Report meeting 26/9 (GLN – Taking charge….)

The Group reaffirms the objectives of work:

– delve into issues related to the guidelines

– acquire data/knowledge to better understand the issues related to taking charge and integration socio sanitaria and deepen/reflect on possible solutions and/or stresses on the theme.

In this way even the Poms can begin to be concrete tools

During the second meeting of the Group took place in Milan on 25 settembre2017, all participants were given and shared that the ownership of the public should be taken into care and should not take parallel streets based on solidarity, Since s. d. are having rights as all citizens.

The Group has been compared on the following aspects:

What is meant by integration socio sanitaria and what to do to promote it?

– focusing on the person with an individualized and comprehensive care project;

– offer flexible services that go to the question (rather than wait for the request d & #8217; help);

– accompany the taking charge by public services and respond to multiproblematicità needs through specific interventions;

– overcome the delegation to the third sector to enable the processes of transformation of an integrated system;

– refuse emergency that logic plays emergence;

– overcome the separations in the reading needs and in response to the needs;

– integrate culture of professions;

– develop training that capitalize existing human resources towards l & #8217; integrating socio sanitaria

– social culture to communicate with health, implement integrated interventions; public/private health and social program and make agreements for access to care between public and third sector entities;

– make individualized projects in network and establish interdisciplinary personal project management tables;

– stabilize experimental projects today;

– do the protocols between the public and private sectors regarding the treatment of clinical emergencies;

– integrate and invest financial resources currently separated (social/health);

From daily practices of entities/subjects of the Group showed that the RESIDENCE and access to care and treatment are interdependent elements and Center for health protection and support to people experiencing poverty both Italian and foreign, and then the Group considers important to deepen some aspects:

1 – The operation of social policies and laws at the national level, regional and municipal that are currently in patchy ... There are different laws that should know better and compare them (at least with regard to access to health care in large cities, Turin, Milan, Bologna, Rome ...). Also have emerged some es. and specific issues:

– residence permit;

– address and registration for the national health system;

– the S.D.. without residence does not have a primary care physician;

– the problem of residence outside the province people s. d

– regional disparities regarding use of all #8217; P & S.T. for non-EU citizens

– essential care, are often guaranteed only by the continuity of intervention of doctors


– S.T. P. does not apply to EU citizens (Opens the code ENI)

– the major problem represented by diniegati asylum requests

– If you don't have the residence you are not logged on Psycho Social Centre etc.

2 – Medication management

Need to raise awareness among s. d. and then all & #8217; use of drugs and educate people to the overall well being (especially for sd with psychiatric disorders or double, Triple diagnosis).

ES.: Home Ian has an infirmary that supports guests in dispensing medication #8217 &;.

Many of the Fiopsd that deal with health have difficulty receiving the Red Cookbook, only a few are authorized (Opera San Francesco).

3 – Delegates to the private social services and hospitals

For hospitals the S.D.. users are difficult to maintain and there is often a proxy for social private ...

And’ need to build synergistic relationships between social and health in order to facilitate the treatment of s. d. appropriate structures

Milan – post acute care for 30 GG i s d. and has an agreement with the region; This reliable service reduces costs for the national health system, but these show that this structure does not respond, quantity and length of stay, real needs .

Continuing care services are needed that can provide time-limited and not able to respond and take charge of persons on the basis of gravity (e.g. cancer and end-of-life);

Turin – the municipality developed virtuous processes in order all & #8217; integration of Sert, Psychiatry etc.

4) S. D. and immigration

Many diniegati from asylum seekers end up on the street.

More than 50% of the homeless on the street is alien and even health these people pose important needs and specificity ... the Group believes it is essential to collect, investigate and learn more about these issues. It is therefore significant to get a picture on the specificity of access to care and health problems related to these people to enable concrete answers and at the same time mitigate, where is expressed, a culture of exclusion that focuses on fear of citizens (of contracting illnesses etc.) or as opposed to minimize any health problems .

Such recurrent diseases? What the path to prevention and/or management of these issues? In this respect, it is considered appropriate to confront GRIS (both local and national).

5) S. D. and mental health

Complex issue, some knots surfaced regarding s. d. highlight the lack programming and integration socio sanitaria and therefore access to care, almost always, only happens on the emergency and the only accessible place remains first aid.. Those who do not have residency (or the residence permit) cannot access mental health Centers ( or Psychosocial Centers)…

For s. d. who do not want or are not able to apply for a cure, If the clinical conditions worsen, Mandatory Medical treatment remains the only tool to take charge.

Important the interaction between physical and mental health through general practice surgeries catalyse the demand

6) S. D. elderly or disabled persons

Strenuous situation and multiproblematica: hard l & #8217; access to relevant departments for the homeless that are handled very often in "parallel circuits" (the elderly can hardly manage to access the RSA); psychiatric him over 65 are no longer dependants of Psychiatry (from the point of view of costs).

7) S. D. and health needs more frequent

Dental diseases



Respiratory diseases

Dermatological diseases

Gastrointestinal disorders and eating disorders

Psychiatric disorders and alcohol or substance abuse


The group will meet again on 28 November 2017 h. 9.30 at the headquarters of the social cooperative Community Project- Via Soperga 13 Milan (MM: Central Station/C)