raport sumar

8/13/2019 RAPORT SUMAR

1/53

REPORT

on monitoring of the human rights

situation in psycho-neurological

institutions in the Republic of Moldova

2013


2/53

2

Contents

ACKNOWLEDGMENTS ................................................................................................................. 4

SUMMARY ........................................................................................................................................ 5

About Moldovan Institute for Human Rights....................................................................................... 5

Main purpose of the visits.................................................................................................................... 5

Glossary. Notions and terms for the care of people with mental deficiencies.................................... 6

INTRODUCTION ............................................................................................................................. 7

Admission............................................................................................................................................ 7

Case referral to highly specialized social services............................................................................. 8

Documents serving as legal basis for admission in the psycho-neurological boarding house:.......... 8

Range of services that should be provided by the psycho-neurological boarding house: .................. 8

Range of psychological, psycho-pedagogical and social interventions undertaken by psycho-

neurological institutions...................................................................................................................... 9

Legal rights to admission, maintenance and release from psycho-neurological institutions........... 10

DESCRIPTIONS of the psycho-neurological institutions under the jurisdiction of the

Ministry of Labor, Social Protection and Family of the Republic of Moldova. ........................ 10

The Brinzeni psycho-neurological boarding house ........................................................................... 11

The Badiceni psycho-neurological boarding house .......................................................................... 12

The Coceiri psycho-neurological boarding house ............................................................................ 13

The Balti psycho-neurological boarding house ................................................................................ 13

The Orhei boarding school for children with mental deficiencies (boys) ......................................... 14

The Hincesti boarding school for children with mental deficiencies (girls) ..................................... 14


3/53

3

Financing of psycho-neurological institutions................................................................................. 15

Staff of psycho-neurological institutions........................................................................................... 17

MAINTENANCE AND SUPERVISION (Admission to the facility) ......................................... 21

The Brinzeni psycho-neurological boarding house........................................................................... 21

The Badiceni psycho-neurological boarding house.......................................................................... 26

The Cocieri psycho-neurological boarding house............................................................................ 35

The Balti psycho-neurological boarding house................................................................................ 42

The Orhei boarding school:.............................................................................................................. 44

The Hincesti boarding school:.......................................................................................................... 45

CONCLUSION AND RECOMMENDATION ............................................................................. 29

Conclusion and Recommendation regarding the respect of the right to mental health of persons

with mental deficiencies in boarding schools:.................................................................................. 29

Conclusion and Recommendation regarding the respect of the right to mental health of persons

with mental deficiencies in psycho-neurological institutions:.......................................................... 49

Conclusion and Recommendation regarding the respect of the right to hosting conditions of persons

with mental deficiencies in psycho-neurological institutions............................................................ 50

The Brinzeni psycho-neurological boarding house........................................................................... 50

The Badiceni psycho-neurological boarding house.......................................................................... 51

The Cocieri psycho-neurological boarding house............................................................................ 51

The Balti psycho-neurological boarding house................................................................................ 51

REFERENCES (National and international legal regulations regarding mental health).............. 52


4/53

4

Acknowledgments

This report benefited from the generous support and valuable contributions of many people and

organizations, by giving feedback on discussions, making available basic documents or carrying out

researches.

We are extremely grateful to Civil Rights Defenders for the professional and financial support for

the implementation of the Project Advocacy for institutional changes and human rights of the

persons within psycho-neurological institutions in the Republic of Moldova.

Finally, we thank the Ministry of Labor, Social Protection and Family of the Republic of Moldova

for the provided general and statistical information.


5/53

5

SUMMARY

This Report is the result of activities carried out within the Project: Advocacy for instituti onal

changes and human r ights of the persons with in psycho-neurological i nstitut ions in the Republi c

of Moldova,implemented by Moldovan Institute for Human Rights.

About Moldovan Institute for H uman Rights

The Moldovan Institute for Human Rights (IDOM) is an independent, non-profit organization,

founded in 2007 by a group of jurists and human rights defenders, which aims to protect the

fundamental human rights and freedoms. The members of IDOM are experienced in monitoring

respect for human rights and adherence to the obligations that the Republic of Moldova accepted

before the OSCE, the United Nations, the Council of Europe and other international organizations.

IDOM conducts advocacy and litigation, informs specific groups, as well as the entire society on

the most severe violations of human rights, caused by the ignorance of superior values of individual

freedoms, social justice, equity and non-discrimination.

The members of IDOM have contributed to writing reports on various human rights violations,

followed by the analysis of the situation, analysis of cases, comparative analysis of national and

international human rights legislation, recommendations for improving the situation addressed to

authorities, etc.

Main purpose of the visits

This Report presents the results of monitoring the human rights situation in the psycho-neurological

institutions in the Republic of Moldova under the jurisdiction of the Ministry of Labor, Social

Protection and Family.

Information gathered from the examination of institutions, legality of admission and maintenance

conditions, from the analysis of personal files of the patients with mental deficiencies, as well as

from the discussions with the medical staff, included in this Report, reflect the unique position of

the Moldovan Institute for Human Rights towards these institutions, towards the existing normative

acts, towards the practice used and methods of admission and also a unique position towards the

maintenance conditions of persons, including their treatment during their stay in psycho-neurological institutions.


6/53

6

Glossary. Notions and terms for the care of people with mental

deficiencies

Deficiencylack or insufficiency of certain mental, intellectual capacities.

Its main symptoms are the following: a) cease or slowing of the rhythm of evolution, especially of

organic functions; and b) reduction of social competence.

Causes of mental deficiency may be: a) individual etiologic cases; and) mental deficiency is the

effect of several causes, which acted simultaneously or successively during the development.

If according to the old paradigm (medical model) disabilitywas a disease (illness), a pathological

state of a person, which, actually, represented the root of all the problems faced by him/her, now,

according to the new paradigm, disability is a situation resulting from the interaction between

persons with impairments and attitudinal and environmental barriers (social model).

The expression mental deficiency is used alternatively with mental handicap, mental delay,

mental retardation, mental disability, mental debility. The term of mental disability tends to replace

the other terms.

According to the UN Convention on the Rights of Persons with Disabilities, persons with

disabilities must be provided with support in exercising their legal capacity [Art. 12 par.(3)],

including in controlling their own financial affairs [Art. 12 par. (5)]. This means that the vicious and

discriminatory practice of depriving persons of their legal capacity (an universal and fundamental

human right) by establishment of guardianship must be abolished and that the decision making

supportsystem for persons in need must be introduced without depriving them of legal capacity,irrespective of the severity of their disability.

