financing deinstitutionalisation

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financing deinstitutionalisation
By Julia Down Hope and Homes for Children BiH
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HOPE AND HOMES FOR CHILDREN BIH

• Background
• HHC in BiH since 1994
• Initially worked to improve conditions in
  institutions - but limited success
• Moved focus to developing family-based services -
  but this did not automatically reduce number of
  children in institutions
• Now concentrating on directly transforming
  institutions

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SITUATION IN BIH

• Population 3.8 mill
• Divided into FBiH and RS
• 3000 children without parental care
• Around 1100 children in 17 institutions

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NATIONAL STRATEGY

• POLICY ON PROTECTION OF CHILDREN WITHOUT PARENTAL
  CARE AND FAMILIES AT RISK IN BOSNIA AND
  HERZEGOVINA2006-2016
• Developed by government with active support of
  UNICEF, SCUK, HHC and others
• Officially adopted in FBiH in January 2008

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NATIONAL STRATEGY

• Outlines detailed and practical plan for
  reforming legislation, building capacity of CSWs,
  developing family-based alternatives to
  institutional care and transformation of
  institutions
• Every institution to be transformed within 10
  years
• Model of transformation outlined in detail in the
  strategy - conforms to the model developed by HHC
• Strategy calls for pilot project to test the
  model in the BiH context

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ZENICA PROJECT

• BACKGROUND
• HHC as lead organisation in implementing pilot
  project
• Negotiations with local authorities led to
  agreement to transform institution in city of
  Zenica
• DC Most institution with capacity for 60 children
  aged 0-18

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TRANSFORMATION OF DC MOST

• Main partner Zenica city municipality as founder
  of institution
• HHC assessed every child and their families
• Recommended a family-based placement for each
  child based on individual needs
• Analysed average number of new children entering
  the institution every year in order to predict
  demand for new services

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SERVICES TO REPLACE THE INSTITUTION

• Prevention
• Reintegration
• Fostering
• Local adoption
• Young adult support
• Small family home

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• HHC providing capital investment, some
  transitional costs, training, management and
  monitoring of project
• Staff of institution have priority in applying
  for jobs in new services
• 18-month project to transform the institution Jan
  2007 June 2008

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TRANSFORMATION OF DC MOST
Total Number of Children 67
Reintegration with biological families 19
Adoption within BiH 12
Placement in foster families 11
Independent living for young people aged 18 and over 13
Placement in Small Family Home 12
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FINANCIAL ANALYSIS ZENICA

• BiH has very decentralised political system
• Institutions for children are managed and
  financed at local level
• This works differently in different locations

Federation of BiH
Republika Srpska
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DC Most financed on per head basis

• Children placed by CSW in municipality from where
  they come
• CSW pays institution monthly rate per child
• The institution has no other formal source of
  income

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RUNNING COSTS OF DC MOST
CAPACITY (aged 0-18) 60
TOTAL BENEFICIARIES PER YEAR 75
FUNDING SYSTEM Monthly Monthly
Centres for Social Work per ?
Zenica-Doboj Canton 265 265
Outside Zenica-Doboj Canton 292 292
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HOW MUCH DOES DC MOST COST THE STATE?
CSW of Children Monthly Per Child TOTAL Monthly TOTAL Annual
Zenica-Doboj Canton 75 45 265 11 925 143 100
Outside Zenica-Doboj Canton 25 15 292 4 380 52 560
16 305 195 660
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RUNNING COSTS OF NEW SYSTEM

• The new system comprises the following services
• Prevention
• Reintegration
• Young Adult Support
• Fostering
• Small Family Home

• ALL NEW SERVICES ARE SUPPORTED BY
• MOBILE TEAM
• 2 Social workers
• 1 Psychologist

