Disability Acts in India (Part 1)

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PM Narendra Modi in his 'Mann ki baat' address --- " We see a person's disability with our eyes. But our interaction tells us yhe person has an extra power. Then I thought, in our country, instead of using the word ' Viklaang' we should use the term 'divyaang' (meaning with divine power). "

“People with disabilities deserve the chance to build a life for themselves in the communities which they choose to live.” –Barack Obama

"My advice to other disabled people would be, concentrate on things your disability doesn't prevent you doing well, and don't regret the things it interferes with. Don't be disabled in spirit, as well as physically."--- Stephen Hawking.

We as Occupational Therapist and Physiotherapist intervene patients in acute, subacute and chronic stages of recovery. Depending upon the patients severity level, few might not regain their original functional level due to permanent or temporary impairments. So in these cases we as rehabilitation team and healthcare professionals should have knowledge about various disability conditions, prognosis of patient, scope of recovery, disability Acts and thereby accordingly make appropriate referrals to various healthcare departments for patients treatment and recovery. We should know which patient will require disability certification. This certificate will improve PwD QOL, equality in work opportunities, concession facilities and various other benefits. 

We have to make patients functionally independent and improve their quality of life, for which availing disability certification is a good option so that patients with temporary or permanent impairments can get certification benefits, keep working in current physical condition and can also get facilities as mentioned is various Disability Acts.

Being disabled doesn't mean un-abled, it's actually Differently Abled. For creating a disability inclusive environment many policies and Acts are implemented all over the world. These laws are meant to create :

• Disability awareness in society.
• Right to equal opportunities to work for disabled/ specially abled people.
• Built disability inclusive and disability friendly environment at home, workplace and public places.
• Support families of PwD.
• Provide reservation for PwD in fields of education, employment, travel etc.

4 Acts related to disability in India :

Fig : 4 Acts related to disability in India

In this article we will add information about 'The National Trust Act, 1999' and 'The Rehabilitation Council of India, 1992'.

THE NATIONAL TRUST ACT, 1999:       

This Act may be called the National Trust for the Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act, 1999. 

• It extends to the whole of India except the State of Jammu & Kashmir. 
• The National Trust is a statutory body of the Ministry of Social Justice and Empowerment, Government of India, set up under the “National Trust for the Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities” Act (Act 44 of 1999).
• The National Trust works towards providing opportunities for capacity development of Persons with Disability (PwD) and their families, fulfilling their rights, facilitating and promoting the creation of an enabling environment and an inclusive society.

Disabilities under NTA : The National Trust works for the welfare of persons with any of the following four disabilities

• Autism
• Cerebral Palsy
• Mental Retardation
• Multiple Disabilities

Schemes of National Trust are:

1) DISHA (Early Intervention and School Readiness Scheme) :

• Early intervention and school readiness scheme.
• Children in the age group of 0-10 years are eligible.
• Provision of therapies, trainings and providing support to family members.
• Day-care facilities to PwD for at least 4 hours in a day.
• Batch size 20 PwDs.
• Registered Organization (RO) should maintain a ratio of 1:1 for LIG (including BPL) and above LIG PwDs. [LIG - Lower income group).
• Scheme will be available in the entire country except J &K.

2) VIKAAS (Day Care) :

• Day care scheme, for children above 10 years, primarily for enhancing interpersonal and vocational skills.
• Provision of caregiving support to PwD is in centre.
• Helps in supporting family members of the PwDs to get some time during the day to fulfil other responsibilities.
• Day-care facilities to PwDs for at least 6 hours in a day along with age specific activities.
• RO should maintain a ratio of 1:1 for LIG (including BPL) and above LIG PwDs.
• Batch size 30 PwDs.
• Scheme will be available in the entire country except J &K.

3) SAMARTH (Respite Care) : 

• Respite home for orphans or abandoned, families in crisis and also for Persons with Disabilities (PwD) from BPL & LIG families including destitute.
• Opportunities for family members to get respite time in order to fulfil other responsibilities.
• Group home facility for all age groups with adequate and quality care service with acceptable living standards including provision of basic medical care from professional doctors.
• Batch size 30 PwDs.
• RO should maintain a ratio of 1:1 for LIG (including BPL) and above LIG PwDs.
• Scheme will be available in the entire country except J &K.

