a DIRETTORE AMM.VO Dott.ssa Maria Gamberini

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1 D 2016/ d 30/06/2016 Pg 1 d 45 DELIBERAZIONE DEL DIRETTORE GENERALE N 154 DEL 30/06/2016 I DIRETTORE GENERALE qst vtv, fvv, d Dtt Ammsttv, d Dtt St, v vst mt, d Dtt d ttvtà S St. A D O T T A d vt ggtt: ADOZIONE DEL PIANO DELLA PERFORMANE , AI SENSI DEL D.LGS. N.150/2009. DIRETTORE GENERALE Dtt. Ig. L Bd DIRETTORE AMM.VO Dtt.ss M Gm DIRETTORE SANITARIO D. Gd Pd DIRETTORE ATTIVITA' SOIO SANITARIA Dtt.ss st d IL DIRETTORE GENERALE Dtt. Ig. L Bd

2 D 2016/ d 30/06/2016 Pg 2 d 45 OGGETTO: ADOZIONE DEL PIANO DELLA PERFORMANE , AI SENSI DEL D.LGS. N.150/2009. IL DIRETTORE GENERALE S st d Rss Ad Ts Pv d (RTP) dtt. At M mt d.187 d 3 g 2013, fmt d.221 d 30 vm 2015 h, tstmt s d fm st st, ttst gttmtà d mdsm d tt d stt d qst fm sst d dmt; Pmss h P d Pfm (PdP) sst dmt gmmt d dt t tmt d d.gs..150/2009 vt d ggtt: Att d gg 4 m 2009,. 15, mt d ttm d dttvtà d v d ff ts d h mmst. - d è dttt tt d gmm f d, h dvd g d g ttv sttg d tv dfs, fmt g ttv f d tmd d ss, g dt ms vt d fm d mmst, hé g ttv ssgt s dg d tv dt. ; h tm Pfm gtv s fs tt h Ad t ttvs gggmt d ftà dg ttv dft, vt tm st sddsf d sg d st d sg dvd d ttvtà; h t tst qst Ad USL h gà dttt PdP fmt t ; Atts h P d Pfm d qst Ad USL ft t sì m dt, t ssmt t d fd mmt h st tssd Sv st m-mg, dvd d mg sttg ò h f fmt, t tst, g ttv d Pgmm d mdt d Gt Rg g ttv d mdt d D G d qst Ad USL; h PdP f st fmt Att d, hé g stmt d d f, gmm t; h, stm sts, PdP dfs dttà d d, s mg sttg, g ttv d, dms d fm g dt d stt, mt mst d qd g d stà, gtd gmt d ts d tgtà; Vst d. 1/2014,.2/2015.3/2016 dttt d OIV, Ogsm Iddt d Vt d d dg t d Sv St Rg d Rg Em Rmg; sdt h PdP gt q t tgt sst d st d - s s d d ft d OIV dv ss dttt t t 30 gg 2016, sttv d dv ss ggt s d t d vg; Rtt tt d dtt gt PdP ;

3 D 2016/ d 30/06/2016 Pg 3 d 45 Atts h fvv d Dtt Ammsttv d Dtt St s td qst tmt fm dgt st d mdsm st d; h d d st vvdmt mt ss d f qst Ad USL; D E L I B E R A 1. d dtt P d Pfm (PdP) tv t q gt t tgt sst d st vvdmt; 2. d sddtt PdP s st d st s dmt Ammst Tst ; 3. d d tt h d d st vvdmt mt ss d f qst Ad USL. I dgt t At M

4 D 2016/ d 30/06/2016 Pg 4 d 45 Dmt fmt dgtmt svt fmt' stt d mtv vgt mt. I st dmt ' tt d dmt g dstt ss g hv d'a.u.s.l. d P. D1-D0-1F-AE-56-B-DF-D-84-FA-B EA-5B-D9-30-AD-58 AdES 1 d 4 d 30/06/ :14:35 Sggtt: ALBERTO MERLI MRLLRT59B17G535W Vdtà tft d 05/11/ :18:21 05/11/ :18:21 Rst d Ats Qfd tfts A G1, Ats S..A./ , IT AdES 2 d 4 d 30/06/ :17:30 Sggtt: MARIA GAMBERINI GMBMRA69T48H294I Vdtà tft d 24/11/ :32:56 24/11/ :32:56 Rst d Ats Qfd tfts A G1, Ats S..A./ , IT AdES 3 d 4 d 30/06/ :22:08 Sggtt: GUIDO PEDRAZZINI PDRGDU56M19D150L Vdtà tft d 16/02/ :53:25 16/02/ :53:25 Rst d Ats Qfd tfts A G1, Ats S..A./ , IT AdES 4 d 4 d 30/06/ :33:14 Sggtt: LUA BALDINO BLDLU67L19F205V Vdtà tft d 03/03/ :12:21 03/03/ :12:21 Rst d Ats Qfd tfts A G1, Ats S..A./ , IT

5 D 2016/ d 30/06/2016 Pg 5 d 45 P d Pfm (30 gg 2016)

6 D 2016/ d 30/06/2016 Pg 6 d 45 INDIE Extv Smmy Pmss Idttà d Ad h sm ttsth gtv d Mss vs d I tst I s I dt m m m G mg sttg dms d fm Dms d fm d tt A d ss A d tg A dg st Dms d fm d ss t A d d A d t, qtà, s gst d sh A d g A d t d ts Dms d fm d v d sv A d d ddtt A d sv gtv Dms d fm d ssttà A m-f A dg vstmt Ms vt d fm Pfm mssv d (sstm SIV-ER) Pfm gtv dvd t (dgt, sstm d vt t sstm mt) gmt ts tgtà Idt d st Agt 1 T dt

7 D 2016/ d 30/06/2016 Pg 7 d 45 Extv Smmy I st P d Pfm sst dmt gmmt tv t I P - tmt d d.gs..150/2009 vt d ggtt: Att d gg 4 m 2009,. 15, mt d ttm d dttvtà d v d ff ts d h mmst. - è dttt tt d gmm f d, h dvd g d g ttv sttg d tv dfs, fmt g ttv f d tmd d ss, g dt ms vt d fm d mmst, hé g ttv ssgt s dg d tv dt. I tm Pfm gtv s fs tt h Ad t ttvs gggmt d ftà dg ttv dft, vt tm st sddsf d sg d st d sg dvd d ttvtà. I st P q stmt gmmt sstt d fmt/tg s d t t ssmt t d fd mmt h st tssd Sv st m-mg, dvd d mg sttg ò h f fmt, t tst, g ttv d Pgmm d mdt d Gt Rg vt 25/01/2015 g ttv d mdt d D G d qst Ad d DGR 171/2015 DGR 1003/2016. It, P è dtt fmtà g ggmt vst d D d OIV-SSR 3/2016, d d gà mt d D 1/2014 2/2015 d OIV-SSR stss. I st dmt f st fmt Att d, hé g stmt d d f, gmm t P d Og Ad. I stm sts, I P dfs dttà d d, s mg sttg, g ttv d dms d fm g dt d stt, mt mst d qd g d stà fs d mtmt, m s vdt, gtd gmt d ts d tgtà. 1 Pmss L Ad, sì m vst d.1/2014 d OIV dg Et Ad d Sv St Rg d Rg Em-Rmg, dtt P d Pfm ss d qt dsst mt d stt d.gs..150/2009. I P dvd d st sg d ttvtà, mss stt, tà d t d, sttg g ttv d Ad, t mt s mt, mttd st s mtd, s ss ttvs q s stt dvdt, sgd g ggmt vst d D 3/2016 d OIV-SSR. T dmt s t d d gst d fm, q s t sgt fs: 1. df ssg dg ttv, d v tts d stt d sttv dt; 2. gmt t g ttv ' d ss; 3. mtgg s d s ttv d vt tvt ttv; 4. ms vt d fm, gtv dvd; 3