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MOBILE TEAM SERVICES MOBILE TEAM SERVICES CAPACITY (per year) OF BENEF. (per year) COSTS (travel direct help)
1. PREVENTION 25 families 100 6 500
2. REINTEGRATION 10 children their families 40 3 000
3. YOUNG ADULT SUPPORT 5 12 000
4. FOSTERING 25 allowances 23 000 training, campaigns 5 000
5. SMALL FAMILY HOME 20 80 000
MOBILE TEAM SALARIES (taxes, allowances, office costs) (ANNUALLY) MOBILE TEAM SALARIES (taxes, allowances, office costs) (ANNUALLY) MOBILE TEAM SALARIES (taxes, allowances, office costs) (ANNUALLY) MOBILE TEAM SALARIES (taxes, allowances, office costs) (ANNUALLY) 35 000
TOTAL ANNUAL COSTS TOTAL ANNUAL COSTS TOTAL ANNUAL COSTS TOTAL ANNUAL COSTS 164500
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SUMMARY
COMPARISION OF TWO SYSTEMS TOTAL OF BENEFICIARIES EACH YEAR TOTAL ANNUAL COSTS COSTS per beneficiary
DC MOST 75 195 660 2 609
NEW SYSTEM 190 164 500 866

• The new system of services provides better
  outcomes for children
• The new system of services is cheaper and more
  cost effectice.
• The new system serves more than twice as many
  beneficiaries annually.

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ADDITIONAL COSTS

• Capital investment provided by HHC
• Purchase, renovation, furnishing and equipping of
  small family home 120 000 euros
• Purchase of vehicle for mobile team 5000 euros
• Transitional costs provided by Zenica
  municipality
• Covering income lost to DC Most due to decrease
  in number of children 16 500 euros

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CHALLENGE

• New system cheaper overall and cost effective BUT
• Cost bearers changed without formal budget
  reallocation
• Running costs used to be spread between as many
  as 20 municipal CSWs at any one time Zenica
  municipality incurred no direct costs

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CHALLENGE

• Running costs of new system are covered by
• 1. Municipal CSWs
• Allowances for foster carers
• Cost of food and clothing for children placed in
  small family home
• 2. Zenica municipality
• Staff salaries and amenities for small family
  home
• 3. Zenica municipality/Zenica-Doboj Canton
• Salaries and other costs of mobile team
• Direct material support to beneficiaries

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GORAZDE PROJECT

• Gorazde canton has no institutions but places
  children in institutions elsewhere in BiH
• HHC together with local authorities planning to
  develop family-based services within the canton
  for current and future children without parental
  care and children at risk of separation
• Services will include prevention, reintegration,
  fostering, young adult support, small emergency
  reception centre
• Services will be supported by a mobile team of 2
  professionals

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GORAZDE PROJECT FINANCIAL ANALYSISRunning costs
of current system
Institution of Children Monthly Per Child TOTAL Annual
Selo Mira 12 250 KM 36 000 KM
Dom Bjelave 1 326 KM 3 912 KM
SOS Village Sarajevo 7 476 KM 39 984 KM
SOS Village Gracanica 9 476 KM 51 408 KM
Dom Porodica 4 550 KM 26 400 KM
TOTAL 33 157 704 KM
80 650
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GORAZDE PROJECT FINANCIAL ANALYSISRunning costs
of new services
Service of Beneficiaries-annually of Beneficiaries-annually TOTAL Annual
Prevention 60 60 10 000 KM
Reintegration 5 5 2 000 KM
Fostering 15 15 54 000 KM
Young Adult Support 6 6 7 200 KM
Emergency Reception Centre 4 4 14 400 KM
TOTAL 90 90 125 122 KM
63 990
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GORAZDE PROJECT FINANCIAL ANALYSISComparison of
running costs of current system and running costs
of proposed new system
COST PER BENEFICIARY TOTAL Annual
CURRENT SYSTEM 2 444 80 650
NEW SYSTEM 711 63 990
HHC INVESTMENT IN SETTING UP SERVICES 450 000 KM
230 000 .....................................
....................................
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CONCLUSION

• Two very different DI projects within BiH context
  demonstrates that there is no blueprint that
  can be applied in every situation but each
  location requires its own unique DI process
• DI projects in Zenica and Gorazde demonstrate
  that DI not only provides greatly improved
  outcomes for children but also that it is
  financially viable in the BiH context