Integrated Center for Inclusion and Rehabilitation (CIIR), in Belém. Agência Pará The Federal Public Defender's Office (DPU) recommended to the Pará State Department of Public Health (Sespa) the adoption of measures to reduce the queue of genetic tests used in the diagnosis of Autism Spectrum Disorder (ASD). According to the agency, around 1,300 people are awaiting care in the state. The wait can be up to 6 years, according to mothers. g1 requested Sespa's position, but had not yet received a response until the last update of the report. ? Follow the g1 Pará channel on WhatsApp The DPU recommendation also calls for an end to the scheduled discharge call with a fixed deadline for patients undergoing treatment at the Integrated Center for Inclusion and Rehabilitation (CIIR) and in the state network. According to the proposal, discharge could only occur with a well-founded technical opinion from the responsible team, taking into account each case. Queue and capacity According to the DPU, the contracted capacity for medical genetics services at the CIIR is "insufficient given the demand". Currently, according to the DPU, there are 200 consultations, 70% of which are destined for the State Regulation System (SER) and 30% for returns and internal consultations. For the regional human rights defender in Pará, Marcos Wagner Alves Teixeira, “such volume is clearly incompatible with the waiting list”. The Public Defender's Office states that delaying the examination compromises access to early diagnosis and adequate treatment. Brazil has more than 2.4 million people with autism Scheduled discharge Sespa informed the DPU that it adopts a “programmed discharge” model in the Intellectual Rehabilitation Program, with a fixed period of six months of intensive care. After this period, the patient is disconnected from the therapeutic cycle, even without an individual assessment of the clinical condition, according to the DPU. The secretariat itself informs that the return queue is "formed precisely by patients who have already gone through a cycle and need a new reevaluation, which consumes 30% of the CIIR's monthly vacancies". In the DPU's assessment, this model "feeds back the queue" and causes "those who have already been served to compete for a place with those still waiting for the first service". Technical assessment The recommendation was also based on consultations carried out by the DPU with professional councils in the area. The Regional Psychology Council assessed that "six months are insufficient even to consolidate the patient's first skills". The Regional Speech Therapy Council highlighted that "the sum of late interventions, delayed exams and interrupted therapies tends to worsen clinical conditions and overload mental health and education services". For the council, "the cost to the State is greater in the long term". The Regional Council of Medicine of Pará (CRM-PA) stated that "the diagnosis of ASD follows criteria from the American Psychiatric Association and that, in cases of intellectual deficit, the Fragile X examination is essential." The agency also highlighted that "SUS faces organizational and family logistics difficulties in guaranteeing this service." What the Ombudsman's Office asks for In the recommendation, the DPU asks for urgent administrative and budgetary measures to reduce the medical genetics queue in Pará. Among the suggestions are the accreditation of new laboratories, the decentralization of the service and the improvement of the flow for collection and processing of the X-Fragile exam. The body also wants the immediate suspension of the scheduled discharge based only on the fixed period of six months. If Sespa accepts the recommendation, the DPU informed that "discharge would depend on a well-founded technical opinion, with individual assessment by the multidisciplinary team, certifying that the measure is clinically beneficial and safe for the patient". VIDEOS: see all the news from Pará Read the latest news from the state on g1 Pará