Unofficial translation
In accordance with subparagraph 17) of paragraph 2 and subparagraph 1) of paragraph 3 of article 32 of the Code of the Republic of Kazakhstan dated September 18, 2009 "On People's Health and Healthcare System" I hereby ORDER:
1. To approve the attached Regulation on activities of health organization for orphaned children and children left without parental care from birth to three years of age, with defects of mental and physical development from birth to four years of age, providing psycho-pedagogical support of families with a risk of abandoning a child.
2. Medical Aid Organization Department of the Health Ministry of the Republic of Kazakhstan in accordance with the legislation shall:
1) ensure the state registration of this order in the Ministry of justice of the Republic of Kazakhstan;
2) within ten calendar days from the date of the state registration of this order, send its copy in paper and electronic form both in the Kazakh and Russian languages to the Republican State Enterprise on the Basis of the Right of Economic Management "Republican Center of Legal Information" for official publication and inclusion into the Reference Control Bank of Regulatory Legal Acts of the Republic of Kazakhstan;
3) within ten calendar days after the state registration of this order, send its copy to periodic printed publications for official publication;
4) place this order on the Internet resource of the Health Ministry ofthe Republic of Kazakhstan after its official publication;
5) within ten working days after the state registration of this order, submit information to the Department of Legal Service of the Health Ministry of the Republic of Kazakhstan on execution of the measures, provided for by subparagraphs 1), 2), 3) and 4) of this paragraph.
3. Vice-Minister of healthcare of the Republic of Kazakhstan Aktayeva L. M. shall be authorized to oversee the implementation of this order.
4. This order shall be enforced upon expiry of ten calendar days after its first official publication.
| Health Minister of the Republic of Kazakhstan | Y. Birtanov |
"AGREED"
Minister of Education and Science
of the Republic of Kazakhstan
___________________Y. Sagadiyev
January 9, 2018
"AGREED"
Minister of Labor and Social Protection
of the Republic of Kazakhstan
__________________T. Duysenova
December 29, 2017
| Approved by Order of the Health Minister of the Republic of Kazakhstan No. 1008 dated December 27, 2017 |
Regulation on activities of health organization for orphaned children and children left
without parental care from birth to three years of age, with defects of mental and physical
development from birth to four years of age, providing psycho-pedagogical support of
families with a risk of abandoning a child
Chapter 1. General provisions
1. This Regulation on activities of health organization for orphaned children and children left without parental care from birth to three years of age, with defects of mental and physical development from birth to four years of age, providing psycho-pedagogical support of families with a risk of abandoning a child shall regulate the activities of health care organizations for orphaned children and children left without parental care from birth to three years of age, with defects of mental and physical development from birth to four years of age in the Republic of Kazakhstan.
2. Health care organization for orphaned children and children left without parental care from birth to three years of age, children with defects in mental and physical development from birth to four years of age, providing psycho-pedagogical support of families with a risk of abandoning a child shall be an infant orphanage.
The infant orphanage in its activities shall be guided by the Constitution of the Republic of Kazakhstan, the Code of the Republic of Kazakhstan dated September 18, 2009 "On People's Health and Healthcare System", regulatory legal acts in the sphere of protection of the rights of orphaned children, children left without parental care, this Regulation, and shall conduct its work under the license for medical activities.
3. The infant orphanage shall be headed by a chief doctor (director).
4. The source of financing of the infant orphanages shall be the funds of the local budget of the region, city of republican significance and the capital, as well as other sources of financing in accordance with the legislation of the Republic of Kazakhstan.
5. The infant orphanage shall be divided into organizations:
1) of a general type, raising and keeping healthy children from birth to three years of age;
2) of a specialized type, raising and keeping children from birth to four years of age, including with defects in mental and physical development (excluding children with delayed psycho-verbal and physical development due to the conditions of upbringing), somatic pathology at the stage of compensation:
with organic damage of central nervous system with mental disorders;
with organic damage of central nervous system without psychiatric disorder, including infantile cerebral paralysis;
with disorders of the musculoskeletal system and other physical defects of development without mental disorder;
with mental retardation in the degree of imbecility, idiocy;
with dementia after suffering organic brain damage;
with mental retardation of all degrees in the presence of gross motor disabilities;
with hearing and speech impairments (deaf, hearing loss);
with speech disorder (stuttering, alalia and other speech disorders) without mental disorder;
visually impaired (blind, weak-eyed);
with inactive tuberculosis;
children with congenital and acquired sexually transmitted diseases after specific therapy, in the non-contagious period of the disease;
children living with HIV and AIDS.
