Reorganizing the system of social services in Kazakhstan

Annotation

The article deals with the reformation of the system of providing special social services to vulnerable segments of the population as an integral part of the implementation of the Action Plan to Ensure Rights and Improve the Quality of Life of Persons with Disabilities in the Republic of Kazakhstan. The main trends of this reform are the disaggregation of residential institutions, their allocation near the place of residence of disabled people, and the creation of home conditions in such institutions.The article accentuates the increased role of the non-public sector in providing special social services and in delivering various types of rehabilitation. The article reviews Kazakhstan’s classification of facilities of special social services and the main challenges of support and carefor the elderly and disabled at such institutions.Information is given on the regulations governing the facilities and organizations that provide special social services, which have arisen since the beginning of the reformation of this field; information is also provided on the requirements and necessary conditions for establishing such institutions, their number and types. Data are also provided on the grounds for the provision of special social services, and recipients of these services.

One of the directions of the Action Plan to Ensure Rights and Improve the Quality of Life of Persons with Disabilities in the Republic of Kazakhstan for 2012-2018, which continues to be implemented currently, is the reformation of the system of social services and provision of special social services. The basis and example for the reformation has been the positive experience of post-socialist states of Central Europe (Poland, Czech Republic, Slovakia, Hungary) in this area and the model of social services for the population of the developed countries of Western Europe and North America.

Over the first two decades of the history of the Republic of Kazakhstan, retirement homes and adult disability homes remained the main stationary institutions in the social assistance system. Together with the nation, residential care homes for the socially vulnerable have experienced the difficulties of the transition to market relations, and the formation of the state. Their daily operationswere affected by economic difficulties that led to inadequate financing of the social sphere [1]. The existing network of care homesof the countryencompasses several types of institutions:

Neuropsychiatric nurseries admit persons with mental chronic diseases who are in need of domestic assistance and medical care, regardless of whether they have relatives who are obligated to care for them.

Neuropsychiatric nurseries admit disabled persons of 1st and 2nd group older than 16 years as referred by departments of social protection of the regions, cities of Astana and Almaty.

Retirement homes and general disability homes admit single people of retirement age as well as 1st and 2nd group disabled persons older than 18 years from among single people.

Retired people and disabled people are transferred from a general type residential care home to a neuropsychiatric nursery based on a medical statement of a medical commission of a psychiatric facility and instruction of a superior organization.

In her work "Social and labor rehabilitation of the disabled in the Republic of Kazakhstan (theoretic and legal aspect)", Mezhibovskaya writes that a positive role of social facilities in the chain of rehabilitation measures is widely recognized. Social facilities for the disabled operate not just to create favorable housing conditions and maintain well-being of the disabled but also to preserve their effective practical activities in the conditions of disrupted social communications [2, p. 58].

According to the Statistics Committee of the Ministry of National Economy of the Republic of Kazakhstan, in 2014, 93 retirement and adult disability homes existed in the Republic of Kazakhstan. Over nineteen thousand people were hosted in them. 

 

Number of care facilities

Number of residents

Republic of Kazakhstan

93

19205

Akmola Region

9

1127

Aktobe Region

2

679

Almaty Region

8

1762

Atyrau Region

2

421

East Kazakhstan Region

15

2644

Jambyl Region

4

958

West Kazakhstan Region

7

1086

Karagandy Region

10

2345

Kostanay Region

10

1557

Kyzylorda Region

3

500

Mangystau Region

2

341

Pavlodar Region

5

1227

North Kazakhstan Region

5

1569

South Kazakhstan Region

6

1464

Astana

2

557

Almaty

3

968

Source: Statistics Committee of the Ministry of National Economy of the Repuhblic of Kazakhstan 

According to articles 51 and 52 of the Budget Code of the Republic of Kazakhstan dated April 24, 2004, social assistance for the retired and disabled is the responsibility of the local governments of the regions, and the cities of the republican significance and the capital. Care homes are established, reorganized and liquidated by decisions of akims in coordination with the Ministry of Social Protection of the Republic of Kazakhstan.

By the order dated March 19, 2008, numbered 72, the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan approved the Rules for using pension payments and state social benefits for disabled people living at public medical and social institutions. Such Rules indicate the right of a guardian (a head of a medical and social institution) to withdraw from the bank account of a person under ward ship not more than 30% of the amount that is monthly deposited into the bank account of such person. With this money, a guardian purchases medicines, items of sanitary hygiene and medical aid if there is none at the institution. Human rights organizations have repeatedly pointed out that this provision contradicts other regulations in the field of providing services to people with disabilities, which prescribed full state provision of disabled people at such institutions.

