Capacity Building from a Global Perspective

Originally posted on Keystone Human Services’ website

“The welfare of all of us is vested in the welfare of each of us.”

This is a powerful sentence embedded within our vision statement, and one which brings with it great responsibility, challenge, and promise. Over the years, we have broadened our exploration of this concept. Since our founding in 1972, the world has become a smaller place, and the responsibility to “create a safer world” has caused us to reach far beyond our roots in central Pennsylvania.  Once again, we are finding ourselves engaging with the struggle for building strong and inclusive communities alongside people with disabilities, their families, partners, and advocates far beyond our borders. This challenge of realizing that the “us” in our vision statement really does seem to mean every single one of us, whether in Chisinau or Harrisburg, Kazakhstan or New Delhi, resonates for us at this time in our development as a force for change.

As one of the first countries to ratify the United Nations Convention on the Rights of People with Disabilities, India is in a promising position to move forward with disability rights. This presents an opportunity to examine the systems of care for people with disabilities and move toward inclusive and community-based services. Many supports and services for people with disabilities are provided with a charitable mindset, and dependent on the benevolence of donor organizations to provide a patchwork of resources to families and people with disabilities. As India becomes a growing economic force in the world, extended family support structures are declining, and long-held traditions of family care for family members with disabilities over generations are at risk. Indian families share the concerns and fears expressed by so many here at home of “what will happen to my family member when I am gone?” In other parts of India, the conditions of abuse, neglect, and exploitation within the institutions, particularly towards women, are being documented and widely shared.

Keystone Human Services International was pleased to be invited to India for a study visit in February 2015, hosted by The Hans Foundation and the Rural India Supporting Trust. Dennis Felty, Elizabeth Neuville, Genevieve Fitzgibbon, and Philip Woffindin spent two weeks examining some of the resources already available for people with disabilities and their families, learning about the gaps that exist,  exploring how current services might be strengthened and improved, and how we might work together to support NGOs and community groups to move in a positive direction. In addition to learning a great deal about what the possibilities and potential are in India, the team also brought back a chance to reflect on what can be learned, and what obligations we have to others, whether they be individuals, families, neighborhoods, or entire societies.

Some of what our team saw in India was surprisingly familiar, and reflected universal stereotypes and deeply-held mindsets about the capacity of people with disabilities that we have seen in many other places. Options for care and support for people with intellectual and developmental disabilities within India appear to be reliant exclusively on family caregivers with little to no support, or in highly segregated, congregated settings—in either case, deeply separated from everyday life. As we have learned through this visit, there are not many community-based services dedicated to people with intellectual disability.

At the same time, the deeply-held history of family care and communal support in village life in India leaves us much to learn from, build on, and apply, whether it’s India, Moldova, Romania, Azerbaijan, Kazakhstan, or the United States. There are more similarities than differences when it comes to the challenges and successes of providing community-based services for people with disabilities, and in some ways, our hard work in the US is now to capture the possibilities of “services in the community” to “services  of the community.” We may have much to learn from other cultures and society in this struggle.

The crux of what we do to address those challenges is capacity building to increase the ability of people, communities, and countries to support people with disabilities to live meaningful lives in the community. Capacity building encompasses how we at Keystone strive to support people with disabilities, the language we use to refer to people, and disability issues, how we integrate and engage people, and how we support people to become part of the broader community.  In addition, it encompasses the powerful decision to move alongside people with disabilities to take their place at the community table.

India is full of promise for a positive future for people with disabilities. During our visit, we met many gifted leaders and committed advocates ready to move India forward with inclusion, although their mindsets about what is possible are sometimes constrained by the legislative frameworks that exist. By building the capacity of leaders across India to envision a system of care where people with disabilities can be fully participating members of their communities, it becomes possible to transform the assumptions about the role of people with disabilities within a society, and move toward a more inclusive, rights-based model.

