Overview of institutional services for persons with disabilities (2014) Introduction and preliminary remarks There are several notes that need to be made at the beginning: The researchers included in the table also the so called “residential community-based services” with a note after the name of the institution/service in the first column. They did that as many of them actually function as institutions and are located in the buildings or in the yards of institutions. There is no official publicly available information about the number of these types of quasi community-based services. However, NGO reports mention this: Bulgaria, Bulgarian Helsinki Committee, Human Rights in Bulgaria in 2011, Annual Report, p.55 (for services for adults with mental disabilities), p.62 (for child care services for children with and without disabilities), available in English at: , Bulgaria, Bulgarian Helsinki Committee, Rights in Bulgaria in 2013, Annual Report, p. 65, available in English at: . The majority of institutions/community-based services that are not specifically designed to accommodate children or adults with disabilities in fact accommodate people with various types of disabilities. This applies for social care homes for children deprived of parental care for example or to social care homes for old people, or the crisis centres for children and adults. Again there is no official publicly available data about this. The majority of the institutions were set up during 1960s. However, no source of information was found to be referred to. In the institutions for adults the length of admission is usually till the end of their lives.
Table 1: Typology of institutions TYPE OF SERVICE SIZE AGE TYPE OF IMPAIRMENT LEVEL OF SUPPORT PROVIDED TYPICAL PROVIDER TYPICAL FUNDER LENGTH OF AGE OF SERVICE Social care home for children deprived of parental care (Дом за деца, лишени от родителски грижи) 11-30 (Total capacity 415 places/ average capacity 20-35 places per home) aged 3 to 6 children deprived of parental care with and without disabilities (intellectual, mental and light physical) Residential, 24 hour support provided local authority National of Labour and Social Policy Over 2 years Over 50 years Social care home for children deprived of parental care (Дом за деца, лишени от родителски грижи) 30-100 (Total capacity 1,938 places/ average capacity 40-50 places per home) aged 7 to Children deprived of parental care with and without disabilities (intellectual, mental and physical) hour support provided local authority National of Labour and Social Policy Over 2 years Over 50 years Social care home for children with 30-100 aged intellectual disabilities Residential, 24 hour local authority National of Over 2 years till Over 50 years 0 Ministry government/ Ministry government/ Ministry government/
intellectual disabilities (Дом за деца с умствена (Total capacity 1,302 places/ average capacity 50-60 places per home) 3 to 18 support provided Labour and Social Policy the age of 18 Social care home for children with physical disabilities (Дом за деца с физически увреждания) 30-100 (Total capacity 70 places/ average capacity 70 places per home) aged 3 to 18 physical disabilities hour support provided local authority National of Labour and Social Policy Over 2 years till the age of 18 Over 50 years Nursing homes for medical and social care for children (Дом за грижи за деца) 30 -100 (Total capacity 2,258 places/ average capacity 75 places per home) aged to 3 (in cases of or mixed types of disabilities hour support provided National authority – of Healthcare National of Healthcare Over 2 years Over 50 years Ministry government/ Ministry government/
mental health problems (Дом за възрастни хора с психични разстройства) capacity 1,036 places/ average capacity 80 places per home) support provided Labour and Social Policy Social care home for adults with physical disabilities (Дом за възрастни хора с физически увреждания) 30-100 (Total capacity 1,315 places/ average capacity 60 places per home) physical disabilities Residential, 24 hour support provided local authority National of Labour and Social Policy Over 2 years Over 50 years Social care home for adults with sensory disabilities (Дом за възрастни хора със сетивни нарушения) 11-30 (Total capacity 133 places/ average capacity 30 places per home) sensory disability hour support provided local authority National of Labour and Social Policy Over 2 years Over 50 years Social care home for 30-100 older people with dementia Residential, 24 hour local authority National Over 2 years Over 50 Ministry government/ Ministry government/ government/
