Paul (2) from nursery due to Diabetes is out – now insurance wants to help

The small Paul (2) has been excluded because of his Diabetes from the day-care centre. While the city of Oberhausen switches in terms of financing of a supervisor more on stubborn, now announces the health insurance assistance for the Hecht family.

A year ago, it was found in the small Paul from Oberhausen in the Ruhr area of type 1 Diabetes. Behind it is a auto immune disease where the Beta cells are destroyed in the pancreas and no endogenous Insulin is produced.

The Affected need to pay attention to the diet, the blood sugar measurement and Insulin injections. A Management that can’t do the two year old alone. Therefore, his mother Nina pike (35) sits in the morning in a side room of the nursery "Schatzkiste", to be able to intervene if Paul needs help. A Situation that is to be done for the family. Because to work is normal for the mother is not possible.

Children with type 1 Diabetes need special support – not only private, but also in the day-care centre. And denied Paul and his family at the end of 2018, the social welfare office Oberhausen with the justification "in the disease Diabetes is a medical Problem that can only be over the area of treatment care covered. Consequently, the application was abzulehnen". (FOCUS Online reported)

Barmer: "We want to help Paul, and him and his family unterstützen"

But now a twist in the case. In the case of the Barmer health insurance it showed up on demand from FOCUS Online "erschrocken" the fact that the Department of social services has almost refuse left four months time, the request of the pike. You will look again in depth with Paul’s Situation.

"For us, it is clear that Paul takes in the day-care centre in addition, help – unfortunately, there is disagreement on, however, how this support is provided and therefore funded soll&quot be;, so Sara Rebein of the barmen, North Rhine-Westphalia. "We want to help Paul, and are still willing to support him and his family with all possible means."

Paul has coupled to an insulin pump, the device is a glucose measurement under his skin. In certain intervals, the Sensor Pauls blood sugar measures to continuously and closely in the tissue. In the case of an impending Hypo, the meter fails the device according to the Alarm. In addition, it transmits the values to the insulin pump.

There is hope for the Hecht family: Paul has to get a new opinion

On FOCUS-Online demand is the cashier, is now with the Hecht family contact to discuss the Situation. "In light of the recent Entwicklung" could it be a new opinion to "to evaluate again, whether with Paul in the meantime, the requirements for a special hospital observation vorliegen". In addition, you will want to speak with children doctor about the frequency for the treatment, care, and the care service to discuss. "The Barmer everything you Possible to find for Paul a fast and unbureaucratic solution."

Nina pike seemed relieved: "I hope that all can agree on, that Paul soon without my accompaniment in the 'Schatzkiste' can. My biggest wish would be if we didn’t have to go to parent us in this jungle of application, if there was a place where everything runs together, and in the case of the Fund, the social welfare and care service."

Social welfare office return the Ball to the cashier and daycare

Compared to FOCUS Online the city of Oberhausen, Germany remains opposed. "According to the legal opinion of the social assistance carrier, no claim to the provision of an additional accompanying person for the child in this case. The specific needs will be covered by the treatment afforded to care for the health insurance, which can be extended in case of need. The supervision of the child is the responsibility of the staff in the children’s Nursery."

Because type 1 Diabetes is a disease, from the point of view of the authority of only the funds and not the city. And because the child is in the nursery, you must decide the educator, whether of the trust.

"The 'Schatzkiste' is a wonderful nursery with great staff. They are really open-minded, but you don’t want to answer. I can understand that. If it has to do with Diabetes and nothing else, you make the fear of doing something wrong and gefährden&quot to the health of the child;, so Nina pike.

Competent service providers do not agree, parents are to supplicant

If the staff at nursery or school the diabetes care takes over, this happens on a voluntary basis. The working group for pediatric diabetology (AGPD) advises that the daycare staff through a Diabetes Team and schools, to convey information on the disease and emergency situations. In addition, concrete agreements between parents and caregivers, it is recommended to fixed the blood sugar checks, medication administration, dosages, and emergency measures, if possible in writing.

A liability risk, was insured Jutta castle of the AGPD Contact to the "Medical Tribune". Children and caregivers are protected by the German Statutory accident insurance. Nevertheless, the children of a kindergarten to be rejected, has also been noted that the AGPD.

The children’s doctors but still see another Problem: "In everyday life, not often shows that a competent service provider in the internal relationship, but the parents have to appear as a supplicant at each of the individual service providers with the granted (but not sufficient) costs of undertaking or the cancellation of another service provider."

Children’s diabetologist will work, that there is a future coordinating body, which shall examine the request of the parents and the appropriate assistance in a coordinated manner. "It is also necessary for the mandatory training of the respective device by the diabetes team and the financing thereof."

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The health insurance is "erschrocken" the social assistance carrier

All the future is still music. Hecht family, it has to do with the conventional application. Of your health insurance, she was first in the summer of 2018, a "selective Betreuung" approved, a maintenance service, three times a day to the upper Hauser Kita "Schatzkiste" to measure the blood sugar level and to inject. For the rest of the costs the city is responsible, which has been appropriately informed of the health insurance Fund.

The merciful man is irritated about the actions of the social carrier, therefore, is active. "We understand the Concerns of Paul’s parents. In addition, we are afraid that the social assistance carrier the responsibility for a part of Paul’s support has been four months after we got him on period, in accordance with (in accordance with § 15 SGB IX). To date, we have from the carrier no response to our Letter of 27. August 2018."

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