Transparency data

Monitoring report 1: Financial resources for the delivery of 'personal assistance' social services

Published 3 March 2025

Chișinău, 2021

This report was developed by Keystone Moldova within the project ’Civil Society Organisations Act for Better Social Services’ financed by the European Union and co-financed and implemented by the Soros Foundation Moldova in partnership with I.P. Keystone Moldova and AO Institute Virtutes Civilis.

Introduction

The ‘Personal Assistance’ social services are among the most requested services, and they represent an urgent necessity for most people with severe disabilities.

Personal assistance is a specialised social service intended for people with severe disabilities, including children with severe disabilities, who meet the eligibility conditions established by the Government Decision no. 314/2012 for the approval of the Framework Regulations on the organisation and operation of the  ‘Personal Assistance’ social service and of the minimum quality standards, with subsequent amendments and additions.  

Personal assistance is included in the ‘minimum package of social services’ according to the Government Decision no. 800/2018. In 2020, the number of personal assistant units was increased by allocating additional financial means from the minimum package of social services. Compared to 2019, the number of personal assistant units increased by 2468 units (from 3590 personal units to 6058 units). In the context of supporting people with severe disabilities, amendments were made to the Law of Population Support Fund, regarding its funding sources, by which the increase of the income and expenses of the Population Support Fund by 71,000.0 was approved. That increase enabled the financing of the ‘Personal Assistance’ Social Service for about 2600 additional units of personal assistants.

As a result of the signing of the Memorandum of Understanding between the United Kingdom of Great Britain and Northern Ireland and the Government of the Republic of  Moldova regarding the return of the funds confiscated by the National Crime Agency, signed on 21 September 2021, it was decided to redirect these funds for the development of the ‘Personal Assistance’ Social Service. In this context, the Ministry of Labour and Social Protection of the Republic of Moldova issued Order no. 3 of 11.10.2021 regarding the approval of the fund limits for the additional financing of the ‘Personal Assistance’ Social Service. Following the consultation and involvement of the territorial social assistance structures in determining the needs, the MMPS estimated the additional employment of 566 personal assistants for a period of 4 months (document no. 09/5237 of 04.10.2021). Subsequently, recalculations were carried out and, based on the MMPS order no. 3 of 11.10.2021, 543 units of personal assistants were established.

A.O. Keystone Moldova is responsible for the monitoring and assessing the correctness of the use of financial resources returned to the Government of the Republic of Moldova and the process of providing ‘Personal Assistance’ social services financed by the European Union, implemented and co-financed by the Soros Foundation Moldova in partnership with Keystone Moldova and AO Institute Virtutes Civilis.

1. The methodology for monitoring the financial resources regarding the development of the ‘Personal assistance’ social services

In order to monitor and assess the correctness of the use of financial resources seized and allocated for the creation of ‘Personal Assistance’ social services, A.O. Keystone Moldova developed the concept and plan for the monitoring of financial resources (Appendix no. 1).

The monitoring objectives include:

1) Monitoring and assessing the use of returned funds for the development of ‘Personal Assistance’ social services and the transparency of the allocation of personal assistance units by the territorial social assistance structure

2) Monitoring the process of providing the newly created ‘Personal Assistance’ social services in accordance with the minimum quality standards

3) Monitoring the process of ensuring the sustainability of ‘Personal Assistance’ social services.

The monitoring plan includes three implementation stages for a period of 6 months. To achieve each objective, 2 months were planned for each stage, as follows:

• Stage 1:  November - December 2021
• Stage 2: January – February 2022
• Stage 3: March - April 2022

The first stage corresponds to the achievement of objective no 1. Monitoring and assessment of the use of returned funds for the development of ‘Personal Assistance’ Social Services and the transparency of the allocation of personal assistant units by the territorial social assistance structures (hereinafter – STAS).

In the process of carrying out monitoring visits within STAS, the following actions were carried out:

1) Organise joint meetings with the participation of STAS representatives (head of STAS, head of the ‘Personal Assistance’ social services, other specialists) and of the Keystone Moldova consultant

2) Analyse the register of requests for the ‘Personal Assistance’ Social Services

3) Assess the documentation regarding the employment of personal assistants

4) Analyse the budget and how resources were allocated.

