DIREZIONE CENTRALE SALUTE INTEGRAZIONE SOCIO SANITARIA, E POLITICHE SOCIALI AGE PLATFORM EUROPE Annual Thematic Conference Toward an age-friendly EU by 2020 Friday17 May 2013 FRIULI VENEZIA GIULIA REGION STRATEGY ON ACTIVE AND HEALTHY AGEING Gian Matteo Apuzzo Local Health Authority n.5 on behalf of the Central Directorate for Health, Social-Health Integration and Social Policies Friuli Venezia Giulia Autonomous Region
2 2
DIREZIONE CENTRALE SALUTE, INTEGRAZIONE SOCIOSANITARIA E POLITICHE SOCIALI Relevant Regional Data Friuli Venezia Giulia Inhabitants 1,200,000 + 65 23% Dependent elderly today 55,000 Dependent elderly in 2051 more than 100,000 No. people in nursing homes 10,500 No. existing facilities -affiliated and subsidized by the Region. 191 -yet there are no new permits pressures from the market No. foreign family assistants 15-20,000 (50% of them non regular)
DIREZIONE CENTRALE SALUTE, INTEGRAZIONE SOCIOSANITARIA E POLITICHE SOCIALI The Age Pyramid Friuli Venezia Giulia region 90+ Piramide età Friuli anno 2003 75-79 60-64 45-49 30-34 15-19 0-4 60.000 40.000 20.000 0 20.000 40.000 90+ 60.000 Maschi Femmine 75-79 Fonte: SIE su popolazione da anagrafe Comunale fonte ISTAT anno 2003 Piramide età Friuli anno 2051- ipotesi centrale 60-64 45-49 30-34 15-19 0-4 50.000 40.000 30.000 20.000 10.000 0 10.000 20.000 30.000 40.000 50.000 Maschi Femmine Fonte: ISTAT Proiezioni ipotesi centrale
DIREZIONE CENTRALE SALUTE, INTEGRAZIONE SOCIOSANITARIA E POLITICHE SOCIALI Trieste is the regional capital city: THE CITY OF TRIESTE a medium-size city (205.535 Inhabitants on 01.01.2011) 56.874 over65 people, 27,54% of the total population. Another crucial data: 21.000 over65 people live alone(36% of the over65 population), and, among them, 13.353 are over75 (10.754 women and 2.599 men). Sources: PdZ and Social Policies Department of the Municipality of Trieste
DIREZIONE CENTRALE SALUTE, INTEGRAZIONE SOCIOSANITARIA E POLITICHE SOCIALI Main challenges in regional welfare an ageingpopulation; a growing dependent elderly population; an impoverishment of natural health networks; Empowerment of potential care-givers the presence of numerous foreign family assistants; the organisation of new models of care and assistance (deinstitutionalisation); the economic sustainability of the regional welfare system the promotion of the autonomy and independent living of elderly and disabled people the right to participation to community life
DIREZIONE CENTRALE SALUTE INTEGRAZIONE SOCIO SANITARIA, E POLITICHE SOCIALI INNOVATION: THE CONCEPT (1) To promote the autonomy of elderly people living in their own dwellings (homes, communities) by supporting demand driven solutions through quality and sustainable welfare systems The need to find innovative solutions to health and social services area. The main goal is to make the old people to live healthly and independently at home as long as possible, through better prevention, innovative home care, community-base solutions.
