Overview of institutional services for persons with disabilities (2014) Table 1: Typology of institutions TYPE OF SERVICE SIZE AGE GROUP Type of Level of support Typical Typical funder Length of Age of / service note Wohnheime für Menschen mit geistiger Behinderung (residential homes for people with intellectual disability) 1-over 100 places Adult Disability 24-hour support provided Private, Benefits/ social security Over 2 years N/A Wohnheime für Menschen mit psychischer Erkrankung/ Behinderung (residential homes for people with mental health problems) 1-over 100 places Adult Mental Health Problem 24 hour Mainly Benefits/ social security Over 2 years N/A Wohnheime für Menschen mit Körperbehinderung (residential homes for people with physical disability) 6-over 100 places Adult Physical Disability 24-hour support provided Private, Benefits/ social security Over 2 years N/A provide
Wohnheime für Menschen mit Hör- und Sprachbehinderung 6-over 100 places Adults Sensory Disability N/A Private, Benefits/ social security Over 2 years N/A Wohnheime für blinde Menschen und Menschen mit Sehbehinderung 11-30 places Adults Sensory Disability N/A Private, Benefits/ social security Over 2 years N/A Außenwohngruppen für Menschen mit Körperbehinderung (small group homes/ living community for people with physical disability as part of a residential service but embedded in a local neighbourhood) N/A Adult Physical Disability N/A Private, Benefits/ social security Over 2 years N/A Außenwohngruppen für Menschen mit Sinnesbehinderung (small group homes/ living community for people with sensory disability as part of a residential service but embedded in a local neighbourhood) N/A Adults Sensory Disability N/A Private, Benefits/ social security Over 2 years N/A
Außenwohngruppen für Menschen mit geistiger Behinderung (small group homes/ living community for people with intellectual disability as part of a residential service but embedded in a local neighbourhood) 1-5 places Adult Disability N/A Private, Benefits/ social security Over 2 years N/A Außenwohngruppen für Menschen mit psychischer Erkrankung/ Behinderung (small group homes/ living community for people with mental health problems as part of a residential service but embedded in a local neighbourhood) N/A Adult Mental Health Problem 24 hour Mainly Benefits/ social security Over 2 years N/A Fachkrankenhäuser / Fachabteilungen für Kinder- und Jugendpsychiatrie (hospitals or wards for children and youth with psychiatric problems) N/A Children Mental Health Problem N/A Mixed Benefits/ social security (health Up to 6 month, 6 month to 2 years N/A
für Menschen mit Behinderungen (institutions for rehabilitation for people with disabilities) N/A Adults N/A N/A N/A Benefits/ social security, national Up to 6 month, 6 month to 2 years N/A Ambulante psychiatrische Pflege (out-patient/ home care for people with mental health problems) N/A Adult Mental Health Problem Variable support on the residents need N/A Benefits/ social security (health N/A N/A Ambulante Pflegedienste home care services) 1-over 100 Older people Older people Variable support provides, on the residents need Mainly Benefits/ social security N/A N/A Heime für Menschen mit (residential homes for people with multiple disabilities) N/A Adult people with 24 hour Private, Benefits/ social security Over 2 years N/A
Internate der Berufsbildungs- und (boarding schools associated to a vocational training or re-training unit/school) 11-over 100 places Adults Mixed (Mental health physical sensory N/A Private, Mainly national Length of training or N/A problem
für Menschen mit Behinderung (Short-time residential home for people with disabilities) 11-over 100 places Children, Adults Mixed N/A Private, Benefits/ social security and private Up to 6 months N/A some services might for different groups, some services address only certain groups, e.g. service for people with physical (residential home for short term care) Not Older people Older people N/A Mainly N/A Up to six month N/A
Einrichtungen mit Seniorenwohnungen einschl. Betreutes Wohnen (housing estate for the elderly with assisted living) N/A Older people Older people Variable support provides, on the residents need N/A N/A Over 2 years N/A Seniorenwohnheime (residential home for the elderly) N/A Older people Older people N/A N/A N/A Over 2 years N/A Vollstationäre (nursing homes for the elderly) 1-over 100 Older people Older people 24-hour Mainly N/A Over 2 years N/A Wohngemeinschaften und andere alternative Wohnformen communities and other alternative living forms) N/A Older people Older people Variable support provides, on the residents need N/A N/A Over 2 years N/A Forensische Kliniken / forensische Abteilungen in psychiatrischen Krankenhäusern (forensic hospitals / forensic wards in psychiatric hospitals) N/A Adult Mental Health Problem 24 hour Mixed Regional (federal states) Over 2 years N/A Table 2: data sources sharing
