ANNEX 2 - DCN 2023-UKR-013_Rehabilitation for Ukraine_IEE.pdf

DCN: 2023-UKR-013

USAID Ukraine / Physical Rehabilitation 1 E&E Bureau IEE Template (Version 1 Jun 2023)

US Agency for International Development (USAID) Ukraine and Belarus

Initial Environmental Examination (IEE)

Program/Project/Activity Data Activity/Project Name: Rehabilitation for Ukraine Assistance Objective: Social Services Program Area: Victims of War Country(ies) and/or Operating Unit: USAID/Ukraine Originating Office: Office of Health Date: October XX, 2023

Original IEE/RCE Original IEE LOP Start Date: April 2024 IEE/RCE History DCN LOP End Date Original IEE/RCE 2023-UKR-013 March 2029 Contract/Award Number (if known): TBD Sector Type(s) from the ECD Advanced Search Tab (https://ecd.usaid.gov) Major: Health Minor: Health Systems Strengthening Recommended Environmental Determination(s):

Categorical Exclusion Positive Determination Negative Determination

With Conditions Deferral

Additional Elements:

Local Procurement Government to Government

Donor Co-Funded Public International Organization (PIO) environmental and social policies and procedures applicable

Climate Change Vulnerability Analysis (included) Climate Change Vulnerability Rating: Low

1. Background and Project Description

1.1 Purpose and Scope of IEE. The purpose of this IEE document is to establish the environmental compliance determinations for the Physical Rehabilitation Activity, as per 22 CFR 216 and USAID ADS 204. This IEE is a critical element of USAID’s mandatory environmental review and compliance process meant to achieve environmentally sound activity design and implementation.

1.2 Project Description. The purpose of the Physical Rehabilitation Activity is to support Ukraine in development physical rehabilitation services. The Physical Rehabilitation Activity will work to achieve this purpose by addressing three independent objectives:

• Component 1: Strengthen national, regional and local leadership, management and governance capacity related to the physical rehabilitation sector;

• Component 2: Increase access to and availability of affordable, quality sustainable physical rehabilitation services, inclusive of assistive technology; and

• Component 3: Promote inclusion and participation of persons with disabilities and civilian victims of war within their families, communities and the country.

https://ecd.usaid.gov/index.php/?filterTab=A#PINIT_2

USAID Ukraine / Physical Rehabilitation 2 E&E Bureau IEE Template (Version 1 Jun 2023)

2. Baseline Environmental Information

2.1 Locations Affected and Environmental Context. The Activity will be implemented nationwide and in selected regions, with a focus on increasing public integrity in the public sector, specifically via skills and capacity building. The Activity will be intentional about working with a variety of public sector offices, and focusing on those that require mentoring and capacity building support. Decisions will be made in close collaboration with USAID, to determine the needs and outcomes of each intervention.

2.2 Description of Applicable Environmental and Natural Resource Legal Requirements Policies, Laws, and Regulations.

Ukraine has an extensive body of environmental laws and policies, many of which provide guidance on environmental and natural resource legal requirements. Key laws and legislated related to this activity include:

• Environmental Protection Act (last amended December 2010): The Act sets up the overall environmental framework and is the paramount legal act for all environmental activities; it briefly discusses biodiversity conservation;

• Land Code (last amended March 2011): Ukraine’s land use legislation which is supposed to ensure “rational land use and protection of lands,” and divides all land into nine categories, including four categories especially relevant to biodiversity conservation:

protected areas, forest lands, agricultural lands, and water lands;

• Law of Ukraine “On environmental impact assessment: (2017);

• Law of Ukraine “On alternative fuel types” (2000);

• Law of Ukraine “On labor protection” (1992); and

• Law of Ukraine “On waste” (1998).

