3.1 COUNTRY PROFILE: CZECH REPUBLIC Lenka Slepičková 3.1.1 Services overall description The services for children and families in the Czech Republic are governed by 3 broad groupings. These are: Ministries (especially the Ministry of Health, Ministry of Education, Youth and Sport, and Ministry of Labor and Social Affairs), Municipalities, And NGOs. The system of support is usually categorized into following age groups: (newborns and toddlers: 0-3, preschool: 3-6, school age: 6-15, adolescents 15-18, youth: 19-26). MINISTRY OF HEALTH Health care for children and youth, as well as primary health care in general, is organized at the district level. The care is free for children and paid for by an obligatory health insurance of economically active persons (citizens pay an insurance premium computed as a percentage of their income regardless of what healthcare they receive or will receive). Children are registered at the general practitioners for children and youth according to the choice of parents made before birth. While general practitioners usually provide the first visit at home after birth, breastfeeding support is provided by maternity hospitals. Certain health insurance companies also cover several sessions with a consultant for breastfeeding after birth (mostly in larger cities), and links to a network of private consultants for breastfeeding. General practitioners also provide obligatory vaccinations against infectious diseases, an important part of the Czech healthcare system. Until three years of age, there are 10 prevention healthchecks (introductory, and in the ages of 14 days, 6 weeks, 3 months, 4 months, 6 months, 8 months, 10 months, 12 months and 18 months). These visits include vaccinations, nutritional advice, investigation of the psychomotorical development, hearing examination (8 months), sight examination (4 months) and general sensual check (18 months). From 3-18 years of age, there are periodical visits planned (at the age of 3, 5, 7, 9, 11, 13, 15 years, and the final one at the age of 18 years and 11 months). These visits include an assessment of parental care (screening for signs of abuse or neglect). MINISTRY OF SOCIAL AFFAIRS governs the state social support for families and sickness insurance, also covering materinity leave. Participation in sickness insurance by an employee is mandatory under the law. Participation in sickness insurance by self-employed persons is voluntary. Maternity Cash Benefit (hereinafter referred to as the “MCB”) is a benefit intended to substitute the regular income and is granted to a woman, who gave birth to a child, for the period of 28 weeks of maternity leave. On the day, on which it should be recognized (6 or 8 weeks before expected date of birth), the individual must still be participating in the sickness insurance scheme or be covered by the protection period arising after the termination of an insured (self-) employment, typically amounting to 7 calendar days. For women whose insured employment ended during pregnancy, the protection period for the entitlement to MCB is equal to the number of calendar days corresponding to the duration of the woman’s last employment, up to a maximum of 180 calendar days. Another precondition for the entitlement to MCB is that, in the last two years prior to her entry under MCB, the individual must have participated in the sickness insurance scheme for at least 270 days. A self-employed person shall be entitled to MCB provided that she fulfils the requirement of participation in the sickness insurance scheme for self-employed for a period of 180 days during the last year prior to her entry under the MCB. In addition, it is also required that the employee no longer works in the employment, no longer receives any salary or remuneration from this employment, or, if self-employed, no longer pursues self-employment. MCB can be provided for a period of 28 weeks to an insured woman who gave birth to a child, or 37 weeks to an insured woman who had multiple birth (2 or more children) and takes care of at least two children after the lapse of the 28-week period. The total MCB granted is to 70% of the daily assessment base1). The state social support for families is regulated by Act no.117/1995 Coll., on State Social Support, as amended. Under this Act, the following benefits for families are available: 1. Child allowance Child allowance is a basic long-term benefit provided to families with dependent children. A dependent child up to the age of 26 years, living in a family with an income of less than 2.4 times the living wage, is entitled to this allowance. The allowance is provided monthly on three levels, depending on the age of the child (up to 6 years of age: 20 EUR, from 6 to 15: 24 EUR, from 15 to 26: 27 EUR). 