Health and Social Services in Emden: Challenges and Developments in March 2026

Health and Social Services in Emden: A Challenge for the Municipality and Society

Health and social services are not only a central part of the municipal responsibilities in Emden but also a key indicator of the city's social stability. In March 2026, it becomes evident that Emden is undergoing change on multiple levels – both structurally and financially. The implementation of the Federal Participation Act (BTHG) and the increasing demand for integration support for children and young people present the city with major challenges.

Integration Support: BTHG Implementation and Structural Issues

The reform of integration support under the BTHG has shifted responsibility for services up to the age of 18 to the municipalities since the beginning of 2020. However, in Emden, the implementation is still not fully secured. An evaluation of BTHG implementation in Lower Saxony has shown that many municipalities – including Emden – have weaknesses in structural planning, financial control, and coordination with service providers.

Although there are guidelines and conceptual foundations, implementation varies widely. Some municipalities pursue a holistic approach, while in others, many aspects remain unclear. Although person-centered care planning is central, in the majority of municipalities, achievable and reviewable participation goals are not being defined. In Emden, the organization of integration support is not fully aligned with legal requirements, which poses risks to the assurance of services.

Funding: Rising Costs and Lacking Financial Control

The cost development for integration support in Lower Saxony is dramatic: from 2020 to 2022, total expenditures increased by 8.5% to 2.67 billion euros. For children and young people, the increase was even 12.7%, and in Emden itself, it stands at 16.3%. However, this growth in spending is not accompanied by consistent financial control.

In Emden, no financial control in accordance with § 21 of the Municipal Accounting Ordinance (KomHKVO) is being carried out, which affects the transparency and predictability of expenditures. Average gross spending per eligible person is 24,316 euros, with school assistance being particularly cost-intensive. Without clear budget planning and evaluation, integration support in Emden remains at risk of becoming overwhelmed.

Gaps in Services and Shortages in Care

The effects of the rising demand are already being felt: there are significant service gaps, particularly in integration groups in regular kindergartens, therapeutic kindergartens, and school assistants. Children with autism spectrum disorders may have to wait up to 1.5 years for care. Offers for children with challenging behavior are often not financially feasible or simply do not exist.

The counseling center for violence (BISS Emden) is another example of the strain on social structures. Case numbers increased by 21.8% in 2025, with an average of 200 children and young people affected. Personnel shortages and a lack of resources are hindering the work of the counseling center. Emden urgently needs more capacity to adequately support these sensitive cases.

Structural Planning and Future Outlook

To overcome the challenges, Emden needs comprehensive structural planning that makes social services transparent and systematically updated. Communication with service providers must be improved to identify gaps at an early stage. In addition, the municipality must deal with increasing social burdens such as mental illness, addiction, and homelessness.

The implementation of the BTHG is a process that requires not only legal but also organizational and financial adjustments. In Emden, it is now crucial to build the missing structures and make optimal use of the existing resources. Only then can the city fulfill its statutory obligations and shape an inclusive, socially strong future.

Conclusion: Emden Must Act – Now

The challenges in the field of health and social services in Emden are clearly defined: lack of financial control, service gaps, rising costs, and organizational deficits. However, there are also opportunities – the necessity to rethink structures can lead to new, inclusive solutions. For Emden, March 2026 marks a decisive turning point: from analysis to implementation.