The JOINT CONFERENCE in today's sitting of January 22, 2015; Visto l'art. August 28, 1997, 9 of Legislative Decree No. 281 and, in particular, paragraph 2, point c), under which this Conference promotes and enshrines agreements between Government, regions, provinces, municipalities and mountain communities, in order to coordinate the exercise of their respective powers and together activities of common interest; Having regard to article 11 of law No. 354 of 1975 and 17 of the Decree of the President of the Republic No. 230 of 2000 which specifies that health care in favor of prisoners and internees must be secured inside the prisons, being possible to have recourse to external medical facilities only when "necessary treatment or diagnostic procedures that cannot be it employs from internal health services to the institutes"; Having regard to the Legislative Decree of December 30, 1992, # 502, as amended, which guarantees the health as a fundamental right of the individual and the collective interest; Having regard to the d.lgs. 230/99 that in art. 1 provides that "prisoners and internees are entitled, like citizens in a State of freedom, to the provision of benefits of prevention, diagnosis, treatment and rehabilitation, effective and appropriate, on the basis of the overall objectives and essential levels of health and special uniforms of assistance identified in the national health plan, and regional healthcare plans"; Having regard to the Decree of the President of the Council of Ministers of November 29, 2001 and subsequent amendments concerning: "definition of essential assistance levels", which defines the essential levels of health care guaranteed by the national health service, in accordance with art. 1 of Legislative Decree No 502 December 30, 1992 as amended; Visto l'art. 2, paragraph 283 of the Act December 24, 2007, n. 244 (budget 2008), which provides that a decree of the President of the Council of Ministers defines the modalities and criteria for the transfer of the prison administration Department and the Department of juvenile justice of the Ministry of Justice to the national health service of the health functions of labour relations, financial resources and equipment and capital goods, regarding prison health; Having regard to the Decree of the President of the Council of Ministers 1 St April 2008 adopted in implementation of the above-mentioned provision, among other things, gives the local health units to ensure detainees, internees and minors undergoing criminal measure meeting-health needs through the performance of prevention, diagnosis, treatment and rehabilitation they-need; See annex A of the Decree of the President of the Council of Ministers which stipulates that ' the performance specialist health unit at the request of the responsible physician or other specialist, to be inside the prison that is in compliance with the safety requirements at the territorial or hospital surgeries "and noted that the mentioned Annex A-as well as the agreement November 20, 2008 adopted pursuant to art. 7 of the Decree of the President of the Council of Ministers 1 St April 2008-bears "guidance on organizational models", according to which the ASL, in the definition of organizational models of health care in prisons, must take account of certain criteria, including the type of restricted (collaborators of Justice, high security etc.) or special needs; Considering that this Conference, at its meeting of July 31, 2008, resolved (Rep. Acts no 81/CU) the creation of "permanent consultation on prison health", among whose duties it is possible also the performance measures investigation activities, to be submitted to the examination of this Conference, the implementation of several times the President of the Council of Ministers Decree 1 St April 2008, as well as the provision of addresses to promote programs of assistance in territorial reality and tools aimed at facilitating coordination between regions regional school districts of the prison administration, and Department of juvenile justice; Having regard to the agreement of the Joint Conference of November 26, 2009, Rep. Acts no 81/CU bearing: "health care facilities within the Italian penitentiary system"; Visto l'art. New Covenant health for 7 years 2014-2016, on which it was sanctioned in session state-regions Conference of July 10, 2014, Rep. Acts # 82/CSR, stipulating that the regions and autonomous provinces undertake to adopt at the Conference, in accordance with art. 9 of legislative decree 281/1997, the preliminary Agreement: "guidelines on methods of delivery of health care in prisons"; implementation of national and regional health networks "; Having regard to the note dated September 22, 2014, by which the Commission's technical coordination health sent the document indicated, processed and shared by the interregional group "prison health", for the purpose of perfecting a unified Agreement at the Conference; Having regard to the note by the Secretariat this document branch September 25, 2014; Whereas, at the meeting of the Permanent Table on penitentiary health of December 15, 2014, held an extensive discussion on the proposal and the relevant central authorities and representatives of the regions have agreed on changes to the text, reflected in the final version of the agreement submitted by the coordination of regions on January 8, 2015 and issued on the same date; Considering that, in the course of the present session of the Conference, the Secretary of health has proposed to insert in art. 2, point 2, the end of the first paragraph, the phrase "also making use of the technologies and innovations that enable the provision of services at a distance", accepted by the regions and autonomous provinces and the local authorities; Acquired in the course of today's sitting, the assent of the Government, regions and autonomous provinces of Trento and Bolzano and local autonomy;

Ratifies the agreement: between the Government, the regions and autonomous provinces and local authorities, in the following terms: considered: the report on hearings of representatives of regional observatories on prison health, in health care theme in favor of detainees, prisoners and minors undergoing criminal proceedings, which took place at the Ministry of health from June 16 to July 12, 2011;
the reports received later from the Department of prison administration and the Department of juvenile justice, which have shown nationally, criticality in terms of access to direct care to detainees, internees and minors subjected to criminal proceedings;
the opportunity to identify the most effective initiatives to ensure health services within the penitentiary, greater uniformity of access paths and dispensing health benefits against thimble population; Considered it necessary to provide guidance for the redefinition contexts and methods with which they are provided health services in favour of detainees in order to favour the overcoming of criticality reported; It is agreed between the Government, the regions and the autonomous provinces of Trento and Bolzano and local authorities, as follows: Art. prison health services Network 1 1. Regions and autonomous provinces and healthcare organizations provide health care to the prison population in prisons and juvenile justice services of their regional territory through a complex system of health services with organizational and functional complexity increasing features, which are the regional and National Network for prison health care. The regions and autonomous provinces define within 180 days the composition and mode of operation of the network so as to ensure that all the health needs of inmates are adequate and appropriate response within the intra-regional structures and territorial prison. To this end, in relation to the characteristics of the population in prison and health needs from this presented, every region and P.A. ensures within its territory the presence of penitentiary health services according to the needs of the prison population in the IIPP. Annex, which forms an integral part of this agreement, describing the General characteristics of types of penitentiary health services where each region and P.A. references for programming of health services needed in the IIPP. The transfer to health services from other regions and is carried out by the prison authorities in case of necessity of highly specialized care or care of particular complexity clinical (cardiac surgery, neurosurgery, organ transplants, Burns, etc.). 2. the regions and autonomous provinces shall notify the composition of service network (intrapenitenziaria, territorial and hospital) and its local and regional organization, the prison authorities and the judicial authorities for determinations of competence. 3. in the event that the Director-General of the competent health authority or his delegate-on the recommendation of Chief Medical Officer of the service-certifies the impossibility to guarantee the level of performance required diagnostic and/or therapeutic at the prison or in the territory of the competent health authority, the transfer of inmates-need of care is carried out by the prison authorities in one of the prisons in the region, taking into account the reviews of the subject which the region has assigned regional network coordination functions (interpenitenziaria regional health network on the proposal of the head of intercompany)/Institute of departure and heard that target service/Institute. For transfers for health reasons in another region, most diseases are reserved solely for gravity, the prison authorities also takes advantage of the collaboration of the regional entity that coordinates the network, whose ratings contribute to discretionary discovery penitentiary inmate transfer seat for health reasons. The source and target health service work together in exchanging information to safeguard the continuity of therapy.