8 D 2016/ d 30/06/2016 Pg 8 d t d sstm mt, sd t d v d mt; 6. dt d stt g g d d t-mmsttv, vt d mmst, hé mtt g st, ttd, sggtt tsst, g tt dstt d sv. A f d ss qtà, mstà d ttdtà d dmt d st d fm, Ad mt dg s st w, m vst d d.gs..33/2013 s dmt Ammst Tst : P d Pfm, dmt gmmt t h, m gà dt, ò md dmt d gmm sstt, g ttv d fm gtv (shd d dgt) d fm dvd (shd d vt dvd). R s Pfm h vd stt gtv dvd ggt stt sg ttv gmmt d ss, v dg vt sstmt, d g t. T sg ttv d ss d t sttg dt d stt d fm sgt, sstt dss d B d Mss, mgt d Nt Itgtv, stt, d D Ad. T t stt dst gd d gggmt dg ttv sttg vst d P d tgt d dgt, hé g mt sgmt. B d Mss Nt Itgtv sd v ssm m s fm vst d m. I P td ss stmt st d gd d d d s: t, f d t ttvtà d d d std m ttv sstà sg fdmt tà sttgh; st f d st dvs tt d tss (stkhds) tà sttgh sgt ss d sstà stv d dt ft (tty). 2 Idttà d Ad 2.1 h sm ttsth gtv d I dt d Psdt d Gt Rg d Em Rmg.566 d 23 gg 1994 h sttt, d d 1 g1994, Ad Utà St L d P h è stt x g ttt t gd ttv ssv ft t sstt Utà St L d Pv d P: USL.1 d st S Gv, USL.2 d P USL.3 d F d Ad. L Att Ad, vst d t. 3, mm 1-s d D.Lgs..502/92 sssv mdf tg, è stt vt d.301 d 3 g 2008 Rg Em Rmg h sss mtt d fmtà DGR.1174/08. Rdtt fmtà L Gd d Rg Em Rmg (DGR 86/2006), dfs sttv s: 1., gh, g sstt stt; 2. sstt gtv sstà; 4

9 D 2016/ d 30/06/2016 Pg 9 d sttgh ( s, ttd, stt) L tt d è st s st w stt d: htt:// 2.2 Mss vs d Mss: Tt d st m dtt d ttd s d sg d st d ttd, sss fm dvd ttv, ttvs tvt t d v, m d st, t, gtd v ss d ssst (LEA), sdd tg t ssst tt sd, g d tt d m t d ss. L Ad tg td m f d ssst f d fm d, sv è dss gt t stt d v sstm, h ttvs Uvstà. Vs: Ad t, vs st, v t sstm g, tv ft dg stkhds, mttv, tsfft sv, st d tt, ttt fsstà d vt v, t d smt, h vt mtà ssv, ssss d ttt g stdd d qtà. Ad h mv ttvmt t d st, tv t d fmt mtà t d stt, d d sst t sg sss d mgt. A t d th d sstm g m - mg, vmst tt gd d tg stttvmt t sstm, h d t g. L Ad, ssvmt d s mss, ssm q v fdt, f d gmm gst d ttvtà: ttà d ttd qtà sstà qtà t ff ff ts ttà d s tgtà 2.3 I tst P ds sstv d tst Ad, s md S 1 2 tv d d B d Mss 2014, st s st w stt sgt d: htt:// 5

10 D 2016/ d 30/06/2016 Pg 10 d 45 Ah qt f d (ssttà m, f tm, mtt s tst tt v ss d ssst), s md s 2 tv d d sddtt B d mss 2014, st d: htt:// 2.4 I s I s mgt Ad USL d P mmt tà (ggt 31/05/2016), sddvs m d t stt tt: RUOLO DONNE UOMINI Tt. Dg Md Vt Dg NON Md Ps St NON Dgt TOTALE RUOLO SANITARIO R. Pfss 4 4 R. T R. Ammsttv TOTALE RUOLO NON SANITARIO TOTALE OMPLESSIVO P qt tt qd mssv d s t t d d, s v s 4.1 d 4 d stt B d Mss I dt m P dt m, s v gf 2, t 1, 2, 3 4 d B d Mss m m Og I mt sttt gtv, s md sd t d tt d, d w s dt. I sts, s f st qt sg: Dsttt: Ad st tt t Dsttt: Dsttt d ttà d P, Dsttt d Lvt Dsttt d Pt; I Dsttt stts mt gt sst tgt stt f d ss, dg stmt d mt fss, qt ssm mtà stts sd d t ttvtà d d Et L, q mtt d Dsttt, mst d Sd d tt, è hmt v d sstà s d gmm, f d fg d sg d ss st d tà d tvt. 6

11 D 2016/ d 30/06/2016 Pg 11 d 45 I Dsttt st qd, tm, t d d mt tt dv vg stt f vtv, dgsth, tth ssst ttv tt d gv tgt d sv st, sst s. I qst d Dsttt v dvdt m mt v h tt f d mmtt, ts m tà d gmm sv ss sd sg d ttd s dtmt tt vt qtà mtt sm stt stt d dmd. S stt dsttt stts t vgt d f ttvtà d d Et, t stt d v m d st, d m, d tg f sv s st. Dtmt: st sttt gtv fdmt d d ttv d gst d, gtd gtà dg tvt vtv, ssst ttv ttà d ssst. E sd ttv d gv, ts m t qttv s d ss. E t g d t d fssst ds d tt sttg, gtv gst h f qtà d sv t d ss ds. I dtmt h sts d ggg tà d tà tv mss sm dtmt f ssst ff, mmt fmt gt, sd d dd s. Ass gst t d ss f d sddsf g ttv gt v d, dttd s gtv h gts sv sdt sstà ssst f d s, tmt t d vt qtà t. Psg 'ttm d's d ss t fmt q d s m ttvs df d t st d ss / d t, hé ttvs mss t d v gtv tgh f d mg qtà d sv ssttà m. Psd U: P stt t sd ftmt tgt, Ad tts sm d sd fm gst d Psd U, ftà d d ù ff sv sd vtd dss, svs, d d sv gtd dst dgt sg, dvsf gd d tstà s d. L st gtv d Psd U sd vtà d d ttà ' dg sd d tt h v d P s q - ssgd mssm vd tà fsstà mttd dss g stmt gtv sttt ss t. I qst dvs stmt sd st sttt mmt gtv h mtt dtmt tsd d fss sst sg st tt d fmt. L d Psd U h f d s mt gt sth ts d sg sd sd, f d t sftt mg, vs ù g, ttà ft d'g d. L mt d fmt s qst md t fs ggf qs f, st qd s tà t, fss, gtv s mt/smt d ttt dvs t gtv s fss. P qt sssmt dt st gf, s md stt t dmt/tt: ATTO AZIENDALE 7

