

OTHER REFERENCES: • Basque Country Strategic Social Services • Disability/dependence. Unification of Plan (2016-2019) evaluation and classification criteria. Miguel • Strategic Plan of the Bizkaia Mental Health Querejeta González. Network 2014-2017 • The impact of the Convention on the Rights of • Mental Health Atlas Bizkaia. Osakidetza Persons with Disabilities in the Spanish legal (2013). system. Human Rights Institute Bartolomé de • Opinion of the European Economic and las Casas of Carlos III University, Madrid. Social Committee on Social Assistance and • Deinstitutionalisation and community living long-term institutionalisation (Exploratory - outcomes and costs: report of a European opinion). SOC / 517 Deinstitutionalisation. study. Mansell J., Knapp M., Beadle-Brown J Brussels, May 27, 2015. and Beecham J. (2007). • Survey on Disability, Personal Autonomy • FEAPS Quality. A model for quality of life, and Situations of Dependency 2008 (EDAD from ethics and quality of service. June 2007. 2008). National Statistics Institute. • European governance. A White Paper. • Statistical use of the Register. National Commission of the European Communities. Statistics Institute (INE). Brussels, 25.7.2001. COM (2001) 428 Final. • Statistical information of the Basque Statistics • Equal opportunities for people with Institute (EUSTAT). disabilities: A European Action Plan (2004- • International Classification of Functioning, 2010). Communication from the Commission Disability and Health - WHO 2001 CIF -. to the Council, the European Parliament, the • Quality of life. A guide for professional in European Economic and Social Committee education, health and Social Services by and the Committee of the Regions. Robert L. Schalock and Miguel Ángel Verdugo. • Ethical and Socially Responsible Management • Mental retardation. Definition, classification System. SGE21. Forética. and support systems. American Association • Social protection for dependents. Santiago on Mental Retardation. (AAMR 2002). González Ortega and Mª Gema Quintero • Intellectual Disability. Definition, classification Lima. Ed. La Ley. and support systems. American Association of Intellectual and Developmental Disabilities • CERMI Collections. (AAIDD). 2014. • Websites of Third Sector organisations in the • The collaboration of the third sector and the field of disability (State level, Basque Country Regional Government of Bizkaia in the field and Bizkaia). of social services. Consolidating the progress • Bizkaia Observatorio del Tercer Sector (Third made and planning the future. Bizkaia Sector Observatory). Regional Government and Round Table for • Agency for Volunteering and Social Civil Dialogue of Bizkaia. Participation (Bolunta). • Mental Health Strategy of the Basque Country. • Basque Innovation Agency. Innobasque. Osakidetza, Basque Health Service. • Psychiatric care and mental health. Strategic Plan • Euskalit Advanced Management Model. 2004-2008. Osakidetza, Basque Health Service.

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