According to UN Convention on the Rights of Persons with Disabilities, persons with disabilities

are those who have long-term physical, mental, intellectual or sensory impairments which in

interaction with various barriers may hinder their full and effective participation in society on an

equal basis with others.

Social assistanceelement of the social protection system, represents the group of facilities and

measures by which the state, local public administration authorities and civil society ensure the

prevention, limitation or removal of temporary or permanent effects of situations that might causemarginalization or social exclusion of a person.

Community services (protection of persons with disability)Services that allow to take care of the

patient in his/her natural life.


7/53

7

INTRODUCTION

Admission

The psycho-neurological boarding house is actually a specialized psychiatric institution for persons

with chronic mental disorders. Therefore, the admission procedure must not differ from the

procedure used by the Psychiatric Hospital. Considering their profound and severe mental disorders

and that they are declared by courts incapable, the admission of beneficiaries in psycho-

neurological institutions is actually involuntary.

Within the current procedure of involuntary admission, patients must undergo compulsory

examination within 48 hours of their admission by a commission of psychiatrists of the facility. If

the admission is founded, the commission of psychiatrists shall send, within 24 hours, appropriate

notice to the court. The psychiatric inpatient admission request sent by the representative of the

facility shall be examined by the judge within 3 days of its receiving.

According to the Framework regulation for the functioning of boarding schools, approved by the

Ministry of Labor, Social Protection and Family of the Republic of Moldova (2008), the boarding

house is an institution for temporary or permanent placement, provider of social and medical

services, for adults with mental disabilities.

Beneficiaries of social services are persons who at one point may find themselves in a difficult

situation generating marginalization or social exclusion when they have no support from their

family or community and depend on third persons.

The purpose of the boarding house is to ensure social protection to beneficiaries by providing

recovery measures, maintenance of capacities and social (re)integration.The objectives of the boarding house are: to provide social and medical care to beneficiaries

according to their special needs and characteristics of individual development; to help socialization

and (re)socialization of beneficiaries in their extended biological family or in community.

At the same time, according to the Instructions on accommodation of the patronized in social

institutions under the jurisdiction of the Ministry of Labor, Social Protection and Family of the

Republic of Moldova, approved by the same Ministry (No 61/227 of 16.02.2000) and Ministry of

Health (No 06-34/188 of 16.03.2000), people with chronic mental disorders, people with disabilities

and third age people who cannot take care of their own may be hosted temporarily or permanently

in these social institutions.

Case referral to highly special ized social services

Case referral to highly specialized residential social services developed at a national level according

to the Law on social services, Case referral mechanism in the social services system approved by

the Order of the Ministry of Social Protection, Family and Child No 55 of 12.06.2009 (currently the

Ministry of Labor, Social Protection and Family of the Republic of Moldova), is an activity carried


8/53


9/53

9

Range of psychological, psycho-pedagogical and social interventions

undertaken by psycho-neurological insti tutions

Adaptation to social needs and development of social habits are the quintessence of psycho-social

interventions necessary for the institutionalized persons with severe mental deficiencies.

Currently, the psycho-pedagogical specialists are using the following fields of psycho-social

interventions to children with severe mental deficiency:

a) motor(general motility, fine motility and ocular-motor coordination, psychomotility).b) communication and language.c) cognitive (reading-writing-communication, mathematics, working with the concept ofnumber).

d) social-affective (personal and social autonomy, socio-affective maturity). Because of thelack of psycho-pedagogical specialists and crowding of the Hincesti boarding school with adults,

the range of psycho-pedagogical interventions to children with severe mental disabilities are verylimited. Also, they actually are reduced only to those elementary.

It urges the Ministry of Labor, Social Protection and Family of the Republic of Moldova,

responsible for the activity of the boarding school and psycho-neurological institutions, to develop

national standards on Specialized medical assistance and Range of psycho-pedagogical,

psychological and social interventions for the patronized with different stages of mental deficiency.

Unfortunately, the range of intervensions used for adaptation to social needs and development of

social habits in the case of persons with severe deficiencies is very limited. This is caused by the

health state itself, the mental deficiency and the lack of certain appropriate forms models ofspecialized interventions in such situations.

Of the 315 persons hosted in the Hincesti boarding school for children with severe mental

deficiencies, 310 had severe mental deficiency. Thus, the psycho-pedagogical interventions of the

staff, medical assistants, educators and nurses are practically limited, according to the staff, only to:

how to hold the spoon; how to use the toilet; how to wipe their mouths; how to stay at the table; how to listen to the staff and thats about it . The staff trained directly in medical assistance consists of: 7 doctors, paid by sponsors and 18

medical assistants paid from the budget; and in psycho-pedagogical interventions 19 persons,

educators, paid from the budget.


10/53

10

Considering the very low number of employees and that the staff is trained in psycho-pedagogical

interventions in two shifts, day-night, we can state that the psycho-pedagogical specialized

support provided to those 417 persons hosted in the Hincesti boarding school is limited only to the

supervision of beneficiaries and their physical care and nutrition.

A part of the specialized equipment donated to the boarding house cannot be used for persons with

severe deficiencies.

Legal rights to admission, medical care and release from psycho-

neurological institu tions

Psycho-neurological institutions do not have an independent jurist to promote and protect the

category of beneficiaries unable to exercise their capacity to act and defend their rights to admission

to the boarding house, compulsory medical care in this facility, maintenance conditions; their rightsto be involved in different educational psycho-social interventions and to release from the boarding

house. It is inconceivable that the facility does not have a jurist independent from its administration.

Accreditation of psycho-neurological institutions, public medico-social

facilities

Psycho-neurological institutions are not subject to the accreditation applied to public medical-sanitary facilities

under the jurisdiction of the Ministry of Health, which aims to establish their capacity to provide to population

appropriate medical assistance. Therewith, the institutions do not have clinical standards to provide medical

services.

Descriptions of the psycho-neurological institutions under the

jur isdiction of the M inistr y of Labor , Social Protection and Fami ly of the

Republi c of Moldova

The Brinzeni psycho-neurological boarding house is located in Brinzeni village, Edinetregion, approximately 225 km from Chisinau. The boarding house is accessible by bus from

Chisinau, Edinet, and some other neighboring localities. The road conditions to Brinzeni are poor

and the traffic is slow.


11/53

11

The institution has a kitchen with dining room, food storage, an animal farm, a greenhouse for

vegetables as well as agricultural land and other unused auxiliary rooms.