12 D 2016/ d 30/06/2016 Pg 12 d 45 PIANO DI ORGANIZZAZIONE 1 SISTEMA AZIENDALE DELLE DELEGHE AI DIRIGENTI d d.185/ G mg sttg dms d fm Qst t st d dmt, qt q d sgt vg dft g mg sttg dms s s t d Ad t m tt dtmt, dtm mg sttg ù mtt dms d fm Ad h s m fmt DGR 171/2015 h m Dtt G d AUSL d P dvd ttv d mdt qq, DGR 1003/ Dms d fm d tt T dms s fs ttt d mtt m mg m sv fft t d fmt. S m d t dstt : A d ss A d tg A dg st A d ss L Ad t ms d fm s q f mmt d ss sv d t d t, sgtmt, d d gg mgmt d tmstvtà d gmm d v tttmt. G ttv g d qst gd: - mgmt d tm d tts t d g vd gstt PS; - tss d ss PS; - mgmt tss d sd g tt; - mgmt d tm d tts t sg v Hs; - mgmt d tm d tts st ssth v gmmt (qst tm s mg svt stt). L fm d s ss s t t s d ù sfh, f h gggmt dg ttv g d : Mtmt d tm tts g d ss st d sst mt P t ssm tt t: 1 L Ad Us d P sd v gtv sss d tà d mtmt d tst t v ss sstà. Ptt sstt gtv d Ad è t v vv d dmd ss ss dttt smt sttst mtgg vf (tt d, m t, t 7.5.1). 8

13 D 2016/ d 30/06/2016 Pg 13 d 45 - mtmt d tm d tts d st ssth mtt t g ttv (DGR 1056/2015: m 90% d st gtt t tm stdd) dvd d v st d mt s d ttà; - mtgg d d DGR 377/2016 d d tv (dsdtt ms); - s t d t: stt sst, h h t, sv st s v t md d md g. Ah t d t dv ss ffttt d t d sst sttt (UO/Amt) h h ttd. Ft ss: d d tm d tts st d v sd I gtt g s mdtà d gst d ss v gmmt ssm tt t. A qst f, d td t d 2016 ( mt s d t) s: - d Tm d Atts d dt tsttv d SDO, ttt st mtt, t tt tm ts d ; - vf d mt hv SIGLA; - dvd d Rss U Ad d t d Dtt St gst d Pgtt SIGLA; - dss mtmt d d fmt d sstm d v d st d tts. L s d St ttà d ssst L s d St, s vvt, h dt stv tm s d ss, m h d tg d sst fft sf sg d ttd. I qst mt ( d ss), st fdmt sg sv d s d St t gt mmt d tvt d md d tv, h P Rg d Pv ; ss mtmt d hmt ttv d t d fm d s tgt mt d s d St gà dvdt. Ps Nst Gt ssst t gvd, mvd ssst stt fsg s tgt s tg, mt d t d gvd st fm. Pt fs è st mv qtà d ss s d mgmt st, mtd m d d h v d t, d st d ss stà. Adà gtt ssst t t, mgd ss mtdh d t d d t m vst d DGR 1921/07 (qst LEA), dd t d d h d d mtd d t d d dt tvg/t stt 2015 dd s tg s, vtmt ss I, II IV, V d Rs (qst LEA 2016). St dttv Fv ss st fm dg dst (tà ), d t d q d g st, gt t d m s d ss ftt gv dt (tà 20-9

14 D 2016/ d 30/06/2016 Pg 14 d ) sv d fttà (v tttmt d mtt sssmt tsmss, dgs tttmt d dmts, s t, fmy g). Ps IVG Gt gg d ss s IVG dvs mtdh vst (hg md), t tt d d tm d tts t s d tft tvt, mt IVG hgh. Assst tt s dst d stt tst (PRIA) D vs d Pgmm g ssst s dst d stt tst (DGR 212/2016) t: - gt d t dgst ttt v s 0-17 ; - ft ss Sv ddt Dst d Stt Atst (t sk sv tt) m fs 0-3 sstt d dst d stt tst, (HAT stv d d st d ms) f d dgs 'vv tmstv d tttmt; - fftt vt f 16 d tà: f d mdtà d ssgg Sv tà dt A d tg L ms d fm s tg s f s h, h dttmt, s f fft d sv ù tgt t d fmt, sg d s d ttà d. G ttv g d qst gd: - ADI mgmt t dg d t t 75; - dm sd tà dt sm gsttt; - dm sd d t fftt d tg h t dt, BPO sms d; - tmt t tv ssst Hs; - tmt s d t d st mt. L fm d s tg s t s sgt d ù sfh: L s d St ttà d ssst m s sft, s d St, s vvt, h dt stv h tm d tg d sst fft sf sg d ttd. I qst mt, sfh t s t s: - s sv d tà dttv d s d St ttvs mtgg d mdtà gtv d ss d s ddt t fftt d tg ; 10

15 D 2016/ d 30/06/2016 Pg 15 d 45 - ttv dg mt fmst s tgt d tg h, t dt mt t 2, BPO sms d, ffd tg t sd tt; - mg dg stmt g vt d s d gst tgt s d t d vst d t (Qst PAI) h d q (Qst AI); Ptv L g d t d Ptv, vvt d qst Ad s d 2015, st d mg qtà d ss, tg t d éq, s tgt sstà d mt, d s fmg d s d ttà d. N t , d s tà s df d sttt d t d s mt (d d éq), s dmt d t stss, s s h dv gt tg t d ttà d. Dv ss h dft s fmtv vt fssst d t, gà vvt s d It, sà st t tt qtà d dt h fs fss fmtv ADI Hs g dt d DM. 43/07. ttà ssst dmss ttt A s d mg tmt 'ssst mt tt ff s d sm ù t tgt è ss mg tà d s, t d t fg tg h st d sttà, 'tt d dmss sd. L tg t Osd Tt ss h stttt ttvs stmt d dmss ttt, t d md gtv f m dmt t dvs sttg ssst. A f d ggg ttm v d fm tm d tg mmt d md gtv mg, Ad s tà t s df d t dvs t tà tv sd tt, qd ss, s dvd d ss (s mg) d s d dmss ttt s s d v tvt ssst. Sv d ssst dm L ssst dm è m d t sv s ttt tt g. Tttv mg tmt ssst mt tt ff s d Osd-Tt sm ù t è ss h Ad qfh tmt ssst dm ttvs ttv d t s d s sst st d ttvtà d ssst dm tgt. Ad mgt tss d ssst dm, ttstd Ad mg v g, sì m d ttstt mg v g tss sf d t t tstttq. Assst s-st t d st mt I Bdgt d St st stmt ggg tg s-st (DGR 1554/2015), sstg d gtt d st s fftt d dst mt gv, ttv d t d St Mt Sv S, smt d tttmt sd t. N sf, Ad s mgà df mt ss mss dss d DSM-DP ttv d Pgtt tt-ttv st d Bdgt d St. It, f d ggg mgg v d tg d 11

16 D 2016/ d 30/06/2016 Pg 16 d 45 s, Ad s tà m d d fm ggmt d s, h ttvs gtt dvs Et L T stt, t v fs d vt dvs, v fmg, df d gtt, vt dg st sdmt d ttvtà d Utà d Vt Mtdms (UVM), mst d Ad d Sv s. Sv s-st tsff L gmm d FRNA st mtt t fm d d tg. L ft t s: - mtgg tmstv tt t d FRNA, FNA FSR sv sst dtt, t tt t d ttt ss ssgt; - sdmt sv d tvt d ss sg ds, tg dmt g Et L; - ft / ms d ttvtà st sv sst dtt fvd s d sstà gst t d sggtt gst d sv dtt h qst ttvtà; - tt ggmt v g d gmm gvssm dstà qst (DGR 2068/2004); - t, m, gmm dg tvt fv d s gv dstà mt d FRNA (DGR 1230/08) FNA - dss d s d ss, s ttà ssst s dstà 'ss sd mg 'ssst sst, t tt sg d s dstà tttv, m mtmt h sst d ddt A dg st Qst è d t mt, qt ttt d Ad s ft mgmt d stt d st d d fmt,, qd, st d d tttmt. Ptmt, dq, tt dg vstmt gmm, f, g, tg fmt t ss vt stt qst. G ttv g ft g st gd, ftt: - mgmt d d d mttà d tvt hg ( t tt d tg d tvt, s d d g); - mgmt d d d mttà d vt t mvvs t d st ; - tss d tmstvtà d ft d vt t; - mgmt d ds st-t ( tm d gt d dg s d m). L fm d stt g st ò ss mgt fd g s sgt d ù sfh, f h gggmt dg ttv g d : 12

