Transcript Roles and accountabilities at local level: planning

Deinstitutionalization and child care
system reform in CEECIS and Romania
Round table organized by HHC Romania
Baia Mare, September 12, 2014
Children in formal care in CEE CIS
Children under 3 in formal care in CEE CIS
2012: The Call for Action!
4
http://www.unicef.org/ceecis/At_home_or_in_a_home_report.pdf
End placing children under 3 in institutions
1. Legislative changes limiting to last resort, and setting strict
conditions for, the placement into institutional care of children
below three years;
2. Allocation of resources giving priority to the development of
appropriate local services allowing alternative solutions for
children below three with special attention to the needs of
children with disabilities;
3. Proper budget allocation for supporting vulnerable families
through the development of appropriate family-based responses
and services;
4. Capacity-building and standards of practice for maternity ward
and paediatric hospital staff to support parents of new-borns with
a disability and parents from most vulnerable groups, in order to
discourage institutionalisation;
5. Partnership with media and civil society to promote social
inclusion of children deprived of parental care and children with
disabilities.
2012: Romania commitments
• evidence-based adjustment of the normative framework
(including but not exclusive, Law on the Promotion and
Protection of Children’s Rights)
• and review of the National Strategy and Operational Plan
for the Promotion and Protection of Children’s Rights
2014-2020, including:
– increase age for prohibition of institutionalization from 2 to 3
– specialization of prevention and protection services with special
focus on children below 3 and for children with disabilities
– correlation and adequate balance of state social assistance
measures of basic social services and cash transfers
– improved effectiveness and real time response of monitoring
instruments
Situation in Romania
The good news
1300
1200
1100
1000
900
800
700
600
500
400
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Rate of children in residential care
Rate of children in family type care
The bad news
2000
1800
1600
1400
1200
1000
800
600
400
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Rate of children in public care
Rate of children in residential care
Rate of children in family type care
Number of children under 3 in residential care
1600
1400
1200
1000
800
600
400
200
0
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
According to Art. 60 of the Law 272/2004 (law on protection and promotion of children’s rights) prohibits the institutionalization
of children below 2:
(1) The placement of the child who has not reached the age of 2 years old may only be decided with the extended or substitute
family and it is forbidden to place him or her in a residential service.
(2) As an exception to the provisions stipulated under paragraph (1), the placement in a residential service of the child who has
not reached the age of 2 years old may only occur in the case in which the child has severe disability and is dependent on
specialized residential care services.”
Children relinquished in medical units
6000
5000
4000
3000
2000
1000
0
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Source: www.copii.ro, www.mmuncii.ro
Why?
Causes of separation
Percentaje of total numbner of
children separated from parents (%)
2009
2010
2011
2012
Parents decese
7.41
7.32
7,14
6,71
Disappereance of parents
1.96
1.75
1,52
1,48
Parents without parental rights
0.85
0.98
0,81
1
Poverty
44.27
44.10
42,72
41,96
Abuz and neglect
21.69
22.23
23,37
25,12
Disability (child)
10.79
10.42
10,69
10,14
Disability (parent)
3.89
3.91
3,74
3,66
Others
9.14
9.29
10,01
9,93
Source: DGASPC, 2012
Causes of separation
Reasons for the
institutionalisation of
children below 3 years of age
in Western Europe countries
parental abuse
or neglect
orphans
disability
social reasons
Source: EU Daphné Programme (2004)
Reasons for the
institutionalization of
children below 3 years of age
in Central and Eastern
Europe countries
parental
abuse or
neglect
true orphans
disability
social
reasons
Prevention services
Number of children benefiting of prevention services, such a
day care centers, counseling and support centers for parents,
family planning services, pre-natal monitoring services
50000
45000
40000
35000
30000
25000
20000
15000
10000
5000
0
2005
2006
Source: www.copii.ro, www.mmuncii.ro
2007
2008
2000
2010
2011
Impact of prevention services?
