National Trust Schemes: Empowering Persons with Developmental Disabilities

For families raising a child with autism, cerebral palsy, intellectual disability, or multiple disabilities in India, the journey is rarely straightforward. Therapy is expensive, schools are often unprepared, caregivers burn out, and the question of what happens to their child as an adult looms large. The National Trust for the Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities – a statutory body under India’s Ministry of Social Justice and Empowerment – was established precisely to address these realities. Set up under Act 44 of 1999, the National Trust discharges two core duties: legal guardianship through Local Level Committees, and welfare through a structured suite of schemes. Five of these schemes – DISHA, VIKAAS, SAMARTH, NIRAMAYA, and GHARAUNDA – form a continuum of support that follows a person with disability from early childhood through the end of life.

What the National Trust schemes are designed to do 🔗

The National Trust’s welfare activities span early intervention, day care, respite care, residential care, and health insurance. Each scheme targets a distinct stage of life or a specific need, and together they create a system where no person with a qualifying disability is left without structured support – regardless of their family’s income, location, or caregiving capacity. The Trust works through a network of over 600 Registered Organisations (ROs) – primarily NGOs – spread across the country, which implement these schemes at the ground level.

The four disability categories covered across all schemes are: Autism Spectrum Disorder, Cerebral Palsy, Mental Retardation (Intellectual Disability), and Multiple Disabilities. Every person seeking to enrol in any scheme must hold a valid disability certificate under the National Trust Act, 1999.

DISHA: starting early, starting right 🔗

DISHA stands for early intervention and school readiness, and it targets the most critical developmental window: children between 0 and 10 years of age. The premise is straightforward – the earlier a child with a developmental disability receives structured support, the better their long-term outcomes in communication, motor skills, learning, and social behaviour.

DISHA Centres provide day-care facilities for at least 4 hours daily, between 8 AM and 6 PM, along with age-appropriate activities. Each centre is required to have a Special Educator or Early Intervention Therapist, a Physiotherapist or Occupational Therapist, and a Counsellor, alongside caregivers and support staff. The combination of these professionals under one roof means children receive multi-disciplinary therapy in a consistent setting – something that would cost families significantly more if arranged independently.

The scheme also extends support to family members, recognising that parents of young children with disabilities need guidance, not just their children. Counselling and training for families are integral to what DISHA Centres offer. This makes DISHA as much about caregiver empowerment as it is about child development.

VIKAAS: building skills through structured day care 🔗

Once a child with a disability moves past the age of 10, DISHA’s mandate ends – and VIKAAS begins. This is the National Trust’s day care scheme, aimed at persons above 10 years of age who need structured activity, skill development, and social engagement outside the home.

VIKAAS is designed to expand opportunities for enhancing interpersonal and vocational skills as individuals transition to higher age groups. VIKAAS Centres are expected to operate for at least 6 hours a day and remain open for a minimum of 21 days each month. Activities are age-specific and include both life-skills training and pre-vocational exercises, helping participants develop independence and capability over time.

There is a secondary but significant benefit to VIKAAS that is often overlooked: it gives family members – especially primary caregivers – time during the day to attend to their own responsibilities. A parent who knows their adult child is in a safe, structured environment for 6 hours is a parent who can hold employment, manage a household, or simply rest. This dual function – caring for the person with disability while supporting the family unit – is central to VIKAAS.

In cases where an RO implements both DISHA and VIKAAS, they may be merged into a single Disha-cum-Vikaas day care scheme, which has been in effect since April 2018 for eligible organisations.

SAMARTH: giving caregivers a necessary pause 🔗

Caregiving for a person with a significant developmental disability is demanding in ways that are difficult to fully articulate. Research consistently shows that family caregivers of persons with disabilities face elevated rates of stress, depression, and social isolation. SAMARTH directly addresses this – not by supporting the person with disability alone, but by providing temporary, structured relief to their caregivers.

The objective of SAMARTH is to provide a respite home for orphans, abandoned persons, families in crisis, and Persons with Disabilities from Below Poverty Line (BPL) and Lower Income Group (LIG) families – including those who are destitute. It also creates formal opportunities for family members to step back temporarily in order to fulfil other responsibilities or recover from caregiver fatigue.

SAMARTH Centres function as group homes for short-term or crisis-based stays. A key provision in the scheme is that if a person with disability above 18 years has spent more than 5 years in a SAMARTH Centre, they are to be transitioned to a GHARAUNDA Centre for long-term residential care. This ensures that SAMARTH does not become a de facto permanent solution when a proper long-term arrangement is what is actually needed.

Eligibility for SAMARTH is focused on the most vulnerable: those with one of the four National Trust disabilities, who are not simultaneously enrolled in DISHA, VIKAAS, or GHARAUNDA. Enrolled individuals are also automatically registered for the NIRAMAYA health insurance scheme.