17 D 2016/ d 30/06/2016 Pg 17 d 45 Rd sd N t v mmtt tv mtmt d d d t sd sd d tt DGR 2040/2015, h và d ss fvv sg dt d st d Ad, m h d svt A d d A d t, qtà, s gst d sh. L sfh h gd fm sg st d tttt s: - stt d v sg s vm d st, s qt vst d DM 70/2015; - sgmt d't d g d d mdh hgh ttm d qt vst g dmmt LEA h mt DRG d t sh d t; - t d sst, sgt mgmt d v d mt d d sh ; - smt d sd hgh vm d ttvtà tm d mmm f 150 s. s d St, ssst tt ttà ssst A f d gggmt d t v d fm A dg st, t gmm sd, Ad s t s h gd mtmt sv d s d St, tmt d ssst tt st ttà ssst. Iftt, vstmt (m tm d ss m) qst m, st t d tt sgt : - s d t ù mss fg; - gst t t d t, md d t stt d gd ttvs s d dvdt; - st d v PDTA, stttt q gdt tg h, sg d md d tv d s tgt ( t, dt, BPO sms d); - g ff d d dt t ù mss, ttvs s d St; - dvd d fg fss ss sst s gst tgt t d t. Assst Pdt L gd: dst dt d st d tst d (RAD) fm dgst d fgtst stt (100 RAD PLS/ md, d md s s d m d ssstt PLS) d 2016 m 10% dg ssstt, mt fm ; mv t d tv w PBA st sstm SOLE gst mt d fgtst, vd g d tv vst, gggmt d ttv mm d m (> 50 t /PLS). L Ad, t, td f tvt mgmt d t sttv d tt tà dt d ttv: ) d tss d s d tt ) d tss d s d mx vt stt q d mx. 13

18 D 2016/ d 30/06/2016 Pg 18 d Dms d fm d ss t T dms s fs ttt d mtt m mg ff d ss t, ttm fss gtv mt v d qtà s d ttt g t svgmt d ms. Evt v d fm qst dms h fftt stv h vs st: qt ù mg mh dttv gtv, tt ù Ad sà gd d ff sv d t qtà t d fmt. L dms s m d t dstt : A d d A d t, qtà, s gst d sh A d g A d t d ts A d d L d d è d t mt fm t d. G ttv g d s fs : - fm s dg md; - vm d ss PS; - vm d ss v s md s hg (DH d); - vm d st d sst mt; - ttvtà d v vt dvs tgt d (v, sg). L fm d s d s t s sgt d ù sfh: Rd sd m s dt, d d t sd sd d tt DGR 2040/2015 DM 70/2015, và d svt stv h A d d. I t, mtt s d vs tt gt dt mssm d st tt vt dtt t f d 2016, m dt DGR 2040/2015; dt và mtt g It, s gmmt sgt : - mmt d vs gm mt d dy hst g (DGR 463/2016); - t H d Sk tm-ddt (IMA, Tm Stk) v mtt mgt t 2015 tv t m s sttv sd HUB (Lt d Emdm, Tm t Stk Ut); - v mgt fm t sttt d sgt ssth: tm d mmm, PTA, ftt d fm, m d ts vst Stk Ut d 1 2 v, m d Tm Gv d t ttt g t dt s vm d st d DM 70/2015 d DGR 2040/2015; - t f 2016 sà gtt g mt tt ttv d STAM STEN sd d vt DGR.1603/2013 (dt LEA), sg mtmt sv ; 14

19 D 2016/ d 30/06/2016 Pg 19 d 45 - vvmt, m s hmt, s mmtt g stdd s vm g st dt d DM 70/2015 d 2040/2015. Osd d mtà I d f S St Tt, và mmtt s d ttv d st tt d Osd d mtà, df d t sd, vd s d vs. T sttt, h st vd stmt d tg sdtt d ttà d, dv stt tt DM 70/2015. L Ad h gà dvdt ft sd d Osd d mtà tt d mt. Pd tt s d St: Md d fmg sst mt m hmt dtmt, Ad td g d tt s d St, t tgt h Osd. I t, gd ffmt d md d g, g, d d Md d Md G s d t, g d d d sst mt t d s d St d mt fmst, ftà d t h t d fmt t. Pm d st ttvtà d v Sst tvt d v m d st vst v P Rg d Pv, t fvd ss d mwmt dvd d mtà sgt mgmt dg st d vt d ss d s. Ad t gtt: gmm v; gmm d sg g; gst tgt d mg; ttvtà d v s mt stà vt g stt d tt d P N Itgt Svg t d mtt fttv, v I ttà t dt, d fft ft mg 'ds v vst d v g 'f 'ds, gtd 'ttvtà d st tv g tvt d m d'ds g gh v, hé 'ds v tf v st sggtt tg h. I t, Ad vd d: m g mt h g m d 500 ds v ; gt m 95% d t v f ds (v gt mdt) 75% d t v tf (>= 65 ) A d t, qtà, s gst d sh G ttv g d s: - mg tss d sd v v; - dm v DRG d t sh d t; - dm m st-hgh; - dm st s t. L fm d d qst s t s sgt d ù sfh: 15

20 D 2016/ d 30/06/2016 Pg 20 d 45 Rd d sh mgmt mt m hmt s, mmt d d sd stà, t t s, d: - t sst md d stt g stdd stt d DM 70/2015 ggg sì vt v d qtà s; - mt v d mt, md d ss ù ttttv s ft d t h vs mg fssst; - d sh, stttt mt hg st-t. I gv d fm d dsstv md Rstt dg ttv g s fmt vt qst sd d fm, hé q s qst sm d dsstv md. T ttv h tmt mtt dtt s A m-f, m gv h fftt stv h d t, qtà, s gst d sh. A f d gggmt d t v d t, s sstà s tmt d fm d d s s tt, td, ttà sd/tt (dmss, dst dtt t, vst sst mt) ssvmt ttv st Pt d A Vst. Gv d ttvtà sttv d g d st ssth Pm vf d t sttv d gtv mdt ttvtà d fm/fm vt md stt (MMG/PLS sst). Vf d t sttv d st sttst d d gtà d d t (dt 9/12/15 d vt v LEA) d st d dgst st, RM msshth T stt q s stt dft d d gtà (DGR 704/2013). Tt d st d s d vt Ass tt t ggmt d ms dvdt gt v d tt d st d s tsfm d v mtv. Agg d tv svg st d vt. Pmv t d v ft d mtt fttv, h ttvs g d mmt fmtv vt g t. Rd fq d mtt v d v ttvs t vt d sh A d g L ttv g d qst è dm md fft tmstv v d dt hst d Rg. P mt mg v d fm d qst, Ad s mvà s sgt d ù sfh: Rt v dt md ù tmstv, s d ff sd fv ttt ttvtà ft t, m stddt fm, d fm tv st d s sv st, gtd tsmss d dt ttd fmtà qt vst d dmt t. I f è d 16