2500
2000
1500
1000
500
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Rate of children in public care
Rate of children benefiting of prevention services
Source: www.transmonee.org
Objectives 2014
Adoption
Child protection
system
Socio-professional
reintegration
?
Reintegration in the natural family
Copyright © 2014, Gabriela Coman
No more invisible children!
Community based service demonstration project
2011 – 2014
Demonstration project 2011-2014
North-East Romania, among
the poorest regions in EU
8 counties with a total of 656
communes out of which 96
were selected to be part of the
demonstration project
In partnership with 8 County
Councils, General Directions for
Social Assistance and Child
Protection, Prefectures, 96
Public Local Authorities
In partnership with the
Ministry of Labour, Family,
Social Protection and Elderly
Persons
FACTS: realities at local level
Only 54% of the cases
are correctly assessed
by social workers
50% face neglect, abuse or
violence
almost 24% are out of school
or at risk of school drop-out
children relinquished or at risk of
relinquishment represent 7.9%
7.5% of all 'invisible' children have no
or limited access to medical services
considerably over-representation of Roma
children (51%)
30% live in households in which adults
completed only primary education
3% of children in rural
area are invisible
43% live in large households, poverty and precarious
housing
80% live in absolute poverty, with less than USD$ 1 per person per day
Current social protection policies
Underfunded
social protection
system
Shortage of
human
resources
Total expenditure
on social protection
17.6% of GDP
1 social worker to
4,300 inhabitants
Total expenditure
on social transfers
other than pension
8.1% of GDP
Over 60% don’t
have specialized
studies
Out of these less
than 10% target
families and
children; 2% for
social inclusion
Huge workload
and often strictly
limited to
granting social
benefits
Poor and uneven
development of
social services
Poor coverage
of cash
transfers
1 to 25 ratio of social
workers rural/urban
Child allowance
among Roma 90%
Only 30% of SPAS are
accredited
GMI among Roma
63%
No standardized
work procedures,
methodology
Family allowance
for Roma 16%
Specialized services
vs. basic social
services
Heating benefit for
Roma 11%
National social protection system, although very complex, provides only a loose safety network
through which many children fall and are trapped for years into cumulative deprivations.
Advocacy: cross-sectoral approach
Universal
child
allowance
School
mediator
Community
nurse
Social
worker
Other
cash
transfers
Minimum
Insertion
Income
Minimum package of integrated care and cash produces
integrated response
Policy Advocacy Objectives
Cash
Insertion
Minimum Income
CARE
Basic social
services
• Analysis of household budget survey data, including
perspective of various typologies and characteristics
of households of families with children;
• Input for definition/design of the benefit formula;
• Modeling of formula of package including the IMI;
• Modeling of integrated basic social services (minim
package of services) increases access and coverage
for invisible and vulnerable;
• Generation of evidence for right balance within the
package of services and cash transfers;
Prevention
first
Protection
only where protection fails
Guaranteed
Minimum
Income
225,000
Other
Special protection
benefits
services
60,000
Counselling
Day care
centers
centers
28,000
19,000
Family support
allowance
250,000
SPAS
Source: www.copii.ro, www.mmuncii.ro
Vision
Special
protection
services
Insertion
Minimum
Income
Community
health
worker
Day care
services
Family support
services
Specialized
counselling
services
Social
worker
Community
center
School
mediator
SPAS = Public services of social assistance at local level
Minimum package of services
Results of the demonstration project
• Children relinquished or at risk of relinquishment
represented 7.9% of all 'invisible' children;
• the total cost per year per child (and his or her family) was
of 250 RON.
– By comparison the standard cost per child per year in a day-care
centres is about 28 times higher.
• Successful rate of prevention: 80%;
– By comparison, the standard cost per child per year in foster care
varies from 14 thousand (for placement of 1 child) to 20 thousand
(for placement of 2 children; and the standard cost per child per
year in residential care is up to some 20 thousand which is about
80 times higher.
School
Church
Family
support
services
Family
doctor
Community nurse
Private
business
School mediator
Social worker
Community
support
center
Local Public
Authority
Thank you!