Rehabilitation and integration of people with disabilities: policy and legislation

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1 Rehabilitation and integration of people with disabilities: policy and legislation 7th edition Council of Europe Publishing Editions du Conseil de l Europe

2 Rehabilitation and integration of people with disabilities: policy and legislation 7th edition Report drawn up by the Committee on the Rehabilitation and Integration of People with disabilities (Partial Agreement) (CD-P-RR) Integration of people with disabilities Council of Europe Publishing

3 French edition: Réadaptation et intégration des personnes handicapées: Politique et législation ISBN , 1 re édition, 1973 ISBN , 2 e édition, 1985 ISBN , 3 e édition, 1988 ISBN , 4 e édition, 1990 ISBN , 5 e édition, 1993 ISBN , 6 e édition, 2002 ISBN , 7 e édition, 2003 The opinions expressed in this work are the responsibility of the author(s) and do not necessarily reflect the official policy of the Council of Europe or of any of the mechanisms or monitoring bodies established by it. All rights reserved. No part of this publication may be translated, reproduced or transmitted, in any form or by any means, electronic (CD-Rom, Internet, etc.) or mechanical, including photocopying, recording or any information storage or retrieval system, without prior permission in writing from the Publishing Division, Communication and Research Directorate (F Strasbourg or Cover design: Graphic Design Workshop, Council of Europe Layout: Desktop Publishing Unit, Council of Europe Edited by Council of Europe Publishing F Strasbourg Cedex ISBN , 1st edition, 1973 ISBN X, 2nd edition, 1985 ISBN , 3rd edition, 1988 ISBN , 4th edition, 1990 ISBN , 5th edition, 1993 ISBN , 6th edition, 2002 ISBN , 7th edition, 2003 Council of Europe, April 2003 Printed in Germany

4 CONTENTS page Preface... 5 Austria... 9 Belgium Denmark Finland Germany Hungary Italy Lithuania Norway Poland Portugal Slovenia Spain Sweden Switzerland United Kingdom

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6 PREFACE The Council of Europe The Council of Europe is a political organisation which was founded on 5 May 1949 by ten European countries in order to promote greater unity between its members. It now numbers 44 member states. 1 The main aims of the Organisation are to reinforce democracy, human rights and the rule of law and to develop common responses to political, social, cultural and legal challenges in its member States. Since 1989 the Council of Europe has integrated most of the countries of central and eastern Europe into its structures and supported them in their efforts to implement and consolidate their political, legal and administrative reforms. The work of the Council of Europe has led, to date, to the adoption of over 170 European conventions and agreements, which create the basis for a common legal space in Europe. They include the European Convention on Human Rights (1950), the European Cultural Convention (1954), the European Social Charter (1961), the European Convention on the Prevention of Torture (1987) and the Convention on Human Rights and Bioethics (1997). Numerous recommenda- 1. Albania, Andorra, Armenia, Austria, Azerbaijan, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Moldova, the Netherlands, Norway, Poland, Portugal, Romania, Russian Federation, San Marino, Slovak Republic, Slovenia, Spain, Sweden, Switzerland, the former Yugoslav Republic of Macedonia, Turkey, Ukraine, United Kingdom of Great Britain and Northern Ireland. 5

7 Rehabilitation and integration of people with disabilities: policy and legislation tions and resolutions of the Committee of Ministers propose policy guidelines for national governments. The Partial Agreement in the Social and Public Health Field The scope of the Council of Europe s activities is vast, since only defence questions are excluded from its competence. Where, however, a lesser number of states wish to engage in some action in which not all their European partners desire to join, they can conclude a Partial Agreement which is binding on themselves alone. The Partial Agreement in the Social and Public Health field was concluded on this basis in 1959 by seven member states with the aim of continuing the work in this field previously undertaken under the Brussels Treaty and then by the Western European Union (WEU). At present, the Partial Agreement has 18 member states; 7 states are observers in the field of integration of people with disabilities. 2 The areas of activity include: protection of public health, particularly consumer health; rehabilitation and integration of people with disabilities. The activities are entrusted to a number of committees of experts or working groups, which are in turn responsible to the steering committee for each area. The work of these Partial Agreement committees occasionally results in the elaboration of conventions or agreements, but the more usual outcome is the drawing-up of recommendations to member governments in the form of resolutions adopted by the Committee of Ministers (composed of the representatives of the states participating in the particular activity). These recommendations/resolutions may be considered as statements of policy or common guidelines for national policy-makers. Governments have actively participated in 1. Member states: Austria, Belgium, Cyprus, Denmark, Finland, France, Germany, Ireland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Slovenia, Spain, Sweden, Switzerland, United Kingdom. Observers: Canada, Estonia, Hungary, Iceland, Latvia, Lithuania, Poland. 6