TITLE/ REFERENCE ORGANISATION COLLECTING DATA YEAR OF DATA BY THE DATA FOR DATA SCOPE OF DATA SERVICE SCOPE OF DATA Please include: title of the survey, data set, study, report, administrative document etc, including full reference with URL if available Name of organisation/ institution that collected the data. Type of organisation e.g. government ministry, local authority, national statistical office academia, NGO Year when data was Time period by the data/ report Desk research, visits to design, sampling, data Local authority area, region, federal state, national Services for people with mental health problems, services for people with services for older people, services for children, large homes etc All hyperlinks were accessed on 7 August 2014. Germany, Federal association of vocational training centres der 2012 Autumn 2012 Own data collection by national Services for people
(Bundesarbeitsgemeinschaft der Berufsbildungswerke) (2012), Teilnehmereingangserhebung Herbst 2012 – Soziodemographische und gesundheitliche Eingangsvoraussetzungen der Neueintritte in die Bildungswerke, Berlin, Bundesarbeitsgemeinschaft der Berufsbildungswerke, available at: (BAG BBW) Federal association of vocational training centres (source gives no more vocational training centres with mental health problems and intellectual disabilities Germany, Federal association of social welfare organizations (Bundesarbeitsgemeinschaft der Freien Wohlfahrtspflege) (2014), Einrichtungen und Dienste der freien Wohlfahrtspflege – Gesamtstatistik 2012, Berlin, Bundesarbeitsgemeinschaft der Freien Wohlfahrtspflege. der Freien Wohlfahrtspflege Federal association of non-statutory social welfare organizations N/A date Own data collection by member National All services provided by social welfare Germany, Federal Ministry of Labour and Social Affairs (Bundesministerium für Arbeit und Soziales) (2013), Teilhabebericht der Bundesregierung über die Lebenslagen von Menschen mit Beeinträchtigungen, Berlin, Bundesministerium für Arbeit und Soziales, available at: Federal Ministry of Labour and Social Affairs N/A N/A Desk study National Services for people with disabilities in general Germany, Federal Ministry of Family Affairs, Senior Citizens, Women and Youth (Bundesministerium für Familie, Senioren, Frauen und Jugend) (2006), Erster Bericht über die Situation der Heime und die Betreuung der Bewohnerinnen und Federal Ministry of Family Affairs, Senior Citizens, Women and Youth N/A 2006 (source gives no more data and desk research National services in general
Bewohner, Berlin, Bundesministerium für Familie, Senioren, Frauen und Jugend, available at: con_sens (2013), Kennzahlenvergleich der überörtlichen Träger der Sozialhilfe, Studie im Auftrag der Bundesarbeitsgemeinschaft der überörtlichen Träger der Sozialhilfe, Hamburg, Consulting für Steuerung und soziale Entwicklung GmbH, available at: . con_sens (Consulting für Steuerung und soziale Entwicklung GmbH) consultancy N/A 2012 (source gives no more based on data as well as own data collection national services for people with disabilities provided by regional social assistance authorities Kozma, A. and Petri, G. (2012), Mapping Exclusion – Institutional and services in the mental health field in Europe, Brussels, Mental Health Europe, available at: . Mental Health Europe member organisations NGO Desk research of existing material as well as collection of expert knowledge 27 EU Member States, and Croatia, Moldova, Serbia and Israel Mental health care delivery Germany, Federal Statistical Office (Statistisches Bundesamt) (2012), Statistiken der Kinder- und Jugendhilfe 2010 – Einrichtungen und tätige Personen (ohne Tageseinrichtungen für Kinder), Wiesbaden, Statistisches Bundesamt, available at: . Federal Statistical Office N/A date data National Youth welfare services Germany, Federal Statistical Office (Statistisches Bundesamt) (2013), Pflegestatistik 2011 – Pflege im Rahmen der Pflegeversicherung. Federal Statistical Office N/A date data as well as National benefits within long based
