Ambulant Betreutes Wohnen – ein Erfolgsmodel?

Situation and Development of Residential
Services for Persons with Disabilities in
Germany
Johannes Schädler
Zentrum für Planung und Evaluation Sozialer Dienste der Universität Siegen
Germany
Structure
1.
2.
3.
4.
Target groups and statistics
Developmental paths
Current political debates and activities
Perspectives
Target groups of residential services for people with
disabilities under the „Integration Act“ (Eingliederungshilfe‘)
§ 53 SGB XII
Estimated percentage
of all users
Per 1000 inhabitants,
(e.g in NRW, 2008)
People with intellectual
disabilities
ca. 66 %
1,9
People with chronical
mental illness
ca. 26 %
1,4
People with physical
disabilities
ca. 5 %
0,2
People with addiction
problems
ca. 3 %
0,3
total
100 %
3,8
Based on ZPE, IH-NRW report 2008)
Three service models and traditions of
residential care for people with disabilities
1. traditional
institutions
2. group homes
(‚stationär‘)
Pwid: 85%
Pwmhp: 50 %
3. ‚supported living services‘:
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(‚ambulant‘)
Pwid: 15%
Pwmhp: 50 %
The big instititution (‚die Anstalt‘)
with its origins in the late 19th century
After internal
modernization processes of
‚conversion‘
Group home (‚Wohnheim‘) with its origins in
the 1960ies:
Special school, ‚24/32/40/48-places‘ group home,
sheltered workshop (‚das teilstationäre Modell‘)
Other group homes
‘individual arrangements and supported living‘
Individually
helpful
arrangement
that is
oriented to
private living
and based on
flexible,
reliable and
needs-based
services.’
Users of residential services per 1000 inh.
Statistical development
4,5
4
3,5
Gesamt
stat. Wohnen
ABW
3
2,5
2
1,5
1
0,5
0
Quelle: Con_sens (Hg.) (2010):
Kennzahlenvergleich der
überörtlichen Träger der
Sozialhilfe 2009. Online
verfügbar unter
http://www.lwl.org/spurdownload/bag/endbericht%202
009.pdf, .
Development: more supported
living, not less institutional care
 Number of service users in supported living
schemes is increasing no decrease in
institutional care settings
 „Additive pattern of change“
 Taken for granted assumption: supported living
schemes are only for the ‚fitter‘ ones
Two ‚worlds‘ of costs and financing systems
 Institutional care
(‚stationäre Hilfe‘)
 Supported living
(ambulante Hilfe)
‚place-related financing
according to ‚needsgroup‘
Time related financing
according to needed
‚hours of support‘
status: resident (accomodation +
services
status: tenant (services)
Pricing of supported living services
 On basis of an individual assessment a number of ‚professional
service hours‘ (Fachleistungsstunde) are granted to the person with
disability
 Contracted providers can offer services
 Professional service hour covers face-to-face support, indirect
support and administrative costs after a given key
 Prize of professional service hour : ca. 50 €
 When parents or other direct family members have more than
700,50 € income per month, they have to contribute with 26 € to the
total costs.
 The disabled person can keep 2.600 € as private property, all the
rest has to be used for contributing to service costs
Pricing in institutional care
 Partly individualised financing of ‚places‘ in institutions according to
a categorial system with five ‚needs groups‘ (Hilfebedarfsgruppen)
 Based on a contract between social services/regional councils and
service provider with three elements:
Investment costs (Investitionskosten)
Technical costs (Sachkosten)
Service costs (Maßnahmepauschale)
 On average ca.: 35,000 – 44,000 € per capita /per year, depending
on the regional conditions
 Refunding per place various in institutions depending on the ‚need
group‘ of the person with disability concerned
Ambulant vor stationär‘ – guiding principle and
‚cost caveat‘ for supported living arrangements
 § 13 SGB XII (social code book) makes a
‚caveat‘:
 If costs for supported living services are higher
than institutional care and institutional care is
acceptable, support can only be provided in an
institution.
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Individuelle Hilfen zum selbständigen
Wohnen in NRW
Traditional mechanism for reproduction of
the ‚institutional model‘ (stationäres Modell)
 „A provider controlled application procedure and
a distance-interested administration,
 under incentives favourable for institutional
provision
 lead to ongoing reproduction of institutional
model“
Future of the Integration Act (SGB XII)
(‚Eingliederungshilfe): ASMK -Process?
Three elements for structural change of
residential service patterns
1. Person oriented service planning
2. Time based and personalized financing separating costs for accomodation and
for services
3. Local disability planning / local
participation planning
Consensual point of reference:
UN Convention on Rights of Persons with Disabilities:
Inclusion and Participation (Article 19)
Dimensions of Local Disability Politics
 Accessibility of public infrastructure
 Empowerment and participation of persons with
disabilities
 Inclusive local service system
 Sensivity and awareness of the public against
risks of discrimination
 Implementation of new professional knowledge in
local planning in the context of ‚kommunale
Daseinsvorsorge‘ and service provision
Thank you!
www.zpe.uni-siegen.de
Zentrum für Planung und
Evaluation Sozialer Dienste
der Universität Siegen
57068 Siegen
Tel./Fax: 0271/740-2228
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