job application procedure when hiring for the family-type placement centres for children with disabilities in the capital city of Sofia. The same problem has been observed in other FTPCs as well. In 2015, the Ombudsman institution, in its capacity as a designated NPM, received letters of concern from managers of homes for medical and social child care (HMSCC) and from providers of social childcare services. The letters of concern to the Ombudsman described a number of cases involving recurring sibling separation by orders of the Heads of Social Assistance Directorates under the Ministry of Labour and Social Policy. Such acts contravene accepted standards of care for vulnerable children as well as the Child Protection Act. The Ombudsman, therefore, called on the MLSP to launch an inquiry into allegations of sibling and kin separation. The Minister of Labour and Social Policy has taken the necessary actions to have such children reunited. A most important recommendation made by the NPM concerning the provision of medical care to institutionalized children with disabilities is that no hospital establishment in Bulgaria should ever turn away a child in need of treatment, nor should a child be discharged at the end of a clinical pathway’s timeline if further treatment is required. The NPM has repeatedly identified cases of denial of medical care or ill-treatment of children with disabilities by external medical specialists. Many hospitals are reluctant to hospitalize institutionalized children due to shortage of clinical pathways granted to them by the NHIF. In such a context, the NPM has repeatedly addressed recommendations to the Ministry of Health regarding the need to set up a working group made up by MoH representatives, NPM experts, ward managers of inpatient children's wards at active-treatment hospitals and active-treatment teaching hospitals, and HMSCC managers with a view to drafting a common strategy to solve those issues. Further to NPM’s repeated recommendations, the Minister of Health issued on 11 September 2015 Order RD 01-192 designating seven multi-profile active treatment hospitals and the Specialized Active Treatment Paediatric Hospital to perform expert assessments of the health status and ongoing health care needs of children with disabilities. Such assessments would underpin the right choice of FTPCs for the children as well as their continued treatment plans at specialized hospital establishments. MEDICO-SOCIAL CHILDCARE INSTITUTIONS 2015 saw the completion of the first project aimed at restructuring eight homes for medical and social child care (HMSCC) for children aged 0 to 3. The now defunct HMSCCs have been replaced by new social service facilities: seven family counselling centres, five early intervention centres, eight centres for maternal and child health, two ‘Mother and Baby’ care units, nine specialized residential care centres for children in need of ongoing health care, eight day-care centres for children with disabilities, three child and adolescent mental health centres, and three foster care centres. In 2015, the National Preventive Mechanism visited the new social service facilities in the municipalities of Gabrovo, Targovishte, Pazardzhik, Plovdiv, and Montana. A positive trend noted by the NPM is the sharp decline in the number of children in residential care following the closure of HMSCCs and the opening of the new social service facilities. The length of stay for children has also been dropping. Most children are accommodated temporarily until their medical conditions are stabilized. Furthermore, the new medico-social service facilities in the above municipalities provide care to both children from the local communities and children with disabilities from residential care facilities. 73