Deutschlandergebnisse, Wiesbaden, Statistisches Bundesamt, available at: . insurance data term care insurance Germany, Federal Statistical Office (Statistisches Bundesamt) (2013), Sozialleistungen 2011 – Empfänger und Empfängerinnen von Leistungen nach dem 5. bis 9. Kapitel SGB XII, Wiesbaden, Statistisches Bundesamt, available at: . Federal Statistical N/A – data National Benefits according to Chapters 5-9 Social Security Code XII Germany, Greifswald University (Universität Greifswald), Institut für Sozialpsychiatrie des Landes (2013), Das System der psychiatrischen Versorgung in Deutschland, Expertise im Auftrag des Deutschen Institutes für Menschenrechte, Greifswald (unpublished). Greifswald, Institut für Sozialpsychiatrie des Landes academia 2013 N/A N/A national Mental health care delivery World Health Organization (WHO) (2011), Mental Health Atlas 2011 – Country Profile Germany, available at: . WHO headquarter, regional and country offices 2011 N/A to be answered by national ministries of health national Mental health care delivery Seifert, M. (2011), ‘Betreutes Wohnen von Menschen mit Behinderung’ in: Bieker, R., Floerecke, P. (eds.), Träger, Arbeitsfelder und Zielgruppen der Sozialen Arbeit, Stuttgart, Kohlhammer, pp. 207-220. academia Information not based on data collection national Thesing, T. (2009), Betreute Wohngruppen und Wohngemeinschaften für Menschen mit geistiger Behinderung, Freiburg, Lambertus. academia Information not on data collection national
Lindmeier, B., Lindmeier, C. (2011), ‘Dienstleistungen für das Wohnen und die soziale Teilhabe‘ in: Beck, I., Greving, H. (eds.), Gemeindeorientierte pädagogische Dienstleistungen, Stuttgart, Kohlhammer, pp. 140-148. academia Information not based on data collection national Overview of community-based services for persons with disabilities (2015) Table 3: community-based services for persons with disabilities Type of community-based service Please provide the name of the type of service in the national language and a translation into English Yes/ No Please if this type of service is in Profile of the users age (children, adults or older persons) type of disability (physical disability, intellectual disability, disability, Explanatory information For each type of service, please provide a short description of: the type and level (i.e. 24 hour, daytime, weekends, etc.) Extent to which support is For each type of service, please provide information about the extent to which users control the support provided. Can If data are available, please specify number of services operating in the country and the number of users Please provide a full reference for
Please indicate if the types of services presented below are given a different name in your country your country deaf or hard of hearing, blind) of support the service provides; location of the service (i.e. city, town, rural areas); who is eligible for the service who is typically the provider and funder of services (i.e. national government, local government, municipality, NGO, private company, etc.)? individuals using the service: recruit and manage staff providing support; determine the activities for which support is needed; determine how the budget for services and supports is used; choose types of equipment and adaptations to meet their needs? this data, including information about the period covered by the data. Please indicate, if data is available, if there has been decrease / increase in the last five years Direct payments / personal budgets/individual budget (cash payment enabling service users to employ personal assistants or freely choose using various service providers) Yes The average age of personal budget users in 2012 was 38.7 years (in 2011 it was 38.3). The latest data from 2010 indicates Personal budgets comprise different types and levels of support depending on service user needs and the Personal budgets enable users to receive support according to what is known as employer’s model [unofficial translation] This means The only available statistics covers the personal budgets funded by social welfare agencies. As already stated this is the case with the large majority of personal
Persönliches Budget (personal budget) differences in users’ age according to different funders of personal budgets: when funded by the social welfare agencies the largest group of users was under 40 (57%); the average age of users funded by nursing care insurance was 79. In the same year (2010) - 41% of users funded by social welfare had psychosocial disability, 34% intellectual disability and 23% physical or sensory impairment. available budget. This service is available in all Länder. Service is available to all persons with disabilities or at risk of becoming so, regardless of the level of disability or the level of risk of becoming disabled. Parents of children with disabilities can also apply for personal budget for their children. Potential funders of personal budgets include: social welfare that they select and recruit assistants according to their needs and preferences. Users are responsible for issuing working contracts and all related administration. The purpose of personal budget and its overall cost needs to be approved by the funder (most often the welfare agency). The latter considers the expert needs assessment in the decision making process and convenes a helpers’ conference budgets. At the end of 2012 – the total of 8,403 disabled people was receiving personal budgets. This number is for 27% higher than in the previous year (6,628). Personal Budgets are most frequently used in
