Kostromskaya Oblast forms part of the Central Federal Okrug, with an administrative, cultural and industrial centre in the city of Kostroma.

The total area of the Oblast is 60,2 thousand square kilometres. The Oblast borders on Vologodskaya, Ivanovskaya, Nizhegorodskaya, Yaroslavskaya and Kirovskaya Oblasts.

The overall number of permanent residents of the Oblast is 766,4 thousand persons, of which 508,8 thousand persons (66,4 per cent) are city dwellers and 257,6 thousands (33,6 per cent) are countryside residents. Density of population amounts to 12,7 persons per square km. 59,2 per cent of the Oblast residents are people of active working age, whereas 23,1 per cent are above working age. The average age of the Oblast inhabitants is 37,8.

The Governor of Kostromskaya Oblast is Mr. Viktor Shershunov, who was vested with the authorities of head of the Kostromskaya Oblast administration on April 21, 2005.

Rehabilitation and social protection of people with disabilities
Basic information

The total number of people with disabilities residing in Kostromskaya Oblast is 89 thousand 259 (12 per cent of the Oblast population).
This number includes:
1449 persons disabled by the Great Patriotic War;
3002 disabled participants of the Great Patriotic War;
136 persons disabled by the disaster of Chernobyl nuclear power station;
3018 disabled children.

The total number of people with disabilities is further broken down by degree of limitation of working activity:
1st degree – 24 per cent;
2nd degree – 49 per cent;
3rd degree – 16 per cent.
11 per cent of the disabled are not bound by the limitation of working activity.

The year 2006 was marked by the decrease in the number of the citizens above working age officially recognized as disabled for the first time:
2005 – 9517 persons;
2006 – 7940 persons.
Other than that, the total number of disabled children reduced as well:
2005 – 3153 persons;
2006 – 3018 persons.

More than 10 thousand disabled individuals have a permanent earned income, including 1795 persons employed by 197 enterprises which comply with the established quota of workplaces for disabled people.

The number of regularly employed people with disabilities has raised. In 2004, there were only 433 employed disabled people, while in 2006 this number reached 934.

1937 individuals reside in boarding institutions for the disabled and in residential institutions for the elderly people, including those 1530 with limited abilities (79 per cent). Among citizens who receive in-home social services, 6900 individuals (79 per cent) are disabled.

The pension for those disabled by the Great Patriotic War in Kostromskaya Oblast averages 6949,87 roubles, for those disabled by the disaster of Chernobyl nuclear power station – 3235,81 roubles, average employment pension for the disabled is 2104,14 roubles. In addition to that, the following monthly monetary benefits are provided:
To disabled persons with limited working activity:
3rd degree – 1610,14 roubles;
2nd degree – 1150,10 roubles;
1st degree – 920,08 roubles;
To people without limitation of working activity – 575,05 roubles;
To disabled children – 1150,10 roubles.

In 2006, 44910 persons were entitled to free provision of medicines, 886 persons were provided with hearing aids (89 per cent), 28 individuals disabled by the Great Patriotic War received automobiles at the expense of the federal budget.

78051 persons enjoy social compensations for housing and utility service payments.

All rehabilitation activities for the disabled are co-ordinated by the Oblast Council for Social Support for People with Disabilities, headed by the administration deputy head for social issues.
In 2007 the Oblast Council adopted an interdepartmental Action Plan for Social Support for the Disabled of Kostromskaya Oblast for 2007-2009.

Public authorities interact with non-governmental organisations for the disabled in the form of supporting contests, assemblies and seminars conducted on the oblast, interregional, all-Russian and international level.

A partnership Project “Young Family” aimed at supporting families of young people with disabilities is being implemented by the Committee 15 for the Issues of Youth and the public organization “White Dolphin”. The Department for Social Protection of Kostromskaya Oblast provides for the participation of the public organization of Kostroma of the All-Russian Society for the Disabled in the programme “National Centre for the Development of Tourism for the Disabled”.

Institutions and organizations for social support and rehabilitation of the disabled

In Kostromskaya Oblast, there are 293 institutions and organizations active in the field of social support and rehabilitation of people with disabilities:
10 residential institutions of social support for the disabled and the elderly citizens;
1 public institution – boarding home for children with mental disabilities;
1 public institution – Oblast-level rehabilitation centre for children and teenagers with limited abilities “Forest Fairy Tale”;
1 public institution – rehabilitation centre and recreational club for the disabled “Nadezhda” (Hope);
1 public institution – “Centre for the Social Well-being of Childhood, Youth and Family”;
1 public institution – “Centre for Rehabilitation Treatment”;
29 public institutions – Comprehensive Centres for social services for the community;
4 public institutions – Centres for social services for the community;
94 specialized nursery groups in pre-school institutions of Kostromskaya Oblast;
16 specialized corrective educational institutions of 8 types, including 2 schools, 13 boarding schools, 1 boarding home for children;
131 corrective classes on the basis of comprehensive secondary schools;
2 spa and curative educational institutions for children in need of a long-term treatment;
1 public institution – “Oblast Social Support Centre for the Family and Children”;
1 Oblast-level hospital for war veterans.

