REVIEW OF THE AJUTOR SOCIAL BENEFITS DELIVERY TO IMPROVE THE UPTAKE OF THE POOR1 1 This technical report has been prepared by Madalina Manea and Razvan Dumitru, Consultants, GSP03, under the leadership of Yuliya Smolyar, Senior Social Protection Specialist, and Vlad Grigoras, Social Protection Specialist, GSP03, for the Moldova: RSR 12: Improving Efficiency of Moldova`s Main Anti-Poverty Program (P164672) task. The team wishes to recognize the generous award of a grant from the World Bank’s Rapid Social Response (RSR) Trust Fund Program, which is supported by the Russian Federation, United Kingdom, Norway, Sweden, Australia, and Denmark, without which this work would not have been possible. 1 Table of Contents Abbreviations ________________________________________________________________ 6 Introduction _________________________________________________________________ 7 Aim and structure of the report ____________________________________________________________ 9 Data and methods ______________________________________________________________________ 14 Chapter 1. Outreach__________________________________________________________ 16 The current outreach of the AS/ APRA program _________________________________________________ 17 Challenge #1: Lack of an operational framework for the AS program Outreach _____________________ 20 Challenge #2: Uneven distribution of outreach activities across raions and localities _________________ 21 Challenge #3: People’s perceptions of who should be entitled to AS/ APRA benefits most often have no relation to the legal eligibility criteria _______________________________________________________ 23 Challenge #4: Misperception about eligibility criteria leads to a negative image of the AS/ APRA program _____________________________________________________________________________________ 24 Conclusions _____________________________________________________________________________ 25 Recommendations: _______________________________________________________________________ 26 Chapter 2. Intake and Registration ______________________________________________ 28 Intake and Registration in the Republic of Moldova ______________________________________________ 32 Application Procedure for AS and APRA in the Republic of Moldova ________________________________ 32 1. Challenges faced by applicants _________________________________________________ 34 a. Challenges related to obtaining documents ________________________________________________ 34 Challenge #1: The lack of physical documents excludes otherwise eligible families from the program, despite alternative means to verify required information. _______________________________________ 34 i. Documents for which information is stored electronically and is reliable ____________________ 35 Recommendations: _____________________________________________________________________ 35 ii. Documents for which information is stored electronically but are not fully reliable ____________ 36 Recommendations: _____________________________________________________________________ 38 iii. Documents for which information is not stored electronically _____________________________ 39 Recommendations: _____________________________________________________________________ 40 General recommendation: ________________________________________________________________ 41 Challenge #2: Potential applicants for AS/ APRA need to present their ID, but there are still cases when people lack appropriate identification documents _____________________________________________ 41 b. Other types of applicant discouragement when applying for AS/ APRA benefits __________________ 41 Challenge #3: Discouragement of potential applicants by social workers and/ or by clerks in the local administration _________________________________________________________________________ 41 Recommendation: ______________________________________________________________________ 42 Challenge #4: The negative image of AS and unwillingness to apply to AS/ APRA due to stigma ______ 42 Recommendation: ______________________________________________________________________ 43 2. Challenges faced by social workers ______________________________________________ 43 Challenge #1: The number of qualified social workers is inadequate.______________________________ 43 2 Recommendations: _____________________________________________________________________ 45 Challenge #2: Social workers have insufficient and out dated materials ____________________________ 47 Recommendations: _____________________________________________________________________ 47 Challenge #3: Redress of Social Workers Grievances/ Disputes with Social Inspection _______________ 47 Recommendation: ______________________________________________________________________ 48 Challenge #4: Making administrative procedures more efficient _________________________________ 48 Recommendations: _____________________________________________________________________ 48 Challenge #5: Social workers need more support in their interactions with vulnerable groups targeted by the AS program ___________________________________________________________________________ 49 Recommendations: _____________________________________________________________________ 51 Conclusions _____________________________________________________________________________ 52 Chapter 3. Assessment of Needs and Conditions ___________________________________ 53 Challenge#1: Identifying the Beneficiary Unit ________________________________________________ 53 Recommendations for identifying the Beneficiary Unit _________________________________________ 59 a. Employment-status Related Challenges ___________________________________________________ 59 Challenge#1: The registration of the unemployed _____________________________________________ 60 Challenge#2: Adults without an eligible status and with two or more children ______________________ 63 Single parents with one or more children ____________________________________________________ 64 Challenge#3: Caretakers of disabled family members without eligible status _______________________ 66 Challenge#4: The eligibility of seasonal employees ___________________________________________ 67 Challenge#5: The eligibility of day laborers __________________________________________________ 68 Challenge#6: The status of students during the summer vacation _________________________________ 68 Recommendations for Status Related Challenges: _____________________________________________ 69 b. Guaranteed Monthly Income (GMI) Related Challenges _____________________________________ 71 Challenge#1: Calculating Land Income _____________________________________________________ 71 Challenge#2: Informal agricultural workers __________________________________________________ 72 Recommendations for the Land Income Related Challenges _____________________________________ 73 c. Proxy-related Challenges ______________________________________________________________ 74 Challenge#1: The proxy threshold _________________________________________________________ 75 Challenge#5: The items of the Proxy Test ___________________________________________________ 