The Republic of Moldova has offered us a glimpse at what is possible when working towards change, as they begin the hard work of shifting from an entrenched institutional base towards an inclusive, community-based model. Much remains to be done, but the potential for developing natural support networks, communal support, and small residential options which promote lives of belonging, health, and contribution can be witnessed, and it is powerful change. Keystone Moldova has worked closely with the Central Government, Rayonal Councils, Social Assistance Departments, Finance Departments, and Local Public Authorities to develop and implement services and the legislative framework to manage and sustain those new services, and to offer them as not only a model for Moldova, but for those of us working in the US as well.

From June 27 through July 3, 2015, Keystone Moldova hosted members of The Hans Foundation and the Rural India Supporting Trust for a preliminary study visit to see the services offered in Moldova for people with intellectual disabilities. These services, such as supported living, foster care, family support, and shared living, provide more informal living situations and make use of the natural supports within the community, including the individual’s family. It was both moving and powerful to see the changes that are happening in the society, the families, the communities, and, most significant, in the lives of the people who have established new lives and new possibilities for a future of growth and belonging.

Much of the great progress made in Moldova comes down to capacity building and increasing natural supports, and we are seeing potential in Kazakhstan. With strong and positive mindsets about disabilities, and leaders and a framework to advance these mindsets, nations can advance the rights of people with disabilities and move forward with inclusion. In the process, they are likely to become better, stronger, and more robust societies.

Because of the universality of these issues, it benefits Keystone to maintain a global perspective. Everything we learn from our work in Moldova, Kazakhstan, Russia, Romania, Azerbaijan, and India informs us about our work in the United States, and vice versa. We are all facing similar challenges and working to do our best to provide services that give people with disabilities the opportunity for a meaningful life in their community.

Some of these challenges can seem daunting, but when we look to our vision of creating opportunities for growth and meaningful life choices so that all people can be valued, contributing members of their community, it becomes much simpler, and we continue to work to advance the human spirit.

Charlie Hooker
President and CEO, Keystone Human Services International

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The Road to Community-Based Services for Children in Kazakhstan

Post by Charlie Hooker, President and CEO of Keystone Human Services International

Originally posted on KHSI’s website

In November 2014, Keystone Human Services International Moldova Association (Keystone Moldova) was recognized by UNICEF Moldova as a Child Rights Champion for their efforts to protect children’s rights and the inclusion of children with disabilities in the community. Keystone Moldova now has an exciting opportunity to share their knowledge and expertise to make the world a safer place for children.

Keystone Human Services International (KHSI) and Keystone Moldova are participating in a new initiative to support community-based social and health services for children with disabilities and their families. Funded by UNICEF Kazakhstan, we will be providing consultation services to the Ministry of Health and Social Development in the Republic of Kazakhstan to develop a national strategic and evidence-based roadmap for community-based services for children ages 0-7 at risk of being abandoned or without parental care.

Kazakhstan is taking steps to ensure the protection of children’s basic rights, aligned with the United Nations Convention on the Rights of the Child. The Convention protects children’s rights to grow up in a family environment, to education, to health, and to protection from harm.

Of Kazakhstan’s 5.3 million children, approximately 30,000 live in state-run child care institutions, and many have lost all contact with their families. We have assembled an international team of consultants to support the Ministry of Health and Social Development to develop a national roadmap to reform this system of care and develop community-based services for children at risk of being abandoned or without parental care. Over the course of a year, the team will provide technical assistance and consultation to strengthen the data management system and develop a preliminary plan for transforming the operation of infant homes and medical social facilities for children with disabilities, as well as providing additional technical advice.

This international team is led by Dr. Ludmila Malcoci, the Executive Director of Keystone Moldova. It also includes Dr. Donald Wertlieb, President of the Partnership for Early Childhood Development and Disability Rights (PECDDR) and Professor Emeritus at Eliot-Pearson Department of Child Development at Tufts University; Eugenia Veverita, an economist and expert in public finance management; and Dr. Anna Kudiyarova, Director of the Psychoanalytic Institute for Central Asia.

