The People's Republic of China Guizhou
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Public Disclosure Authorized The People’s Republic of China Guizhou Aged Care System Development Program Environmental and Social Systems Assessment (ESSA) Public Disclosure Authorized (Final) Public Disclosure Authorized January 30, 2019 The World Bank Public Disclosure Authorized Acronyms ADL Activities of Daily Living AWS Administration of Work Safety CAB Civil Affair Bureau CT Computerized Tomography DOCA Department of Civil Affairs DLI Disbursement-Linked Indicators DRC Development and Reform Committee EPB Environmental Protection Bureau EA Environmental Assessment EHS Environment, Health and Safety EIA Environmental Impact Assessment EPL Environmental Protection Law ESSA Environmental and Social System Assessment GRM Grievance Redress Mechanism DOEP Department of Environmental Protection HC Health Commission HCF Health Care Facilities MEE Ministry of Ecology and Environment MEM Ministry of Emergency Management MEP Ministry of Environmental Protection NHs Natural Habitats NPC National People’s Congress PCRs Physical Cultural Resources SC State Council SEPA State Environmental Protection Administration 2 Table of Contents EXECUTIVE SUMMARY .................................................................................................................................... 4 SECTION I: INTRODUCTION ....................................................................................................................... 13 1.1 Methodology .............................................................................................................................. 13 1.2 National Context ...................................................................................................................................... 13 1.3 Guizhou Provincial Context .................................................................................................................. 14 1.4 Sectoral (or multi-sectoral) and Institutional Context of the Program ...................................... 16 SECTION II: PROGRAM DESCRIPTION .................................................................................................. 19 2.1 Program Contents ................................................................................................................................... 19 2.2 Program Development Objective(s) (PDO) ....................................................................................... 20 2.3 Program Description .............................................................................................................................. 20 SECTION III: POTENTIAL ENVIRONMENTAL AND SOCIAL EFFECTS ................................... 23 3.1 Environmental and Social Screening ...................................................................................... 23 3.2 Potential Environmental Benefits and Risks .......................................................................... 25 3.3 Potential Social Benefits and Risks .......................................................................................... 28 SECTION IV: ENVIRONMENTAL MANAGEMENTSYSTEM ........................................................... 34 4.1 Legal Framework Applicable to the Program ......................................................................... 34 4.2 Implementation of Environmental Management Systems ..................................................... 40 4.3 Environmental Management Agencies and Capacity Assessment ........................................ 50 SECTION V: SOCIAL MANAGEMENT SYSTEM ................................................................................... 55 5.1 Legal and Regulatory Framework .......................................................................................... 55 5.2 Implementation of Social Management Systems .................................................................... 67 5.3 Institutional Arrangement for Implementing the Program .................................................. 70 SECTION VI: ASSESSMENT OF ENVIRONMENTAL AND SOCIAL SYSTEM AGAINST PforR POLICY AND DIRECTIVE ................................................................................................................. 75 6.1 Assessment of environmental management systems against core principles .......................... 75 6.2 Assessment of social management systems against core principles ......................................... 78 SECTION VII: STALKHOLDERS CONSULTATION ............................................................................ 87 SECTION VIII: RECOMMENDATIONS ..................................................................................................... 88 Annex 1: List of Applicable Environmental and Social Law, Regulations and Guidelines ............... 90 Annex 2: Summary of Consultation Workshop .......................................................................................... 100 Annex 3: Institutional Responsibilities and Duties and Information Required .................................. 106 3 EXECUTIVE SUMMARY 1. The proposed Guizhou Aged Care System Development Program (the Program) is expected to bring about major positive environmental and social benefits by increasing equitable access to basic package of aged care services and to strengthen the quality of services and the efficiency of the aged care system in Guizhou Province, which will directly benefit about 3.27 million urban and rural elderlies and improved management practice of medical wastes in selected five prefectures in Guizhou Province, including Guiyang, Zunyi, and Liupanshui, and Qianxinan and Qiannan. Here basic package of aged care services refers to the public financed aged care services, which would cover home- and community-based aged care, and institutional care. The types and levels of basic package of aged care services will be determined by the local district or county government based on the affordability of public resources for the targeted elderly population. Under the Program, it is expected that 955,000 elderly population in urban areas, and about 2,32 million elderly people in rural areas could increase their access to improved basic home based and community based aged care services, and institutional care, and their aged care condition could be improved along with the economic development in the country. 2. The Program includes upgrading, rehabilitation and/or new construction of a range of aged care facilities at the county or district level, township or sub-district level, and residential community or village levels. The scale of the physical structure may range from institutions in communities, home based aged care station in rural and urban areas, to “happiness home” in rural village and welfare homes in urban and rural areas. 3. The activities supported under the Program are not expected to take place in or near environmentally sensitive areas (e.g., significant natural habitats, protected areas, or natural forests, or physical cultural resources at or above county level) and have no significant land acquisition or social risks. Activities will not involve dams or be located in disputed areas or international waterways. 4. Nonetheless, some of the activities supported under the Program have potential negative impacts and risks associated with construction and operation of the activities. The potential environmental risks identified for further assessment include the medical waste and radiation issues associated with institutions physically integrating aged care with health care that to be constructed, upgraded or expanded under the Program. While the potential social impact identified for further assessment include certain amount of land acquisition, involvement with ethnic minority communities, equal access of improved aged care facilities and consultation and grievance procedures. Overall, these risks and potential impacts are substantial. 5. This Environmental and Social Systems Assessment (ESSA), prepared by the World Bank team, provides a comprehensive review of relevant environmental and social management systems and procedures, institutional capacity and performance, in China and the Guizhou province; identifies the extent to which the country/local systems are consistent with the World Bank Policy and Directive for Program-for-Results (PforR) financing, and recommends necessary actions to address the gaps as well as opportunities to enhance performance during the implementation of the Program. Potential Environmental and Social Effects and Risks Environment 6. The potential environmental and social effects and risks of the program activities have been screened and further analyzed at early stage, to exclude the activities of high risks and identify the effects of primary concern for further assessment. The environmental effects and risks of primary concern are medical wastes and radiation associated with the activities to construct, upgrade or expand the aged care facilities which will provide health care or to purchase aged care and health care service from such institutions. 4 7. The Program will promote the coverage, efficiency, equity and quality of aged care service by tiered delivery1 in selected five prefectures in rural and urban areas. As an integral part of the tiered delivery, the elderlies will be entitled to the health care service. The Program will promote the integration of aged care with health care by coordination with hospitals (non-physical integration) and the provision of basic health care in aged care institutions (physical integration). During