4) GHARAUNDA (Group Home for Adults) :

• An assured home and minimum quality of care services throughout the life of the PwD.
• Adequate and quality care service with acceptable living standards including provision of basic medical care from professional doctors.
• Vocational activities, pre-vocational activities and assistance for further training.
• Batch size 20 PwDs.
• RO should maintain a ratio of 1:1 for LIG (including BPL) and above LIG PwDs.
• Scheme will be available in the entire country except J &K.

5) NIRAMAYA (Health Insurance Scheme) :

• Affordable Health Insurance to PwDs.
• Health insurance cover of up to Rs. 1.0 lakh.
• Facility for OPD treatment including the medicines, pathology, diagnostic tests, etc. Regular medical checkup for non-ailing disabled, Dental Preventive Dentistry.
• Surgery to prevent further aggravation of disability, non- Surgical/ hospitalization, corrective surgeries for existing disability including congenital disability.
• Ongoing Therapies to reduce impact of disability and disability related complications, alternative medicine transportation costs, no pre-insurance medical tests required.
• The scheme will be available in the entire country except J&K. 

6) SAHYOGI (Caregiver training scheme) :

• Setting up Care Associate Cells (CACs).
• Provide training and create a skilled workforce of care associates to provide adequate and nurturing care for Person with Disabilities (PwDs) and their families who require it. 
• It also seeks to provide parents an opportunity to get trained in caregiving if they so desire.
• Provide a choice of training through two levels of courses primary and advanced.

7) PRERNA (Marketing Assistance) :

• Prerna is the marketing assistance scheme with an objective to create viable and widespread channels for sale of products and services produced by PwDs.
• This scheme aims at providing funds to participate in events such as exhibitions, melas, fairs, etc. to sell the products made by PwDs.
• The scheme also provides an incentive to the Registered Organisation (RO) based on the sales turnover of the products.
• The National Trust shall fund RO participation in national, regional, state and district level events such as fairs, exhibitions, melas etc. for marketing and selling products and services prepared by PwDs.
• At least 51% of employees of these work centres should be PwDs covered under National Trust Act.

8) SAMBHAV (Aids and Assisted Devices) :

• It aims to provide information and easy access to device and appliances, aids and software etc for betterment and empowerment of PwDs of the National Trust disabilities. It setups an additional resource centre, in each city of the country.
• Combine and collect the Aids, software and other form of assistive devices developed with a provision of display and demonstration of the devices.
• Maintaining information, pertaining to aids and assistive devices present at Sambhav centre, on the National Trust website. 
• Display and demonstration of the devices to the concerned stakeholders.
• List of assistive devices should also include learning kits, aids related to mobility and communication etc. The cost of any new aids or assistive devices added to the centre (even if it has been imported) will be reimbursed to the centre as per the financial limit determined by the National trust.

9) BADHTE KADAM (Awareness and Community Interaction) :

• Badhte Kadam aims at community awareness, sensitisation, social integration and mainstreaming of Persons with Disabilities. 
• It has below mentioned objectives:
• Raise awareness in the public, regarding Person with Disability (PwD) covered under the National Trust Act and encourage their inclusion in the society, social integration and participation of persons with disabilities in all aspects of life.
• Disseminate information on preventive strategies for the disabilities under the National Trust Act,1999.
• Sensitize community stakeholders.
• Publicize and maximize benefits of the National Trust schemes for Registered Organization(RO), PwDs and for families of PwDs.
• Increase representation in remote areas and in areas where the National Trust is under represented.
• Spread awareness about myths and misconceptions about disability, disability etiquette etc.

THE REHABILITATION COUNCIL OF INDIA (RCI), 1992 :

The RCI was setup as a statutory body and its specific role is to develop, standardize and regulate training programmes courses at various levels in the field of rehabilitation and special education. Mission and vision is to provide services to persons with disabilities and to ensure that treatment is provided by  qualified professionals or personnel and it serves as an accreditation and quality control facility.

Later in year 2000, few amendments were made in RCI Act, 1992. The need of amendment was arisen in view of developments in rehabilitation and  education sector from 1992 onwards. A need to benchmark all programmes and courses with those being conducted at national and international levels to ensure quality in rehabilitation education and to bridge the gap in quality rehabilitation care human resource.

