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The main actors responsible for health are both the federal state of Belgium as well as the German-speaking Community of Belgium as top-level authorities. When talking about the German-speaking Community, the mostly involved entity is the Department of Health and Seniors of the Ministry of the German-speaking Community. The German-speaking Community has a Minister for Health as member of the Government of the German-speaking Community. In the federal Government, there is also a Minister for Health. The Parliament of the German-speaking Community has a Committee for Health.
Other relevant actors include the Department for Self-determined Living (Dienststelle für Selbstbestimmtes Leben, DSL), the Center for the healthy Development of Children and Young People Kaleido (Kaleido Ostbelgien), the Center for Remedial Training (Zentrum für Förderpädagogik, ZFP), the Advisory Board for Health Promotion (Beirat für Gesundheitsförderung) and the Public Social Welfare Centers (Öffentliches Sozialhilfezentrum, ÖSHZ), of which there is one in every municipality in Belgium.
Department for Self-determined Living
The legal basis for the creation of the Department for Self-determined Living is the Decree of 13 December 2016 on the Creation of a Department of the German-speaking Community for Self-determined Living (Dekret vom 13. Dezember 2016 zur Schaffung einer Dienststelle der Deutschsprachigen Gemeinschaft für selbstbestimmtes Leben). Article 3.3 a) and b) of aforementioned Decree define a part of the target group of the Department:
Beneficiaries: the following natural persons: (a) Children and adolescents: Persons between the ages of 0 and 21 who, because of long-term or permanent physical, mental, or intellectual impairment or sensory impairment and interacting with various barriers, may be prevented from participating fully, effectively, and equally in society. (b) Adults: persons between the ages of 21 and the legal retirement age who, because of long-term or permanent physical, mental, or sensory impairments, and who, in interactions with various barriers, may be prevented from participating fully, effectively, and equally in the society due to long-term or permanent physical, mental or sensory impairments;
Consequently, children and young people are within the target group of the Department.
The general tasks of the Department are defined in Article 6.1,2 and 3:
1. informing the general public about the existing support measures and services in the offers in the Department's area of responsibility by means of awareness-raising, public relations work and dissemination of documentation; 2. on its own initiative or at the request of the Parliament or the Government, monitoring developments in the area of relations in the Department's area of responsibility; 3. on its own initiative or at the request of the Parliament or the Government, the preparation of proposals or recommendations for the adjustment of the service with the corresponding framework conditions. The Department may also, at the request of other authorities, prepare proposals or recommendations for the adjustment of the supply with the corresponding framework conditions
This means, the Department may be involved in policy-making if the government or the parliament consider it useful.
As specified in Article 77, the Department for Self-determined Living is the legal successor of the Department for People with Disabilies (Dienststelle für Personen mit einer Behinderung), which itself had been created by the Decree of 19 June 1990 on the Creation of the Department in the German-speaking Community for People with Disabilities (Dekret vom 19. Juni 1990 zur Schaffung einer Dienststelle der Deutschsprachigen Gemeinschaft für Personen mit einer Behinderung).
Kaleido is the Center for the healthy Development of Children and Young People. It has been created by the Special Decree of 20 January 2014 on the Creation of a Center for the healthy Development of Children and Young People (Sonderdekret vom 20. Januar 2014 zur Gründung eines Zentrums für die gesunde Entwicklung von Kindern und Jugendlichen). The tasks of Kaleido are defined in Article 3.1 (general objective) and Article 3.2 (mission of the Center) of the Decree of 31 March 2014 on the Center for the healthy Development of Children and Young People (Dekret vom 31. März 2014 über das Zentrum für die gesunde Entwicklung von Kindern und Jugendlichen):
Art. 3.1 - General objective
According to Article 3 of the Special Decree, the general objectives of the Center are as follows: 1. to promote optimal physical and mental health of children and adolescents, including pregnancy counseling, 2. to support the optimal development of the educational potential and inclusion in general and vocational education of children and adolescents, 3. promoting a safe environment for children and adolescents to protect them from accidents and intentional harm, 4. promoting economic security and a decent standard of living for children and youth as a basis for healthy development, 5. promoting children and youth as part of a developmentally supportive network of family, friends, neighbors, and community, 6. promoting the inclusion of children and youth in the community, 7. fostering children and youth's ability to make a positive contribution to society.
Art. 3.2 - mission of the Center
Without prejudice to Article 3.1, the mission of the Center is to promote the healthy physical, psychological and social development of children and adolescents at an early stage. The term "early" is understood in the sense of prevention and includes measures that: 1. start at an early point in the child's development, whereby measures before the child's birth already belong to the spectrum of the field of action, 2. start at an early stage of a possible maldevelopment. Preventive work focuses on promoting the well-being of children and adolescents by supporting individual competencies and resources and by creating environmental and living conditions conducive to development in their primary living spaces. The center is a preventive and not a therapeutic institution. It takes care of planning, coordination, implementation and evaluation of preventive universal, selective and indicated measures, whereby: 1. in each case, protective factors and risk factors of healthy development are included in the analysis of each issue, 2. the support is focused on empowerment and the development of competencies of the child or adolescent as well as the strengthening of resources in the influencing circumstances, 3. risk factors and/or harmful influences are reduced, compensated or eliminated. A main focus is on the continuity of prevention offers during the life span from about minus nine months to about 20 years, so that there is no inefficient interruption of support opportunities in important transitional phases such as pregnancy, infancy, infancy-kindergarten, kindergarten-primary school, primary school-secondary school, special school-regular school, school-education, education-professional life. In order to fulfill its mission, the center works closely with all partners involved in the healthy development of children and adolescents. and adolescents. It promotes exchanges with Belgian and foreign institutions that have the same or similar institutions that have the same or a similar mission.