The work of this international team builds on Keystone Moldova’s experience and expertise providing inclusive, community-based systems of care in the Republic of Moldova. For the past ten years, Keystone Moldova has been actively involved in the reform of the social protection system for people with disabilities in Moldova and has supported the Moldovan Ministry of Labor, Social Protection, and Family in the transformation of the Orhei Institution for Children (Boys) with Intellectual Disabilities, including the development of the legal framework and policy for social inclusion, and the development and implementation of over 60 pilot community-based services for people with intellectual disabilities.

As we have seen in Moldova and we’re sure we’ll see in Kazakhstan, community integration opens many opportunities for children and adults at risk of institutionalization, from education in classrooms with their peers to employment opportunities. The entire community benefits from  inclusion.

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Advancing the Rights of Children and Adults with Disabilities: The Charter of Principles and Commitments

Keystone is committed to advancing the rights of children and adults with disabilities. Through innovation and best practices, we are supporting community-based systems of care and advocating changes in public policy.

As service providers, advocates, and change agents, we ensure the political process recognizes the rights of people with disabilities throughout civil society. Recently, Keystone Moldova developed a charter detailing a series of commitments to promote the rights and freedoms of people with disabilities.

This Charter of Principles and Commitments (Charter) builds on the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which the Republic of Moldova signed in 2007 and ratified in 2010. By ratifying the CRPD, Moldova committed itself to developing and implementing policies and laws to secure the rights and social inclusion of people with disabilities, including legal equality and full participation in the community.

Although great progress has been made on a national level, barriers to social inclusion still exist. The Charter highlights a series of commitments through 2018 to address these inequalities. These commitments include

  • developing legislation to ensure the legal rights of persons with disabilities;
  • developing a legal framework to support persons with disabilities in decision-making;
  • ensuring accessibility and reasonable accommodation in the physical environment;
  • increasing the amount of financial resources allocated to social services that promote inclusion and independent living;
  • continuing to reform the residential care system and diversifying community social services;
  • implementing inclusive education according to the provision of the Education Code and the Education Strategy 2020;
  • promoting inclusive employment, including existing legal provisions related to the employment of people with disabilities; and
  • ensuring people with disabilities have equal access to adequate health care.

You can read the full Charter here. It was presented to and signed by fifty-one civil society organizations in Moldova, as well as six political parties. The Charter was supported by the East Europe Foundation, which is providing support for the Central Election Commission to develop and promote regulations on access for people with disabilities in electoral processes.

There is much work to accomplish before barriers to inclusion are truly dismantled. Nevertheless, the pace of reform continues to increase, and we move closer to an inclusive world.

Join me in supporting reforms like the Charter of Principles and Commitments in Moldova, as we continue to make the world a better place for everyone. A simple way to support these reforms is by making a donation to further Keystone’s work in Moldova. Another way to support us is to follow Keystone Moldova on Facebook to stay up to date on the tremendous work that we are doing and share it with your friends and colleagues. Whatever you choose, your support and involvement are greatly appreciated.

Charlie Hooker
President and CEO, Keystone Human Services International

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Include Women: The Social and Financial Inclusion of Women and Girls with Disabilities

Dennis Felty, President of Keystone Human Services, announces our Commitment to Action at CGI's 2013 Annual Meeting.

Dennis Felty, President of Keystone Human Services, announces our Commitment to Action at CGI’s 2013 Annual Meeting.

The institutionalization and segregation of people with disabilities is one of the great human rights challenges of our time. Women and girls with disabilities are at especially great risk of social and economic exclusion because of both their gender and their disability. Between discriminatory laws and practices, as well as stigmatizing attitudes and beliefs, there is little to prevent the institutionalization of people with disabilities. Women and girls who live in segregated residences become invisible—forgotten—tucked away in institutions or hidden at home by their families, never having an opportunity to participate in life.

Even more, women with disabilities around the world face significant challenges in attaining adequate housing, health, education, vocational training, and employment.

In 2013, Keystone Human Services (KHS) made a commitment to support women and girls with disabilities to empower themselves. Through the Clinton Global Initiative (CGI), we have developed a Commitment to Action—Disabilities: Social and Financial Inclusion for Women and Girls. Over the next three years, we will work to support women and girls with disabilities in the United States and Eastern Europe to empower themselves and improve their social and financial inclusion.

