Government Vision and Leadership in Reducing the Number of Children in Institutions, including

Children with Disabilities – Lessons Learned and Next Steps

George KakachiaHead of Social Protection Department,

Ministry of Labour, Health and Social Affairs of Georgia

Dushanbe, 2013

• Total population - 4.2 million

• Child population - 979.500

• Children with disabilities- 9000

• Internally displaced persons – 300.000 (28% 0-18)

• Children not registered at birth – 8%

• Extreme child poverty (below 1 USD) -12 %

• Official child poverty – 28%

• Official poverty – 26%

Country Profile

Children were Overwhelmingly Institutionalized Because of Poverty and Disability - 90% had a Living Parent

Deinstitutionalization and child care system reform launched in 2005

Several major steps have been taken under the framework of the Reform:

Development and improvement of relevant legislation to reduce administrative barriers for child’s reintegration into biological family, adoption and placement in foster care;

Defining of central responsible agency for child care and guardianship;

Establishment of regional guardianship and care panels;

Development of social workers profession and strengthening their role;

Adoption of the child protection and deinstitutionalization action plan by the Government of Georgia

Overview of the Reform

Reduction of the number of orphanages from 47 to 3 and the number of their beneficiaries from 5200 to 122 Opening 44 small group homes (for 6-18 year olds) throughout the country

Financing prevention and reintegration programs

Provision of free health care for children 0-5 years, and for disabled

children

0-18 years from 2012 and universal health insurance from 2013 Strengthening alternative services: Foster care (emergency, regular, specialized)

Overview of the Reform (Cont.)

THERE ARE THREE MAIN PRIORITIES OF THE REFORM: Reintegration of children living in the institutions into biological families

Provision of various social benefits as a preventive measures against child abandonment

Substitution of orphanages with alternative-family based services like small group homes and foster care

Overview of Reform (cont.)

CHILDREN RETURNED TO FAMILY ENVIRONMENT

77 children adopted 1055 children placed in foster care 353 children reintegrated to biological families 44 small group homes with 329 children Number of social workers - 239 The reintegrated families and children in foster care are provided with health insurance

Results of the reform for 2013 (January-June)

Changes in Country’s Child Care Profile

Children in 2 Large Institutions (6-18) (children with disabilities)

52

Children in 1 Infant Home (0-5) Those with Disability

70 (total)

59 Children in 44 Small Group Homes

329

Children in Foster Care(Including 104 Children with Disabilities)

1055

Children in Church Run InstitutionsApproximatel

y 1000

2005 2013 Children in 45 Large Institutions (6-18)

4900

Children in 2 Infant Homes (0-5)

220

Children in Small Group Homes

0

Children in Foster Care

100

Children in Church Run Institutions

Approximately

1000

Children Living in Institutions Compared to Alternatives over a 5-Year Period

New Frontier of Family Support Services for Children Supported by the State

Early Intervention service for children with disabilities

0

Foster care for children with disabilities 20

prevention, food vouchers 200

Mother/baby shelters (places) 30

Social work services (basic) 80

Early Intervention service for children with disabilities

150

Foster care for children with disabilities 100

prevention, food vouchers 450

Mother/baby shelters (places) 50

Social work services (basic)

240

2005 2013

Challenges and Plans Placement of Children in Institutional Care

• Need for more preventive/family strengthening programs

• Lack of specialized foster care families for children with severe disabilities and health needs

• Early identification and timely intervention for disabled children

• Identification and provision of services for disabled children based on their individual needs

• Monitoring of the alternative services and ensuring of child care standards

• Disability stigma

Next Notable Steps towards the Reform in 2014

-Recommendations of the Committee on the Rights of the Child (from 2008) – still valid for children with disabilities:

1)Ensuring children with disabilities have equal access to education;2) Making the necessary human and financial resources available; 3) Expanding community based programmes, including parent support groups; 4) Undertake awareness raising campaigns; 5) and improving data collection.

Future Plans and Challenges - Focus on Disability

•Convention on Rights of Persons with Disabilities - already adopted; will be ratified soon

•Reforming of the disability assessment system and replacement of the ,,medical” model by the ,,social” model. Social approach is based on assessment functional abilities and social needs of a person (child) rather than diagnosis of the health condition.

Future Plans and Challenges - Focus on Disability (cont.)

• Completion of Deinstitutionalization for children with disabilities:

• Establishment of alternative community-friendly services for children with special needs (specialized foster care; small group homes; palliative care)

• Establishment and further development of family support services (Early intervention, day care, parent support services, etc) to reduce a risk of separation

Future Plans and Challenges - Focus on Disability (cont.)

- Success of the child care reform in Georgia is based on close cooperation and coordination with International organizations, donors, local NGOs and business community

- EU, UNICEF and USAID are the biggest contributors to the reform

Coordination of Activities with Stakeholders

Thank You!