The majority of beneficiaries are former residents of orphanages for children with mental

disabilities from the left bank of the river Nistru, who have been transferred to this institution after

the start of the military conflict in 1992. Since 2004, the Brinzeni psycho-neurological boarding

house hosts also chronic patients from psychiatric hospitals and the Orhei and Hincesti boarding

schools .The official capacity of the Brinzeni psycho-neurological boarding house is 301, of whom, 79 had

schizophrenia, 175 had mental disabilities and 47 had epilepsy.

According to the doctors, 12 persons from the boarding house were placed in other facilities after

being diagnosed with pulmonary tuberculosis.

From 9 August 2013, the boarding house experienced a 12 -month tuberculosis outbreak.

According to the statistical information presented by the administration of the Brinzeni psycho-

neurological boarding house, since 2 January.2013 there are 311 patients, of whom 183 are men and

128 are women.

Men :

Age : No of persons :

20 - 30 years 22

31 - 40 years 36

4150 years 51

51 - 60 years 52

61 - 70 years 4

over 70 years 4

Women :

Age : No of persons :

20 - 30 years 16

31 - 40 years 34

4150 years 24

51 - 60 years 34


12/53

12

61 - 70 years 12

over 70 years 8

From the total number-311 patients on 2 January 2013 NoDisabled people, I degree 104

Disabled people, II degree 205

Disabled people, III degree 2

Bed-ridden 32

From the total number-311 patients on 2 January 2013 No

First-degree relatives 71

Second-degree relatives 66Third-degree relatives 50


First-degree relatives 71

Second-degree relatives 66

Third-degree relatives 50

Orphans (have no relatives) 124


Schizophrenia 81

Profound and severe mental retardation (total), 177

Mild mental retardation 20

Severe mental retardation 157

Consequences of organic cerebral affections with dementia 20

63 of 311 patients do not have a Court decision.248 of 311 patients do not have a legal representative.

During 2012, from the total number of patients, 22 have been placed in the Psychiatric

Hospital from Balti and 3 in the Phthisiology Hospital from Pavlovca, Briceni region.

The Badiceni psycho-neurological boarding house is located 5 km from Badiceni village, inthe Soroca region, covering12 hectares.


13/53

13

The road to the institution is damaged and during winter, access is limited.

The boarding house has an administrative building with a surface of 350 sq.m., built in 1957 and

repaired in 2006; apartment building with two levels with a surface of 2100 sq.m., built in 1986 and

partially repaired in 2005 (by changing the roof) and in 2010 (by changing the doors and windows);

laundry room built in 1986; food storage built in 1985; boiler house built in 1986 and repaired in

2011.

The electricity is delivered according to the agreement concluded with S.A. Red-Nord-Vest. Theboarding house has an artesian well that provides drinking water and a coal boiler house. The sewer

system is working, but it is old and needs to be reconstructed.

The capacity of the Badiceni psycho-neurological boarding house is 460.

On the visit day, in the Badiceni psycho-neurological boarding house there were 455 beneficiaries,

of whom 241 men and 214 women. All the beneficiaries have identity cards, which are kept in

personal files and have been paid from the budget of the institution.

Depending on the nosological form, the beneficiaries are distributed: No

Schizophrenia 117Mental retardation 277

Epilepsy with dementia 25

Organic disorder with dementia 36

The Coceiri psycho-neurological boarding house is located in Cocieri village, Dubasariregion, 46 km from Chisinau.

On the visit day, in the Cocieri psycho-neurological boarding house there were 346 beneficiaries, of

whom 200 men and 146 women. The patients of the institution are from the age of 4 years and

above and benefit from complete maintenance. The Balti psycho-neurological boarding house is located 3 km from the center of Balti,covering 45282,6 sq.m. , of which 8922,6 sq.m. are the total surface of the building and 36360

sq.m.the pertaining land. The patients of the institution are men and women of different ages who

benefit from complete maintenance.

The Balti psycho-neurological boarding house began operating in August 1984. It has 4 apartment

buildings for the hosted beneficiaries, outpatient department equipped with consulting rooms,

treatment rooms, physical therapy, vaccination, massage rooms, clinical laboratory, dental

departments, gynecological departments. The institution has a kitchen with dining room, food

storage, events room, library, laundry room, autonomous heating system, houses for transportationunits and other auxiliary rooms.


14/53

14

The Orhei boarding school for children with mental deficiencies (boys) is a publicinstitution of social assistance which provides placement services to children with mental

disabilities towards their recovery, social and family rehabilitation and (re)integration. The Orhei

boarding school is meant for children with mental disabilities from the age of 4 to 18 years. The

capacity of the institution is 350.

The boarding school is located in close proximity to Orhei and consists of a building with 4 levelsand a building for hospitals boiler house.

The Hincesti boarding school for children with mental deficiencies (girls) operatesaccording to the Framework regulation for the functioning of boarding schools, approved by the

Order of the Ministry of Labor, Social Protection and Family No 45 of 13.06.2008.

The boarding school for children with mental deficiencies is a public institution of social assistance

which provides placement services to children with mental disabilities towards their recovery,

social and family rehabilitation and (re)integration. The Hincesti boarding school is meant for

children with mental disabilities from the age of 4 to 18 years. From the total number ofbeneficiaries, 174 persons are over 18 years, respectively, 141 are underage. The youngest

beneficiary is 4 years old and the oldest52 years.

On the visit day (11 January 2013) to the boarding school for children with mental deficiencies

(girls) we found out that according to documents there were 315 patients, of whom only 141 were

children (46 being bed-ridden) and 174 were adults (48 being bed-ridden). From the 94 bed-ridden

persons, 68 were suffering from convulsions.

Depending on the nosological form, from the total number of 221

children and adults, persons not bed-ridden are distributed:

No

Mild mental retardation 2

Profound mental retardation 3

Severe mental retardation 216

Statistical dynamics from the last 3 years of

beneficiaries presence in the boarding school, on

the visit day is the fol lowing:

2011 2012 2013

Hosted primarily 13 9 7

From home 5 6 1


15/53

15

From other facilities 8 3 6

Released 8 26 13

To relatives 3 2 1

In other facilities 5 22 12

Deceased 3 2 0

F inancing of psycho-neurological insti tutions

The Brinzeni psycho-neurological boarding house:

Total budget for facility 14834,8 thousand lei, of which 14834,8 thousand lei : 365 days =40,6

thousand lei.

One day per person hosted in the boarding house: 311 beneficiaries = 1300 thousand lei (somatic-

1305,0).

