Transparency data

Monitoring report 3: Ensuring the sustainability of 'personal assistance' social services

Published 3 March 2025

Chișinău, 2022

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.

1. Methodology for monitoring the process of ensuring the sustainability of ‘Personal Assistance’ social services

The monitoring of the process of ensuring the sustainability of the ‘Personal Assistance’ social services (3rd stage) was carried out between 6 April 2022 and 5 May 2022.  In order to carry out this task, 36 monitoring visits were carried out in all 36 STASs / 35 UATs.

The process of organising the monitoring visits took place under the conditions of relaxation of the restrictions regarding the COVID-19 pandemic. As in the first stages of the monitoring, the geographical area was taken into account, and the planning of visits in each STAS took place by means of electronic mail. Thus, for a better organisation of the process, the monitoring sheet was sent by email, since its completion required more time than the hour reserved for discussion. The participants in the discussions were mostly the heads of the AP services, and in some districts these discussions took place in a wider circle, including heads of STAS, accountants, human resources specialists.  

During the monitoring process of the ‘Personal Assistance’ social services, the following methods and techniques were applied:

a) Planning weekly visits depending on the geographical area and sending the form by email to each STAS (Appendix 1)

b) Discussions with STAS specialists (STAS and/or heads of the ‘Personal Assistance’ social service). A total of 36 meetings were held, attended by 98 people

c) Completing the record sheet of the monitoring visits, which included the basic information regarding the most important findings and recommendations regarding the provision of service by the AP (Appendix 2)

d) Completion of the monitoring sheet for 36 STASs regarding the AP situation for the year 2022 (Appendix 3)

e) Taking photo sessions to document the visits

2. Analysis of indicators regarding the development of ‘Personal Assistance’ social services in 2022

The most important progress indicator analysed during the monitoring visits was the total number of personal assistants employed from the financial sources of ANAS, of APL and from seized sources. The collected indicators reflect the situation at the time of the visits. If we refer to the total number of AP services in 2022 compared to 2021, then the number of AP units has increased from 5586 in 2021 to 6305.25 in 2022. Thus, we find that the number of AP units increased by 719.25 AP units in 2022. 

If we analyse this indicator for each STAS, we notice that the increase in the number of APs is due to the new AP units approved by the Chișinău Municipal Council, which approved 340 units at the beginning of the year. This contributed to the fact that there is no waiting list in Chișinău today.

For other STASs the increase in the number of AP units is insignificant or it even decreased. For example, in  Călărași it decreased by 16 units, in Cimișlia - by 6.5, in Hîncești – by 19 AP units, Ocnița - by 6.5, Taraclia - by 3 AP units. The number of AP units continues to decrease as the 4 months of employment from seized sources comes to an end.

Another important monitored indicator is the number of APs employed. This indicator increased by 483, from 5907 in 2021 to 6390 in 2022. During the monitoring visits it was found that the practice of hiring APs for less than one AP unit for beneficiaries requiring a high level of support continues. Thus, in the Telenești district, in order to cover a larger number of beneficiaries, all APs are employed for 0.75 units. This practice is also found in other STASs, such as Leova, Călărași, Dondușeni, Fălești, Glodeni, Orhei, Ocnița, Soroca, Ungheni. We would also like to highlight the increase in the number of AP service units in 2022 by 15 units compared to 2021. However, the lack of transport in order to organise visits by the service provider means that the monitoring of the AP services is not carried out according to the approved framework of regulations.  

Figure 1. Number of AP units and staff in 2021-2022

Year	Number of AP staff	Number of AP units
2022	6390	6305.25
2021	5907	5586

Another indicator which was monitored, refers to the total number of APs, depending on gender. The number of women employed as APs continues to prevail: 80% women compared to 20% men.

Of the total number of APs employed in 2022 (6390), approximately 88% are people from within the family and 12% are people from outside the family. These people are hardly identified by family members or by STAS, and during the annual leave it is difficult to replace the AP with other employed people.

The monitoring of the AP services highlighted the large number of elderly people (63+) employed as APs (1267), which represents 20% of the total number of APs. They are usually the parents of the disabled people who have no other alternative, and who, in order to increase their family’s income, work as APs.

