 The Ministry of labor and social policy is developing
an important strategic document
Strategy for De-institutionalization
of Social Services in the Republic of Macedonia (2007-2014)
In recent years, the process of
de-institutionalization began its realization in the Republic
of Macedonia. This process covers, on one hand, taking out
residents from social institutions and development of alternative
forms as an assistance of the families so that their children
should stay in the community, on the other hand. Nevertheless,
in order to have programmed and planned realization of this
reform on national level, it is necessary to create a strategy
for de-institutionalization in the Republic of Macedonia
(2007-2014).
The need of creating and developing a Strategy for de-institutionalization
of social services, derives from the fact that the quality of
care for the residents placed in public institutions for social
care may be improved with the process of de-institutionalization,
in which different relevant factors should actively participate:
the referent center for social work of the resident placed in
the institution, the institution in which the person is placed,
biological families, foster-care families, day centers and the
support from the local community.
The objectives, actions and the measures given in the Strategy
for de-institutionalization are in accordance with the Programme
for work of the Government of the Republic of Macedonia for 2006-2010,
the Millennium Development Goals, the goals for European Partnership,
the Law for Local Self-Government, the Law for Social Protection,
as well as the other legal and sub-legal acts. The guidelines
given in the Strategy define the new roles of the Ministry of
Labour and Social Policy and its institutions on one side, and
the new competencies and responsibilities are defined for the
local self-government units and the civil sector, which they
should take over as managers, providers or users of social services
on the other side.
The goal of this document is to establish legal and professional criteria,
dynamics and stakeholders of the reform initiatives and programmes, which in
the following 7 years should contribute for greater legal and social protection
of the target groups and for realization of the reform of the social protection
for the children and the families on the whole territory of the Republic of
Macedonia.
The reforms in the system of social services demand re-assessment
of the roles and responsibilities of the central and local structures
and accordingly this strategy is aimed towards creation of new
services based in the community and involving the civil sector
and other stakeholders in the community, for achieving better
quality standards.
The Strategy promotes and strengthens the partnership between
the state, local authorities, civil and private sector in service
provision for social care, and its aim is to present the situation
of the social needs, to promote the social well-being and to
facilitate integration of certain groups of beneficiaries according
the following objectives:
- Improving the quality of care for citizens exposed
at social risk;
- Creation of network of different social services
on local level, according the needs of the beneficiaries;
- Promotion of the principle of active participation
(beneficiaries and theirs families) in the creation of policy
and decision making, as well as in the evaluation of the
services offered in the social sector;
- Graduate transformation from institutional services
into community based services;
- De-centralization of social services and transfer
of the responsibilities and competences to the local self-government
units in their management and financing with local incomes
that will be provided through the process of fiscal de-centralization;
- Introducing pluralism of social service providers,
provision of sustainability and continuity of the services.
The Strategy for de-institutionalization especially
gives attention to the current situation of the children and
adults in need. With the gained experience during the years
and the conducted studies for diversity of social services
and their location in the country, the main groups in need
are identified. These groups include children without
parents and parental care, children with educational and social
problems, children victims of trafficking, children victims
of violence, children and adults with disability. This part
of the Strategy provides review of the current situation of
these groups, the problems that they face, and offers recommendations
and activities for overcoming the disadvantaged situation.
While developing this Strategy, the process of de-centralization
and its relation to de-institutionalization of social services
in the Republic of Macedonia was
considered. Therefore, the decisions regarding the
planning and service provision for citizens should be made
on local level where the needs arise and where the beneficiaries
live. Thus, responsibilities, budgets and services primarily
are responsibility of the local authorities and of the local
self-government units. Respecting the principle of de-centralization
is the best guide in social service provision and the best
opportunity for the beneficiaries of these services, but the
de-centralization as a principle demands new distribution of
tasks and responsibilities between the central and local authorities.
The Ministry of Labour and Social Policy sets the rules related
to service provision and to development of the system for control
and evaluation of the services in a way that each individual
may give its opinion relating the level of implementation of
these policies and whether these funds are used in an efficient
manner.
Two guidelines should be followed in the future relating to the
conclusion of the process of de-centralization of social services
and delegating responsibilities and finances to the local self-government
units. The first guideline refers to de-institutionalization
of institutions for social protection, their transformation and
provision of small housing capacities on local level.
This Strategy, apart the role of the local self-government units, refers
to the role which civil sector have, and should have in the future. The role
of the civil sector comprised of NGOs and private legal entities will increase
as one of the main social service providers in the local community. They will
act as defenders (protectors) of the rights and interests of the groups in
need, they will propose recommendations for improvement of the legislation
regarding social services, and they will conduct preventive interventions and
interventions for raising public awareness by educating and informing the public
regarding the negative situations and their consequences for the individual,
the family and the local community.