adults with dementia (Дом за възрастни хора с деменция) (Total capacity 825 places/ average capacity 60 places per home) support provided of Labour and Social Policy Social care home for older people (Дом за стари хора) 30-100 (Total capacity 5,593 places/ average capacity 70 places per home) Old older people with and without disabilities Residential, 24 hour support provided local authority Mixed (National donors) Over 2 years Over 50 years Centre for family-type (Център за настаняване от семеен тип) ( residential service) 6-10 (Total capacity 677 places/ average capacity 6-15 places per centre) (people with mental health problems intellectual disabilities, physical disabilities) Residential, 24 hour support provided Mixed (local authority/ Voluntary/ not for profit (NGO)) National of Labour and Social Policy Over 2 years 10 years Ministry Ministry government/
Centres for family-type for children (Център за настаняване от семеен тип за деца) (residential service) 11-30 (Total capacity 1,201 places/ average capacity 10-20 places per centre) children with and without disabilities Residential, 24 hour support provided local authority/ NGO National of Labour and Social Policy Over 2 years 10-15 years Supervised жилище) (residential service) 6-10 (Total capacity 104 places/ average capacity 6 places per house) Adults with and without disabilities impairment group not specified Residential, Daytime support provided, no night time staffing Mixed (local for profit NGO) National of Labour and Social Policy Over 2 years 5-10 years Shelter (Приют за лица) ( residential service) 30-100 (Total capacity 70 places/ average capacity 35 places per shelter) Impairment group not specified, adults with and without disabilities 24 hour support provided Mixed (local for profit NGO) National government Up to 3 months 5-10 years Ministry government/
Shelter for children (Приют за деца) ( residential service) 11-30 (Total capacity 60 capacity 15 places per shelter) Impairment group not specified, children with and without disabilities Residential, 24 hour support provided Mixed (local for profit NGO) National government Up to 3 months 5-10 years Protected home (защитено жилище) (residential service) 6-10 (Total capacity – 1,061, average capacity - 8-12 places per home) Mixed (intellectual disabilities, mental health problems) Residential, 24 hour support provided Mixed (local for profit NGO) National of Labour and Social Policy Over 2 years 5-10 Transitional home (Преходно жилище) ( residential service) 6-10 capacity 100 places/ average capacity 10 places per home) Intellectual disabilities, mental health problems support provided, no night time staffing Mixed (local NGO) National of Labour and Social Policy Over 2 years 5-10 years Transitional housing for Total capacity Children at risk, intellectual Residential, Daytime local authority National Over 2 years 5-10 years Ministry government/ Ministry
children (Преходно жилище за деца) (residential service) 134 places/ average capacity 8 places disabilities, mental health problems support provided, no time staffing of Labour and Social Policy Crisis centre for children victims of violence or trafficking in human beings (кризисен център за деца жертви на насилие и трафик) (residential service) 11-30 (Total capacity 145 places/ average capacity 10-15 places per centre) Victims of violence or trafficking in human beings with and without disabilities Residential, 24 hours support provided Mixed (local for profit NGO) National of Labour and Social Policy Up to 6 months 8 years Crisis centre (кризисен център за възрастни жертви на насилие и трафик) (residential service) 6-10 (Total capacity 45 places/ average capacity 10 places per centre) Victims of violence with and without disabilities Residential, 24 hours support provided Mixed (local for profit NGO) National of Labour and Social Policy /NGOs Up to 6 months 10-15 years Ministry
Centre for short term (Център за временно настаняване) (residential service) 30-100 capacity 625 places/ average capacity 40-50 places per centre) Homeless people with and without group not specified Residential, 24 hour support provided Mixed (local for profit NGO) National of Labour and Social Policy Up to 3 months 10-15 years Social centers for vocational training (социално център) 30-100 capacity 447 places/ average capacity 60-65 places per centre) and (aged 14 to 35) Intellectual, mental health problems and sensory disabilities Residential, Daytime support provided, no night time staffing but the services are residential National and local authority/ NGO National of Labour and Social Policy Over 2 years 10-50 Mother and baby units (Звено майка и бебе) (residential service) 6-10 (Total capacity 75 places/ average capacity 7-8 places per unit) with Children and mothers at risk with and without disabilities hour support provided Mixed (local for profit NGO) National of Labour and Social Policy Up to 6 months 5-10
