2. Social Services Local Partnership Area - A5

3. About Mr. Mario Rossi Lisbon, 4- 9 JULY 2015 2 Born in Atripalda (AV) on August 20 th 1940 Living in the same area the local social service unit is in charge of (A5 Area ) Height: 1.75 Appearance: grey –haired, unassuming Status: widower He decides to apply to the PUA of the local partnership area for Social Services and Health Care. dott.ssa Maria Russo

4. About us: what does PUA stand for? It stands for an integrated and inclusive approach to social, healthcare and care-oriented services which is meant to increase social workforce effectiveness in the responsibility of taking charge of complex needs. Indeed, the social demand for social and health services, matches local level interventions, actions and government provisions only if it is taken into account that the multi-level nature of any need always requires interrelated and coordinated solutions. Lisbon, 4- 9 JULY 20153dott.ssa Maria Russo

5. Mr. Rossi knocks at the door… toc toc! Lisbon, 4- 9 JULY 20154 Mr. Rossi is RECEIVED by a professional social worker dott.ssa Maria Russo

6. Mr. Rossi expresses a need Lisbon, 4- 9 JULY 20155 The first phase is the active listening of the demands and individual needs “... I feel lonely and tired, I cannot fully extend myself in all domestic activities and routines, sometimes I can’t even go to the grocery store... my wife passed away six months ago and my two sons are working abroad...” dott.ssa Maria Russo

7. FIRST READING OF NEED What can we do for Mr. Mario Rossi? Although he lives alone, he lives in a small town and his house is in a built-up area; what’s more, he walked to our office... He claims to follow a cure for his aches and pains, but he hardly remembers the name of his medicines…... His certified disabling condition exceeds 75% and he visibly finds it difficult to move around Lisbon, 4- 9 JULY 20156dott.ssa Maria Russo

8. WHAT kind of need? Social Sanitary Social-Sanitary The social worker makes it clear that both a social and health need can occur: he is requested to give information to the office and to steer the range of services and opportunities around Mr. Rossi’s expectations and demands. Lisbon, 4- 9 JULY 20157 SOMEONE WILL ATTEND TO THE USER’S MEDICAL CARE, SOMEONE ELSE WILL AID TO GO SHOPPING... dott.ssa Maria Russo

9. STEP TWO: THE INTEGRATED ASSESSMENT BETWEEN SOCIAL AND HEALTH CARE Lisbon, 4- 9 JULY 20158 IEU Integrated Evaluation Unit At this point a Second Level rating is arranged in order to activate a professional team in accordance with the case and its evidences, e. g., a Social worker a Geriatrician a General practitioner dott.ssa Maria Russo

10. THE INSTRUMENTS OF SOCIAL EVALUATION SVAMA SOCIAL - MULTIDIMENSIONAL DATA EVALUATION ELDERLY USERS SINA CARD - CARD SERVICE INFORMATION NON SELF-SUFFICIENCY PEOPLE WHAT HAPPENS NOW? Access Card Evaluation Board: Area Mobility: Area Of Activities Of Daily Living: Cognitive Disorders Area Area Of Behavioral Disorders Economic Condition Housing Conditions Familial Status Stress Condition Of The Care Giver Support Social Network Lisbon, 4- 9 JULY 20159dott.ssa Maria Russo

11. From the evaluation to service providing Low intensity support services Proximity Services  Helpline or teleservice  Social transport  Meals or laundry at home  other  Lisbon, 4- 9 JULY 201510dott.ssa Maria Russo

12. From the evaluation to service providing Average intensity support Checks for economic support for home care  Home care up to 10 hours per week  semiresidential  other  Lisbon, 4- 9 JULY 201511dott.ssa Maria Russo

13. From the evaluation to service providing High intensity support service Home care from 11 to 18 hours a week  Home care: more than 18 hours per week  residential  other  Lisbon, 4- 9 JULY 201512dott.ssa Maria Russo