77 Recommendations for the Proxy Score: _____________________________________________________ 78 Conclusions _____________________________________________________________________________ 78 Chapter 4. Enrolment ________________________________________________________ 79 Challenge #1: Informing beneficiaries about the result of the application __________________________ 80 Recommendations: _____________________________________________________________________ 83 Challenge #2: Ensure the reasons for the rejection of the application are easy to understand ___________ 84 Recommendation: ______________________________________________________________________ 86 Conclusions _____________________________________________________________________________ 86 Chapter 5. Transactions for Payments and Services ________________________________ 87 Challenge #1: Delayed receipt of the first payment for AS ______________________________________ 91 Recommendations: _____________________________________________________________________ 92 Challenge #2: Beneficiaries only have general information about when they should receive the first payment _____________________________________________________________________________________ 93 Recommendations: _____________________________________________________________________ 94 3 Conclusions _____________________________________________________________________________ 95 Chapter 6. Grievance Redress Mechanism ________________________________________ 96 The Role of the Social Inspection (SI) _________________________________________________________ 98 Recommendation: _____________________________________________________________________ 100 The Role of the National Agency for Social Assistance ___________________________________________ 100 Challenge #1: The need for a Grievance Redress Office (GRO) _________________________________ 100 Recommendations for Grievance Redress Office _____________________________________________ 101 i. Proposed Functions for the GRO ___________________________________________________ 101 ii. Proposed Institutional Placement for the GRO ________________________________________ 101 Challenge #2: Information needed for expressing grievances and complaints ______________________ 102 Recommendation: _____________________________________________________________________ 103 Challenge #3: Filing complaints about social workers without fear of retaliation ___________________ 103 Recommendation: _____________________________________________________________________ 103 Further Recommendations for Implementing the Grievance Redress Mechanism ___________________ 104 Conclusions ____________________________________________________________________________ 106 Chapter 7. Monitoring of Processes and Outcomes ________________________________ 107 1. Basic Monitoring ____________________________________________________________ 110 Challenge #1: Ensuring that people know they have to recertify _________________________________ 110 Recommendations: ____________________________________________________________________ 112 Challenge #2: Keeping families who need AS/ APRA in the program between (re)certifications, once they have registered ________________________________________________________________________ 112 Recommendation: _____________________________________________________________________ 113 1. Monitoring of Compliance with Conditionalities __________________________________ 114 Challenge #3: Monitoring the use of AS money by beneficiaries ________________________________ 114 Recommendation: _____________________________________________________________________ 116 Challenge #4: Involving beneficiaries in pro bono community work _____________________________ 117 Recommendation: _____________________________________________________________________ 118 2. Monitoring of Accompanying Measures and Graduation __________________________ 119 Challenge #5: Are the benefits in the right amount or form to support graduation from the program? ___ 119 Recommendation ______________________________________________________________________ 123 Challenge #6: Are the accompanying measures of the AS program appropriate for encouraging and facilitating graduation from poverty and thus from the program? ________________________________ 124 Recommendations: ____________________________________________________________________ 124 Conclusions ____________________________________________________________________________ 125 Chapter 8. Oversight and Control ______________________________________________ 126 Challenge #1: Limited legal mandate of the Social Inspection __________________________________ 128 Recommendation: _____________________________________________________________________ 128 Challenge #2: TSSW staff are insufficiently aware of inspection methodology ____________________ 128 Recommendation: _____________________________________________________________________ 129 Challenge #3: The fine line between taking the right decision in case of an error and taking a decision that is perceived by social workers/ beneficiaries as unjust __________________________________________ 130 Recommendations: ____________________________________________________________________ 130 4 Challenge #4: The inspection campaign results are poorly communicated, directly effecting actual and potential beneficiaries. __________________________________________________________________ 131 Recommendation: _____________________________________________________________________ 132 Challenge #5: The Social Inspection is focused primarily on reducing the inclusion errors but less on reducing the exclusion errors_____________________________________________________________ 132 Recommendation: _____________________________________________________________________ 132 Challenge #6: Insufficient information exists about the role Social Inspection may have in addressing household complaints __________________________________________________________________ 133 Recommendation: _____________________________________________________________________ 133 Conclusions ____________________________________________________________________________ 134 Conclusions and Key Recommendations ________________________________________ 135 Annexes __________________________________________________________________ 140 BIBLIOGRAPHY _____________________________________________________________ 148 5 Abbreviations APRA Ajutor pentru Perioada Rece a Anului (heating allowance) AS Ajutor Social CNAM National Company for Medical Insurance CNDDCM National Council for Determining Disability and Work Capacity EFC Errors, Fraud, and Corruption HBS Household Budget Survey GMI Guaranteed Monthly Income GRM Grievance Redress Mechanism GRO Grievance Redress Office HCD Human Centered Design IDAM Small Area Deprivation Index IMAS Institute for Marketing and Sociological Studies Inc. LFA Labor Force Agency MHLSP Ministry of Health, Labor and Social Protection NASA National Agency for Social Assistance NEA National Employment Agency NSIH National Social Insurance House RTGS Real Time Gross Settlement SAAIS