The separate groups of nursing care shall be organized for visually impaired or hearing-impaired children with mental retardation of all degrees having gross motor disabilitiesthat make their education difficult..
6. In accordance with the legislation of the Republic of Kazakhstan, the administration of the infant orphanage shall take measures to protect the rights and legitimate interests of children, including the rights of children to live and be raised in family, housing, alimony from parents for the child maintenance, payment of social allowances for health reasons and legal status of children, ( survivorbenefits). ).
7. In order to attract public attention to the problems of the infant orphanage, providing organizational, advisory and coordinating activities in the infant orphanages, a Board of Trustees, which is one of the forms of collegial management body, shall be established.
The Board of Trustees shall consist of representatives of territorial bodies of executive authorities, health and education departments of regions, cities of Astana and Almaty, and non-governmental organizations (children's funds, public organizations, non-profit organizations that protect the rights of children).
8. The Board of Trustees shall:
1) exercise public control over observance of the rights of children, and expenditure of charitable aid, received to the account of the infant orphanage;
2) develop proposals on amendments and/or additions to the Charter of the infant orphanage;
3) develop recommendations on priority directions of development of the infant orphanage;
4) make proposals to the authorized body or the local executive body in health care area, about elimination of the deficiencies in the infant orphanage, revealed by the Board of Trustees;
5) hear the reports of the chief doctor (director) about the activities of the infant orphanage, including quality of the rendered health services, the use of charitable assistance and the measures taken to place children-orphans and children left without parental care in Kazakhstani families.
Employees of the infant orphanage shall assist in providing information on the issues related to the competence of the Board of Trustees.
9. In order to ensure the realization of the right of a child to live and grow up in a family, a Council (an advisory body), approved by the internal Regulation, shall be established, consisting of the chief doctor (director) of the infant orphanage, heads of departments, a social worker, a psychologist, a tutor, a lawyer, an authority, carrying out guardianship and trusteeship functions, as well as representatives of non-governmental organizations in the sphere of protection of children's rights.
The Council shall:
1) make decisions about the success of the development of the child, identify the child's problems and offer ways of their solution;
2) analyze families that have temporarily placed the children in the infant orphanage, families in difficult life situation and those who have the potential risk of abandoning a child (their living conditions, place of work, place of study, social status);
3) provide moral and psychological support to parents or legal representatives whose children are brought up in the infant orphanage, to solve their problems, including assistance in employment, study, while paying special attention to primipara mothers for the early return of the child to the biological family;
4) discuss proposals on the need to change a plan for organization of everyday life of a child, develop necessary correction and rehabilitation activities;
5) consider issues relating to decision-making about further work with the child;
6) consider issues to conduct rehabilitation activities, medical interventions.
A meeting of the Council shall be held at least 2 times a month.
Chapter 2. Structure and objectives of the infant orphanage
10. The structure of the infant orphanage shall have the following branches (groups):
1) a branch (group) for healthy children by the number of children: from birth to 1.5 years of age – 10 children, from 1.5 to 2 years of age – 13 children, from 2 to 3 years of age – 15 children;
2) a branch (group) for sick children with diseases amenable to treatment or correction, with the number of children not more than 10;
3) a branch (group) for children in difficult life situation, with the number of children: from birth to 1.5 years of age – 10 children, from one to two years of age - not more than 10, from two to three years of age - not more than 15;
4) a branch (group) for children with gross congenital malformations, not amenable to correction, with the number of children not more than 8;
5) a branch (group) for rehabilitation of children – a branch (group) for a day care for children with disabilities with lesions of the central nervous system, musculoskeletal system without paroxysmal disorders, Down syndrome or disease, with the number of children not more than 14. The branch (group) conducts a medical rehabilitation of children that need additional measures for restoration of physical, emotional, verbal, tactile functions.
Branches (groups) for children in difficult life situations shall be established to support families in difficult life situations, with the risk of abandoning a child.