In accordance with the monitoring plan, visits were carried out between November – December 2021 in 35 UAT/36 STASs, with the exception of one UAT (Dondușeni). It was not possible to carry out visits in the Dondușeni district due to the red alert code regarding the infection with COVID-19. The visits were planned depending on the geographical area, in order to cover all UATs in 15 visits (Appendix no. 2). For these reasons it was necessary to plan 3-4 sessions per day in some cases of monitoring visits.

During the reference period, 36 working sessions  (35 sessions in person and  1 session online), which were attended by 143 specialists  (130 women (91%) and 13 men (9%) from the territorial social assistance structures (heads of territorial social assistance structures and/or heads of the ‘Personal Assistance’ Social Services, accountants, human resources specialists.

During the monitoring process, the documentary analysis was carried out, the  AP files were assessed, who is to be employed from the confiscated sources and who the beneficiaries of the AP services will be; the minutes of the multidisciplinary commission regarding the approval of the AP,  the analysis of the report for October 2021 presented by STAS to  ANAS, the analysis of the registration register of AP applicants.

The documentation of the monitoring visits was carried out on the basis of the record sheet of the monitoring visits (Appendix no. 3), which was systematically improved by the consultant and the monitoring progress was reported weekly to the project director within A.O. Keystone Moldova.

2. Assessment and monitoring of the use of returned funds for the development of the ‘Personal Assistance’ social services

During the monitoring process, it was necessary to collect several indicators to identify the strengths and weaknesses regarding the organisation and functioning of the ‘Personal Assistance’ social services. During the monitoring sessions, the following indicators were collected regarding the functioning of the service:

• number of AP units financed from the minimum package of social services (ANAS) and from the local budget
• number of AP employed, including AP service heads
• number of disaggregated AP beneficiaries (children and adults)
• number of requests registered on the date of the visit
• number of AP units distributed by ANAS from seized sources and allocated financial resources

2.1. Analysis of progress indicators regarding the development of ‘Personal assistance’ social services

The most important progress indicator regarding the AP development, collected during the monitoring sessions organised with STASs, was the total number of AP units and the funding sources. AP units are financed from the minimum package of social services or from local budget sources.   Figure 1 shows the number of total AP units for the period 2019 - 2021, which include both financing from the minimum package of social services and from the local budget.

Figure 1. Distribution of AP units in the last 3 years (2019 - 2021)

Year	ANAS	APL
2021	2351.75	3290.75
2020	2468	3590
2019	336	3254

The analysis of this indicator highlights that the number of AP units in 2020 compared to 2019 increased by approximately 41% (2468 units), but it decreased in 2021 by 416 compared to 2020. This fact led to difficulties maintaining the number of employed APs. The decrease in the number of units in 2021 is due to the reduction of funding from the minimum package of social services.

From the total number of AP units (5642,5 for the year 2021, 2351,75 are from the minimum package of social services (ANAS), and 3290,75 from the local budget of UAT. At the same time, we note that the ratio of units financed from the minimum package of social services (ANAS) and those financed from the local budget per UAT is different. In the case of UAT the contribution of APL is higher than 50%, and most AP units are financed from the local budget in Cahul (87%), Chișinău, DGAMS (84%); Soroca (70%); Anenii Noi (68%). The other 15 UATs are provided by the minimum package of social services in the majority of AP units. The highest percentage of coverage of AP units is found in Nisporeni (79%), Glodeni (76%), Ungheni (72%), Cimișlia (67%).

Fig.2 Distribution of AP units financed from the minimum package of social services (ANAS) and from local budgets.

Percentage	ANAS	APL
Units financed	42% (2351.75)	58% (3290.75)

Another collected indicator is the number of employed APs, including AP heads. This indicator offered the possibility to understand if APs are employed depending on the support needs of the beneficiaries.

