ENVIRONMENTAL AND SOCIAL SYSTEM ASSESSMENT Parana Public Sector Modernization and Innovation for Service Delivery Operation - “Paraná Eficiente” (P168634) March 7, 2022 Page | 1 Table of Contents Sumário Executivo .............................................................................................................................................. 4 Executive Summary.......................................................................................................................................... 11 Section I. Introduction and Methodology ..................................................................................................... 18 Methodology for Assessing the Borrower’s Environmental and S ocial System ................................ 19 Section II. Program Description ...................................................................................................................... 22 II.1 Geographic Scope ............................................................................................................................. 22 II.2 Thematic Scope ................................................................................................................................. 24 II.3 Institutional Arrangement: Implementing Agencies ...................................................................... 27 II.4 Institutional Arrangement: Implementing Partners ........................................................................ 30 II.5 Previous Experience of the Implementing Agencies with the Program or Similar Activities ..... 31 Section III. Description of Expected Program Environmental and Social Effects ...................................... 32 III.1 Likely Environmental and Social Effects ......................................................................................... 32 III.2 Contextual risk factors ...................................................................................................................... 33 III.3 Institutional capacity and complexity risks ..................................................................................... 34 III.4 Reputational and political risks ........................................................................................................ 34 Section IV. Assessment of Borrower’s Environmental and Social Management Systems relevant to the Program ............................................................................................................................................................ 36 IV.1 Main Elements of the Borrower System in light of Core Principle #1 ......................................... 36 IV.2 Main Elements of the Borrower System in light of Core Principle #2 ......................................... 42 IV.3 Main Elements of the Borrower System in light of Core Principle #3 ......................................... 46 IV.4 Main Elements of the Borrower System in light of Core Principle #4 ......................................... 57 IV.5 Main Elements of the Borrower System in light of Core Principle #5 ......................................... 59 IV.6 Main Elements of the Borrower System in light of Core Principle #6 ......................................... 67 Section V. Stakeholder Consultations ............................................................................................................ 70 Section VI. Overall Findings, Recommendations and Actions: ................................................................... 74 VI.1 Overall Findings ............................................................................................................................... 74 VI.1.1 On the Adequacy of the Environmental Management Systems ............................................... 74 VI.1.2 On the Adequacy of the Social Management Systems .............................................................. 77 VI.2 Program Action Plan ........................................................................................................................ 79 VI.3 Action Plan Summary Matrix ........................................................................................................... 82 VI.4 Implementation Support Plan ......................................................................................................... 85 Section VII. Supporting Annexes and Reference Documents. .................................................................... 86 ANNEX 1 – Detailed Description of the Implementation Partners ......................................................... 86 ANNEX 2 – Most Relevant Pieces of the Legal and Regulatory Framework .......................................... 89 Page | 2 ANNEX 3 -List and Brief Description of Environmental and Social Studies Required during the Licensing Process in the State of Paraná ................................................................................................. 109 Page | 3 Sumário Executivo Este relatório resume a Avaliação dos Sistemas Ambiental e Social que são relevantes para o Componente Programa por Resultados (PforR) do Projeto Paraná Eficiente (Modernização do Setor Público e Inovação na Provisão de Serviços) – P168634. A avaliação teve por base fontes secundárias oficiais e consultas a partes interessadas. Este projeto é uma operação híbrida (no valor total de 130 milhões de dólares) abrangendo um componente PforR (120.5 milhões de dólares) e um Componente de Financiamento de Projetos de Investimento/IPF (9.5 milhões de dólares) proposto pelo Estado do Paraná para apoiar atividades incluídas em cinco programas de governo definidos no Plano Plurianual do Paraná (PPA 2020-2023). O Projeto Paraná Eficiente é uma operação subnacional com o Governo do Estado do Paraná. Localizado na Região Sul do Brasil, o Paraná está organizado em 22 regiões administrativas e 399 municípios, dos quais 77 por cento têm uma população inferior a 20.000 habitantes. Com uma superfície de cerca de 200.000 km2 (2.35% do território brasileiro), o Paraná cobre dez regiões fitogeográficas que apresentam peculiaridades climáticas e geomorfológicas. A população estadual atinge aproximadamente 11,5 milhões de habitantes (5% da população brasileira) e se caracteriza pela diversidade étnica. A taxa de urbanização corresponde a 86,4% e os indicadores socioeconômicos do estado estão acima das médias nacionais. O Paraná é uma das unidades da federação com renda e capacidade mais elevados no país, mas há significantes bolsões de pobreza e grande desigualdade no acesso a serviços públicos essenciais, particularmente nas áreas rurais. A desigualdade econômica é igualmente elevada. Em 2018, o centésimo mais rico da população detinha 10.2% da massa total de renda, enquanto o quinto mais pobre detinha apenas 4.2% da riqueza. No mesmo ano, 13,7% da população estadual viva abaixo da linha da pobreza (renda domiciliar per capita abaixo de 5,50 dólares por dia) e 27% abaixo da linha da extrema pobreza (renda domiciliar per capita abaixo de 1,90 dólares por dia).1 O Projeto Paraná Eficiente é uma operação multissetorial e o componente de PforR apoiará atividades em três áreas de resultado. A primeira Área de Resultados refere-se à Prestação de Serviços de Saúde e apoiará duas atividades: (a) Resposta à COVID-19 por meio da ampliação do número de leitos hospitalares para atender ao aumento da demanda por tratamento da COVID-19 e (b) a reorganização dos serviços de saúde por meio da conversão de pequenos 1 As características ambientais, sociais e político-administrativas aqui apresentadas foram extraídas de diversas fontes, incluindo: IPARDES, Os Vários Paranás: As espacialidades socioeconômico-institucionais no período 2003- 2015 / Instituto Paranaense de Desenvolvimento Econômico e Social. – Curitiba: IPARDES, 2017 (available at http://www.ipardes.pr.gov.br/sites/ipardes/arquivos_restritos/files/documento/2019- 09/varios_paranas_relatorio_2017.pdf ); IPARDES, Anuário Estatístico do Estado do Paraná 2019 (available at http://www.ipardes.gov.br/anuario_2019/index.html); IPARDES, 2017: Indicadores de Desenvolvimento Sustentável por bacias hidrográficas do Estado do Paraná (available at http://www.ipardes.gov.br/IDS/index.php/IDS2017/index ); ITCG, ZONEAMENTO ecológico - econômico do Estado do Paraná – Curitiba: ITCG, 2018 (available at http://www.iat.pr.gov.br/Pagina/Zoneamento-Ecologico- Economico-ZEE ); and IBGE, Síntese de Indicadores Sociais: Uma Análise das Condições de Vida da População Brasileira 2020 – Rio de Janeiro: IBGE, 2020 (available at https://biblioteca.ibge.gov.br/visualizacao/livros/liv101760.pdf). Page | 4 hospitais em Unidades de Cuidado Multiprofissional (UCMs). A segunda área de resultados refere-se à Gestão Ambiental e de Risco de Desastres, por meio do aprimoramento (a) de sistemas de informação geoespaciais para monitoramento ambiental multiuso e gestão de risco de desastre (inclusive na saúde) e (b) da precisão dos sistemas de alerta precoce para gestão de risco de desastre. A terceira área de resultados trata da Gestão do Setor Público e apoiará o fortalecimento dos sistemas e capacidades do setor público para aumentar a eficiência e eficácia da prestação de serviços pelo setor da saúde (e recuperação pós-COVID). O Projeto Paraná Eficiente será implementado conjuntamente por quatro secretarias de estado e uma autarquia, com o apoio de entidades parceiras: a SEPL, SEAP, SESA, Casa Civil e o IAT. As três primeiras secretarias possuem ampla experiência com a implementação de outros projetos anteriormente apoiados pelo Banco Mundial e com seus princípios e políticas operacionais. Em virtude de suas atribuições legais, adicionalmente às agências executoras a Coordenação da Defesa Civil, a Controladoria Geral do Estado (CGE) e sua Coordenação de Ouvidoria e a Superintendência Geral de Diálogo e Interação Social (SUDIS) também terão papel importante de apoio à implementação do projeto e na gestão dos riscos ambientais e sociais de suas atividades Os riscos ambientais e sociais das atividades incluídas no componente PforR do Projeto Paraná Eficiente foram classificados como de grau moderado. Os riscos e impactos ambientais e sociais negativos dessas atividades são identificados como previsíveis, temporários e reversíveis. São também de baixa magnitude e localizados, sem previsão de que se estendam além dos sítios específicos das obras a serem realizadas. A probabilidade de efeitos adversos severos ou significativos para o ambiente e a saúde humana é baixa e medidas rotineiras de precaução e mitigação são consideradas suficientes para a prevenção de acidentes. Considera-se que os riscos e impactos ambientais e sociais associáveis às atividades apoiadas podem ser facilmente mitigados de uma maneira previsível. Essas atividades não envolverão grande obras civil que possam levar a impactos adversos significativos sobre os habitats naturais ou o patrimônio cultural; elas não requerem aquisição de terra em uma escala que possa levar a impactos significativos relacionados com o reassentamento involuntário ou a restrição de uso da terra; e elas também não devem gerar impactos adversos relacionados à emissão de gases de efeito estufa. O Estado do Paraná conta com um marco regulatório bem estabelecido e boa capacidade institucional para a gestão de riscos e impactos ambientais e sociais em todos os setores abrangidos pelas áreas de resultados apoiadas pelo componente PforR. A legislação e as estruturas de governo desfrutam de estabilidade e estão submetidas a robustos instrumentos de controle judicial e extrajudicial (incluindo os meios de comunicação de massa e a opinião pública). Estão presentes mecanismos para promover a transparência, o controle social e “accountability”. A participação social em esferas de deliberação sobre políticas públi cas é parte integral da governança pública nos setores apoiados. O Paraná desenvolveu – ao longo das décadas – tanto um marco regulatório adequado quanto a capacidade institucional necessária para cumprir com a devida diligência à gestão de potenciais impactos ambientais e sociais associáveis às atividades apoiadas. Portanto, o Projeto Paraná Eficiente será implementado sob um ambiente legal e regulatório onde (i) há significativa segurança em relação à jurisdição das agências implementadoras, (ii) o arcabouço legal e regulatório Page | 5 responde suficientemente à gestão de riscos e impactos ambientais e sociais relacionados a projetos complexos e (iii) o cumprimento desse marco regulatório é adequadamente fiscalizado. As autoridades legais e regulatórias sobre todas as atividades apoiadas estão claramente estabelecidas. A avaliação dos efeitos ambientais e sociais esperados das atividades incluídas em um Programa de Resultados considera seis princípios básicos (e seus elementos-chave de planejamento), definidos pela Orientação do Banco de Financiamento do Programa por Resultados para Avaliação de Sistemas Sociais e Ambientais (em vigor desde setembro 18, 2020). Estes princípios básicos se referem à capacidade do sistema de gestão ambiental e social do Programa de: (i) promover a sustentabilidade ambiental e social no desenho do Programa, evitar, minimizar ou mitigar impactos adversos e promover a tomada de decisão informada em relação aos seus efeitos ambientais e sociais; (ii) evitar, minimizar ou mitigar impactos adversos resultantes do Programa nos habitats naturais e recursos culturais físicos;2 (iii) proteger a segurança do público e dos trabalhadores contra os riscos potenciais associados com (a) a construção e/ou operação de instalações ou outras práticas operacionais no âmbito do Programa, (b) a exposição a produtos químicos tóxicos, resíduos perigosos e outros materiais perigosos, e (c) a reconstrução ou reabilitação de infraestrutura localizada em áreas sujeitas a riscos naturais; (iv) administrar a aquisição de terras e a perda de acesso a recursos naturais de uma forma que se evite ou minimize o deslocamento forçado e ajude-se as pessoas afetadas a melhorarem ou, no mínimo, restaurarem seus meios de subsistência e padrões de vida; (v) dar a devida consideração à adequação cultural e ao acesso equitativo aos benefícios do Programa, dando atenção especial aos direitos e interesses dos Povos Indígenas e às necessidades ou preocupações dos grupos vulneráveis; e (vi) evitar o acirramento de conflitos sociais, especialmente em estados frágeis, áreas pós-conflito ou áreas sujeitas a disputas territoriais. Extraíram-se duas conclusões gerais da Avaliação do Sistema Social e Ambiental do Estado do Paraná: • Em primeiro lugar, a avaliação concluiu que o Programa será desenvolvido em um ambiente legal ou regulatório onde há uma certeza sobre a jurisdição das agências implementadoras, que gozam de estabilidade, forte fiscalização e controle por órgãos judiciais e extrajudiciais (incluindo meios de comunicação e opinião pública). A legislação e a estrutura regulatória abordam adequadamente os potenciais riscos ambientais e sociais e impactos de projetos complexos e a aplicação e cumprimento desse marco regulatório são fortes. A autoridade legal e regulatória de todos os Programas incluídos no Projeto está claramente estabelecida. • Em segundo lugar, a experiência anterior do Governo do Estado e das agências de implementação no desenvolvimento de programas e projetos do mesmo nível de complexidade é relevante e seu histórico em relação a questões ambientais e sociais é bom. Não há preocupações significativas relacionadas à sua capacidade e comprometimento ou seu histórico em relação ao engajamento com as partes 2 Não estão previstas, no Programa, atividades que envolvem a conversão ou degradação significativa de habitats naturais críticos ou patrimônio cultural físico crítico. Ademais, tais tipos de atividades não são elegíveis para financiamento por Programas por Resultado. Page | 6 interessadas. Sua capacidade técnica e institucional, seu histórico e os recursos financeiros e humanos disponibilizados para a gestão do Programa e de seus riscos e impactos ambientais e sociais são adequados. Nenhuma mudança crítica na estrutura legal ou regulatória é necessária antes que a operação possa prosseguir. As principais conclusões da avaliação centram-se em dois aspectos. Em primeiro lugar, destaca a robustez do Sistema de Gestão Ambiental (SGA) do Estado do Paraná. No entanto, a avaliação também considera que o Governo do Paraná reconhece que houve um enfraquecimento das instituições responsáveis pela gestão ambiental e vem fazendo diversos investimentos para reverter a tendência de que os serviços prestados pelos órgãos responsáveis ocorram de forma anacrônica e demorada, com significativa falta de padronização e transparência e fazendo com que a fiscalização e monitoramento ambiental encontre-se em nível abaixo do desejável. Em consequência, a avaliação requer e recomenda que três medidas sejam adotadas para garantir a adequação do processo de gestão de riscos ambientais e sociais aplicáveis às operações do Programa de Resultados. Em primeiro lugar, a operação de Unidades de Cuidados Multiprofessional (UCM) e hospitais requer atenção com a gestão de resíduos sólidos gerados por serviços de saúde, medidas relacionadas à saúde e segurança ocupacional - para proteger