De-institutionalization in the multilevel system of mandates and accountabilities

1. De-institutionalization in the multilevel system of mandates and accountabilities Ms. Vesna Bosnjak, Senior Expert, ISS International Social Services

2. The Themes • Why past efforts did not achieve the results ? • How to fill the gaps in present strategies ? • Management of the transition to fully regulated (new) system of services

3. 1.Why past efforts did not achieve the results? • Closing down institutions as “quick fix” solution, disregarding improvements in individual condition of the child • Accelerating exits from institutions does not stop new entries • Improving institutional care does not contribute to the decrease in number of placements • Developing alternative care without direct to de-institutionalization produce sub-optimal or no impact on de-institutionalization • Strategies and plans did not integrate all the ingredients for multi level efforts and over a short (and medium) term • “bussiness as usual” undermined and/ or contradicted reform efforts

4. 2. How to fill the gaps in present strategies? • Normative domain • Analysis relevant for planning • Quantitative planning targets

5. 2. 1. Normative domain • Regulate standards and costs for all services - not for service establishments! • Mandates of establishments to be acquired and changeable, not prescribed • Regulate financial sources to be equally available for all services - with intergovernmental transfers from national to local level, when local revenues insufficient!

6. 2.2 Analysis relevant for planning -and /or evaluation of plans • Quantifythe placement capacity(for short, medium and long term) in residential institutions on the basis of de/institutionalization targets (i.e. reduction of entries, acceleration of exits) • Forecast the needed supply of family substitute and family and child support services for children who would, if trends continue, enter in institutions and for the ones targeted to exit institutions • Forecast the needed extension of the supply of family and child support services for children and families at risk (including prevention of family separation)

7. 2.2 Analysis relevant for planning -and /or evaluation of plans -continuation • Forecast approximate number of staff for – employment, (re)- training, deployment and /or laying-off in residential institutions • Forecast the number of staff required in statutory services and their training needs, based on the expected workload in case management . • Adjust all above targets /forecasts to the expected overall budgetary capacities at national, regional and local level (in short, medium and long term). • Design budgetary mechanisms for intergovernmental transfers within the principles of equity and “money follows the client”

8. 2.3 Quantitative planning targets • Ratio between institutional and other family substitute care • Ratio between placement capacity in family substitute and family and child support services • Reduction of rates of entries and increase in exits from institutions • Number of personnel for employment, (re) training deployment and lay-off in care services • National parameters to guide local and inter -municipal planning

9. 3. Management of transition • “Legitimized” temporary structures instead of arbitrary “piloting” • Placement capacity and individual care plans • De-regulation and/or temporary regulation: mandates, staff transfers, plurality of service providers

10. 3.1 “Legitimised” temporary structures instead of arbitrary “piloting” • Introduce temporary mandates and accountability structures for implementation of planned targets by existing and new stakeholders • Define the planning methodology and establish municipal and/or inter municipal planning framework • Introduce transition financial mechanisms and /or financial arrangements in line of “money follows the de-institutionalised client” • Assure other transition costs

11. 3.2 Placement capacity and individual care plans • Number of new placements in alternative care to be assured for de-institutionalized children and / or prevention of new placements in institutions ( i.e. define primary secondary and tertiary target groups for alternative care) • Statutory services obliged to revise and plan alternative care for children originating from their locality and, at present, placed in institutions (can be supported by ad hoc teams employed temporarily or on project basis to fill the gaps in the capacity of statutory services and government bodies)

12. 3.3 De-regulation and /or temporary regulation of potential mandates of residential institutions, staff transfers, plurality of service providers • Allow residential institutions to provide alternative services on the basis of inter municipal planning targets • Devise a strategy for deployment of institutional staff in alternative services --regardless of their sectoral belonging • Define tender and commissioning procedures for new service providers as an entry point leading to long term goal to establish licencing and accredition