In 2022, the number of adults with disabilities was higher than the number of children, that is 4815 adults compared to 1608 children, an increase of 103 children compared to 2021. Thus, the number of adult beneficiaries (over 18 years old) represents 67% of the total number of beneficiaries. When hiring Aps in all the STASs, priority is given to children to ensure their rehabilitation and social inclusion, and the number of adults is kept at the same level in 2022.

 During the monitoring, the emphasis was placed on updating the number of applicants for the AP service, which in May 2022 was of 2495 requests compared to 3825 requests in November 2021. The number of requests is constantly changing in different STASs. If in Chișinău the situation has been reached when the hiring of the AP takes place at the time of application, in other districts the hiring of the AP takes place after different periods depending on the number of requests compared to the number of available units. In case of termination of the employment contract after 4 months of AP, the service provider assured the beneficiaries of keeping their place on the waiting list in the request register.

Figure 2. Number of requests in 2021-2022

Year	Number of requests
2022	3436
2021	3825

In conclusion, taking into account the difficult situation that has been created in the country, the increase in the number of AP requests, there is a risk that the number of AP services will decrease, if they are not financed from the state budget. The representatives of the STASs recommend the financing of the AP services in proportion of 50% by ANAS and respectively 50% by APL of the second level. This proposal comes mostly from the STASs, which have funded AP units in a higher proportion from the APL than from the minimum package of social services.

3. Ensuring the sustainability of ‘Personal Assistance’ social services developed from seized sources

Based on the MMPS order no.3 of 11.10.2021, it was established that 543 AP units from seized sources should be hired for 4 months by STAS, according to the list of requests. Thus, the hiring of the APs lasted from October 2021 to April 2022. Out of 36 STASs, APs were hired in 34 STASs, in accordance with the distribution of AP units made by the MMPS, with the exception of 2 UAT (Dubăsari and UTAG). In Dubăsari the hiring of 6 APs did not take place and in UTA Găgăuzia 17 AP units were hired from the seized sources for one year, instead of 50 AP units allocated for 4 months. Another exception is the employment by STAS Telenești of AP for 0.75 workload (all APs in Telenești are employed in this way). It should also be mentioned that STAS Călărași hired APs for 4.5 months from seized sources.

The sustainability of AP services needs to be ensured from the minimum package of social services, which did not happen after 4 months of hiring the AP. Therefore, during the monitoring visits the situation in each STAS was different in terms of ensuring sustainability of AP services. The monitoring of the 36 STASs highlighted the following situations in relation to the employment period of the APs and ensuring the sustainability of these services:

• 7 STASs hired APs for 1 year (Anenii Noi, Ialoveni, UTA Găgăuzia, DGAMS Chișinău, DGPDC Chișinău, Briceni, Ungheni). In the case of UTA Găgăuzia, 17 AP units were hired for one year, instead of 50 planned by ANAS.
• 7 STASs that ensured sustainability after 4 months until December 2022 from local financial sources until the time of the visit (Basarabeasca, Dondușeni, Leova, Nisporeni, Stefan Vodă, Strășeni, Taraclia).
• 9 STASs that ensured sustainability from the financial sources distributed by ANAS as a result of the rectification of the state budget  (Rezina, Criuleni, Rîșcani, Telenești, Sîngerei, Călărași, Ocnița) without interrupting the employment contract of the AP or will continue after the completion of 4 months of employment (Bălți și Cantemir).
• In the case of 12 STASs, APs were fired after 4 months of employment (Soroca, Drochia, Hîncești, Glodeni, Căușeni, Cimișlia, Fălești, Florești, Soldănești, Cahul, Edineț, Orhei). In some of these districts, continuity was ensured for only a few units (Soroca - 3 units, Drochia – 1 unit, Cimișlia - 3 units). Currently, the AP rehiring process is taking place in all these districts, after the completion of the procedure for approving the changes in the budget.

Thus, the total number of units for which sustainability was ensured represents 322 units (situation on 20 June 2022) out of 543 approved by ANAS.