Center for Public Support (Център за обществена подкрепа) (not residential service) 30-100 (Total capacity 4,037p laces/ average capacity 30-60 people serviced in each) and Adults and Children with and without disabilities at risk Daytime support provided, mainly consultation and therapeutic work Mixed (local for profit NGO) National of Labour and Social Policy 3 months up to 1 year 5-10 years Center for work with children from the street (Център за работа с деца на улицата) ( not residential service) 11-30 (Total capacity 231 places/ average capacity 18 places per centre) Children with and without disabilities at risk Daytime support provided, no night time staffing (local for profit NGO) National of Labour and Social Policy Mixed lengths of 5-10 years Centre for social rehabilitation and integration (Център за социална и интеграция) (not residential 30-100 (Total capacity 2,277 places/ average capacity 30 - 40 places per centre) Mixed (intellectual disabilities, mental health problems , physical disabilities) Daytime support provided, no night time staffing Mixed (local for profit NGO) National of Labour and Social Policy Mixed lengths of 10-15 years
service) Centre for social rehabilitation and integration for children (Център за социална и интеграция за деца) (not residential service) 30-100 capacity 1,205 places/ average capacity 30 – 40 places per centre) Mixed (Intellectual disabilities, mental health problems, physical disabilities) Daytime support provided, no night time staffing Mixed (local for profit NGO) National of Labour and Social Policy Mixed lengths of 10-15 years Day care centre for old people (Дневен център за стари хора) (not residential service) 11-30 (Total capacity 1,304 places/ average capacity 20-30 places per centre) Old Old people with and without disabilities Daytime support provided, no night time staffing Mixed (local for profit NGO) National of Labour and Social Policy Mixed lengths of 10-15 years
Day care centre for children with disabilities (Дневен център за деца с увреждания) (not residential service) 11-30 (Total capacity 1,947 places/ average capacity 20-30 places per centre) Mixed (Intellectual, mental health problems, physical disabilities) Daytime support provided, no night time staffing local authority/ NGO National of Labour and Social Policy Mixed lengths of 10-15 years Day care center for adults with disabilities (Дневен център за възрастни хора с увреждания) (not residential service) 11-30 (Total capacity 1,740 places/ average capacity 20-30 places per centre) Mixed (Intellectual disabilities, mental health problems, physical disabilities) Daytime support provided, no night time staffing local authority/ NGO National of Labour and Social Policy Mixed lengths of 10-15 Day centre for children and adults with disabilities (Дневен център за деца и 30-100 (Total capacity capacity 50 places and Mixed (Intellectual disabilities, mental health problems, physical disabilities) Daytime support provided, no night time staffing Mixed (local for profit NGO) National of Labour and Social Policy Mixed lengths of 10-15 years
възрaстни с увреждания) (not residential service) per centre) Psychiatric hospitals болници) Over 100 (Total capacity capacity 200 per hospital) and Mental health problems 24 hour support provided National authority/ of Health National of Health Mixed lengths of Over 50 years Special boarding school for children with intellectual disabilities (Помощни училища за деца с умствена 30-100 (Total capacity capacity 70 places per school) aged 7 to 16 Intellectual disabilities, mixed types of disabilities Residential, 24 hour support provided for 9 months of the year National of Education and Science Ministry of Education and Science Over 2 Over 50 years Recreation boarding school училища) 30-100 capacity aged 7 to 16 Chronic health conditions/ disabilities Residential, 24 hour support provided for 9 months of the year National of Education and Science Ministry of Education and Science Over 2 years Over 50 years
capacity 65 per school) School for children with deviant behaviour (Училища за ученици с девиантно поведение) 30-100 (Total capacity capacity 42 per school) aged 7 to 14 Children with deviant behavior with and without disabilities Residential, 24 hour support provided for 9 months of the year National of Education and Science Ministry of Education and Science Over 2 years Over 50 years Table 2: data sources TITLE/ REFERENCE ORGANISATION COLLECTING DATA YEAR OF DATA PERIOD COVERED BY THE DATA FOR DATA SCOPE OF DATA 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 Year when data was Time period covered by the data/ report Desk research, visits to Local authority area, region, federal for people with mental health
Children ministry, local authority, national statistical office academia, NGO design, sampling, data state, national for people with for older people, for large homes etc Annual report of the Activity of the Social Assistance Agency for 2013 (Годишен отчет за дейността на Агенцията за социално подпомагане за 2013), available at: The Social Assistance Agency 2013 1 January -31 December 2013 data National adults and older people with mixed service service service