These shall include:
a branch of temporary stay (a crisis center) for children with mothers from families in difficult life situations with the risk of abandoning a child;
a branch for a day stay of children from families in difficult life situations with the risk of abandoning a child;
a branch to support families in difficult life situations with the risk of abandoning a child;
a branch for adoptive parents and parents from families in difficult life situations with the risk of abandoning a child to teach the skills of child care/ a branch for social workers and psychologists of the medical organizations of primary health care and maternity hospitals to teach the methods of prevention of social orphanhood;
The purpose of establishment of the branches (groups) for children in difficult life situations shall be the provision of psychological assistance to families in difficult life situations with the risk of abandoning a child, preservation of the contacts of the child with the family and support in social adaptation.
The main objectives of the branches (groups) for children in difficult circumstances shall be:
the dedicated work of medical, pedagogical workers and psychologists with parents and their close environment with a potential risk of abandoning a child;
moral and practical support for primipara mothers in a difficult social situation (condemnation of relatives and friends the upcoming role of a single mother);
creation of conditions, contributing to the preservation of family ties between the mother and the child;
the mother's involvement in educational process of the child;
to provide favorable conditions for raising and harmonious development of the child;
to ensure and protect the rights of the child, freedom of individual development, and inadmissibility of any forms of discrimination; to provide children with quality medical care, timely correction of the defects in psychophysical development;
preparation for discharge of a child to the biological family;
involvement of parents in child maintenance on the basis of agreements.
Activities to support families in difficult life situations with the risk of abandoning a child shall include:
assessment of the needs of families and children in difficult life situations;
preparation, discussion with parents and revision of the individual plan of family support for not less than once in 3 months;
implementation of measures to improve the motivation of families who are in a difficult life situation;
legal advising on restoration of the lost ties of the family and the child;
referral for professional support or social assistance to other government organizations (mental health services, education and social protection organization) to provide other social guarantees in accordance with the target groups;
preparation of the child to join an adoptive family or return to a biological family;
preparation and socio-psychological support to biological, adoptive families that need additional consultations on child care in a home environment;
work with the tutorship and guardianship authorities to place the child in an adoptive family and adoption;
assessment and monitoring of the development and raising of children in adoptive families.
As and when necessary, a number of similar branches (groups) shall be established. The branches (groups) shall be established for children of different ages or in the branches the children shall be distributed by age on the basis of the commonality of the daily routine and diet. In the latter case, the children and staff, engaged in their upbringing, shall be transferred from one branch (one group) to another (the other) together, except for the transfer of children for medical reasons.
11. The primary responsibility of the infant orphanage shall be the upbringing, housing and medical assistance to orphaned children, children left without parental care from birth to three years of age, children with defects in mental and physical development from birth to four years of age, providing psycho-pedagogical support to families with the risk of abandoning a child, escort of children to a family.
Chapter 3. Functions of infant orphanage
12. Functions of the infant orphanage shall be:
1) raising of a child on the principles of ensuring and protecting the rights of the child's personality, freedom of his individual development, comfortable contact with the ethnic culture and traditions, unacceptability of any forms of discrimination;
2) provision of a medical care to children in the framework of guaranteed free medical assistance with the introduction of the method of integrated management of childhood diseases: ongoing health monitoring of the condition of children in accordance with Annex 1 to this Regulation, the organization of preventive medical examinations of children;
3) rendering of special social services to families in difficult situations, with the risk of abandoning a child, to train them to care for children. To teach the methods for prevention of social orphanhood to the social workers and psychologists of the medical organizations of primary health care and maternity hospitals.
The children that are in the infant orphanages shall undergo routine medical check-ups twice a year.
Routine medical check-ups (examination by specialists, laboratory and instrumental testing) shall be carried out in accordance with the Rules of routine medical check-ups of target groups of the population, approved by the order of the acting Minister of Health of the Republic of Kazakhstan dated November 10, 2009 № 685 (registered in the Register of the State Registration of Regulatory Legal Acts under No. 5918).
Routine medical check-ups shall be conducted by experts of health care organizations, providing primary health care, on a call-out basis in the infant orphanage.
After the routine medical check-up of children by a pediatrician with regard to the opinion of specialists and laboratory and diagnostic studies, a comprehensive assessment of the health status of children with the definition of health group, assessment of physical and neuro-psychical development shall be made.
