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[seal] Ministry of Health Lazio Region [seal]
THE MINISTER OF HEALTH in agreement with THE PRESIDENT OF THE LAZIO REGION
IN VIEW OF Articles 32, 117, paragraph 2, letter q), and 118 of the Constitution;
IN VIEW OF Article 47-additional (bis) of the Legislative Decree of 30 July 1999, No. 300, which duly assigns to the Ministry of Health state functions regarding the protection of human health;
IN VIEW OF the Law of 23 December 1978, No. 833, laying down the "Establishment of the National Health Service" and particularly Article 32 of that law;
IN VIEW OF Article 117 of the Legislative Decree of 31 March 1998, No. 112, concerning the assigning of the administrative tasks and functions of the national state to the regions and local authorities;
IN VIEW OF the Decree-Law of 25 February 2020, No. 19, on "Urgent measures to counter the COVID-19 epidemiological emergency" and particularly Article 2, paragraph 2, and Article 3, paragraph 1, of that Decree- Law;
IN VIEW OF the Decree-Law of 16 May 2020, No. 33, converted with modifications by Article 1, paragraph 1, of the Law of 14 July 2020, No. 74, on "Further urgent measures to tackle the COVID-19 epidemiological emergency";
IN VIEW OF the Decree-Law of 30 July 2020, No. 83, on "Urgent measures related to the expiration of the declaration of the COVID-19 epidemiological emergency made on 31 January 2020" which extended until 15 October the state of emergency and the measures taken to limit the epidemic referred to in the Decree-Laws of 25 March 2020, No. 19, and of 16 May 2020, No. 33;
IN VIEW OF the Decree-Law of 7 October 2020, No. 125, concerning “Urgent measures related to the extension of the declaration of the COVID-19 epidemiological state of emergency, the COVID alert system’s continuity of operation, and the implementation of the (EU) Directive 2020/739 of 3 June 2020";
IN VIEW OF the decree by the President of the Council of Ministers on 13 October 2020, laying down “Further implementing provisions of the Decree-Law of 25 March 2020, No. 19, which was converted into law with some modifications by the Law of 25 May 2020, No. 35, addressing “Urgent measures to tackle the COVID-19 epidemiological emergency,” and the Decree-Law of 16 May 2020, No. 33, which was converted into law with some modifications by the Law of 14 July 2020, No. 74, addressing "Further urgent measures to tackle the COVID-19 epidemiological emergency" published in the Official Gazette of the Republic of Italy on 13 October 2020, No. 253; 2 IN VIEW OF the decree by the President of the Council of Ministers of 18 October 2020, laying down “Further implementing provisions of the Decree-Law of 25 March 2020, No. 19, which was converted into law with some modifications by the Law of 25 May 2020, No. 35, addressing ‘Urgent Measures to tackle the COVID-19 Epidemiological Emergency,’ ” and the Decree-Law of 16 May 2020, No. 33, which was converted into law with some modifications by the Law of 14 July 2020, No. 74, on "Further urgent measures to tackle the COVID-19 epidemiological emergency" published in the Official Gazette of the Republic of Italy on 18 October 2020, No. 258;
IN VIEW OF the resolutions by the Council of Ministers of 31 January 2020, 29 July 2020, and 7 October 2020 which declared and extended the state of emergency in the national territory in response to the health risk linked to the onset of pathologies arising from transmissible viral agents;
IN VIEW OF the declaration by the World Health Organization of 11 March 2020, whereby the COVID-19 epidemic was qualified as a “pandemic” given its global spread and severity levels;
CONSIDERING the ongoing development of the epidemiological situation, the particularly widespread nature of the epidemic, and the increased number of cases within the national territory;
IN VIEW OF the Ordinance by the Ministry of Health of 21 September 2020 which laid down further measures in relation to epidemiological developments at the international level;
IN VIEW OF the document on “Prevention and response to COVID-19: the evolution of the strategy and planning for the autumn-winter transition phase” prepared by the Ministry of Health and the Higher Institute of Health in coordination with the Regions and Autonomous Provinces, with the latter providing general inputs for strengthening preparedness in order to address infections during the 2020-2021 autumn-winter season (referring to Protocol 7474 issued 12 October 2020 by the Conference of Regions and Autonomous Provinces);
CONSIDERING that
- the regular monitoring of COVID-19 cases has shown a steady increase in terms of the number of infections, which have been registered alongside increased testing activity;
- as highlighted in the previously cited document by the Ministry of Health, non-pharmacological measures aimed at slowing the transmission of the SARS-COV-2 virus and preparedness measures are necessary as is enhancing already implemented containment measures. Pending the development of immunity, additional measures also needed which include building within health services a system of coexistence and adapting these services to address the combined management of the virus and its pathologies among infected patients who are often asymptomatic or have few symptoms;
- in this regard, the Phase VI Actions drawn up by the Health Directorate of the Lazio Region require further enhancement in terms of hospital capacity, taking charge of the situation and territorial management of assistance activity. This means increasing the allocation of dedicated COVID beds and separate assistance pathways as well as strengthening preventative functions and monitoring infections;