8 Preface their formulation: the delegates to the Partial Agreement committees are both experts in the field in question and responsible for the implementation of government policy in their national ministries. This procedure provides for considerable flexibility in that any state may reserve its position on a given point without thereby preventing the others from going ahead with what they consider appropriate. Another advantage is that the recommendations are readily susceptible to amendment should the need arise. Governments are furthermore called upon periodically to report on the implementation of the recommended measures. A less formal procedure is the publication of general guidelines intended to serve as a model for member states. Each government can interpret these guidelines in accordance with its own law and practice in the matter. Bodies of the Partial Agreement in the Social and Public Health field enjoy close co-operation with equivalent bodies in other international institutions. Contact is also maintained with international non-governmental organisations (INGOs) working in related fields. 7

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10 AUSTRIA I. General policy 1. Principles In 1992 the Austrian Federal Government agreed on a Disability Concept stating cornerstones of Austrian policy on disability matters: Disability is one of the many forms in which human life occurs: it should be accepted as such and the people concerned should not be excluded in any way from participating in society. Austria s disability policy must be based on an overall view of people and must take equal account of their physical, mental, emotional and social needs. It should therefore be oriented towards the following principles: Prevention Disability should be avoided as far as possible by preventative measures. Integration People with disabilities must be able to participate in society to the largest extent possible. Standardisation The lives of people with disabilities should differ from those of non-disabled people as little as possible. 9

11 Rehabilitation and integration of people with disabilities: policy and legislation Self-determination People with disabilities should be able to make their own decisions on matters that affect them, to the same extent as nondisabled people do, or at the very least to participate in them. Helping people to help themselves Assistance should be oriented towards reinforcing the abilities of people with disabilities and their social environment and enabling them to achieve as much independence as possible. Finality Assistance for people with disabilities should be provided irrespective of the cause of the disability. Normal place of residence Assistance should be available to all people with disabilities who are normally resident in Austria in accordance with the provisions of the law and regardless of their nationality. Customisation A scale of assistance should be offered in accordance with the needs of the individual, paying particular attention to shortterm and transitional assistance. Decentralisation Assistance for people with disabilities must be easily accessible, and should be close to the place of residence or work wherever possible. Smooth transition The various types of assistance available for people with disabilities must complement one another, and particular attention should be paid to the points of transition between the various aspects of life. 10

12 Austria Rehabilitation Pensions or care benefits should only be approved once all forms of rehabilitation have been exhausted. Mobile and community assistance Institutional stays should be avoided wherever possible. Mobile, community and semi-institutional assistance should be given priority. Transparency In all facilities, priority should be given to small, transparent units in preference to large institutions. Accessibility The assistance provided must be made accessible to the people concerned through information and advice. 2. Aims The general aims of policy concerning the matters of disability are to implement the above-mentioned principles in any aspect of everyday life. 3. Fields of intervention Following the above-mentioned principles all the fields of social life must be adapted to the needs of people with disabilities as far as possible by means of legislation on the one hand, mainstreaming on the other hand. 4. General Directives Art. 7 Sec. 1 of the Austrian Constitution was amended in 1998 to contain an expressive prohibition of discrimination on account of disability. 5. Definitions On 27 September 1988, the parliament drew up a series of resolutions on disability policy. For example, it asked the Federal Government to subject the definition of the terms disability 11

13 Rehabilitation and integration of people with disabilities: policy and legislation and disabled person to comprehensive examination, to coordinate them and to unify them if the differences are not justified from a practical point of view. The Austrian Committee for Social Work then organised a symposium on the subject on behalf of the Federal Ministry of Labour and Social Affairs. The participants examined the definition of the term disabled from economic, social and legal points of view, and came to the conclusion that at the time it was not possible to establish a uniform definition of disabled in law and make this the foundation for benefits. However they did agree that the definition of the term disabled would have to be broad enough to include the disabilities and special needs of people with disabilities relating to their social activities. With this in mind, two definitions have been drawn up to which the Federal Government and the provincial authorities have been asked to adhere in their disability policy: Disabled persons are persons of all ages who have a permanent and substantial physical, mental or emotional impairment in an area of social relationships important to their everyday lives. Persons who are threatened with such an impairment in the foreseeable future are also regarded as disabled. Areas of social relationships regarded as vital are childrearing, education, employment, other occupations, communication, living and leisure activities. Disabled persons are those persons who are not able to sustain regular social relationships, acquire and perform gainful employment and achieve a reasonable and adequate income without assistance. In the discussions on the Federal Disability Act, which came into force on 1 July 1990, the demand was voiced for a definition of disability to be incorporated into the law. However, given the current legal situation, no legal consequences could be attached to such a definition. It was therefore decided not to incorporate a legal definition. 12