14. PERSONAL CARE PLAN Mr. Rossi will be provided social health home care service for a number of 3 week accesses equivalent to 10 hours per week (first level service) Lisbon, 4- 9 JULY 201513dott.ssa Maria Russo

15. UNIFIED ACCESS DOOR Lisbon, 4- 9 JULY 201514 SINGLE POINT OF ACCESS SOCIAL NEEDS SOCIAL SERVICES NEED HEALTH HEALTH SERVICE NEED SOCIAL HEALTH INTEGRATED EVALUATION UNIT NETWORK OF SOCIAL AND HEALTH CARE HOME TREATMENTS SEMI RESIDENTIAL RESIDENTIAL OTHER SOLUTIONS dott.ssa Maria Russo

16. MONITORING MONITORING OF USERS’ ACCESS, depending on: SOCIO DEMOGRAPHIC INDICATORS INQUIRY / REQUEST / APPLICATION CITY OF RESIDENCE CIVIL STATUS AND AGE GENDER EDUCATION EMPLOYMENT ECONOMIC CONDITIONS HOUSING Condition FAMILY CONTEXT / CHRONIC AND DISABLING CONDITIONS Lisbon, 4- 9 JULY 201515dott.ssa Maria Russo

17. MONITORING MONITORING OF THE SOCIAL OFFER, based on: HOSPITALS AND HEALTH SERVICE UNITS PROVISION aids Doctor’s surgery or private practice RESIDENTIAL STRUCTURES SEMI RESIDENTIAL STRUCTURES HOME SERVICE RANKING Lisbon, 4- 9 JULY 201516dott.ssa Maria Russo

18. MONITORING Checking of ENTERING requests and applications: AREA OF INTERVENTION INTENSITY OF NEEDS (MILD, MEDIUM, HIGH) TYPE OF NEED (SOCIAL, HALTHCARE, BOTH) PERFORMANCE REQUIREMENTS Lisbon, 4- 9 JULY 201517dott.ssa Maria Russo

19. MONITORING Checking outputs: STRUCTURES PERSONNEL WAITING TIME PERFORMANCE REQUIREMENTS Lisbon, 4- 9 JULY 201518dott.ssa Maria Russo

20. MONITORING IMPACT ASSESSMENT: RECEPTION - INFORMATION COMMUNICATION ACCESSIBILITY-USABILITY ' TIMES OF ‘PUA’ PROCEDURE TIME DELIVERY SERVICES Lisbon, 4- 9 JULY 201519dott.ssa Maria Russo

21. MONITORING FINAL ASSESSMENT (OUTCOMES): COST CUTTING FOR RESIDENTIAL SERVICE INVESTMENT POLICIES OF INTEGRATION SOCIAL AND HEALTH SHIFT FROM A MERE FUNCTIONAL ORGANIZATIONAL MODEL OF ‘PUA’, TO A MORE ORGANIC ONE REDUCED TIME TO WAIT BEFORE AN EFFECTIVE TAKING CHARGE DECREASE OF OVERLAPPING IN RESPONSES and PATHS OF CARE ACHIEVEMENT OF PROFITABILITY AND ECONOMIC RETURNS IN THE LONG TERM Lisbon, 4- 9 JULY 201520dott.ssa Maria Russo

22. MONITORING MONITORING OF IMPACT: EXPENDITURE FOR RESIDENTIAL SERVICE HAVE BEEN REDUCED BY APPROXIMATELY €550,000.00 (2012) TO ABOUT € 300,000.00 (2014) Lisbon, 4- 9 JULY 201521dott.ssa Maria Russo

23. What is Health ? Health is " a state of complete physical, mental and social well being and not merely the absence of the state of disease or infirmity.“ World Health Organization Lisbon, 4- 9 JULY 201522dott.ssa Maria Russo

24. Life is not to live, but to live in good health. Marziale (roman poet) Thank you for listening Lisbon, 4- 9 JULY 201523dott.ssa Maria Russo