More than 7 thousand persons with disabilities annually receive rehabilitation services from the institutions of social support and from educational institutions. In 2006, 299 disabled children who could not attend educational institutions were provided with home-based study programmes.

6771 citizens receive services on an in-home basis from 83 divisions of Centres for Social Support.

Apart from that, there are several non-governmental organisations active in the field of social support for the disabled:
• Public organization of Kostromskaya Oblast of the All-Russian Society for the Disabled;
• Regional public organization of the city of Kostroma of the All-Russian Society for the Visually Impaired;
• Regional public organization of the city of Kostroma of the All-Russian Society for the Hearing Impaired;
• Youth public organization for the disabled “White Dolphin”;
• Youth club for the disabled “Elenium”.

Rehabilitation System for the Disabled – Overall Targets

Rehabilitation services (medical, social, psychological, educational, occupational etc) are provided to the disabled as part of individual rehabilitation programmes developed together by hospitals and health care institutions, bureaus of medical and social examination, educational authorities and communal employment agencies. These activities are co-ordinated by the institutions for social protection.

As far as medical rehabilitation for the disabled is concerned, Kostromskaya Oblast has an established system of medical support, prosthetic support, and provision of medicines upon medical prescription.

Health care for the disabled is provided within the framework of the programme of the state guarantees of free medical assistance. The programme is adopted annually by the resolution of the Oblast governor. The programme’s cost for one citizen (including people with disabilities) in 2006 averaged 2599,2 roubles. In the Programme draft for 2007 this norm is planned to reach 3129 roubles.

Among all registered individuals disabled by the Great Patriotic War, in 2006, 82 per cent were addressed in the course of comprehensive medical examination by different health care and preventive institutions of the Oblast, and 90 per cent of those in need received in-patient treatment.

In 2006, 262 persons with disabilities received an assignment to federal health care institutions providing cardiac surgery and institutions providing treatment for eye diseases and oncological diseases. 27 disabled individuals underwent expensive surgeries of endoprosthesis of large joints (in 2005 there were only 24 of such patients). A normal financial allocation from the federal budget for highly qualified medical assistance for one quota for cardiovascular surgery is 133 thousand roubles, neurosurgery – 114 thousand roubles, traumatic and orthopaedic surgery – 87,7 thousand roubles, ophthalmology – 44 thousand roubles.

In 2006, on the basis of federal clinical hospitals 192 disabled children received diagnostic and specialized medical assistance, 62 disabled children received care in federal spa and health resorts. Two computer tomographs were acquired at the expense of the Oblast budget (more than 50 million roubles allocated) in order to improve the quality of medical rehabilitation.

Disabled persons with severe renal failures receive specialized treatment in the division of haemodialysis of municipal department for healthcare “First City Hospital of Kostroma” equipped with an artificial kidney. In 2006, a total budget spent on these purposes reached 14,2 million roubles, which amounts to 3% of the Oblast budget (258 thousand roubles spent per patient).

A division of social and medical rehabilitation is established in the public institution “Gerontological Centre Oktyabrsky”. The division implements comprehensive activities aimed at the prevention of chronic disease exacerbation in elderly patients, as well as at providing psychological support and stress relief. The centre is equipped with treatment and diagnostic facilities, a laboratory, a functional diagnostic unit, a portable electrocardiograph, ultrasonic equipment, an ultrasonic scanner for thyroid gland diagnostics, a procedure unit, a dental surgery unit, a massage unit, a dressing ward, a physiotherapy unit, stress relief facility, as well as with therapeutic physical training facilities and a gym. Experienced medical and social rehabilitation specialists of the divisions for in-home social assistance of community centres for social services provide highly qualified medical and social support to the disabled.

Children are provided with comprehensive medical and social assistance by all community institutions for social protection and educational institutions. The division for medical and social assistance of the public institution “Recreational and Health Care Centre “Forest Fairy Tale” provides the following services to children: therapeutic physical training, therapeutic massage, physical therapy including electric sleep, thermo-therapy, inhalations, “Mountain Air”, phototherapy, laser and plaster therapy, physical training and swimming. The Centre is equipped with state-of-the-art technology: a therapeutic blanket, “Grossa” body builder, “Adeli” suits, various positioners, detensor mat (for soft stretching of the spine), therapeutic and diagnostic complex “Rista-EPD”, mechanotherapeutic facilities, etc.