Subsequent monitoring and improvement shall be carried out together with specialists of health care organizations, providing primary health care.
Additional diagnostic tests and check-ups by the relevant specialists shall be made if medically required.
13. Acceptance of children to the infant orphanage and discharge from it shall be made in the following way:
1) the infant orphanage accepts children from families, maternity hospitals and clinics, minors adaptation center (hereinafter – MAC) based on the referral of the local executive bodies.
2) children from maternity hospitals are accepted directly in the group, and from families, MACs and clinics - to the quarantine group, or a sick-room, with the subsequent transfer to the group.
Children with acute infectious diseases, active tuberculosis, contagious skin diseases, acute viral diseases, acute diseases of the central nervous system, severe trophic disorders and diseases requiring hospital treatment shall not be accepted to the infant orphanage.Their treatment shall be carried out in hospitals of children healthcare organizations and the acceptance to the specialized groups of the infant Orphanage shall be carried out after the recovering.
14. Acceptance of children to the infant orphanage shall be carried out upon the availability of the following documents:
1) a referral of the local executive body about the placement of a child in the infant orphanage;
2) a certificate of birth or a medical birth certificate (if available) of a child;
3) an extract from the records of development of the child (medical records of the inpatient) or the records of the newborn, with the obligatory detailed anamnesis data, including information on inheritance, conclusions of specialists and laboratory tests, including screening for HIV/AIDS, tuberculosis, syphilis and HBs - antigen (if any );
4) a certificate on absence of infectious diseases in the family or organization where the child comes from, issued by a medical specialist;
5) a certificate from the place of study, place of work of parents or legal representatives (if any);
6) an inspection certificate of the guardianship and trusteeship bodies on the living conditions of the family in case of a return of the child to the family, a certificate of availability or absence of housing, in the case of temporary placement of the child in the infant Orphanage (if any);
7) documents, confirming the lack of parents or their inability to up-bring their children: a death certificate, a certificate of birth of the form No. 4 (information about a father written on the basis of a statement by the mother), the court decision on deprivation of parental rights, on recognizing them as legally incapable, deeming to be missing, the court decision on imprisonment, an act on delivery of a lost (left) child, a statement of one or two parents or guardians replacing them, on a temporary placement of a child in the infant orphanage in accordance with Annex 2 to this Regulation, a statement on relinquishment of parental rights and a consent to adoption, notarized or certified by the head of the organization in which the child left without parental care is placed or the body, carrying out the functions of trusteeship or guardianship, at the place of adoption of the child or at the place of residence of the parents, in the form, approved by Order of the Minister of Education and Science of the Republic of Kazakhstan No. 16 dated January 16, 2015 (registered in the Register of the State Registration of Regulatory Legal Acts under No. 10280);
8) documentation to receive allowance for a child disabled from childhood. Thus, within three days, the territorial department of social protection at the place of residence of the parent or parents shall receive information about the placement of a child in the infant orphanage (if available).
15. When accepting children abandoned or left in medical organizations to the infant orphanage, , the following documents shall be issued:
1) an act of delivery of the lost (left) child in the form approved by Order of the Minister of internal affairs No. 1098 dated December 29, 2015 (registered in the Register of the State Registration of Regulatory Legal Actsunder No. 12953), compiled in the presence of the local police. A copy of the act on leaving a child shall be sent to the territorial bodies of the Ministry of internal affairs of the Republic of Kazakhstan;
2) an act of leaving a child, drawn up by the administration of healthcare organizations and certified by the seal;
3) the request of the health care organization to the guardianship and trusteeship about the transfer of the child to the infant orphanage;
4) documentation, confirming the registration of birth in the bodies of registration of instruments of civil status (if available).
16. In case of temporary placement of children to the infant orphanage, who have parents or legal representatives, the Healthcare Department or at its instruction, the administration of the infant orphanage shall make an agreement about the period of stay of the child, the responsibilities of parents, conditions of participation in their maintenance and upbringing.
17. The infant orphanage shall keep the medical records in accordance with the regulations of the Republic of Kazakhstan in effect.
18. Information about the accepted children shall be recorded in the register Log of acceptance of children to the infant orphanage in the form No. 121, approved by the order of the Acting Health Minister of the Republic of Kazakhstan dated November 23, 2010 № 907 (registered in the Register of the State Registration of Regulatory Legal Acts under No. 6697), (hereinafter – the register log of acceptance of children to the infant orphanage).