Social Assistance Automated Information System SFS State Tax Service SI Social Inspection TLFA Territorial Labor Force Agency TSIH Territorial Social Insurance House TSSW Territorial Structures of Social Work WB World Bank 6 Introduction The Republic of Moldova has made significant progress in reducing poverty among its population, whether poverty is measured by international or national thresholds. Governing and administrative bodies demonstrate their commitment to poverty reduction by their efforts in several areas, including the social assistance system. The transformation of the system of social protection over the past decade has led to positive results in increased coverage of vulnerable groups and greater cost efficiency. Nevertheless, challenges remain to increase the coverage of the poor with existing programs and to review the programs’ effectiveness in supporting beneficiaries to rise above poverty levels over the long term. The Ajutor Social program is the main instrument providing a safety net for poor families and lifting them from poverty. The social assistance program Ajutor Social began in 2009. It was conceived as a proxy means-tested program of cash transfers to replace benefits that were granted to those belonging to a certain category (prestații categoriale). Ajutor Social was introduced to counter the fragmentation of social protection programs and the inefficiency of public money investments in the programs. The Ajutor Social (AS) is provided to disadvantaged families to alleviate poverty and to assist them in becoming self-reliant. To qualify for the AS program benefit, applicants have to meet three sets of criteria including having a family income below a threshold set as the guaranteed minimun income (GMI), the employment status of family members, and a family welfare confirmed through the proxy means test. The amount of benefit is contingent on the income gap between household monthly income and the GMI threshold, which is established annually in the State Budget law. Families eligible for AS are also eligible for financial support for heating assistance during the cold winter months or APRA. However, the income threshold for receiving APRA is higher than for AS, and thus more families qualify for APRA benefits. In the course of this report, we refer to AS/ APRA eligibility as the eligibility for one or both of these components of the safety net program. Efforts to ensure self-reliance are focused on 7 assisting the unemployed members of beneficiary families to find a job. Please refer to Annex 1 for detailed descriprion of the AS and APRA programs. The AS and APRA programs contiuously expanded their coverage and maintained good targeting accuracy. The overall coverage of the benefits improved significantly in 2010-2017. While in 2010 only 3.5 percent of the entire Moldova population received the AS transfers, in 2017 the coverage reached 7.3 percent. The APRA program covered 13.7 percent of people in 2017. Figure 1 features expansion of coverage of the bottom quintile by the means-tested AS/APRA and the largest categorical benefit programs. It shows that the coverage gains achieved by the means tested programs drove improvements in the overall social assistance coverage of the poor. While the cost of the two programs comprised just about 30 percent of the overall social assistance budget and 0.5 percent of GDP in 2017. Moreover, as demonstrated in Figure 2, in terms of the share of transfers that accrue to the poorest 20 percent of population (benefit targeting accuracy), both programs have consistently performed above the categorical ones, and above the overall social assistance targeting. While the program was reaching larger number of the poor people, it had somewhat limited contribution to improving their living standards because the benefit amount has been relatively small representing 30 percent of the beneficiaries’ overall income. Figure 1: Beneficiary Coverage of the Figure 2: Benefits Targeting Accuracy in the Bottom Consumption Quintile Bottom Consumption Quintile 70.0 100.0 90.0 60.0 80.0 50.0 70.0 40.0 60.0 50.0 30.0 40.0 20.0 30.0 20.0 10.0 10.0 0.0 0.0 2010 2011 2012 2013 2014 2015 2016 2017 2010 2011 2012 2013 2014 2015 2016 2017 All social assistance Social allocations All social assistance Social allocations Child allowances (SA) Ajutor social Child allowances (SA) Ajutor social Heating allow. Heating allow. 8 Source: AdEPT SP outputs based on annual HBS datasets No comprehensive approach exists to resolve the exclusion of the poor from the program— even though the government demonstrates its continuous commitment to including more vulnerable families. Household Budget Survey (HBS) data indicates that about 44 percent of eligible households were receiving AS benefits in 2016, indicating that a significant percentage of the poor have been excluded from the AS safety net. Implementation experience suggests that changing the program parameters and budget allocation may not be sufficient to increase the uptake of the poor families as the exclusion may stem from the shortfalls in benefits delivery/ program implementation. The government has amended the eligibility criteria for the AS program to reflect changes in society by increasing the income and proxy thresholds, for example (see Annex 1 for details). The Ministry of Health, Labor and Social Protection (MHLSP) recently approved a draft resolution to increase the income threshold for APRA eligibility (MHLSP 2018a).2 While the effects of the most recent changes have not yet been assessed, previous changes have not always produced the intended increase in the uptake of the poor. Families excluded from social programs in error must be identified and included across the social assitnace delivery chain. Aim and structure of the report This report identifies the existing forms of exclusion from AS/ APRA and recommends evidence-based solutions to eliminate them. Poor families continue to be excluded from the AS program. To ensure that the AS program reaches the most vulnerable families, the program must be continuously assessed and adjusted based on evidence of its impact. This report examines the efficacy of the AS program at every stage of the delivery of AS benefits. The stages of the program are identified in Figure 3, based on A Sourcebook on the Foundations of Social Protection Delivery Systems by Lindert et al. (2018). 2 Currently, the income threshold for APRA is determined by multiplying the income threshold for AS with a coefficient. This coefficient increased from 1.6 to 1.95. 9 Figure 3: Stages in the Ajutor Social Delivery System3 Each stage of the benefit delivery system needs to be amended to correlate with the principles of Human Centered Design (HCD) (see Box 1 below). HCD focuses on the needs and aspirations of the people a program is designed to help. To achieve this focus, potential beneficiaries must be included in all stages of program development before its implementation. HCD also assumes a continuous incorporation of feedback from beneficiaries during the growth of the program. And, when measuring impact, some measure of beneficiary satisfaction should be included, in addition to poverty alleviation indicators. 