In addition, the reports of the Human Rights Ombudsman in the Republic of Kazakhstan have emphasized potentially high vulnerability of people at care homes and their forced dependence on the administration of such facilities. The Office of the Ombudsman lists the main deficiencies that have been typical for suchfacilities for many years in the country. In particular, the following problems were noted:

A large number of persons under caremakes it difficult to provide effective rehabilitation assistance, and in orphanages this creates problems with ensuring appropriate care for each child;

Persons with disabilities staying at care homes are isolated from the outer world and are deprived of the adequate access to information;

Care homes are weak at using activities that would promote labor rehabilitation of the disabled. Residents may not work actively and fruitfully and enjoy their rights to labor;

Low salaries lead to high turnover and lack of qualified workforce, which makes it impossible to arrange rehabilitation measures;

The buildings of care homes are not adapted for independent movement of persons with disabilities. Due to inadequate funding, buildings are not repaired in time and are not in a proper condition. The facilities are poorly equipped with special auxiliaries;

The system of residential care facilities is closed and hardly in contact with public organizations dealing with issues of the disabled; the system does not cooperate with national and international non-governmental organizations protecting the rights of persons with disabilities [3].

The Law of the Republic of Kazakhstan dated December 28, 2008 "On Special Social Services" has become a regulatory and legal framework for reforming the system of social services, which originated as early as the implementation of the Program for the Rehabilitation of the Disabled for 2006-2008. Its very first article provides the following definition: "Special social services are a set of services that provide a person (family) in a difficult life situation with the conditions for overcoming existing social problems and aim to create equal opportunities for them to participate in society." This law specifies the types and grounds for providing special social services, assessment and determination of the need for special social services.

The grounds for receiving such services are the following:

  • disability;
  • social alienation;
  • social deprivation;
  • difficult social background [4].

In 2009-2011, the Government developed and approved the standards of requirements for social services provided to persons with disabilities and senior citizens, which establish the content of each type of service, scope of services and the rules of provision of such services that must be applied by social protection authorities, social organizations and associations, other legal persons – irrespective of their organizational and legal forms – involved in providing social services to lonely senior and disabled persons. The Government also identified the rules of assessmentand determination of the need for special social services, the list and the amount of special social services provided on a free and paid basis.

In parallel, there is work underway to break down the existing care homes and found small-capacity homes. Given the current queue nationwide, especially in relation to specialized care homes, it is possible to transfer mental patients to newly created specialized small capacity care homes. Specialized care homes are opened in cities of medium and small size; the quality of special assistance to senior and disabled persons is improving with conditions being enhanced and made to feel like home.

Small care homes operate in the form of territorial centers that provide services at home and day care services. Social service centers are being established, which are organized according to a modular principle. Depending on the needs of the clients, various modules of social services are used: domestic, medical, psychological, pedagogical, labor, cultural, economic and legal.

In her work already mentioned above, by proposing to create new types of social facilities for the disabled, Mezhibovskaya emphasizes that one of the most important social rehabilitation objectives faced by the care homes for young people with disabilities is, from her point of view, to establish social communications both among the residents and with healthy people outside such care homes. This will lay the basis for the social therapy, which must encompass, among others, such elements as comfort in rooms, being able to self-service, self-management, mode of work (five day stay, day care), organizing micro- and macro-teams, individualized cultural therapy, psychotherapeutic skills of the personnel, providing leave [2, p. 66].

The official bulletin of the Statistics Committee "Organizations providing special social services" for 2015 provides data on the number of institutions of various types and the number of disabled residents thereof:

In-patient type organizations – healthcare facilities (organizations) to be used for round-the-clock or temporary (up to three months) stay for service recipients in a hospital environment.There were 228 such organizations nationwide;

Semipermanent type organizations – day care centers, territorial and rehabilitation centers, and other organizations intended to render special social services, in the environment of a long-term or temporary stay (up to 6 months) for service recipients in the organization. The number of semi-permanent facilities across the country was 60 institutions;

Temporary stay type organizations are designed for round-the-clock temporary residence (up to one year) or temporary stay (at night). In 2015, there were 48 institutions of this type [5].

According to the Ministry of Labor and Social Protection of the Population of the Republic of Kazakhstan, following the implementation of the first phase of the Action Plan to Ensure Rights and Improve the Quality of Life of Persons with Disabilities, the ratio of the number of different new types of institutions of the social service system has also changed [6].

The new phenomenon for the social services of the country is the social service centers that may consist of several divisions, including daytime stay, social assistance at home, social rehabilitation, etc.