os trabalhadores de lesões, doenças ou impactos associados à exposição a perigos encontrados no local de trabalho - e exposição dos pacientes a riscos para sua saúde e segurança. A estrutura regulatória sobre essas questões é robusta. Um requisito para o funcionamento dos serviços de saúde é a existência de um Plano de Gerenciamento de Resíduos Sólidos dos Serviços de Saúde e o Código de Saúde do Paraná exige a adoção de medidas rígidas de segurança e saúde ocupacional para permitir o funcionamento dos serviços de saúde. Os órgãos responsáveis pela aplicação dessas medidas têm forte atuação no estado do Paraná. Para garantir a gestão adequada de tais riscos, é necessário que a Unidade de Gestão do Projeto registre as evidências de conformidade com as medidas ambientais e trabalhistas dos 40 hospitais selecionados que serão convertidos em UCM e dos hospitais com aumento do número de leitos em resposta à Covid-19. Em segundo lugar, a preparação dos Planos de Desenvolvimento Regional Produtivo Integrado pode levar a efeitos futuros no meio ambiente e na sociedade que não são previsíveis. As atividades apoiadas por esses planos terão impactos ambientais e sociais muito positivos - conducentes a um caminho de desenvolvimento verde - na medida em que se baseiam em princípios de sustentabilidade ambiental e social A preparação destes planos tem como premissa os Objetivos de Desenvolvimento Sustentável da Organização das Nações Unidas e, portanto, incorporam critérios relacionados com (i) prevenção, redução e mitigação de riscos e impactos ambientais e sociais, (ii) proteção e conservação da biodiversidade e habitats críticos e naturais, (iii) prevenção da poluição e uso sustentável e eficiente de recursos, (iv) saúde e segurança da comunidade, (v) proteção do patrimônio cultural, (vi) ampla consulta com as partes interessadas (incluindo comunidades tradicionais e povos indígenas, uma vez que estão presentes na área de influência dos Planos ) e (vii) inclusão social. Finalmente, é recomendado o monitoramento dos resultados das atividades de inovação ambiental por meio de indicadores atribuíveis para garantir que o fortalecimento esperado do SGA do estado seja alcançado e que a atividade apoiada pelo componente de Assistência Page | 7 Técnica do Projeto de “Dimensionamento da Força de Trabalho” seja estendida aos órgãos responsáveis pela gestão ambiental.3 A avaliação também extraiu quatro conclusões sobre a adequação do sistema de gestão social (SGS) do Estado do Paraná. Em primeiro lugar, não se espera que as atividades apoiadas envolvam trabalhos em condições de trabalho perigosas e inseguras e o SGS é bem desenvolvido e capaz de lidar com os riscos associados às condições de saúde e segurança ocupacional. As atividades do setor de saúde dentro das UCM e dos hospitais existentes para responder à Covid-19 podem expor os profissionais de saúde e os pacientes a perigos para a saúde, mas esses riscos não são sem precedentes e podem ser gerenciados por procedimentos padrão bem conhecidos. Os protocolos que regem o funcionamento dos serviços de saúde no Brasil são rigorosos e fortemente aplicados em todo o Estado do Paraná. A estrutura regulatória das relações trabalhistas compreende normas adequadas de saúde e segurança ocupacional para a operação de instalações de serviços de saúde. Esses locais de trabalho são regulamentados e administrados de acordo com normas e medidas de saúde e segurança ocupacional restritas, bem implementadas e supervisionadas de perto. Essas regras exigem que os empregadores públicos e privados desenvolvam e forneçam treinamento aos seus funcionários sobre preparação e resposta a planos de emergência, programas de prevenção de riscos ambientais e programas de saúde ocupacional e controle médico. Uma segunda conclusão é que não se espera que as atividades apoiadas tenham impactos adversos diretos e significativos relacionados com a aquisição de terras e reassentamento involuntário. Esta conclusão minimiza o fato de que o SGS mostra algumas lacunas com os requisitos estabelecidos pelo Princípio Básico 4 da gestão de riscos ambientais e sociais das operações PforR - resumidamente: (i) o valor da compensação devido à posse da terra em condições nas quais as reivindicações de terras ou ativos são reconhecidas de acordo com o legislação nacional, (ii) disposições relativas à assistência de reassentamento para inquilinos e famílias co-residentes; (iii) distinção de direitos entre pessoas que invadem a área antes ou depois de uma data limite e (iv) disposições para o estabelecimento de um mecanismo de reclamação para lidar exclusivamente com reclamações sobre reassentamento involuntário. No âmbito do Programa proposto, os Planos de Desenvolvimento Regional Produtivo Integrado podem levar futuramente a atividades que requeiram a aquisição de terras, uma vez que algumas instalações de infraestrutura podem ser incluídas na lista de investimentos a serem apoiados. Como o componente PforR apoiará a preparação desses Planos, uma capacitação sobre este tema foi proposta como medida recomendada. Uma terceira conclusão é que não se espera que as atividades apoiadas causem a realocação de Povos Indígenas ou tenham impactos adversos sobre (i) terras e recursos naturais sujeitos à sua propriedade tradicional ou sob seu uso ou ocupação costumeira; ou (ii) sobre os conhecimentos tradicionais dos povos indígenas; ou (iii) sobre aspectos de sua herança cultural que sejam materialmente imprescindíveis à sua identidade étnica; ou (iv) aspectos culturais, cerimoniais ou espirituais de suas vidas. O SGS compreende medidas robustas para garantir não apenas a consulta significativa e a participação dos Povos Indígenas, 3 Esta atividade de Assistência Técnica tem como objetivo a obtenção de subsídios para a implementação de política de ingresso para o curto, médio e longo prazos, a partir da identificação do número suficiente e adequado de servidores qualificados para que os órgãos entreguem serviços públicos com rapidez e eficiência. Page | 8 assegurando-lhes oportunidades para se beneficiarem do Programa, mas também para dar atenção adequada aos grupos vulneráveis a privações ou quaisquer formas de discriminação. Por fim, a avaliação conclui que não se espera que o Programa leve à marginalização de grupos sociais ou à exacerbação de conflitos sociais. Pelo contrário, algumas atividades tendem a ser socialmente inclusivas e terão efeitos distributivos positivos. A prioridade dada pelo Governo do Paraná aos grupos sociais desfavorecidos e vulneráveis na provisão de acesso às iniciativas de resposta da Covid-19 reduz o risco de que certos grupos possam vir a acreditar que são discriminados e marginalizados devido a suas identidades e status. Tópicos Ações Propostas Gestão de Riscos Ambientais A Unidade de Gestão do Projeto manterá um especialista em gestão de riscos ambientais e sociais ao longo de todo o ciclo do Projeto. Ele será responsável por assegurar a execução do Plano de Ação, seu monitoramento e relatoria. Cada Unidade Executora terá um ponto focal para a gestão de riscos ambientais e sociais relevantes. Gestão do ambiente de A Unidade de Gestão do Projeto enviará um relatório de trabalho e resíduos sólidos em conformidade em relação às medidas estabelecidas nas estabelecimentos de serviços Resoluções SESA 544/2020 e 1268/2020 ao Banco Mundial. de saúde. Para aferição da elegibilidade ambiental e social das despesas relacionadas à conversão dos 40 hospitais selecionados em UCMs. a Unidade de Gestão do Projeto reportará sobre a publicação e o cumprimento da Resolução SESA que instituirá a Unidade de Cuidados Multiprofissionais – UCM no Estado do Paraná, e fixará as diretrizes e critérios para adesão e estruturação, bem como recursos de custeio e investimento. Potenciais restrições que os Amplo processo de divulgação do Programa entre os Povos Indígenas e outros representantes dos Conselhos e Comitês Estaduais existentes que grupos desfavorecidos e contam com ampla representação de grupos sociais vulneráveis e vulneráveis podem enfrentar sua consulta sobre as medidas que podem ser tomadas para em termos de (a) acesso a garantir que seus constituintes sejam beneficiados pelo Programa plataformas e canais digitais – Monitoramento do acesso e grau de satisfação dos povos tais como as que serão usadas indígenas, desfavorecidos e vulneráveis com os serviços digitais. durante as oficinas e treinamentos que ocorrerão durante a preparação dos Planos de Desenvolvimento Produtivo Regionais ou em virtude da digitalização de serviços governamentais – devido ao “fosso digital” e (b) acesso justo e equitativo aos serviços e instalações de saúde apoiados pelo Programa (incluindo os relacionados com a resposta da Covid 19) devido Page | 9 Tópicos Ações Propostas a suas identidades e status (incluindo Povos Indígenas). Limitações enfrentadas nos Definição de indicadores mensuráveis e atribuíveis para monitorar processos de licenciamento e os resultados alcançados em termos de melhoria do desempenho gestão ambiental no Estado do e eficácia das agências responsáveis pelo licenciamento e gestão Paraná. ambiental em decorrência da inovação ambiental. Monitoramento contínuo. Planos de Desenvolvimento Adoção de princípios e critérios de sustentabilidade ambiental e Regional Produtivo Integrado inclusão social na seleção das atividades a serem apoiadas a partir como instrumento do dos Planos de Desenvolvimento Regional Produtivo Integrado. desenvolvimento sustentável. Treinamento sobre medidas apropriadas, melhores práticas e lições aprendidas para abordar (evitar, minimizar e mitigar) impactos adversos relacionados com a aquisição de terras, restrições ao uso da terra e reassentamento involuntário para equipes envolvidas com a elaboração dos Planos de Desenvolvimento Regional Produtivo. 4 Transparência, engajamento Implementação de uma campanha de divulgação das atividades das partes interessadas, apoiadas pelo Programa, contando com meios de comunicação de engajamento do cidadão e massa e a criação de uma página oficial do Programa dentro do responsabilidade social na website oficial do estado (incluindo um serviço de informação ao gestão das atividades apoiadas cidadão e FAQs), e uso redes sociais. pelo Programa. Continuação da divulgação da Ouvidoria Estadual, suas atribuições e canais de reclamação. Acompanhamento contínuo das solicitações de informações, sugestões e cumprimentos relacionados às áreas de resultados do Programa e atividades que chegam ao sistema de ouvidoria do Estado. Adaptação do planejamento e execução das atividades apoiadas pelo Programa a partir da análise das manifestações desses cidadãos. 4 Esta ação visa preencher as lacunas entre o Sistema de Gestão Ambiental e Social do Estado do Paraná e os requisitos definidos pelo Princípio Fundamental 4 de gestão de riscos ambientais e sociais nas operações de PforR, bem como a Norma Ambiental e Social 5 do Banco Mundial – Aquisição de Terras, Restrições ao Uso de Terras e Reassentamento Involuntário. Estes treinamentos podem ser abertos a funcionários de todas as agências envolvidas na implementação do Projeto. Page | 10 Executive Summary This Report summarizes the assessment of the Environmental and Social Systems that are relevant for the Program for Results (PforR) component of Parana Public Sector Modernization and Innovation for Service Delivery Operation - “Paraná Eficiente” (P168634). The assessment was based on official secondary sources and virtual consultations with stakeholders. This project is a hybrid operation (US$130 million) comprising a PforR component (US$ 120.5 million) and an Investment Project Financing (IPF) component (US$ 9.5 million) proposed by the State of Paraná (Southern Brazil) to support activities included in five key government programs as defined at Multi-Year State Plan (PPA 2020-2023). The “Paraná Eficiente” Project is a subnational operation with the State of Paraná. Located in the South Region of Brazil, The state of Paraná is organized in 22 administrative regions and 399 municipalities, of which 77 percent have less than 20,000 inhabitants. With a surface area of about 200.000 km2 (2.35% of Brazil’s territory), the state of Paraná covers 10 phytogeographic regions that feature geomorphological and climate peculiarities. With an ethnically diverse population of approximately 11.5 million people (5% of the total Brazilian population) and an urbanization rate equal to 86.4%, the state’s socioeconomic indicators are above national averages. Paraná is one of the highest income and highest capacity of Brazil’s states, but there are significant pockets of poverty and inequality in access to essential public services, particularly in rural areas. Economic inequality is equally high. In 2018, the richest 1% accounting for 10.2% of the total mass of income, while the poorest 20% hold only 4.2% of the wealth. In the same year, 13.7% of the state population lived under poverty (less than 5.5 USD per day) and 2.7% under extreme poverty (less than 1.9 USD per day).5 The Paraná Eficiente Project is a multi-sector operation and the PforR component will support activities in three result areas. The first Results Area refers to Health Service Delivery and will support two activities: (a) COVID-19 response through the expansion of SESA hospital bed capacity to respond to the increased demand for COVID-19 treatment and (b) the reorganization of health service delivery through the conversion of small hospitals into Intermediary Care Unit (UCMs). The second results area refers to Environmental and Disaster Risk Management, through the strengthening of (a) geospatial information for multi-use environmental monitoring and disaster risk management (including in health) and (b) accuracy 5 Data on environmental and social characteristics of the state of Paraná have been drawn from several sources, including: IPARDES, Os Vários Paranás: As espacialidades socioeconômico-institucionais no período 2003-2015 / Instituto Paranaense de Desenvolvimento Econômico e Social. – Curitiba: IPARDES, 2017 (available at http://www.ipardes.pr.gov.br/sites/ipardes/arquivos_restritos/files/documento/2019- 09/varios_paranas_relatorio_2017.pdf ); IPARDES, Anuário Estatístico do Estado do Paraná 2019 (available at http://www.ipardes.gov.br/anuario_2019/index.html); IPARDES, 2017: Indicadores de Desenvolvimento Sustentável por bacias hidrográficas do Estado do Paraná (available at http://www.ipardes.gov.br/IDS/index.php/IDS2017/index ); ITCG, ZONEAMENTO ecológico - econômico do Estado do Paraná – Curitiba: ITCG, 2018 (available at http://www.iat.pr.gov.br/Pagina/Zoneamento-Ecologico- Economico-ZEE ); and IBGE, Síntese de Indicadores Sociais: Uma Análise das Condições de Vida da População Brasileira 2020 – Rio de Janeiro: IBGE, 2020 (available at https://biblioteca.ibge.gov.br/visualizacao/livros/liv101760.pdf). Page | 11 of early warning systems for disaster risk management. The third results area deals with Public Sector Management and will support the strengthening of public sector systems and capacities to increase health sector delivery efficiency and effectiveness (and post COVID recovery). The proposed “Paraná Eficiente” Project will be jointly implemented by five four secretariats and one autarkic unit with the support of associated entities: the State Secretariat of Planning and Structuring Projects (SEPL), the State Secretariat of Administration and Pension System (SEAP), the State Secretariat of Health (SESA), the Governor’s Chief of Staff Secretariat (“Casa Civil”) and the Water and Land Institute (IAT) . SEPL, SEAP and SESA have substantial experience working with previous Bank-supported projects, Bank’s principles and operational policies. Due to their legal attributions, in addition to the implementing agencies, key roles in project implementation and environmental and social risk management of project activities shall be played by: the State Coordination of Civil Defense and Protection Civil Defense, the State's Comptroller General and General Ombudsman Office, and the General Superintendence of Dialogue and Social Interaction. The environmental and social risks of the activities included in the PforR Component of the “Paraná Eficiente” Project have been classified as moderate. The few potential negative risks and impacts of the proposed PforR program are likely to be predictable, temporary and/or reversible. They will be low in magnitude and site-specific, without likelihood of impacts beyond the actual footprint of a few construction sites. They have a low probability of serious adverse effects to human health and/or the environment and routine safety precautions are expected to be sufficient to prevent accidents. They can also be easily mitigated in a predictable manner. The activities supported by the PforR Component of the Paraná Eficiente Project are not expected to involve large civil works that may lead to significative adverse impacts on natural habitats and cultural heritage, nor require land acquisition with and/or resettlement of a scale or nature that will have significant adverse impacts on affected people. These activities are not likely to constitute a significant source of gross GHG emissions. The State of Paraná