3 Sketched following Figure 3 in the concept note A Sourcebook on the Foundations of Social Protection Delivery Systems by Lindert 2018. 10 Box 1: Human Cantered Design (HCD) Approach HCD assumes a positive take on problem-solving, whereby all challenges are resolvable. It also builds on the idea that community members facing a challenge are best equipped to participate in identifying and implementing solutions for it. The approach works with the assumption of strict association between needs and solutions. Aim: to reach desirable, technically feasible and financially viable solutions for the community. The course of action in HCD includes (a) interaction with the community, which fosters creativity; (b) iterative process of transposing creativity into implementable tools - going from simple to complex; (c) testing and revising the solutions. Steps in the process: Inspiration, Ideation and Implementation, each with its specific methods. The Guide to Human Centered Design by IDEO.org lists and discusses a series of methods that can be used at each step. Firstly, the Inspiration phase consists of ways to understand the nature and hierarchy of specific needs of the community (e.g., framing the design of the project, putting together a team, using data collection and others). Secondly, exploring the data, transforming it using multiple media, sharing data and results with other team members and with the community, as well as receiving feedback are key parts of the Ideation stage. Finally, during the Implementation, it is recommended to use roadmaps and ‘live prototypes’, to evaluate available resources and search for sources of funding, to forge partnerships, engage in monitoring and evaluation, and generally make use of various instruments to ensure the success of this phase and of the process as a whole. Example of a project using HCD Approach: Vroom – Early Childhood Development project in the USA, designed by IDEO.org in partnership with the Bezos Family Foundation. Purpose: to improve interaction between children and their families for better neurological development in early childhood. Methods • Inspiration: visiting economically disadvantaged communities in California, New York, and Pennsylvania; collecting data through interviews with parents, experts in child development and medical doctors, and through observation of existing child development programs. • Ideation: analysing interviews for common themes, developing the main messages of the campaign, testing ideas by inviting mothers for discussions. • Result and implementation: the team’s efforts lead to an extensive campaign to persuade adults to make better use of the time spent with their children, turning interactions in learning opportunities. The team came up with an advertising strategy and worked with an advertising campaign to implement it. Source: Ideo.org (2015) The Field Guide to Human Centered Design. Design Kit. Reaching the most vulnerable families requires government efforts to disseminate information about the AS program and its eligibility criteria, as well as efforts to support families to apply or recertify to the program. Clear responsibilities must also be established for all actors involved in the AS process. Monitoring and targeted support for families included in the program and 11 efficient mechanisms of inter-institutional collaboration are essential to lift families out of poverty. Chapter 1 of the report explains the need for a coherent specific outreach strategy for the AS program in order to transmit accurate information and to sustain program legitimacy. Chapter 2 explains the AS program’s intake and registration and explores possibilities to reduce the number of documents that families must provide to apply for AS/ APRA. It also offers suggestions to cross-check and verify applicants’ information through various information systems. The chapter also assesses the difficulties encountered by social workers and means to address them. Social workers are pivotal in the effort to increase the uptake of the program. Assisting social workers in doing the job increases their availability to actively prevent exclusion errors. Chapter 3 Assessment of Needs and Conditions is a brief evaluation of the difficulties in the process of assessing the applications for AS/ APRA. Does the program succeed in reaching the poorest families? Are the eligibility criteria affectively identifying the poorest families or are vulnerable families inadvertently excluded? Employment requirements appear to be the most problematic set of criteria for establishing eligibility. This set of criteria is justified based on the program goal of assisting the unemployed to integrate into the labor market. Nonetheless, the range of employment-related statuses does not adequately reflect the irregularity of some jobs, e.g., seasonal employment. More intense engagement with applicant families is necessary to identify the employment statuses of their members. In addition, the activation measures implemented by the Labor Force Agency would be more effective in the case of AS beneficiaries if more resources were deployed for this purpose. Chapter 4 discusses enrolment in the program once the application was evaluated. In this stage, two issues are addressed. The first issue is the importance of informing the families about the result of their application through a channel of their choice. The second issue refers to the language and framing of the message, which should be easy for applicants to understand. The message expressed should be grounded in HCD principles, especially in the case of families whose applications were rejected. 12 The next three chapters are more focused on the relationship among institutions involved in the AS delivery system. Chapter 5 Transactions for Payments and Processes discusses institutional arrangements behind the payment process of AS/ APRA and focuses on two problematic aspects: delay of first payment and uncertainty regarding the moment when the first payment should be made. Part of the solution to resolve this issue is an increased reliance on technological solutions for inter-institutional collaboration and communication with beneficiaries. Chapter 6 Grievance Redress Mechanism makes the case that the mechanism is a useful tool to exercise continuous control over exclusion errors. The grievance redress mechanism (GRM) requires an entity to manage the resolution of potential complaints from program beneficiaries or applicants. Feedback received from the GRM can be used to continually improve the program by putting people’s concerns and problems at the center of the process. Chapter 7 Monitoring of Processes and Outcomes discusses aspects of follow up with beneficiaries once they are included in the program. The chapter focuses on monitoring to retain beneficiary families in the program once their applications are accepted and for as long as they are in a vulnerable situation. The chapter also explores ways to support beneficiary families in a sustainable graduation from the program and from poverty. For the program to achieve these