The State Audit Office of Latvia has concluded that disability status achieves its purpose only partially in Latvia. The basic task of determining disability is to provide support to people with functional impairments, which would allow reducing the barriers created by functional limitations and ensuring equal opportunities. However, in practice, the status often serves to compensate for income, rather than to safeguard access to necessary services.
IN BRIEF:
- More than 221 thousand people with disabilities live in Latvia, and their number has increased by more than 15% from 2018.
- In 2024, at least 1.039 billion euros (6.4% of total state budget expenditure) were allocated from the state budget for disability expertise and support, while local and regional governments allocated at least another 20 million euros.
- Disability status achieves its goal only partially because it is more often used to compensate for income, rather than as a basis for targeted support, as no state institution assesses the needs of a disabled person as a whole and receiving support largely depends on the knowledge of the person himself/ herself or his/ her relatives.
- Disability determination is carried out in accordance with laws and regulations but is not organized in the best possible way. The process is not fully digitalized, is based mainly on a medical approach, and the transition to the assessment of new functioning and activities has been delayed until 2030.
- The support system is fragmented and unequal, especially at the municipal level, as the availability and scope of services vary significantly depending on the place of residence, most notably in care support.
- Care and transport support is not sufficiently targeted, therefore the State Audit Office of Latvia emphasises the need to focus funding and support mechanisms more on actual needs of the people, rather than formal criteria.
“During the audit, we have established that no state institution in Latvia assesses the health, social, mobility and daily functioning needs of a disabled person in general. Whether and to what extent a disabled person receives and uses assistance depends largely on the knowledge, initiative and ability of the person himself/ herself or his/ her relatives to navigate the fragmented system, and not on the targeted actions of the government. State institutions do not assess what support a specific person needs,” indicated Ms Maija Āboliņa, Council Member of the State Audit Office of Latvia.
In 2024, there were more than 221 thousand people with disabilities in Latvia, and their number has increased by more than 15% from 2018. In 2024, the state allocated at least 1.039 billion euros, or 6.4% of the state budget, for disability expertise and support, and local and regional governments allocated at least another 20 million euros. A significant portion of the funds is used for income support (pensions and allowances), but a smaller portion is used for services that help overcome daily difficulties (care, transportation, rehabilitation).
Disability is determined according to laws and regulations, but not in the best possible way
The State Medical Commission for Expert-Examination of Health and Working Ability (hereinafter referred to as the Commission) carries out disability expertise. The audit concluded that the determination of disability was generally carried out in accordance with laws and regulations; however, the process was not organised optimally. Referrals for disability expertise are still prepared in paper form, but it will be possible to prepare them in E-health platform only in 2029. In addition, the Commission does not have access to data held by other state institutions on personal medical examinations, technical aids, received care or rehabilitation. Therefore, a significant part of the information must be collected by general practitioners, and this increases the administrative burden.
The medical approach still dominates in determining disability, although a transition to the assessment of limitations in functioning and activities in accordance with the International Classification of Functioning, Disability and Health (ICF), developed by the World Health Organization, was announced in 2015. The reform has been postponed several times, and the new approach is planned to be introduced only in 2030 currently. The expert examination itself is also too narrow because it determines disability but it does not assess what support measures an individual needs to mitigate the consequences of disability in everyday life.
“The disability expert examination should also assess the support an individual needs, and this information should be usable in social services and with service providers. It would allow disability status to be used not only as a formal criterion, but as a basis for targeted assistance, as a roadmap to the necessary support. It also corresponds to the original purpose of the Disability Law of Latvia: when determining disability, to assess also a set of support measures needed by an individual and, if necessary, to provide the social service with recommendations for an individual rehabilitation plan,” stressed Ms Maija Āboliņa.
The audit has found that the human resources of the Commission for determining disability are insufficient. Approximately 60% of experts still work above optimal workload, which is why decisions are not always made within the established deadlines. The situation is also worsened by the task assigned to the Commission to extend disability leaves after 26 weeks, which is essentially the responsibility of the health sector. This function requires about four medical expert positions annually, and according to auditors’ estimates, its transfer to the health sector could reduce decision delays by up to 46%. The State Audit Office of Latvia points out the need to review both the number of positions and the tasks set to the Commission so that disability determination is sustainable and timely.
Support system is fragmented and unequal
Disabled people have access to various types of support in Latvia such as income replacement, care, mobility and transport support, social rehabilitation, housing adaptation, technical aids and tax breaks. However, the auditors conclude that the availability and content of these supports vary significantly depending on the place of residence.
