ESPN Thematic Report on Social protection for people with disabilities - [Malta]

Abstract

This report analyses some important cash and in-kind social protection provisions available to adults with disabilities (i.e. aged 18 or above). There are other important provisions available to them in other areas not covered in this report. In line with Article 1 of the UN Convention on the Rights of Persons with Disabilities, “people with disabilities” should be understood as “those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others”. The employment rate of people with disabilities is over 30 percentage points below that of people without disabilities, and they are more reliant upon social protection. Disability-specific income support consists of non-contributory assistance and a contributory invalidity pension. Non-contributory benefit levels have been raised since 2017 and are not means-tested. However, one third of those with severe activity limitation are at risk of poverty or social exclusion, which is twice the rate of those without disabilities. The contributory scheme, known as the Pensjoni għal Invalidità (invalidity pension), has higher benefit levels, yet the maximum rate depends upon having made sufficient contributions; that said, the contributory requirement is waived where disability is assessed above 90%. In both instances, assessment is largely based on a medical diagnosis and the degree of disability. The take-up of the Assistenza għal Diżabilità (disability assistance) appears to be low compared with the prevalence of activity limitations according to Eurostat data. While it is unclear to what extent this is affected by the nature of assessment, the issue of non-take-up merits further study. In respect of healthcare, people with disabilities have access to universal primary and hospital care, though long waiting lists result in a relatively high rate of unmet healthcare needs among this group. They are also entitled to free medical aids (including medicines and prosthetics) which are normally means-tested, though this requirement is waived for most levels of disability assistance. In respect of housing, people with disabilities have access to a scheme run by the Housing Authority that includes technical advice and grants of up to €6,000 for adaptation works and between €5,000 and €20,000 for stair- and platform-lifts (depending on residence type). The grant is paid on a reimbursement basis, which may prove difficult for people without their own resources. Furthermore, the maximum adaptation grant of €6,000 is very low and would require significant out-of-pocket payments at today’s prices in the construction and trades sectors. People with disabilities may also apply for a non-contributory means-tested rent allowance, and benefit from a higher income ceiling than people without disability. That said, prevailing rental rates make it unlikely that people with disabilities on anything less than a modest income plus disability assistance could live independently. There are no specific old-age pensions for people with disabilities, or any specific unemployment benefits. People with disabilities willing and able to work enrol on a special unemployment register with less stringent activation requirements and with dedicated support to find, take up and retain work. Grants for assistive technology are relatively modest, and people without their own resources often need to apply to the Malta Community Chest Fund (a semi-charitable entity), and undergo another means test, in order to supplement these grants. Personal assistance, which is not means-tested, comes in three tiers depending on the hours of support needed each week; there is currently a waiting list for such assistance. As contemplated in the national strategy for 2020-2030 on the rights of disabled people, reforms to disability assessment and eligibility are set to take place within nine years – including a strengthening of personal assistance schemes, and further investment in assistive technology research. It is recommended that a unified approach to assessment be undertaken in the shortest time possible; and that benefit adequacy receives close attention, with due consideration to the extra costs of disability and rises in the cost of goods and services. The alleviation of poverty among people with disabilities merits explicit attention in any action plans pursuant to the recently launched national strategy.