The study of a model development of primary health care services integrated with social services for persons with disabilities project is supported by Thai Health Promotion Foundation for the policy to practice by collaborating with government network partners and public sector. The network partners are as follows; the National Health Security Office (NHSO), Sirindhorn National Medical Rehabilitation Institute, Ministry of Public Health (SNMRI), Thailand Council for Independent living (TIL), and Department of Empowerment of Persons with Disabilities, Ministry of Social Development and Human Security. The purposes are to drive the policy to practice for the sustainable development goals (SDG 17), to develop and caring for the health and well-being of persons with disabilities, to increase the opportunity/ reduce inequality in accessing health and social services for persons with disabilities (SDG 10)

The efforts of driving to change the health system to meet the needs and improve the quality of life for persons with disabilities in the context of Thai society starts from the policy proposal for “Persons with Disabilities Service Center” operated by organizations with disabilities and certified by the Disabled Organization Standard of Department of Empowerment of Persons with Disabilities to be “Joint Service Unit” in the National Health Security System. This started with a proposal for the needs of a network of disabled people's organizations at a meeting of the Committee on Health for Persons with Disabilities appointed by the National Health Commission, then Ratchasuda College, Mahidol University conducted a research study on “Opportunities and limitations of co-organization of Medical Rehabilitation Services by Service Centers for Persons with disabilities” (2019), and synthesized the results of the study into policy proposals presented to the National Health Security Office, Department of Empowerment of Persons with Disabilities and Network of Disabled Organizations. Finally, the National Health Security Board has approved and issued a notification that “Persons with Disabilities Service Center” registered to be “Joint Service Unit” according to the announced criteria dated 28^th November 2019 and to accelerate continuous research and development to achieve “Persons with Disabilities Service Center" which can actually participate in the service. However, Ratchasuda College, Mahidol University serves as an academic unit to create a body of knowledge to support the drive for health system changing to meet the needs and improve the quality of life of persons with disabilities.   

The result of continued operation in collaboration with the network partners during 2019 to 2021, make the propulsion of policy proposals for the development of the national health security system and the movement of “Persons with Disabilities Service Center” to be “Joint Service Unit” in the National Health Security System concretely as follows:    

• In 2020: The development of standards, criteria that support the policy and the announcement of the National Health Security Office to provide service centers for persons with disabilities can be registered as a Joint Service Unit as follows;

1. Service standards, Criteria for evaluating the request for registration as a service unit (by Sirindhorn National Medical Rehabilitation Institute, Ministry of Public Health (SNMRI)/ Ratchasuda College, Mahidol University/ Thailand Council for Independent living (TIL) and the National Health Security Office (NHSO)), proposed and certified according to the standards of the Department of Medical Services by Sirindhorn National Medical Rehabilitation Institute, Ministry of Public Health (SNMRI) and announced by the National Health Security Office (NHSO) 
2. Service Scoping and criteria of payment for service fees to the service centers for persons with disabilities (by the National Health Security Office (NHSO)/ Thailand Council for Independent living (TIL)/ Ratchasuda College, Mahidol University/ Sirindhorn National Medical Rehabilitation Institute, Ministry of Public Health (SNMRI)) by the working group who develops the scope of services and determines the criteria for compensation for service fees, independent living skills training for service centers for persons with disabilities has studied and analyzed the cost of various services in service centers for persons with disabilities and proposals for alternative ways to pay for government services. In 2020, the National Health Security Office (NHSO) has approved the budget of the fiscal year 2021 at the rate of 9,000 Thai Baht per service 1 person/ 1 time.      
3. Development of a training course for providers of independent living skills training for persons with physical and mobility disabilities in accordance with the service standards that sets the standards of service providers, must be trained according to the curriculum standards certified by Ratchasuda College, Mahidol University (by Ratchasuda College, Mahidol University/ Thailand Council for Independent living (TIL)/ Sirindhorn National Medical Rehabilitation Institute, Ministry of Public Health (SNMRI)/ the National Health Security Office (NHSO) and Department of Empowerment of Persons with Disabilities). This is the aforementioned course, Ratchasuda College Use the guidelines according to the standards of education management of the country to organize the process together with related various sectors, starting from persons with disabilities who are experts from their own experiences, Ministry of Public Health with professional, Thai Health Promotion Foundation who is responsible for health insurance system. The National Health Security Office (NHSO who promotes the health of everyone, the National Health Commission Office (NHCO who promotes policy development and participation in accessing health services for persons with disabilities, and Department of Empowerment of Persons with Disabilities who is responsible for the quality of life development system for persons with disabilities. They prepare a certificate course with at least 36 hours of theory session and practical training Including a study visit to related services not more than 3 months. This has been done under the curriculum administration committee with relevant agencies as committee members.
4. Training courses with certificates “Independent living skills training service for persons with disabilities (for persons with physical and mobility disabilities) for service providers” batch 1. Aiming to create trainees to be both service providers according to service standards which will make it eligible to be able to register the service center as a joint service unit and can also be a trainer for the next batch of service providers in the future. The training was held from 7^th, August to 30^th, September 2021, there were 12 participants from 3 service centers for persons with disabilities; namely, Independent Living Center for Persons with Disabilities Chonburi, Nonthaburi and Pathumthani.