The EU-Ukraine Association Agreement was signed by the European Union and Ukrainian President Poroshenko in June 2014, and ratified by the Verkhovna Rada (Parliament of Ukraine) and the European Parliament in September 2014. The Association Agreement focuses on support to core reforms, economic recovery and growth, and cooperation in areas including energy, transportation, social development, education, and environmental protection. Under the Environment chapter of the Association Agreement, Ukraine is supposed to gradually harmonize its environmental legislation to that of the EU within the stipulated timeframes. Specific commitments include harmonization of laws and regulations on:

• Environmental impact assessment and strategic environmental assessment;

• Public access to environmental information;

• Conservation of wild flora and fauna;

• Development of a national biosafety system;

• Emissions of volatile organic compounds;

• Marine environmental policy;

• Industrial emissions;

• Greenhouse gas emissions allowance trading;

• Substances that deplete the ozone layer; and

• Assessment and management of flood risks.

2.3 Environmental Capacity Analysis. The primary government institutions responsible for environmental protection and biodiversity conservation in Ukraine are the: Ministry of Ecology and Natural Resources, Ministry of Agrarian Policy and Food, Ministry of Agriculture, and Ministry of Internal Affairs. The Ministry of Ecology and Natural Resources (MENR) is the primary government authority responsible for the protection of the environment, ecological safety, treatment of waste, hazardous chemicals, pesticides and agricultural chemicals, and perform state ecological expertise.

USAID Ukraine / Physical Rehabilitation 3

One of the main constraints faced by the MENR is the lack of capacity to develop adequate legislation and to enforce it, including issues related to inadequate financial support, weak biodiversity conservation training programs, limited expert potential, and low level of staffing for critical functions. In recent years, environmental policies have been stalled by delays in adoption of necessary legal acts and regulations due to frequent changes in the government and vested interests.

Low levels of capacity, including inadequate governance and weak institutions, have demonstrated negative impacts on the environment, with economic factors often underlying these weaknesses.

Specific, proximate causes of environmental threats include corruption, illegal logging/fishing, irrigation and other aspects of the conversion of land for agriculture, and the physical and chemical effects of bombs, shells, and missiles in the conflict zone. For example, Ukraine ranks below other low- and middle-income countries in its commitment to biodiversity and habitat protection.

According to the Journey to Self-Reliance, FY 2019 Country Roadmap, Ukraine received a relatively low score of .42 out of 1 for Biodiversity and Habitat Protection. USAID's 2017 Biodiversity Analysis found that the country’s ecosystems and species are experiencing each of the five general types of direct threats recognized by the Convention on Biological Diversity. These threats include over-exploitation, habitat change, nutrient loading and pollution, invasive alien species, and climate change. Although efforts have been made to address these issues since 2014, weak implementation and enforcement of existing laws have stymied long term success.

While there has not been a notable change in climate across the country, there has been an increase in both the intensity and frequency of drought, heavy rainfall, and heavy snowfall events.

The vulnerability of the largely urban (69.7 percent in 2015) population is magnified by infrastructure deficiencies such as an aging and fragile housing stock and limited potable water supply. Post- 2014 economic shocks and the humanitarian crisis in the east have diverted resources from climate adaptation strategy and planning.

A 2018 Climate Risk Management (CRM) Screening for Ukraine, conducted as part of USAID/Ukraine Country Development Cooperation Strategy (2019-2024), considered the following, projected future climate changes:

• Increasing temperatures, heat stress, and heat waves, particularly in the far east and south;

• Changing seasonal rainfall patterns;

• Increasing evapotranspiration and decreasing overall water balance;

• Moderate increase in dry spells and droughts, particularly in the south;

• Increasing intensity and frequency of heavy rainfall events, especially in the north;

• Increasing frequency of flash flood events; and fewer early spring floods;

• Potential increase in dust storms due to increasing temperatures and drier conditions, particularly in the south; and

• Increase in the rate at which the sea level is rising (the Black Sea has risen 5-8 inches since

1900).

Response to the ongoing Russian invasion has strained resources within the government and throughout the country. Although environmental capacity may vary throughout the country, it is considered likely that environmental oversight capacity has been diminished due to the diversion of resources and personnel. As such, it is expected that environmental oversight capacity for these activities will be diminished, delayed, or impossible at this time.

