Individual budget model for community based social services for children with disabilities in Latvia: analysis of results of pilot project

To estimate effectiveness of IBM pilot project in addressing social, health care and educational needs of children with disabilities and their parents. The IBM pilot project was implemented in 10 municipalities of Latvia. A total of 102 children with disabilities and their parents participated in the pilot project during 12 months period. Individual needs of every child were identified by multidisciplinary team (need assessment was carried out by social, educational and health care professionals) in close cooperation with child and family. The protocol for evaluation of functioning of children was based on International Classification of Functioning, Disability and Health (ICF). The international tool KIDSCREEN was used to assess QOL. The assessment procedure took place prior to entering to pilot project and after its completion. Effectiveness was estimated for use of resources, achieved outputs and outcomes. The pilot project was financed by European Social Fund and state budget. Altogether 536 specific, measurable goals were included in individual support plans for 102 children. A total number of 402 (75%) goals were achieved. Results showed positive dynamics in functioning of 47 (46%) participants with disabilities. Decrease of activity limitations in 9 domains according ICF were obtained. Children reported higher QOL measures in 8 out of 10 dimensions of KIDSCREEN, with especially positive changes in dimensions School Environment, Peers & Social support. The results of the pilot project demonstrated IBM as effective tool for providing individual support to receive community based services ensuring positive change in indices of child's functioning and QOL.