has strong institutional capacity and well-established regulatory framework in all sectors included in the result areas to be supported by the PforR component. The governance structures and legislation enjoy stability, strong oversight by judicial and extra- judicial bodies (including mass media and public opinion). There is in place a set of mechanisms to foster transparency, social control and accountability. Social participation in policy decision-making is an integral part of the public governance of these sectors. The State of Paraná has also developed over the years both the adequate regulatory framework and the institutional capacity needed to undertake the necessary environmental and social due diligence with respect to the potential impacts that the supported activities may cause. Finally, the Project will be developed in a National and State legal or regulatory environment where (i) there is significant certainty about the jurisdiction of the implementing agencies, (ii) the legislation and regulatory framework adequately address potential environmental and social risks and impacts of complex Projects, and (iii) enforcement is strong. The legal and regulatory authority of all supported activities are clearly established. The assessment of the expected environmental and social (E&S) effects of activities included in a Program for Results considers the six core principles (and their key planning elements) set by the Bank Guidance Program-for-Results Financing Environmental and Social Systems Page | 12 Assessment (issued and effective September 18, 2020). These core principles refer to the Program E&S management system’s capacity to: (i) promote E&S sustainability in the Program design, avoid, minimize, or mitigate adverse impacts, and promote informed decision-making relating to a Program’s E&S effects; (ii) avoid, minimize, or mitigate adverse impacts on natural habitats and physical cultural resources resulting from the Program;6 (iii) protect public and worker safety against the potential risks associated with (a) the construction and/or operation of facilities or other operational practices under the Program, (b) the exposure to toxic chemicals, hazardous wastes, and otherwise dangerous materials under the Program, and (c) the reconstruction or rehabilitation of infrastructure located in areas prone to natural hazards; (iv) manage land acquisition and loss of access to natural resources in a way that avoids or minimizes displacement and assists affected people in improving, or at the minimum restoring, their livelihoods and living standards; (v) give due consideration to the cultural appropriateness of, and equitable access to, Program benefits, giving special attention to the rights and interests of Indigenous Peoples, and to the needs or concerns of vulnerable groups; and (vi) avoid exacerbating social conflict, especially in fragile states, post-conflict areas, or areas subject to territorial disputes. The overall conclusions of the Borrower’s Environmental and Social System Assessment are two-fold: • First, the assessment concluded that the Program will be developed in a legal or regulatory environment where there is significant certainty about the jurisdiction of the implementing agencies, which enjoy stability, strong oversight by judicial and extra- judicial bodies (including mass media and public opinion). The legislation and regulatory framework do adequately address potential environmental and social risks and impacts of complex Projects, and where enforcement is strong. The legal and regulatory authority of all Programs are clearly established. • Secondly, the past experience of the Borrower and the implementing agencies past experience in developing programs and projects of the same level of complexity is relevant and their track record regarding environmental and social issues is good. There are no significant concerns related to their capacity and commitment for, and track record in relation to stakeholder engagement. The technical and institutional capacity of the Borrower, its track record and the financial and human resources available for management of the Program and its environmental and social risks and impacts are adequate. No critical changes to the legal or regulatory framework is needed before the operation can proceed. The main conclusions of the ESSA with regards to the Environmental Management Systems (EMS) of the State of Paraná highlights two aspects. On the one hand, the ESSA points out the robustness of the Paraná State EMS. On the other, the ESSA observes that the Government of Paraná recognizes that there has occurred a weakening of the institutions responsible for environmental management and is investing on several measures to revert the trend of the provision of services by the responsible environmental agencies in an anachronistic and time- 6 Program activities that involve the significant conversion or degradation of critical natural habitats or critical physical cultural heritage are not eligible for PforR financing Page | 13 consuming manner, with a significant lack of standardization and transparency, environmental enforcement. In consequence, the ESSA requires and recommends three measures to improve adequacy of the Paraná State EMS to the core principles of management of environmental and social risks of Program for Results operations. First, the civil works for the reforms of and the operation of intermediary care units ( Unidades de Cuidados Multiprofessional, UCM) and hospitals require attention with the management of solid waste generated by health services, measures relating to occupational health and safety – to protect workers from injury, illness, or impacts associated with exposure to hazards encountered in the workplace or while working – and exposure of patients to health and safety risks. The regulatory framework on these issues is robust. A requisite of the operation of health service facilities is to have in place a Health Services Solid Waste Management Plan and the Paraná Health Code requires the adoption of strict measures of occupational safety and health to allow the operation of health service facilities. The agencies responsible for the enforcement of these measures have a strong capacity in the state of Paraná. To ensure the adequate management of such risks, it is required that the Project Management Unit records the evidence of compliance with the environmental, health and labor measures the 40 selected hospitals that will be converted in UCM and hospitals with an expanded number of beds to respond to Covid-19. Second, the preparation and implementation of the Regional Productive Development Plans may lead to downstream and future effects on the environment and society that are not foreseeable. The activities supported by these plans will have very positive environmental and social impacts – conducive to a green development path – as far as they are based on principles of environmental and social sustainability. The UN-SDGs are tenets of these plans, which incorporate criteria related with (i) avoidance, reduction and mitigation of environmental and social risks and impacts, (ii) protection and conservation of biodiversity and critical and natural habitats, (iii) pollution prevention and sustainable and efficient use of resources, (iv) community health and safety, (v) protection of cultural heritage, (vi) broad consultation with stakeholders (including traditional communities and Indigenous Peoples as they are present in the area of influence of the Plans), (vii) social inclusion, and (viii) monitoring and evaluation procedures. Finally, it is recommended to monitor the outcomes of the environmental innovation activities through attributable indicators to ensure that the expected strengthening of the state’s EMS is being achieved and that the activity supported by the Technical Assistance component of the Project on “Strategic Workforce Plans” be extended to the bodies responsible for environmental management.7 The assessment also draws four conclusions on the adequacy of the Borrower’s social management system. First, the supported activities are not expected to involve works under significant risky and unsafe workplace conditions and the Borrower’s Environmental and Social System is well-developed an able to deal with the risks associated with occupational health and 7 This Technical Assistance activity aims to obtain subsidies for the implementation of the recruitment policy for the short, medium and long term, through the identification of a sufficient and adequate number of qualified employees so that the agencies can deliver public services quickly and efficiently. Page | 14 safety conditions. Health sector activities within UCM and existing hospitals to respond to Covid-19 may expose health workers to health hazards, but these risks are not unprecedent and can be managed by well-known standard procedures. The protocols that rule the operation of health service facilities in Brazil are rigorous and strongly enforced across the State of Paraná. The Brazilian labor regulatory framework comprises proper standards of occupational health and safety for the operation of health service facilities. These workplaces are ruled and managed according to restricted, well-implemented and closely oversighted occupational health and safety standards and measures. These rules require public and private employers to develop and provide training to their employees on preparedness and response to emergency plans, environmental risk prevention programs, and occupational health and medical control programs. A second conclusion is that the supported activities are not expected to have significant direct adverse impacts related with land acquisition and involuntary resettlement. This conclusion minimizes the fact that the Borrower’s Environmental and Social System shows a few gaps with the requirements set by Core Principle 4 – briefly: (i) the compensation amount due to adverse possession under conditions in which claims to land or assets are recognizable under the national law, (ii) provisions with regards to resettlement assistance for tenants and co- inhabitant families; (iii) distinction on entitlements between persons who encroach on the area before or after a cut-off date and (d) provisions for the establishment of a grievance mechanism to deal exclusively with claims on involuntary resettlement. In the scope of the proposed Program, the Regional Productive Development Plans may lead to downstream effects related with land acquisition as some infrastructure facilities may be included in the list of investments to be supported. As the PforR component will support these Plans, a capacity building on this topic has been proposed as a recommended measure. A third conclusion is that the supported activities are not expected to cause relocation of Indigenous Peoples or have adverse impacts on (i) land and natural resources subject to traditional ownership or under customary use or occupation; or (ii) Indigenous Knowledge; or (iii) on Indigenous Peoples cultural heritage that is material to their ethnic identity; or (iv) cultural, ceremonial, or spiritual aspects of their lives. The Borrower’s Environmental and Social System comprises robust measures to ensure not only meaningful consultation with and participation of Indigenous Peoples so devising opportunities to their benefit from the Program, but also appropriate attention to groups vulnerable to hardship or discrimination. Finally, the assessment concludes that the Program is not expected to lead to marginalization of social groups, the exacerbation of conflicts among social groups, or social unrest. On the contrary, some activities tend to be socially inclusive and have positive distributive effects. The Government of Paraná focus on disadvantaged and vulnerable social groups on the provision of access to COVID-19 response initiatives reduces the risk that certain groups could come to believe they are underserved and marginalized due to their identities and status. However, due to the “digital divide” (access to technologies and “digital illiteracy”), some of these disadvantaged and vulnerable groups may face disproportionate challenges and barriers with the expansion of the digitalization of governmental services. Hence, vulnerable users will have different needs and preferences for accessing e-services and may need additional assistance to transition to digital government services. Page | 15 Based on these conclusions, an Action Plan was agreed to enhance the Borrower’s Environmental and Social Risk Management System. Some of these actions will be supported by the IPF Technical Assistance Component of the Paraná Eficiente Project. Issues addressed Actions / Measures to be taken Environmental and Social Risks The PMU will include one environmental and social risks Management management specialist throughout the Program life cycle. This specialist will be responsible for ensuring this Action Plan is followed, monitoring and reporting on its achievements. Each executing agency will keep a focal point for the management of E&S risks of its activities according to the relevant ESS Management of working The PMU will submit a Report on compliance with the environment and solid waste in measures provided for in SESA Resolutions 544/2020 and health service facilities 1268/2020 to the World Bank. The Project Management Unit will report on (a) the publication of the SESA Resolution that will establish the Multiprofessional Care Unit – UCM in the State of Paraná and will set the guidelines and criteria for adherence and structuring, as well as funding and investment resources and (b) compliance with this Resolution to evidence the environmental and social eligibility of expenses related to the conversion of the 40 selected hospitals into UCMs. Potential constraints that A broad process of dissemination of the Program among the Indigenous Peoples and other representatives of the existing State Councils and Committees disadvantaged and vulnerable that have broad representation of vulnerable social groups groups may face in terms of access and their consultation on measures that might be taken to to digital platforms and channels – ensure that the constituencies they represent are benefitted such as those used during the by the Program. workshops and trainings that will be carried out for the preparation Monitoring of accesses and level of satisfaction of Indigenous of the Productive Regional Peoples and other disadvantaged and vulnerable social Development Plans or by the groups with governments’ digital services. digitalization of governmental services – due to the digital divide as well as to fair and equitable access to health services and facilities supported by the Program (including those related with Covid 19 response) due to their identities and status. Limitations faced in the Definition of measurable and attributable indicators to environmental licensing and risk monitor the results achieved in terms of improving the management processes in the State performance and effectiveness of the agencies responsible of Paraná. for environmental licensing and management as a result of environmental innovation. Regional Productive Development Adoption of principles and criteria of environmental Plans contribution to sustainable sustainability and social inclusion in the selection of activities development. to be supported from the Regional Productive Development Plans. Page | 16 Issues addressed Actions / Measures to be taken Training on appropriate measures, best practices and lessons learned to address (avoid, minimize and mitigate) adverse impacts related to land acquisition, restriction on land use and involuntary resettlement for the teams working on the preparation of the Productive Regional Development Plans. 8 Transparency, stakeholder Implementation of an information dissemination campaign of engagement, citizen engagement Program-supported activities, using mass media, a dedicated and social accountability in the official webpage of the Program within the State's official management of Program website (including a citizen information service and FAQs), supported activities. and the use of social media. Continued dissemination of the State Ombudsman System, its attributions and channels to lodge complaints. Continued monitoring of requests of information, suggestions and compliances related with Program supported results areas and activities that reaches this System. Retrofitting of the planning and implementation of Program supported activities on the basis of the analysis of these citizen’s manifestations. 