The Badiceni psycho-neurological boarding house:

On 30 September 2013, the execution of the State budget was: according to the plan mentioned for

the management period - 11697.8 thousand lei, financed 11532.8 thousand lei, effective costs -

11707.1 thousand lei.

The Hincesti boarding school:

Plan mentioned for the year 2013: lei

From the Budget 15268,6 thousand

Executed for 9 months, 2013 10631,5 thousand

Effective costs for 9 months, 2013 10770,7 thousand

Plan mentioned for the year 2013: lei

Special means

Executed for 9 months, 2013 923,4 thousand

Effective costs for 9 months, 2013 613,3 thousand


16/53

16

Humanitarian aid:

Received for 9 months, 2013 471,7 thousand

Including:

Food 55,9 thousand

Medicines 20,3 thousand

soft inventory 231,3 thousand

household materials and objects 164,2 thousand

Spent 319,1 thousand

Including:

Food 84,0 thousand

Medicines 26,1 thousand

soft inventory 67,9 thousand

household materials and objects 141,1 thousand

Maintenance costs of patients: lei

Food

according to the budget 32,10

de facto 32,70

Medicines

according to the budget 5,94

de facto 6,96

Total per person/day: 10770,7 thousandaccording to the budget 153,71

de facto 142,00

From the discussions held with the management, the institution has received financing according to

the established terms, the main source being the state budget and donors. No delays in salary

payments have been noticed. Currently, the staff of this institution is worried about low salaries and

insufficient staff members. There is no periodical independent monitoring on the expenditure of

money and material resources (from the budget and donors) received by the boarding school.

Therefore, it is impossible to monitor the expenditure of money and material resources for each

beneficiary.


17/53

17

Staff of psycho-neurological institu tions

Insurance of psycho-neurological institutions with specialized staff:

No Facility Balti Brinzeni Badiceni Cocieri

Basic Emp

loye

d

Basic Emp

loye

d

Basic Empl

oyed

Basic Emp

loye

d

Professional doctors

1. Head doctor 1.0 1.0 - - 1.0 1

2. Therapist 1.75 1.75 1.5 1.5 2.0 2

3. Psychiatrist 2.0 2.0 2.5 2.5 1.0 1

4. Dentist 1.0 0.5+

0.5

0.5 0.5 0.5 0.5

5. Surgeon - - 0.5 0.5 - -

6. Gynecologist 0.5 0.5 0.5 0.5 0.5 0.5

7. Epidemiologist 0.5 0.5 0.5 0.5 - -

TOTAL 5.75 5.75 6.0 6.0 5.0 5

Medium medical staff

1. Chief medical

assistant

1.0 1 1.0 1.0 1.0 1

2. Medical assistant

on guard

20.0 20 13.0 13.0 17.0 17

3. Medical assistant

masseur

1.0 1 0.5 0.5 1.0 1

4. Procedure medical

assistant

3.0 2 1.0 1.0 1.0 1


18/53

18

5. Social assistant 0.5 0.5 1.0 1

TOTAL 25.0 25 16.0 16.0 21.0 21

Low medical staff

1. Nurse 115.0 115 62.0 62 123.0 123

2. Ergotherapy

instructor

- - 3.0 3 2.0 2.0

TOTAL 115.0 115 65.0 65 123.0 123

Other employees

1. Educator - - - -

2. Librarian 0.5 0.5 - -

2. Jurist 0.5 0.5 - -

3. Cultural entertainer 0.5 0.5 - -

TOTAL 1.5 1.5 - -


19/53

19

Comparative characteristics.

Insurance of boarding schools with health care staff

Orhei Hincesti

No Unity According

to staff

scheme

Occupied

with

natural

persons

According

to staff

scheme

Occupied

with natural

persons

Professional doctors

1. Head doctor 1.0 1 0.25 0.25

2. Therapist 1.0 0.5 - -

3. Psychiatrist 1.0 0.25 1.0 1

4. Neurologist 1.0 - 0.5 0.5 external

part-time

employment

5. Dentist - - 1.0 0.5 external

part-time

employment

6. Pediatrician - - 1.0 9 (8

sponsorships)

7. Gynecologist - - 0.5 0.5 external

part-timeemployment

TOTAL 4.0 1.75 4.25 11.75 (8-

sponsors)

Medium medical staff

1. Chief medical

assistant

1.0 1 1.0

2. Medical assistant 17.0 11 18.0 20+2

(sponsorships)

3. Procedure medical

assistant

1.0 1 1.0 1

4. Medical assistant -

masseur

3.0 3 1.0 1

TOTAL 22.0 15 21.0 24

Low medical staff

1. Medical assistant 2.0 2 -

2. Nurse 113.0 96.5 108.0 186 (+78,

part-time


20/53

20

employment)

TOTAL 115.0 98.5 108.0 186

Other employees involved directly in the health care of beneficiaries

1. Speech therapist 1.0 1 - -

2. Educators 8.0 9 19.0 19

3. Social assistants 3.0 2 1.0 1

TOTAL 12.0 12 20.0 20


21/53

21

MEDICAL CARE AND SUPERVISION

(Admission to the facility)

The Brinzeni psycho-neurological boarding house

Living conditions: The boarding house has 3 apartment buildings with 2 levels. On each level there

are a number of rooms/bedrooms, 1 rest room, 1 sanitary unit and 1 storage place for clothes and

shoes, some of them have been donated and others have been bought by the institution.

During the day and night, patients in each group are supervised by 1 nurse.

The source of artificial light in each room is provided by bulbs, mounted on the ceiling, the light

quality being satisfactory. Also, the windows are large enough to let the natural light come in duringthe day (in picture).

The boarding house is completely connected to autonomous heating system, which is broken for at

least half of a year, thus patients are freezing and sleeping two in beds to warm up, are using broken

electric heaters and have to wash themselves with cold water. According to what we have been told,

the renovation of the heating system may take yet 2-3 weeks (in picture).


22/53

22

Currently, the boarding house is in quarantine because of the tuberculosis outbreak. The institution

does not have sufficient electric heaters to warm the rooms and the use of several electrical heaters

overloads the electrical system.

During the discussions with the staff, we found out that in certain groups there are no:

Additional quilts; Bedside tables for personal belongings; The halls of the institution are mouldy and there is a strong smell of cigarette smokeeverywhere, because patients (especially men) smoke in halls and rooms (in picture).


23/53

23

Personal hygiene: The sanitary conditions in each unit were satisfactory (in picture).


