THE CZECH REPUBLIC

General section on Independent Living

1.1. Overall implementation of Article 19

Implementation of this article is found to be inadequate.

1.2. Choice of living arrangements

Disabled people cannot freely choose their living arrangements. There are still segregated settings (social care institutions, psychiatric hospitals, group homes and other) for disabled adults (incl. older people with disabilities) and children.

1.3. Deinstitutionalisation strategy

The country does not have a deinstitutionalisation strategy. There are some non-profit groups and a few independent activists working on this issue. Little progress has been made in the last 5 years on this topic.

The received responses also say that funds provided by the EU are still being used for renovation or building of new institutions for disabled people in the Czech Republic.

1.4. Access to mainstream services

Access to mainstream services is described as inadequate in all areas, including education (primary, secondary and tertiary), housing, health care, public transport and culture, as well as access to employment in the open labour market. There is a law protecting disabled people from discrimination in the labour market, but its implementation is inadequate.

1.5. Access to personal assistance

The Czech Republic has a personal assistance system (PA-system) in place to help facilitate the inclusion of disabled individuals in the community. The details of the PA-system will be provided in the following pages.

General information about the PA scheme/policy

2.1. Personal assistance scheme: general information and corresponding legislation

Access to personal assistance (PA) in The Czech Republic is, in general, described as inadequate.

The scheme is available on the national level and codified in a separate national law. Disabled people in rural or remote areas have access to the scheme depending on the region, while those living in residential care settings do not have the possibility to apply.

There are restrictions on what PA can be used for. The organisation providing PA defines tasks assistants can perform.

There is no waiting list to access PA in the country. There is no information on how the number of PA users has changed in the last 5 years. There have been changes to the legislation/policy that affected access to PA in the same time period, but the effect they had is unclear.

2.2. Funding of Personal Assistance

In the Czech Republic the PA scheme is funded from the state budget as well as local/regional authority and civil society actors (e.g., foreign donors, private funders, charities, etc.). It is paid through direct payments, such as personal budgets. The funding does not allow users to employ assistance from the open labour market or hire services which are not directly related to personal care. The PA budget is generally not sufficient to cover the user´s needs in practice.

The scheme is limited by a cost ceiling per user and users whose support needs exceed the cost ceiling are directed towards residential care (for example, social care institutions, group homes, nursing homes etc.).

No additional costs for assistants are covered by PA funding.

Receiving personal assistance does not restrict the users’ eligibility for any other benefits, support and/or services.

Family members are allowed to be paid as PAs only in certain circumstances.

There is no information if any research has been carried out on the costs of PA in the county.

2.3. Eligibility and needs assessment procedures

Children and adults with psycho-social disabilities, physical, cognitive or sensory impairments, including those over 65 years of age are all eligible for PA in the Czech Republic. Legally the budget does not decrease after 65 years of age, however in reality people over 65 are rarely approved for PA in the first place.

Access to the PA-scheme requires medical certification of the applicant as a prerequisite for applying. The scheme is provided irrespective of individual or family income as well as insurance status. It is unclear if there are any other determining factors.

The eligibility assessment and needs assessment are both led by professionals such as doctors, social workers and psychologists. The support a person receives is based on the assessment of their needs. According to the information received, applicants do not have access to adequate information and peer support prior and during the assessments, and the assessors do not receive any training on the Independent Living Philosophy or the social model of disability.

There is not a specific assessment tool that is used and the assessment procedure is not considered straightforward and transparent. Respondents indicate that the assessment system makes it very difficult to receive adequate financial support. The assessment is repeated over a fixed period of time. It does not cover the applicants needs for assistance in all areas of life, including family, intimacy education, employment and leisure.

Following their assessment, the applicants are ranked through a point-based system and only those who achieve a certain scoring receive assistance. The outcome of the assessment is expressed in hours of assistance per unit of time (day or week) and in needs categories or desired outcomes (for example, dressing, cooking, shopping, socialising, studying, etc.). The number of assistance hours per user is limited.

A disabled person can appeal (file a complaint against) the outcome of their procedures but according to responses, this might lead to a termination of their contract. The appeal procedure is not considered effective, straightforward and transparent. It does not entail additional expenses for the user, but legal aid or other types of support during this process are not available.

2.4. Characteristics of PA provision and recruitment

The users are not well informed about their choice of providers, but they can choose who provides their PA. Assistance can be provided by municipality or the local authority, religious organisations, non-governmental organisations, including disabled people’s organisations (DPOs), residential care providers, or the person can employ a PA directly. It is unclear if users can freely select and hire their assistance.

A person can hire more than one assistant, depending on the funding available. The users cannot keep their assistance when moving to a different municipality within the country or when moving to another country. The quality of provision is not monitored either.

PA users are not provided with training on how to manage their PA.

It is unclear if people with cognitive impairments are not allowed to manage their own assistance. Supported decision making is not available for those who need it to manage their assistance. Peer support is available depending on the service provider.

2.5. Working conditions of assistants

Contradictory information was received concerning the working hours of assistants and whether the assistance hours are fixed or there can be flexibility. The provision of assistance is bound to a setting, so assistance can, for example, only be provided at home, school or place of work. It is unclear if the users need to account for their use of assistance. The availability of contingency arrangements, if assistants become unavailable, depends on the provider.

Personal assistance is recognised as a profession. However, no specific qualifications are necessary for people to work as PAs. PAs receive training on providing assistance, which is not mandatory and it is provided by professionals, as part of formal education (e.g., medical professionals, social workers, psychologists, etc.).

The wages of personal assistants are protected by minimum wage regulations. Personal assistants are entitled to benefits such as social security and paid leave (annual, sick and parental). Given the information provided the level of salaries PAs receive is unclear.