DIREZIONE CENTRALE SALUTE INTEGRAZIONE SOCIO SANITARIA, E POLITICHE SOCIALI THE CONCEPT (2) INNOVATION IN THE SOCIAL SECTOR Innovative processes should lead to: New models of social protection New social relations New territorial networks The innovative models should get a step forward in terms of: Sustainability Solidarity (relations, behaviors, actions) Social Responsibility (co-operation, inclusiveness, openness, dialogue) CAPITALIZATION: policies review, laws renewal, financial resources refocus sing, services re-organization. Although not always possible a clear costs-benefits analysis
DIREZIONE CENTRALE SALUTE, INTEGRAZIONE SOCIOSANITARIA E POLITICHE SOCIALI Innovation in the regional social care system The most recent regional plans and legislation have defined a model of integrated system of social and health services, strengthening the role of the Municipalities in managing integrated services: The promotion of home care is developed mainly through the partnership between Municipalities and Local Health Authorities. Innovative models for integrated care: multi-dimensional and cross-sectoralevaluation of needs, personal tailored project, integrated taking on. Innovative tools of local integrated health and social planning: Territorial activities Program (PAT) and Local Plan of social policy (PdZ, Piano dizona)
DIREZIONE CENTRALE SALUTE INTEGRAZIONE SOCIO SANITARIA, E POLITICHE SOCIALI FVG REGIONAL STRATEGY on Active and Healthy Ageing Regional Law on Innovati on Regional Social and Health Plan Accessibi lity/ Indipend ent living funds Tools and funds Autono my funds Local Plans for social policies (PdZ) EU funds, projects and networks Beneficiaries Families Local Authorities (muncipalities, health authorities) Care givers Regional Integrated System NGOs Third sectors Sectors and issues Science and research centers Housing and Accessibility ICT and social innovation Integrated home-care and community develpment Education Stakeholders
DIREZIONE CENTRALE SALUTE INTEGRAZIONE SOCIO SANITARIA, E POLITICHE SOCIALI Housing: Innovation in the home care system Accessibility: experimentation (in 3 different places) of an evaluation system of accessibility of buildings on the basis of WHO-ICF approach (with the specific contribution of WHO FIC CC) Autonomy: Presto a casa/back home project, two domotic flats, one of them for training, the other one for temporary staying Regional Law 1/2005, art. 3, Promoting Indipendent living (Abitarepossibile), advanced home care models for the elderly, 10 Municipalities involved so far Co-housing (Condominio solidale), promoting also intergenerational solidarity ICT: Regional Law on Innovation 26/2005, art.22 Innovation in the welfare system Regional network on ICT, and quality of life at home (among public and private partners) Regional services on tele-help, tele-assistance, tele-monitoring Community development: Local Plans for social policies (PdZ) Community foundations, new organizational model of PPP in managing and financing initiatives at local level for taking care of elderly and people with disability Advanced integrated home-care(formal care plus voluntering families as informal carers and community animators)
DIREZIONE CENTRALE SALUTE, INTEGRAZIONE SOCIOSANITARIA E POLITICHE SOCIALI The integrated home care system for the elderly in Trieste Milestones from 2003for the integrated home care services (started thanks to regional funds based on the national law on social services reform n.328/2000): the Integrated single office (PUI -PuntoUnicoIntegrato), where the taking in people for care was implemented jointly by social and health professionals (joint needs assessment). From 2003 around 12.317 people contacted the PUI (in 2011 there were 1398 contacts, which 43% of entered in the integrated social-health program). The Primary Home care Intervention(PID Pronto InterventoDomiciliare), in case of unexpected events and needs. From home care assistance service (SAD, servizio di assistenza domiciliare) and Nursing home care service (SID servizio infermieristico domiciliare) to Integrated Home Care Assistance (ADI assistenza domiliare integrate): from standardized services to tailor-made services. PdZ, Local plans for social policies(2006-2010, 2010-2012, 2013-2015) Sources: Social Policies Department of the Municipality of Trieste
DIREZIONE CENTRALE SALUTE, INTEGRAZIONE SOCIOSANITARIA E POLITICHE SOCIALI The city of TRIESTE Some examples of active participation of old people in social initiatives of the Municipality of Trieste: Planning: Local Plan of social policy (PdZ), involvement of localassociationsrepresentingbeneficiaries in the localand sub-local planning of services and projects Assessment: involvingbeneficiaries in the evaluationofthe Project Passi d Argento, throughquestionnaires and interviews with partcipants Managing: Social center for neighborhood socialization Marenzi, managedbyanassociationofoldpeople (built up through a social participatory planning, firstly comanagement, then direct management) Sources: PdZ and Social Policies Department of the Municipality of Trieste
DIREZIONE CENTRALE SALUTE INTEGRAZIONE SOCIO SANITARIA, E POLITICHE SOCIALI FVG - REGIONAL INNOVATION PROJECTS IN WELFARE SECTORS Regional Law n. 26/2005 on Innovation, Scientific Research and Technology Development Art.22, Innovation in the Welfare Sector: the Region can promote and finance projects of research and innovation on healthcare delivery system and social services, promoting partnership and involving the private sector. 15 projects/year on:promotion ofqualityoflife at home forelderlyand dependent; Adaptation of apartments with technologies(domotics); - Teleassistance and telemedicine;
DIREZIONE CENTRALE SALUTE, INTEGRAZIONE SOCIOSANITARIA E POLITICHE SOCIALI FVG Region most recent experiences on innovation in welfare system: Regional Laboratory on Accessibility, Domotics and Quality of Life A Regional Laboratory involving public and private partners (PA, SME, R&D) Housingand indipendent living Social Innovation (PPP and community welfare) ICT The Laboratory, started as a project, then officially established by a Regional Act (FVG Region Health and Social Services Regional Plan 2010-2012, through the Local Health Agency n.5 that acts on Region s authority with its Operational Plan 2011). Now it is a cluster on Ambient Assisted Living (FVG as @ Lab) included in the Italian national cluster initiatives.
