LITHUANIA

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 adults cannot freely choose their living arrangement. 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 has a deinstitutionalisation strategy but it is described as inadequate. There has been limited progress on this topic in the last years.

According to the responses, funds provided by the EU are still being used for renovation or building of new institutions for disabled people Lithuania.

1.4. Access to mainstream services

Access to all mainstream services, including education (primary, secondary and tertiary), housing, health care, public transport, culture and employment in the open labour market is described as inadequate. It is unclear if there is a law protecting disabled people from discrimination in the labour market.

1.5. Access to personal assistance

Lithuania has a personal assistance system (PA-system) in place to help facilitate 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 Lithuania requires improvement.

The scheme is available on the national level and is delivered as a pilot project which has been running for 2 years. Access to the scheme for disabled people in rural or remote areas depends on the region. Those in residential care do not have access to the scheme.

There are no restrictions on what PA can be used for. There is a waiting list to access PA, but the overall number of PA users has increased in the last years. No changes have been made to the legislation affecting access to PA in the same time period.

2.2. Funding of Personal Assistance

The scheme is co-funded by the EU (through the European Structural and Investment Funds), with the state providing the rest of the funding.

PA is not paid through direct payments, such as personal budgets. The funding allows users to employ assistance from the open labour market. However, it does not allow them to hire services not directly related to personal care and the PA budget is generally not sufficient to cover the users’ needs in practice.

The scheme is limited by a cost ceiling per user but there is no information if those users whose support needs exceed the cost ceiling are being directed towards residential care.

The PA scheme covers no additional employment costs or any other costs related to assistants.

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

No research has been carried out on the costs of PA in the county. Family members are not allowed to be paid as PAs.

2.3. Eligibility and needs assessment procedures

Persons of working age, or specifically in this case those of ages 16-65 with psycho-social disabilities or physical impairments are eligible for PA in Lithuania.

The scheme is provided irrespective of individual or family income, family (including marital) situation, the user’s level of social activity, including involvement in paid work and/or education and/or volunteering, as well as their insurance or citizenship status.

Both the eligibility and the needs assessment are led by professionals such as doctors, social workers and psychologists. The support a person receives is based on the assessment of their needs. There is no information if people have access adequate information or peer support, before and during their assessment, or if assessors receive any training on the Independent Living Philosophy or the social model of disability.

The assessment is conducted in the form of a structured interview, using lists of pre-defined activities and/or needs. In general, the assessment procedure is considered straightforward and transparent. It covers the needs for assistance in all areas of life, including family, intimacy education, employment and leisure and it is repeated over a fixed period of time.

The outcome of the needs assessment is expressed in hours of assistance needed by the user per unit of time (week, month, etc.). The number of assistance hours per user is limited. There is no information if a disabled person can challenge the outcome of their procedures, or what the appeal procedure entails.

2.4. Characteristics of PA provision and recruitment

Users can freely choose who provides their PA, but the responses indicate they are not sufficiently informed about their choice of providers. In practice choice is limited because there is only one type of provider. Assistance is provided by non-governmental organisations, including disabled people’s organisations (DPOs). Assistants are not selected by the user, but instead appointed by the provider and the legislation defines a maximum number of PAs a person can have.

The user can keep their assistance when moving to a different region or local authority within the country but not when moving to another country. The quality of provision is also not monitored.

The users are provided with training on how to manage their PA. The training can be carried out by NGOs, DPOs or user cooperatives and it covers the topics of recruitment and management of personal assistants.

Supported decision making is not available for those who need it to manage their assistance. Peer support is available.

People with intellectual disabilities are not allowed to manage their own assistance.

2.5. Working conditions of assistants

The user determines the times when assistance is provided, but with some restrictions. The users can also save and transfer “assistance hours” as needed. Provision of assistance is not bound to a particular setting, so the users can freely decide where and how to access assistance.

The users need to account for their use of assistance and the support to meet these administrative requirements is provided by organisations run by disabled people or user cooperatives.

The availability of contingency arrangements, if assistants become unavailable, depends on the provider.

Personal assistance is not recognised as a profession but specific qualifications are necessary for people to work as PAs. Assistants receive training on providing PA, which is provide by NGOs and it is mandatory.

The wages of personal assistants are protected by minimum wage regulations.