goals, it is important to include closer cooperation between institutions providing social services. Improved communication with beneficiaries, with regular reassessment of the level of benefits are also advised. Chapter 8 Oversight and Control examines how mechanisms that target error, fraud, and corruption might influence exclusion errors. We identified some characteristics of the inspection process that create uncertainty, which can be discouraging for potential applicants. It might be useful if the Social Inspection’s activities focused on exclusion errors in addition to detecting inclusion errors. As mentioned, the structure of this report follows in part the structure in the Sourcebook on the Foundations of Social Protection Delivery Systems. The first five chapters of this report reflect 13 the stages in Figure 3 above. For the processes included in monitoring, we departed slightly from the structure suggested in the Sourcebook. We considered it more useful to address some aspects of monitoring in Chapter 7, i.e., basic monitoring, monitoring the compliance with conditionalities and the accompanying measures, and other aspects separately. In Chapter 8 Oversight and Control, monitoring and resolution of errors and fraud are considered. While Chapter 6 is dedicated to the grievance redress mechanism. Data and methods The results presented in this report are based on the analyses of a variety of data including, legal and other administrative documents, administrative data obtained from the main information system of the AS program, the Social Assistance Automated Information System (SAAIS), as well as data from a survey, interviews, and a series of focus groups. The legal instruments we consulted throughout the report were Law 133 from June 13, 2008 on Ajutor Social, as well as the Government Decision No. 1167 from October 16, 2008 to approve the Regulation regarding the way of determining and paying the Ajutor Social. For each chapter, we consulted other Government decisions with a direct impact on the particular subjects discussed. We also reviewed the Communication Guide for Social Workers and the Report of the Social Inspection for 2017 , the most current available at the time this report was written. We also used data from the Ministry of Economics and Infrastructure on the Small Area Deprivation Index (IDAM). The index is computed based on 48 indicators ranking 843 mayorships in the rural area based on different dimensions of socioeconomic development. Details about this dataset are available on the Ministry’s website.4 The methodology we employed is based on one of the main principles of HCD, which is to involve (potential) beneficiaries in any effort to improve the social protection program . Throughout the report, we use inputs from social workers, beneficiaries, and potential beneficiaries as much as possible, and tailor our recommendations in consideration of the points of view they expressed in the interviews conducted by members of the World Bank team. In the course of this report, whenever we speak of survey data, we refer to the World Bank survey on 4 The most current available datasets are from 2014. For more information, please see the relevant pages of the Ministry of Economics and Infrastructure’s website, https://mei.gov.md/ro/content/indicatori-social-economici-pe- localitati. 14 households potentially eligible for AS/ APRA. The survey was carried out by the Institute for Marketing and Sociological Studies (IMAS) Moldova from June through July 2018. Whilst the survey sample included 1,441 households, the low response rate returned 828 completed questionnaires, of which 824 were analyzed for this report. A low response rate mainly stems from many people being absent from the household and a significant share of refusals. The time of the survey could also explain the response rate. It overlapped with the agricaltural season when many people could have been out of their houses working in other households/localities or abroad. Throughout the report we indicate where low number of observations induces limitatons to the analysis. In total, 871 families provided sufficient data to be classified in one of three categories: (i) eligible households that receive the benefits; (ii) eligible household that do not receive the benefits; and (iii) ineligible households that receive the benefits. For the purpose of this report, a family’s eligibility for the program was determined using the data collected in the survey and evaluated based on the eligibility criteria included in the Regulation regarding the means of establishing and paying the Ajutor Social (AS Regulation).5 However, 96 families were deemed not eligible according to their survey responses, but the families claimed they were receiving AS/ APRA. For such families, the analysis considered families eligible who passed the eligibility tests for income and proxy and said they received AS/ APRA, but had at least one family member whose declared employment status was ineligible. Of the 96 families, 53 were considered eligible for the purpose of this report and were therefore included in the analysis. In total, of the 871 families, 370 families are eligible for AS and or APRA benefits, including 238 families that are eligible for both benefits, and 132 families are eligible for APRA. The analyses are also based on an extensive set of interviews with representatives of the Ministry of Health, Labor and Social Protection (MHLSP), Social Inspection, Labor Force Agencies, with social workers and representatives of the Territorial Structures of Social Work (TSSW) at raion level, as well as focus groups with beneficiaries and potential beneficiaries of AS/ APRA in the raions of Căușeni, Cimișlia, Criuleni, and Hîncești, which were part of qualitative research done in 2017 by the representatives of the World Bank in the Republic of Moldova. There were three 5 The verification of the eligibility of families was done by Alexandru Sînchetru. 15 interviews with the representatives of the Ministry of Health, Labor and Social Protection, two interviews with the representatives of the Social Inspection, one interview at the National Labor Force Agency, two interviews with the representatives of the Territorial Labor Force Agencies in Criuleni and Căușeni raions, seven interviews with the representatives of the Direction for Social Work and Family Protection in Hâncești (1), Cimișlia (2), Criuleni (3), Căușeni (1), seven interviews with social workers in seven mayorships in different raions, eight focus groups in four towns including Hîncești, Hârtopul Mare, Cimișlia, and Zaim—two focus groups per town. Together, the eight chapters provide a number of possibilities to improve the delivery chain of the Ajutor Social (AS) program. We acknowledge the efforts of the government and local authorities to continuously improve the AS program and to prevent exclusion errors. We also highlight some remaining program shortcomings that leave vulnerable families beyond the reach of the program by improving its efficiency and effectiveness. To improve efficiency, we advise better inter-institutional cooperation and especially a