19. For each child, accepted to the infant orphanage, a personal data file of a child, which is kept by the chief doctor (director) of the infant orphanage shall be made and shall include the following documentation:
supporting medical documentation of a child;
application form for the incoming child;
an order for acceptance of a child in the infant orphanage;
submission of the petition to the local executive body (guardianship and trusteeship) to place children in the infant orphanage;
documentation on placement of a child on the waiting list for housing, preservation of the existing housing of the child;
documentation about the accounts opened in second tier banks for crediting the alimony, collected from parents for the child support and other social payments for orphans, children with disabilities;
correspondence with state and law enforcement bodies to clarify the legal and social status of the child, search for birth parents and relatives;
the order of discharge of the child from the infant orphanage.
20., Children shall be discharged from the infant orphanage in the following cases:
1) when returning to their biological family;
2) when transferring to the organizations of education system or social protection;
3) in case of adoption;
4) when making a custody, transferring the child to foster care and other forms of placement in a family.
21. The return of the children, temporarily placed in the infant orphanage, to the parents or legal representatives, shall be made based on their application. Extension of stay in the infant orphanage by the decision of the local executive body and territorial health authorities shall be made on the basis of the new agreement.
In order to protect the rights and interests of children, in case of unjustified refusal of the parents or persons, replacing them, to take the child upon the expiry of the period, specified in the agreement, the administration of the infant orphanage, within three working days, shall send a letter to the authority, carrying out functions on trusteeship and guardianship of the respective administrative-territorial unit to take measures to realize the child’s right to live and be raised in the family, including file a lawsuit for deprivation of parental rights in accordance with subparagraph 2 of paragraph 1 of article 75 of the Code of the Republic of Kazakhstan "On Marriage (Matrimony) and Family".
22. Transfer of children from the infant orphanage to the medical and social institutions, education organizations for orphaned children left without parental care, , shall be carried out in accordance with the conclusion of the psychological-medical-pedagogical consultation .
23. Information on children subject to transfer shall be reported to the territorial bodies of education and social protection of the population 6 months before the date of transfer.
24. At the time of transfer, the infant orphanage shall provide the children, transferred to residential organization, with clothing and shoes according to season.
25. Transfer of children for adoption shall be made in the manner prescribed by Resolution of the Government of the Republic of Kazakhstan № 380 dated March 30, 2012 "On Approval of the Rules of Transfer of Children, Being the Citizens of the Republic of Kazakhstan, For Adoption". When transferring the children for adoption, an entry on the transfer of children for adoption shall be made in the Register Log of Acceptance of Children to the Infant Orphanage, without specifying the names and addresses of the adoptive parents. Information about adoption shall be kept by the chief doctor (director) of the infant orphanage and submitted to the investigative and judicial authorities upon their official request in accordance with the legislation of the Republic of Kazakhstan.
26. When placing to the hospital, health camp, the children shall not be considered as discharged and shall not be registered as newcomers in the Register Log of Acceptance of the Children in the Infant Orphanage.
27. When sending a child for treatment to the hospital, health camp or rehabilitation center, the administration of the infant orphanage shall record the information about hospitalization in the records of the child’s development.
Organization of current medical supervision for children in the infant orphanage
The purpose of current medical supervision in the infant orphanage shall be the early disease prevention in the group, overwork of children in a team, as well as identification of individual peculiarities and deviations in children behavior.
Current medical supervision shall be carried out by the tutor and the doctor:
1) by the tutor - daily and many times during the day based on the reasons, describing the behavior and health of children.
Health indicators: body temperature, form of stool, condition of pharynx, skin (for children of the first year of life also the increase of the body weight).
Behavior indicators - the prevailing emotional state and mood, the nature of wakefulness, relationships with adults and children, the presence or absence of negative habits, the manifestation of individual characteristics, such as irritability, fatigue, lethargy.
The tutor of the group shall make a morning examination of children after their awakening. The results of supervision of children shall be submitted to the doctor on duty and the next shift of the personnel of the group.