14 Austria II. Prevention and health education 1. Aims The Austrian Federal Government adheres to the comprehensive definition of health as set out by the WHO. In this context, prevention, rehabilitation and community care in particular must be given more support than was previously the case. The Federal Government therefore intends to: further extend accident prevention and preventative healthcare; extend community medical care and rehabilitation facilities; and integrate psychological and psychotherapeutic measures into general health care. The following measures should also be taken in respect of rehabilitation: the setting up of rehabilitation wards in hospitals; the provision of rehabilitation in old-age and nursing homes; the extension of after-care to ensure that rehabilitation measures are successful. With regard to psychiatry, the Federal Government intends to: develop a decentralised, community psychiatric care system and help mentally disabled people to leave psychiatric institutions whilst at the same time setting up adequate long-term care structures. 2. Prevention of impairment, disability or handicap: accident prevention There are approximately 600,000 accidents in Austria each year; of these almost 5,000 are fatal and about 460,000 necessitate sick leave (with hospital treatment required in about 220,000 cases). Associated with this is not only the human suffering, which is almost impossible to quantify, but also the 13

15 Rehabilitation and integration of people with disabilities: policy and legislation enormous cost to the economy, estimated at about every year. The number of accidents at work has been falling slightly for some years, as a result of employee protection regulations, medical care at work, the activities of workplace inspectors and preventative measures by accident insurance companies. Some 2,000 people suffer from job-related illnesses and almost 200,000 accidents at work are registered every year. Efforts to eliminate health risks at work and to reduce the risk of accidents must therefore be continued. A draft for a Work Protection Act, which complies with EC regulations, stipulates that employers must take specific risks stemming from employees disabilities into account when assessing risk in their companies and drawing up the corresponding protective measures. Furthermore, medical and safety care at work is to be extended gradually to include all employees. In view of the trend towards a leisure society, we will need to pay increased attention to traffic and leisure accidents and those in the home, particularly as they are more significant overall than accidents at work. Initial steps have been taken in the form of an obligation on the part of health insurance providers, introduced in 1992, to undertake health promotion and accident prevention measures. Accident prevention measures being taken by the various agencies bearing the costs should furthermore be co-ordinated in a comprehensive, nation-wide concept. 3. Preventative healthcare Preventative healthcare should concentrate primarily on people in high-risk groups (e. g. drinking, smoking, overweight people and those subject to stress) or on age groups more prone to accidents (children and old people). Participation in preventative examinations run by health insurance companies has increased to about 500,000 persons per year. This indicates that Austrians are becoming increasingly health-conscious, although the services offered by health insurance companies (e. g. voluntary well-man/woman 14

16 Austria examinations, obligatory medical examinations for schoolchildren and apprentices) are not yet being taking up in sufficient numbers. 4. Health education Health education is included as a main focus in the teaching plans of all social, pedagogic and care professions. III. Identification and diagnosis Medical investigations beginning with pregnancy and early recognition during childhood and continuing at school and at the working place try to identify impairments as soon as possible to begin therapy and rehabilitation immediately. IV. Treatment and therapeutic aids 1. Medical treatment The medical and orthopaedic care for disabled persons do not really differ from that of any other person. Such care is rendered by doctors or hospitals that are integrated into the general social security system. Only the financing of the care might be different. Of course there exist medical institutions that specialise in disabled children and grown-ups. 2. Assessment of abilities Assessment of abilities generally is offered by expert teams of the provincial governments and the Public Employment Service. Also the integrative enterprises (sheltered workshops with normal wages) test their applicants. In some provinces (e.g. Vienna) assessment with regard to the general labour market is offered as a service of some non-profit organisations (NPOs) for people with disabilities. 15