8 This action aims to address the gaps between the Environmental and Social Management System of the State of Paraná and the requirements defined by the Core Principle 4 of environmental and social risk management in PforR operations as well as the World Bank Environmental and Social Standard 5 – Land Acquisition Restrictions on Land Use and Involuntary Resettlement The training may be open to the teams of all agencies involved in the implementation of the Project. Page | 17 Section I. Introduction and Methodology This Report summarizes the assessment of the Environmental and Social Systems that are relevant for the PforR component of Parana Public Sector Modernization and Innovation for Service Delivery Operation - “Paraná Eficiente” (P168634). This project is a hybrid operation (US$130 million) comprising a Program for Results component (US$ 120.5 million) and an Investment Project Financing (IPF) component (US$ 9.5 million) proposed by the State of Paraná (Southern Brazil) to support activities included in four key government programs as defined at Multi-Year State Plan (PPA 2020-2023). These Programs are: • Health Sector Innovation in Parana (Saúde Inovadora para um Paraná Inovador – Program 03). This program aims to improve efficiency and quality of public health services through the reorganization of the state’s health service delivery network and the integration of SESA’s health information system. The Program supports the reorganization of the health service delivery network, including conversion of small hospitals into multidisciplinary care units; and the integration of health sector information systems (financial, administrative, and service delivery data) to improve management at different levels of SESA. In addition to these activities, a specific budget line for the COVID-19 response was included under Program 03 for FY20 and 21. • Future Parana: Sustainability and Tourism (Paraná do Futuro: Sustentabilidade e Turismo – Program 02). This program aims to promote sustainable and healthy development and the prevention and minimization of the impacts of extreme weather events and climate change through: the management of multiuse, high accuracy, geospatial database; management of water resources and solid waste ensuring water supply and the impacts of extreme weather events and climate change; coordinating the execution of civil protection and defense actions and operations derived from natural, mixed or man-made disasters in the prevention, preparation, mitigation, response and recovery phases; and management of natural resources and protected areas; environmental registration and regularization of rural landholdings, supporting the restoration of legally defined on-farm protected areas; land regularization on behalf of small-scale farmers. • Public Management, Transparency and Compliance (Gestão Pública, Transparência Compliance – Program 40). This program led by SEAP aims to strengthen the operational efficiency of the state administration through more efficient administration and personnel policies. The program supports, inter alia, the adoption of good practices on HRM and procurement; and improvements in the quality and availability of the digital services through the state digital platform (PIA). • Planning for Parana (Planeja Paraná – Program 44). This program aims to: improve systems and data for public policy planning and decision making; strengthen institutional capacity for public sector planning through targeted training; and to prepare regional productive development plans in the more challenged areas of the Page | 18 state, including those most affected by COVID-19, environmental degradation, and climate change. The Program development objective is to support the state government in mitigating overall impacts of COVID-19 pandemic by improving the efficiency and delivery of health and other priority public services. Methodology for Assessing the Borrower’s Environmental and Social System The Environmental and Social Systems Assessment follows the methodology proposed by the Bank Guidance Program-for-Results Financing Environmental and Social Systems Assessment (issued and effective September 18, 2020) – hereafter referred as The Bank Guidance. Three main activities were carried out to make the assessment of the Borrower’s Environmental and Social System. Firstly, the assessment considered the likely environmental and social effects of the activities to be supported – taken also into consideration the contextual risks, the risks related with institutional capacity, the reputational and political risks. The findings of this assessment are described in Section III. Secondly, the assessment of the expected environmental and social effects of activities included in a Program for Results considers the six core principles (and their key planning elements) set by The Bank Guidance. These core principles and the aspects they cover are described below: Core Principles Aspects under Consideration Core Principle #1: The ESSA addresses questions related with the capacity, commitment and Program E&S track record of the Borrower’s system to: (a) operate within an adequate management systems legal and regulatory framework to guide Environmental and Social impact are designed to (a) assessments, mitigation, management and monitoring at the PforR promote E&S Program level; and (b) incorporate recognized elements of good practice sustainability in the in Environmental and Social assessment and management, including: (i) Program design; (b) early screening of potential impacts, (ii) consideration of strategic, avoid, minimize, or technical, and site alternatives (including the “no action” alternative), (iii) mitigate adverse explicit assessment of potential induced, cumulative, and transboundary impacts; and (c) impacts, (iv) identification of measures to mitigate adverse E&S risks and promote informed impacts that cannot be otherwise avoided or minimized, (v) clear decision-making articulation of institutional responsibilities and resources to support relating to a Program’s implementation of plans, and (vi) responsiveness and accountability E&S effects. (through stakeholder consultation, timely dissemination of the PforR information, and responsive GRMs). Core Principle #2: The ESSA addresses questions related with the capacity, commitment and Program E&S track record of the Borrower’s system to: (a) identify, and screen for management systems adverse effects on potentially important biodiversity and cultural resource are designed to avoid, areas and provide adequate measures to avoid, minimize, or mitigate minimize, or mitigate adverse effects; (b) support and promote the protection, conservation, adverse impacts on maintenance, and rehabilitation of natural habitats; (c) avoid significant natural habitats and conversion or degradation of critical natural habitats and, if avoidance is physical cultural not technically feasible, include measures to mitigate or offset the adverse Page | 19 Core Principles Aspects under Consideration resources resulting impacts of the PforR Program activities; and (d) take into account potential from the Program. adverse effects on physical cultural property and provide adequate Program activities that measures to avoid, minimize, or mitigate such effects. involve the significant conversion or degradation of critical natural habitats or critical physical cultural heritage are not eligible for PforR financing. Core Principle #3: The ESSA addresses questions related with the capacity, commitment and Program E&S track record of the Borrower’s system to: (a) promote adequate management systems community, individual, and worker health, safety, and security through the are designed to protect safe design, construction, operation, and maintenance of Program public and worker activities; or, in carrying out activities that may be dependent on existing safety against the infrastructure, incorporate safety measures, inspections, or remedial works potential risks as appropriate, (b) promote measures to address child and forced labor; associated with (a) the (c) promote the use of recognized good practice in the production, construction and/or management, storage, transport, and disposal of hazardous materials operation of facilities or generated under the PforR; (d) promote the use of integrated pest other operational management practices to manage or reduce the adverse impacts of pests practices under the or disease vectors, (e) provide training for workers involved in the Program; (b) exposure production, procurement, storage, transport, use, and disposal of to toxic chemicals, hazardous chemicals in accordance with the relevant international hazardous wastes, and guidelines and conventions; and (f) include adequate measures to avoid, otherwise dangerous minimize, or mitigate community, individual, and worker risks when the materials under the PforR Program activities are located in areas prone to natural hazards such Program; and (c) as floods, hurricanes, earthquakes, or other severe weather or affected by reconstruction or climate events. rehabilitation of infrastructure located in areas prone to natural hazards. Core Principle #4: Considering this core principle, the ESSA addresses questions related with Program E&S systems the capacity, commitment and track record of the Borrower’s system to: (a) manage land avoid or minimize land acquisition and related adverse impacts; (b) identify acquisition and loss of and address economic or social impacts caused by land acquisition or loss access to natural of access to natural resources, including those affecting people who may resources in a way that lack full legal rights to resources they use or occupy, (c) provide avoids or minimizes compensation sufficient to purchase replacement assets of equivalent displacement and value and to meet any necessary transitional expenses, paid before taking assists affected people land or restricting access; (d) provide supplemental livelihood in improving, or at the improvement or restoration measures if taking of land causes loss of minimum restoring, income-generating opportunity (e.g., loss of crop production or their livelihoods and employment); and (e) restore or replace public infrastructure and living standards. community services that may be adversely affected by the Program. Include measures in order for land acquisition and related activities to be planned and implemented with appropriate disclosure of information, consultation, and informed participation of those affected. Core Principle #5: The ESSA addresses questions related with the capacity, commitment and Program E&S systems track record of the Borrower’s system to: (a) undertake meaningful give due consideration consultations if the Indigenous Peoples are potentially affected (positively Page | 20 Core Principles Aspects under Consideration to the cultural or negatively), to determine whether there is broad community support for appropriateness of, and the PforR Program activities; (b) ensure that Indigenous Peoples can equitable access to, participate in devising opportunities to benefit from exploitation of Program benefits, customary resources and indigenous knowledge, the latter (indigenous giving special attention knowledge) to include the consent of Indigenous Peoples; and (c) give to the rights and attention to groups vulnerable to hardship or discrimination, including, as interests of Indigenous relevant, the poor, the disabled, women and children, the elderly, ethnic Peoples, and to the minorities or other marginalized groups; and if necessary, take special needs or concerns of measures to promote equitable access to PforR Program benefits. vulnerable groups. Core Principle #6: The ESSA addresses questions related with the capacity, commitment and Program E&S systems track record of the Borrower’s system to consider conflict risks, including avoid exacerbating distributional equity and cultural sensitivities. social conflict, especially in fragile states, post-conflict areas, or areas subject to territorial disputes. This assessment according to the core principles was based on consultations of official sources and governmental websites and its findings are presented in Section IV. Finally, the assessment was also based on consultations with key stakeholders. Three main topics have been addressed during these consultations: (i) the environmental and social risks and impacts that the stakeholders associate with the activities included in the Paraná Eficiente Program; (ii) their assessment of the institutional capacity of the Paraná State Environmental and Social Risk and Impacts Management System to deal with these risks and impacts; and (ii) their views of the critical measures that are needed to be taken to strengthen this System. The task team consulted representatives of Indigenous Peoples, quilombola and traditional communities as well as representatives of the Academia, NGOs, and civil society in the State Environmental Council. The findings of this process of consultation are summarized in Section V (below). Page | 21 Section II. Program Description II.1 Geographic Scope The Paraná Public Sector Modernization and Innovation for Service Delivery Operation - “Paraná Eficiente” (P168634) is a subnational operation with the Government of the State of Paraná. Located in the South Region of Brazil, The state of Paraná9 is organized in 22 administrative regions and 399 municipalities, of which 77 percent have less than 20,000 inhabitants. With a surface area of about 200.000 km2 (2.35% of Brazil’s territory), the state of Paraná covers 10 phytogeographic regions that feature geomorphological and climate peculiarities. The floristic composition comprises the Atlantic Forest biome and a remnant of the Cerrado Biome. The Atlantic Forest biome corresponds to different ecosystems, such as ombrophilous dense atlantic forest (auraucaria forest), mixed ombrophilous forest, semideciduous seasonal forest, steppe (fields), herbaceous vegetation, mangroves, “várzea” and rupestrian vegetation. Of special interest are the critically endangered Araucaria Forest (which once covered more than one third of the State’s territory) and the coastal Atlantic Rainforest, Brazil’s most threatened forest ecosystem. The Atlantic Forest biome originally corresponded to 97% of the State’s territory. Currently this threatened biome it has been reduced to 18% of its original area (well-preserved native areas comprise less than 3-5% of Paraná). Savanna vegetation is the core feature of the remnant of the Cerrado biome. The climatic conditions in Paraná range from tropical to sub-tropical and temperate zones, with temperatures ranging from 30°F to 80°F. The subtropical and temperate zones in Paraná get frost in the winter season (June-September). The state is well supplied by hydrological resources. A well-distributed river basin network, makes Paraná one of the country’s main hydroelectric supplier. Parana’s topography consists of a narrow coastal plain separated from the interior of the state by an abrupt wall: the Serra do Mar mountain range to the west of which are 3 successive plateaus. More than half of the state is above 2000 feet in altitude. The soils are generally fertile, although prone to erosion. Historically, agricultural based activities have been the main land use in the State of Paraná. The intensive use of land contributed to soil and forest degradation, especially along riparian forests, and has affected not only ecosystem services, but also led to biodiversity loss, increased carbon emissions and others ecological and socioeconomic impacts. 