Center for Remedial Training
The Center for Remedial Training has been created by the Decree of 11 May 2009 on the Center for Remedial Training, for the improvement of special education in regular and special schools and for the support of the promotion of pupils with impairments, adaptive or learning difficulties in mainstream and special schools (Dekret vom 11. Mai 2009 über das Zentrum für Förderpädagogik, zur Verbesserung der sonderpädagogischen Förderung in den Regel- und Förderschulen sowie zur Unterstützung der Förderung von Schülern mit Beeinträchtigung, Anpassungs- oder Lernschwierigkeiten in den Regel- und Förderschulen). In Article 6, this Decree also defines the tasks of the Center for Remedial Training:
The Center for Remedial Training, together with the special schools of the educational system organized and subsidized by the German-speaking Community, is responsible for ensuring basic special needs education in the German-speaking Community. In particular, it performs the following tasks: 1. providing special education instruction at the remedial elementary and remedial secondary school levels; 2. coordination of special education support measures in the integration projects; 3. assistance and advice in the preparation of individual support plans; 4. provision of specialized personnel for special educational support in mainstream schools; 5. advice and support for mainstream schools and centers for training and further education in SMEs and small and medium-sized enterprises in matters relating to special needs education; 6. assistance in methodological-didactic, pedagogical and psychological competence development of regular schools and centers for education and training in SMEs and small and medium-sized enterprises at the level of special education support; 7. assistance in professional integration of pupils and ensuring integrative internships in companies; 8. teaching for sick children; 9. care for pupils who, due to special difficulties, have to leave normal school activities for a certain period of time and require socio-educational care with the aim of reintegrating them into everyday school life as quickly as possible; 10. organization and implementation of measures to enhance the special educational competencies of the teaching staff; 11. consulting and monitoring in the field of intercultural pedagogy and language support; 12. cooperation in the development of concepts in the field of special education and in the control of their implementation.
In order to fulfill these tasks, the Center for Remedial Training cooperates with all partners active in the field of special needs education and in particular with the Department of the German-speaking Community for Self-determined Living.
Advisory Board for Health Promotion
The legal basis of the Advisory Board for Health Promotion is the Decree of 01 June 2004 on Health Promotion and medical Prevention (Dekret vom 01. Juni 2004 zur Gesundheitsförderung und zur medizinischen Prävention). The tasks of the Adviory Board are defined in Article 7 of the Decree:
§1 The Advisory Council shall advise the Government on health promotion issues on its own initiative or at its request. In addition, the Advisory Council may, on its own initiative or at the request of the Government, prepare proposals for the implementation of the concept of health promotion referred to in Article 2, as well as perform a liaison function between the actors in health promotion. The Government shall submit to the Advisory Council for its opinion all preliminary drafts of decrees and regulatory decrees in the field of health promotion, as well as the preliminary drafts for the adoption of the concept and priorities mentioned in Article 2. §2 The Parliament of the German-speaking Community may, through its President, request an opinion from the Advisory Council. The Advisory Board shall send this opinion to the applicant within a period determined by the Parliament. If the Advisory Council delivers an opinion on a preliminary draft decree, the Government shall deposit it in Parliament together with the draft decree.
Public Social Welfare Center
The legal basis of the Public Social Welfare Centers is the fundamental law of 08 July 1976 on the Public Social Welfare Centers (Grundlagengesetz vom 088. Juli 1976 über die öffentlichen Sozialhilfezentren). Article 57 defines the general mission of the Public Social Welfare Center:
§ 1 - Without prejudice to the provisions of Article 57ter, the public social assistance center has the mission of providing individuals and families with the assistance that the general public owes them. It shall provide not only emergency or curative assistance, but also preventive assistance. It promotes the participation of the users in the social life. This assistance may be material, social, medical, socio-medical or psychological.
General distribution of responsibilities
Health is one of the so-called "personal" matters which have been transferred under the state reforms from the federal state to the Community. Thus the German-speaking Community is responsible in its area for health policy, with the exception of some areas which still fall in the area of responsibility of the federal state (matters such as hospital legislation, the State Office for the Disabled and Health Insurance LIKIV, vaccination regulations etc. continue to be governed uniformly for all at national level).
The German-speaking Community is responsible for:
- care policy within and outside care institutions (hospitals, retirement homes)
- health education and health promotion and
- preventive medicine (preventive actions)
In the health area, alongside the specialist medical and paramedical staff, numerous organisations and services work that have specific tasks and are subsidised to do this by the German-speaking Community. Here the Ministry of the German-speaking Community is responsible for guiding, subsidising and inspecting these health services.
With regard to notifiable infectious diseases, the Ministry of the German-speaking Community takes on the tasks that are comparable with those of the public health authorities in Germany: monitoring notifiable infectious diseases and ordering medical measures that may be necessary, for example in the case of meningitis, tuberculosis etc.
Furthermore, the Ministry plans and executes its own campaigns in terms of national health. The German-speaking Community also subsidises building and equipping measures in the two hospitals in the German-speaking area as well as the emergency doctor service in Eupen and St. Vith.
There are a few examples of cross-sectorial cooperation in the German-speaking Community. For example, the Youth psychiatry of the hospital in St. Vith cooperates with an outreach team of social workers to reach out to young people. Another example would be Kaleido, the Center for Healthy Development of Children and Young People, that offers preventive health care in schools, in cooperation with youth information centres and outreach youth workers. Youth work in general aims to offer health-prevention and to promote health and well-being of young people.