2.4 Climate Change Vulnerability Analysis. Drawing on information from the CDCS CRM, a climate risk screening has been completed as part of the design process for this activity and a complete analysis can be found in Annex A. Per the Mandatory Reference, the screening assigns a

USAID Ukraine / Physical Rehabilitation 4 E&E Bureau IEE Template (Version 1 Jun 2023) qualitative climate risk rating based on both the probability of a negative impact and the severity of that negative impact. The screening also explores opportunities, risk management options, how the climate risks are addressed by the projects (including whether the risks are accepted), and what steps may be needed to address the risks at the project/activity level. Climate risks are rated as Low for this Activity.

3. Environmental Impacts and Recommended Mitigation Measures

Component 1 – Strengthen national, regional and local leadership, management and governance capacity related to the physical rehabilitation sector

Sub-activities Potential Impacts Mitigation Measures Recommended Threshold Determinations

1.1 Support the creation and

implementation of the Interministerial Coordination Structure

N/A N/A Categorical Exclusion

1.2 Provide technical

assistance as needed to the Ministries of Health and Social Policy and to relevant regional officials through mentorship and capacity building

1.3 Support development of

a national multisectoral physical rehabilitation strategy in partnership with WHO

N/A N/A Categorical Exclusion

1.4 Establish physical

rehabilitation and assistive technology (AT) quality of care standards and guidelines based on patient outcomes at all levels of the health system

N/A N/A Categorical Exclusion

1.5 Support the Ministry of

Health to introduce and implement ICF (International Classification of Functioning, Disability, and Health) standards

N/A N/A Categorical Exclusion

1.6 Provide technical

assistance to the GOU to guide the development of sustainable financing for patient-centered physical rehabilitation and AT services

N/A N/A Categorical Exclusion

1.7 Support improvement of

management Information systems operations at health

USAID Ukraine / Physical Rehabilitation 5 E&E Bureau IEE Template (Version 1 Jun 2023)

Sub-activities Potential Impacts Mitigation Measures Recommended Threshold Determinations facilities to capture data on rehabilitation and AT

1.8 Develop

recommendations to improve accessibility of facilities providing physical rehabilitation services (This activity will involve no implementation – it is planning only)

Component 2 – Increase access to and availability of affordable, quality and sustainable physical rehabilitation services, including assistive technology

Sub-activities Potential Impacts Mitigation Measures Recommended Threshold Determinations

2.1 Support the development

of a scalable model for Primary Health Care-level rehabilitation services and pilot the model in selected oblasts

N/A N/A Categorical Exclusion

2.2 Strengthen physical

rehabilitation professional clinical skills through capacity building, including but not limited to typical war injuries

N/A N/A Categorical Exclusion

2.3 Create linkages with

complementary health and social services, including mental health and psychosocial support

N/A N/A Categorical Exclusion

2.4 Improve and promote

referral pathways that facilitate access to rehabilitation and AT services

N/A N/A Categorical Exclusion

2.5 Scale up multi-disciplinary

treatment approaches to new facilities

N/A N/A Categorical Exclusion

2.6 Increase capacity

(training) of the workforce to provide appropriate AT, with an emphasis on mobility devices

N/A N/A Categorical Exclusion

2.7 Support the national and

regional governments in sustaining of AT provision to patients within existing rehabilitation services

N/A N/A Categorical Exclusion

2.8 Improve national

standards for rehabilitation education curricula in line with international standards

USAID Ukraine / Physical Rehabilitation 6 E&E Bureau IEE Template (Version 1 Jun 2023)

Sub-activities Potential Impacts Mitigation Measures Recommended Threshold Determinations

2.9 Improve standards for

continuing professional education for physical rehabilitation professionals, including P&O, in line with international standards

N/A N/A Categorical Exclusion

2.10 Build partnerships

between international and local university programs to develop a new cadre of physical rehabilitation professionals

N/A N/A Categorical Exclusion

2.11 Support the existing

rehabilitation workforce by addressing their burn-out

N/A N/A Categorical Exclusion

2.12 Support the development

of new and strengthen existing professional rehabilitation associations and their relationships with international counterparts

N/A N/A Categorical Exclusion

2.13 Work with the local

governments to ensure physically accessible rehabilitation services supported by local finance (no rehabilitation or construction is envisioned).