24/53

24


25/53

25

The bathroom and sanitary unit are divided in two rooms. In one of the rooms there are 2-3 toilets

(many of them broken) and 1 sink. In the other room there are 1-2 showers, which, according to

certain nurses have not been used by patients for quite a long time, because the heating system doesnot work and there is no hot water.

Many sanitary units of the institutions are broken and are not connected to the centralized sewer

system. The floor is wet or there are large surfaces of water. The working group saw how a patient

with locomotor disability had to go to the toilet through these surfaces of water and her clothes got

wet eventually. According to the staff, all the beneficiaries have a face towel, soap and toothbrush.


26/53


27/53

27


28/53

28

During the day and night, patients in each group are supervised by 1 nurse and 1 medical assistant

for 6 groups.


quality being satisfactory, but unfortunately, in most of the groups, only 4 of the 8 bulbs are on, the

others are pulled out or broken. Also, the windows are large enough to let the natural light come in

during the day, but also to air the room, so there is no odor.

During the cold time of the year, the facility is completely heated, having for that purpose a boiler

house (in picture). The rooms temperature is relatively good and varies between 21-23C.


29/53

29

Clothes, shoes and bed linens are kept in wardrobes (in pictures). Some of the beneficiaries have

personal bedside tables, which can be fastened with a lock in order to protect their personal

belongings.


30/53

30

Most of the groups are clean. There are carpets on the walls and the floors are covered (in pictures).


31/53

31


32/53

32

Personal hygiene: The sanitary conditions in each unit were satisfactory. The humidity is high and

varies between 71-76%. The walls and ceilings of certain rooms are mouldy (in pictures).


33/53

33


34/53

34

The bathroom is separated from the sanitary unit by a concrete wall. In these rooms there are 2

toilets, 1 bath and 2 sinks. Each sanitary unit has hot water.

Patients have the possibility to use the bathroom everyday for personal hygiene.

Here were found large quantities of sodium chloride, which stood at hand patients (in pictures).


35/53

35

Dietary: Patients have meals three times a day, at preset hours. The facility has also special food

storage: for meat, dairy products, berries, tins, fruits and vegetables.

Other occupational activities: The beneficiaries of the institution have the possibility to be involved

in tailoring and auxiliary household activities.

The Cocieri psycho-neurological boarding house

Apartment building: During the night, patients in each unit are supervised by 2 nurses and duringthe day by 1 nurse.


quality being satisfactory during the night. Also, each room has windows which let the natural light

come in during the day.

There is no ventilation system, so the rooms are aired by opening the windows.

The institution is completely connected to autonomous heating system.

Bed linens were clean. They are changed once in 10 days.

Most of the rooms on the 3rd

floor are equipped only with beds, thus there are no individual bedside

tables and wardrobes for clothes or other personal belongings (in pictures).


36/53

36


37/53

37


38/53

38

Whereas on the 1stand 2

nd floor, we have noticed at least one bedside table or wardrobe in each

room, where there are 2-4 beneficiaries (in pictures).


39/53

39


40/53

40

Each unit has a restroom for the patients. This is equipped with chairs or couches and a TV set (in

pictures).


41/53

41


42/53

42

The institution has also a library, which is on the 2nd

floor. It has Romanian and Russian literature:

books, newspapers and magazines. Recently, the Adevarul Holding made a donation: several

collections of universal literature, novels and fiction. According to the librarian, beneficiaries come

often to the library.

Dietary: Regarding the dining room, patients have meals three times a day and according to the

director of this facility, the average daily spending for patients food is of 35,50 lei.

We have to mention that, according to the chef, patients with special dietary needs (50 persons)

have a separate menu, depending on their health state.

The institution has also food storage.

According to the beneficiaries, some of them are satisfied with the food offered here, but some do

not like it and say that it is not enough and they are often hungry. Others told us that they are

periodically visited by their relatives who bring them food supplies.

Personal hygiene: According to the nurse, patients take a bath twice a week: on Tuesdays andFridays.

The sanitary conditions were unsatisfactory on the 3rd

and 2nd

floor. Thus, these places need major

repair and endowment with all the necessary. The sanitary conditions were satisfactory on the 1st

floor.

The sanitary unit has:

3rd

floor, Group 3V and 3G: 2 toilets, 1 sink and 1 shower.

3rd

floor, Group 3B: 2 toilets, 1 sink and 1 bath.

2nd

floor, Group 2V: 2 toilets, 2 sinks and 2 showers.

2nd

floor, Group 2 B i 2G: 2 toilets, 1 sink and 3 baths.

1stfloor, Group 1V i 1 B: 2 toilets, 2 sinks and 2 showers.

Patients receive shoes and clothes from their relatives or periodically from donations. The dirty

clothes are collected in a room, where there is also the laundry. The clothes are washed, dried here

and put in separate rooms, on separate shelves. According to the responsible person, in the morning

some of them are dressed with clothes chosen at random, by size and others recognize and wear

only their clothes.

The Balti psycho-neurological boarding house

Apartment building No 2

On the 4th

floor there is the Unit for women.On the 3

rdfloor there is the Unit for men.

On the 2nd

floor there is the Unit for men and women.

The most difficult unit regarding the provision of care services and medical assistance is the one

which has almost 200 persons with severe mental disabilities: mental retardation, senile dementia

etc., who are under a closer supervision in the Building No 2 (so-called secure care unit).


43/53

43

Beneficiaries from this category are hosted in a separate building, with 4 levels and are under

continuous supervision.

There are 50-70 beneficiaries on each floor, supervised by 3 nurses: 1 man and 2 women. The

beneficiaries are distributed depending on the severity of disability: on the 1stfloor there are hosted

persons with locomotor disabilities, on the 3rd

and 4th

floor persons in severe conditions and

persons transferred from other units due to the deterioration of their mental health.

The access doors to the units located on the 3rd

and 4th

floor are locked 24 hours a day. The majorityof doors are open and the handles are removed. But certain doors have hanging locks, fastened on

the visit day. Some rooms had no bulbs. The windows are grated. On average, there are 5-7

beneficiaries hosted in each room.

We have measured four rooms chosen at random on each floor:

3rdfloorroom with 9 beds measured 31,34 sq.m. (although there were 11 persons in thisroom);

4thfloor room with 7 beds measured 30,76 sq.m. and room with 6 beds measured 17,42sq.m.;

2ndfloorroom with 4 beds measured 18,84 sq.m.According to the staff, enhanced security measures are necessary because the beneficiaries are very

aggressive.