Most often, day care centers are established at Kazakhstan's social service centers. Analyzing the work of day care units in similar Russian centers, Dementyeva N.F. and Starovoitova L.I. write that day care units of the Social Adaptation Centers can be considered as rehabilitation departments, which represent medical, social and labor rehabilitation activities to varying degrees. It is necessary to change the status of such units, to intensify the emphasis on a truly rehabilitative impact, to redirect the administrators of the center's activities and, in particular, the day care units towards the rehabilitation approach [7, p. 139]. 

 

Until 2009

After 2009

Social adaptation centers for homeless

 

25

Day care/day time stay units

 

50

Care homes

93

105

Rehab centers for the disabled

11

21

"Assistance at home" units

449

512

NGOs that provide special social services

 

81

Source: Ministry of Labor and Social Protection of the Republic of Kazakhstan 

According to the Ministry of Social Protection of the Republic of Kazakhstan, in 2015, out of those living (receiving a service) at social service organizations, the following numbers had disabilities:

Group 1(18 years and older) – 3188; group 2 (18 years and older) – 13320; group 3 (18 years and older) –352.

The disabled of age 16-17: group 1 (16-17 years) – 230; group 2(16-17 years) – 287; group 3(16-17 years) – 352 [5].

Reformation of the social services system aims to build a market of social services with a developed infrastructure. A prerequisite for the development of such a market is the improvement of the methodology for the formation of a social contract, with public associations mandatorily engaged in the provision of social services to single citizens, including those living in social protection facilities.

In 2003-2005, Kazakhstan implemented a program of state support to non-governmental organizations in the form of financing from the budget, in 2005 Kazakhstan adopted the Law "On State Social Contract", and competitions for socially significant projects in which non-governmental organizations participate have been held since 2006.

At present, 51 out of 60 institutions that provide special social services are owned by the state (republican - 1, municipal - 50), nine are privately owned, including five owned by public and religious associations. Licensing and accreditation of such institutions are entrusted to social protection authorities, which adjust their requirements in order to stimulate the interest of non-governmental associations and businesses in this field [5].

As the market of social services is formed, it will be possible for Kazakhstan to use technologies of social vouchers long used in developed countries. Under this system, a consumer who has a state subsidy for receiving social services in the form of a voucher freely determines which service provider to approach. The voucher system expands the freedom of choice for a consumer, contributes to the growth of the quality of services through market competition [8]. However, Kazakhstan still has to solve the problem of insufficient attractiveness of the sphere of social services to the population for small and medium-sized businesses and create a competitive market environment.

Also, the factors influencing the quality of social services provided to the population by social service institutions include the conditions of accommodation at such institutions, the staffing of institutions by specialists and their qualifications, and the availability of the requisite technical equipment. The Ministry of Social Protection has developed qualification requirements for social workers in the field of social protection of the population, and the rules for attestation of social workers in the social sphere.

Thus, it can be stated that in the Republic of Kazakhstan, as in other post-Soviet states, the continuing adoption of international best practices and the reformation of the system of social services for the populationand provision of special social services is taking place as part of a gradual transition from a paternalistic model of social policy to a policy of social partnership. In the context of the social partnership policy, the state broadlyengages public associations and businessesin resolving socially important tasks, while remaining the main agent of social policy, retaining a coordinating and controlling role, resorting to economic methods of regulation that should contribute to the formation of the social services market.

 

References:

  1. Esetova G.K. Some peculiarities of social policy in the Republic Kazakhstan // Bulletin of the Kazakh national pedagogical university after Series of «Sociological and Political sciences». – 2012. - №1(32). – p. 99-101.
  2. Mezhibovskaya V. Social and labor rehabilitation of the disabled in the Republic of Kazakhstan (theoretic and legal aspect). – Almaty: Baspa, 1997. – p. 128.
  3. Reports of the Human Rights Ombudsman in the Republic of Kazakhstan for 2006 and 2014 [e-resource] – Access is free: http: //ombudsman.kz.
  4. Kurmanov A.M., Abdikalikova K.A., Akashev R.D. Social assistance in Kazakhstan. – Astana: Printing House, 2013. – p.
  5. The official bulletin of the Statistics Committee of the Ministry of National Economy "Organizations providing special social services" for 2015[e-resource] – Access is free: http://stat.gov.kz/.
  6. Official website of the Ministry of Labor and Social Protection of the RoK [e-resource] – Access is free:http://convention.enbek.gov.kz.
  7. Dementyeva F., Starovoitova L.I. Social work in the facilities of the social and rehabilitation profile and medical and social expert assesment: handbook for students of higher vocational education. – M.: Akademia Publishing House, 2013. – p. 272.
  8. Social contract as the tool of social policy.Review of international experience. – Minsk: UN/UNDP Representative Office in the Republic of Belarus, – p. 64.
Year: 2017
City: Almaty
Category: Sociology