Our Commitment encompasses two complementary goals. First, we will support girls and women living the United States and the Republic of Moldova to leave state institutions or prevent them from ever entering them so they can live and thrive in the community with the support of family, education, employment, support teams, and the community at large.

Second, we will develop an inclusive, family-oriented workforce model to promote the full and equal human rights of women with disabilities and women who are caregivers of children with disabilities.  Women will gain improved access to employment, education, and participation in vocational training. Ultimately, this workforce model will reduce obstacles to labor inclusion and promote women’s equal rights to full employment and fair pay.

Within the Republic of Moldova, we have implemented a transitional employment program, as well as supportive employment and training in basic business skills and mentoring for women.

In the United States, several women have moved out of state institutions and moved into community settings in Connecticut, and KHS has contracted with the Department of Developmental Services to provide services to these women in their own communities.

As women move out of state institutions and join the community, KHS has developed a training program for staff at the institutions to educate them on developing person-centered plans, re-evaluating the individual’s needs, and the level of quality care to ensure continuity and the individual’s security and comfort before, during, and after they transition to life in the community.

We’re very excited about our Commitment to Action. Keystone has been a part of CGI since 2007, and CGI has played a large part in bringing the role of disabilities in global health to the forefront. In the year since we made our Commitment, we have seen the beginnings of a change in society’s perception of women with disabilities. Just as importantly, women with disabilities themselves have increased their self-esteem and empowerment. We are working hard to continue our work to support the rights of women with disabilities and women caregivers of children with disabilities.

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A Word from the President and CEO

Originally published on KHSI’s website

People often ask why we support children and families in Moldova when there are so many children in our own backyard that need help. This is always an interesting question because Keystone Human Services does support children and families in the United States. Capital Area Head Start is one of our programs, serving over 1,100 children and families in Cumberland, Dauphin, and Perry Counties in Pennsylvania, and we provide services and supports for children through our other services, such as our early intervention services for children from birth to three years of age and behavioral health services for children and adolescents.

Our history and expertise providing community-based human services can benefit people in other countries. Our mission and vision is not limited to serving those within specific geographical boundaries, but should reach individuals on a global level. Consistent with our vision and Keystone’s strategic intent, we have an obligation to share ideas, service models, and our expertise with those in other countries who wish to learn and benefit from all we know and do through our organization. We have been honored to partner with the Open Society Foundations, the Soros Foundation, the Government of Moldova, the United States Agency for International Development, the European Commission, the Clinton Global Initiative, the American Network of Community Options and Resources (ANCOR), and the International Federation of Educative Communities (FICE), which have assisted us to carry out our initiatives and goals for a better and safer world. We have the opportunity to provide consultation and support to Romania, the Russian Federation, Azerbaijan, and Moldova through these partnerships.

From our initial interaction with local social service workers in Moldova in 2002, KHS has been invited by other Eastern European countries to visit their communities, provide training and consultation, share our expertise, and work with other providers in developing community-based services and supports for individuals in very untenable situations, similar to those experienced in Pennsylvania in 1972 when Keystone Human Services was founded. The bias toward an institutional model of care is still strong in many countries, including the United States, even while we continue to advance a strong community-based model.

Keystone Human Services looks at best practices in human services from a global perspective, and often, we see more natural, efficient service models outside the United States. Countries like Moldova that have few financial resources need to rely on natural supports, and those natural supports are the ideal support system, focusing on relationships that occur in daily life. People with disabilities receive support from their family, friends, neighbors, and others within the community, rather than paid support.

Of interest is the Community for All-Moldova Program, in which the majority of those leaving institutions are joining their families, and only a small number of individuals are moving into residential services.  In addition, the Community Centers in Tudora and Bacioi provide educational, social, psychological, and nutrition services to children and their families living in difficult social situations.

Our strategic plan calls for us to be a global leader in human services. Our work in Moldova honors and supports people to live within their community, and we are continually learning from our experience. As we assist Moldova to move forward in the process of supporting people, we are looking at ways we can be a resource and an asset for other countries. Disability issues are global and there is no one country that needs more assistance than another.