2007 Annual Report, Human Rights in Bulgaria, available at: Bulgarian Helsinki Committee 2007 1January – 31 December 2007 Desk Research and and Visits National Children and adults with and adults with mental health Number of children raised in institutions () Homeless children – shelters, day care centers, and homes for short term accommodation – up to 31.12.2012, available at State Agency for Child Protection data National Children with Medical care and nursing homes for children (Домове за грижи за деца) available at: National Statistical Institute data National Children with Crisis centres for children in Bulgaria for 2013 (Кризисните центрове за деца в България през 2013) , available Bulgarian Helsinki Committee 2013 2013 Desk Research and fieldwork research (consisting of visits on spot, reviewing National Children with and without 2012 2012
of service in the national language and a translation into English Please indicate if the types of services presented below are given a different name in your country type of disability (physical disability, intellectual disability, psycho-social disability, deaf or hard of hearing, blind) the type and level (i.e. 24 hour, daytime, weekends, etc.) 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.)? information about the extent to which users control the support provided. Can 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? country and the number of users Please provide a full reference for 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 budget (cash payment enabling service to employ personal No - - - -
assistants or freely choose using various service providers) ‘Personal assistant’ (личeн асистент) - provided under the National Programme Assistants for People with Disabilities. The aim of the is to provide employment for unemployed people in order to relieve the situation of families with a person with disabilities who needs constant care. Personal assistant users can only be: - Children under the age of 18 with permanently reduced work capacity or type and level of disability that requires for them to have assistance; - Children or adults leaving an institution for people with disabilities; - Adults of low status with 90 % and above reduced work capacity or type and level of disability that requires for them 24-hour service. Provided both in cities and rural areas. It is particularly important for rural areas, small towns and villages where there are few or no other CBSs. Providers can be municipalities, NGOs and private companies registered with the Social Assistance Agency, and the Regional Directorates of the Social Assistance Agency. The ‘personal assistant’ requires that the user’s will and preferences are established in advance and included in the user’s personal plan and taken into consideration by the provider. The plan is written in plain language comprehensible to the user. The user has the right to make a justified and reasoned request for their personal assistant to be changed. The personal assistant is necessarily an unemployed There are currently 2,639 adult users and 1,001 children users. The waiting lists for personal assistance services are long due to the lack of sufficient funding for personal assistance services to meet the needs of people with disabilities throughout the country.
Disabilities. A type of personal assistance. The aim of the service is to provide employment to unemployed people to meet the daily needs of people with disabilities and severely ill people living alone, including organising activities for their social inclusion. who require assistance, children up to the age of 18 with permanently reduced work capacity, who require assistance, severely ill people living alone who experience difficulties taking care of themselves, or adults or children with disabilities leaving institutional care. 50 % or more possibility for social adaptation, who require assistance; 12 hours per week for seriously ill people living alone who experience difficulties looking after themselves; 10 hours per week for adults and children leaving institutional care. Children and adults leaving institutional care users of the personal assistant service can also use a social assistant twice a week for up to 3 hours. People with disabilities can receive additional support beyond the hours for which they have to pay user’s personal plan is developed with the user’s participation. If this is not possible, the user is represented by a relative or a guardian or custodian. The plan is written in plain language comprehensible to the user. The user has the right to make a justified and reasoned request for their personal assistant to be changed. Instead, the service is and funded under the ESF. The waiting lists for personal assistance services are long due to the lack of sufficient funding for personal assistance services to meet the needs of people with disabilities throughout the country.