DIREZIONE CENTRALE SALUTE, INTEGRAZIONE SOCIOSANITARIA E POLITICHE SOCIALI MAIN PARTNERS OF FVGas@LAB
Municipality of Trieste, AREA Science Park, ATER KITCHEN CUCINA SINGLE ROOM BATHROOM CUCINA BALCONY DOUBLE ROOM LIVING ROOM ENTRANCE
Local Health Authority of Trieste Key Components HIS Central Unit Mambo 2 HIS Portal Video Conference Vital Monitors Environmental and Bi-directional Monitors
Regional Strategic Project ASPAD Integrated activities promoting home-care and accessibility Topromotehome-care and accessibilityofthe local welfare system To support local networks for the home-care Tosupport innovative management of social and health services To promot accessibility of ambient of life To promote community animation forpartecipation and inclusion
DIREZIONE CENTRALE SALUTE, INTEGRAZIONE SOCIOSANITARIA E POLITICHE SOCIALI EUROPEAN INITIATIVES SUPPORTING REGIONAL POLICIES 1.FVG asa L@b Committment to EIP-AHA, D4 Action Group on Age-friendly environments, cities and regions 2. 3. CASA -Consortium for Assistive Solutions, CORAL network Policy development for AAL innovation uptakes 4. SmartCare (DREAMING follow up) Integrated Care Collaborative Platform, aiming at the integration between social and health service providers
DIREZIONE CENTRALE SALUTE INTEGRAZIONE SOCIO SANITARIA, E POLITICHE SOCIALI HELPS Housing and Home-care for the Elderly and vulnerable people and Local Partnership Strategies in Central European cities Central Europe Programme, Call for Strategic Project Proposals Lead Partner: Regione Autonoma Friuli Venezia Giulia 12 partners + 3 associated partners 8 countries involved Duration: 36 monthsoctober 2011 September 2014 www.helps-project.eu
DIREZIONE CENTRALE SALUTE INTEGRAZIONE SOCIO SANITARIA, E POLITICHE SOCIALI HELPS INTEGRATED APPROACH ACCESS TO INFORMATION INTEGRATED MANAGEMENT OF CARE SERVICES ELDERLY & PEOPLE WITH DISABILITIES ACCESSIBILITY OF DAILY LIFE SPACES NEIGHBORHOOD COMMUNITIES ICT SOLUTIONS EMPOWERMENT OF PROFESSIONALS
Montebello Project in Trieste DIREZIONE CENTRALE SALUTE INTEGRAZIONE SOCIO SANITARIA, E POLITICHE SOCIALI
DIREZIONE CENTRALE SALUTE INTEGRAZIONE SOCIO SANITARIA, E POLITICHE SOCIALI THANK YOU FOR YOUR ATTENTION! Gian Matteo Apuzzo, Ph.D. Senior researcher and Project manager matteo.apuzzo@welfare.fvg.it Tel: (+39) 0432 933 141 Fax: (+39) 0432 933 138 skype: matteo.apuzzo