On the 4th

and 3rd

floor the hosting conditions are unsatisfactory: there is a strong smell of urine,

cigarette smoke, beds are old, some beds do not have mattresses or linens and the hall is dirty, the

minimal necessary furniture is missing (bedside tables, chairs, wardrobes), in certain rooms

switches are not running, the bulbs are missing and the concrete floor is full of holes and poses a

threat to life and that is why it must be repaired as soon as possible.

During the night, the clothes of beneficiaries are kept in separate rooms. In the morning they are

dressed with clothes chosen at random, by size.

There is no ventilation system, so the rooms are aired by opening the windows.On the 2

ndfloor the hosting conditions are better comparing to the other floors, because linens are

clean, there are wardrobes and bedside tables, the floor is in good condition and in some rooms the

floors are covered with carpets in good condition. The source of artificial light in each room is

provided by a bulb, mounted on the ceiling, the light quality being satisfactory during the night.

The institution is completely connected to autonomous heating system. It is cold in the halls, since

there are no heaters. The rooms are also not warmed up well.

During the visit, we have noticed that in the so-called Secure care unit there are periodically

transferred not only persons with disturbances or deteriorated mental health, but also persons who

consumed alcohol in excess, fought or aggressed other beneficiaries, who didnt listen to the staff or

tried to escape from the facility.

Apartment building No 3

On the 1stfloor there are hosted persons with locomotor disabilities, but the elevators do not work

and patients have difficulty in moving without help. On a whole, the hosting conditions are

satisfactory. The windows are not grated. There are 1-2 beneficiaries hosted in a room, 4 at most.

They are allowed to decorate their sace at their own will. They are allowed to put a telephone line in


44/53

44

their room at their expense, to decorate the room with personal belongings (additional furniture, TV

set, Microsystems etc.), lock their rooms. Beneficiaries from this building are allowed to choose

their roommates and form couples.

During the day, beneficiaries are not involved in recovery/resocialization and maintenance of

capacities activities; their only occupation is to take care of the living spaces and to nurse bed-

ridden beneficiaries. They go for a walk, play cards, watch television, talk.

Dietary: Patients have meals three times a day, at preset hours.

The 2nd

, 3rd

and 4th

floor from Building No 2 (Secure care unit) has its own dining rooms, located on

the same floor, but the conditions are unsatisfactory.

The facility has also a dining room for patients from the open care unit, who have meals in two

turns, the average daily spending for patients food being of 30,40 lei.

We have to mention that, according to the chef, patients with special dietary needs have a separate

menu, depending on their health state. Bed-ridden patients have meals directly in their rooms.

The facility has also a storage place for food supplies, food samples and for food preparation.

Personal hygiene: The sanitary conditions in each unit were satisfactory. According to the patients,

hot water is always available and there is no special schedule for bathroom visits.

The hygienic conditions in the bathroom and sanitary were unsatisfactory, even if, from 1998 until

2002, the boarding house was sponsored by the Dutch Foundation, when all the bathrooms and

toilets have been repaired according to European standards.

The bathroom and sanitary unit are divided in three rooms. In one of the rooms there are 4 hands

and foot wash sinks. In another room there are 4 shower units, isolated from each other by a special

wooden wall. In the 3rd

room there are 4 toilets. According to certain patients, they have a bath only

once a week.

According to beneficiaries: During the visit, we have discussed with more patients, who expressed

their opinion regarding the life in the facility and the attitude of the staff towards them. Some of

them are happy that they have a place to sleep and eat. Others want to go home, but their relatives

do not have possibilities to take care of them.

The Orhei boarding school:

Apartment building: During the day and night, patients are supervised by a nurse, educator andmedical assistant.

The source of artificial light in each room is provided by a bulb, mounted on the ceiling, the light

quality being satisfactory during the night. Also, each room has windows which let the natural light

come in during the day.

There is no ventilation system, so the rooms are aired by opening the windows.

The institution is completely connected to autonomous heating system.


45/53

45

It is clean here, thus the conditions are satisfactory.

Each group from the 2nd

floor has:

rest room with a TV set, chairs and tables; wardrobe for clothes and shoes; bathroom equipped with 3 baths; activity room; sanitary unit equipped with 4 toilets and 4 sinks, small compartments for towels, soaps andtooth paste.

Dietary: Patients have meals three times a day, at preset hours.

The average daily spending for patients food is of 33 lei and it is completed, on need.


menu, depending on their health state.

The facility has also satisfactory food storage: for meat, dairy products, berries, tins, fruits and

vegetables.

Personal hygiene: The sanitary conditions in each unit were satisfactory.

Bed linens were clean.

Patients receive shoes and clothes from their relatives or periodically from donations. The dirty

clothes are collected in a room, where there is also the laundry. The clothes are washed, dried here

and put in separate rooms, on separate shelves.

Other occupational activities: The facility has an events room, a gym and a pool. There are often

sporting and cultural competitions.

The Hincesti boarding school

Sanitary conditions: On need, the facility has two special rooms fit out for short-term hosting of

patients relatives. Usually, they stay 2 days at most.

According to the director, currently there are 92 bed-ridden girls, who always use wheelchairs.

On the territory there are enough ramps to allow them to move. To this end, the director told us that

they need some new wheelchairs (size 21-22), because a few of the existing have already broken.

Living conditions: The beneficiaries are divided into 17 groups of 16-20 people and placed

according to age and diagnosis, of which 1 group consists of 8 girls with the most severe mental and

physical complications.

The boarding school has 3 apartment buildings with 2 levels.

During the night, patients in each group are supervised by 2 nurses and during the day by 1

medical assistant and 2 nurses.


46/53

46


quality being satisfactory. Also, the windows are large enough to let the natural light come in during

the day, but also to air the room, so there is no odor in the entire facility.

The boarding house is completely connected to autonomous heating system and the boiler house is

gas powered.

Clothes, shoes and bed linens are kept in separate wardrobes. Thus, each patient has her shelf with

necessary clothes and shoes.

The walls of the facility are painted with scenes and images from fairy-tales or cartoons; the interior

decoration is well-done and pleasant. Also, each group has a TV set.

Personal hygiene: The sanitary conditions in each unit were satisfactory.

The bathroom and sanitary unit are divided in two rooms. In one of the rooms there are 3 toilets and

1 sink. In the other room there is 1 bath, 1 shower and 1 washer.

According to the nurse, patients have a bath twice a week: on Tuesdays and Fridays and practice

daily personal hygiene. All the beneficiaries have a face and a foot towel, soap, toothbrush.

Members of the working group have been ensured that hot water is always available.