The tutor of the group shall measure the body temperatures of children. At the 1st year of life the temperature shall be measured twice a day, in the morning and in the evening, for 2 and 3 years of age – once in the evening. The measurement data shall be recorded in the temperature sheet of the medical records of the child (for the infant orphanage): the 026-1/y form for girls and the 026-2/y form for boys, according to Order of the Acting Health Minister of the Republic of Kazakhstan № 907 dated November 23, 2010 (registered in the Register of the State Registration of Regulatory Legal Acts under No. 6697);
2) by the doctor – the current supervision of children shall be carried out in the following periods:
children in the first month of life - every day;
from 1 month to 3 months – once every 3 days;
from 3 months to 6 months – once every 5 days;
from 6 months to 9 months –once every 7 days;
from 9 months to 1 year –once every 10 days;
from 1 year to 4 years – once per month.
The weighing of children shall be carried out within a specified period of examination.
In case of illness, a pediatrician shall carry out daily monitoring of the condition of the child and make notes in the individual development records and a dynamic supervision by the medical staff shall be provided until the child’s recovery.
The following information shall be reflected in the child’s records: time of examination (date and time), body weight, number of teeth, size of bregmatic fontanel, temperature, process of adaptation of the children, newly accepted, returned to the group, transferred to the group - until the end of adaptation, assessment of general status, a description of the objective status, the nature of wakefulness and sleep, feeding nature (changes), the dynamics of body weight in the past period, the suffered diseases, change in somatic status, psychological development, behavior and conclusion, if necessary, change of prescriptions.
If a child is ill, a doctor shall indicate the following information in the child’s records: time of examination (date and time), time (date and time) of transfer to the sick-room, diagnosis, prescriptions according to the current diagnostic and treatment protocols (regimen, diet, laboratory tests, drug therapy, exercise therapy, physiotherapy). At the same time an entry shall be made in the Registration Log of Outpatients in the form 278/y, approved by Order of the Acting Health Minister of the Republic of Kazakhstan № 907 dated November 23, 2010 (registered in the Register of the State Registration of Regulatory Legal Acts under No. 6697).
When taking a child for a regular medical check-up, the control records of the dispensary supervision shall be compiled according to the form 030/y, approved by Order of the Acting Health Minister of the Republic of Kazakhstan № 907 dated November 23, 2010 (registered in the Register of the State Registration of Regulatory Legal Acts under No. 6697).
On the day of the planned vaccination, the examination of the child shall be conducted and an entry about the possibility of vaccination shall be made with the indication of the body temperature, description of the objective status, diagnosis, type of vaccination, or a medical counter-indication (the reason, period for which the vaccination is postponed) shall be specified as well.
After the vaccination, the medical supervision shall be provided in the post-vaccinal period, according to the periods, established by Order of the Minister of National Economy of the Republic of Kazakhstan № 190 dated March 6, 2015 "On Approval of Sanitary Rules "Sanitary-Epidemiological Requirements for Preventive Vaccination of Population" (registered in the Register of the State Registration of Regulatory Legal Acts under No. 10740).
To the Chief Physician of the infant orphanage __________________________________
an Application on temporary placement of a child in the infant orphanage
I inform the following about myself: full name
__________________________________________________________________________
Date and place of birth:_______________________________________________________
__________________________________________________________________________
Registered (a) (registration date and address):______________________________________
__________________________________________________________________________
Passport or identity card (number, date of issue and issuing authority): _________
__________________________________________________________________________
Marital status: ______________________________________________________________
Education:_________________________________________________________________
Kinship (mother, father, grandmother, grandfather, guardian, etc.):_____________________
__________________________________________________________________________
Please accept (and transfer) my child ____________________________________________
___________________________________________________year of birth, born in the
maternity house №_____ city ____ to the infant orphanage for a period of __________ year.
The reason for the temporary placement of the child in the infant orphanage is _____________
I am warned that in the case of unjustified refusal to take the child in the period specified in
the application, as well as refusal to participate in the child’s upbringing, the administration
of the infant orphanage has the right to file a lawsuit for deprivation of parental rights in
accordance with subparagraph 2, paragraph 1 of article 75 of the Code of the Republic of Kazakhstan
"On Marriage (Matrimony) and Family";
Signature of mother or legal representative:______________________
Signature of the head of the infant orphanage:_____________________
Date (day, month, year) ______________________________________
The seal of the organization:
