Interim operating procedures for the management of facilities with persons who are highly vulnerable and at high risk of health and social care exclusion during the COVID-19 epidemic
“Interim operating procedures for the management of facilities with persons who are highly vulnerable and at high risk of health and social care exclusion during the COVID-19 epidemic” is a technical-procedural document whose aim is to provide holders of responsibility at various levels in the management of groups of very vulnerable, marginalised people, both Italian and foreign, clear, easy-to-apply instructions that are consistent with the legislative framework produced in Italy during the COVID-19 public health emergency. The Undersecretary of State at the Ministry of Health, Sandra Zampa, requested that INMP prepare this document, on the basis of the legislative mandate it holds, its experience in the field of equity in health and the guidance documents it has produced on these specific topics.
The health problems of people who are highly vulnerable and at risk of health and social care exclusion, in fact, represent the main challenge of modern welfare systems. Such people frequently escape prevention policies as their legal-administrative status may be indefinite, or they may simply be difficult to reach. It is therefore difficult for public services to provide assistance. There is thus the need to produce a useful document that guides standardized national prevention measures in these population groups in the completely new and rapidly evolving context of the coronavirus epidemic. The document provides not only instructions on how to prevent infection and its spread but also a careful assessment of the risks attributable to the diverse contexts in which these people live. This multidimensional assessment considers the organization of dwellings, the freedom of movement towards the outside world people living in facilities have and the demographic and health profiles of these people, all of which play a key role in determining the specific risk of infection and of disease. These three dimensions, therefore, determine the theoretical basis on which the various settings are placed in spatial contexts of risk determined by said dimensions; the settings are the recipients of the operating procedures to manage and mitigate said risk. The ad hoc operating procedures are therefore situated in the context of the Italian migrant reception system, structured as first reception, necessary to carry out the very first interventions of material and health assistance after embarkation or crossing the land border, and second reception in SIPROIMI facilities, which foresee long-term integration pathways managed by local institutions and reception of asylum seekers during the COVID-19 emergency. The procedures are considered ad interim precisely because they concern the current epidemiologic situation and are therefore subject to change in light of any variation in the epidemiology of the novel coronavirus itself.
To produce a document that is as complete as possible, INMP has availed itself of the collaboration with various institutional subjects, including the National Association of Italian Municipalities (ANCI), the Italian National Institute of Health (ISS), the Ministry of the Interior, and the Presidency of the Council of Ministers, with the Department for Antidrug Policies and the Civil Protection Department. We thank them all for their precious contribution.
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