9 Data on environmental and social characteristics of the state of Paraná have been drawn from several sources, including: IPARDES, Os Vários Paranás: As espacialidades socioeconômico-institucionais no período 2003-2015 / Instituto Paranaense de Desenvolvimento Econômico e Social. – Curitiba: IPARDES, 2017 (available at http://www.ipardes.pr.gov.br/sites/ipardes/arquivos_restritos/files/documento/2019- 09/varios_paranas_relatorio_2017.pdf ); IPARDES, Anuário Estatístico do Estado do Paraná 2019 (available at http://www.ipardes.gov.br/anuario_2019/index.html); IPARDES, 2017: Indicadores de Desenvolvimento Sustentável por bacias hidrográficas do Estado do Paraná (available at http://www.ipardes.gov.br/IDS/index.php/IDS2017/index ); ITCG, ZONEAMENTO ecológico - econômico do Estado do Paraná – Curitiba: ITCG, 2018 (available at http://www.iat.pr.gov.br/Pagina/Zoneamento-Ecologico- Economico-ZEE ); and IBGE, Síntese de Indicadores Sociais: Uma Análise das Condições de Vida da População Brasileira 2020 – Rio de Janeiro: IBGE, 2020 (available at https://biblioteca.ibge.gov.br/visualizacao/livros/liv101760.pdf). Page | 22 With an ethnically diverse population10 of approximately 11.5 million people (5% of the total Brazilian population) and an urbanization rate equal to 86.4%, the state’s socioeconomic indicators are above national averages. The state’s Human Development Index reaches 0.749 against 0.726 of Brazil and fifth place among all 26 states and the Federal District. The forecast is that the pace of population growth in Paraná is expected to slow down, with ever lower growth rates. After a slight increase in the early 2010s, the total fertility rate should resume its downward trend over the next few decades. Regarding mortality, two trends will mark its evolution. On the one hand, the gross mortality rate is expected to increase with the number of deaths per thousand inhabitants going from 6.30 in 2020 to 7.30 in 2030 and, finally, to 12.06 in 2060. On the other, early mortality is expected to be reduced, particularly infant mortality. Thus, the age structure of the population will be altered due to the population decrease among children and young people and the increasing participation of the elderly in the state population. It is estimated that the elderly will count for 20% (up from the current 15.7%) of the state population by 2040 and the children (0 to 14 years of age) for 16.6% (down from the current 24.3%). The dependency rate is expected to increase with the elderly increasing their participation in this contingent, from 32.3% in 2010 to 52.6% in 2030. The state’s illiteracy rate among the population over 15 years of age is 4.2% (lower than the Brazilian rate of 4.9%). The state economy – based on agroindustry – is the fifth largest in the country and contributes with 6.4 percent of the country’s GDP. In the context of Covid-19,11 the labor market participation rate has remained mostly stable in the state: it was 62.8% in May 2020, dropped to its lowest level in July (61.4%) and fully recovered in November (62.9%). The employment and unemployment rates showed the same trends. The former equaled 56.5% in May, 54.2% in July and 56.6% in November 2020; whereas the later equaled 10.0% in May, peaked at 11.7% in July and came back to 10.0% in November.12 The rate of employed people who have been away from work due to social distance decreased from 10.2% in May to 2.2% in November 2020 (following identical regional and national trends). Among them, 45% did not receive payments in May and only 16.9% were in this condition in November.13 The average income from jobs steadily increased throughout this period, from BRL 2,199 in May up to BRL 2,412 in November 2020.14 The share of the household total income represented by the 10 The state population not only comprises descendants of Polish, Italian, German, Ukrainian, Dutch, Spanish, Japanese, and Portuguese, but also 26,559 indigenous peoples, mostly from the Kaingang, Guarani and Xetá peoples (IBGE, Os indígenas no Censo Demográfico 2010: primeiras considerações com base no quesito cor ou raça. Rio de Janeiro: 2012, available at https://www.ibge.gov.br/indigenas/indigena_censo2010.pdf). Most of them (around 62%) live within the 26 indigenous lands spread over 19 municipalities found in the state of Paraná. Out of these 26 Indigenous Lands, 12 have been regularized, six are Indigenous Reserves, three have been demarcated, two have been declared and three are under study by FUNAI. In these lands there are 29 villages (http://sii.funai.gov.br/funai_sii/informacoes_indigenas/visao/visao_terras_indigenas.wsp). There are also 2,236 families and 8,000 people in 50 traditional black and quilombola communities. The total Afro-Brazilian population counts for 28.3% of the state population. 11 Ipardes, Estimativas do Paraná – PNAD Covid 19 – Novembro 2020, available at http://www.ipardes.pr.gov.br/sites/ipardes/arquivos_restritos/files/documento/2021- 01/PNAD_COVID_novembro_2020.pdf. 12 The state employment rate during the first quarter of 2020 was 58.8%, whereas the unemployment rate was 7.9%. 13 The state employment rate during the first quarter of 2020 was 58.8%. 14 Above regional and national averages along the period: 1.8% above the regional and 12.5% above the national average in November 2020. Page | 23 Federal Emergency Aid was smaller in the state than in the country, but higher than in the South region: from 6.0% in May, up to 7.1% in July and August and down to 4.4% in November 2020.15 Paraná is one of the highest income and highest capacity of Brazil’s states, but there are significant pockets of poverty and inequality in access to essential public services, particularly in rural areas. The state’s average household per capita income is 13% higher than in the country - R$1,621.00 (around 300 USD) and R$1,438.00 (around 265 USD), respectively. Economic inequality is high and the state holds some poverty pockets. In 2018, the richest 1% accounting for 10.2% of the total mass of income, while the poorest 20% hold only 4.2% of the wealth. In the same year, 13.7% of the state population lived under poverty (less than 5.5 USD per day) and 2.7% under extreme poverty (less than 1.9 USD per day).16 Around 3.5% of the state population live in irregular urban settlements, where infrastructure, housing conditions and land tenure are precarious. The state has a housing deficit of 511,746 units, out of which 37,019 are locate in rural areas or in traditional communities. Around 40,000 urban residencies are located in at-risk areas. The latest available data on connectivity (2016) shows that 85.5% of the state population had access to internet. II.2 Thematic Scope The proposed “Paraná Eficiente” Project supports the implementation of the COVID recovery plan and activities across four Programs of the Parana State Multi-Year Plan (PPA). The Parana Public Sector Modernization and Innovation for Service Delivery main objective is to support the state government in mitigating overall impacts of COVID-19 pandemic by improving the efficiency and delivery of health and other priority public services. The PforR component (US$120.5 million) will support four Government programs in the PPA, with a focus on activities that strengthen health services delivery, including for COVID-19 response, and effectiveness through institutional strengthening and the use of information technology. Activities include support to clinical and intensive-care unit beds at a critical moment of the pandemic, while providing financial incentives to municipalities to adhere to a proposed reorganization of the state health system. Cross-cutting interventions will benefit the health sector of the entire state territory through strengthened central environmental management and public sector efficiency. The activities are detailed below under three results areas. Results Area 1: Health Service Delivery will expand hospital capacity to deliver COVID-19- related treatment, restructure public health service delivery, rationalize the hospital network and strengthen coordination of care across hospital and PHC levels. This results area has two 15 At the national level, the Federal Emergency Aid counted for 9.3% of the household income in May, peaked at 10.6% in July and dropped to 6.0% in November 2020. At the regional level, these rates equaled 5.0%, 6.2% and 3.9%, respectively. In the state of Paraná, the Federal Emergency Aid represented in average an increase of 119% of the income of the first decile and 28.9% of the second decile. 16 These figures are lower than the country’s averages (poverty and extreme poverty rates equal to 25.3% and 6.5%, respectively), but higher than the regional averages (12.1% and 2.1%, respectively). IBGE, Pnad Contínua, 2018. Page | 24 activities. Activity 1 – Support to COVID-19 response, Activity 2 – Reorganization of health service delivery and Activity 3 – New technologies for the state health system.. The first activity will support the expansion of SESA’s hospital capacity to respond to the increase in the demand for COVID-19 treatment during the pandemic. This activity is supported by Disbursement Linked Indicator 1 (Average number of hospital beds available to treat COVID-19 patients within designated healthcare facilities). This DLI captures state of Parana’s efforts to mitigate the effects of the COVID-19 pandemic through the expansion of public sector ICU and clinical capacity. The second activity will support the reorganization of the state’s public health system through the conversion of small hospitals into UCMs. UCMs will improve coordination of care across primary and tertiary care, with a particular focus on the health needs of the state’s growing elderly population. This activity is supported by two Disbursement Linked Indicators: DLI 2 (Number of multidisciplinary care units implemented) and DLI 3 (Production rate of UCMs). DLI 2 is scalable and is measured by the number of small hospitals converted into multidisciplinary care units with an end target of 40 units in year 5. Agreements (convenio) will be signed between SESA and municipal health authorities to guide the use of funds. Energy efficiency measures will be applied, to the extent possible, to ensure minimum performance levels for significant energy-consuming equipment such as refrigerators, ceiling fans, lightbulbs, and residential air-conditioning systems in line with the national energy conservation programs - Brazilian Program for Labelling (PBE)17 and the Selo Procel.18 DLI 3 is expected to achieve 80 percent in year 5.19 The third activity will support the development and roll out of the state’s digital strategy and operational plan, with a focus on: (i) specific health sector digital solutions – such as the ambulance management system (SAMU Mobile) – and health sector training on the use of new technologies and digital solutions; (ii) on the use of environmental and health data to analyze, forecast and respond to health challenges related to climate change and environmental conditions; and (iii) on training on the use the GeoPortal system for environmental monitoring. As part of the state’s effort to map all existing digital systems, a diagnostic of existing digital systems and gaps in the health sector will be carried out and a plan of action will be prepared. Accordingly, the adoption of the state digital services strategy and operational plan will be done sequentially: mapping of existing digital state services in line with federal standards; prioritization based on citizens and user’s feedback; design and roll out of the digital strategy operational plan through a digital portal (PIA). These activities support the government’s objectives of increasing the quality and use of digital public services and will consider the needs of women, the poor and vulnerable groups to facilitate their access and use of digital services. 17 https://www.gov.br/inmetro/pt-br/assuntos/avaliacao-da-conformidade/programa-brasileiro-de- etiquetagem/conheca-o-programa. 18 http://www.procelinfo.com.br/main.asp?TeamID=%7B88A19AD9-04C6-43FC-BA2E-99B27EF54632%7D. 19 The UCMs will be implemented by the municipalities through an adherence process. By providing financing incentives, the state will endeavor efforts so they can be implemented based on environmental-friendly practices. However, municipalities are autonomous, as part of SUS governance, to decide how to implement the conversion and activities related to the UCMs. Page | 25 The activity is supported by DLI 5) and the Disbursement Linked Results (DLRs) include: (a) the preparation and roll out of the state’s ambulance management system (SAMU Mobile); (b) upgrades to the public sector capacity school online training system; (c) training for ambulance and hospital personnel on its use; (d) a diagnostic of digital services needs in the health sector; (e) the roll out and implementation of the platform for managing and monitoring the regional development plans (Portal Parana Produtivo); and, (f) improvements to the existing project management system (SIGMA-PP) and an increase in its use by institutions managing structural projects. Refurbishment works of existing buildings will be required only for the conversion of small hospitals into CMU (Results Area 1, activity 2). They are expected to be minor and to have no significant adverse environmental or social impacts. They are expected to be site-specific. They are not expected to require land acquisition. Results Area 2: Environmental and Disaster Risk Data for improved service delivery, which will support the development of information systems to improve environmental and disaster risk data to inform public health decision-makers about threats to public health and to public health assets. The results area has two activities: Activity 1 - Strengthening of geospatial information for multi-use environmental monitoring and disaster risk data (including key data from the environmental health surveillance sector) and Activity 2 - Improving the accuracy of early warning systems for natural disaster risk management and the environmental management systems. The first activity will include: the preparation of the planialtmetric base of the state territory, at a scale of 1:50000; geological risk map (Gravitational Mass Movements - MGM; Carstic Reliefs; Soil Collapse / Erosion) in 40 municipalities; spatial data infrastructure (IDE); an online geographic platform with applied intelligence for access to environmental services, aiming to give transparency and publicity to environmental processes, facilitating access to information for entrepreneurs and control bodies (GeoPR portal); and networks for monitoring air quality and hydro meteorological with satellite data will be expanded and modernized. This data will allow for a better understanding of the spatial distribution of environmental health threats, as well as the identification, quantification, and assessment of the physical structures and population at risk. It can also help identify and map disaster risks to prioritize natural hazards management to support health emergency planning, and guide for risk assessment and management on a range of health-relevant topics. As part of the second activity, early warning systems are increasingly applied to mitigate the risks posed by natural hazards. More accurate precipitation data and flood risk map in urban perimeters of twelve municipalities have been initially identified to be supported.20 With these maps, risks will be better located, planning will be correctly dimensioned, floods could be anticipated and, more specifically, lives could be preserved via mitigating provision of emergency health services. These municipalities were prioritized based on the history of previous occurrences and intensity of the phenomenon. 20 It should be noted that the set of preselected municipalities – namely: Morretes, Rio Negro, Curitiba, Pinhais, Piraquara, São José dos Pinhais, Araucaria, Campo Largo, Fazenda Rio Grande, Colombo, Almirante Tamandaré and Balsa Nova – may change. Page | 26 These activities are supported by DLI 4 (the deployment of an online platform for environmental management containing key health surveillance information and key disaster risk information), which tracks critical milestones to achieve more effective environmental assessments by the state and the private sector and disaster risk management using technologies to strengthen the collection of critical environmental information on precipitation, temperature, water and air quality. Results Area 3: Planning and Public Investment Management. The results area has one activity: Activity 1 – Deployment of regional productive development plans and a new public investment management system in support of post COVID economic recovery. This activity will support post-COVID recovery through the preparation and approval of regional productive plans in eight lagging regions within the state, with a focus on productive activities. It will also support the identification and preparation of investment projects identified in the plans up to and including appraisal. Activities will also include the development and implementation of a new electronic public investment management (PIM) system with updated processes and procedures, including updated standards for the screening of climate change risks of planned investments. II.3 Institutional Arrangement: Implementing Agencies The proposed “Paraná Eficiente” Project will be jointly implemented by four state secretariats and one autarkic unit, with the support of associated entities: the State Secretariat of Planning and Structuring Projects (SEPL), the State Secretariat of Administration and Pension System (SEAP), the State Secretariat of Health (SESA), the Governor’s Chief of Staff Secretariat (“Casa Civil”) and Instituto Água e Terra (IAT). SEPL21 will be responsible for coordinating, monitoring, and reporting on program activities and results. The State Secretariat of Health (SESA) will be responsible for implementing the Health Service Delivery results area. the Institute of Water and Land (IAT) will be responsible for implementing the Environmental and Disaster Risk Management results area. Finally, the State Secretariat of Administration and Social Security (SEAP), the Casa Civil, and SEPL will be responsible for implementing the Public Sector Management results area. A Project Management Unit (PMU) has been established in the Government Development and Priority Projects Division (Coordenação de Desenvolvimento Governamental e Projetos Estruturantes) in SEPL. The PMU core team includes environmental and social specialists who are responsible for monitoring of and compliance with environmental and social management measures and actions that might be required. In addition, a Steering Committee will be established through a state decree to provide strategic direction, guidance, and oversight for implementation; promote internal coordination among institutions; monitor achievement of results; and recommend and take actions to resolve bottlenecks when necessary. The Steering Committee will comprise the secretaries, directors, or their designated representatives, from all 21 www.planejamento.pr.gov.br Page | 27 participating agencies: SEPL, Casa Civil, IAT, SESA, SEAP, as well as from the Secretariat of Finance22 and the