21 D 2016/ d 30/06/2016 Pg 21 d 45 mt sstm g, st f d gmm gv g thé ss s ss d tty. Pttfm gsth fmth ù ft R, d mmt d v sftw GRU (Gst Rss Um) d sftw gst d mmsttv t (GAA), qst tm gg fs d df d tt d g (gg 2016). Dffs d SSI, ttvs mg stt tm d Rg fm, vs dt ffmt fssst md: t mg sà fs d Dtmt d Pm, mt N d Pm. sdmt d v s s dmtt, mtmt d ttv d ttt md sst t 2016, mtmt gmt g sdmt d Fs St Ett (FSE), q stmt d m ttd sg d ft, gmt t tmt, mt d DPM 178/2015. Sv d ss d tg d sv mmsttv, gst d st t v d s mt d ss mmsttv vvt , v st d g st h s d tg dmt t dvs Utà Otv d mmsttv, gst d st. I v d s g gdà s fftmt t, s, s ss, vt ttm t d d A Vst, s ttvtà ù stdd, dq, ù d / f A d t d ts G ttv d qst A sst : - d tt d tt P T Ad Pv d s md, P st s st w d d htt://ts.s..t/ssitm.sx?idssitm= vvd d ttt g tt. dt fm vst d D.Lgs..33/2013, sì m mdft d D.Lgs.. 97/2016, ssd mt ggmt, v stt mtgg d s d st dmt Ammst Tst, m vst d Pgmm T Ad Ts t st s st sddtt d htt://ts.s..t/ssitm.sx?idssitm= P t fdmt d gmt s md sssv Pgf 5, gmt ts tgtà, g Dms d fm d v d sv Qst dms s fs ttvtà t h s s d st fss d s mgt Ad,, dq, h fftt dtt s v d qtà d ff d ttvtà sddtt d ttvtà d st. S m d d dstt : 17

22 D 2016/ d 30/06/2016 Pg 22 d 45 A d d ddtt A d sv gtv A d d ddtt G ttv g d qst s: - ff Ptsh md d S d Uvstà (d/v/t d ts); - ttvtà d fdsg tmt d t/ss h m st sst. L Ad mv, smt gtt s mgmt v, q t tgt d, s gggmt dg ttv d st d fsstà d gggmt d g d. I gtt d gtt d mgmt/v, s sv: - tv t, s st d fssst; - mt d gmm Rg d SSN ( ft, gtt d md, gtt Rg-Uvstà, gtt d v,.); - s hst/st d stà d, d vt vt ttd (ss, fd, mt, AIFA). I mt è stt dttt st gmt dtm t h dv t gst d ttvtà, tv vt g f, t fmt : - ss/dt/t ft; - sstà d gtt; - UU.OO. d st mtt t; - gst d fd d, mgmt v. L Ad h tsì vvdt stt, t d g d D, g st d st m g t mt d g st/hst tm d /v/smt, ft d sf gmm ; g d v h t s mt, q d stm, d fm mmt t Uvstà, fvd s ù ttv d sd A d sv gtv L ttv g d qst è q d mt m t fvv st, sv mgmt fss s. L sfh d : V d t m Itg ttt ttvtà d ddtt m s dstt mss d. Mg m fft fmtv EM, h v d A Vst, vs ttt fssst st tsst. Pgtt s d dvs d st sttgh vgmt d s d d sv d, m s Ft St vvt 2015 tt m mtà d V ttt fssst d ttvs mgmt 18

23 D 2016/ d 30/06/2016 Pg 23 d 45 d sstm d vt d sstm mt, sì m dstt dttg sssv Pgf 4.2, Pfm gtv dvd t (dgt, sstm d vt t sstm mt), g. 22. I gv d ss m L ttvtà f sv gtv dv g md stt g P Ad d Ass. S hm h qst mt d ss d tg d ttvtà t-mmsttv d st t Ad, s v v h d A Vst, f d mg ff gst gg dgt df d fsg d ss m, sgt d ss. 3.4 Dms d fm d ssttà T dms gd sf stttmt m-f gst d d d è stttmt t gggmt d vt v d fm d ff gst. sst d d : A m-f A dg vstmt A m-f G ttv g d qst s: - mt mg v d st t; - mt mg g dt d v d ss; - mt mg fss fmtv vs Rg. L tt d Ad s tà s sgt d ù sfh: Mgmt dttvtà ff dg Et d SSN, stt d gg d d g d LEA I gg d m dt s q d t ttvtà d, qd và sgt dt ttt d t. L t ttvtà mtt qst s, t: - stt mtgg d gst d dmt m-f; - st Rg d tf vst d't. 6 d'its Stt-Rg d 23/3/2005, ttstt dg dmt tmst 'ttv ssgt; - sd d d tm d gmt d ft d sv d SSR; - mgmt d'mgtà, d fttà d'gggtà d sttv ttvs t m dg shm d vst d D.Lgs.. 118/2011, vf d tt d stt t tt t d dss d D.Lgs.. 118/2011, d tv sst tv d d g, tt t d P d t g, m tm, t tt m d md mst E, SP d LA; 19

24 D 2016/ d 30/06/2016 Pg 24 d 45 - mg ss v g d st t-sst df d v s tv d sstm fmtv g gst d' mmsttv-t. I gv d ss d qst d sv Immt f Ad St Itt-ER mt ss d dmt d dg qst. t t ttv smt d v fm d f ttvs vgmt d s qft tt Ad St ttvtà d t dg qst gstt v g d Itt-ER, qs d sv ss sstm st g dvt sm ù t. Immt Sstm g dmt d ssv (SP-ER) h vd gst, t h d ftt, h d d d dmt d tst. I gv d fm d dsstv md Rstt d ttt d ss fsst fmt vt qst d fm sd. Amt d s fm g vt d t h, mgd t tt g m stmt d d t s t ù fft d fm. Ads md g s fm g dttt d mmss g d fm f d stt vs d t. Ads mg d sm t d v dgs vt d tttmt s. sdmt d fss fmtv D.M. mt md ù t sm d dsstv md t 'dmt d ss stt ttt fsst. I gv d ss m Rstt d P Ad d Ass. Sv d ss d g gst d vs d t sd, sd t hmt dtmt, ttv d d ss m mgt A dg vstmt I qst Ad h tt ssttà dg vstmt ttvs tt stt g, m h ss, f d t tà d tfmt, s ttvs d tm d ddt h ttvs s d mt. I tm g, Ad dtt t d gst d tm d d tg ft gggmt d tsff g d st st dvdd t d q t ss ssmtà d ssst d s sst sstà d ttd st sd. N stt d P dg vstmt d , d gd: Gst d tm mm N gmm d tvt d dgmt d d mtst d sttt st, sd qt vst d mtv d v d, Ad h vst qf, df sttt d dvs sd gtv/sttg d d tt d mt. G 20

