“The Government Would Either Have to Raise Taxes or Not Pay EU Dues, to Implement President’s Proposals on the Handicapped” Sega newspaper, 10 November 2006 “Gaping Hole in the Budget After Parvanov’s Veto” Novinar newspaper, 10 November 2006 “The State Needs 600 Million Lv. More for the Handicapped, But Cannot Get It from Anywhere” Monitor newspaper, 10 November 2006
The Truth About the IPDA Yana DOMUSCHIEVA
These hysterical headlines announced the (entirely accidental) failure to enact into law a discriminatory and outright harmful practice, as part of the Integration of People with Disabilities Act, namely the division of disabled persons into groups based on percentage of disability. BACKGROUND In 2003, the word “handicapped” [“invalid” in Bulgarian], bristling with negative connotations, was replaced by “persons with disabilities.” After that first strained step towards social inclusion, in 2005 we finally saw the arrival of the Integration of People with Disabilities Act (IPDA). Pretentiously touted as progressive and humane, it introduced the monthly social integration supplement, intended to cover the additional expenses faced by people with long-term disabilities. There were a total of seven supplementary benefit schemes: for transportation, information and telecommunication services, education, rehabilitation, accessible information, rent, dietetic foods, and medication. The biggest one is 11 levs, and the amount for rehabilitation is no more than 165 levs, once a year. You need two documents, in order to get your hands on this paltry integration supplement: a decision by the Labor Expert Physicians’ Commission (LEPC), which uses a standardized medical model to determine how much of your working capacity has been lost, expressed as a percentage of that of a healthy person; and a social evaluation, which, on the basis of the LEPC decision, designates what your needs are and recommends which supplements are appropriate for you. Nothing new here. There is no individual approach in the needs assessment procedure, which would take into account the age, the level of education, place of residence, employment, daily life, and
personal opinion of the disabled person. The Guidelines for Enforcement of the Integration of People with Disabilities Act (GEIPDA) also came into effect in 2005. They introduced additional restrictions on the supplements: only persons with at least 71% loss of working capacity could receive benefits for transportation, dietetic foods, accessible information, municipal rent, and education. A loss of at least 90% would be needed for information services and therapeutic bathing treatment. What does this mean in practice? Here is a random sampling of four disabilities from the LEPC’s Regulation on the Medical Evaluation of Working Capacity, which do not qualify for a single supplement: the loss of one arm at the forearm level (50%); loss of both thumbs (60%); functional deafness (60%); and diabetes (up to 70%). All serious conditions, yet completely ignored by the IPDA. Are public transport or a regular car truly accessible for a person with one arm? And does not a deaf person need speech therapy and the information services of the Internet, and a diabetic person special foods and bathing therapy for the organs damaged by the disease? SUPREME ADMINISTRATIVE COURT DECISION On 4 May 2006, the Center for Independent Living filed a complaint with the Supreme Administrative Court (SAC), against the restricted access to integration supplements in the GEIPDA, which provided people with a lower percentage of disability with nothing, and only the group with over 90% with rehabilitation. On 10 September 2006, the Court found the disputed restrictions in the GEIPDA to be in contravention of the IPDA’s intent of establishing conditions and guarantees of factual equality of persons with disabilities. The SAC decision
reads: “In the event of a level of damage of 50 or more than 50 percent to the anatomical, physiological, or mental health of a person, the prerequisites are present for him/her to receive a monthly supplement ... for social integration.” The SAC abolished the mechanical determination of the right to a supplement according to percentage of lost working capacity. The criteria reverted to those prescribed in the IPDA: type and degree of disability and individual needs, as determined by the social evaluation. The decision was promulgated in the State Gazette on 18 July 2006. THE EMPIRE STRIKES BACK Just two days later, on 21 July 2006, the MPs Hasan Ademov, Hristina Hristova and Petar Mratskov introduced a bill in Parliament to amend and broaden the Integration of Persons with Disabilities Act. The three MPs resourcefully found a way to circumvent the SAC decision, by writing the recently abolished percentagebased restrictions into the law itself. To repeat: the practice from the GEIPDA, found to be discriminatory, would be introduced into the IPDA itself. The bill also contained a new idea: development of a methodology for individual needs assessment of persons with disabilities. Mratskov, Ademov, and Hristova argued about the need for broader access to the supplements and of an