TIRANA, June 13- At least 725 million lek (5.9 million euros) will be the cost of implementing disability assessment reform in the social protection system for 2019, and implementing an action plan 2019-2024. The document approved by the government and already published in the Journal Gazette underlines that the implementation of the reform affects over 141,740 persons (4.8 percent of the population) who are officially recognized as having a disability.
Out of these persons, 73,425 people are work disabled who benefit both from social security payments and additional payments to the social protection scheme, and 68,315 adults and children who receive disability payments and other benefits in the defense system social. Of the latter fraction, 19,060 people or 28 percent receive a payment to cover the personal assistant service that was previously called custody service.
Reforming the disability assessment system is necessary for several reasons. First, for reflecting contemporary international practice of transforming medical assessment into a bio-psycho-social assessment, to reflect the new concept of disability as an interaction of functional impairments caused by a disease with psychological and social factors. Secondly, to increase the efficiency of the assessment by creating administrative mechanisms that significantly reduce the degree of abuse, increase credibility and reduce the cost of the assessment. And thirdly, to improve the service for citizens. Moreover, this reformation is a necessity to unify the assessment approach to the principles set forth in the Convention on the Rights of Persons with Disabilities, as well as the relevant Article of Law no. 93/2014, dated 24.7.2014, “On the inclusion and accessibility of persons with disabilities.”
The reformation aims to implement a new system of assessment according to the “social model” and reduce the percentage of beneficiaries without disability; increase the transparency of the scheme by creating an electronic register; to create an integrated services system that combines social care services with payment benefits; and to establish and strengthen the monitoring and inspection mechanism for quality of service delivery at central and local level.
The report also underlines that a disability assessment reform is needed as it currently presents numerous problems related to the criteria, process and management of the disability assessment system. The current assessment process is said to be long and complicated. It works differently for different types of disabilities, complicated for the benefit seeker and ineffective, difficult to manage from an administrative point of view, and costly. This has to do with the fact that the process involves several steps, firstly by providing a leaflet to the Medical Appointment Commission for Work Capability (MACWC) from bedsperson health institutions, with the exception of the blinds provided by the Forensic Commissions and persons with mental health problems from the Community Mental Health Centers or equipment for epicrisis for the persons who are being re-commissioned.
Secondly, medical and administrative documentation is transmitted by the social administrator of the local government under the jurisdiction of which is an individual resident at the MACWC. Third, the evaluation of the documentation by the doctor of the Regional Directorate of the State Social Service. Fourth, commissioning and decision-making by MACWC, established by the Social Insurance Institute. Fifth information on the decision taken by the Regional Directorate of the State Social Service. Sixth, the transfer of relevant information and documentation for administration to the unit of local self-government by the Regional Directorate of the State Social Service.
The Committee in many cases is estimated to have an extraordinary flow that results in one day being treated from 150 to 200 cases. To change this view, it is decided to follow some steps aimed at reforming the document as well. So until December 2019, five multidisciplinary Disability Assessment Committees have been set up in the Tirana district. Until June 2020, six other commissions will be set up for the districts of Durres and Elbasan, and by December 2024 it is aimed that 17 other commissions will be set up in nine other districts of the country. Likewise, it is intended to increase the transparency of the scheme, the improvement of the registry as well as the complaints review committees.
The assessment of disability is aimed at determining the right to receive benefits in payment or other special benefits. The study of the benefits of disability in the social protection system has highlighted the following problems, like a privileged and unjustified treatment of some categories of disability who benefit both from the social security system and from the system of disability social protection. Secondly, there is no escalation of the payment due to the needs caused by the disability effect in carrying out basic life activities. Thirdly, there are no legal stipulations for the age of commissioning, which causes many of the old age diseases to be handled with disability payments. And lastly, contrary to international experience, there is no differentiation for payments for children and adults.
However, the Ministry of Health said in April that it seeks to undertake to cut 27 percent of its funding for persons who display light impairments by 2024, and instead to integrate them in the working market through educational, professional training, and employment promoting programs.
