PROGRAMME OF ADVANCEMENT THROUGH HEALTH & EDUCATION (PATH)

Transcription

1 PROGRAMME OF ADVANCEMENT THROUGH HEALTH & EDUCATION (PATH) 1. PURPOSE AND OBJECTIVES OF THE PROGRAMME The Government of Jamaica has introduced a new Unified Benefit Programme, executed by the Ministry of Labour & Social Security. The Programme replaces the Outdoor Poor Relief Programme of the Ministry of Local Government and Community Development, and the Food Stamp and Old Age/Incapacity Programmes of the Ministry of Labour and Social Security. The purpose of the Programme is to rationalize the operations of the three existing income transfer programmes so as to eliminate duplication, reduce administration costs, streamline the use of resources, and increase effectiveness in delivery of benefits to the poor. The rationalization ensures a transparent, equitable system of beneficiary selection. The objectives of the Programme are to: (1) to increase educational attainment and improve health outcomes and thus reduce poverty, (2) Reduce current poverty by increasing the value of transfer to the poor. (3) Reduce child labour by requiring children to maintain a minimum of 85% school attendance, per term. (4) Serve as a safety net by preventing families from falling further into poverty, in the event of adverse shock. 2. TARGET POPULATION AND GRANTS Table No. 1: Target population CATEGORY NUMBER Jamaican population 2,590,400 Estimated number of households 719, ,640 Estimated number of poor households* 445,115 Number of poor in population* 236,000 Programme target Children 0-17 years 168,000 Pregnant and Lactating Women 11,000 33,000 Elderly Poor 19,000 Disabled 5,000 Other Destitute Persons TOTAL 236,000 * Under poverty line The level of benefits per beneficiary is of J$ (US$ 6.5) in year 1 and increased to $ (US$ 7.5) and $ (US$ 9.0) in years 2 and 3 respectively and are equal for all of them 3. PARTICIPANTS INVOLVED IN P.A.T.H OPERATIONS There are two types of participants in the operation of PATH; those directly involved in the delivery of the benefits, and those that indirectly support the overall operations. Those that participate directly are: (a) The Ministry of Labour and Social Security, (b) The Ministry of Local Government & 1

2 Community Development, (c) The Payment Agency, (d) Primary and Secondary schools, (e) Health Centres, (f) Beneficiary families and family representatives. Participants who support the overall operations are: (a) The Planning Institute of Jamaica, (b) The Ministry of Finance and Planning, (c) The Ministry of Education, Youth and Culture, (d) The Ministry of Health, (e) The World Bank. 4. OPERATIONAL CYCLE OF THE PROGRAMME Eligibility Criteria: There are several eligibility criteria for acceptance on the Programme and several categories of beneficiaries. Qualified Applicant: To become qualified for a benefit, persons must complete a Targeting Questionnaire and who, based on the information submitted and the application of the scoring formula, attain a score which is at or below the cut-off point established for the Programme. Each member of the household is entitled to receive only one benefit. The priority ranking is: 1 st children, 2 nd elderly, 3 rd disabled, 4 th pregnant and 5 th other poor. Individuals who are in receipt of a National Insurance benefit and are a part of a family that qualifies for PATH are not eligible for a benefit under this Programme. There are five broad categories of beneficiaries. These are: (a) Children 0-17 years, (b) Elderly over 65 years, (c) Persons with Disabilities, (d) Pregnant & Lactating Women, and, (e) The Destitute Poor Registered Beneficiary: To become a registered beneficiary an individual must: (a) Be a qualified applicant. (b) Submit all the required documentation, and (c) Attend enrolment and sign the Agreement Letter. Compliant Beneficiary: All registered beneficiaries, in order to continue to receive their benefits, must be compliant with the health and education conditionalities established by the Programme. Compliance: At the end of the second payment, the Family Representative will visit clinic and school to validate the relevant compliance card/form, for the two previous pay periods. TARGETING PROCESS PATH is aimed at the poorest and most vulnerable of the population, and targets all poor households. A new household targeting system has been developed from data collected during the annual Survey of Living Conditions for Jamaica. A new scoring formula, which identifies and ranks the household that are poor, is operated. The targeting process is aimed at identifying and registering qualified applicants. This process comprises a number of stages, from public education through to implementation. Letters are sent to beneficiaries of the three previously mentioned social welfare programmes to ensure that they are included in the targeting exercise. ENROLMENT PROCESS Enrolment is the stage by which qualified applicants are incorporated to become beneficiaries of the PATH Programme. They are also orientated about the Programme and informed about their obligations and regulations governing payments. All qualified applicants are invited through letters to attend designated locations for enrolment, and to take along proper documentation as indicated below: (a) all members of family birth certificates or other document to verify age, (b) all adult members valid form of identification, (c) disabled persons verification of disability from doctor or health professional, (d) pregnant or lactating 2