more extensive use of the current features of the existing information system, SAAIS, as well as suggested possibilities for further developing its uses. To improve effectiveness, our recommendations are intended to include other eligible poor families in the program and ultimately to alleviate poverty. Chapter 1. Outreach This section reviews the first part of the delivery chain process of the Ajutor Social (AS) and Ajutor pentru Perioada Rece a Anului (APRA) programs, i.e., Assessment of Potential Eligibility, and within it, at the very first stage of the process, Outreach. Outreach is comprised of a range of activities to facilitate the flow of information about Ajutorul Social and Ajutorul pentru Perioada Rece a Anului to the target population. Outreach also aims to provide support to vulnerable families to apply for the program. Its focus is on delivering information about a social assistance program to reach the target population and to make individuals aware that they could benefit from assistance if needed (Leite et al. 2017: 16 78). Outreach activities also encourage people to apply to the AS program if they believe they might be entitled to receive a benefit (Leite et al. 2017: 78). Informing the intended population about the objectives, eligibility criteria, rights, and responsibilities of social assistance programs serves a dual purpose: helping people decide if they are eligible for the program and increasing the transparency and legitimacy of the programs. In this chapter, we will evaluate the current outreach activities of the AS/ APRA program and suggest potential strategies to make them more efficient. Following Leite et al. (2017: 78), the analysis addresses the core topics that define the program outreach. We review the strategies at different administrative levels to inform the intended population about the program. We also identify the specific activities in the program targeting vulnerable groups and the actors responsible to define, organize, and implement the outreach activities. The analysis will detail the channels currently used to disseminate information about the programs and will recommend developing new channels. We examine the role of communities in the outreach strategy and whether language differences are considered in the design of the outreach activities. This approach helps us to identify the most important challenges to maximize the uptake of eligible families into the program. We conclude with a synthesis of our recommendations. The current outreach of the AS/ APRA program The older a program becomes, the higher the risk that its focus on outreach activities diminishes. The social assistance program Ajutor Social is 10 years old. Over time, the central and local authorities have decreased their focus on outreach. With a few exceptions,6 the general tendency is to deemphasize the need for an extensive outreach strategy. The increase in the program’s coverage, and examples of social workers that were proactive in outreach activities,7 6 A communication campaign was carried out with the World Bank’s financial support between 2013 and 2014. 7 “Deci despre ajutorul social se știe. Se știe, s-au făcut în afară de astea că s-au făcut la nivel republican, noi am avut pliante, noi am avut ieșire în teren, noi avem biroul de informații pentru populație, eu personal în fiecare săptămână vinerea ies în teren și am întâlnire cu cetățenii individual pentru întrebările care sunt. Și cea mai mare întrebare și cele mai multe întrebări... ce este legat de ajutorul social. Deci noi facem campaniile astea de informare și avem și puse la toate, că sunt pliante, una alta dar beneficiarii câteodată știu mai bine ca specialiștii nuanțele, unde se poate... de șmecherit. Știu proxy-urile? Da, proxy-urile nu cred că știu ei, dar cred că... dar cum se calculează, care sunt procentajele, una alta, le cunosc. Le cunosc? 17 are some of the arguments used to support deemphasizing outreach—even though the AS program continues to exclude families in need of assistance. In 2010, the program included 3.4% of the population, which represented 14% of the bottom quintile of the population. In 2017, individuals in 100,000 households received AS, which is 7.5% of the population and 38% of the poor. In 2017, the heating allowance (APRA) covered 13.7% of the population and around 45% of the poor. Despite the age of the program, individuals and families lack information about social assistance programs. In the absence of a coherent outreach strategy, gaps in information are covered in an unstructured or informal way, resulting in individuals or families misunderstanding the programs, or lacking complete information about them. Information about the AS program is disseminated organically by word of mouth through various individuals. Qualitative data indicate that potential applicants find out about the program from friends, relatives, clerks in the local administration, neighbors, and other beneficiaries, but also from doctors, community carers, and mailmen.8 To improve the uptake of eligible families into the AS program, the current unstructured outreach phase of the program must be improved. The partial information received in unstructured ways by families is insufficient to raise awareness about a families’ eligibility to apply to the program. Certain vulnerabilities of the poor, including disabilities or isolation, might prevent them from learning about the AS program. Also, insufficient information about the program might lead to the perception of a lack of transparency in the distribution of benefits and thereby delegitimize the program. The survey data shows that discrepancies exists between actual and perceived program eligibility (see Table 1). Eligible families that believe they are ineligible for the program increase the exclusion error of the program. And a high pool of ineligible families that believe Da, păi cum... ei vin și spun, ia uite, că trăiesc cu un membru atâta, că este –10, +10 și face calculul, că a văzut doamna...� (representative of TSSW in Cimișlia raion) 8 “The mailman told me because he saw that I was ill and I barely walk around the house and he told me. Hey, did you get some help? I told him that I didn’t receive anything, and he said, go to the townhall and ask because they need to give you because you are seriously ill. And I came and they gave me for the first time, but after that I don’t know what kind of meeting they had…because this is not for every year. They did not come to give me the next year, and I waited for another 2-3 year.