2. Housing allowance Property owners or tenants registered as permanent residents in that property are entitled to a housing allowance of 30 % (in Prague 35%) if family income is insufficient to cover housing costs and if family income is lower than the relevant prescriptive costs set by law. 3. Parental allowance A parent who personally and duly cares for a child who is the youngest in the family is entitled to parental allowance. Parental allowance is provided until the total amount of 8,627 EUR is drawn. This amount can be drawn up until the child is 4 years of age. A parent may elect the monthly amount of parental allowance and duration of provision with the condition that at least one parent in a family is a person participating in sickness insurance. The monthly amount of parental allowance is calculated using a daily assessment base for determining MCB or sickness benefit related to child’s confinement or adoption according to the act on sickness insurance. A parent is entitled to parental allowance provided: · a child under the age of 2 years attends a creche or other facility for pre-school children for a maximum of 46 hours a month; · a child attends a remedial care centre, creche, kindergarten or similar facility for disabled pre-school children for no more than 4 hours a day; · a child of disabled parents attends a creche, kindergarten or similar facility for pre-school children for no more than 4 hours a day; · a disabled child attends a creche, kindergarten or similar facility for pre-school children for no more than 6 hours a day. The parent’s income is not tested; the parent may carry out an occupational activity without losing their entitlement to parental allowance. 4. Birth grant This is a one-off benefit for low-income families to help them to cover cost related to the birth of their first child and second live-born. Families are entitled to the birth grant provided the family income in the calendar quarter prior to the birth of the child does not exceed 2.7 times the family’s living wage. The birth grant amounts to 510 EUR for the first child and 392 EUR for the second child. The following services in the category of social prevention services in the Act 108/2006 Coll., are relevant for ISOTIS target groups (socially disadvantaged families): Early care intervention Early care is the social service for families with children under 7 years with a physical or mental impairment or in a chronic health condition. The service aims to support the family and the development of a child with special needs. The service helps with education, inclusion, provides informational support. The service is free and is provided by the centres of early care (mostly run by NGOs) or special education centres. Asylum houses Asylum houses provide temporary accommodation to persons in a difficult social situation relating to a loss of permanent housing. This service includes food and specialized social counselling, i.e. an assistance with claiming and the rights of the clients, and the mediation of contact with institutions. This service is paid, but the fee is limited by the law. There are also shelters for women, mothers and children, run mostly by charities or NGOs in the Czech Republic. These shelters offer temporary accommodation to such people who have no other option of housing, and often are the victims of domestic violence (some shelters do not have a public address in order to protect them). The women and mothers are supported psychologically and socially, and trained in parenting skills. The clientsare also offered a safe environment with social counselling and various activities. Night dormitories Provide accommodation to homeless persons including facilities for personal hygiene. This service is paid, but the fee is limited by t law, it is usually in range of 1-3 EUR/night). Social activation services for families with children The aim is to support families who are in a long-term critical life situation (financial problems, housing or health problems, low level of education, addictions, unintended pregnancies, domestic violence etc.), that can endanger the healthy development of children and even result in the court orders and the institutional care for the children. The aim is to ensure that the children will grow up with parents in a safe and stimulating environment through professional support and long-term assistance, and become responsible for dealing with difficulties and challenges. The service is free and includes the long-term and regular cooperation with a social worker, based on the needs of family (case management approach). MINISTRY OF EDUCATION, YOUTH AND SPORT (The ECEC system in the Czech Republic) Czech parents, mostly mothers, usually take care of the child personally (being supported by maternity leave in the first months and by parental leave until their child is four years old). Mothers usually return to work (full-time jobs mostly) when the children are 3 years old. Increasingly, more mothers are interested in non-family care for children younger than 3 years (because of demographic, economic and social conditions), but these intentions are kept back by deficiency of day-care and early childhood education facilities. The dominant type of Early Childhood Education and Care (ECEC) facilities are kindergartens for children from 3 to 6 years, run by municipalities, operated according to the Education Act and listed in School Registry. The enrollment rate is about 80 % of children (almost 100 % in the last, compulsory grade). Attendance is free;parents pay just for meals and cultural and social activities, and these fees are relatively low. Attendance is compulsory in the last grade (before entering primary school) from September 2017. The placing of all children in this grade must be securedand must be completely free. The kindergartens are mostly run by municipalities or counties (in the school term 2015/16, it was 93 % of all kindergartens), whilst some are run by the private sector (6 % in the school term 2015/2016) or by churches (1 % in the school term 2015/2016). There are also private playgroups or nurseries (paid