Dietary: Patients have meals four times a day, at preset hours.


menu, depending on their health state.

The facility has also food storage: for meat, dairy products, berries, tins, fruits and vegetables

Expired products have been found (51 milk packets and several candy boxes).

Other occupational activities: The beneficiaries of the facility have the possibility to be involved in

different activities, such as: embroidery, crocheting, drawing, music and dance. In the auxiliary

household therhhhe are involved 10-15 girls. Other 10 girls learn to cook and set the table.

The facility has also:

- An events room with capacity of 100 seats. Here, children organize concerts and variousexhibitions.

- An equipped classroom. Here, children are taught necessary subjects, such as: Romanian,

mathematics, history, geography, biology etc.

- A gym and a massage room.


47/53

47

Each year on 1 June, the international childrens day, meetings with patients parents and relatives

are taking place.

According to the director, we found out that shortly an Irish institution will provide financial

support for the construction of a house in Hincesti for 12 girls from the boarding school, who will

live there, cook by themselves, clear up etc. in order to reintegrate in society. Thus, their

competences will be periodically monitored and analyzed to know if they have registered anyprogress to that effect.

CONCLUSION AND RECOMMENDATION

Conclusion and Recommendation regarding the respect of the right to mental health of

persons with mental def iciencies in boarding schools:

1. No standards of professional care, general medical, psychiatric, psychological and socialcare of the patronized in the boarding schools in the Republic of Moldova have been developed and

approved.

2.

State institutions from this field approved, adhered and developed Laws, GovernmentDecisions and Ministerial Orders in compliance with international practices.

3. By default of the standards of work, the medical staff, including the auxiliary one, trained inthe care of the patronized limit their tactics, forms and range of care, taking into account life

experience and advices from other colleagues.

4. The lack of medical and auxiliary professionals with elementary, middle and high educationin the field, the worrying low number of employees, reduce their role only to the following

activities:

for persons with moderate mental deficiencies:- their supervision;- exclusion of the possibility of escape from facility;- prevention, in as far as possible, of aggressive incidents between the patronized;- other occupational activities are casual. for persons with severe mental deficiencies:- their supervision;

- their food and dressing;


48/53

48

- their escorting in and out the facility.

persons with relapsed mental disorders and aggressive behavior: The Hincesti and Orheiboarding schools do not have the possibility to provide psychiatric care to beneficiaries. The

number of employees is worryingly low and inadequately trained in psychiatric and psycho-social

care of persons with mental disorders and aggressive behavior.

5. Also, there are no unique standards for completion of various registers with medical,psycho-social and other interventions used in relation to beneficiaries. Each institution completes

the registries differently. Even the patronized are named differently etc.

6. The psycho-pharmacological treatment is used occasionally. The medical staff, especiallythe low and medium, applies sometimes this treatment voluntarily.

7. There is no independent institution in the Republic of Moldova to monitor the respect ofbeneficiaries right to health, use of medicines and food received from donations and sponsorships.

Thus, the risk of violation of fundamental rights and freedoms of persons under long-term

hospitalization is obvious.

8. Completion of medical and social acts, letter of referral to the boarding house from the placeof residence or from other similar facility, is often superficial and does not contain details regarding

the mental state and range of social skills of the beneficiary.

9. Often the letter of referral to the boarding house of a person is based on the social factorand ignores the mental and social possibilities of the beneficiary to adapt or integrate partially in the

community.

10. There is no effective mechanism of monitoring the respect of patrimonial rights of thepatronized in boarding houses. Thus, the cases of beneficiaries expropriation are not excluded.

Comparative analysis depending on the nosological form of the beneficiari es from boarding

houses:

No Nosological form Boarding house Orhei Boarding house Hincesti

Total Children Adults Total Children Adults

1. Epilepsy 72 20 52 - - -

2. Schizophrenia 5 2 3 - - -

3. Mental retardation 136 43 93 315 141 174

4. Asthma 2 2 - - - -

5. Blindness 14 9 5 - - -

6. Deafness 7 - 7 - - -

TOTAL - 551 236 76 160 315 141 174

Benef iciaries in boarding houses without a Court Decision regarding their capacity of exercise:

The Hincesti Social Assistance and Family Protection Department, as guardianship authority,

confirms that the Director of the Hincesti Boarding House is considered STATE GUARDIAN of


49/53

49

the orphans and children left without parental care in the Hincesti boarding house for children with

intellectual deficiencies.

Bed-r idden persons:

These persons need continuous supervision and personal care, 24 hours a day.

The Hincesti boarding house94 persons; The Orhei boarding house86 persons.Medical acts of persons placed in boarding houses are officially sent to Court by ignoring the

legislation in force regarding the judicial procedure of adopting court decisions on the establishment

of guardianship. The case is not examined before sending to court the medical acts of beneficiaries,

as required by law.

Furthermore, there is no regulation on the establishment of guardianship of the patronized.

The nosological characteristics of the patronized in boarding houses reveals that most of the persons

hosted in facilities have mental disabilities. Thus, according to international practices, the treatment,maintenance and release of persons hosted in the Hincesti and Orhei boarding houses are the same

as those practiced by Psychiatric Hospitals. Thus, the standards of maintenance and of the staff

must comply with these practices.

The medical staf ffrom the boarding schools paid from the State budget cannot practically ensure

the minimal medical assistance.

Of the 12 natural persons, qualified doctors of the Hincesti boarding house, 9 are paid by donors (!)

Furthermore, it is also worrying the situation regarding the low medical staff, which, ultimately,

ensures the personal care of persons with severe mental deficiencies, including of those bed-ridden.

Of the 186 nurses of the Hincesti boarding house, 86 are paid by donors. Thus, the situation can get

out of control and become disastrous if donors will stop paying the medical staff.

Conclusion and Recommendation regarding the respect of the right to mental health of

persons with mental def iciencies in psycho-neurological institu tions:

1. According to the nosological structure of patronized, psycho-neurological institutions in theRepublic of Moldova are psychiatric facilities for patients with chronic mental deficiencies. Thus,

the qualified staff, trained in the attendance of beneficiaries must have knowledge and professionalskills for the residential care of persons with chronic mental deficiencies.

2. Thus, the necessary psychiatric assistance, including psychotropic and the services ofpsychological, psychotherapeutic and psycho-social intervention cannot be ensured by the current

structure and number of qualified staff.

3. No standards of work with persons with mental deficiencies placed in psycho-neurologicalinstitutions have been developed and implemented in the Republic of Moldova.


