Ukraine is preparing fundamental changes to the system of determining disability. Instead of focusing on a medical diagnosis, it will assess how a person copes with everyday tasks. This approach, known as the assessment of daily functioning, aims to create a fairer and more inclusive social protection system adapted to the real needs of people with disabilities.
What the draft law is about
The draft law submitted to the Ministry of Health proposes changes to many laws of Ukraine. The main idea is to move from a medical model of disability to a social model. This means that instead of focusing on diseases and their consequences, attention will be paid to how a person functions in their environment and what needs to arise in this regard.
Key provisions of the draft law:
- Assessment of daily functioning: It is established as a separate type of medical assessment conducted by a multidisciplinary team of specialists.
- Expert commissions: Special commissions for the assessment of the person’s daily functioning (EKOPFO) are being established. The commissions will include not only doctors of various specialties, but also social workers, psychologists, occupational therapists and other specialists who can assess a person’s needs from different angles.
- Individual approach: Assessments will take into account the individual needs and circumstances of each person, not just a medical diagnosis.
- Comprehensive assessment: Different aspects of life will be taken into account, such as self-care, communication, learning, work, social activities, etc.
- Individual rehabilitation programme: Based on the results of the assessment, an individual rehabilitation programme will be developed to support and develop the person’s abilities, taking into account their needs and capabilities.
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What exactly will change with the adoption of the draft law on assessment of daily functioning
The procedure for determining disability will undergo significant changes. Instead of referring a person to the MSEC, the Medical Advisory Commission (MAC) will refer him or her to the Expert Commission for the Evaluation of the Person’s Daily Functioning (ECOPFO). The assessment will be carried out by a team of specialists, which will include not only doctors, but also social workers, psychologists and other specialists who are able to comprehensively assess a person’s needs. Standardised tools and techniques will be used to ensure objectivity and a unified approach. The ECOPFO will assess a person’s ability to self-care, move, communicate, learn, work and socially engage. Instead of a disability group, the degree of loss of functional capacity will be determined on a 100-point scale, which allows for a more accurate determination of a person’s needs. Based on the results of the assessment, ECOPFO will develop an individual rehabilitation programme aimed at restoring and compensating for lost functions, as well as at social adaptation and integration.
The changes will also affect the social protection and support system. The state will ensure the provision of social services to persons with disabilities in accordance with their individual needs, provide assistance in employment, professional orientation, and retraining, and promote the creation of a barrier-free environment. It will also ensure the accessibility of infrastructure. At the same time, persons with disabilities will retain the right to all benefits and guarantees provided by law.
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How it will affect people’s lives
The new system will allow for a more accurate identification of the individual needs of people with disabilities, which will contribute to more effective rehabilitation and better social adaptation. Individual rehabilitation programmes will be more effective as they will be tailored to the needs of each person. Overall, the draft law aims to ensure equal opportunities for all Ukrainian citizens, regardless of their health status.
Possible difficulties in implementing the new system
Possible difficulties include resistance from MSEC staff, who may lose their jobs or influence. There is also a lack of qualified staff to carry out day-to-day assessments. Implementation of the new system will require significant financial expenditures for training, creation of the ECOPFO, and development of assessment tools. It is also important to conduct a broad information campaign to explain the essence of the new system and its benefits to the public.
The move to assessing activities of daily living is an significant step towards creating a more equitable and effective social protection system for people with disabilities in Ukraine. However, significant efforts and challenges are needed to successfully implement the new system.
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