17 Rehabilitation and integration of people with disabilities: policy and legislation V. Education 1. Aims One important precondition for the success of rehabilitation measures is the early recognition of disabilities: there are both private and public institutions which offer early recognition and formative support services. There are special institutions in Austria for disabled children where trained personnel provide the children with special support. Especially in less developed rural regions there exists a service rendered by the Federal Offices of Social Affairs, the mobile counselling service for juvenile disabled persons. Teams of medicines, psychologists and social workers counsel parents of disabled children and juveniles concerning all matters of disability, education and support. An increased family allowance benefit, which rises from the age of ten, is paid for each physically or mentally disabled child. The Austrian Federal Government aims to achieve as high a level of integration of disabled children and young people in schools as possible. For this reason it will be necessary to create additional facilities for special needs assistance and joint teaching of disabled and non-disabled children, despite the fundamental recognition of the special needs school as a possible educational institution. The government therefore intends to: set up different forms of organisation for joint teaching and special educational assistance (e. g. integrated classes or special needs teachers); replace obligatory attendance of special needs schools with a choice of different special needs schools; equipping special needs schools with additional facilities for the active support of integrative school attendance (special educational centres); and extending assistance for disabled pupils in general and vocational middle and senior schools. 16

18 Austria 2. Mainstream education When a child is disabled, the question often arises as to whether he/she would be better off in a common school or a special needs school. Under no circumstances should it be automatically assumed that a disability necessitates a special needs school. Children normally begin their schooling at the age of six and are obliged to spend at least nine years at school. In general, the system of Sonderschulen (specialised classes or schools) is still common: there are special schools for remedial children as well as special schools for the hard of hearing, blind or physically disabled children. There are also experiments made with the integration of children with disabilities in general schools. In addition, the effort has been made to improve the possibilities of common teaching of children with disabilities and those without disabilities: A recent draft of a bill (amendment law of the Schulorganisationsgesetz ) shall provide common teaching at primary school (age band 6-10), at lower secondary school and at advanced secondary general school / lower level (age band 11-14). The concept of integration comprises children with physical and mental disabilities as well as those with a learning disability. Supplementary teachers with special instructions shall be engaged to ensure best results. There exist also special training aids for disabled children and, if necessary, special teaching books are available. By school integration, we mean disabled and non-disabled children being taught together, which can go a long way towards preparing for later integration into society. The disabled children will be given remedial lessons where necessary, but will participate in normal lessons as far as possible and remain an integral part of the class. Numerous studies prove that integrating children in this way can have a positive effect on the social contacts and personal development of all the children concerned and that non-disabled children are not disadvantaged as a result. In many cases, the special 17

19 Rehabilitation and integration of people with disabilities: policy and legislation assistance that can benefit the entire class can even result in better academic achievements all round. Problems may arise for disabled children in common schools because there is no protective framework like there is in a special school. This can result in a greater fear of school and lower self-esteem. However, for many disabled children, the benefits of an integrative school that meets certain requirements outweigh the disadvantages. These requirements in particular include special training for teachers, the availability of the additional necessary staff and material aids, reasonable class sizes, less frontal and more project-based teaching, a greater involvement on the part of parents and the necessary advice for all concerned. If the journey to school is too long, all children are entitled to free transport; special attention is paid to disabled children. 3. Special education A child can attend a special needs school if he or she is able to attend school but cannot be taught in a primary or senior school because of his or her disability. Special needs schools have eight or nine school levels, they are divided up according to the nature of the disability and are either schools in their own right or are attached to a common school in the form of special needs classes. The task of a special needs school is to help the disabled child to acquire the education he or she would otherwise have received at a common school, to prepare for his/her entry into professional life or to enable him/her to transfer to a middle or senior school to the extent his/her disability allows. These schools have specially trained teachers and teaching resources specific to the disabilities concerned, and plans of instruction are adapted to suit the disability. The maximum number of pupils in classes in special needs schools is 18

20 Austria established in law at between eight to fifteen, depending on the nature of the disability. From a historical point of view, the introduction of special needs schools was undoubtedly a big step forward. The right of disabled children to an education was thus generally recognised, and the isolation and social exclusion suffered by people with disabilities was moderated. However, special needs schools have a number of serious disadvantages: The choice of a special needs school can be difficult for children with complex disabilities. The school may be a long way away from the child s home town, forcing him/her to board at the school and leave his/her own social milieu. There is often little cross-over between special needs schools and common schools, so that the label special needs pupil will remain, along with all the associated social discrimination and poorer job opportunities in our high-achievement society. In special needs schools, the focus will in particular be on the child s disability instead of on its individual skills. The tenet of every school that it should focus on what the children can do instead of what they cannot do is all the more applicable to special needs schools. Special needs schools will continue to be necessary for some children with disabilities. However, wherever possible, the aim should be to promote and to give priority to integrating disabled children into common schools. 4. Education and rehabilitation If education is necessary after accidents or vocational diseases, the costs are provided by the social insurance institutions. 5. Education of adults with disabilities Supplementary education of adults can be subsidised if the education is apt to improve the vocational situation of a disabled person. 19