50/53

50

4. Admission, medical care and release of patients from psycho-neurological institutions mustbe the same as from psychiatric facilities.

5. Mental health reformin the Republic of Moldova must be completed with the role andneeds of the psycho-neurological institutions under the jurisdiction of the Ministry of Labor, Social

Protection and Family of the Republic of Moldova.

6. Cooperation with the Department of psychiatry of the University of Medicine andPedagogical University Ion Creanga would allow the Ministry of Labor, Social Protection andFamily of the Republic of Moldova to develop standards of good practices in its subordinated

facilities.

The patronized in the Brinzeni and Badiceni psycho-neurological boarding houses are not officially

under the guardianship of an authority, or Ministry of Labor, Social Protection and Family of the

Republic of Moldova, or psycho-neurological boarding house.

In the Brinzeni psycho-neurological boarding house there were, on the visit day, according to the

social assistant, 247 (!) patients who did not have a court decision recognizing their incapacity of

exercise.

Conclusion and Recommendation regarding the respect of the r ight to hosting conditi ons

of persons with mental def iciencies in psycho-neurological insti tuti ons.

The Brinzeni psycho-neurological boarding house

1. The maintenance conditions are unstable. The heating system is repaired in the middle ofDecember, considering that the boarding house is in quarantine because of the tuberculosis

outbreak.2. Persons hosted in the boarding house do not benefit of legal support for the protection oftheir rights. We saw persons with visible bodily injuries. To that effect, there are no clear

procedures regarding the recording of these injuries.

3. Bed-ridden beneficiaries are placed at the upper floors of the apartment building.4. There is no independent person to monitor the distribution of goods, food, clothes, donationsetc. to patronized.

5. The status of the staff, especially of the staff involved in education and treatment (doctors) isnot empowered by the competent state institutions.

6. The boarding house keeps a large quantity of medicines, including anticonvulsant andpsychotropic and there is no independent person to monitor their use.

7. The legacy of the therapeutic activity of doctors paid by donors is not clear.8. Referral and detention in the boarding house does not have a LEGAL support.9. Contrary to national and international provisions, the Republic of Moldova ignores thecreation of an independent national institution for the protection and promotion of the rights of


51/53

51

persons with mental disorders and intellectual deficiencies hosted in psycho-neurological

institutions.

10. IDOM is opened to competent national authorities to establish the violations of the rights ofpersons with mental disorders and intellectual deficiencies and to remove them from the existing

normative acts and current practice.

The Badiceni psycho-neurological boarding house

1. During the visit, in the group No 10, a medical container for the storage of pills labeled (tizertsin psychotropic substances) was found in the bedside table of the nurse on

guard. It contained 34 pills of different sizes, which have been taken away and transmitted to police

officers who came on the scene at the request of the director of the boarding house. Furthermore, a

500 ml container which contained a yellow liquid, with alcohol odor, was taken away from the

same bedside table.

2. In three groups there were insufficient beds for beneficiaries and in other groups the numberof tableware (cups and spoons) was insufficient.

3. Beneficiaries in group No 18 had insufficient linen, thus, there were only 12 pairs of sparesocks and 3 pairs of underwear for 21 patients.

4. In certain groups, patients are having meals in their bedrooms. Also, the dishes are washedhere.

5. In certain sanitary units there were uncovered containers with sodium chloride, at thedisposal of patients.

6. There was high humidity (71-77%) in certain wards and sanitary units.7. Beneficiaries do not have spare individual clothes and shoes.8. Nurses take away the pensions of certain beneficiaries.The Cocieri psycho-neurological boarding house

1. During the visit, beneficiaries complained about the use of physical force by the staff of theboarding house who hit with sticks and other tools.

2. During the visit we found out the following:- unsatisfactory conditions in the sanitary units, as well as the lack of hygiene products freelyavailable to beneficiaries (soap, shampoo, toilet paper, tooth paste and toothbrush);

- lack of appropriate accommodation for persons with physical disabilities, in wheelchairs,who do not have the possibility to go for a walk;

-

lack of bulbs, but also the broken source of artificial light;- existence of a detention place. The low qualified staff decides who is detained and for howlong;

- unsatisfactory conditions in the kitchen.The Balti psycho-neurological boarding house

1. During the visit we found out the following:


52/53

52

- certain beneficiaries did not have identity cards;- two persons in one bed, but also female beneficiaries hosted with male beneficiaries in thesame ward;

- beneficiaries were engaged in physical work outside the boarding house;- certain beneficiaries take away the pensions of other beneficiaries;- expired medicines at medical workplaces;- the restroom was not equipped with special furniture and the beneficiaries were staying onthe floor;

- the electrical system was broken;- the floor was full of holes and posed a threat to life;- lack of mattresses and their replacement with pieces of sponge.

REFERENCES

National and international legal regulations regarding mental health:

Helsinki Declaration on Human Rights, 12-15 January 2005. UN Convention on the Rights of Persons with Disabilities (CDPD) adopted in New York bythe UN General Assembly on 13 December 2006 and signed by the Republic of Moldova on 30

March 2007, ratified by the Law No 166/09.07.2010.

The Republic of Moldova adopted the European Declaration on the Health of Children andYoung People with Intellectual Disabilities and their Families: Better health, better lives: children

and young people with intellectual disabilities and their families.

Law on social inclusion of persons with disabilities No 169 of 09.07.2010. Strategy on social inclusion of persons with disabilities (2010-2013). Law No 60 of 30.03.2012 on social inclusion of persons with disabilities. National Program regarding the creation of an integrated system of social services(Government Decision No 1512 of 31.12.2008), by the Order No 353 of 15.12.2011 of the Ministry

of Labor, Social Protection and Family of the Republic of Moldova.

Law No 169 of 09.07.2010 for the approval of the Strategy on social inclusion of personswith disabilities (20102013).

Law on mental health No 1402 din 16.12.1997. Government Decision No 1500 of 31.12.2004 for the approval of the Standard Regulationon functioning of the social residential institutions destined for elderly and persons with disabilities.

Government Decision No 506 of 11.05.2006 for the approval of the natural norms formaintenance of persons hosted in social institutions.


53/53

Government Decision No 520 of 15.05.2006 for the approval of the expenditure norms formaintenance of persons hosted in social institutions.

Government Decision No 1025 of 28.12.2012 for the approval of the National MentalHealth Program for the years 2012-2016.

Framework regulation for the functioning of boarding schools. Instructions on accommodation of the patronized in social institutions under the jurisdictionof the Ministry of Labor, Social Protection and Family No 06-34/188 of 16.03.2000.