GIVEN that
- with Protocol Note No. 837904, of 30 September 2020, which was forwarded to all trade associations and bodies within the Regional Health System, the administration requested the possibility of indicating the availability of ordinary acute care beds, intensive care and semi-intensive care services, and post-acute phase care units (Unità di Degenza infermieristica/UDI) as well as residential territorial health and socio-healthcare assistance; 3 - the following health facilities: Ospedale Israelitico, Villa Tiberia, Villa Serena, San Feliciano, Policlinico Di Liegro, Ospedale Vannini, Campus Bio Medico, INI Città Bianca, Villa delle Querce, Casa di Cura Guarnieri Istituto Dermopatico dell'Immacolata-IDI, Nuova Itor, Regina Apostolorum, Policlinico Casilino, Villa San Pietro Fatebenefratelli, and Policlinico Gemelli have expressed interest in being designated a COVID Centre (either totally or partially) dedicated to assisting patients suffering from SARS-CoV-2; on 20 October 2020, the Regional Health Service system and its bodies indicated the actions they are preparing in order to tackle interventions aimed at strengthening services and providing combined management to assist COVID patients;
IT IS CONSIDERED appropriate, therefore, that in order to strengthen health service availability and to counteract and limit the spread of COVID-19, the following actions must occur:
- increasing the allocation of beds dedicated to COVID-19 patient care. This means identifying additional public and private facilities other than those already included in the COVID network. These facilities may be may be even partially dedicated to this end, thereby increasing the number of COVID network beds. Specifications for this are set out in the table attached to this Ordinance and are an integral and substantial part of it (ANNEX 1), - mandating the Health and Social Integration Directorate, in coordination with the Regional Crisis Unit, to define the transfer of activities amongst the different points in the network. This is needed to implement the upgrading noted above. This will also consequently involve the overall rearrangement of service activity due to the conversion of hospital units. It will further entail the partial or other related reallocation of assigned funding levels; - giving the Health and Social Integration Directorate the mandate, in coordination with the Regional Crisis Unit, to direct the potentially necessary adapting of the overall assistance arrangements to align with the evolution of the COVID-19 emergency; - limiting movements between the hours of 24:00 and 05:00, with the exception of movements due to justified work needs, absolute necessity or health reasons; - enhancing distance learning in both secondary schools and universities;
IT IS CONSIDERED that the factual and legal situations set out and explained herein take into account the exceptional and urgent conditions needed to protect public health, which are all aimed at counteracting and limiting the spread of the virus.
the following ordinance is issued:
Article 1 (Strengthening the COVID network)
1. In order to limit the spread of COVID-19, it is considered necessary to increase the allocation of beds dedicated to COVID-19 patient care. This means identifying additional public and private facilities, other than those already included in the COVID network, which may be even partially dedicated to COVID care thereby increasing the number of beds in the network. Specifications to this end are set out in the table attached to this Ordinance and are an integral and substantial part of it (ANNEX 1); 2. The Health and Social Integration Directorate, in coordination with the Regional Crisis Unit, is given the task of defining the transfer of activities amongst the different points in the network. This is needed to implement the upgrading ordered above. This will also consequently involve the overall rearrangement of service activity due to the conversion of hospital units. It will also further entail the partial or other related reallocation of assigned funding levels; 4 3. The Health and Social Integration Directorate of the Lazio Region, in coordination with the Regional Crisis Unit, will oversee the potentially necessary adapting of overall assistance services to align with the evolution of the COVID-19 emergency.
Article 2 (Limitation of movements at night)
1. Movements are prohibited throughout the regional territory from 24:00 to 05:00 with the exception of those motivated by proven work requirements (travelling between work and a home, residence or dwelling), absolute necessity or for health reasons. Movements between 24:00 to 05:00 due to the exceptional situations indicated above must be supported by a written declaration (ANNEX 2) pursuant to Articles 46, 47 and 76 of the Decree by the President of the Republic of 28 December 2000, No. 445.
Article 3 (Enhancing integrated digital learning in higher secondary educational institutions and Universities)
1. Higher secondary educational institutions should increase the use of integrated digital learning to include fifty per cent of students, with the exclusion of first-year students; 2. Universities should increase the use of integrated digital learning to include seventy-five percent of enrolled students, with the exclusion of training activities that require being physically present or require instrument use (such as, for example, activities in scientific laboratories, training activities to be carried out in clinical services according to defined plans made by the involved facilities or internship activities for health degree courses which cannot be delayed).