The financial sources for ensuring the sustainability of AP units were identified by STAS from their own sources (Ștefan Vodă, Leova, Basarabeasca, Briceni, Taraclia), and for other 12 STASs from financial sources additionally approved from the budgets of the district or municipal councils (UAT Chișinău, UTA Găgăuzia, Ialoveni, Briceni, Ungheni, Anenii Noi, Strășeni, Ungheni, Orhei, Nisporeni).

The STASs Criuleni, Rezina, Călărași, Ocnița, Telenești, Sîngerei, Rîșcani managed to use the financial sources allocated from the state budget distributed as a result of the budget rectification for the year 2022. Thus, 23 STASs ensured the sustainability of AP social services laying off APs after 4 months.   

 In the case of 12 STASs, the personal assistants were fired, and they are going to be hired again later (after the budget correlation procedure has been carried out at the district meetings).

 2 STAS s have not yet completed the 4-month period: for Bălți the contract for 7 units finishes on 30 June 2022, and in the case of Cantemir district on 30 July 2022. No APs were hired from seized sources in Dubăsari district.

Figure 3. Ensuring AP sustainability from seized sources

APs	Distributed APs	Ensured sustainability
Total	534	322

4. Main findings and recommendations

As a result of the monitoring visits, it was noted that:

• The ‘Personal Assistance’ service remains a necessary and highly requested service for people with disabilities throughout the country
• The number of applicants for AP services continues to remain quite high compared to the possibility of approving new units (only the Chișinău municipal council approved AP units, which cover the needs of AP beneficiaries
• In 2022, the number of AP units increased due to additional financial resources distributed from seized sources, but also the number of AP units additionally approved by some UAT (Chișinău municipal council)
• 23 STASs ensured the sustainability of the AP services without interruption for a period of at least one year
• Out of 543 AP units distributed to 36 STASs from seized sources, sustainability was ensured in 322 AP units
• In the case of 12 STASs, the dismissal of the AP took place after the 4-month period due to the lack of financial resources at the local level, and after the allocation of additional sources from the state budget, the AP were rehired
• The operation of AP services is based on the employment of family members, and a small number of APs are from outside the family (12%), and they are identified with difficulty by STASs
• During the period of the AP’s annual leave, the beneficiary is not offered another service, or another AP employed by the service provider in accordance with the framework of regulations. Thus, the de facto personal assistant continues to provide services to the beneficiary during the leave period
• AP services are financed from two funding sources (APL sources and from the minimum package of social services). Under these conditions, the service provider produces 2 types of reports, two databases, APs are employed for different periods (determined and undetermined), which create difficulties and ambiguities in the provision of the services

The analysis of the situation in the field, as well as the discussions with the STAS representatives, highlighted the following measures regarding the development of the ‘ Personal Assistant’ services:

1) The financing of AP services should be carried out from two sources (local budget and state budget) on a 50/50 equity basis for each STAS

2) The AP service provider must treat all APs in a non-discriminatory manner, in accordance with the Work Code, regardless of where the financial sources come

3) The financial sources for the AP service should be planned from the state budget

4) The AP units financed from the minimum package of social services should also include the position of the head of the AP service, respecting the normative framework in force (ratio 1:30)

5) During the AP’s annual leave, in the absence of a substitute or other social service, the provision of the service will be suspended, and the beneficiary will be able to access the care allowance

6) The employment of personal assistants must take place in accordance with the needs of the beneficiary, according to the Work Code

On 7 June 2022 ANAS organised a ZOOM meeting with STAS representatives (head, accountant), the heads of the financial departments for the district councils, where the following topics were discussed:

a) The employment of APs on a full-time basis (in districts where they are employed for less than one unit)

b) Clearing the withholding of the AP’s salary (during this period arrears on APs’ salary have accumulated)

c) rehiring AP units in the districts where AP layoffs were made. From discussions with the representatives of 12 STASs, it was found that the hiring is currently underway, and for the beneficiaries of the care allowance, the hiring will be done from 1 July.

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

DGPDC: General Directorate for Protection of Children’s Rights

DGAMS: General Directorate of Medical and Social Assistance