The following was found in the result of this indicator:

• In 15 STASs, primary emphasis is placed on the needs of the beneficiaries and all APs are employed on one unit or the number of assistants insignificantly exceeds the number of approved units (Chișinău, Bălți, UTA Găgăuzia, Glodeni, Ungheni, Cimișlia, Rezina, Basarabeasca, Cantemir, Criuleni, Ialoveni,);
• The number of personal assistants employed is higher than the number of approved units in 15 STASs, this is explained by the fact that STASs want to cover a larger number of beneficiaries and hire  APs for  0.5 or 0.75 units (Telenești, Anenii Noi, Soroca, Drochia, Hîncești, Căușeni, Orhei, Briceni, Rîșcani,  Strășeni, Florești, Dondușeni);
• The insufficiency/lack of financial resources at the local level or the non-allocation of financial resources by ANAS causes the STASs to employ APs part-time. In 2021 compared to 2020 fewer resources were allocated, which put STASs in a position to reduce the number of hours of AP, being employed on 0.5 or 0.75 units. This caused dissatisfaction both on the part of the beneficiaries and on the part of the APs.
• In 19 STASs the ratio one service head unit to 30 AP units is not observed. The largest number of APs belonging to a head of service unit can be seen in UTA Găgăuzia 3:230; Nisporeni 1:190; Leova 1:90; 2:117; Săngerei:119; Rezina 1:70.
• In two STASs (Strășeni, Nisporeni) there are differences of opinion regarding the name of the position of the head of the AP service (the name ‘Head of AP’ is not recognised).

Out of the total number of 5943 beneficiaries of the AP social service, 1494 are children with severe disabilities, which represents about 25%, and 4449 are adults with severe disabilities (75%).

Figure 3. Distribution of beneficiaries by age (children, adults)

Percentage	Children	Adults
Distribution	25% (1494)	75% (4449)

The analysis of this indicator highlights that the number of adults with disabilities who access the AP service has increased as a result of the establishment of the degree of disability and the recommendations of the National Council for the Determination of Disability and Work Capacity. During the monitoring sessions, representatives of practically all STASs mentioned this.

At the stage of conducting monitoring visits, AP units from confiscated sources were employed in 17 STASs. This was done at different times depending on:

1) the period during which the assessment of the needs of the applicants/persons with severe disabilities was carried out

2) the identification of potential personal assistants

3) the approval of the AP units at district/municipal council meetings

Therefore, in order to keep the care allowance, in the case of  3 STASs (Ialoveni, Șoldănești, Nisporeni) the employment of APs was carried out in several stages depending on the status of the beneficiary (corresponding to the age and the period of establishing the degree of disability from childhood). The employment of APs for children and persons with disabilities from childhood, beneficiaries of care allowance, is carried out on the 1st of the month, and for the other categories it can be carried out throughout the month. We can see in the table below the date of employment of the APs:  

Table 1. UAT that employed APs from seized sources for the period October to December 2021

Number	Name of UAT	Date, month of employment from seized sources	Number of employed units
1.	Anenii Noi	1 October 2021	8
2.	Glodeni	11 October 2021	10
3.	Ialoveni	14 October 2021	10
3.	Ialoveni	1 November 2021	12
4.	Soroca	15 November 2021	16
5.	Taraclia	22 November 2021	8
6.	Cimișlia	1 November 2021	22
7.	Șoldănești	7 November 2021	7
7.	Șoldănești	1 December 2021	5
8.	Fălești	1 December 2021	22
9.	Basarabeasca	1 December 2021	2
10.	Rezina	1 December 2021	17
11.	Florești	1 December 2021	4
12.	Hâncești	1 December 2021	20
13.	Ștefan Vodă	1 December 2021	5
14.	Dondușeni	20 December 2021	6
15.	Briceni	15 December 2021	5
16.	Nisporeni	1 October 2021 – 06 December 2021	29
17.	Edineț	22 December 2021	11

We find from the results of the analysis of the data regarding the hiring of  APs that in the period October – December 2021, 219 APs were hired  (on a full-time basis, according to the MMPS letter of 04.10.21, no. 09/5237) out of the total number of 543 units, which represent about 40%.  From 01 January 2022, 19 STASs are going to hire APs, because the meetings of the district/municipal councils took place in the second half of December and, according to the letter of 27.10.2021 no. 07/2-17d/16 issued by the Ministry of Finance and sent to all the finance departments, ”transferred amounts that will not be assimilated, will be able to be used in the following year”.

