Over 400 amendments voted. The text will be discussed in the Council Chamber from 10 November, the final go-ahead is expected by November. Among the planned interventions, the realization of the Territorial Operational Centers, the Hospitals and the Community Houses. The Center for the Prevention and Control of Infectious Diseases will also be created within 6 months of the approval of the law. The completion of the upgrading of the entire territorial network is expected in three years.
27 OTT – Green light by majority from the Health Council Commission, chaired by Emanuele Monti (Lega), to the draft law amending the Consolidated Law on regional health laws. The majority groups voted in favor of the measure (Lega, Forza Italia, Fratelli d’Italia, Noi con Italia, Lombardia Ideal and the councilor Viviana Beccalossi of the Mixed Group); against the minority groups, PD, M5S, Lombardi Civici Europeisti and Niccolò Carretta of the Mixed Action Group). In a statement, the councilor Michele Usuelli (+ Europa-Radicali) declared that he had deserted the works “due to the absence of democratic confrontation”.
The more than 400 amendments tabled by the various groups were voted on today.
The bill will arrive in the Chamber on 10 November, the day on which the general debate will begin. The Conference of Presidents of the council groups then planned to devote every weekday from 10 to 26 November to discussion and voting. The Regional Council is therefore expected to approve the new law by November.
“The draft law 187 (amending the consolidated text of regional health laws) – summarizes a note from the Council – deals with implementing a general strengthening of territorial medicine and the area of prevention, specifying the competences of the various stakeholders (ATS, ASST, Department and General Management), establishing Community Homes, Community Hospitals and Territorial Operational Centers and strengthening Integrated Home Care (ADI). Among the novelties, the institution within the ASST (Territorial Social Healthcare Companies) of the districts, of the functional prevention departments and of the primary care departments ”.
The ASSTs are assigned implementation of the steering and planning acts, the ATS are responsible for planning the activities of the departments, coordinating and signing the agreement with general practitioners and investment policies. The ASSTs continue to be divided into a hospital pole (divided into departments) and a territorial network (divided into districts). The connection with the mayors of the territory is achieved at the district level. Other important points of the bill concern the public-private relationship (“equivalence and integration of the socio-health offer of accredited public and private structures”) and the role of general practitioners, which is defined as “central” in the path of care of clients, in particular those suffering from chronic diseases.
Resources – For the Lombardy Region, the forecasts of the National Recovery and Resilience Plan allow for the provision of 203 Community Homes, 60 Community Hospitals and 101 Territorial Operational Centers with investments of over 300 million for Community Homes, over 150 million for Community Hospitals and 17.8 million for the Territorial Operations Centers. Another 85 million in regional funds will be allocated to the Center for the Prevention of Infectious Diseases. Overall, including regional resources to upgrade the supply network, 1 billion and 350 million of funds are allocated for healthcare construction. As the new structures are built, staff costs when fully operational are estimated as follows: 17 million 800 thousand in 2022; 28 million 700 thousand in 2023; 29 million 700 thousand in 2024.
The territorial network – One district for every 100,000 inhabitants (one for every 20,000 in mountain areas). The new Lombard health map will be based on this network, which in the provisions of the law will bring together the offices, the districts in fact, where “to assess the local need, make planning and implement the integration of health professionals (general practitioners, pediatricians, outpatient specialists, nurses and social workers) “. In the district, which will be “a physical location easily recognizable and accessible by citizens”, the territorial structures will find place: Community Houses, Territorial Operational Centers and Community Hospitals.
The Community Houses, where multidisciplinary teams will operate, will constitute the single point of access to health services and will be the reference point for the chronically ill. The Territorial Operational Centers (one for each district) will have the function of coordinating home services with the other health services and will make use of all telemedicine and digital medicine activities: television, teleconsultation, telemonitoring. The Community Hospital is the health structure of the territorial network that deals with short-term hospitalizations and patients who require medium / low clinical intensity health interventions. Usually equipped with twenty beds (up to a maximum of 40), it has a mainly nursing management.
Timetable – Within 90 days, the establishment of the districts is foreseen with the appointment of the directors and the establishment of the primary care departments and functional prevention departments. The Territorial Operational Centers will be created within 6 months of the establishment of the districts. 40% of hospitals and community homes will be built by 2022, 30% by 2023 and the remaining 30% by 2024. The Center for the prevention and control of infectious diseases. The completion of the upgrading of the entire territorial network is expected in three years.
October 27, 2021
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