Amended RCI Act, 2000 : An Act to provide for the constitution of the Rehabilitation Council of India to provide fro accessible, quality and affordable habilitation and rehabilitation education; to meet the demand of high quality professionals and personnel in all parts of the country; to encourage professionals to adopt latest research in their work and contribute to research; to maintain and enforce high ethical standards in services provided by professionals and personnel; and for matters connected therewith or incidental thereto in line with the provisions of Rights of Persons with Disabilities Act, 2016

Few objectives are:

• Map programmes and courses in habilitation and rehabilitation being conducted at the national and international levels and prescrib benchmark standards for the same.
• Admit, conduct examination and award certificate or diploma;
• Regulate programmes and courses at universities or institutions granting recognised qualifications, as per benchmark standards prescribed by Regulations;

• Aid and advise universities and institutions on fixation of tuition and other fees and charges to be charged to students enrolled for acquiring recognized qualification.
• To maintain Central Rehabilitation Register for registration of professionals/ personnel under the categories of : Under the amended RCI, 2000 Act various healthcare workers are divided into Schedule 1 (Professional) and Schedule 2 (Personnel). 
• Schedule 1 Professionals includes Audiologist and Speech Therapists, Clinical Psychologists, Physiotherapist, Occupational Therapist, social worker, rehabilitation counselor, vocational counselor, prosthetist and orthotist, respiratory therapist, braille teacher, psychiatric assistant etc. Professional is one who has acquired a minimum of bachelors' degree or above in any recognised qualification or is an associate member of the Institution of Rehabilitation professional.
• Schedule 2 Personnel includes Psychiatric assistant, Occupational Therapist assistant, respiratory therapist, special educator, physical therapist assistant, recreational therapist etc. Personnel is one who has acquired a diploma or certificate in any recognised qualification.
• To collect information on a regular basis on education and training in the field of rehabilitation of people with disabilities from institutions in India and abroad.
• To encourage continuing education in the field of rehabilitation and special education by way of collaboration with organizations working in the field of disability. 
• Establish an institution of rehabilitation professionals which will enroll fellows, members and associates.
• Prescribe code of conduct, ethics and etiquettes for professionals and personnels.

Disability certificate:

A disability certificate (also known as PwD certificate or PH certificate or handicap certificate) is a document that certifies the type and extent of holder’s disability. 

In India, this certificate is usually issued by medical boards constituted in certain government hospitals. Disability certificate is an important document for persons with disabilities because it entitles the holder to get benefits / facilities and rights of persons with disabilities. Government of India and state governments provide a host of facilities to disabled people but all these facilities are available only to those who hold a valid disability certificate.

Criteria for Getting Disability Certificate :

Any person suffering with disabilities as mentioned under The Right of Person with Disabilities Act, 2016 is eligible to apply for a disability certificate. However, when the medical board does disability evaluation — the certificate is issued only to those who fulfill any of the following criteria:

• Person must have minimum 35% mental handicap or disability.
• Person must have an orthopedic disability of minimum 40%.
• In case of deaf people, the minimum disability percentage should be 40% i.e. 60 to 70 DB hearing loss. Severe (75% and above) to profound (100%) hearing loss person will get more benefits.
• Visual impairment : More benefits are availed if person is complete blind (disability 90% or more). 

MUST KNOW: Disability Certificates will soon be replaced by Unique Disability ID Cards in India.

Benefits of the Disability Certificate :

With disability certificate, the government has attached a number of benefits and facilities. These benefits vary from state to state and also according to the type and extent of disability. 

Following are some of the general facilities that a disability certificate holder can avail. If you want to get any of these benefits, we advise you to get more specific information:

• Scholarship schemes for students with disabilities.
• Concession in railway fare, airplane fares.
• Rebate in income tax.
• Reservation in government jobs.
• Free travel in state transport buses.
• Loan for starting own business.
• Subsidized prosthetic aids and assistive devices (like wheelchairs).
• Group insurance for government employees with disabilities.
• Unemployment allowance to educated disabled persons.
• Incentive for eye donors.

Thankyou for reading !!!!

Dr. Sheetal Tatar-Dhande, Dr. Pallavi Khadse-Kolhe, Dr. Ashwini Sangar