STAS observed the order in the register of requests, and in case of refusal of employment for 4 months, the applicants remained on the waiting list.  STAS Soroca decided to hire the assigned units only for a month and a half, being on the safe side in case of lack of resources (as a rule, unused resources are reimbursed at the end of the year).

Another monitoring indicator was the number of requests to access the AP ^{[footnote 1]} social service. The analysis of the record of requests, as well as discussions with STAS representatives, showed that there is an increase in the number of requests. Thus, in four months the total number of requests increased from 3593 to 3825 (by 232 more).

At the same time, we note that:

• In some UATs the number of requests remained the same (Ialoveni, Nisporeni, Stefan Vodă, Basarabeasca, Criuleni).
• In some UATs the number of requests decreased ((Rezina, Bălți, Soroca, Telenești, Dondușeni);
• In some UATs the number of requests increased, the highest number being registered in UTA Găgăuzia – 453; Sîngerei – 200; Ungheni - 200.

2.2. The degree of transparency regarding the allocation of personal assistant units by territorial social assistance structures

Ensuring the degree of transparency regarding the allocation of personal assistant units by territorial social assistance structures was assessed from a double perspective:

1) The level of information of people with disabilities and their families regarding the AP service (in general).

2) The level of information of people with disabilities and their families regarding the procedures for admission to the AP service and ensuring transparency in the decision – making process within the district multidisciplinary committees.

STAS provides information to the population about the AP service through information bulletin boards in town halls, informing beneficiaries about the decisions of the multidisciplinary committee, activities to promote the AP service (meetings with representatives of the Employment Agency, with GPs, students), placing the information regarding the AP service on the FB page, the website of the district, councils or  STAS.

Regarding the AP units distributed from confiscated sources, STAS representatives reported that the beneficiaries were informed about the following aspects:

1) The origin of the financial sources regarding the employment of the new AP units;

2) Hiring the APs for a fixed period of time (for 4 months);

3) Lack of guarantee regarding the continuity of the provision of this service after 4 months.

People with disabilities / their legal representatives were given the opportunity to decide on the acceptance / non-acceptance of the AP service for 4 months.

Most STASs mentioned that they do little promotion of the service because there is a large number of requests for APs, and it is not possible to cover all the needs.

2.3. Initial training of the personal assistants

In accordance with the framework regulations for the functioning of the ‘Personal assistance’ social service and the minimum quality standards ^{[footnote 2]}, the initial training is planned by the service provider based on the unified curriculum approved by the MMPSF, and the initial training is carried out before the employment of the personal assistants.

During the monitoring visits, STAS representatives presented different points of view regarding:

1) The period of initial training (before or after employment);

2) The number of hours allocated for the initial AP training;

3) The topics for the training hours.

In 4 UAT (Florești, Orhei, Ungheni, Chișinău) the initial training is carried out according to the curriculum developed by the service provider, which includes several subjects, and which is carried out by STAS specialists, before the employments of APs. In the case of the other UATs the training is reduced to an employment training on responsibilities, filling in the time sheet, monthly reporting, etc., which last for a maximum of 2 hours. This type of training is mostly carried out by heads of the AP, who, in turn, mentioned that they need to be trained (Șoldănești, Ocnița, Nisporeni, Strășeni, Leova, Rezina, Anenii Noi, Glodeni, Ocnița).

At the same time, the representatives of some STASs believe that the initial training can be carried out even after hiring the APs, because as a rule, the personal assistants are members of the families, who know the beneficiaries (Taraclia, Ștefan Vodă, Căușeni, Fălești).

During the pandemic period, which coincides with the allocation of a larger number of AP units from the minimum package of social services, a low level of AP training was mentioned;

The vast majority of STASs are not aware of the MMPS approved initial and continuous AP training curriculum.

STAS representatives mentioned that they do not have an operational manual of the service, assessment and monitoring tools, which need to be developed by ANAS.