individual approach to their distribution. The percentage restriction would thus return, disguised as broader access?! Some peculiar and yet obscure methodology would be used to determine a person’s individual needs and thus, the possibility of receiving integration supplements. The efficacy of combining these two approaches - a universal one and an individual one - is unclear. On the one hand, your personal needs may include rehabilitation and transportation supplements, but on the other, you could fall into a percentile group of persons not legally entitled to a supplement... The Bulgarian parliament passed the proposed amendments to the IPDA on 14 September 2006. On 28 September 2006, the President exercised his veto power, returning part of the law for further discussion. Both the SAC and Georgi Parvanov indicated that the percentage restrictions (Art. 42 a through g) for receiving the supplements did not conform to IPDA’s purpose, and in reality would significantly reduce the possibility for social integration of citizens with disabilities. THE LIES On 11 October 2006, the Parliamentary Committee on Labor and Social Policy rejected the presidential veto and returned the bill to the plenum for a new vote. An “Information Sheet on the Funding Necessary under Art. 42 of the IPDA, Should the President’s Veto Be Upheld”, prepared by the Ministry of Labor and Social Policy (MLSP), was distributed among the MPs in attendance. The sheet read that everyone “disabled with a 50% or more than 50% long-term reduction in working capacity would receive funding under all seven components of the monthly supplement for social integration, pursuant to Art. 42, Para. 1 of the IPDA.” The truth, which unfortunately failed to reach the media, is different. The equal access to supplements, imposed by the SAC decision, actually would not allow everyone to receive all seven
supplements, since there are additional requirements for some of them. Persons with sensory disabilities receive 8.25 levs per month for accessible information. Only students get the 11 levs for education. The 8.25 for dietetic foods is provided only when prescribed by a physician. The supplement for rent is only for those who live in municipal housing. There is another juicy lie on this information sheet: “According to NII [National Insurance Institute] data, the number of persons with disabilities as of 31 December 2005 was about 850,000. At an average monthly supplement amount of 60 levs, some 600 million levs will be needed,” the 60-lev figure being the sum of all seven monthly supplements. Given the false data about the real amount of supplements received, the 600 million was just to scare the MPs. But that is not all. The number of persons with disabilities is also debatable. According to NII data, at the end of 2005 there were 850,000 citizens receiving some sort of disability pension. But does that figure accurately reflect the number of people eligible for supplements? On 28 September 2006, the MLSP announced that the number of people benefiting from supplements had already reached about 500,000. Before the enlargement, an average of 9.8% of the population of the EU had disabilities. Exactly how many there are in this country, with what disabilities, is their number rising, and other trends. We do not know, because the necessary information system is yet to be developed at the Agency for Persons with Disabilities! Thus, any budgetary calculations regarding integration and assistance funding remain imprecise! However, these realities did not prevent the parliamentary Social Welfare Committee from rejecting the President’s veto. Due entirely to poor organization, however, the restrictions to the IPDA were only two votes short from being passed. In a session that barely lasted 45 minutes, the Committee saved face by making a trivial adjustment to the contested Art. 42: 90% disabled persons with no assistant would receive a double supplement for rehabilitation. This time, our usually sluggish Members of Parliament mustered 132 votes with lightning speed, and the amendments to the IPDA became a reality on 22 November 2006. The MPs were placated. As for the idea of integration, may it rest in peace. REAL CARE, OR JUST A DESPERATE MEASURE? The no-win situation that emerged - MPs realized the impotence of the IPDA and its failure to achieve integration only when the allocated funds had been spent - is a reminder of the need for changes not in the law, but in the LEPC, which administers it. The introduction of percentage restrictions would placate the Ministry of Finance and assuage the Members of Parliament. However, as long as evaluation by the LEPC - which treats people like interchangeable objects and assigns them a percentage of lost working capacity (for that matter, capacity to do just what kind of work?!) according to a uniform chart - is the guiding factor in the evaluation of the needs of citizens with disabilities, there will be no integration. The Ministry of Labor and Social Policy will overrun its budget every year, not just due to corruption and incompetence, but also because of parliamentary lethargy. But... that is truly nothing new.