Project summary: 

The project involves the establishment of joint cross-border medical teams in the field of mental health, autism and normal pregnancy, as well as the creation, on an experimental basis, of a Single Centre for cross-border reservations. In the perspective of integration with the social-assistance sphere, the project dedicates a pilot action to cross-border services and interventions for the inclusion of vulnerable groups in the population.

1. CUP: in terms of cross-border CUP, the project has made possible the achievement of a new level of cross-border cooperation, which serves as a first basis for future upgrades to the system. Thanks to the pilot project, a system has been established in which patients can book themselves to services across the border using the same procedure by which they book themselves to services in their own country, including through the online electronic booking platform in the case of Slovenian patients. Due to the Covid-19 outbreak and the reduced range of services, cross-border CUP adherence was low. Therefore, an analysis of the cross-border reservation system was conducted in the last phase of the project, which outlined the main problems and offered solutions for possible future projects. In this way, the project prepared an IT base and administrative analysis that can be used in the possible future development of cross-border CUP;

2. Mental health: in the field of Mental Health, professionals from the cross-border working group have designed health budgets that provide comprehensive care for users, from job placement to residential housing. The exchange of best practices and collaboration of institutions on both sides of the border is invaluable in the treatment of patients with mental health problems and also provides a solid foundation from which new collaborations and acquisitions can grow in the future. In the Skupnostni center building, space dedicated to the mental health day center has been renovated.; 

3. Autism: regarding autism activities, employees of ASUGI Goriziano and the Department for Disabled Youth and Rehabilitation in Stara Gora acquired new knowledge and certificates for the use of the ESDM and CCA method from world-renowned lecturers. Through joint work, they shared best practices and applied the new knowledge taking advantage of the new clinic space for child neuropsychiatry at Basaglia Park;

4. Normal pregnancy: for women in the cross-border area, the maternity ward in Šempeter pri Gorici has been renovated, which we have further improved by purchasing new equipment for physiological childbirth, while at Basaglia Park the construction of a new Women's Health Center is in motion. Midwives and gynecologists from the three EGTC GO municipalities visited the best European centers for physiological childbirth, where they gained new knowledge and created new services for women in physiological pregnancy and the postpartum period.;

5. Social inclusion: In the three municipalities, the project has made possible the establishment of three info points that offer citizens information on social welfare programs taking place on both sides of the border. In the municipality of Nova Gorica the info point is located within the Skupnostni center, in Gorica it is located in Baiamonti Street, and in the municipality of Šempeter-Vrtojba it takes place in the daily center for the elderly.

CROSSBORDER BOOKING SYSTEM

The activity aimed to overcome administrative and operational obstacles, in order to give to the citizens of the EGTS area the possibility to book and use cross-border health services from both parts of the border, regardless of the state of origin, thus putting into practice the principle of the free movement of patients from the EU Directive 2011/24. The healthcare offerings of the two territories, the booking systems and the supplying system of Italian and Slovenian healthcare services were analyzed, in order to find administrative and legal solutions that would allow the creation of a network of cross-border healthcare services. All activities are carried out in close collaboration with the Slovenian Ministry of Health and with the Central Health Administration, Social Policies and Disabilities Department of the Friuli Venezia Giulia Region, and with the entities that deal with the technical, administrative and financial aspects of booking and providing health services: Insiel, the Slovenian National Institute for Public Health NIJZ (Nacionalni inštitut za javno zdravje Republike Slovenije) and the Slovenian Institute for Health Insurance ZZZS (Zavod za zdravstveno zavarovanje Republike Slovenije). 

The list of health services provided in the territory of the EGTC GO has been approved and the number of places reserved for the pilot action has been identified on a weekly basis. 

An agreement was reached on how to implement the cross-border booking system. 

On the basis of the indications provided by the analysis and taking into account the technical characteristics of the two Italian and Slovenian IT systems,the cross-border procurement system was designed as an intermediate environment for EGTC GO, which connects the existing platforms (CUP FVG and eNaročanje) and thus allows residents in the territory of EGTC GO to access health services on both sides of the border. The system has been opened to the public in April 2021.

MENTAL HEALTH

Thanks to the project, a joint Italian-Slovenian team was created with the task of drawing up common guidelines for taking care of patients between 18 and 35 years of age with mental health problems. The guidelines describe the actions that need to be carried out in the event of an acute situation and provide for the socio-professional reintegration of young people with mental health disorders. 

The first project activity consists of an analysis of the differences and synergies of the methods of treatment of people with mental health problems in Italy and Slovenia. The aim was to understand if and how it is possible to activate a joint service for the treatment of Italian and Slovenian patients. The cross-border team developed a joint model capable of increasing the quality and accessibility of cross-border services. 

The model requires that the multidisciplinary team carries out the following activities: 

• Information and prevention activities. Promotion of informative meetings with other local figures (health district, schools, general medicine doctors, social services). Carried out on 11/12/2018. 

• Community intervention in the crisis. The joint team has defined a crisis management protocol which made it possible the use of the geographically closer reception structures (Mental Health Centers), as an alternative to normal hospitalization practices active in Slovenia; 

• Socio-professional reintegration. According to the guidelines developed by the mixed team, personalized rehabilitation projects was activated, aiming at the re-acquisition of social skills/job capacity by the patients. This was achieved thanks to a personalized rehabilitation health budget, tool that is widespread in Italy, but which was an absolute novelty for Slovenia. In February 2019, Slovenian members of the cross-border team participated in a training session on use of the health budget. 

In September and October, the training course for the joint medical team on community mental health practices, deinstitutionalization courses and individual rehabilitation courses took place. During the project, both the Slovenian and Italian sides identified users who meet the criteria and included them in individual activities that have been going on since the beginning of 2020. A total of 18 young users with mental health problems have been involved so far, as part of work inclusion activities.