Please consider joining me in supporting Keystone Human Services’ work in Moldova. Your support is greatly appreciated and helps us move forward toward an inclusive, global community.

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The Human Rights of People with Disabilities

The 5th edition of the Health and Human Rights Resource Guide was recently published by the FXB Center for Health and Human Rights at Harvard University and Open Society Foundations. We’re very pleased that Keystone Moldova’s work to promote human rights and social inclusion of people with disabilities in Moldova has been included within this publication.

The Health and Human Rights Resource Guide is designed for use by people working in the health and social services fields, litigators, and policymakers. Significantly, it looks at disabilities from a rights-based approach. Too often, people with disabilities are denied their basic human rights and sometimes aren’t even viewed as humans who have rights. They’re segregated and denied equal access to the law, health care, education, employment, and the right to make their own decisions, among many other things.

The rights-based approach to disability taken by the Convention on the Rights of Persons with Disabilities, adopted in 2006, and explained in the Health and Human Rights Resources Guide seeks to protect and promote the rights of people with disabilities, change the public’s attitudes and behaviors, and develop policies and laws to guarantee the civil, cultural, economic, political, and social rights of people with disabilities.

Disability rights are human rights. They’re universal, transcending borders and cultures, and they guarantee that people with disabilities receive equal access and opportunities afforded to other human beings as basic human rights, which is why it’s so important to educate individuals with disabilities, their families, and the public about the rights of people with disabilities.

Keystone Moldova recently held a seminar for parents of children with disabilities on how they can ensure their children’s rights, including children’s right to education. Parents came in with questions about school inclusion, access to health care, and accessibility to buildings. They were empowered to become strong advocates for their children and change the current social situation and promote the rights of their children and others.

Keystone Moldova is diligently working toward deinstitutionalization and the support of people with disabilities within the community. They have developed and implemented a system of community-based services and continue to work with the ministries and local government to develop the legal framework for these services and policies pertaining to people with disabilities and their rights. Just as importantly, they are working to change the public’s attitude and behavior toward people with disabilities to create a society of mutual respect and acceptance.

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New Website for Keystone Foundation for Children and Families in Russia

We are happy to announce that Keystone Foundation for Children and Families in Russia has a new website. You can visit the new site at to learn about the work the Foundation is doing toward inclusion for people with disabilities in Russia.

The Foundation is a registered Russian nonprofit organization whose mission is to create an environment where children and adults with disabilities have the opportunity to become valuable and productive members of society and live meaningful lives.

Katya Babina, Executive Director, says, “We are very excited that our new website is fully updated according to the new strategy of the Foundation’s work in Russia. Now visitors can get all the information about our key programs on inclusion for people with disabilities into society and about our important work with public outreach. We also believe the new site will help us in our fundraising activities by bringing more conscientious and dedicated people to our team of supporters.”

Please visit to learn more about Keystone Foundation for Children and Families.

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Healing from the Beslan School No. 1 Tragedy Continues

At the School on Kominterna Street, children, their parents, and teachers happily join in the festivities celebrating the first day of school. With so many smiles, it’s hard to believe that just across the street, in the gym of the old Beslan School No. 1, is a memorial to the children and adults whose first day of school turned into a nightmare.

Nine years ago, on September 1-3, 2004, over one thousand children, teachers, and parents were held hostage by Chechen terrorists. They were held in the school gym for three days with almost no water and food. Bombs were strung between the basketball hoops and around the room. Following chaotic gunfire, the bombs detonated and part of the gym collapsed, killing 334 people, including 186 children, and injuring 810.

What was supposed to be a joyous first day of school became a tragedy.

In October following the tragedy, Keystone Human Services sent experienced mental health professionals and Student Assistance Program specialists to Moscow, Russia to train and assist clinicians from Beslan who were providing support to their community day and night for 40 days straight. Many of these same clinicians continue to provide support to Beslan to this day since the attack on School No. 1.