Ensuring the participation of the citizens in the decision making
process is another responsibility of the civil society, which
is realized through managing social debates, transfer of needs,
priorities, ideas and opinions of the community, into concretely
formulated recommendations, which have influence on the life
of certain category of persons included in the decision making
processes.
In this Strategy special attention is given to financing of social
services, their sustainability and continuation. Till present,
social services and other types of support for persons in need
were limited by the funds of the central budget. The state financed
the entire programmes for social payments and material assistance,
and the state budget financed the social services managed by
the state, while the other types of social services in the community
were financed by NGOs through their own budgets or with sources
provided from different donors.
Recommendations arising from this Strategy are that the Ministry
of Labour and Social Policy must plan the funds for the package
of financial assistance at the beginning of the year for each
municipality, in accordance with the submitted requests by the
local self-government units in collaboration with the centers
for social work and to prepare evaluation on national level.
The savings or less spend sources from the fund for financial
assistance made due to good management and efficiency by the
local self-government units and centers for social work should
stay in the local communities. These funds will serve for sustainability
of the programmes from the work in the community or social services
during the year.
The transfer of relevant funds at the beginning of each year
will be accompanied by the transfer of residential institutions
to local authorities. The local self-government units will take
over all responsibilities for financing new social services that
need to be established.
Financing social services comprises of funds allocated by the
state central budget; funds planned from local taxes; incomes
from properties and other activities of the municipalities; contributions
from the beneficiaries of social services; donations; sponsorships
and other ways of financing provided by organizations, physical
or legal entities and other individuals.
The Strategy, also, considers the needs assessment and planning
within the local community. Social services must be provided
according the needs of the beneficiary and they must focus on
the persons in need, especially to the person and the family
where the person lives.
The needs assessment considers factors that hinder individuals
to lead active life in the community and it starts with an analysis
of the social situation of the individual and aims towards support
of the independence and autonomy of the individual, respecting
the individual life-style choice.
The needs for services are identified in the process of assessment,
in order for the beneficiary to gain independence and greater
autonomy. Also, the types of services are identified, which may
directly be provided for the individuals and their families in
order to assist and facilitate rehabilitation of the individuals.
The Strategy also considers the guarantees of the social services’
quality. All social services provided by the different
public or private providers must guarantee certain level of quality
in accordance with the standards. The quality of the
social services comprises the core of each system for social
protection. The Ministry of Labour and Social Policy is in charge
that the quality is based on several standards that represent
a set of principles, which guarantee the defined indicators for
quality of services. The quality of services depends on three
main elements: definition of standards; monitoring of achievements
regarding the set of quality standards; and evaluation and improvement
of the quality of social services.
The standards clearly and in transparent and measurable manner
define the criteria needed to be achieved by social service providers.
They are included in a public document, which helps the service
providers to fulfill its obligations. The standards serve as
a base for monitoring the quality of the services. After the
preparation and introduction of the standards to the providers,
they are tested and assessed in practice. To evaluate the achievement
of the standards, according to approved standards, monitoring
system should be created, which will function through regulatory
mechanisms, for example, licensing and inspection.
All NGOs and private providers, which deliver social services, should
be licensed according to the existing legislation. The Ministry of Labour and
Social Policy should give license only in cases when it is confirmed that the
service provider achieves the minimum standards requested according the legislation
for provision of these type of services. The main goals of the licensing
process are: protection of the beneficiary from non-qualitative provision of
the service, application of the draft-standards as well as improvement of the
quality level in the services. The licensing should rely on criteria for assessment
of the capacities of the institution, the environment, personnel, services
and the way services are delivered.
Licensing with priority of public or private subjects, which will provide
services in the area of social protection, for example:
- Centers for institutional care for children without
parents and parental care, children with educational and
social problems, persons with disability, elderly persons,
persons addicted to alcohol and drugs, victims of trafficking
and family violence.
- Day centers for children with special needs, adults
with disability and elderly persons.
- Counseling services for family planning, in-home
services for persons with disability, elderly persons who
live alone or chronically ill persons.
- Rehabilitation centers for persons with disability,
training for social workers, reintegration of abused women
and women – victims of trafficking.
Receiving
the licenses, NGOs and other private social service providers
will make contracts with the local self-government units in accordance
with the legislation and the rules defined by the Ministry of
Labour and Social Policy.
The inspection, as
a regulatory mechanism, controls the achievement of the standards,
it evaluates the provided service by comparing it with the existing
standards as a warning system, in case applied policies have
not reached the expected results. It
should be mentioned that inspection should not be seen as punishable
and “fear-provoking” process, but as a useful, constructive and
transparent process that promotes development.
We have to mention
that this is a working version of the proposal Strategy for deinstitutionalization
of social services that may undergo certain changes in the future.
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