State Attorney-General Office (Procuradoria Geral do Estado, PGE).23 SEPL provides advisory and direct support to the State Governor, performing functions of planning, coordination and control of the general action of the government. Its areas of action include: (a) the elaboration, coordination and support to the development of structural, strategic and priority projects of the State Government; (b) the formulation, oversight, monitoring and evaluation of the implementation of public policies for multisectoral development; (c) the coordination of the integrated development policy of the territory of Paraná aiming at local and regional sustainability; (d) the formulation of policies to induce and encourage integrated productive development aimed at local and regional economic sustainability; (e) the coordination of the elaboration, monitoring, review and updating of the Pluriannual Plan - PPA and the Integrated Productive Regional Development Program and the analysis of results; (f) the planning and modernization of the organizational structure of state agencies and entities, as well as the creation, relocation, transformation and extinction of filling positions in commission and public management functions; (g) the coordination of activities related to the identification, structuring and analysis of technical, economic-financial and legal feasibility studies for projects subject to privatization as well as the monitoring of the execution of projects and partnership contracts developed; and (h) the technical and functional coordination of the State Planning System. Casa Civil24 is a top-level body in the state administration, providing advice and direct support to the Governor. It was created under the terms of Law 8,485/1987 (lastly amended by Law 19,848/2019) and has – among others – the following assignments: (a) direct and immediate assistance to the State Governor in his civil and political representation; (b) the public relationship with civil and political authorities, within the scope of its activities, with the Federal Executive Branch, state, municipal and federal Legislative Branches and with other spheres of Government; (c) the promotion, coordination and monitoring of the actions of the State Government in the municipalities, in articulation with the other Secretariats and public entities; (d) the coordination of Government representation units in and outside the State; and (e) the general administration of the Palace and of the official residences of the Governments. SEAP25 has as the basic competence the exercise of the necessary means-activities for the functioning of the State Executive Branch as well as the definition of public policies and the macro management of eight large areas: (i) human resources and pension system; (ii) state public servants’ health; (iii) logistics for public contracts; (iv) standardization of administrative activities not inherent to the civil service; (v) official transportation; (vi) real estate and movable assets; (vii) preservation of public documents of historical or administrative value; and (viii) training of public servants and coordination of other training centers.26 22 https://www.fazenda.pr.gov.br/. 23 https://www.pge.pr.gov.br/. 24 https://www.casacivil.pr.gov.br/. 25 https://www.administracao.pr.gov.br/. 26 State Law 19.848/2019, State Law 20.070/19 and Decree 3,888/2020. Page | 28 SESA27 has the mission of planning, developing and managing the state health policy in line with regional disparities and promoting civil society participation to strengthen the Unified Health System (SUS) and improve the health conditions of the state population. SEMA is responsible for operating the state’s Health Care Network, implementing the priority lines of care, strengthening primary care and providing outpatient and hospital care. It is responsible for strengthening the process of regionalization of health care, strengthening health surveillance, improve social participation and the quality of expenditures in the health sector.28 The Water and Land Institute (Instituto Água e Terra – IAT) was created in 2019 (State Law 20,070/2019) merging three state bodies the Land, Cartography and Geology Institute, the Paraná Waters Institute and the Paraná Environmental Institute. The mission of IAT is the protection, preservation, conservation, control and restoration of the natural capital of the state, aiming to promote sustainable development and to improve quality of life with the participation of society. The institutional structure of IAT comprises seven departments organized by thematic areas. They are: (a) the Licensing and Granting Department,29 (b) the Natural Heritage Department,30 (c) the Environmental Sanitation and Water Resources Department,31 (d) the Territorial Management Department,32 (e) the Administrative and Financial Department, (f) Geographical Intelligence and Information Center and (g) the Technical Assistance Department. In addition, IAT counts with 21 Regional Offices33 and on: (a) a Social Communication Office that is responsible for publicizing the actions of IAT and SEDES; (b) a Transparency Portal (http://www.transparencia.pr.gov.br/pte/orgao=IAT) where mandatory matters (such as Expenses, Contracts, Agreements, Organizational Structure, Bids, Payments, List of Servers, Remuneration, Suppliers and Travel Status) are disclosed to the society; and (c) a website to answer questions and complaints from citizens and interested parties (http://www.iat.pr.gov.br/Pagina/Fale-Conosco), which is integrated to the State’s network of sectoral Ombudsman Offices. 27 https://www.saude.pr.gov.br/ 28 Source: SES’s Strategic Map, available at https://www.saude.pr.gov.br/Pagina/Mapa-estrategico. 29 This department has the attribution of granting and monitoring the Environmental Licensing, Environmental Authorization and Water Resources Granting of undertakings and activities that use environmental resources considered effective or potentially polluting or those that, in any form, may cause environmental degradation and comprises three units: Licensing Management, Grant Management and Monitoring and Inspection Management. 30 This department is responsible for (a) prepares, executes and monitors plans, programs, actions, technical projects and policies to encourage the conservation and restoration of biodiversity, (b) manages Conservation Units, (c) carries out environmental inspection, and (d) manages native and exotic fauna, among other activities. It comprises three units: Biodiversity Management, Environmental Restoration Management and the Protected Areas Management. 31 This department is responsible for preparing, executing and monitoring plans, programs, actions, technical projects and policies for the preservation, conservation, recovery and management of the state's Water Resources and Solid Waste. It comprises two units: Sanitation Management and Water Basin Management. 32 This department is responsible for preparing, executing and monitoring plans, programs, actions, technical and political projects in the mineral, geological, agrarian, land, cartographic, geoprocessing areas, as well as the territorial zoning of the State. It comprises two managerial units: Geosciences Management and Land Regularization Management. 33 These regional offices are located in the cities of Curitiba, Campo Mourão, Cascavel, Cianorte, Cornélio Procópio, Foz do Iguaçu, Francisco Beltrão, Guarapuava, Irati, Ivaiporã, Jacarezinho, Londrina, Maringá, Paranaguá, Paranavaí, Pato Branco, Pitanga, Ponta Grossa, Toledo, Umuarama e União da Vitória Page | 29 II.4 Institutional Arrangement: Implementing Partners Due to their legal attributions, in addition to the implementing agencies, key roles in project implementation and environmental and social risk management of project activities shall be played by:, the State Coordination of Civil Defense and Protection Civil Defense, the State's Comptroller General and General Ombudsman Office, and the General Superintendence of Dialogue and Social Interaction. These agencies and sub-agencies are briefly described in this section. The State Coordination of Civil Defense – DC were instituted through State Decree 9,557/2013.34 DC reports directly to the State Governor and, at the state level, it is the central normative, planning, coordination, control and guidance body of all preventive, mitigating, preparation, response and recovery measures related to civil protection and defense. DC comprises 18 Regional Civil Protection and Defense Coordinators - CORPDEC, in order to allow greater proximity between the State Coordination and Municipal Coordination, and the State Center for Risk and Disaster Management – CEGERD, which was inaugurated on April 25, 2017 and facilitates the monitoring of meteorological conditions that can cause disasters and the monitoring of these events.35 The State Coordination of Civil Defense discloses annual reports of the planned and executed actions of response to natural and human-made disasters.36 The State's Comptroller General and General Ombudsman Office – CGE is the central body of the State System for the Control of the Executive Branch and was instituted by Law 17,745/2013. The CGE regulation was approved by Decree 2,741/2019. Pursuant to Law 19,848/2019, CGE directly advises the State Governor for the purpose of planning, coordination, control, evaluation, promotion, formulation and implementation of mechanisms and guidelines for preventing corruption and transparency, promoting social participation in the management of public services, and grievance redressing. Its basic organizational structure comprises at the level of programmatic execution: (a) an Internal Control Coordination, (b) an Integrity and Compliance Coordination, c) and Internal Affairs Coordination, (d) a Coordination of Ombudsman, (e) a Transparency and Social Control Coordination, and (g) a Public 34 Previously, Civil Defense was created in the state of Paraná in 1972 (State Decree 3,002/1972) and incorporated to the Military House in 1992. Lately, the Paraná Information System for the Management of Natural Disaster Risks - SIGRisco PARANÁ was instituted by State Decree 9,941/2014 for planning, systematization and analysis of information of mapping, monitoring, forecasting and alerting on meteorological , hydrological, geological and oceanographic events. CEPDEC’s Internal Regulation and institutional structure were approved by State Decree 2,596/2019. 35 CEGERD’s main objective is to provide support to municipalities affected by disasters. CEGERD’s information supports municipalities in the documentation for decreeing an emergency situation or a state of public calamity. CEGERD includes a disaster monitoring and management room, where all Civil Defense occurrences in the State are monitored in real time allowing the issuance and dissemination of Civil Defense Alerts via SMS to the population of Paraná and the contact with the Regional Civil Defense Districts through videoconference and VOIP telephony. In 2018, CEPDEC issued more than 27,000 alerts. 36 In 2018, 429 events were reported by 194 municipalities (mostly from the Campos Gerais, Norte e Oeste and Leste and Litoral regions) to the Defense Civil Informatized System (SISDC). These events affected 144,612 people (displacing 2,661 people, hurting 53 and killing 16 people) and caused public and private losses of BRL 180,9 million. Wind and rains caused 86% of these events. Page | 30 Expenditure Observatory. And, at the systemic execution level, CGE counts on Sector Integrity and Compliance Centers (NICS).37 II.5 Previous Experience of the Implementing Agencies with the Program or Similar Activities SEPL, SEAP, IAT and SESA have substantial experience working with previous Bank-supported projects, Bank’s principles and operational policies. Only the Chief of Staff (“Casa Civil”) has no previous experience with Bank operations. Bank-supported projects Land Management Project (1989-1997), P037828 Rural Poverty Alleviation and Natural Resources Management Project (1998-2006), P070522 Paraná Biodiversity GEF Project (2003-2008) and P126343 SWAp for Paraná Multi-sector Development Project (2014-2019) helped introduce sustainable agricultural practices and improve environmental and disaster risk management awareness. A central dimension for ensuring a sustainable development path for Paraná relates to the Government’s environmental management capacity and its ability to manage risks and respond to natural disasters. Overall, the State has a very good experience and capacity to address environmental issues. Indeed, the public sector capacity for environmental and disaster risk management was significantly strengthened through the setting up of a highly effective disaster risk monitoring unit, mapping and risk-profiling of high risk areas, and an integrated system to automate the process of submitting and approving environmental and water use licenses, generating significant time-savings for small producers and individual users and improved monitoring and control by the state environmental agencies through automated water use monitoring. Institutional strengthening was the core theme of P126343, supporting institutional changes related with governance, accountability and results-based management processes that require a long-term commitment and have a steep learning curve.38 Paraná State has also experience executing Interamerican Development Bank's projects and with international cooperation agencies. 37Paraná State Decree No. 2,741/2019, Annex I, Article 3. 38 World Bank, P126343 SWAp for Paraná Multi-sector Development Project Implementation Completion Report, available at https://wbdocs.worldbank.org/wbdocs/drl.html?objectId=090224b0879edfbb&standalone=true&respositoryId= WBDocs. Page | 31 Section III. Description of Expected Program Environmental and Social Effects The environmental and social risks of the activities included in the PforR Component of the “Paraná Eficiente” Project have been classified as moderate. III.1 Likely Environmental and Social Effects The potential negative risks and impacts of the proposed PforR program are likely to be predictable, temporary and/or reversible. They will be low in magnitude and site-specific, without likelihood of impacts beyond the actual footprint of a few construction sites. They have a low probability of serious adverse effects to human health and/or the environment and routine safety precautions are expected to be sufficient to prevent accidents. They can also be easily mitigated in a predictable manner. The main direct immediate negative environmental effects identified refer to activities included in the first results area (Health Service Delivery). These effects may include: (i) occupational health and safety (OHS) issues faced by medical staff and public health servants and patients of hospital units involved in the combat to COVID-19; (ii) the generation of waste by health service providers and, consequently, safety issues related to the handling, transportation and disposal of hazardous and infectious healthcare waste; and (iii) the moderate and site-specific environmental and social impacts associated with the renovation works of the small hospitals for their conversion into UCMs, including workers’ occupational safety and health issues. These risks are already foreseen, and the standards of safety design and operation of health facilities, the management of waste generated by health service providers. The existing protocols and measures to manage hazardous materials and waste generated by providers of health services are robust and adequately overseen as well as the standards for ensuring the occupational health and safety of health workers. Indeed, UCMs will generate less risky situations as they will neither operate with radiological instruments (reducing OHS risks), nor carry out surgeries (reducing the risk of generation of contaminated waste). Furthermore, the small-scale renovation works of small hospitals are neither expected to lead to adverse impacts on natural habitats and cultural heritage, nor require land acquisition with adverse impacts related to land acquisition, restrictions on land use or involuntary resettlement. These activities aimed to improve health service delivery are expected to have positive distributional and pro-poor effects as the public health service network benefits the most the lower income population. Following the principles of the Unified Health Care System (SUS), the envisaged activities of improvement of the health information system and Covid-19 response take into consideration the needs to facilitate the access to public health by vulnerable social groups. Page | 32 Meanwhile, the activities included in second results area of Environmental and Disaster Risk Management are expected to reduce and mitigate adverse risks and impacts of environmental threats, natural hazards and geological risks to human health and safety as well as economic assets faced by citizens and businesses located in high risk zones. No adverse environmental and social risks and impacts are expected from its implementation. Finally, the third results area (Public Sector Management) include a set