between BGN 0.17 (€0.09) and BGN 0.34 (€0.17) per hour depending on the user’s income level. Provided both in cities and rural areas. Providers can be municipalities, NGOs and private companies registered with the Social Assistance Agency, and the Regional Directorates of the Social Assistance Agency. ‘Assistants for independent living’ (асистенти за независим живот). A type of personal assistance. This service is provided by the Sofia Municipality and is not funded out of the national The people eligible to apply are adults with disabilities, who experience difficulties in their social inclusion and looking after themselves. Children over the age of 5 with 50 % and above type and level of disability. Provided 24 hours, up to 300 hours per month. Available only in the capital city, Sofia. Provided by Sofia municipality. NGOs argue that personal assistance services offered in Bulgaria are not sufficient to ensure the The user can choose their assistant and the activities for which he/she receives support. It is uncertain to what extent the users can control the service in practice, as the care is more often In 2014, there were 898 users (520 adults and 378 children) and 943 assistants for independent living. The waiting lists for personal assistance services are long due to the lack of
budget. It is the only assistance service in Bulgaria recognised by the European Network on Independent Living as a personal assistance service. equal participation of people with disabilities. than not provided by relatives of people with disabilities on whom the users are dependent. sufficient funding for personal assistance services to meet the needs of people with disabilities in Sofia. ‘Family-type residential centre for children and youth’ (Център за настаняване от семеен тип за деца и младежи) A type of residential service. Children between the ages of 3 and 18 and young people between the ages of 18 and 29 with different types and level of disability who cannot live in their families and need support for independent living. 24-hour care and can be provided by the state, municipalities, NGOs or private companies. The service is opened in towns or villages with functioning health, educational and social services and opportunities for cultural and sports activities. The placement of children and youth takes into consideration their preferences, their age and development level, as well as the opinion of their legal representative unless it contradicts the child’s or young person’s interest. The service provision requires the child’s or young person’s active participation. There are currently 182 family-type accommodation centres in the country, which have 796 adult users and 1,186 children users. ‘Family-type residential Adults of different ages, genders and 24-hour care and can be provided The user’s personal plan is There are currently 182
centre for adults’ (Център за настаняване от семеен тип за лица) Type of residential service. types and level of disability who are either leaving institutional care or at risk of institutionalisation. by the state, municipalities, NGOs or private companies. The service is opened in towns or villages with functioning health, educational services, other CBSs and opportunities for cultural and sports activities. developed in accordance with their will, preferences and personal goals. The provider creates opportunities for users to freely express their opinions, to make independent decisions and to participate in discussions concerning the everyday life and rules in the centre. family-type accommodation centres in the country, which have 796 adult users and 1,186 children users. ‘Transitory home’ (преходно жилище) A type of residential service. Yes. Adults or children in risk with various types of disabilities who are preparing to leave institutional care. 24-hour care and can be provided by the state, municipalities, NGOs or private companies. The service is provided on the territory of the institution of the care leavers, either in a separate building or in the same one. There is no reference to support. are currently 38 transitional homes with 96 adult users and 109 children users.