agencies, health insurance, nursing care insurance, Federal Labour Office, accident insurers, pension insurance, youth welfare services, agricultural pension scheme, war victims compensation scheme and integration offices. The latest available comprehensive data on personal budgets demonstrates that the most frequent funder (81%) are the local and where users can put forward their perspectives. Exceptionally, personal budgets funded by the accident insurers do not require an application and are awarded automatically.
the decisions largely depend on assessments of funding bodies. Any disabled person who is not in need of support at all times is eligible for these services. Typical providers of personal assistance are different The exception are job assistants that can be contracted by the disabled person directly and receive payment per hour, per day or monthly. Einzelfallhilfe (individual case work) Both adults and children with disabilities are entitled to using this service. Einzelbetreuung (individual care) Both adults and children with disabilities are entitled to using this service.
professional groups and their associations (social workers, social education workers, specialised nurses, as well as students of these disciplines). The assistants are mostly Integrationshilfe (integration support) This service is for school children. The number of school children with disabilities receiving integration support (Integrationshilfe) in 2012 was 33,515. This service seems to be the one with the highest yearly increase (in 2010 – 25,945 children received this type of support and in 2011 – 29,647).
The applications for this service should firstly be made to health, nursing or pension insurance. In case of job assistance the applications should firstly be made to integration or employment offices. If rejected by those funders the service is then funded by local and regional Interdisziplinäre Frühförderung (interdisciplinary early support) This service is for children who are disabled or at risk of becoming disabled and are under the age of 3. In the year 2012 – 133,320 children received interdisciplinary early support service (interdisciplinäre Frühförderung). Arbeitsassistenz (job assistance) Job assistance is for people with disabilities in regular employment.
welfare agencies, in of the applicant’s income level. Residential (usually small residential services in the community – such as group homes, protected homes, family type arrangements, etc.) Yes Wohnstätten/ Wohngemeinschaften/ Therapeutische Wohngemeinschaften (shared flat-shares) The service is available to adults with disabilities, regardless of the type of impairment. Therapeutic is typically used by people with psychosocial disabilities. The workers in these services are not available at all times. Some services provide on-call duty over the weekends and in the night time. People with disabilities who are Service users do not recruit workers. According to different providers’ rules they can choose their individual care supervisor (Bezugsbetreuer) at the most. However In 2012 about 19, 000 Persons with disabilities lived in shared accommodation.
not in need of intensive care are eligible for the service. The residential services are provided by private agencies, by independent welfare associations or church-charities. They are typically funded by local and regional welfare agencies. this right is not guaranteed. Users have limited influence on service provision in terms of budget allocation, and the amount and the content of activities offered. They can participate in the development of their individual care plan. Betreutes Einzelwohnen/ Appartment Wohnen (assisted single living) The service is available to adults with disabilities, regardless of the type of impairment. Service workers are available for limited amounts of time as in individual care plans. The eligibility criteria and service providers are same as for shared accommodation (pls see above). The same as for shared accommodation. This type of residential service is not differentiated in federal statistics.