The division is equipped with a wide range of orthopaedic therapeutic devices, including soft stilts and a dry swimming pool. A large number of specialized measures is undertaken for general health enhancement, including symptomatic treatment.

One should point out the experience of the public institution “Nadezhda” (Hope) (rehabilitation centre and recreational club) which specializes in rehabilitation of disabled children and young people by means of physical training and sport. The centre prepares athletes for Olympic and Paralympic games.

More than 500 young people with disabilities are being rehabilitated by means of sports and physical training. Athletes of Kostroma won a number of Russian national championships among people with locomotive dysfunctions, cerebral palsy, the visually and hearing impaired. Athletes of the Centre participate in and win the world championships and European and World Special Olympic Games (25 athletes, 52 medals).

The Centre provides horse riding courses for 22 disabled children. In August of 2006, Special Olympic Games of Russia took place in Kostroma with the participation of disabled athletes from 32 Russian regions. Athletes from “Nadezhda” won the right to take part in the World Summer Special Olympic Games in China in 2007.

As far as social, psychological and educational rehabilitation is concerned, the respective services are provided on the interdepartmental basis, by the social service institutions and by educational authorities, with the assistance of public and non-governmental organizations for the disabled.

The department for social protection of the community in co-operation with the Committee for the Issues of Youth and the non-governmental organization for young people with disabilities “White Dolphin” holds round tables and seminars on various disability issues crucial to disabled young people.

Qualified professionals from the Oblast-level Centre for Social Health, Childhood, Youth and Family provide advice and expertise to families with disabled children. The helpline for young people is run by volunteers and provides counselling on all disability-related issues.

The municipal Department for cultural heritage, culture and tourism has developed computer software enabling disabled children to study the history of Kostromskaya Oblast in the course of art therapy.

In order to increase the educational opportunities of visually impaired children and to ensure their exposure to the socially meaningful information and cultural heritage, the Department started to publish books in Braille format and large print. Since then, the Department has published a few collections of works of blind poets: “Eyes of the Soul”, “Runway” (by a Kostroma poet V. Volkov), collection of poems for children “Rainbow” (by T. Rasulova).

Significant assistance to the disabled of all age ranges is rendered by the centres of social support. Social and psychological rehabilitation to people with disabilities is provided by 14 day care centres, 20 residential institutions for elderly and disabled citizens and 83 in-home social service divisions. These institutions are aiming to improve social inclusion, integration and adaptation of people with disabilities in the society. These problems are addressed on the basis of informal clubs for the disabled and their families, established under the centres of social services. The clubs are established to facilitate the recreational activities, communication and information exchange between the members. Clubs such as “Healthcare”, “Life Is a Song Worth Singing”, “Hope”, “I Believe” are active at most centres of social services and specialize in the following fields:
• recreational and sports activities;
• folk songs;
• needlework, handicrafts etc.

Social clubs help people with disabilities acquire confidence and new interests, review their attitudes, overcome difficulties, and understand their value for the society.

All institutions support recreational and sports circles where disabled people can spend their spare time. In order to raise motivation, institutions use the following methods: art, music and cinematographic therapy. The disabled can practise different crafts, such as dough modelling, birchbark patchwork, herbs and plants composition, plaster modelling. The public institution “Gerontological Centre Oktyabrsky” provides extensive psychological counselling to its residents. The Centre has developed a number of questionnaires and diagnostic cards and provides psychological therapy through tests, training seminars and consultations. The Centre is equipped with a library, a cinema hall, colour TV-sets, tape recorders, a video camera, a stereo system, a church in the name of Reverend Sergiy Radonezhsky.

Institutions for children are focused on the provision of social, cultural, psychological and educational rehabilitation services. In order to identify and develop skills, knowledge, hobbies, social experience and physical abilities, the public institution Oblast-level rehabilitation centre for children and teenagers with limited abilities “Forest Fairy Tale” widely uses the methods of computer diagnostics. An individual rehabilitation programme is elaborated by the professionals of the centre for each disabled child in order to develop the child’s creative abilities.

|Based on individual intellectual features, physical abilities and age of patients, the Centre offers facilities for the following recreational activities: drawing and arts, applied arts, fluffy toy making, embroidering, basketry, singing, dancing, theatre, reading.

