1. Deinstitutionalization – “Still muddling, not yet through” Goals, Pitfalls, Learning, Challenges Radostina Paneva Andro Dadiani SOS Children`s Villages International

2. Deinstitutionalization (De-I) is:
Decreasing reliance on institutional and residential care with a complementary increase in family- and community-based care and services;
Preventing separation of children from their parents by providing adequate support to children, families and communities;
Preparing the process of leaving care, ensuring social inclusion for care leavers and a smooth transition towards independent living.
De-I is systematic policy implementation not just sporadic projects

3. Timeframes of Reform Processes
UN CRC Ratification
1992
“Social Services and Social Assistance law” (2002
Approved De-I plan 2015
Reduction of number of children to 24 in 3 group of 8
201
Only 800 children to remain in institutional care by
2023
Latvia
UN CRC 1991
CPC and first steps of child care reform 2000
De-I Strategy and Plan approved 2010
Closed all institutions for children with disabilities – 2016
All institutions to be closed by 2025
Bulgaria
UN CRC ratification
1997
Launch of De-I processes
2000
First De-I action plan
Closure of all (49) but 2 state institutions
2013
Last “wave of De-I” 2015
Georgia

4. Lithuania as seen from the outside
UN CRC concluding observations (CRC/C/LTU/CO/3-4, 4 October 2013)
The large number of cases of deprivation of parental rights and placement of children, in particular children under the age of 3, in care institutions;
Very low number of foster families and inadequate support provided to them;
Lack of monitoring system of non-governmental children’s homes which often fail to comply with the legal requirements for hygiene, quality of services and space

5. Management of the De-I process
Challenges
Clarity of plans and their timeframes
Division of roles and responsibilities between various agencies responsible for children’s issues
Monitoring and evaluation
Communication of De-I goals and progress of reforms to stakeholders and wider public
Lesson learned
Changing of legislation are essential (with regards to rights, services, finance)
Leaders within the country championing De-I processes
Regular monitoring and modification of plans
Closure of institutions should be an important planned milestone
Less developed services for prevention and reintegration = no decrease of children in formal care
Plans are often developed “under conditions of maximum ignorance and minimum experience”

6. Financial mechanisms – Key issues
Comparing the cost of institutional care and community-based services
Currently provided care which is free to the state in reality is a hidden cost, paid by external donors
Economic implications
Ring-fencing the current volume of funding
Initial investment for starting up the needed services
Costs must be based on, and reflective of the structure of specific services

7. Cost implications of keeping institutions

8. Service development – key issues
Financing of services
Regulation of services
Variety of available alternatives
Flexibility of existing services to address the emerging needs of children
Understanding that new quality services should be cheaper than institutions in short term period

9. Examples: Georgia
Emergency foster care ensured that all new referrals to child protection system were diverted to family based care
Foster care – main family substitute care alternative
SGHs – a service used for sibling groups, older children (variety of models)
Specialized SGHs (e.g. for children with severe disabilities)
1424 Children in Foster Care – o/w 210 children with disabilities
352 Children in SGHs – o/w 7 in specialized SGH
387 Children in large scale residential care (in 2 State run and 2 Church run institutions)
Per/capita amount of financing in FC and SGH are the same although financing modality very different

10. Community based services
Institutional care
Support in a family
Alternative care
Prevention services
Reintegration
Kinship care
Guardianship (with an extended family or family friends)
Adoption
Foster Care
Small group homes
Support services needed by all children:
Medical services
Education services
Social services
Universal services for all children not just the ones at risk ones

11. Workforce
Staff of the old institutions
Staff of the new community based services, especially SGHs
Professionalization of the staff
Staff turnover and regular support
Foster care givers

12. New placements – key issues
Thorough assessment of children
Stability/permanency of the placement
Scrupulous preparation of a child for a new placement
Placement dilemma: close to the family or close to the services?
Referral mechanisms
Child is not a number in the statistics

13. Children and Families’ Support services
Centers for community support
Day care centers
Short term/emergency care placement
Crises centers
Mother and baby centers
Integrated services for early childhood development
Day care centers for children with severe mental disorders
Integrated social – health services
Universal services for all children

14. Residential care or small institutions
Small group homes
Number of children in the service
Target group
Professionals working in SGH ( various options)
Standards for physical environment = standards connected with quality of life
Coordination between social and health and education systems (for children with special needs)
Residential care or small institutions

15. Child at risk Foster care Services for a child
Services for foster families
Child at risk
Child and risks assessment
Decision to place in foster care
Matching with suitable foster family
Formal placement in foster family
Child is cared for by foster family
Child leaves foster care
Child at risk
Recruiting foster families
Assessment and training
Accredita-tion of foster families
Matching and first placement
Support and develop-ment of foster families
Foster family retires or withdraws

16. Children in institutional care as % of child population
Lithuania – (3276) 0.58 %
Latvia – (1218) 0.31%
Bulgaria - (1050) 0.08%
Georgia – (387) 0.04%

17. Bulgaria

18. Bulgaria
Professional foster care was established in Bulgaria in the framework of a 3-year state project ( ) “I have a family too” financed by the EU, operative programme “Human Resources”.
It was implemented in 83 municipalities. Total budget - 10 500 000 EUR. (2015) ; 202
Results ( ):
2220 foster families in total
2206– professional foster families.
Number of children in foster families – 3195 children; 5% children with disabilities.
80 % coming from families
12 % from institutions
8 % SGH

19. Examples: Bulgaria
Professional foster care: Foster parents receive the same as above monthly allowances per child plus financial compensation for their work.
For one child in care: 435 BGN/217 euro per month/child and this is 150% of minimum salary in the country;
For 2 children in care: 464 BGN/232 euro per month/child and this is 160% of minimum salary in the country;
For 3 children and more in care: 493 BGN/247 euro per month/child and this is 170% of minimum salary in the country.
Financial standard for the service “foster care” including support services for foster parents and children is under development.

20. Thank you !