Component 3 – Promote inclusion and participation of persons with disabilities and civilian victims of war within their families, communities and country

Sub-activities Potential Impacts Mitigation Measures Recommended Threshold Determinations

3.1 Sensitize the Ministries

of Health and Social Policy on the benefits of increased representation of persons with disabilities in decision-making and the development of physical rehabilitation services and policies

N/A N/A Categorical Exclusion

3.2 Strengthen the capacity

of selected DPOs/NGOs to support persons with disabilities and veterans at the community level (social, legal and informational support)

N/A N/A Categorical Exclusion

3.3 Reduce stigma and

discrimination against persons with disabilities through communication and information activities

USAID Ukraine / Physical Rehabilitation 7 E&E Bureau IEE Template (Version 1 Jun 2023)

Sub-activities Potential Impacts Mitigation Measures Recommended Threshold Determinations

3.4 Support the development

of rehabilitation and disability-focused peer-support groups

N/A N/A Categorical Exclusion

3.5 Provide access to

information about availability of rehabilitation services and resources for persons with disabilities

N/A N/A Categorical Exclusion

3.6 Ensure that rehabilitation

services are accessible and inclusive.

N/A N/A Categorical Exclusion

4. Conclusions of the Environmental Review

4.1 Recommended Environmental Determinations:

Categorical Exclusions:

A categorical exclusion is recommended for the following sub-activities under 22 CFR 216.2(c)(2):

• Sub-activities under Components 1, 2, 3 under §216.2(c)(2)(i) Education, technical assistance, or training programs except to the extent such programs include activities directly affecting the environment (such as construction of facilities, etc.)

4.2 Negative Determination Terms and Conditions:

4.2.1 Prior to initiating any activity that has a Negative threshold determination, the IP shall prepare an environmental review document in the SERF format provided by the MEO, unless the activity only includes sub-activities that require a SERF, in which case the IP may prepare an environmental review document in the SERF format provided by the MEO.

After discussing with the BEO and with approval from the MEO, the IP may prepare a single environmental review document that covers multiple sub-activities that are similar in nature and potential impact on the environment. The COR/AOR and MEO shall approve the environmental review document prior to implementation. The BEO reserves the right to rescind the approval of an environmental review document due to environmental risks. For each site-specific activity, the environmental review document shall include a Certification of No Adverse Significant Effects on the Environment signed by the IP, COR/AOR and the MEO; assigned a Document Control Number (DCN) and posted to the Environmental Compliance Database (ECD).

4.2.2 Preparation of environmental review documents shall be captured in annual work plans, and therefore budgeted for and reviewed for adequacy at least annually.

4.2.3 Changes in activities and their associated environmental reviews shall necessitate amending the IEE.

4.3 USAID Monitoring and Reporting

4.3.1 The AOR/COR, with the support of the MEO, is responsible for monitoring compliance of activities by means of desktop reviews and site visits.

4.3.2 The AOR/COR is responsible for confirming that the IP includes environmental compliance requirements and monitoring results as part of their routine project reporting to USAID.

4.3.3 The AOR/COR is responsible for monitoring, to the extent practicable, that the IP complies with applicable host country environmental requirements.

4.3.4 If at any time the project is found to be out of compliance with the IEE, the AOR/COR or

MEO shall immediately notify the BEO.

USAID Ukraine / Physical Rehabilitation 8 E&E Bureau IEE Template (Version 1 Jun 2023)

4.3.5 A summary report of Mission’s compliance relative to this IEE shall be sent to the BEO on an annual basis, normally in connection with preparation of the Mission’s annual environmental compliance report required under ADS 203.3.8.5 and 204.3.3.

4.3.6 The BEO or his/her designated representative may conduct site visits or request additional information for compliance monitoring purposes to ensure compliance with this IEE, as necessary.

4.4 Implementing Partner (IP) Environmental Compliance Monitoring and Reporting

4.4.1 The IP is required to comply with applicable host country environmental requirements.

4.4.2 If an individual activity is found to pose significant adverse environmental effects that have not been identified and addressed in the approved environmental review documents, new environmental review documents shall be developed to include environmental safeguards for such effects.

