Personal Assistance in Finland - legislation, implementation, statistics and challenges for the future

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1 Personal Assistance in Finland - legislation, implementation, statistics and challenges for the future Jaana Huhta Senior Legal Officer Ministry of Social Affairs and Health Juha-Pekka Konttinen Senior Specialist National Institute for Health and Welfare (THL)

2 Finnish Disability Policy - Context Finland's Disability Policy Programme National legislation - the Constitution United Nations The Convention on the Rights of Persons with Disabilities Council of Europe Council of Europe Disability Action Plan European Union The European Disability Strategy

3 Services for Persons with Disabilities The basic objective of disability services is to enable persons with disabilities to live and function on an equal footing with other people The responsibility of municipalities (appr. 330) as providers of services and support measures is of key importance Private service providers and non-governmental organizations complement public services, and municipalities buy some of the services from them

4 Special Services for Persons with Disabilities Provisions on special services are laid down in the Services and Assistance for the Disabled Act (the Disability Act, 1988/2009) the Act on Special Care for persons with Intellectual Disabilities (1977) the Act on Interpretation Services for Persons with Disabilities (2010) All services under the acts are cost free for the service user Services support independent living in the community and the functional capacity of the person

5 Special Services for Persons with Disabilities Persons with severe disability have subjective rights to housing services ( service housing ) personal assistance transportation services out-of-home activities which support independent living and social interaction ( daytime activities ) necessary home alteration work to enable independent living necessary devices and equipment in the home to enable independent living Interpretation services for people who are deaf, deaf-blind, hard-ofhearing or have a speech disability (organized by The Social Insurance institution of Finland since 1 st September 2010)

6 Special Services for Persons with Disabilities 2009 legislative reform Subjective right to personal assistance services Right to a service needs assessment within 7 days of contact Right to an individual service plan etc. The Disability Act and the Act on Special Care of Persons with Intellectual Disabilities will gradually be merged into new legislation

7 Personal assistance - what is it? Personal assistance is a service under the Disability Act. Assistance is provided by another person to a person with a severe disability, either at home or outside the home. Personal assistance is meant for activities that one would do by oneself, but is not able to do because of his/her disability or longterm illness. The purpose of personal assistance is to assist the person to act according to his/her own choices. The person himself/herself makes the decision about: what kind of assistance he/she will have when, where, and how to receive the personal assistance who works as the assistant.

8 Who is entitled to personal assistance? Personal assistance is granted for people with severe disabilities for: everyday activities (such as mobility, dressing up, caring for hygiene, getting dressed, cooking & eating, cleaning, managing your personal affairs) work, education, hobbies social participation and social interaction A person with a severe disability is defined as a person who due to his/her longterm or progressing disability or illness, necessarily and repeatedly needs the assistance of another person for activities mentioned above and the need for assistance is not primarily due to an illness or functional limitations related to ageing (other services in the Disability Act do not refer to ageing or age related conditions, that is to say they are not grounds for dismissal in other services)

9 The extent of personal assistance Personal assistance must be granted to the extent that the person needs. The extent must be evaluated in such a way that the assistance enables a person to live with human dignity. Personal assistance for hobbies, social participation and social interaction is at least 30 hours / month (if less is not sufficient to secure the need of assistance in these functions). Individual needs and the situation of the person with disabilities is to be taken into consideration.

10 Three ways to organize personal assistance 1. Employer model The person with a severe disability is the employer of the assistant. Costs caused by this employment relationship are compensated by the municipality of residence. 2. Voucher model The person with a severe disability receives a voucher for acquiring assistance services. The voucher is provided by the municipality of residence and it must be of a reasonable value. 3. Assistance service The municipality acquires assistance services for the person with a severe disability. Service is acquired from private producers or organized by the municipality itself on its own or together with one or more municipalities.

11 National Institute for Health and Welfare (THL) / Juha-Pekka Konttinen

12 The subjective right to services has increased service use since 2009: the number of the service users has almost doubled (SOTKAnet.fi and Nurmi-Koikkalainen / Muuri) National Institute for Health and Welfare (THL) / Juha-Pekka Konttinen

13 The number of elderly clients has increased and the number of the clients under the age of 17 has decreased. (SOTKAnet.fi and Nurmi-Koikkalainen / Muuri) National Institute for Health and Welfare (THL) / Juha-Pekka Konttinen

14 Personal Assistance System Number of clients and net costs per 2011 (Kuusikko) and variation between (2011 value of money) Asiakkaat Muutos 10 11, % Kustannukset, Muutos 10 11, % Helsinki , ,5 Espoo , ,1 Vantaa , ,1 Turku , ,9 Tampere , ,3 Oulu , ,7 Kuusikko , ,5 National Institute for Health and Welfare (THL) / Juha-Pekka Konttinen

15 Some Statistics on Services for Persons with Disabilities Statistical Yearbook on Social Welfare and Health Care 2012 THL Statistics and Registers THL: SOTKAnet Statistics and Indicator Bank Statistics Finland (finances and activities of municipalities and joint municipal boards) THL: Handikappservicen 2010 Delrapport om kommunenkäten THL: Statistics and Costs on Disability Services (to be published in 2013) National Institute for Health and Welfare (THL) / Juha-Pekka Konttinen

16 Challenges in developing personal assistance and other disability services Starting point: special legislation for people with disabilities is needed also in the future to reassure the necessary services to enable equality, participation and indispensable care To be developed: personal assistance to clearly cover also support and guidance care and supervision while supporting self-determination eligibility to services regardless of the nature of the disability development of the various ways to organize assistance possibilites to develop daytime activities and increase freedom of choice - individual budgeting? questions of the responsibilities of the employer are there enough assistants (competence and education) economical situation (costs)

17 vammaispalvelujenkäsikirja.fi handbokforhandikappservice.fi Thank you for listening! National Institute for Health and Welfare (THL) / Juha-Pekka Konttinen