for exclusively on a commercial basis), run by companies (employers of parents) or other private institutions, but they are not many, and they are not controlled by the Ministry of Education as they are not part of a school system. From the term 2020/2021, it will be obligatory for kindergartens to accept also children older than 2 years. Currently, there are only paid private facilities on commercial basis for children under 3 years old, as “Traditional” nurseries working as medical institutions (managed by Ministry of Health) ceased to exist in 2012 (their legal status was changed) – however, they only partly covered the demand anyway. The nurseries were not sufficiently replaced by other forms of care of children under 3 years of age. Individual paid care (au-pairs, nannies) is used by less than 5 % of families. For Roma children and children living in deprived areas, there are playgroups run by NGOs or preparatory classrooms, adjucent to primary schools. They have been managed by the Czech Ministry of Education, Youth and Sports since 2000 and became part of the School Act as a legally guaranteed supporting measure for socially disadvantaged children as well as for children with learning difficulties. Their aim is mostly to teach the Czech language and to prepare the children for the regime of compulsory primary education (hygiene habits; basic and fine motor skills; the ability to follow classroom rules, internalization of a structured and regular character of different activities; socio-emotional skills; self-regulation etc.). They should help ensure etter integration of a child to the first grade collective and to prevent school failure at the very beginning of a child's school career. Statistics from the school year 2015/2016 show 4514 enrolled children. Only children who are socially disadvantaged (confirmed by the Educational and Psychological Counselling) and who had postponed enrolment to the first class are eligible. Before- (open mostly from 6.30 am) and after-school (open mostly until 4 – 5 pm) clubs are mostly run by primary schools and they are intended for children from 6 to 12 years. They are situated in schools,offer various activities, and are used by a big percentage of families, as the end of school hours is much earlier than the end of their work day (and the majority of Czech parents work full-time). The fee is very low. For children from disadvantaged groups, there are after-school clubs organised(?) by NGOs, providing also extra lessons, assistance with homework etc. These are mostly situated in deprived areas. The services for families are provided mostly by the public sector or by NGOs. The commercial subjects are entering the field of ECEC, but as the fees for attending the private kindergartens are high, they are used only by the minority of families. The most part of primary health care is provided by commercial subjects, but as it is paid by obligatory health insurance, for the consumers it plays no role. Nationally, the most important NGO working with the disadvantaged (mostly Roma) families is People in Need. In many deprived areas, they run programmes for such families as following: · Family consultations: The objective of family consultations is to search for, motivate, provide social assistance and give advice to families with children living in a difficult social situation that excludes them from the rest of society. The purpose of providing these services is to help families with issues they cannot resolve by themselves, which have a negative impact on the family environment and the development of the child. A long-term and intensive cooperation is emphasized, as well as an individual social assistance with standing up for one’s rights and legitimate interests and honing parental skills. · Tutoring: This service is intended for children who are having problems at school and suffer with a lack of support at home. The reason for this is primarily because their parents have a low level of education, usually they completed only elementary school. The purpose of this service is primarily to stop children from performing poorly at school, although tutoring also brings many other positive effects. Tutoring, both individual and group, is mostly performed by volunteers. One example of these effects is a raise in the child’s interest in school, which usually reduces the number of missed classes and increases activity during lessons. · Low threshold clubs: Low threshold clubs exist for different age groups. With children (6 - 13 years of age) the work of club is concentrated on eliminating truancy. The clubs also represent an alternative to classic afterschool activity clubs which the socially disadvantaged families cannot afford, and are a place where they can do their homework. With the youths (14 - 18 years of age) they focus on discouraging premature school drop out, , which usually results in resignation of ambition for a higher level of education. With all age groups, they address the problem of exposure to addictions and their prevention (alcohol, drugs and gambling). Locally, there are many NGOs offering similar in service support in deprived areas. An interesting activity run by a NGO called “Women for Women” is the project “Lunches for children” providing free school lunches for children whose families are in a difficult social situation (the families can participate in a project on the basis of a referral from teachers or headmasters). The positive results of this project are seen not only in better nutrition of such children, but also in improved school attendance and social inclusion. Since March 2017, this project cooperates with the Ministry of Social Affairs who partly contributes to this help. Since 2013, free lunches were provided to ca. 10,000 school children. 