of activities aimed at strengthening public sector systems and capacities for health service delivery, which include the support to the roll out and implementation of the platform for managing the Productive Regional Development Plans. The Regional Productive Development Plans aims to foster regional development and reduce regional inequalities applying principles of sustainable development and a participatory approach and there is no expectation that they would lead to large-scale land use changes or any impacts related with land acquisition, restrictions on land use or involuntary resettlement. Indeed, positive effects are related with the sustainable development approach that will be followed and may include preservation of ecosystems, efficient use of energy and natural resources, reduction of waste generation, income and job generation. The induced and downstream effects of these plans may also contribute to reduce greenhouse gas (GHG) emissions. Measures are recommended to ensure the engagement of disadvantaged and vulnerable social groups, including an assessment of barriers to their participation due to gaps on digital literacy and accessibility. Thus, the definition of the methodology for the preparation of these plans emphasizes the need of broader and meaningful consultation with women, Indigenous Peoples, traditional communities and other disadvantaged and vulnerable social groups. This activity will also support the government’s program to strengthen the availability, quality and use of digital systems and services in the health sector. Considering the obstacles related with the digital divide, the design of these systems and services shall give particular consideration to the needs of women, the elderly, the poor and vulnerable groups to facilitate their access. The activities supported by the operation are neither likely to have adverse impacts on GHG emissions, nor to affect adversely protected areas, critical, natural or modified habitats that include significant biodiversity value. III.2 Contextual risk factors The State of Paraná has a well-established regulatory framework in all results areas to be supported by the PforR component. The governance structures and legislation enjoy stability, strong oversight by judicial and extra-judicial bodies (including mass media and public opinion). There are in place a set of mechanisms to foster transparency, social control and accountability. Social participation in policy decision-making is an integral part of the public governance of these sectors. The context is neither ridden by recent or ongoing social conflict, nor social fragility. The institutional sustainability of the outcomes will be ensured by employing technologies as a tool for improving government services and institutionalizing the underlying changes in public sector management. Page | 33 III.3 Institutional capacity and complexity risks The implementation of the supported activities will involve multiple sectors and state agencies. The multi-sectoral nature of the PforR component adds to the complexity of the operation and makes clear a strong need of coordination between the implementing agencies. The implementing agencies have at least the minimum institutional capacity required (staff, budget, availability of implementation resources, training, etc.) to carry out defined responsibilities under the applicable Programs’ systems. Furthermore, one of the explicit main goals of the supported operation is to enhance the institutional capacity and performance of the state environmental agency on the enforcement of the state’s robust regulatory framework. The regulatory framework and institutional capacity to oversee the operation of health service facilities – including the management of solid wastes and addressing occupational health and safety issues (affecting workers and users) are adequate. There are no significant concerns related to the State of Paraná’s and the implementing agencies’ commitment for and track record in relation to stakeholder engagement. Multiple multi-stakeholder state councils are established by law and regularly operating as consultative or deliberative boards. Finally, the State of Paraná and the implementing agencies have built a positive track-record working with environmental and social issues in previous operations with the World Bank and other multilateral organizations as well as when developing programs and projects of the same level of complexity. Nevertheless, the Government of Paraná has acknowledged that there was a weakening of the responsible environmental agencies and its consequences on the environmental licensing, inspection and monitoring processes and is making investments on technological innovation, digital transformation, and the enhancement of evidence-based geospatial information, aiming to improve and integrate its environmental management systems.39 These investments aim to improve the efficiency of these agencies and processes and, consequently, to contribute to avoid overuse of natural resources, conversion and degradation of critical natural habitats. III.4 Reputational and political risks Brazil has modern, advanced environmental, social and labor laws, reflecting a political culture of significant environmental and social protection. There are robust regulatory frameworks in 39 Thus, the Government of Paraná is investing on the enhancement of evidenced-based geospatial information and the enhancement of an online geographic platform (IDE – Spatial Data Infrastructure – “Infraestrutura de Dados Espaciais”). These investments are expected to allow the use of geographic intelligence as a decision support tool for analysis in environmental licensing processes and improvements in the Environmental Enforcement System and Infraction Notices. These processes will be integrated with the geo portal and with the system of the Military Police of the State of Paraná and will develop and implement the system of environmental inspection and management of infringement notices based on the use of mobile devices in the field. Thus, they are expected to improve the efficiency of these agencies and processes and, consequently, to contribute to avoid overuse of natural resources, conversion and degradation of critical natural habitats. Page | 34 place at the country and state level ruling environmental licensing and protection, labor and working conditions, access to public health care, access to information and rights of users of public services as well as the operation of grievance redressing mechanisms. The Program will be developed under a nation- and state-wide legal or regulatory environment where there is significant certainty about the jurisdiction of the implementing agencies, the regulatory framework do adequately address potential environmental and social risks and impacts of complex Projects, and enforcement of the regulatory framework is strong. The legal and regulatory authority over all activities supported by the project are clearly established. Broad campaigns of information disclosure about the supported activities, participatory approaches promoting the engagement and continued consultation of key stakeholders, availability of an efficient grievance redress mechanism and use of citizens’ manifestations to foster adaptative management on the implementation of the supported activities are seen as able to strengthen the existing systems that foster transparency and access to information as well as social accountability, participation and control in the different sectors in the State of Paraná. They are expected to minimize potential misinformation and controversies around the supported activities. Page | 35 Section IV. Assessment of Borrower’s Environmental and Social Management Systems relevant to the Program This section describes the main elements of applicable Borrower systems (including its practices and performance record), makes an assessment of these systems against core principles and planning elements) and provides an analysis of the acceptability of these systems that takes in consideration the level of environmental and social risks of the Program and the extent to which Borrower systems and practices are aligned with World Bank core principles The assessment of the expected environmental and social effects of activities included in a Program for Results considers the six core principles (and their key planning elements) set by The Bank Guidance. A synthetic description of the six core principles and the key planning elements they cover was presented in Section I – Introduction and Methodology. The conclusions of the Environmental and Social System Assessment are presented below according to each core principle. IV.1 Main Elements of the Borrower System in light of Core Principle #1 Paraná State agencies operate within an adequate legal and regulatory framework to guide environmental and social impact assessments, mitigation, management and monitoring of the environmental and social effects. The Program will not lead significant impacts on the environment and society. Its supported activities will not have adverse environmental and social impacts covering large geographical areas, including transboundary impacts, or global impacts such as greenhouse gas (GHG) emissions.40 Institutional responsibilities for the assessment of environmental and social impacts is clearly ruled by Law. They are under the attributions of the Water and Land Institute (IAT), which belongs to the institutional structure of SEDEST – one of the leading implementing agencies. Meanwhile, the assessment and management of environmental and social impacts related with the management of solid waste and hazardous materials managed by health service facilities are under the attributions of the State Health Surveillance System (VISA), which is coordinated by the Health Surveillance Coordination under the institutional structure of SESA and comprises health surveillance teams (both at the central level of SESA-PR and the 22 Regional Health Departments of the state) and by the health surveillance teams of 399 municipalities. 40 On the contrary, Program activities related the management (reduction and renewal) of the state fleet of vehicles may contribute – although slightly – to reduce greenhouse gas (GHG) emissions and pollution prevention. Improved public state asset management may contribute to efficient use of energy and water and also contribute to reduce GHG. Page | 36 Some stakeholders highlighted the ongoing debate on the municipalization of the environmental licensing process (review of CEMA’s Resolution 88/2013) and its potential adverse impacts on this process.41 By law, the environmental licensing process of activities require the environmental and social screening and assessment of all activities that may have significant environmental and social impacts.42 The procedures in place follow a proportionality principle, so the requirements vary according to the anticipated risks and significance of impacts. The type, depth, breadth and scope of the environmental and social impact studies that are required in each situation vary according to the anticipated risks and expected impacts. While licensing may not be required for low impact activities, those with significant anticipated risks and impacts require an Environmental Impact Assessment (EIA) and an Environmental Impact Report (RIMA) to guide environmental agencies in authorizing (or not) the proposed development initiatives. The licensing of these type of activities have to undergo public hearings engaging key stakeholders. Some stakeholders pointed out that the Brazilian legislation requires that speleological studies from enterprises to be located in areas with karst potential (in accordance with Decree No. 99.556 / 1990, Decree No. 6.640 / 2008, Normative Instruction MMA No. 2/2017 and CONAMA Resolution No. 347/2004) are carried out and consider this to be a fragility in the State’s environmental licensing process. This assessment of environmental and social impacts required for the licensing process takes into consideration strategic, technical, and site alternatives (including the “no action” alternative) and requires an explicit assessment of potential induced, cumulative, and transboundary impacts. The impact assessment carried out for the licensing process also requires the identification of measures to mitigate adverse environmental and social risks and impacts that cannot be otherwise avoided or minimized and the definition of who will be responsible for supporting the implementation of the required mitigation plans. Some stakeholders pointed out the downgrading and downsizing of the State agencies responsible for environmental risk and impact management and the reduction of their contingent of technical staff throughout the years and pointed out the needs of (a) hiring on a more permanent-basis of skilled technical staff to carry out on-the- ground work of environmental oversight and screen the self- declared information provided by project developers during 41 Throughout this section, the yellow boxes highlight the comments and suggestions received from the stakeholders consulted for the preparation of this assessment. The consultation process is summarizes in Section V (below). 42 The main pieces of the regulatory framework are summarily described in Annex 2. Page | 37 the environmental licensing process and (b) providing the responsible environmental State agencies with the means needed for on-the-ground activities. Some stakeholders pointed out the need to improve articulation between different governmental agencies (executive and judiciary branches) to improve the environmental licensing and risk management processes. Others called attention to the need to assess possible interactions between changes in management procedures resulting from the activities supported by the Program in the environmental licensing process and the recent changes in environmental legislation, in order to capture gaps that may generate inappropriate approvals in environmental licensing processes and required that the Environmental Police is involved in the planning process to ensure that new environmental management and licensing processes and procedures follow effective oversight and due diligence. Environmental Impact Assessment and Report An Environmental Impact Assessment (EIA) is required for any activity or enterprise that uses environmental resources, effective or potentially causing significant pollution or other forms of significant degradation of the environment. It is carried out previously for the analysis of the environmental feasibility and must necessarily be succeeded by a Public Hearing. The Environmental Impact Report (RIMA) is the document that reflects the conclusions of the EIA and has to be presented during the public hearing in an objective manner and with information in language accessible to the general public, so that one can understand the advantages and disadvantages of the activity or enterprise as well as the environmental consequences of its implementation.43 EIA/RIMA may also be required if, on the occasion of the presentation of other Environmental Studies, it is observed that the activity has the potential of causing significant environmental impacts. As described in CONAMA Resolution No. 01/1986,44 the preparation of the EIA should minimally cover: (a) the proposition of technological and locational alternatives; (b) the Areas 43 EIA/RIMA are required for all the projects listed in CEMA Resolution No. 107/2020 (art. 59), which takes in consideration the size and location of the activities to be licensed and makes EIA/RIMA mandatory in works with significant environmental impacts, such as: railways, airports, ports, waterways, highways, vicinal roads that cross priority areas for environmental conservation; oil and gas pipelines; power generation facilities and transmission lines; large dams, sanitation systems, drainage system, dredging of natural and artificial bodies of water in areas declared to be environmentally sensitive/relevant; mineral and oil extraction facilities; large landfills and systems for treatment, processing, co-processing and final destination of toxic and hazardous waste as well as toxic and hazardous waste incinerators; industrial and agro-industrial complexes and units and industrial districts; urban settlements, condominiums and housing estates of high demographic density, when located in priority areas for conservation or large urban upgrading projects located in areas of high social interest; large agricultural projects and forest plantations of exotic species, among others. 