Implementing the system of personal following financing (PFF) in Flanders: more than a challenge !

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disabilityinclusionorganizational changepersonal financing systemself-direction of PwD

Organisation name Flemish Agency for people with a disability (PwD)

Contact person: Rudi Kennes

rudi.kennes@vaph.be

Supporting people with a disability at the regional level in Flanders as part of Belgium: In Flanders, persons with disabilities (PwD) can enjoy all kinds of interventions and financial allowances to help reduce the additional costs of their disability, and they can use organized care and support, or receive funds to organize this care and support themselves. However, in Belgium, the competences for these allowances and support forms are divided between different levels, since Belgium is a federal state: So, Interventions are therefore given from the federal government, or from the Flemish government. At the federal level, we can mention for example intervention in medical costs, and intervention in the purchase of mobility aids, given from the National Social Security Institute (Riziv).
Another important provider of financial support at the federal level is the Federal Public Service for Social Security. They deal with providing the allowance as a replacement for income, and the allowance in function of integration into society. At the regional level, and speaking for Flanders, several specific measures are foreseen in the fields of employment, education, childcare, culture and leisure, and of course: welfare.
Mainly speaking, the measures from Welfare, Public Health and Family Ð who are under the jurisdiction of our hosting minister today Jo Vandeurzen – deal with the Flemish system for Social Protection, youth care, and Ð the theme we apply for in this form – the care and support for Persons with a Disability. The Flemish Agency we represent, not only intervenes in the purchase of aids and adjustments to the home of people with disabilities, but is mainly responsible for the care and support for minor and adult PwD. In concrete terms, our Agency mainly provides the following measures with regard to persons with a disability:  financial support for indicated devices, and for modifications to the home environment (for both minor and adult PwD), directly accessible care and support (for minors and adults), and not directly accessible care and support. Regarding the not directly accessible care and support we focus on in this application form, one must actually make a distinction between minors and adults:  for minors: the Personal Assistance Budget (PAB) and guidance, daycare and accommodation within a Multifunctional Center (MFC);  for adults:  (mainly) a Person-following Budget (PFB), and some forms of direct financing of social services for restricted target groups.

How support was being organized during the last decades: For many decades, and just into the recent past, services Ð so called Ôservice providersÕ –  and facilities in Flanders were recognised for providing a specific type of support. This support was broken down into types or categories of traditional care, like (semi-)boarding schools, homes for workers and non-workers, day centres, sheltered housing, assisted living, etc. Over the few past years, all these facilities for minors and adults have been transformed into a Flexible Provision for Adults (FAM) on the one hand and Multifunctional Centres (MFC) for minors on the other.  The FAM and MFC organisational models allowed more customised support to be provided to people with disabilities. Nowadays, even this model of support has been almost completely abandoned, and the  transition to a system of individual funding of the PwD themselves has been almost fully implemented, speaking for the adult PwD. Various motives lay at the basis of this total change: the international trend to move away from an institutionalized disability policy and to focus on individual forms of financing; the UN Convention on the Rights of Persons with Disabilities, focusing on Article 19 on the right to independent living; the ultimate aim to eliminate waiting lists in the domain of care and support for PwD; the right of self-determination of the person with a disability with the possibility of self-directing the needed care and support.

The new system of personal financing is already anchored by new regulations. This cannot simply be reversed. It concerns a whole laundry list. The basis of this, of course, is the decree on the introduction of personal financing. For minors with a disability, the so called intersectoral access point within the Integral Youth Assistance will make the link with funding based on objective needs. This is a shared responsibility of our Agency with that of the Agency for Youth Welfare and that for Care & Health. The corner stones on how exactly personal follow-up financing will be further elaborated  during 2019, and the implementation is to be expected somewhere in 2020. Also via triggering for social entrepreneurship in the traditional service providers and via intersectoral cooperation, the well-being of the PwD increases and is sustained. As we told before, also other public services at the regional level want to start a constructive dialogue with our Agency, in order to translate the impact of it in their own policy and regulations. Via monitoring and permanent evaluation we also try to anchor our achievements. One of these methods, of course, concerns scientific research. A lot of it already has been done. The implementation of the system is also systematically evaluated within the administration through the registration of individual complaints and proposals from users. A few events were also planned that should contribute at a higher aggregate level to a critical follow-up of the effects of the new financing system: a well selected number of scientists was invited on an interdisciplinary colloquium on 18 May 2018 to set up a forum for the further roll-out of the evaluation of the person-to-person financing for persons with disabilities. In the very near future, on the 4th of July, a next event will take place during which a complete review of the implementation process will be executed. This event is actually in preparation.

At this very moment the administration of the Flemish government is preparing her contribution to the next government declaration at regional level. One of the issues in preparation not only deals with the potential use of the elaborated system on personal funding for other entities within the domain Well-being, Health and Care, but also for other flanking domains like education, living, and employment.

Regarding the potential use of this new system of financing for elderly care, the theoreticalstudy has been executed; this may be followed up by setting up a trial framework. The system of the PFF is also being tried out in the psychiatric settings where people with a double diagnosis (PwD + psychiatric disorder) are being helped.

Since our Agency is officially part of the Disability High Level Group (DHLG) at the European level, we also see a great opportunity in highlighting our model on this forum as a source of inspiration for other members of the European Union. The academically network on disability (ANED) already took account of this and incorporated the reporting on our implementation in their recent reports for Belgium as a country member of the European Union.



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