25 D 2016/ d 30/06/2016 Pg 25 d 45 tvt dvdt t t t tv vmt d v d vst sttt st sd tt t, sà mq dt d mt d ss ss. I g, Ad td t tmt g vstmt sttt d mtst sg sd h, mt d d d t sd, ssm dft d md H d Sk, v tt, s s d St. Tg mdh fmth Ftgg v tg t d h è tmt st ( h vht) dt d, t fft stttt dv st mg s s dtt s ss v mtà d tvt; gg g qttv h fttm s è vmt gt, m d sm dt dm fm, md d gt sm vt stdd qttv d fft. P qt gd IT, vstmt d t tss: - mmt d gfh h d d ttfm d Gst Iss-ss, d sstm d gmt t stss g tv vt; - mmt d sstm IT h gts ssgg d gm d DH q d DSA g d st dgsth tth d stà -mtgh, mttd tst mt d DB -mtg; - mmt d sstm h gts gst ttm d s d fm dmss d gm d v mt, thé s smmst d Fm Eg Dtt (fss FED); - qs v tv gst d ts, dgmt d dttv d AVEN; - tt mmt d gtt g GRU; - mmt mtmt d sstm d qs ft d st dsh d gfh; - mtmt d sstm d qs ft d dg dgh - IS (dgy Ifmt Systm); - mtmt d gtt d fmt d s t. 4 Ms vt d fm I sstm d ms vt d fm d è sstm mss h s t dvs ss, stmt fs. I gf h sg dsv sttmt g stmt d gmm t d gst tt d Ad, ggd d tg: Pfm mssv d Pfm gtv dvd t 4.1 Pfm mssv d (sstm SIV-ER) G stmt d ms d fm mssv d s q sggt d L gd d OIV (D 3/2016) vg fmt ttvs st P d Pfm 21

26 D 2016/ d 30/06/2016 Pg 26 d 45 t R d Pfm. T v è mt t Ad qt st d fftt vt t tt d m t Ad h Rg: tt sstm d dt d stt (SIV-ER) è, ftt, m ttt Ad mmg, mtt mtt fss s t sttv g. It, mtdg dttt qst v gv fdmt d t fm d g ttv d mdt d D G: g dt d fm dvdt s, ftt, k gf d D g h dvd g ttv d mdt. Qst s h d svt mt ff t d, hé st d d gmm d vs d tvt d v g. 4.2 Pfm gtv dvd t (dgt, sstm d vt t sstm mt) L ms d fm gtv dvd t s gg stmt m sdt, d sttv f-, h s d mt d tt s d, sttg dt P d Pfm tt dg ttv d gmm g. L ttv è q d v vt sstmt d t sgtmt gmm ttvtà. D 2003 sstm d tv d d dttvtà v t m sstm h vd s s d dg h q d mt t sf ts mtt tt qt gmmt sd d g d dgt, m sttg d. I t ss Utà Otv, t d Rsstà (dr), vg vst m éq tgt, f s dgt s d mt, d sgmt dg ttv ssgt dt sd d df d dgt. T sstm è ttt, tt, d sgt g: - dgt è stmt t d gmm, t, tv vt; - sstm d tv è t d, ttt s dgt ttt s d mt; - v ffmt d g,, tà d f/sstà tà d ttv gt/stt ggt, sd g tv; - t gtt è dtt gst dgt, s d gtt sttg; - s ffm s stt f s stt d sqd, ttv g dr, ttvs t d ttt g t. I sstm d dgt L gst dgt st s sm d ttvtà d s stts td tv, d fmt, d gmm sttg d dg d d gmm g. I sstm d dgt, s g s fmt s dstt Rgmt d dgt d, dmt t h h ttv d df sstm d dgt 22

27 D 2016/ d 30/06/2016 Pg 27 d 45 q msm tv d mt d ss d gmm t d sstmt d gst, tt d qt vst d DGR 865/2013. Sd qst dmt (vst mgg 2016), stts mt g d sstm d dgt sgt mt: - dgt d dv qds mt d ssttà m sd t d ssttà t; - dgt dv ss sss dttgt sg v d sstà; ss stts t tgt d B m vtv, ss d L.R. 50/1994; - dgt ssm v d mg t d m gmm, f d tt t dffs ss d g v; - t h fm s: ) Dtt G Dtt d Msttt ) Dtt d Msttt tv Dtt d U.O. mss Sm dtmt; - dgt mssv d s m d: dgt tv dgt tsvs. I dgt tv tv st shd d dgt t d sstà d (Msttt DR) t: ttv d ttvtà; ss ssgt (ftt dttv); ttv d qtà/gv ; ss m. I dgt tsvs s dgt d qs d ftt dttv ss d s fmt. s dgt tsvs st sttsm d dgt m g d. I gst d dgt tsvs è ss d ftt dttv tt s ss d qs gst. Gts tt gmm, qs mtgg d dvs ftt dttv. Ot ftt dttv dgt tsvs s st ttv sf dvt d d gmm d Ad. I dgt tsvs f fmt dtmt d d st (Dtmt Fmt, Dtmt T, Dtmt Ammsttv, t.) Psd U. F t d dgt tsvs P A d Ass P dg Ivstmt. I s d dgt st d dvs fs: Rd d L gd, h mt D Sttg d, q, s vt, s fà gd g, g ttv d mdt, dmt d gmm st stv d dt. L g: fs d g d vv sg d st d dgt d t d D Sttg Msttt. A s d st s gd vt d è tt Msttt tv DR; stss è mgt d dt stv d dt q d dgt. A tt d t sg vg h stt sd stt d tst d t d Dtt d Msttt. L tst s ftt sgt d s d shd h vgd g t t d Msttt tv DR. Pm d g D Sttg s gt t t sf UU.OO. d st dgt. 23

28 D 2016/ d 30/06/2016 Pg 28 d 45 s g fm d shd d dgt dftv: g s hd ts stts d shd d dgt t Dtt G Dtt d Msttt t Dtt d Msttt d Rss d dr. I dgt sì dft v ssgt ss d Msttt s ds fm dgtt s st tt. E mt d Dtt d Msttt sss h dgt dt s tt s t d sttt gtv. I s d dgt s svg sd tmst dft mt d Ad tmst d gmm g d stt gd d. Dt è mq hst Rss d Msttt d DR ttt ttvtà d vf d dmt mssv d gst d dgt d s qt dft sd d g. L vf s tt mdt mtgg d dgt tv d dgt tsvs. I sstm d tg d st d mtgg d dgt tv d dgt tsvs è s ds gmt d tmst d tà tv d st (t d Gst, Qtà Fm, Rss Um). I ss d Msttt d DR s tt gt m stt d s d dmt d gst h ttvs t t. I ss t d dgt vd h fs d vs d dgt: s vst t sf t D Sttg d Rss d Msttt st ss mt d mdfh dmtt g ttv gt. If, s v dt d f sgt vt d stt. L dt d f ssm dmt dg ttv d dgt, è dstt D Sttg Rss d Msttt d è ft h d vd t d stt sì m dft g d tgtv d. L vt d stt sgt stts mmt d sts vg sdt ttt g mt ggttv h h ft s gggmt dg ttv. I t fs v dtmt t d gggmt dg ttv stt s ssgt. I qd d sts d stt v sttst tt d D Sttg f d vt dmt mssv d Bdgt t fm dffs. I stt d vt d Msttt d tv UU.OO. s smt Dtt d Msttt tsst d U.O. t d Gst. Pss ss t mdfh vt s s d mt ggttv sdt d. I stt d ss d vt v fmt d d Dtt G. Sssvmt vt è tsmss d U.O. t d Gst Dtt d Msttt gtmt ttt tst dtt dttg d vd d stt f. Sstm d vt dvd sstm mt P s d Dg (Md vt SPTA) è vst fm d vt dvd d dgt; fdmt d sstm d vt s st d NL vgt d gd g: - t d vtt; - s d ttvtà d t d vtt d m st; 24

