A. Accessibility as a factor for cost-effectiveness

From 2019 to 2021, Estonia had an intensive task force focusing on improving accessibility.[1] In this small society with a lot of digital development, it is crucial to enable the offering of digital services for citizens’ interaction with authorities and all forms of accessibility. In August 2021, the policy recommendations of the task force were published and are currently due to be implemented.

Task force recommendations also highlighted that evidence-based information on accessibility, costs and benefits of accessible solutions should be promoted. Independent living is heavily dependent on accessible solutions for the built environment as well as access to information, including information in alternative formats. In order to achieve this, studies are being conducted and data collection is proposed to be thorough, backing up national action plans such as the Estonia 2035 strategy and the Welfare Development Plan 2023–2030.

In March 2022, analysis of the impact of accessibility for social services – requested by the Estonian Ministry of Social Affairs and conducted by the consultancy agency Civitta Ltd. together with Accessibility Forum NGO – highlighted how accessible provision of services will impact the cost of services. This raises the question of whether it is possible to offer more services if services are made accessible.[2]

More accessibility-related developments were due in 2022. Transposition into national legislation of the EU Accessibility Act was expected to be achieved by the end of June 2022, with a review of the legislation guaranteeing accessibility of the built environment expected to be finalized by the end of 2022. The EU financial programme for 2021–2027 began and monitoring of equal treatment in the use of cohesion policy instruments was expected to continue, with the Equality Competence Center of the European Union Cohesion Policy Funds having already established in 2015, hosted by the Estonian Ministry of Social Affairs. The competence centre provides support to all stakeholders who deal with implementation of the funds.[3]

The study led by Civitta Ltd. addressed the impact of accessibility in the following social services:

List of seven services. These services are home support service, personal assistant service, support person service, social transportation service, offering accommodation service, unemployment board travel to workplace service, and services of personalised service model for special care.

The study identified that the eight major services listed above had the highest impact if offered in an accessible way. Other services also had a direct or indirect impact if offered in an accessible way. In many cases, accessible service provision was also evaluated as having an impact on staff needs, with an accessible environment easing up staff workloads. Meanwhile, in the case of people with complex dependency needs, service need did not reduce even with improved accessibility.

The State currently loses up to 47 million euros annually due to inappropriate levels of accessibility. Furthermore, the chart below shows which services, if offered in an accessible way, would bring savings and to what degree. Those saved sums could be used to offer more services, given increasing demand due to demographic structures and the current level of service provision being lower than needed.

Figure 4. Overview of the costs of service provision

A grouped bar chart on the average annual cost with and without improved accessibility for different services. These services are home support service, support person service, personal assistant service, social transportation service, accommodation service, services of personalized service model for special care, every-day activities support service, living in community service, supported living service, supported employment service, and travel to the workplace service. For the supported employment service and the living in community service, the average annual costs with and without improved accessibility are the same. For the rest of the services, the average annual cost without improved accessibility is higher than the average annual cost with improved accessibility.

Source: Extract from Civitta Ltd. presentation for the Estonian Ministry of Social Affairs.

The need for services is much higher than the current level of service provision. This is highlighted by the case studies of interval care provision for adults leading into solutions of independent living. Equally, certain services like the personal assistant service are struggling with multiple shortcomings, including a low level of availability (insufficient number of hours offered, as this is determined at the municipal level in each of the 79 municipalities) combined with low hourly rates and a lack of assistants.

The Civitta Ltd. study is an important step forward as a contribution to a knowledge-based approach to policy making but needs to be taken into consideration in policy development and budget planning. The national legal environment requires accessible solutions. The Social Insurance Board, a State agency that guides individuals through special care solutions, has also focused on improved accessibility, with contract signing resolution solely for fully accessible service providers in the pipeline. All these steps are towards a more barrier-free society coincide with earmarked funds expected by civil society and at municipal level to improve the accessibility of the mapped shortcomings.

Figure 5. Gaps in service provision

The line graph illustrates gaps in service provision with two lines representing actual and needed services. The x-axis lists various services: home supported service, support person service (for children and adults), personal assistant service, social transportation service, accommodation service, personalized service model for special care, everyday activities support service, living in the community service, supported living service, supported employment service, and travel to the workplace service. While the graph demonstrates minimal differences between the actual and needed lines for most services, the largest gap is evident in the 'travel to the workplace' service, where the actual service is reported as 1,488 while the needed service is 20,000

Source: Extract from Civitta Ltd. presentation for the Estonian Ministry of Social Affairs.

Note: The blue bar shows the current level of service provision and the orange bar shows the level required. In many cases, the required level is higher than the provision available today. Savings from accessible offering of services could fill the gap.

[1]     Republic of Estonia, Ministry of Social Affairs (n.d.).

[2]     The final study is available in Estonian on the website of the Estonian Ministry of Social Affairs: Republic of Estonia, Ministry of Social Affairs (n.d.).

[3]    Competence Centre (n.d.).