• In 2021: Registration of service centers for persons with disabilities as a joint service unit and follow up the operation of the service centers. 

1. Prepare service center to register as a joint service unit; there are 3 service centers who are ready according to the criteria of the National Health Security Office (NHSO) and request for registration and assessment; namely, Independent Living Center for Persons with Disabilities Chonburi, Nonthaburi and Pathumthani. All 3 centers passed the assessment and the National Health Security Office (NHSO) announced to be a joint service unit, which later changed to “Referral service unit specialized in medical rehabilitation” in the health insurance system. All 3 centers have piloted IL services for 8 persons with disabilities (persons with disabilities who receive complete services).   
2. Monitoring and evaluation of the provision of independent life skills training services for persons with disabilities of joint service units to provide pilot services; namely, Independent Living Center for Persons with Disabilities Chonburi, Nonthaburi and Pathumthani. These centers have been registered by the National Health Security Office (NHSO) which the operation of the center conforms to the specified standards with the quality and effectiveness of results but still unable to achieve the target of 100 people in the fiscal year 2021 due to the situation of the epidemic of COVID-19. It was also found that service fee compensation rate as approved at the rate of 9,000 Thai baht per service 1 person/ 1 time, still not suitable for the nature of the service is complicated due to providing services for persons with physical disabilities or severe movement and it takes time to be able to have an independent lifestyle. Independent lifestyle plans for some persons with disabilities may include several plans, the payment rate may not be appropriate and unfair to such service so there was a review and prepare service cost proposals proposed to the Bureau of Community Health Service Support and propose the proposal to the National Health Security Office (NHSO) to approved according to the proposal of the Bureau of Community Health Service Support, the rate was adjusted from 9,000 Thai Baht =/ person to be 11,000 Thai Baht in the fiscal year 2022.
3. Service Center Network Expansion to increase the number for the opportunity to access service of persons with disabilities by organizing the network meeting and prepare the service centers (via zoom), the service centers for persons with disabilities who attend the readiness are as follows:   

•  5 New Disabled Service Center Group; namely, Service Center for Persons with Disabilities, Thai Heart Volunteer Ubonratchathani, Disability Rehabilitation Association Kantharalak District, Independent Living Center for Persons with Disabilities, Sisaket Province, Chao Phraya Surasak City Municipality Center for Independent Living of Persons with Disabilities, and Independent Living Center for Persons with Disabilities, Phutthamonthon, Nakhon Pathom Province   
• 3-Original pilot centers group increases personnel potential development; namely, IL Center Chonburi, IL Center Nonthaburi and IL Center Pathumthani 

• Action plan in 2022 is an ongoing project operation to achieve sustainability.

1. Curriculum development and adjusting the training format in accordance with the situation for the implementation of the center's personnel development. To increase the service centers continuously, including the trainee’s potential development to able to use the technology for the service. 
2. The training course batch 2; to increase the personnel in accordance with the criteria of the National Health Security Office (NHSO).
3. Follow up and assess the operation of the service centers to follow up the systematic result, affect to “Independent living” of persons with disabilities who request for the service. Review the concept and key principles to promote independent living, the participation in society and the quality of life of persons with disabilities through the condition reviews/ important factors and the development process of the public health system mechanism “Independent living centers for persons with disabilities” to “Joint service unit” to “Rehabilitation Referral Service Unit”  
4. Expansion of the network of IL service centers and service centers that provide other types of services not less than 10 places and able to initially serve at least 20 people with disabilities/ 2 service centers, including increasing access to services for at least 200 persons with disabilities.  

The result of driving the policy into concrete practice in the pastis the development of integrated service systems and policies in order to achieve universal and fair access to better quality of life outcomesIn this case is the development of service center for persons with disabilitieswhich is a service mechanism to promote and develop the quality of life of persons with disabilities in the community. It isunder the standards and supervision of the Department of Empowerment and Development of the Quality of Life of Persons with Disabilities, Ministry of Social Development and Human Security. Also able to be joint service unitin health under the National Health Security Systemwith standard quality and efficientincluding the development of a service set scopeto offer as a service item in the medical rehabilitation benefits package forpersons with disabilities with the fair rateto submit to the National Health Security Office. As well as developing mechanisms to continuously improve service quality in cooperation with network partners