1. Presentation in the Working group What facilitates decisions on institutional placements as a "last resort" Vesna Bošnjak

2. Mandates and accountabilities • Standardization and reordering of services and financial flows • Continuum of services

3. 1. Mandates and accountabilities • Introduction of case management in government organs in charge of decisions and case monitoring • Decision making either placed in one statutory organ or all decision makers applying the same methodology • Potentials for improving or supporting parental (or wider family) capacity - key criteriafor decision-making on type of service and it's length • Case manager is accountable for examination of all possible alternatives before taking a decision on institutional placement

4. 1. Mandates and accountabilities - continued • Case manager accountability enforced regarding efforts undertaken with family of origin to shorten child separation from family environment • (Admission criteria for residential institutions can not replace the decision on placement by a competent state organ • Exceptions from above rule should be clearly stated in law and secondary legislation (i.e. sheltering homeless, legal aid and independent representation and services entirely paid by service users) • Accountability of service providers should be established in case of irregular admission to services

5. 2. Standardization and reordering of services and financial flows • Standardization and development of services for prevention of institutionalization • Planning as a means for achieving right balance among different types of services and service providers • Eliminating the budget priorities given to institutional care versus community and family-based care

6. 3. Continuum of services • Prevention of abandonment, abuse, diminish the necessity for coercive and/or rehabilitation interventions towards parents • Family support services contribute to reducing the need for substitute family care • Family reintegration and stopping entries in residential care become feasible once services (and/or other interventions restoring parental capacities or providing community level interventions for children with disabilities, behavior problems etc.) become available • Substitute family arrangements reduce excessive reliance on institutional care