3 women verification of pregnancy, and/or expected/actual date of delivery, (e) non-family relationship letter from Justice of the Peace or Pastor to affirm that the Household Head is the guardian. Mode of Payment: Payments will be made to qualified and compliant beneficiaries through electronic transfers to the designated pay agency, which will in turn disburse to the beneficiaries. Beneficiaries are paid every two months. Payments are ideally made to the Family Representative. However, the elderly or A disabled adult living in a household may request that payments be made directly to themselves, or they may appoint an agent. 5. VERIFICATION OF HEALTH VISITS AND SCHOOL ENROLMENT Conditionalities for Health Grants: Immediately following the enrolment process, the household members are required to make their first visits to the health centres and to establish their schedules for subsequent visits. The schedule established depends on the age and category of the beneficiary as indicated in Table (2) below: Table 2: Required Number of Health Visits by Category of Beneficiary Age/Status Required Number of Health Visit Per Year 1. Children Birth to 11 months 5 12 to 71 months 2 2. Pregnant 4 (or pro rata depending on when in pregnancy women applies for benefit) Lactating At 6 weeks and between 3 to four months post delivery 3. Adults Elderly Twice per year Disabled Twice per year * Poor Twice per year * Since only the Head of Household is entitled to a benefit, only the Head of the Household is required to comply with the health conditionalities of the Programme. Conditionalities for Education Grants: Children 6-17 years of age are required to satisfy the conditionality for Education Grants by maintaining school attendance of, maximum 85%, per term. Based on the average number of days in a school term, the maximum number of allowable absences (15%) is equivalent to nine days. If a child aged 6-17 has a severe disability which prevents him/her from attending school, they are treated as disabled, and compliance conditions are that as for the disabled (2 visits per year). 6. SUSPENSION AND TERMINATION FROM PROGRAMME Suspension: Registered beneficiaries are suspended from the Programme because of: (a) noncompliance with the health and education conditionalities; (b) non-collection of benefits for 2 consecutive payment cycles. Table 3 below gives more details on the reasons why registered beneficiaries may be suspended, by category. 3

4 TABLE 3: REASONS FOR SUSPENSIONS TYPES OF GRANTS REASONS FOR NOT RECEIVING BENEFITS Health?? Non-compliance with the visits indicated in the schedule agreed during the period?? Does not turn in the certification of visits made by the Family Representative within the indicated periods, to the Parish Office.?? Non-collection of benefits for two consecutive pay cycles. Education?? Non-compliance with at least 85% of the class attendance in the period.?? Non-collection of benefits for two consecutive pay cycles. Terminations Payments to beneficiaries are terminated because of the following: (a) death, (b) expressed request to leave the Programme, (c) proven fraud in the submission of information on the household, (d) non-compliance for 3 consecutive compliance periods. In the event of (d), beneficiary will be entitled to appeal. 7. APPEALS An Appeals Committee is to be established in each Parish and will be responsible for addressing the concerns of beneficiaries and civil society, who: (a) are dissatisfied with termination(s) from the Programme, (b) concerned about exclusion of needy persons. Each parish Appeal Committee shall comprise of relevant stakeholders and NGO s. 4

5 STRENGTHS AND WEAKNESSES OF P.A.T.H PROGRAMME S STRENGTH WHY? 1. Target Groups : Vulnerable in Society The Government recognised that the Social Safety Net in Jamaica needed to be reformed. Through a series of consultative workshops with key stakeholders, the Government found that there were a myriad of programmes that assisted the vulnerable, but they were inefficient, ineffective and lack cohesiveness in their focus. The government then designed a policy matrix which looked at all the vulnerable groups in society and how to deal with them. It was a result of these workshops that PATH was first conceptualised. PATH targets not all poor: but the most vulnerable poor. Target groups are: Children, Elderly, Disabled, Pregnant and Lactating. 2. A new programme that rationalises old programmes which in one case has been in the Jamaican law since the 1800 s 3. PATH though due to its funding is described as a project for the next 4 years it is in fact a Programme. 4. In terms of compliance PATH does not penalise the entire family if one member does not comply with the programme s conditionalities. PATH replaces three existing welfare programmes: Food Stamp, Out door Poor Relief and Old age and incapacity programmes. These programmes target the same beneficiary target population and are administered by two sets of Social Workers in two Ministries. It is expected that the rationalisation will result in decreased administration cost and eliminate the duplication of services. Jamaica has a long history of Welfare programmes. Since PATH replaces 3 existing social programmes, it is already described as a programme and not a project as it will become Jamaica s only income transfer programme. PATH will not end when the World Bank funding ends in In fact at one stage during the discussions with the Bank, Jamaica had to present a sustainability plan for PATH. The value of the benefit a family receives is based on who in the family is eligible to receive a grant. For example the family through the application of the scoring formula is eligible to benefit under PATH. However, it is only those members of the family who fall within the categories listed are eligible to receive a grant. It is only those eligible members of the family who have to satisfy the conditionalities. When those conditonalities are not satisfied the individual not the entire family is terminated. 5

6 5. PATH keeps family score constant for two years. 6. PATH beneficiaries are automatically eligible for benefits under other programmes. 7. PATH employs a case management approach. Jamaica s scoring formula places great emphasis on the demography of the family. Changes in the family structure would mean that if the scoring formula was reapplied, a number of families who benefit under PATH would no longer be eligible. PATH keeps all family scores constant over a period of two years after which each family will be reassessed (scoring formula reapplied). Operationally this is easier to handle, otherwise the beneficiary group would be very dynamic. PATH only provides cash to the poor. Though the value of the benefit is significantly greater than the current programmes, the benefit is still small. Cash alone will not have all the desired impact on the lives of the poor. Through agreements with the Ministries of Health and Education, all PATH beneficiaries will automatically be eligible for benefits under programmes in those Ministries. For example, PATH beneficiaries will receive 100% waiver on their school fees and will not be required to pay to access lunches in schools where the MOE has a school feeding programme. Similarly, all members of PATH families will not be required to pay fees at Public Hospitals. The benefit of this is : 1. Increase effectiveness of Jamaica s poverty strategy. 2. Scarce resources are concentrated to the poorest in society. A unit is a currently being set up in the Ministry to handle special cases. That is, there will be some poor persons who need more than an income transfer programme to assist them. These may be the destitute, street people, abused persons etc. This unit within the Ministry will be staffed by highly trained social workers who will handle these types of cases. It is not expected that they will see to every need but that through the linkages with other agencies and NGO s the Social Worker will be able to refer persons to relevant agencies. 6

7 PROBLEM CAUSE SOLUTION 1) Targeting a) Use of a The use of a scoring formula is new to social programmes in Jamaica. The current Get all Social Workers on board early. Explain how new method scoring programmes relied on the assessment of of targeting will work and its formula (Proxy means test). the Social Worker. Changing this culture is difficult. implication. b) For the Pilot, PATH is under targeting. c) Still not sure how to handle cases that are genuinely poor but not eligible under the formula. Development took long over 1 year. A number of trial and errors. PATH is under targeting because simulated numbers for pilot parish were not obtained. This could be for a number of reason which we are now fully investigating. But PATH believes it has to do primarily with the scoring formula. We are still refining how the formula will work. Had formula been developed earlier at least some amount of testing and refinement could have been done before. A scoring formula is a proxy used to identify the poor based on a number of characteristics that correlates with poverty. But they are not 100% accurate. If using a scoring formula that is new, test early. Put mechanism in place to handle. For PATH we are proposing that based on the error rate of the formula can set a target number for persons who do not qualify but based on an assessment by the social worker should be included on the programme. This in itself creates problems both from the standpoint of the MIS handling such cases and from the beneficiaries. Also, convincing the Bank to allow or pay for beneficiaries when there was some amount of subjectivity involved in their selection maybe difficult. We are not sure yet because we have not discussed this with the Bank. 7

8 2. MIS lags behind field implementation of the programme. The operation of PATH will be driven by the MIS system especially from the user end. This approach is new to us in Jamaica. That is, the MIS systems that drive the current programmes were mainly developed for payment and reconciliation at the central level. Path will use a decentralised system where all beneficiary records will be stored and can be access by all Social Workers across the island. Systems take time to develop. There is no base system that can be purchased off the shelf and modified to suit one own needs. Maybe through this workshop we can share information and designs of MIS systems. 3. Programme design Programme design was not finished until after we started the Pilot. It was difficult to finalise design of PATH simply because it was merging three programmes. Pressure came from the various programmes officials to ensure that their beneficiaries would not loose but gain under PATH. 4. Lengthy procurement process World Bank Procurement procedures though objective and transparent are lengthy. Since loans that support conditional grant transfer programmes are fairly new, there is no precedence in the Bank to follow in the procurement of some kinds of services. For example the procurement of pay agents. Ensure that there is agreement, both from the political directorate and technical staff, as to what the new programme will and will not do. Get working group of persons actually involved in the operation of the old Programmes to assist in the design of new Programme. Begin procurement process early. Set field implementation timeline based on procurement timeline. Bank needs to examine the procurement of non traditional services/goods. 5. Number of beneficiary groups. 6. Political pressure to implement. 7. Institutional Arrangements PATH provides benefit to a number of target groups. In terms of compliance monitoring, operationally it is more difficult to manage when payments are calculated based on the individual within the family complying. Election year for Jamaica and programme is seen as a good one, one that may be a plus in the Government s performance. Ministry knew that the PATH programme is only a project because of the funding arrangements. We were not 100% sure of how to handle this, what the structure of the project vs. the organisation should be. A study was commissioned to look at this but this has taken much longer than anticipated. Ensure that there is an understanding of the programme very early. Set up Project Unit early so that work on project can begin and then work out the institutional arrangements. This may be more costly but is easier from a project management perspective. World Bank User N:\Safety Nets\Mexico CCT Workshop\Jamaica.doc March 12, :09 PM 8