Special welfare services can be used by an adult who has a mental disorder and cannot be helped by other social welfare support measures.

Special welfare services can be used from age 18, but a person can be placed on the waiting list for the service from age 16. This means that if your child may need a special welfare service, you can start applying for the service as soon as they turn 16.

In Estonia there are three types of special welfare services, divided into 11 different services. Special welfare services can be used while living at your own home, or in a home-like group setting in accommodation offered by the service provider. The need for a service depends on what kind of help, and how much, your child needs. It also matters whether the need for help relates only to activities, or also to self-care and ensuring supervision. Living in accommodation provided by the service provider, the child can still visit home and spend time with family, close ones and friends, just like any other adult who has moved out of their childhood home and started their own life. 

Support services – services aimed at people who live in their own homes (in some cases also in accommodation organised by the service provider), with the goal of helping the person cope with everyday life (including studying and working). The person is supported and guided, according to their needs, with household tasks, managing finances, looking for and doing work, finding leisure activities, etc., so that they can take part in society on an equal footing. 

Support services are divided into:

• Daily Living Support Service (IET) – for an adult living at home with a mental disorder who needs support and help with everyday activities.
• Daily Living Support Service for People with Autism Spectrum Disorder (IETaut) - for an adult living at home with a diagnosis of autism spectrum disorder, who exhibits persistent, intensive, extreme, harmful behaviour and therefore needs constant supervision, and who needs help with self-care and cannot manage everyday activities on their own.
• Supported Employment Service (TT) – for an adult with a mental disorder and no work ability, who needs ongoing support and guidance to find work and/or while working.
• Supported Living Service (TE) – for an adult with a mental disorder who is able to take care of themselves and manage everyday activities with guidance, but who needs support while living independently.

Transitional services – services aimed at people who do not yet need round-the-clock special welfare service, but who can use a service on the service provider's premises with overnight accommodation. The aim of these services is to provide guidance, help, support and supervision, and to postpone the move to round-the-clock services. For one of the transitional services, the aim is also to reduce the caregiving burden on close family members.

Transitional services are divided into:

• Community Living Service (KE) – for an adult with a mental disorder who can manage self-care and take part in household chores, but who needs guidance with everyday activities during the day, and support with meals and housing.

• Day and Weekly Care Service (PNH) – for people with moderate, severe, profound or other specified or unspecified intellectual disability, who need a substantial amount of care or supervision, but who can live at home with their close family, using the special welfare service according to their own and their family's needs.

   

Round-the-clock services - services aimed at people who need constant assistance and supervision to cope with everyday life, and who therefore live in accommodation provided by the service provider. The aim of these services is to ensure a safe living environment, and to develop and maintain the person's independent coping ability. These services provide guidance and assistance with care tasks, communication, planning time, spending free time, finding learning opportunities, developing work skills and practising work tasks, building health awareness, etc.).

Round-the-clock services are divided into:

• Round-the-Clock Special Welfare Service (ÖE) – for an adult with a mental disorder for whom an assessment carried out by the Social Insurance Board has established a need for a round-the-clock special welfare service, who needs help with self-care and cannot manage everyday activities on their own, and for whom help cannot be provided through other social services, and who is not using other special welfare services.
• Round-the-Clock Special Welfare Service for People with Autism Spectrum Disorder (ÖEaut) – for an adult with a diagnosis of autism spectrum disorder who exhibits persistent, intensive, extreme, harmful behaviour and therefore needs constant supervision, help with self-care, and cannot manage everyday activities on their own, and for whom help cannot be provided through other social services, and who is not using other special welfare services.
• Round-the-Clock Special Welfare Service for People with an Extreme Need for Assistance and Support (ÖT) – for an adult with a mental disorder for whom an assessment carried out by the Social Insurance Board has established an extreme (round-the-clock) need for assistance and support, who needs help with self-care and cannot manage everyday activities on their own, and for whom help cannot be provided through other social services, and who is not using other special welfare services.
• Round-the-Clock Special Welfare Service for People in Unstable Remission (ÖR) – for a person with a severe, profound or persistent mental disorder in unstable remission, who needs help with self-care and cannot manage everyday activities on their own, and for whom help cannot be provided through other social services, and who is not using other special welfare services.
• Round-the-Clock Special Welfare Service Ordered by the Court (ÖK) - for an adult with a mental disorder who, due to their state of health, is persistently unable to understand or control their own behaviour, and who poses a danger to themselves and/or others if not placed in a care institution to receive round-the-clock special welfare service, and where the use of previous services has not proved sufficient, or no other services can be used. The decision on the need for the service is made by a court, meaning the person's placement in the service is involuntary (without their consent).

To apply for a special welfare service, submit an application for special welfare services to the Social Insurance Board. There are five ways to submit the application – choose whichever is most convenient for you:

• fill in the application at a Social Insurance Board customer service point
• fill in the application in the state portal eesti.ee
• send the application by post to Paldiski mnt 80, 15092 Tallinn
• send a digitally signed application to the email address [email protected]
• submit the application via the self-service portal under "Communication and notifications"
  
  The Social Insurance Board processes applications for special welfare services within 40 working days of receiving a complete application and other documents. The senior specialist (needs assessor) checks entitlement to the service based on health data, and contacts you to carry out an assessment of your child's need for help and support (from age 16). The assessment determines whether your child needs a special welfare service, or whether other services are needed instead (e.g. social rehabilitation, local government services), using the needs assessment tool for adults' need for help and support. The assessment does not determine capacity for activity or participation, but assesses coping in seven areas of life: social relationships, physical health, mental health, work/study, leisure time, everyday activities, and living environment.

There may not always be a vacancy with the desired service provider or sufficient resources in the state budget to refer a person to a service. In this case, the Social Insurance Board will add the person to the queue and issue a queue notification.

You can ask the senior specialist for information about movement on the waiting list and receiving the service (special welfare service waiting list). Contact details can be found here. 
 

You can ask your regional service consultant for information on the queue and accessing services. If a queue notification has been issued for your child, you can track their position in the service queue on the Social Insurance Board’s website.

If your child starts using a special welfare service that includes accommodation and meals, you must pay a personal contribution for the accommodation and meal costs incurred while using the service. Such services include the day and weekly care service, the community living service, and all round-the-clock special welfare services.
 

The maximum cost of the personal contribution is set by the annual State Budget Act. However, if accommodation and meals are provided under better conditions than required by legislation, the special welfare service provider may charge more than the maximum amount for using the service.

Social Welfare Act

Special care