If there’s one thing we understand, it’s that it takes many years to heal and learn to cope with the effects of a tragedy. The need for healing continues long after the tragedy itself, and so we continue to provide support to the Children’s Rehabilitation Program at the Polyclinic in Beslan. These services continue to provide valuable support to the children and adults affected by the tragedy that took place nine years ago. Children and adults have access to family counseling services, psychiatric services, home visits, and other creative therapies, as they cope with anger, anxiety, sadness, confusion, and the loss of loved ones.

The gym of School #1 is now filled with photographs and flowers. Across the street, children laugh and learn as the school year begins. And we continue to support the children, adults, and families affected by the School No. 1 tragedy so they can live their lives and look toward the future with hope. If you would like to join us in supporting the services at the Polyclinic in Beslan, please make a donation. Every contribution helps and is greatly valued by our colleagues in Beslan.

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The Beginnings of Inclusive Education in Russia

Inclusive education is a key part of building an inclusive society, where people with disabilities are accepted and welcomed into the community. Children with and without disabilities benefit from inclusive classrooms. In Russia, inclusive education has received a lot of support from the government and authorities. However, very few people know how to efficiently begin inclusion in schools, although there are a few schools that are trying to truly include students. Other schools are doing a simplistic version of inclusion, where one child joins a classroom, sometimes with a tutor paid by the child’s parents. There are currently no standards, rules, guidelines, or evaluation system.

The Keystone Foundation for Children and Families aims to promote inclusive education. “Keystone’s goal is not only to promote the idea in general to the public, but also to develop an efficient and effective model of inclusive education in Russia,” says Katya Babina, General Director. “In order to reach this goal, we will need to unite the knowledge of international experts with Russian best practices.”

Recently, the Institute of Inclusive Education Problems hosted a conference dedicated to examining inclusive education and its implementation. On June 26-28, the 2nd International Scientific-Practical Conference, “Inclusive Education: Practice, Research Methodology,” was held in Russia by the Ministry of Education and Science of the Russian Federation, Moscow Department of Education, Educational and Methodical Association of Higher Educational Institutions of Russian Federation on Psychological and Pedagogical Education, Moscow State Budget Institution of Higher Professional Education “Moscow State University of Psychology and Education,” Institute of Inclusive Education Problems of MSUPE.

The conference fostered conversations about inclusive education, based in science, theory and methodology, practice, and society. It included presentations by experts from around the world. Keystone Human Services International was invited to give a presentation, and we asked Dr. Thomas Neuville, a professor at Millersville University and an expert in inclusive education, to present. We have often partnered with Thomas for educational opportunities.

Dr. Neuville spoke about inclusive education in the United States, where inclusion has moved along a continuum from institutions to fully integrated schools, although truly inclusive education has still not been achieved.

The United States has learned several powerful lessons about inclusive education from the experience of the past several decades. There are four directives and several methods that work together to create a child’s best chances for true inclusion and growth.

First, inclusion should start right away in ordinary settings. Historically, segregating children, even if it’s under the guise of preparing them for inclusion, leads to children falling behind and they often never fully rejoin the community.

Teachers and educators should also presume that children are competent and build a strong relationship with the student so they can work with the student’s learning style. Current teaching methods can be used to educate all children together.

Conferences such as this one continue to build knowledge about inclusive education so all children can attend school with their peers and receive a quality education. Thank you to the Institute of Inclusive Education Problems and thank you to Dr. Neuville and Millersville University for sharing your expertise.

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I Have a Family

“We have a rule in our family,” says Angela Cretu. “When we work, we work all together. When we rest, eat or do everything else—we do it together, too. And Mihai has become a part of it.”

Angela and her husband Vasile are Shared Living Assistants for Keystone Moldova, and they have welcomed Mihai into their family. Before he came to live with Angela and Vasile, he spent many years in an institution.

When Mihai left the institution, he had very few skills. He could make his bed, change his sheets, and fold his clothes. Now that he has joined a family, he has blossomed and can do many things on his own—washing dishes, sweeping the floor, feeding the chickens, collecting eggs, feeding the other animals, planting and harvesting the garden.

He has gained more skills, but more importantly, he has gained a family who cares about him.

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