Local and regional governments offer social services according to financial capabilities, not people’s needs, although many social services have been provided for in laws and regulations for about 30 years. In order to prevent inequality, a minimum basket of social services was established by law in December 2024, which should be fully implemented by 2029. However, only two of the seven services provided to people with functional disabilities were provided in all local and regional governments in Latvia, namely, long-term social care and social rehabilitation in an institution, as well as home care for people with severe functional disabilities. For example, the group home (apartment) service for people with mental disabilities, which was to be mandatory from 2025, is currently available in only 38 local and regional governments.
Moreover, both the availability of services and their content vary because people with similar needs can receive different services in different local and regional governments. For instance, home care for the same level of care has a completely different number of hours in different local and regional governments: it ranges from 2 to 6 hours per week at the lowest level of care (level 1) and from 10 to 35 hours per week at the top level (level 4). Consequently, opportunities of an individual to receive the necessary support are closely linked to their place of residence, and it does not facilitate equality.
Support for care and transport is insufficient and not targeted
The auditors consider that the most significant shortcomings are precisely in care support. It is fragmented, insufficient and difficult to administer because one need is covered by several types of support, namely, both state allowance for care and care services in local and regional governments, none of which are sufficient. The audit has found that 63.6% of children and 83.2% of adults with very severe functional disabilities who receive state allowance for care do not use municipal care services. It shows that these people often organize care themselves or their relatives do. At the same time, the state allowance for care does not even cover the average cost of the service, which is at least 220 euros higher than the amount of the allowance.
As a solution to improve the situation, the Ministry of Welfare of Latvia only envisages an increase in the state allowance for care, which is planned from 2030. In the auditors’ opinion, this will not improve the situation significantly because some people will not have access to care services in the required amount anyway. The State Audit Office of Latvia stresses that the funding planned to be directed to increasing the allowance should be invested primarily in the care service itself.
Transport support is also fragmented: it is provided both as an allowance and as a service and relief for public transport and payments related to the operation of a personal car. In order to make these types of support more targeted, the auditors believe that the opinion of the Commission on medical indications for special adaptation of a passenger car and receipt of an allowance for compensation for transport expenses should be revised. This opinion is a prerequisite for receiving three types of state-provided support: a vehicle adaptation service, a state allowance for compensation for transport expenses and a card for the use of parking spaces for disabled people. However, significant shortcomings have also been identified in the application of these supports.
The vehicle adaptation service is too narrow, as it is intended only for cases when an individual drives a vehicle himself or herself, but it does not include adaptations for passenger transport, for example, the construction of a ramp or securing a wheelchair. In its turn, the state allowance for compensating transportation expenses in the amount of 105 euros per half-year covers, at best, only a small part of the fuel costs, but it does not cover the actual costs necessary for a person with severe functional limitations to be able to move, for instance, to adapt the family vehicle or use specialized transport.
The procedure for obtaining a parking card for disabled is also not user-friendly. Although only the information at the disposal of the Commission is required for issuing the card, the card is issued by another institution, the Road Traffic Safety Directorate thus creating an administrative burden. The auditors believe that the procedure for issuing the card should be simplified.
Recommendations of the State Audit Office of Latvia #PēcRevīzijas
Nine recommendations have been made to the Ministry of Welfare, as the leading state institution in the field of equal opportunities for people with disabilities so that disability status could be used as a basis for targeted support in the future, rather than just a formal status. By implementing the recommendations:
- The circulation and quality of information required for determining disability will improve by reducing the administrative burden;
- Disability determination for children and adults will become more impartial;
- When determining disability, the support needed by an individual will also be assessed and recommendations for further rehabilitation will be provided;
- the capacity of the Commission will be strengthened and thus decisions will be made in a more timely manner;
- State and municipal support, including for care and transport, will become more equal and better adapted to people’s real needs.
The State Audit Office of Latvia will also inform the action group for reducing bureaucracy about the shortcomings identified during the audit in the issuance of parking cards for disabled people.
Additional reading: audit report summary, infographics.
About the State Audit Office of Latvia
The State Audit Office of the Republic of Latvia is an independent, collegial supreme audit institution. The purpose of its activity is to find out whether the actions with the financial means and property of a public entity are legal, correct, useful and in line with public interests, as well as to provide recommendations for the elimination of discovered irregularities. The State Audit Office conducts audits in accordance with International Standards of Supreme Audit Institutions of the International Organization of Supreme Audit Institutions INTOSAI (ISSAI), whose recognition in Latvia is determined by the Auditor General. Upon discovering deficiencies, the State Audit Office of Latvia provides recommendations for their elimination, but it informs law enforcement authorities about potential infringements of the law.