and two at the most. In accordance with a care level - host families receive a lump monthly payment for the service they provide from the nursing care insurance. The accommodation and other living costs for the person with disability are covered by welfare agencies. In-home (home help, home care service) (home help consists of assistance with household tasks, such as shopping, cleaning, cooking, etc. Home-care services include assistance with daily routine tasks such as getting up, dressing, bathing and washing or taking medicines) Yes This service is available to adults and children in need of nursing care. People with defined care level (1-3) are eligible for this service as well as those without a defined Depending on the user’s care level the daily service provision is between 1.5 and 5 hours. Additionally, if people’s daily living competences happen to be Service users can choose between different nursing care agencies entitled to provide outpatient nursing care. Since 2008 users have a possibility of choosing one single care In relation to services covered by the nursing care insurance – in the year 2013 there were 12, 745 outpatient nursing care services serving the total of 615,846 users.
The service is funded either by health care or nursing insurance or by welfare agencies. The former can cover only part of the costs as a matter of principle. Day care centres (service provided during set periods of the day; includes support, meals and some aspects of personal care, as well as social and cultural activities) Tagesförderstätte (day activity centre) and Tagesstätte für Menschen mit seelischen Beeinträchtigungen / Yes This service is for adults with disabilities. Day care centres are used by people with physical and intellectual impairments as well as by people with psychosocial disabilities (Tagesstätte für Menschen mit The centres can be attended 5 days a week or less frequently. In regard of eligibility of people with physical disabilities the service is for those who cannot attend sheltered workshops because of not being able to Service users cannot make the decisions about workers’ recruitment, expenditures and daily programmes. At the most they can choose their care supervisor (Bezugsbetreuer) and prioritise activities. However the day centres are not formally obliged to respect user’s choices and In regard of people with physical disabilities in the year 2013 – 25,890 were attending day centers Since 2007 the average yearly increase in number of users is 7.6%. In regard of people with
welfare agencies. Family support / Respite care (provides supports to carers in their caring role and allows them to have a break, may be formal or informal, and may be provided in the home or out of the home) Familienentlastende Dienste / Familienunterstützende Dienste (family disburdening services /family support services) Ersatzpflege/ Verhinderungspflege/ Vertretungspflege (substitute care/ replacement care) Yes Both family services are for children and young people with disabilities and their families or carers. Replacement care is for people whose regular (family) carers are temporarily not available due to illness or other reasons. These services are not limited to any particular type of disability. The purpose of family support services is to enable parents/carers of disabled children to have a break and take part in leisure and cultural activities. At the same time the service supports autonomy of children outside of their homes. The service can last from several hours to several days in continuation. The purpose of replacement care is to enable continuity of The type and the amount of service relies on the needs of concrete families/persons in need of care. People who have continuously been cared for in the minimum period of 6 months are eligible for replacement care. The families/persons in need of care themselves largely decide about the helpers, place of support as well as None of the related statistics differentiates specifically the recipients of family support services. The replacement care was introduced in 2015 so there is no data available.
honorary workers and are available in all regions. The family support services can be funded by nursing care insurance, health insurance and social welfare agencies. The replacement service is funded by nursing care insurance. Foster care (where children are placed in the domestic environment of a family that is not their own) Pflegefamilie (foster family) Yes This service is for children and teenagers. Children and young people with physical, intellectual or mental disabilities Foster care is always full time. It can be short term (until biological parents are able to care for the child again) or The youth welfare offices remain responsible for contact with children and families as well as for the overall supervision of foster care. The only available statistics is about children with psycho-social disabilities (seelisch behinendert). In 2013 – 106 children were in
can use the service. long term (until the age of 18). The notion of ‘family’ includes single households as well as couples with or without children. A care permission issued by expert services is needed before one can become a carer. The typical funders for children with psycho-social disabilities (seelisch behinendert) are youth welfare services while social welfare services foster care. One other report explains that foster care statistics is not considered due to very low number of cases.