29 D 2016/ d 30/06/2016 Pg 29 d 45 - dst d sggtt h vt m sd st; - ts d t; - vt f h t md tst sstm mt; - tvt d vtt d vtt d m st tddtt d sd st. I t d vt, g tm d shd d vt fs d ss s stt dft mdt st t sggtt sd. A tm d ss d vt, stt dtt d g dgt s t d t dvd, ft d qt d fd d stt. L df dg ttv dvd vt vvg tddtt ttvs q d df dg ttv d vt. I q h t ss d vt. A vtt, qd, è hst d: - s fd t mtmt fss,, gtv d t; - dff vt sd d tm, d tt d s; - t smt vt stv; - s ff ffmt fdk stttv sd t ts mtv d mmt vttv; - dtf d mgmt sv dvd mt mmt. Phé ò s ss vtt dv ss stt d st dmt d D d U.O. Rss Um (t) d U.O. Qtà Fm t d Gst qt d mt. L fm ss vg ft m d t ds s st tt d ggt msmt. D ft vt ts, vt d sd st (h è g s gt) h dtt d tv mdf, v tg, vt d m st. L ttv m d ss vttv è q d mg mssvmt stt gtv qtà d sv dtt, tt d ss d s vs sddsfmt d sg d ttd d t st t. I d sstm d vt tgt d Ad Us d P s: - ts d ss d t st d vt ffttt; - ggttvtà d mtdg dg stmt tt; - st d mtv h s s d vt ffttt; - fm t vt dgt - t d vtt ttvs tvt; - dtt s d ttvtà d vtt d t d vtt; - vt f fmt ms, sm tst; - dtà ttà d s ss tttv. L mt d sstm d vt tgt d s d Ad USL d P s: L gd vt d d s, dmt h dsv md sm tst s, ss, mtdg, stmt, tm, tt, sg d ttt v tg d vt d md qd g; 25

30 D 2016/ d 30/06/2016 Pg 30 d 45 L shd d vt: sst md stdd d s sts d vt ffttt h, vt mt, v sttstt s d vtt, s d vtt s mmt; I dss dvd, fs tstt g ddt svt ( fmt g v d dgt) ss U.O. Rss Um, h md ttt st fss d ddt. P tv d stt/dttvtà ttv vt d stt d dgt è svt d mmss mst d Dtt d U.O. t d Gst, d Dtt d U.O. Qtà Fm d Dtt d U.O. Rss Um ss d dgt tsvs; gd sss d mmss è ftt d Dtt G mdt tt dtv. P vt d st dvd d Dg s vst dvs gsm d vt: - I Dtt/Rss d U.O. d t, dgt ss d dr - I Dtt d dtmt dtt d U.O.; - I DSA/DAA Dtt d Dtmt; - I g T vt d sd st. I ss d vt vst s qtt: 1. Vt d stt ggt (fm d tm) 2. Vt d mt ssdt (vt dvd) 3. Vt d ttvtà gst / dg h fss / d s gtv ( tm d m qq d sv; d 15 f ) 4. Vt d v smt tmt st s t d mt, t st. I Sstm d d vt tg qd d gd s vg s d vt: d s s è ftt d m s è ftt. L vt d stt f fmt m g ggtt d ss vt tg tg: - ttv ggt, st sgt (vt d tm) - dmt, fm d U.O. (vt d tm) L vt d mt f v fmt sd g ggtt d ss vt tg tg: - dmt, fm (vt dvd) - mg fs, tt ft (vt dvd) - mtmt gtv (vt dvd) - tttd fss (vt dvd) - mt t-fss, mg,. (vt dvd) L vt d ttvtà gst, fss, gtv q v smt f fmt ttt d dt. N s vt s dvs d vtt, qst dvà dh s dsd m sd st, svd s d shd svt vtt. I dgt vtt dvà sf mtv td 26

31 D 2016/ d 30/06/2016 Pg 31 d 45 vvs d gd d sd st: dd shd, mq dd m g t t d (q) g vtv d dt d tddtt. 5 gmt ts tgtà I gmt è gtt mdt tt d qt vst t d st P h ttvs sgt : - ttvtà fmtv; - ggmt stt d s Ammst Tst d st d, sd t d qtà, tmstvtà sgftvtà d fm; - g d tv tt gt ts d d ft d dvs tg d stkhds. 6 Idt d st P g A d fm, t d s Dms, s stt dvdt dg dt d stt, h ms md dttgt g ttv g d g A. L Agt 1 T dt , t 80 dt v 2015, sm vs d fm 2016,

32 D 2016/ d 30/06/2016 Pg 32 d 45 Agt 1 T dt A d Ass d Dmd Idt Tss std d sd (d d) sdt - GRIGLIA LEA Tm d tts x t m ss:. vst sttt sd d t t 30 gg Tm d tts x t m ss:. sm dgst sttt sd d t t 60 gg % d ssstt tm mssm d tts f sg v Hs <= 3 g Tm d tts md t t m vst sst sv d St Mt Adt Itv Am - Tgt d m d ss - GRIGLIA LEA % d t gstt PS d g vstt t 30 mt % d t gstt PS d vd vstt t 1 V Ad V Ad (d dt) V Rg ,03 155,81 141,08 d d d 94,72 93,14 97,17 st st st 96,92 94,78 97,77 mtmt mtmt mtmt 88,47 86,85 68,93 mtmt mtmt mtmt 5,24 4,93 12,13 mtmt mtmt mtmt ,52 78,56 68,82 mtmt mtmt mtmt 64,55 65,79 64,54 mtmt mtmt mtmt Tss d ss PS 353,74 347,62 380,84 mtgg mtgg mtgg 28

33 D 2016/ d 30/06/2016 Pg 33 d 45 A d Itg Idt Tss std sd tà dt (< 18 ) sm gsttt tt - GRIGLIA LEA Tss std d sd m d dt ( v g tm), BPO sms d x sdt, >= 18 - GRIGLIA LEA % d >= 65 tttt ADI - GRIGLIA LEA Tss std d sd TSO x sdt mgg Assstt d t d Ptv dm / Hs, ddt % d v Hs d d v >= 30 g Tss d t d'ssst dm >= 75 V Ad V Ad (d dt) V Rg ,25 195,29 188,83 d d d 445,32 418,59 418,24 d d d 4,13 4,46 4,31 mtmt mtmt mtmt 28,78 28,77 26,05 d d d 57,17 55,33 63,55 st st st 17,29 21,13 17,41 mtmt mtmt mtmt 146,13 147,44 198,13 st st st 29

34 D 2016/ d 30/06/2016 Pg 34 d 45 A dg st Idt % d sttm sh dg st-t f 3 g Mttà 30 g d tvt d yss t Mttà 30 g d tvt d vvst sstt d vv V Ad V Ad (d dt) V Rg ,88 68,64 77,62 st st st - - 1, ,26 Mttà 30 g IMA 12,24 9,13 9,2 d d d % d gsth h t t 2 g d'ss t IMA Mttà 30 g sms d gst Mttà 30 g sm tt d't ddm 46,12 44,8 42,67 mtmt mtmt mtmt 10,91 8,46 12,13 mtmt mtmt mtmt 1,64 3,13 1,65 mtmt mtmt mtmt Mttà 30 g ts shm 8,74 6,77 11,6 mtmt mtmt mtmt Mttà 30 g BPO tt % d tvt t 120 g d tvt svtv tm mg d mmm 9,88 10,91 9,48 mtmt mtmt mtmt 5,03 5,04 6,42 mtmt mtmt mtmt 30

