National Preventive Mechanism HEALTH CARE IN INSTITUTIONS FOR CHILDREN WITH DISABILITIES In the institutions for children with disabilities, beneficiaries with chronic diseases often require inpatient care. Patients are often discharged from inpatient units inappropriately early, which is caused by the expiration of the insurance limit. A beneficiary of the Kojori Institution for Children with Disabilities, G.T., born on 05/07/2004, was admitted to the Kojori Institution for Children with Disabilities on November 29, 2010, with the diagnosis of pediatric cerebral palsy, profound mental retardation, and acute bronchitis (bronchospasm). At the time of admission, the child’s condition was grave, with respiratory insufficiency; S/he was transferred to an inpatient unit in an ambulance car. On December 2, s/he was discharged from the inpatient unit, though, at the end of the same day, s/he was transferred back to the unit in an ambulance car. On December 6, s/he was discharged again, and on December 7, s/he was returned again to the unit. Due to frequent complication of the disease, s/he requires inpatient treatment. By the time of the monitoring, the beneficiary was in hospital. The 2010 Report on the Monitoring of the Rights of Persons with Disabilities by the National Preventive Mechanism devoted considerable attention to the inadequacy of medical service provided for children with disabilities. As a result of response to materials sent to the structures of state control, several medical workers had their licenses of professional activity suspended/revoked. Unfortunately, at the time of the monitoring of 2012, the issue of inadequate medical service was still relevant in the aforementioned institutions. In this respect, the situation in the Senaki children’s house was particularly difficult. The Case of Sh.K. – Late and Inadequate Medical Service On May 15, 2012, a representative of Public Defender received a phone call about deterioration of the health condition of beneficiary Sh.K., which, according to the author of the phone call, had been caused by inadequate medical assistance. As soon as Public Defender initiated the case on his initiative156, he requested information from LEPL State Care Agency. According to the letter157 sent from the State Care Agency, six-year-old Sh.K. had died on April 26, 2012, in the Kutaisi Regional Medical Diagnostic Center for Mothers and Children. However, the real circumstances of the case were as follows: On April 26, 2012, six-year-old Sh.K. (diagnosed with pediatric cerebral palsy, spastic paraplegia, and severe psychomotor retardation) was in the Senaki Institution for Children with Disabilities. The child had been admitted to the Senaki children’s house on April 2, 2012158. According to the entry made by a pediatrician, at the time of admission, the child’s condition was of average severity; In addition to low functional status (s/he was unable to sit and walk, constantly lay in bed, was unable to speak and come into contact), his/her health problem was thin, spotted rash (nettle-rash) on his/her neck, body, and limbs which his/ her parent could not relate to intake of food. Other data, according the pediatrician’s entry, were as follows: temperature –36.80, pale-colored skin, coronary sounds clear when hearing on the lungs, vesicular breathing. Two months after the child was admitted to the institution, his/her health condition changed sharply. According to Form #100 issued by the Kutaisi Regional Medical Diagnostic Center for Mothers and Children: “Six-year-old Sh.K. has been hospitalized in the inpatient unit with: 156 Case N.0853-12, May 17, 2012 157 Letter N.08/584, June 6, 2012 158 The aforementioned is confirmed by documents provided by LEPL State Care Agency on June 11, 2012 – a sheet on the examination of the patient, a pediatrician’s consultation sheet. www.ombudsman.ge NPM Report