Furthermore, “Forest Fairy Tale” holds an annual Oblast-level arts and crafts festival for disabled children “Believe in Yourself!”. In April-May of each year municipal, city and regional creative festivals for disabled children are conducted. Each year, more than 1450 children and teenagers of Kostromskaya Oblast take part in the festival.

The aim of the festival is to discover and promote emerging talent in disabled children, to help them to adapt in mainstream settings, to attract the attention of governmental institutions and NGOs to the problems of disabled children.

The division of psychological counselling of “Forest Fairy Tale” works to correct and promote the disabled children’s cognitive and intellectual activity, psychological and emotional condition, resolve personal problems and help establish interpersonal relationships. This is implemented through a variety of methods, such as psychological diagnostics, psychological prevention, psychological treatment, and psychological training conducted in the specially equipped rooms and laboratories. The complex of social and psychological services is designed to assure the child of the positive effect of treatment, of child’s own potential, to focus the child on the positive approach.

Therefore, other than specific kinds of psychological rehabilitation, the Centre also uses the comprehensive system which includes integrated psychological technologies involving music therapy, drawing therapy, fairy therapy, occupational therapy, various games and a sensory room.

Psychological rehabilitation is coupled with social and educational rehabilitation methods. The latter are aimed at promoting social activity, confidence, and personal development of disabled children. These tasks are implemented by a range of professionals, such as speech therapist, social workers, occupational therapists, vocational teachers. The centre is equipped with classes for social and occupational adaptation, for a hairdressing apprenticeship and for basic craftsmanship training course.

Occupational rehabilitation of people with disabilities is one of the priorities of the Oblast administration and the Oblast Duma. The law of Kostromskaya Oblast No. 258-ZKO of April 11, 2005, “On Establishing a Quotas for Workplaces for the Disabled on the Territory of Kostromskaya Oblast” spells out a quota system for disabled people. Enterprises, irrespective of ownership, with more than 100 workers, are obliged to create special workplaces for disabled, with the quota of 2 per cent of the overall number of employed by an enterprise.

Pursuant to the quota system, 1197 workplaces were created in 193 enterprises of the Oblast; the number of the disabled actually employed is 1787. The Oblast employment centre provided counselling to 810 people with disabilities in 2006; 36 disabled persons have received occupational training. The training is conducted with the view of subsequent job placement, based on available vacant jobs.

In 2006, training was provided to equip disabled people with the following skills sought-after on the local job market: lift operating, personal computer skills, cutting, sales assistance, electric welding, turning work.

Occupational and vocational training is one of the main components of the rehabilitation process conducted in Susaninsky Psychoneurological Residential Institution. Under the guidance of professional coaches, the residents acquire skills in horticulture, cattle breeding, street cleaning, loading, nursing, cleaning, sewing. A special emphasis is put on teaching self-care skills and household chores to disabled residents. The institution is equipped with a special room for adaptation to general social and living conditions, where the residents can learn sewing, ironing and cooking.

In order to increase employment opportunities for disabled children, new vocational schools have been established by educational authorities (2004 – 3, 2006 – 15 vocational schools). These institutions were equipped with the shoemaking, joinery and automobile repair machinery. A collection of books on orientation in social and living conditions as well as training and methodological recommendations were bought for specialized (corrective) vocational schools for people with disabilities.

A detailed account of all young disabled people leaving vocational schools is kept in order to optimise the system of occupational rehabilitation of disabled children and to control their employment status.

In 2006, co-operation agreements were signed between public corrective educational institutions for children with hearing, visual, speech and locomotive disabilities, including the boarding school of Denisov, and inter-school training complexes and vocational institutions. Under these agreements, in 2006, 23 young disabled people received training in hairdressing, PC use, basic nursery and psychology, massage and bookbinding, and obtained qualification certificates.

In 2005, 279 young people with mental and physical disorders received training in vocational schools.

Sub-programmes “Disabled Children”, “Healthy Child”, “Family and Children”, implemented within the Oblast-level targeted programme “Children of Kostromskaya Oblast”, are aimed at improving the quality of rehabilitation services.

The Programme provides for the enhancing of material and technical basis of institutions for disabled children, the acquisition of methodological materials and training programmes for the rehabilitation process.

A residential for children with mental disorders is being built in Kostromskaya Oblast. The construction is financed from the federal and Oblast budgets.

Rehabilitation of people with disabilities is widely supported in mass media. The Oblast newspapers and magazines regularly cover issues related to the rehabilitation of the disabled. In particular, the local newspaper “Youth Line” covers the events and activities held by the youth public organization “White Dolphin” and publishes poems by young disabled people in its poetry corner. The local newspaper “Northern Truth” holds a permanent column on disability issues and publishes letters from disabled readers to the editor, public authorities and NGOs.

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