35 D 2016/ d 30/06/2016 Pg 35 d 45 Mttà 30 g d'tvt hg tm mg d m Mttà 30 g d'tvt hg tm mg d stm Mttà 30 g d'tvt hg tm mg d % d m dt t t t % d m dt t t s % tvt hg ftt d d fm ffttt t 2 g d'mmss P d t tg s m % tvt sttm s ffttt t vm d ttvtà s 90 s % tvt tm mg d mmm ffttt t vm d ttvtà s 135 s Tm d tts tvt hg ftt t/ 1,22 1,22 1,04 mtmt mtmt mtmt 1,9 3 4,35 mtmt mtmt mtmt 5,24 5,39 3,76 d d d 0,64 0,68 0,83 mtmt mtmt mtmt 0,89 0,76 0,97 mtmt mtmt mtmt 64,25 62,05 70,38 st st st 20,72 19,82 18,65 d d d 79,67 54,74 77,21 mtmt mtmt mtmt 98,88 98,87 79,08 mtmt mtmt mtmt mtmt mtmt mtmt 31

36 D 2016/ d 30/06/2016 Pg 36 d 45 A d Pd Osd Idt % d v md t sg t d tà >= 65 Id d Pfm d Dg Md (IPDM) v t hg Id d Pfm d Dg Md (IPDM) v t md V Ad V Ad (d dt) V Rg ,78 1,77 3,18 mtmt mtmt mtmt 0,38 0,37-0,47 d d d -1,51-1,88-0,72 mtmt mtmt mtmt Dg md -t 0,71 0,7 0,8 mtmt mtmt mtmt Vm d ss PS mtgg mtgg mtgg Vm d v gm d DRG md Vm d v gm d DRG hg mtgg mtgg mtgg mtgg mtgg mtgg Vm d v DH DRG md mtgg mtgg mtgg Vm d v DH DRG hg mtgg mtgg mtgg 32

37 D 2016/ d 30/06/2016 Pg 37 d 45 A d Pd Tt Idt Nm ssstt ss Dtmt d St Mt (DSM) x sdt - GRIGLIA LEA Tss std d v x 100 sdt sv Nsht Ift Vm d st d sst mt: dgst Vm d st d sst mt: vst Vm d st d sst mt: t V Ad V Ad (d dt) V Rg ,35 22,33 20,18 mtmt mtmt mtmt 7,32 6,92 7,06 mtmt mtmt mtmt mtgg mtgg mtgg mtgg mtgg mtgg mtgg mtgg mtgg 33

38 D 2016/ d 30/06/2016 Pg 38 d 45 A d Pd - Pv Idt % d fmt sgt d md t t st d smtt d fm % d s tvstt sgt d md t t st d f ttvt fs % d d h h tt sg mmmgf stt d vtt % d s h h tt sg tt stt s vtt t v tf g - GRIGLIA LEA t v svt 24 ms m - GRIGLIA LEA % d ddt st - GRIGLIA LEA Svg d mtt fttv dg vmt V Ad V Ad (d dt) V Rg ,5 52,4 48,6 st st st 30,4 32,9 33,8 st st st 72,96 76,71 75,3 st st st 47,34 51,03 50,29 st st st 54,35 51,51 51,86 st st st 95,15 94,75 92,91 mtmt mtmt mtmt 10,15 10,26 10,07 mtmt mtmt mtmt 98,33-98,73 mtmt mtmt mtmt 34

39 D 2016/ d 30/06/2016 Pg 39 d 45 A d t, qtà, s sh Idt % d v Dy-Sgy DRG LEA hg Nm st ssth mt d Rs Mgt (RM) x 100 sdt - GRIGLIA LEA Tss d v d d t dgst sdt - GRIGLIA LEA Tss std d ss d t md sdt - GRIGLIA LEA Rt t v ttt DRG d t sh d t (g. B Ptt St ) v ttt DRG sh d t gm d - GRIGLIA LEA Tss d sd v d md v x sdt Id d ss x t sttst tvt hg, dg >= 4 g s d tms vs fd m m x dmss DRG hg % d sttm sh Dy- Sgy v d 0-1 g V Ad V Ad (d dt) V Rg ,2 49,2 49,84 st st st 4,71 4,1 6,6 mtmt mtmt mtmt 5,91 6,41 2,97 d d d 135,09 137,96 122,71 d d d 0,22 0,23 0,22 mtmt mtmt mtmt 10,09 9,91 10,03 mtmt mtmt mtmt 0 3,44 4,1 mtmt mtmt mtmt 2,08 1,99 2,54 mtmt mtmt mtmt 46,96 31,92 35,8 mtmt mtmt mtmt 35

40 D 2016/ d 30/06/2016 Pg 40 d 45 A d g Idt Tmstvtà v d dt stt d d mt V Ad V Ad (d dt) V Rg ,5 st st st A d t - ts Idt % stt d ssvmt dg gh d ts % d ss gstt s ttt dvt d tv d Itt-ER % d ss gstt s ttt dvt d tv d A Vst V Ad V Ad (d dt) V Rg ,31 85,64 96,91 st st st 39,27 31,3 44,41 st st st 23,43 25,24 30,49 st st st 36

41 D 2016/ d 30/06/2016 Pg 41 d 45 A d ddtt Idt N gtt d ft d t qtà d dt N gtt d ft d t qtà d tà tt V Ad V Ad (d dt) V Rg mtmt mtmt mtmt mtmt mtmt mtmt A d sv gtv Idt V Ad V Ad (d dt) V Rg % d ds 'dg d m t 25,54-26,52 st st st 37

42 D 2016/ d 30/06/2016 Pg 42 d 45 A m-f Idt Ss fmt sd t DRG V Ad V Ad (d dt) V Rg ,13 184,89 228,89 mtmt mtmt mtmt st t tt 1.780, , ,12 mtmt mtmt mtmt st t ssst sd 717,46 712,74 710,4 d d d st t ssst dsttt 1.012,47 996, ,59 st st st st t ssst st ttv mt d vt d v Tss d t fss DM s t m tt gst mg 52,1 50,19 54,13 mtmt mtmt mtmt 99,16 96,92 94,57 mtmt mtmt mtmt Ss fmt tt -t 152,66 154,23 157,54 d d d Idt d tmstvtà d gmt % d sm d m t d vtt st st d ts mtmt mtmt mtmt 77,84 76,01 79,84 st st st 38

43 D 2016/ d 30/06/2016 Pg 43 d 45 A dg vstmt Idt V Ad V Ad (d dt) V Rg % d d d vstmt d 52,05 61,95 st st st 39

44 D 2016/ d 30/06/2016 Pg 44 d 45 DELIBERAZIONE DEL DIRETTORE GENERALE N 154 DEL 30/06/2016 PROEDIMENTO DI ONTROLLO Tsmss g Sd t t / d 07/07/2016. Tsmss f d Sd t t.. - d -. Tsmss Rg dt - t t.. -. RELAZIONE DI PUBBLIAZIONE L st d v t A Pt g stv d d 07/07/2016. IL DIRIGENTE RESPONSABILE DELL'U.O. GESTIONE FLUSSI DOUMENTALI ( Dtt. At M )

45 D 2016/ d 30/06/2016 Pg 45 d 45 Dmt fmt dgtmt svt fmt' stt d mtv vgt mt. I st dmt ' tt d dmt g dstt ss g hv d'a.u.s.l. d P. 5F-E1-7F-8E-B-3A-90-B0-BE-AB-FA-A3-7-9E-3E-D1-9E-41-6A-2E AdES 1 d 1 d 07/07/ :23:38 Sggtt: ALBERTO MERLI MRLLRT59B17G535W Vdtà tft d 05/11/ :18:21 05/11/ :18:21 Rst d Ats Qfd tfts A G1, Ats S..A./ , IT