‘Protected home’ (защитено жилище) A type of residential service. Adults with psychosocial disabilities, who have spent a big part of their lives in institutional care, or in exceptional cases, people, including with disabilities, at risk of institutionalisation. There is no limitation with regard to the type of disability included in the methodology. However the document provides for the group to be accommodated in one protected home (between 6 and 10 persons) according to their needs and level of disability. All residential services provide 24-hour care and can be provided by the state, municipalities, NGOs or private companies. 4) The service is provided in houses or flats in smaller or bigger towns and villages. The Methodology recommends that the service users are stimulated as co-authors of their personal development plans in order to regain their confidence and to feel secure in a supportive environment. There are currently 124 protected homes with 1,051 users. ‘Monitored home’ (наблюдавано жилище) Young adults leaving institutional care, transitional home or protected home 24-hour care. The service can be provided by the state, municipalities, There is no reference to support. There are 19 Monitored homes with 75 users .
difficulties to organise their daily lives alone or with the help of relatives. It includes food delivery, monitoring of the health condition and help with receiving medical care, cleaning, provision of heating materials, repair work, provision of clothes, shoes and bedding, activities, purchase of food and other necessary goods paid by the users, administrative, financial and legal services. with the help of relatives. (delegated service), there is no methodology developed by the Social Assistance Agency (SAA) (Агенция за социално подпомагане, АСП) regulating the provision of the service. and funded under the ESF. Day care centre for children and adults with intellectual and physical disabilities (дневен център Children and adults with intellectual and physical disabilities. The services are daytime, provided in bigger towns by municipalities, NGOs and private companies. There are no provisions or guidelines regulating to what extent the support is self-directed. There are 200 day care centres in Bulgaria with 3,073 adult users and 2,302 children users.
за деца и младежи с умствени и физически увреждания) Social rehabilitation and integration centre for children and adults (център за социална рехабилитация и интеграция за деца и възрастни) A type of day-care centre. Children and adults with various types and degrees of disabilities. The services are daytime, provided in bigger towns by municipalities, NGOs and private companies. The user’s personal plan is drafted with the user’s participation, where this is possible and appropriate. There are currently 42 social rehabilitation and integration centres in the country with 2,735 adult and 1,408 children users. Community support centre (център за обществена подкрепа) A type of day care centre. Families and children at risk of institutionalisation. The services are daytime, provided in bigger towns by municipalities, NGOs and private companies. The service-users have the right to choose and direct the services they receive, including the are currently 106 centres for community support with 5,207 children users. Day-care centres – general comments: There is lack of services for children with disabilities living in small towns and villages in the country as well as transport links to the regional cities. Moreover, 10 of the existing day-care centres provide week-care for children and adults with disabilities. Family support / Respite care (provides supports to carers in their caring role and allows them to No - - - -
have a break, may be formal or informal, and may be provided in the home or out of the home) Foster care (where children are placed in the domestic environment of a family that is not their own) Yes Children who temporarily cannot or should not live with their parents, including children whose parents cannot provide adequate care and children and newborn at risk of institutionalisation. The service can be provided by municipalities, Social Assistance Directorates, NGOs and private companies. - In March 2015, there were 2,304 children in foster care. The overall number of foster families is 2,362. There is no disability disaggregated data in relation to foster care. Children with disabilities are one of the five priority groups for foster care. The service is also available for children with disabilities accommodated in institutions. Informal support (help provided by another person Non-institutional care and support for people with disabilities in - - - -
close to the user - family members, relatives and friends - without any official forms of support) Bulgaria is provided informally and most often by family members. Peer (provided by non-professionals with the counsellor and the client having equal status, and sharing experience and assistance in gaining independence and self-confidence) No - - - - Circles of support (informal of people close to the user to whom she/he can turn for support) No Crisis intervention and emergency services (various activities aimed at supporting an Yes Foster care can be provided as an emergency measure to children at high risk. Crisis centres are also available - - There are currently 20 crisis centres, with 44 adult users and 106 children users. There are no
individual or a family to overcome a difficult situation, for example,: individual and family counselling, crisis resolution (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) to children and women victims of domestic abuse and trafficking. data. In March 2015, there were 2,304 children in foster care. The overall number of foster families is 2,362. Befriending (service provided by trained volunteers to help overcome isolation and enable full involvement in the community and social life) No - - - -