Article 4 (Final provisions)
1. The provisions of Article 1 of this Ordinance are in force from the date of its publication. 2. The provisions of Article 2 of this Ordinance are in force from 24:00 on 23 October 2020 for a 30-day period. 3. The provisions of Article 3 of this Ordinance are in force from 26 October 2020 for a 30-day period.
The current ordinance is being forwarded to the competent supervisory bodies for registration and publication in the Official Gazette of the Republic of Italy.
The Minister of Health The President of the Lazio Region Roberto Speranza Nicola Zingaretti Speranza RO 2020.10.21 20:57:36
CN=SPERANZA ROBERTO C=IT 2.5.4.4=SPERANZA Digitally signed by NICOLA 5.4.42=ROBERTO RSA/2049 bits ZINGARETTI C: IT [seal] O:Lazio Region/80143490581 5
ANNEX 1
COVID-19 HOSPITAL NETWORK
Intensive and ASL Ordinary Intensive and Ordinary Beds Semi-intensive Care Facility (local health Beds Semi-intensive Care Beds Total under scheme Beds authority) 21.10 under scheme 21.10
Fondazione Gemelli-Columbus ROME 1 130 144 79 99 243
Policlinico Umberto I ROMA 1 124 210 38 64 274 Celio ROMA 1 100 100 17 50 150 San Filippo Neri ROMA 1 20 95 25 120 Santo Spirito ROMA 1 16 16 San Giovanni Addolorata ROMA 1 16 16 16 Sant' Andrea ROMA 1 18 28 8 10 38 Bambino Gesù ROMA 1 30 30 3 3 33 Villa Tiberia ROMA 1 35 35 12 46 81 San Feliciano ROMA 1 20 89 89 IDI ROMA 1 18 50 4 54 Villa San Pietro FBF ROMA 1 20 20 Sant' Eugenio ROMA 2 12 12 Pertini ROMA 2 12 12 Policlinico Tor Vergata ROMA 2 60 88 3 29 117 Campus ROMA 2 24 24 24 Nuova Itor ROMA 2 40 40 Vannini ROMA 2 132 8 14 146 Casillino ROMA 2 10 10 10 Clinica Guarnieri ROMA 2 30 5 35 INMI Spallanzani ROMA 3 225 234 42 44 278 Grassi ROMA 3 20 4 24 San Camillo Forlanini ROMA 3 70 8 78 ICC ROMA 3 62 62 48 58 120 Israelitico ROMA 3 34 70 4 74 Di Liegro ROMA 3 20 20 San Paolo ROMA 4 16 16 Palestrina ROMA 5 40 3 43 Tivoli ROMA 5 22 33 33 Colleferro ROMA 5 4 4 4 Albano ROMA 6 71 9 80 Nuovo Ospedale dei Castelli ROMA 6 30 30 4 4 34 Villa delle Querce ROMA 6 36 36 Regina Apostolorum ROMA 6 20 20 20 Belcolle VITERBO 48 83 9 19 102 De Lellis RIETI 18 25 8 8 33 Spaziani FROSINONE 67 86 10 10 96 Villa Serena FROSINONE 38 38 INI Città Bianca FROSINONE 136 136 Santa Maria Goretti LATINA 58 106 6 12 118 TOTAL 1191 2381 301 532 2913
Ordinary Beds Added Intensive and Semi-intensive Care Beds Added Total Beds Added
1190 231 1421 6
ANNEX 2
SELF-DECLARATION PURSUANT TO ARTICLES 46, 47 and 76 of the Presidential Decree No. 445/2000
The undersigned , born in residing in Street and domiciled in Street Identification document No. issued by on ____. .____ telephone number , is aware of the criminal consequences foreseen in the event of making a false declaration to a public official (Article 495 of the Italian Criminal Code)
I DECLARE UNDER MY OWN RESPONSIBILITY
Ø not to be subject to quarantine measures resulting from a positive test for COVID-19 or any other health measure aimed at limiting the spread of infection (with the exception of movements made with the approval of health authorities); Ø to be aware of the currently in-force regulatory measures for limiting the spread of COVID-19 and which concern the restriction of movements by legal persons within the national territory; Ø to be aware of the other measures and limitations provided for by ordinances or other administrative provisions adopted by the President of the Region or the Mayor in accordance with the current regulations; Ø to be aware of the penalties indicated in Article 4 of the Decree-Law of 25 March 2020, No. 19, and Article 2 of the Decree-Law of 16 May 2020, No. 33; Ø that my movement is due to: o -proven work needs o -health reasons o -other reasons permitted by the current regulations or by the above-mentioned decrees, ordinances and other provisions defining measures to prevent the spread of infection; (specify the cause for your movement):
______;
Ø that the move started from (indicate the start address)
______
Ø and will end at the following destination (indicate destination address)
______;
Ø with regard to this movement, it is further declared that:
______
Date, time and place of check ______
Signature of the declarant The Police Official