� (Focus group in Hîncești raion) 18 they are eligible, decreases the legitimacy of the program and adds to the already intense activity of social workers (see Chapter 2: Intake and Registration). Table 1: Mismatch between objective and perceived eligibility for AS (%) Objective Perceived eligibility Total eligibility Eligible Not eligible Eligible 89 11 100 Not eligible 79 21 100 Source: World Bank Survey on households potentially eligible for AS/ APRA, April 2018. People also have difficulties identifying the criteria they fail to meet, which is further evidence of their poor knowledge about the program (see Table 2). For example, 47% of families that presume they are ineligible for AS because of the proxy means-test, actually meet this criterion (Table 2).9 These situations are more problematic when the family is eligible based on 9 For a similar assessment in the case of APRA, please see Annex 1: Ajutor Social Program Description The Ajutor Social (AS) is a national social assistance program providing guaranteed minimum income benefits (cash transfers) to the poor families in Moldova. The program`s roll-out began in 2009. The benefit eligibility is determined based on three tests: (i) an income test that verifies if the actual household income is below the established level guaranteed minimum income (GMI); (ii) proxy means test that applies a set of proxies considering households characteristics and assets to verify the household living standards are below the set proxy score; and (iii) employment test that implies that the jobless members of the household should be registered with the employment agency with a few exceptions. The amount of the benefit is the difference between the guaranteed minimum income and the actual household income. To receive the benefit households must apply for it and re-certify every 12 months. If they fail to do so their benefit stops. However, if a household has no members of working age capable to work, the benefit is granted for 24 months, after which the household conditions need to be re-confirmed. The beneficiary households must continuously report changes in the household circumstances and income as that may affect their eligibility. Starting 2011, a heating allowance (aka APRA) program was introduced to pay income support cash transfers during five months of the heating season to the recipients of AS and those whose income is somewhat higher than GMI (see details below). Both programs draw on the same delivery mechanisms. 19 Beneficiaries of AS and APRA are also entitled to free health insurance. AS has fundamentally changed the approach to providing cash benefits in Moldova by focusing on poor households, rather than individuals that fall into a certain category. In the process, the reform has challenged the old modus operandi on several important aspects: - It introduced a new cadre of over 1,000 social workers throughout the country who operate at the community level to administer benefits` application and processing with the caseload of around 100-120 registered applications per year/per social worker. - It encouraged complementarity between the social safety net and employment services and changed expectations regarding the work of Employment Agency. - It created a functional monitoring system of social assistance, based on an administrative record maintained in the brand-new Management Information System (MIS) and the annual household survey data. - It improved flexibility of the budgetary process whereby allocations are done based on analysis rather than historic expenditures. - Continuous adjustments were made to the key program`s parameters such as: - The GMI level was continuously updated (it was 430 lei per adult equivalent in 2009, became 530 in January 2010, then 575 in July 2011, 640 in January 2012, 680 in November 2013, 720 in November 2014, 765 from April 2015, 900 from October 2016 and 961 from April 2017). - A benefit indexation rule is applicable from April 2017, based on CPI of the previous year. - The proxy model was updated several times with a new approach implement from 2014. - An income disregard was introduced after 2009 for wage employment initially at 60 lei per employed member per month, and then increased to 120 lei in 2013 and 200 lei in 2014. - An additional disregard of 200 lei of monthly childcare allowance and pension top-ups was introduced in 2014. - The income threshold for APRA was initially set at 1.4 times GMI, but in 2013 the increment was raised to 1.6 and in 2018 to 1.95 times the GRM. - A requirement to perform community works by jobless beneficiaries of working age was introduced in 2018. - A cooperation agreement introduced in 2017 is signed by the beneficiary household to commit it to use the cash transfers for the benefit of the family, primarily to meet the basic needs of children. The Figure A1.1 bellow shows how the number of beneficiary households changed from the onset until March 2019. It also demonstrates seasonality of the program`s enrolment which is a reflection of sizable share of beneficiaries engaged in agriculture. Figure A1.1. Monthly Number of AS and APRA Beneficiaries, 2008-2019 20 200 Thousands 180 160 140 120 100 80 60 40 20 0 2008.12 2009.04 2009.08 2009.12 2010.04 2010.08 2010.12 2011.04 2011.08 2011.12 2012.04 2012.08 2012.12 2013.04 2013.08 2013.12 2014.04 2014.08 2014.12 2015.04 2015.08 2015.12 2016.04 2016.08 2016.12 2017.04 2017.08 2017.12 2018.04 2018.08 2018.12 APRA AS Source: Administrative data To manage budget pressure, the new poverty tested benefits expanded gradually as other categorical programs were phased out. As demonstrated in Figure A1.2, the AS/APRA spending increased over years. However, it constitutes about 30 percent of the overall social assistance budget envelope and 0.5 percent of GDP. More resources may become available to expand the programs as the Government advances consolidation of categorically targeted benefits that still prevail in Moldova`s social assistance system. Figure A1.2. AS and APRA Monthly Expenditure, 2008-2019, millions MDL 70 Millions 60 50 40 30 20 10 0 2010.08 2016.01 2008.12 2009.05 2009.1 2010.03 2011.01 2011.06 2011.11 2012.04 2012.09 2013.02 2013.07 2013.12 2014.05 2014.1 2015.03 2015.08 2016.06 2016.11 2017.04 2017.09 2018.02 2018.07 2018.12 HA AS Source: Administrative data During the early years of AS/APRA programs` implementation the funds allocated for the benefits in the national budget were not spent in full because of slow expansion of benefits coverage (see Figure A1.3 below). As the programs matured and programs` expansion intensified in 2015-2016 the budget plan had to be adjusted to meet the demand for benefits. As 21 all criteria or when the situation of a poor but ineligible family worsens on income or proxy and its members do not realize that they became eligible for the AS program. Table 2: Reasons offered for the perceived ineligibility for the AS program contrasted with the situation of the family (%) The family does not The family meets Total Total meet the respective the respective (%) (N) criterion for AS criterion for AS I do not meet the 78 22 100 41 income criterion I do not meet the 53 47 100 36 proxy criterion Source: World Bank Survey on households potentially eligible for AS/ APRA, April 2018. demonstrated in Figure A1.3 below, the necessary adjustments were introduced, and the programs received enough budget to pay benefits to the enrolled households. Figure A1.3. Planed, Adjusted and Executed Budget for AS and APRA, 2010-2017, millions MDL 700 Millions 600 500 400 300 200 100 0 AS HA AS HA AS HA AS HA AS HA AS HA AS HA AS HA 2010 2011 2012 2013 2014 2015 2016 2017 planed adjusted executed Source: Administrative data Annex 2: Supplementary tables Table A2.1, in the Annex 2. 