NIRAMAYA: affordable health coverage for a neglected population 🔗

Healthcare costs are one of the most significant financial burdens faced by families of persons with disabilities. Ongoing therapies, specialist consultations, corrective surgeries, and hospitalisation costs can be ruinous for low and middle-income families. NIRAMAYA exists to remove that financial barrier.

The NIRAMAYA Health Insurance Scheme provides comprehensive coverage of up to Rs. 1 lakh per year on a reimbursement basis. The coverage encompasses a wide range of medical needs: OPD treatment including medicines, pathology and diagnostic tests; regular medical check-ups for non-ailing disabled individuals; dental and preventive care; hospitalisation; corrective surgeries for existing and congenital disabilities; ongoing therapies; alternative medicine; and transportation costs.

Several features make NIRAMAYA particularly well-suited to its target population:

• No pre-insurance medical tests are required, which removes a common barrier for persons with complex medical histories.
• Pre-existing conditions are covered, unlike most private insurance policies – a critical distinction for people whose disabilities may involve chronic health complications.
• A single premium applies across all age bands, meaning the cost does not increase as a beneficiary ages.
• There is no age limit; children and adults alike are eligible.
• The enrolment fee is Rs. 250 for BPL families and those with monthly income up to Rs. 15,000, and Rs. 500 for those above this threshold.

The scheme runs on a financial year cycle (April to March), and renewal must be completed annually. Enrolment for the 2026-27 policy year opened on 1 February 2026 through the National Trust portal. Applications are processed through Registered Organisations, which assist families in completing the process and can also help with claim submissions after treatment.

GHARAUNDA: a home for life 🔗

Perhaps the most profound – and the least discussed – of the National Trust schemes is GHARAUNDA. It confronts a question that occupies the minds of virtually every parent of a child with a significant disability: what happens to them after we are gone?

GHARAUNDA is designed to provide an assured home and a minimum standard of quality care throughout the lifetime of adults with autism, cerebral palsy, intellectual disability, or multiple disabilities. Eligibility begins at 18 years of age. Each GHARAUNDA Centre accommodates a standard batch of 20 persons with disabilities, with a maximum of 26.

The scheme goes beyond simply providing shelter. Centres are required to offer vocational activities, pre-vocational activities, and assistance for further training. Each centre must have at least two Special Educators who also provide vocational training, a Physiotherapist or Occupational Therapist, caregivers, and support staff. Activity rooms, vocational rooms, recreation spaces, and hygienic lodging are mandatory infrastructure requirements. Physical trainers and speech therapists are additionally encouraged.

Financially, the National Trust provides funding to GHARAUNDA Centres under three heads: a one-time setup cost, a recurring monthly fund per beneficiary, and a crisis fund. This ensures ROs can maintain the centre’s operations sustainably over the long term. The scheme maintains a 1:1 ratio between LIG (including BPL) and above-LIG participants, making it accessible to families across income groups. For families who can afford to contribute, payment is arranged directly between them and the RO.

In some cases, where an RO runs both SAMARTH and GHARAUNDA, these can be merged into a single Samarth-cum-Gharaunda Residential Scheme, offering a seamless continuum from crisis respite care to permanent residential support.

How the five schemes work together 🔗

What makes the National Trust’s scheme architecture coherent is its lifecycle logic. DISHA addresses children in their most formative years. VIKAAS picks up from adolescence onwards, building skills and supporting families through daytime care. SAMARTH steps in when caregivers need relief or families face crisis. NIRAMAYA runs concurrently across all stages, ensuring that health costs never become a reason to forgo necessary medical care. And GHARAUNDA provides the permanent, dignified answer to the lifelong care question.

Families do not need to navigate these schemes independently. The National Trust’s network of over 611 Registered Organisations across India serve as ground-level access points, helping families identify the right scheme, complete enrolment, and access support. Local Level Committees also handle the legal guardianship dimension, which often becomes relevant as a child with disability approaches adulthood and families need formal legal arrangements.

It is worth noting that a person with disability cannot be simultaneously enrolled in multiple centre-based schemes (e.g., both DISHA and VIKAAS, or both SAMARTH and GHARAUNDA). The design assumes a progression from one scheme to the next as the individual’s age and needs evolve.

What do you think? Given that the National Trust schemes are delivered through registered NGOs, how effectively do you think this model reaches families in remote or underserved areas of India? And considering that GHARAUNDA addresses the long-term care question that haunts so many families of persons with disabilities – do you think lifelong residential care, when provided with dignity and skill development opportunities, represents genuine inclusion, or does it risk becoming another form of institutionalisation?

References

1. https://nationaltrust.nic.in/
2. https://depwd.gov.in/en/national-trust/
3. https://thenationaltrust.gov.in/content/innerpage/our-schemes-at-a-glance.php
4. https://nationaltrust.nic.in/samarth-scheme/
5. https://nationaltrust.nic.in/niramaya/
6. https://studylib.net/doc/12831696/niramaya-national-trust-scheme-guidelines-health-insuranc…
7. https://nationaltrust.nic.in/gharaunda-scheme/