3. Main findings

During the monitoring meetings held with STAS representatives, a series of problems and difficulties were identified in the implementation of the financial resources allocated for the creation of the ‘Personal Assistance’ social services from seized sources, with reference to:

1. Funding the AP Social Service

• Uncertainty regarding the financing of AP units allocated to STAS from the minimum package of social services. It is unclear why some UAT are financed in accordance with approved units while others have a funding deficit. Therefore, the STASs do not trust that in 2022 they will have financial resources allocated to all AP units financed in 2021 from the minimum package of social services;
• The financing of AP units allocated from seized sources does not include the annual award and it creates a discrepancy with the other functional AP units;
• ANAS did not provide financial resources (from seized resources) for the AP Service head units.

2. Legal issues

• According to the Work Code, employment for 4 months represents a violation of the AP employee (this period is only valid for seasonal employees);
• The violation of the right of people with disabilities to social services according to needs is confirmed, and, in the case of lawsuits, there is the probability of losing the lawsuits from STAS.

3. AP training

• Lack of internal procedures and methodological support, work tools for the AP service;
• Lack / insufficiency of qualified personnel to carry out AP training;
• The vast majority of STASs do not allocate resources for staff training;
• The difficulty of participating in training (most APs are family members and have no one to leave the beneficiaries they care for with for a long time).

At the same time, we note that:

• All UATs welcomed the contribution to the development of the AP Social Service from seized sources, but consider that the number of units is necessary to be established for a period of 1 year, with the possibility of funding in the following year;
• The procedure for approval of new units by district/municipal councils made the period of employment of personal assistants from seized sources different. APs were hired in 17 STASs in 2021, and in the other 19 STASs, the hiring will take place from 1 January 2022;
• Ensuring transparency in the case of employment of APs from seized sources is carried out in different ways: by informing people with disabilities and their families through STAS specialists and district and municipal councils.
• The initial training is not planned by the service provider based on the unified curriculum approved by the MMPS;
• Heads of the AP service require initial training at the time of employment, because most of the time they are responsible for the AP training organised at STAS level;
• Initial training of personal assistants needs essential improvement;
• The employment of APs for 4 months (1.5 months - Soroca) by STAS, without having clarity regarding the continuation of the employment contract represents a violation of the rights of both employees and beneficiaries;
• The employment of personal assistants on a part-time basis constitutes a violation of the right of the beneficiary and the employee.

4. Recommendations

As a result of the monitoring visits and the documented analysis regarding the employment of AP from seized sources, it is recommended:

1. The participation of STAS representatives in the meetings organised by ANAS and the discussion of the question regarding the continuation of the financing after 4 months of the AP units from the minimum package of social services, but also of the financing of the AP service head units, resulting from the 1:30 ratio;

2. The organising of joint meetings between the representatives of STAS and the Council for Determination of Disability and Work Capacity regarding the access by people with severe disabilities of the ‘Personal Assistance’ Service, with an emphasis on the correctness of assigning the Personal Assistance’ recommendation and the difficulties that arise in the process of assessment of the beneficiary’s needs carried out by the service provider;

3. Improving the distribution mechanism and financing of AP units from the minimum package of social services for the development of the AP service in strict correlation with the existing needs in each UAT;

4. Information regarding the right of persons with disabilities to qualify for social services in accordance with the UN Convention for the Rights of Persons with Disabilities, the Work Code and exclusively for the ‘Personal Assistance’ social service and the appeal procedures in case of non-compliance with this right;

5. Development by ANAS of the Operational Manual that includes assessment and monitoring tools, etc;

6. Dissemination at national level of the curriculum and course support for the initial and continuous training of APs.

Abbreviations

ANAS – National Social Assistance Agency

ASC – Community Social Assistance

AP – Personal Assistance

APL – Local Public Administration

CMC – Chișinău Municipal Council

CR – District Council

MMPS – Ministry of Work and Social Protection

STAS – Territorial Structure of Social Assistance

UAT – Administrative - Territorial Unit

Footnotes

1. The number of AP Service requests was examined, starting with July 2021 (at the time of distribution of AP units from seized sources) and ending with the November – December period (when monitoring visits were carried out). ↩

2. Government Decision no.314/2012 for the approval of the framework regulations on the organisation and operation of the ‘Personal Assistance’ social service and the minimum quality standards ↩