Presentation of the Policy Paper “Proposals for the Policy of Rehabilitation for People with Health Problems”

On November 21, the Kyiv hotel hosted a presentation of the policy paper “Proposals for the Policy of Rehabilitation for People with Health Problems”.

The event was organized by the Agency of Legislative Initiatives with the support of USAID RADA Program: Responsible Accountable Democratic Assembly, implemented by East Europe Foundation.

As of now, the public system of rehabilitation services does not ensure an adequate coverage, which makes access complicated for people in need of such services. This issue requires public attention.

The study examines the capacity of the rehabilitation system to ensure the further implementation of the UN Convention on the Rights of Persons with Disabilities and the International Classification of Functioning, Disability, and Health (ICF). The purpose of the policy paper is to elaborate proposals for the public policy in the field of rehabilitation of persons with health problems based on the implementation of the UN Convention on the Rights of Persons with Disabilities and promote their maximum independence. It focuses on the international and national standards for rehabilitation of persons with disabilities, as well as gaps in Ukrainian legislation and law enforcement practice as regards access to rehabilitation services and auxiliary aids.

Proceeding from the analysis results, the paper suggests possible ways to improve the public policy in this area, outlines the prospects for introducing an alternative system that would be based on the ICF implementation.

The event was attended by around 3o participants, including MPs’ assistants, representatives of the Secretariat of the VRU Committee on Health Care, the Secretariat of the VRU Commissioner for Human Rights, the State Service of Ukraine for War Veterans and Anti-Terrorist Operation Participants, the Institute of Social Technologies, International University of Human Development ‘Ukraine’, eHealth, Clinical Hospital ‘Feofaniya’, and representatives of the public.

Oleksandr Zaslavskyi, Deputy Chairman of the Board of the Agency for Legislative Initiatives, pointed out that the Agency for Legislative Initiatives, within the framework of the RADA Program, promotes the strengthening of the analytical capacity of the Verkhovna Rada of Ukraine in the legislative process. Specifically, the Agency resumed the activity of the European Information and Research Center, which currently operates autonomously preparing policy briefs and responses to MPs’ requests. The Agency for Legislative Initiatives proposes two types of documents for consideration by committees: Policy Papers and Shadow Reports. Shadow Reports are aimed at strengthening the oversight function of committees and focus on analyzing certain laws; Policy Papers are documents that should be considered first and foremost within the policy cycle, prior to the bill itself. The Agency for Legislative Initiatives intends to introduce the practice of consideration of analytical papers that examine the outlined problem, the current policy, its effectiveness and flaws, provide stakeholder analysis and alternative solutions to the problem. Such documents are considered at committees’ meetings, during roundtables involving the broadest number of stakeholders; besides, they are handed out to MPs in the session hall. All these measures are aimed at improving the quality of legislation.

Bohdan Moisa, Coordinator of the analytical division of the Ukrainian Helsinki Human Rights Union, said that the existing rehabilitation system could not effectively respond to current challenges. Moreover, its legal framework does not comply with the international commitments undertaken by Ukraine in 2009 when it ratified the UN Convention on the Rights of Persons with Disabilities. The World Health Organization (WHO), whose mission carried out an assessment in December 2015, also confirmed that Ukraine’s rehabilitation system did not meet the international standards.

“Unfortunately, Ukraine lacks any tangible interagency coordination of healthcare, education and social protection as regards the issues of rehabilitation of people with disabilities, while the established system of rehabilitation does not meet the needs of people with disabilities in terms of access to services, especially in rural areas. The current rehabilitation industry lacks a comprehensive system for assessing needs, interdisciplinary work in providing services and their direct focus on the client.”

Mr. Moisa elaborated on the groups of people in need of rehabilitation services, outlined problems associated with ascertaining disabilities, and examined the responsible organizations and institutions. Mr. Moisa also covered the topic of availability and diversity of rehabilitation centers, drawing attention to the fact that the lack of such centers affects most people with psychosocial and intellectual disorders. Speaking about positive initiatives, the author mentioned the launching of the pilot project “Creation of a System for Early Intervention Services”, as well as the introduction of professions such as physical rehabilitation physician, physical therapist, and ergotherapist into the Occupational Classification.

Mr. Moisa also elaborated on the international experience of providing rehabilitation services, focusing on the gradual transition from inpatient rehabilitation facilities to service provision at the place of residence and day care facilities. He described the British, Swedish, Czech, Polish and Israeli models of rehabilitation services. Mr. Moisa concluded his presentation with the proposal to adopt the ICF implementation approach proposed by the Ministry of Health while preserving the current achievements of the rehabilitation system for persons with disabilities.

The discussion focused on such issues as financing the provision of quality rehabilitation services; social protection of persons taking care of persons with disabilities (guardians); bias in disability assessment; limited possibilities of the ICF for adequate assessment of disability; staffing schedule of specialists providing rehabilitation services; clarification of the terms “physical rehabilitation”, “social rehabilitation” and “psychological rehabilitation”; and building multidisciplinary teams in rehabilitation institutions.

For additional information, please contact Iryna Cherpak at tel.: +38067 242 80 91.

Photo-gallery of the Event

Photos by Oleksandr Kovalenko