Question 19230 — people with disabilities

Summary

Ms. Danièle Obono questions the Minister of Solidarity and Health about the lack of places for children with disabilities in medical-educational institutes (IME). The mission of medical-educational institutes is to welcome children with psychological disabilities, whatever the degree, and to support them in their learning thanks to a multidisciplinary team offering adapted methods. They As such, they fulfill a fundamental mission for the socialization of these children. Unfortunately, there is a severe shortage of places in this type of establishment. This has unfortunate consequences in several ways. Many children are forced to wait in queues, a wait which can be extremely long, often several years. Meanwhile, the solutions found can only be DIY: a few hours of care in a day hospital, obligation to stay at home. They are not adapted to the needs of the child and cause difficulties for families. There were 13,000 children without an educational solution in 2015 according to the Unapei association. The consequences also affect other establishments, which are saturated. Due to a lack of suitable places in IME for children requiring it, the latter continue to be followed in the child psychiatry sector which then no longer has the space to treat new children. All this leads many families to place their children in Belgium. In addition to the heartbreak of leaving your child miles away because you are unable to do otherwise, several scandals have erupted in recent years regarding care in these establishments. In fact, there is developed a lucrative sector of caring for French disabled children. A Libération investigation in 2014 demonstrated how the reduction of charges sometimes took precedence over the quality of reception, leading to situations of mistreatment. This operation is done with the dubbing of financial supervision, including social security, which finances places in Belgium, to the detriment of local reception in the territories. French. In 2017, the National Solidarity Fund for Autonomy financed the care of 1,444 children in approved establishments in Belgium to the tune of 78.2 million euros. As part of the various national plans undertaken, 8,464 places have been programmed between 2017 and 2021, for a total amount of 352.8 million euros. Of these places, 3,259 are specifically intended to support children, including 1,374 places in establishments - particularly in IME. This proves insufficient given the number of children requiring support in EMI and who cannot be accommodated in an “ordinary environment”. In a letter dated July 18, 2018, the commission for the rights and autonomy of disabled people (Cdaph) of Seine-Saint-Denis, which identified 3,400 children receiving care in an IME type establishment in this only department, already questioned the Secretary of State in charge of people with disabilities on the “general shortage of places” in structures for children. UnapeiI estimates that there is a shortage of between 45,000 and 50,000 medico-social places, all combined, to accommodate people with disabilities. The guidelines are well recommended by professionals who master their work and by parents concerned about the well-being of their child. Unfortunately, they cannot succeed due to the numerical insufficiency of current systems and the absence of sufficient alternatives. An effort is also necessary to support these establishments in training staff and supporting caregivers, as recommended by the Handicap France group in an open letter to the UN rapporteur dated 20 October 2017. She therefore wants to know what she intends to put in place to meet this very specific need for EMI places so that each child, whatever their particularities, has access to specific care adapted to their needs throughout France.

Machine translation from French. The official text remains authoritative.

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