4.4.3 IPs shall report on environmental compliance requirements and monitoring results as part of their routine project reporting to USAID.

4.4.4 After the IP has finalized its activities at a specific site, the IP shall sign a Record of Compliance certifying that the organization met all applicable conditions and submit it to the COR/AOR. The COR/AOR shall keep the original for the project files and provide a copy to the MEO and BEO. The ROC shall be assigned a DCN and posted to the ECD.

5. Mandatory Inclusion of Requirements in Solicitations, Awards, Budgets and Workplans

5.1 Appropriate environmental compliance language, including limitations defined in Section 6, shall be incorporated into solicitations and awards for this activity and projects budgets shall provide for adequate funding and human resources to comply with requirements of this IEE.

5.2 Solicitations shall include Statements of Work with tasks for meeting environmental compliance requirements and appropriate evaluation criteria.

5.3 Environmental mitigation and monitoring requirements, when available, shall also be included in solicitations and awards.

5.4 The IP shall incorporate conditions set forth in this IEE into their annual work plans.

5.5 The IP shall ensure annual work plans do not prescribe activities that are defined as limitations, as defined in Section 6.

5.6 The USAID Mission will include an indicator for environmental compliance as part of the project’s performance monitoring plan. (For example, if an IEE has a threshold determination of negative determination, then a possible indicator is if the IP complied with the ERC/EMMP.)

6. Limitations of the IEE: This IEE does not cover activities (and therefore should changes in scope implicate any of the issues/activities listed below, a BEO-approved amendment shall be required), that:

6.1 Normally have a significant effect on the environment under §216.2(d)(1), including:

• Programs of river basin development;

• Irrigation or water management projects, including dams and impoundments;

• Agricultural land leveling;

• Drainage projects;

• Large scale agricultural mechanization;

• New lands development;

• Resettlement projects;

• Penetration road building or road improvement projects;

• Powerplants;

• Industrial plants;

• Potable water and sewerage projects other than those that are small scale.

6.2 Support project preparation, project feasibility studies, engineering design for activities listed in §216.2(d)(1);

USAID Ukraine / Physical Rehabilitation 9 E&E Bureau IEE Template (Version 1 Jun 2023)

6.3 Affect endangered and threatened species or their critical habitats per §216.5, FAA 118, FAA 119;

6.4 Provide support to extractive industries (e.g., mining and quarrying);

6.5 Promote timber harvesting per FAA 117 and 118;

6.6 Lead to new construction, reconstruction, rehabilitation, or renovation work;

6.7 Support agro-processing or industrial enterprises;

6.8 Provide support for regulatory permitting;

6.9 Lead to privatization of industrial facilities or infrastructure with heavily polluted property;

6.10 Research, testing, or use of genetically engineered organisms except in accordance with ADS

211; or

6.11 Assist the procurement (including payment in kind, donations, guarantees of credit) or use

(including handling, transport, fuel for transport, storage, mixing, loading, application, clean-up of spray equipment, and disposal) of pesticides or activities involving procurement, transport, use, storage, or disposal of toxic materials per §216.2(e) and §216.3(b). Pesticides (cover all insecticides, fungicides, rodenticides, etc. covered under the Federal Insecticide, Fungicide, and Rodenticide Act); and

7. Revisions

7.1 Under §216.3(a)(9), if new information becomes available that indicates that activities covered by the IEE might be considered major and their effect significant, or if additional activities are proposed that might be considered major and their adverse effect significant, this environmental threshold decision will be reviewed and, if necessary, revised by the Mission with concurrence by the BEO. It is the responsibility of the USAID COR/AOR to keep the MEO and BEO informed of any new information or changes in the activity that might require revision of this IEE.

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USAID Ukraine / Physical Rehabilitation 11

Annex A: Climate Risk Screening and Management Tool

1: Components or Sub-activities 2: Time-frame and Geography 3: Climate Risks* 4: Climate

Risk Rating* 5: How Climate Risks are Addressed in the Activity*

6: Accepted Climate Risks*

1.1 Support the creation and implementation of the

Interministerial Coordination Structure

0-20 years

Country-wide

-Challenges to improving health system outcomes due to health impacts from increasing temperatures, increased frequency and/or intensity of extreme weather events such as floods and droughts, as well as decreased water quality and quantity for an already limited potable water supplies

-Impacts to stable supply of essential drugs and commodities at appropriate prices due to supply chain interruption from extreme weather events as well as altered demand resulting from changes in climate patterns and seasons

-Impacts to medical education, e-health and health delivery strategies due to extreme weather events

-Impacts to implementation of in-person trainings, meetings, events and capacity building activities due to extreme weather events

Low

-Consider climate risks to the health system and incorporate capacity building for health workers and policy-makers to identify, assess, and address climate risks

N/A

1.2 Provide technical assistance as needed to the

Ministries of Health and Social Policy and to relevant regional officials through mentorship and capacity building

1.3 Support development of a national multisectoral

physical rehabilitation strategy in partnership with WHO

1.4 Establish physical rehabilitation and assistive

technology (AT) quality of care standards and guidelines based on patient outcomes at all levels of the health system

1.5 Support the Ministry of Health to introduce and

implement ICF (International Classification of Functioning, Disability, and Health) standards

1.6 Provide technical assistance to the GOU to guide

the development of sustainable financing for patient-centered physical rehabilitation and AT services

1.7 Support improvement of management Information

systems operations at health facilities to capture data on rehabilitation and AT

1.8 Develop recommendations to improve accessibility

of facilities providing physical rehabilitation services (This activity will involve no implementation – it is planning only)

2.1 Support the development of a scalable model for

Primary Health Care-level rehabilitation services and pilot the model in selected oblasts

USAID Ukraine / Physical Rehabilitation 12 E&E Bureau IEE Template (Version 1 Jun 2023)

1: Components or Sub-activities 2: Time-frame and Geography 3: Climate Risks* 4: Climate

Risk Rating* 5: How Climate Risks are Addressed in the Activity*

6: Accepted Climate Risks*

2.2 Strengthen physical rehabilitation professional

clinical skills through capacity building, including but not limited to typical war injuries

2.3 Create linkages with complementary health and

social services, including mental health and psychosocial support

2.4 Improve and promote referral pathways that

facilitate access to rehabilitation and AT services

2.5 Scale up multi-disciplinary treatment approaches to

new facilities

2.6 Increase capacity (training) of the workforce to

provide appropriate AT, with an emphasis on mobility devices

2.7 Support the national and regional governments in

sustaining of AT provision to patients within existing rehabilitation services

2.8 Improve national standards for rehabilitation

education curricula in line with international standards

2.9 Improve standards for continuing professional

education for physical rehabilitation professionals, including P&O, in line with international standards

2.10 Build partnerships between international and local

university programs to develop a new cadre of physical rehabilitation professionals

2.11 Support the existing rehabilitation workforce by

addressing their burn-out

2.12 Support the development of new and strengthen

existing professional rehabilitation associations and their relationships with international counterparts

2.13 Work with the local governments to ensure

physically accessible rehabilitation services supported

USAID Ukraine / Physical Rehabilitation 13 E&E Bureau IEE Template (Version 1 Jun 2023)

1: Components or Sub-activities 2: Time-frame and Geography 3: Climate Risks* 4: Climate

Risk Rating* 5: How Climate Risks are Addressed in the Activity*

6: Accepted Climate Risks* by local finance (no rehabilitation or construction is envisioned).

3.1 Sensitize the Ministries of Health and Social Policy

on the benefits of increased representation of persons with disabilities in decision-making and the development of physical rehabilitation services and policies

3.2 Strengthen the capacity of selected DPOs/NGOs to

support persons with disabilities and veterans at the community level (social, legal and informational support)

3.3 Reduce stigma and discrimination against persons

with disabilities through communication and information activities

3.4 Support the development of rehabilitation and

disability-focused peer-support groups

3.5 Provide access to information about availability of

rehabilitation services and resources for persons with disabilities

3.6 Ensure that rehabilitation services are accessible

and inclusive.

* means a required element, according to the Mandatory Reference