3.1.2 Equality issues (regarding ISOTIS target groups) 3.1.2.1 Differential access to services In the field of services for children and families in the Czech Republic, there are universal services (no condition of access) that are provided for free; services with limited access or income tested; or services provided for a fee (that is, as in case of the social prevention services, regulated by Law). Here is the summary of the fees and type of access to the services described in a previous section: · Primary health care for children – universal, no conditions of access · Breastfeeding consultation – partly universal (consultations covered by health insurance), partly on a commercial basis · Sickness insurance – only for officially employed persons or self-employed, who are willing to pay for it · Maternity leave – strict conditions regarding the previous employment career of a woman (see previous section) · Child allowance – income tested, available for a big proportion of low income families · Parental allowance – universal · Housing allowance – low income families, but as the conditions are quite strict (the 3-month rent must have been paid etc.) and sometimes prevent efficient help · Child grant – income tested, available to a big proportion (one third) of low income families · ECEC for children under 3 – almost non-existent in the Czech Republic, provided on a commercial basis and unavailable for most families as the fees are high · ECEC for children aged 3-5 – there are fees, for some Roma families this service is unavailable. Access is limited also by a general lack of places in kindergarten and by cultural reasons (it is common to rely exclusively on family care in Roma communities, it is not common to use the service located far from the place of living, etc.). · ECEC for children from 5 to 7-access is universal and guaranteed by law. In practice, there are many kindergartens informally “refusing” Roma children by referring parents to the segregated preschool institutions such as preparatory classrooms (information from the stakeholders from the NGOs). · Preparatory classrooms - only children who are socially disadvantaged (confirmed by the Educational and Psychological Counselling) and who had postponed enrollment to the first grade are eligible. · Before and after school club – the fees are low, but they can (in combination with cultural factors mentioned above) still prevent the attendance of Roma or low-income children · Early care intervention – no fee, universal access · Asylum houses – low fee, access is limited by places available · Night dormitories – low fee, access is limited by places available · Social activation services for families with children – free 3.1.2.2 Targeted Programmes 1. Child allowance – Low-income families 2. Child grant – Low-income families 3. Housing allowance – Low-income families 4. Preparatory classrooms – For Roma and socially disadvantaged children Social activation services and other services and programmes run mostly by the NGOs are often targeted services for low income or Roma families. 3.1.3 Monitoring The external evaluation of other services is rare, the services are evaluated mostly within the organisation providing them on the basis of various criteria. The services run by the Czech Ministry of Education are evaluated by the Czech school inspection on a regular basis. 3.1.4 Language The language support is provided only in preparatory classrooms for Roma children or in tutoring programmes, but it is a support in the language of instruction (Czech language), not in Roma languages. 3.1.4 Main challenges 1. The system of ECEC and its usage follows a very strong pattern in the Czech Republic (no ECEC care facilities and 100 % of time spent with a primary caregiver until 3 years, and the whole day 5 days a week in an institution from 3 years, as both parents are working full-time), preventing parents to employ more flexible strategies of combining care and paid work. Almost no ECEC institutions for children under 3 are available and other forms of care are rare or expensive. 2. The preparatory classrooms can lead to the segregation of Roma children in preschool age. At the moment, their existence is sometimes used as an “excuse” for the mainstream kindergarten headmasters who are not willing to accept Roma children in their classes, not even in the compulsory, last year of attendance (and they refer parents to the segregated preschool institutions instead - an information from the stakeholders from the NGOs working in the field). The preparatory classrooms do not support the Roma language competencies of children. 3. Certain social benefits (Housing allowance or Maternity leave) underlie such strict conditions (type of rent or connection to the previous employment and income) that in practice they are not helping the families in need. 4. NGOs are operating mostly within temporary projects (in terms of funding), so their help cannot be consistent or developing well. They work in an insecure situation as at the end of a financial year they often do not know the budget for the next year.