21 Rehabilitation and integration of people with disabilities: policy and legislation VI. Vocational guidance and training 1. Assessment of vocational aptitudes Assessment of vocational aptitudes generally is offered by the Public Employment Service. In some provinces (e.g. Vienna) assessment with regard to the general labour market is offered as a service of some NPOs for people with disabilities. 2. Guidance Assistance for vocational integration is rendered by the provinces, the Public Employment Service and the Federal Offices of Social Affairs. In this respect services play an important role additionally to the possibility of funds for employers. Those services are rendered by NPOs and financed by the Federal Offices of Social Affairs, the Public Employment Service and the provinces. The measures are summarised under the title of supported employment and are called Arbeitsassistenz (employment counselling). 3. Vocational training There is one special large vocational training centre for people with disabilities, the BBRZ ( Berufliches Bildungs- und Rehabilitationszentrum ) that provides certified training and vocational orientation for up to 700 people. Additionally a number of smaller training centres offer non-certified training opportunities for different groups of people with disabilities. Benefits for training are offered mainly by the Public Employment Service. The disabled persons attending a training course receive a benefit. Under certain circumstances allowances for training can also be paid by the Accident Insurance or the Pension Insurance. Further possibilities for receiving training are training as an apprentice in a company on the open labour market. In Austria, there exists the so called Dual training system : education is provided in companies as well as in part-time vocational schools which provide for basic technical knowledge, supplying the education and training in companies. 20

22 Austria Several forms of financial support for the employer as well as for the apprentice are available. There exist apprenticeship promotions for the young people who are particularly disadvantaged or have dropped out of apprenticeship (people with physical, psychological or mental disabilities); the departmental offices of the Public Employment Service have a special responsibility towards people in this category. If a disabled person does not have the prerequisites for a regular job or work in a protected workshop due to the handicap, a course of therapy is given to maintain and develop the existing talents. Pocket money is normally given to the disabled person during the time spent at the employment therapy workshops. VII. Employment 1. Principles Work in the form of vocational or enterprising occupation has become a central importance in our modern industrial society. The workplace and work content are very important for acceptance and recognition in the social unit and for personal development. Some countries have acknowledged this fact to the extent of anchoring an individual s right to work in their constitution, a step, which is somewhat contradictory to the concept of free enterprise. In Austria it is, however, an important socio-political target within the limits of free enterprise to keep the labour market open to minorities. Therefore promotion of vocational integration for disabled persons on the open labour market or in sheltered institutions plays an important role. In this way all different kinds of occupations which provide an income are respected as socially acceptable work. Life is development, however, and a person s working life cannot be viewed as detached and isolated from his or her entire life. Previous education, training, career searching and trial phases are all part of the success of vocational 21

23 Rehabilitation and integration of people with disabilities: policy and legislation integration of disabled persons. Establishing and subsidising sheltered workplaces in industry and the foundation and running of sheltered institutions generally are under the responsibility of quite a few authorities (Federal Offices of Social Affairs, Public Employment Service, social insurance institutions and the provinces). The Federal Offices of Social Affairs are responsible for securing the social status of disabled persons, applying their skills and knowledge appropriately and improving their competitiveness with the non-disabled. Here are now the essential elements of establishing, subsidising and maintaining sheltered workplaces in industry and the present system of sheltered institutions in Austria. 2. Employment in an ordinary working environment The possibility of integration for disabled persons in the open labour market is a priority socio-political aim and an essential contribution to the entire social integration. To meet these requirements the rehabilitation authorities offer material, financial and personal help as well as work-related legal protection. Material help There are various aids the rehabilitation authorities can provide in this context: mobility aid for reaching the place of work for people who cannot use usual means of transport; adaptation of the workplace including equipping or adapting both the workplace itself and its environment (e.g. sanitary installations for wheelchair users); local consultancy by occupational therapists and provision of modern technology. Quota system An employer with at least 25 employees in Austria is obliged to employ a registered protected disabled person for every 25 employees. This quota can be altered on the order of the Federal Minister for Social Security and Generations for 22

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