Aila Kumpulainen. Services for people with intellectual disabilities in 2004. Helsinki, 2007. 137 pp. (Reports of the Ministry of Social Affairs and Health, Finland, 1236-2115, 2007:30) ISBN 978-952-00-2356-0 (paperback), ISBN 978-952-00-2357-7 (PDF)

It is estimated based on the study that there were about 35,000 persons with intellectual disabilities in Finland in 2004, of which 27,000 used services organised within the framework of special care for people with intellectual disabilities. Some of the persons entitled to special care services could cope with other services and some of them did not want to have special care services. The proportion of people who used special care services of the population was 0.52 % in the whole country. The proportion varied in different parts of the country from 0.32 to 0.83 per cent. The proportion of service users was largest in the group of school-age persons (0.67 %). In the entire country, 12,500 persons (47 %) using special care services lived with their families. Half of those living with their families were children or young people, and half of them were aged over 18. Housing services within special care were provided to about 7,500 persons (28 %), and 2,700 persons (10 %) were in institutional care. The adults with intellectual disabilities who lived independent lives numbered 3,300 (12 %), and about 1,000 persons were placed in family care.

The net costs of special care services for persons with intellectual disabilities incurred by municipalities amounted to about EUR 480 million in 2004. The three largest service categories were housing services EUR 185 million (40 %), institutional services EUR 161 million (34 %) and work and day activities EUR 94 million (20 %). The costs of special care amounted to EUR 17,800 per inhabitant/year on average. The costs varied by region, from EUR 11,800 in the Province of Oulu to EUR 21,800 in the Province of Southern Finland. Measured in net costs the municipalities produced themselves 32 % of the special care services and purchased 68 %. The share of the special care districts of the purchased services was 48 % and that of other service providers (companies, foundations, NGOs) 20 %. Municipal authorities have assumed a greater role as providers of housing services and work and day activities, and increased the purchase of these services from other service providers. The division of labour between the municipal authorities, special care districts and other service providers varies greatly throughout the country.

Social welfare and health care services are provided to people with intellectual disabilities under several laws. The principle observed in organising services is that the general laws have

precedence over special laws. On the other hand, the major part of the social services for persons with intellectual disabilities is organised on the basis of the Act on Special Care for Mentally Handicapped Persons. Every fourth intellectually disabled person also used services under the Services and Assistance for the Disabled Act. The costs of those services amounted to almost EUR 20 million. As regards the universal social services, people with intellectual disabilities used most the support for informal care, which covered about 4,500 clients with intellectual disabilities. The costs of informal care were about EUR 15 million.

It appears from the replies of municipal authorities that the present legislation needs to be clarified. Although there is general agreement that general laws have precedence, in practice the authorities often have to apply special laws. This may result in overlaps as they have towork based on provisions in several laws, as well as in inequality between clients in different parts of the country.

A major part of the municipalities considered the services obtained by persons with intellectual disabilities better or at least as good as the services obtained by other client groups. Housing services and temporary care are the largest single services in need of development.

Key words: Family care, non-residential services, people with intellectual disabilities, residential care, social services, special care for people with intellectual disabilities, welfare for people with disabilities