Report on the State of Human Rights in Institutions for Persons with Disabilities The practice that we have studied makes it clear that the school staff were, indeed, unaware of their obligation to report in the framework of the referral mechanism for child protection; specifically, in accordance with Paragraph 2 of Article 6 of the Joint Order No.152/N-496-45/N of the Minister of Labor, Health and Social Affairs of Georgia, the Minister of Internal Affairs of Georgia, and the Minister of Education and Science of Georgia on the Approval of Referral Procedures for Child Protection: “If there arises a doubt that a child was subjected to violence, the administrations of schools, medical establishments, and specialized institutions for children, as well as village physicians, shall be obliged to identify the urgent condition related to violence against the child and a well-founded doubt about violence against the child and manage the case within the competence determined by the referral procedures for child protection.” In accordance with Paragraph 3 of Article 6 of the same Order, the source of doubt about violence against a child may be the following: a) Presence of signs of physical injuries on a child’s body (bruises, fresh wounds, fresh scratches, fresh sores, difficulty in walking, swellings on the body, fractures); b) Suspicious behavior of a child (if a child is agitated or depressed, has fears, does not want to go to school, does not attend school regularly, does not do lessons, is uncared for, does not want to return home, is sexually developed beyond his/her age, has knowledge about sex that does not correspond with his/her age, has undergone a radical change in character, or cannot explain the causes of a trauma).” Analysis of the information obtained during the monitoring and its comparison with the obligations imposed on the staff of child care institutions by the referral mechanism for child protection from violence makes it clear that in all the aforementioned cases the employees of the institutions were not only able, but also obliged by law to respond adequately to the safety needs of the children, which they failed to do. Public Defender addresses the Minister of Education and Science of Georgia with recommendations to: Ensure the retraining of staff of public schools (with a boarding house service), so that they are able to fulfill the obligations envisaged by law to protect children who are victims of domestic violence; Ensure the activation of the referral system of child protection, so that, in every case when there is a well-founded doubt that a child was subjected to violence or neglect, the responsible state bodies are notified and all measures envisaged by law are taken to prevent violence. Health Care in Infant Houses The monitoring group has assessed the availability of medical services for beneficiaries of infant houses, provision of quality medicines, and other measures of health care. The outcomes of the monitoring have shown us that the medical services in infant homes are limited to the services of primary healthcare. The December 9, 2009 Resolution No. 218 of the Government of Georgia, which determines the measures to be taken with the aim of insuring the health of the population in the framework of state programs and the terms of the insurance voucher, says that beneficiaries of the State Care Agency shall be provided with insurance vouchers. Furthermore, Article 3 of the same Resolution determines the medical services covered by the voucher139. 139 „a) Reimbursement of expenses of outpatient services: a.a) Outpatient service (service provided by a family doctor or a district physician); outpatient service provided by specialists, urgent outpatient service; service provided by a family doctor, district physician, or a doctor’s assistant at the patient’s home, if necessary); ANNUAL REPORT OF THE PUBLIC DEFENDER OF GEORGIA NPM Report 2012 THE RIGHT TO HEALTH CARE