As part of mental health, the infrastructural arrangement of premises intended for the work of a joint cross-border group is also envisaged. The premises are now part of the mental health center on the ground floor of the Community Center in Nova Gorica. The works were completed in 2021. The arrangement of the premises was carried out by a joint public procurement of EGTC GO and the Municipality of Nova Gorica.

AUTISM

The project aimed to introduce the early diagnosis (as early as 18 months of age) of the autism spectrum disorder. International studies confirmed that early treatment can significantly improve communication, relational, cognitive and adaptive skills. One of the most important objectives was to raise awareness of the importance of early diagnosis of primary care pediatricians as well as families and other operators who, for various reasons, use being in contact with children. 

A working group of experts was set up to draft a joint medical. The protocol plans the use, already in very young children, of the M-CHAT, one of the most internationally advanced tools for the diagnosis of the autism spectrum disorders. For the treatment it recommends the use of the ESDM method, which is currently the most effective in babies from 18 months onwards. For this end, the joint cross-border medical team took part in the ESDM course, taught by one of the most accredited American experts in this field at an international level. At the end of the course, experts has obtained a license to treat children with autistic spectrum disorder through this method. 

At the Basaglia Park in Gorizia, spaces have been redecorated for the joint medical team to use during the treatment of children with autism spectrum disorders from both the two states, through the ESDM method. Didactic material was purchased for the application of the ESDM method. The works were completed in July 2019. The new spaces were inaugurated on 21.11.2019 

PHYSOLOGICAL PREGNANCY

Thanks to the project, pregnant women in the territory of the three municipalities are able to benefit from pre and postpartum services, provided by a cross-border group of obstetricians and gynecologists who take into account the best European practices. These services were not present in Slovenian or Italian territory, as they represent an innovative method in today's obstetric practice. 

The first project activity analysed differences and synergies of the treatment methods for pregnant women in Italy and Slovenia. A transnational working group was established, who has developed a joint treatment model for normal pregnancy, which provides for the innovative services that will be provided by the joint cross-border medical. 

At the end of 2018, the cross-border agreement was signed for the adoption of the model, which is based on the excellences of the two territories, but above all takes into account the models adopted in the three most advanced European centers in the treatment of physiological pregnancy in Holland, Denmark, England , which the working group had the opportunity to visit between May and June 2018. 

In April 2019, the working group identified the activities that are jointly provided. Information materials have been prepared to inform women about the cross-border services offered. Services include: Gymnastics for pregnant women, Aquatic courses in pregnancy, Aquatic courses for newborns and Meetings for Support groups. 

On 12.12.2019 the agreement was signed between Splošna bolnišnica "Dr. Franca Derganca" Nova Gorica and the Healthcare Agency n. 2 "Bassa Friulana-Isontina" for carrying out the swimming pool activities foreseen in the action of physiological pregnancy. 

In December 2019 the first scheduled activity started - Meetings with pregnant women. 

The project planed the construction of new infrastructures where the activities of the cross-border multidisciplinary mixed team are carried out. At the Basaglia Park spaces will be renovated to house the "Birth Path" center for pre-birth activities. At the Šempeter Hospital, several rooms have been identified within the maternity ward that was renovated into physiological rooms to offer relaxing and tranquil environment for new mothers and their newborns. A conceptual design and the final project was prepared. On 27.5.2021 a call for infrastructural works based on the final project was published. 

SOCIAL INCLUSION 

The action, which takes place in collaboration with the three founding municipalities of the EGTC GO, aimed to create a network of cross-border social services for the population of the EGTC GO area, in particular for the weaker groups. The result of the action is a cross-border protocol, which provide for the joint supply of social services, involving all the managing bodies of social services and private associations. Three information points were created where citizens are able to obtain information on the possibility of providing social services and on the type of cross-border services.  

A permanent cross-border working group has been set up consisting of staff from the three municipalities, which deal with the construction of a network of social services that require joint assistance.  

Training and in-depth moments dedicated to the social services operators of the three cities were organized. The first training session was organized on May 13, 2019 in Nova Gorica followed by various thematic tables in June and September on the themes of "Seniors and disabilities", "Social unease and poverty" and "Minors and families". 

Three information points were created in the three municipalities, where citizens are able able to receive information on existing services throughout the area and how they can use them. By creating a cross-border social network, Italian and Slovenian citizens are able to use the services provided by all three municipalities. In Nova Gorica, the information point is hosted at the Skupnostni center, which has been affected by important infrastructural works thanks to additional funds from the Municipality of Nova Gorica, which carried out important interventions to adapt the building. The call was published in December 2019. 

In Gorizia the infopoint was created on the ground floor of the Multipurpose Center of Gorizia. The works ended in October 2019 and the spaces were inaugurated on 18.12.2019. 

In the Municipality of Nova Gorica, the information point was located in the Community Center, where infrastructural works were carried out with the help of additional funds from the Municipality of Nova Gorica, which intends to thoroughly renovate the building. The works were completed in June 2021.

In the Municipality of Šempeter-Vrtojba the Info point is located in the Center za dnevne aktivnosti starejših, and it was activated on June 3 of 2021. 

Main results: 

The results that were achieved are:

- greater skills and qualification of cross-border teams in the health and social field;

- analysis of the state of the art, methodologies and clinical, administrative and legal aspects in the health system in Slovenia and Italy and in the social-welfare sector;

- comparative analysis of the two health and social care systems (Slovenian and Italian);

- establishment of cross-border interdisciplinary teams and working groups;

- administrative and technical solutions to create cross-border health services;

- cross-border booking system ( CUP) for health and social services;

- infrastructures dedicated to cross-border services

Programma Interreg V-A Italia-Slovenija