are more likely to fund children with physical and intellectual disabilities. Informal support (help provided by another person close to the user - family members, relatives and friends - without any official forms of support) Pflegegeld (nursing care money) / Pflegezeit (care period) Yes Home care already mentioned above can also be provided by family members or people close to service users. People with any type of disability or in need of care are eligible for this support. The legislation doesn’t differentiate strictly between older people with disabilities and older people in need of nursing care – hence the service is available for both. A formal status of ‘severely impaired’ (Schwerbehindert) is not necessary in This type of support is provided by carers (Pflegepersonen) in distinction to specialised carers (besonderen Pflegekräften). The latter can be employed in order to disburden carers. This service is funded by social welfare agencies and by nursing care insurance The person in need of care is in charge of finding the carer from their family or friends. The amount of support depends on the care level. The informal home care can be for a short period only (Pflegezeit) - for example following an accident, as well as provided on a long-term base. The welfare agencies refund times of carers’ absence from their employment and also support pension schemes. The lump monthly amounts are fixed In the year 2012 – 37,064 persons received informal support funded by social welfare agencies. In the year 2011 - 1, 182, 057 received this service funded by nursing care insurance.
Peer support/counselling (provided by with the counsellor and the client having equal status, and experience and assistance in gaining independence and Peer Beratung (peer counseling) Selbsthilfe (self-help) Yes This service is for adults with disabilities regardless of their age or type of disability. Peer counselling and self-help are typically provided by organisations of disabled people. This service can be funded by single health insurance agencies or by their umbrella organisation. In order to receive this funding, self-help organisations need to work in accordance with the medical classification of illnesses and disabilities. As many of them do not adopt this framework, this service relies on volunteers or receives funding within different larger projects that entail self-help and N/A The latest data about the number of groups is from 2004 and relates solely to groups within welfare (Freie In that year the total of 3,108 self-help groups of people with chronic illnesses and disabilities were active. This number 203 groups of people with mental illness, 108 of people with intellectual disabilities, 391 of people with disabilities, 75 groups of carers
peer-counselling components. Further source of funding is pharmaceutical industry. and 2,281 groups of people in need of health-related after-care or with long-term care needs. Circles of support (informal group of people close to the user to whom she/he can turn for support) Crisis intervention and emergency services (various activities aimed at supporting an individual or a family to overcome a difficult situation, for example,: individual and family counselling, crisis resolution teams (usually rapid support for people living in the community who are experiencing a mental health crisis) and emergency foster care where children at risk of neglect or abuse) yes These services are not specifically targeted to people with disabilities and are conceptualised for everybody with a specific (such as domestic and other violence, emotional crisis, suicidality, addiction, problems with upbringing of children in disadvantaged families etc.). The degree of the These services have different opening times and offer different levels of support. They usually offer counselling and/or emergency Emergency services are available across the country. Users proactively seek the great majority of these services, apart from for example family support (Sozialpädagogische Familienhilfe) which is an outreach service. The support is tailored to different needs. The helpers are coming into families for 10 – 20 hrs a week. This form of support is The federal statistics of public children and youth welfare reports the numbers of families who were receiving support at the end of the following years: 2010 – 61,808 2011 – 63,559 2012 – 65,642
Diverse Notrufe (various hotlines) Krisendienst (Crisis intervention service) Telefonseelsorge (Samaritans) Frauenhäuser (shelters for battered women) Kindernotdienste (shelters for children) Sozialpädagogische Familienhilfe family support) Etc. accessibility of these services for people with different impairments varies and is subject to philosophy, sensitivity and policy of a particular service. The typical providers are NGOs, independent charitable associations and church charities. Most of these services receive state funding. not specifically targeted to children/parents with disabilities and is meant to address any social faced in upbringing children . 2013 – 68,350. Befriending (service provided by trained volunteers to help overcome isolation and enable full involvement in the community and social life) Yes These services are provided to people in and outside of institutions, who are lonely, old, ill, or disabled. These services are typically provided by voluntary organisations and NGOs working in the respected fields (with old people, Reports from German Surveys on Volunteering provides only the data relating to older people and children. People with disabilities