22 Directors of the Territorial Structures of Social Work (TSSW) and the social workers interviewed generally believe that most people eligible for the AS program know about it. In fact, the data shows that the share of people benefiting from AS is much lower than the estimated share of Moldovans living in poverty. As expected, non-beneficiaries are less satisfied than beneficiaries. The least satisfied are those who believe they are eligible and are not receiving benefits (see Table A2.2.2 and Table A2.3 in Annex 12). Low levels of satisfaction can have a negative impact on the image of the program and on social workers, but satisfaction can be improved through a well-designed outreach campaign. The next section offers a range of possible solutions to address the following problems in outreach in order to improve the outreach strategy of the AS program. 1. Lack of an operational framework for the as program outreach 2. Uneven distribution of outreach activities across raions and localities 3. Split opinions about who should be entitled to receive AS, with no relation to formal criteria Challenge #1: Lack of an operational framework for the AS program Outreach No unified national strategy for outreach activities exists to respond to the specific needs of the population eligible for the AS program. No mention is made about outreach responsibilities at any administrative level concerning laws pertaining to Ajutor Social, the Law 133/13.06.2008 on Ajutor Social, and the Decision 1167/16.10.2008 for the approval of the Regulation regarding the means of establishing and paying the ajutor social. Activities to reach vulnerable families and individuals are guided by the more general Law 547/25.12.2003 concerning social work. According to the Law 547, the outreach strategy is designed by the central and raion authorities, who also have implementation prerogatives. The MHLSP is responsible for the design and promotion of the social work policies at the national level (Article 12). Article 13 of the same law specifies that raion-level public authorities are responsible for informing the population about social benefits programs (point h) and for ensuring that vulnerable groups receive the benefits they are entitled to (point i). At the local level, the role of social workers is mainly related to implementation. 23 Training activities for social workers that focus on communication strategies for the AS/ APRA program are insufficient. Social workers only have access to the Communication Manual to guide their outreach for the AS/ APRA program. The manual has various shortcomings. For example, the manual merely recommends appropriate behavior in communication at the local level, communication that generally is initiated by someone else or which arises as a consequence of someone else’s actions. Encouragement for social workers to take more initiative is limited, even though initiating outreach is crucial to reaching the vulnerable population. Social workers are advised to use a questionnaire to assess the level of public knowledge of the program. They are also given some instruction on possible ways to inform the public. The manual was published in 2014. Regular updates would enhance the manual’s usefulness. The lack of an outreach strategy results in the public’s confusion over the names of different but similarly named social assistance programs. Some people think that AS is provided by the town hall and that they qualify for it once a year or once every other year. The source of confusion is the word ajutor (aid), which has been used for another assistance program with similar application procedures. The decision to provide benefits for the other program was also communicated to beneficiaries through the raion’s TSSW. Since 2018, however, the program causing the confusion has changed its conditions, which should reduce its confusion with the AS/ APRA program. Nevertheless, people will continue to refer colloquially to various social assistance programs using the word ajutor (aid). Challenge #2: Uneven distribution of outreach activities across raions and localities Because of a lack of national guidance and support for the outreach activities, the activities vary across localities. By establishing an outreach strategy, with the limited resources available, the less developed areas would be the most urgently targeted and the outreach efforts would be highly concentrated there. Currently, there is modest uptake rates of eligible families in less developed areas. Survey data suggests little connection between the level of inclusion of eligible 24 families in the program and the level of development of the raion, as measured by the Small Area Deprivation Index (IDAM).10 Gaps seem to exist in outreach activities within the communities, potentially affecting the most vulnerable groups as well. Qualitative information indicates that some older and impaired members of a community that live in greater isolation were unaware of the AS/ APRA program, even after 10 years of its existence. These people might be uninformed or unable to apply for benefits due to their age or impairments. Or, they may not have the necessary documents and therefore social workers did not inform them about the program. Social workers may also lack the incentives to make the effort at outreach to such potentially time consuming beneficiaries of the AS/ APRA program, despite their obvious vulnerability. The implementation of outreach activities vary across localities, potentially negatively effecting the perception of the program. Because outreach procedures are not standardized and established at national and local levels, social workers developed their own outreach methods. Their methods, however, are not always adequate in messaging, frequency of communication, and targeting of potential beneficiaries. For instance, social workers were reported to have pressured families to apply for programs. Feeling harassed, the families sued the social workers.11 Such a backlash could discourage social workers from doing outreach. Outreach activities only partly consider the linguistic barriers of Russian monolinguals. Currently, the population’s interactions with government institutions generally are conducted in Romanian, “the state language.� However, authorities are also able to issue official documents in Russian. In communities with large numbers of Roma, Romani language speakers may be required, even though some family members are probably fluent in Russian or Romanian/ Moldovan. In the 2014 census, 0.3% of the population identified their ethnicity as Roma. At the 10 The correlation coefficient between coverage of eligible families for AS (% survey data) and the Small Area Deprivation Index across raions for 2014 is -0.3. For more information on IDAM, please see the Introduction. 11 “We practically covered all that might be eligible. Well, you can’t go to…, ‘cause we actually had some information that complaints were filed in the courtroom because the social worker forced people to register for Ajutor Social. We were sued. [...] we had 2-3 years ago a gathering at the Ministry, a meeting in which specialists told us: <