44 http://conama.mma.gov.br/?option=com_sisconama&task=arquivo.download&id=745. Page | 38 of Influence (ADA, AID and AII); (c) the Environmental Diagnosis of the physical, biotic and socioeconomic environment; (d) the Environmental Prognosis, contemplating the future operation of the enterprise; (e) the Matrix of Environmental Impacts; (f) the Environmental Programs of mitigation and/or compensation; (g) the cumulativeness and synergy with other enterprises of the same category or not; (h) the compatibility with the legal provisions (municipal, state or federal); and (i) information for calculating the level of impact.45 In Paraná, whenever an EIA/RIMA is required, before applying for the Preliminary License (LP), it is necessary to consult IAT in relation to the preliminary survey and identification of aspects of environmental impediments in the area of installation of the project.46 There are multiple channels through which the Government of the State of Paraná aims to ensure transparency of public actions, foster social accountability, and respond to citizens. These channels include sectorial state councils with a multi-stakeholder composition – such as the State Health Council, the State Environmental Council, the State Water Resources Council and the State Social and Economic Development Council – as well as state councils and committees that ensure participation of vulnerable social groups on policy decision-making.47 All these bodies are established by law and hold consultative and deliberative powers. Many stakeholders highlighted the importance of transparency of public data to allow social control and enhance social accountability. Others called attention for the need to monitor and rigorously evaluate the results of the implementation of technological innovation in licensing and environmental management processes, to promote online accessibility and transparency of all environmental licensing procedures for all interested parties and to ensure full public disclosure of all costs related with the Paraná Efficient Program. To ensure and enhance the dialogue between the State Administration agencies and organized civil society, social movements, NGOs and other collectives from the third sector, the Government of the State of Paraná has created the General Superintendence of Dialogue and Social Interaction – SUDIS, which is also in charge of coordinating several State Councils that have at minimum equal participation of society an civil society organizations and carry out 45 Other environmental instruments may be required during the licensing process by IAT. They are listed and briefly described in Annex 4. IAT webpage keeps available for public consultation the list of activities and enterprises that carried out EIA/RIMA and also the minutes of the Public Hearings that have been convened since 2010 (http://www.iat.pr.gov.br/Pagina/EIA-RIMA). 46 http://www.iat.pr.gov.br/Pagina/EIA-RIMA. 47 Such as the State Council of Indigenous Peoples and Traditional Communities, the Working Group of Traditional Peoples and Communities of Paraná, the State Council for the Promotion of Racial Equality, the State Council for Women’s Rights, the State Council for the Rights of Persons with Disabilities and the State Council for the Rights of the Elderly, which will be considered below. Page | 39 consultative, deliberative and oversight responsibilities in some of the sectors covered by the Program. Many stakeholders emphasized the need to ensure free, prior and informed consultation of Indigenous Peoples and Traditional Communities in all activities that interfere with their lands and livelihoods. A further and key channel to ensure responsiveness and accountability, is the State’s Comptroller General (CGE), which organizational structure comprises both the Transparency and Social Control Coordination and the Ombudsman Coordination (OUV). The attributions of the first coordination include, among others: (i) the proposition and coordination of actions that encourage citizen participation in social control; (ii) the formulation, coordination, promotion and support for the implementation of plans, programs and projects and the proposition of rules aimed at preventing corruption and promoting transparency, access to information and social control in the State Executive Branch; (ii) the monitoring of transparency policies and access to information within the executive branch in compliance with Federal Law 12,527/2011 – “Access to Information Law”, and the publication of all acts involving expenditures, programs and goals carried out by the Public Administration, except as provided for by Law; (iii) the conduction of educational campaigns and actions, aiming to promote social control and access to information as an instrument of control; and (iv) the management of the Paraná State Transparency Portal.48 OUV aims the establishment of effective mechanisms that allow effective popular participation and daily exercise of citizenship. OUV coordinates the 72 sectoral ombudsmen distributed in the organs of the State. Government of Paraná,49 through the Integrated System for Ombudsman Management – SIGO of the State Executive Branch.50 OUV is responsible for: (a) receiving, analyzing and responding to the claims made by users of public services (b) training of multiplying agents in the organs of the Executive Branch aiming to streamline the processing of citizen claims, (b) defining standards for measuring the level of satisfaction of citizens using public services and carry out users’ satisfaction surveys with the services provided, (c) systematizing the information made available by SIGO sectoral units, consolidating and disseminating statistics on citizen claims, and (d) using this data for proposing and monitoring the adoption of measures for the prevention and correction of failures and omissions in the provision of services.51 48 Paraná State Decree No. 2,741/2019, Annex I, Article 17. 49 The list of sectoral ombudsmen offices of the executive branch of the State of Paraná is available at http://www.cge.pr.gov.br/Pagina/Rede-de-Ouvidores-Setoriais. Resolution No. 07 of 2015 regulates the competencies of the ombudsmen of the organs and entities of the Paraná Executive Branch. 50 SIGO is a computerized system of mandatory use by the state agencies for receiving, analyzing and attending citizen manifestations. Implemented since 2011, SIGO allows the integration of the Ombudsman of the Executive Branch of the State of Paraná, in order to receive, verify, process and answer the calls and manifestations of Paraná citizens received by each Ombudsman, It also allows OUV to monitor and control demands with the quality and rigor required by legal standards. 51 The annual OUV Management Reports consolidate this information, point out flaws and suggest improvements in the provision of public services. Paraná State Decree No. 2,741/2019, Annex I, Article 17. Page | 40 OUV receives and processes claims (i.e., requests of information, suggestions, complaints, denouncements and compliments) about government actions and programs. Once inserted in the system, the claim is analyzed and immediately forwarded to the competent body for solution within a predetermined period. After being examined and considered satisfactory by OUV, the measures adopted are communicated to the interested party.52 The manifestations can be registered through the: telephone number 0800-041-11-13; face-to-face service; email; mail; the WhatsApp application; and the link http://www.cge.pr.gov.br/Pagina/Registre-sua- Reivindicacao on the institutional portals of the State. There are three ways to register a manifestation: (i) identified (registration details are mandatory), (ii) confidential (registration details are requested, but kept in possession of the Ombudsman Office and will not be passed on and/or transmitted during the course of the processing of the claim; and (iii) anonymous (registration details are not required).53 Users can follow the processing of their manifestations through the http://www.cge.pr.gov.br/Pagina/Consulte-sua-Reivindicacao. A dedicated webpage is also available where users can evaluate the services provided by the OUV (http://www.cge.pr.gov.br/Formulario/Pesquisa-Ouvidoria). In addition, OUV published a Citizen's Primer54 to guide on the lodging, processing and resolution of claims and keeps a dedicated webpage to answer frequently asked questions.55 In 2020, SIGO was adapted to the context of COVID-19 incorporating three new features for the manifestations in the Ombudsman and for requests based on Access to Information Law – namely: (i) allowing the users of the website to register their manifestations related to the pandemics in a specific channel; (ii) allowing users to choose whether to forward the request through the Ombudsman or whether to request data under the Access to Information Law; and (iii) allowing users to choose to register their manifestations as “confidential” in the website, which ensures that personal data, such as the name of the applicant, is not included in the internal processing of the request, as provided by law. The user remains identified in the system, but his/her identity is not shared with the sector that receives the request. Additionally, the OUV website included an option for the users to state whether their manifestation was or not related with the pandemics, allowing for dedicated and fast processing.56 The 2020 OUV Work Plan also included: (i) the publication of a Letter of Rights and Duties of Public Service Users to publicize the services provided by the Ombudsman's Coordination, such as access channels, requirements for the fulfillment of the request, phases deadlines for 52 Depending on the severity of the claim, prior investigation, inspection, or an audit procedure are carried out before conclusion and response. 53 Regardless of this choice, users’ data are safe and safeguarded by CGE, based on legal requirements to protect the users of public services. 54 The Citizen’s Primer (Ouvidoria – Cartilha do Cidadão – A Sua Voz no Governo) was first published (and remains available) on the CGE website in August 2019 (http://www.cge.pr.gov.br/sites/cge/arquivos_restritos/files/documento/2019-08/cartilhadocidadao_0.pdf). 55 http://www.cge.pr.gov.br/FAQ/OUVIDORIA-Perguntas-Frequentes. The Primer and the FAQs inform the user of the ombudsmen system of its key features: what is an Ombudsman and what is its function, who can use and when the user shall go to the ombudsman, what are the rights and duties of the public service users, how users can make a manifestation and what they shall inform, what are the procedures and timelines during the response period, and how they are informed about the processing of their claims. 56 This is part of the program called Programa Descomplica created to register manifestations related to COVID-10: http://www.cge.pr.gov.br/Pagina/Programa-Descomplica. Page | 41 processing, the form of service provision and quality standards, which would be available on CGE digital media and in printed format as well as in Portuguese, English and Spanish language; (ii) the carrying out of a Public Services User’s Satisfaction Research; (iii) training of sectoral Ombudsmen; (iv) the creation of the Consultative Council of the Ombudsmen of the Executive Branch of the State of Paraná aiming to improve the service to citizens; and (v) a study to improve the accessibility of the SIGO System to people with disabilities and guarantee their rights to receive priority assistance. The Program will rely on this system as its grievance redressing mechanism. The channels for lodging complaints and ask information available through the OUV System will be informed in all webpages dedicated to disclosure of Program-related information. IV.2 Main Elements of the Borrower System in light of Core Principle #2 The country and the state have strict rules and clear procedures with respect to the identification of adverse effects on potentially important biodiversity and cultural resource areas. In both areas, adequate measures to avoid, minimize or mitigate adverse effects are well known and broadly applied. The Program will not have potential adverse effects on potentially important biodiversity areas. None of the supported activities are expected to have direct, indirect or induced impacts leading to conversion or degradation of critical natural habitats. No supported activity is expected to promote large scale changes in land use or access to land and/or natural resources that can have significant adverse impacts on the environment too. The Program will not have potential adverse effects on physical cultural heritage (legally protected cultural heritage areas, archaeological sites and materials, built heritage, natural features with cultural significance or movable cultural heritage). Notably, the conversion of small hospitals into UCM and the expansion of hospital capacity to respond to Covid 19 are not expected to have significant impacts on critical natural habitats. The operation of UCM and hospitals may involve potential a risk related to hospital management waste and contamination. However, this risk is minor because (a) are ruled by restrict, well-implemented and closely oversighted standards on management of waste and hazardous materials and (b) the Government of Paraná has a strong track-record and well- developed institutional capacity to manage waste and hazardous substances in a manner that reduces immediate and future impacts to the environment and society. The robust legislation and institutional capacity to manage waste generated by health service providers also reduces risks of degradation of critical natural habitats. The Regional Productive Development Plans aim to promote regional development based on sustainable development principles and require the assessment of the diverse impacts that economic activities and infrastructure may have on the regional environment, aiming to ensure a well preserved and well connected ecosystem. They are based on a sustainable development approach that highlights the environmental dimension (preservation of ecosystems, efficient use of energy and natural resources, and reduction of waste generation) and the social inclusion dimension (prioritizing areas of high social vulnerability and aiming to reduce the Page | 42 drivers of regional and social inequalities). As they must also follow the Brazilian Forest Code and other laws and regulations concerning natural habitats and protected areas (Law 12.651/12; SNUC - Law 9985/00, Decree 4340/02 and Decree 5758/06), these plans are expected to contribute to the protection of natural habitats, sustainable use of lands and natural resources. • Management of Impacts on Biodiversity Areas In matters related with biodiversity areas, critical and natural habitats, the Brazilian environmental framework is modern, broad, and innovative in technical terms. The Brazilian Federal Constitution of 1988 (FC 1988) guarantees every citizen the right to an ecologically balanced environment, of common use and essential for maintaining a healthy quality of life. Moreover, public authorities and society are identified as responsible to preserve the environment for present and future generations (Article 225). It also establishes the concurrent jurisdiction of the federal government, the states, the federal district, and local governments to: protect the environment and combat pollution in any of its forms; preserve the forests, fauna and flora; register, monitor and oversee the granting of rights (i.e. concessions) to conduct research, exploration or extraction of water or mineral resources in their territories (Article 23). The Brazilian environmental framework encompasses legislation on a National Environmental Policy (Laws 5,197/67 and 6,938/81 and Decree 99274/90), on water resources management (Laws 9,433/97, 9,966/2000 and 9,984/2000), on environmental crimes (Law 9,605/98 and Decree 3,179/99), on environmental education (Law 9,795/99 and Decree 4,281/2002), on the national system of protected areas (SNUC – Law 4,771/65 and Law 9,985/2000), on forest concessions (Law 11,284/2006) and on the protection of native vegetation (known as the Forest Code, Law 4,771/65 amended by Law 12,651/2012). The Forest Code, SNUC and National Water Resource Policy enshrine principles for living natural resources, and water use and management.57 This legislation provides for the maintenance of natural vegetation cover in each private rural property as a “Legal Reserve” (LR) and Areas of Permanent Protection (APPs), which include riverbanks, headwaters, steep slopes and mountain tops. It also requires the inscription or landholdings in the Rural Environmental Registry (CAR) as a way to register the responsibilities of maintaining native vegetation in rural properties, under the regimes of Legal Reserve (RL) and permanent preservation areas (APP). The CAR is the baseline for defining the appropriate management of forest resources and land use. The Native Vegetation Protection Law of Brazil (known as the Forest Code) defines the criteria that are nowadays countrywide adopted for the protection of natural habitats as well as the proportion of a given private rural landholding that can be used for agriculture, silviculture or cattle ranching, as well as the areas of native vegetation that must be maintained under protection or restricted use. The Forest Codes increased the enforcement power of public authorities by establishing that the landowners or landholders must request authorization of the environmental agency to suppress native vegetation outside APPs and LRs. The National 57 The main pieces of the regulatory framework are summarily described in Annex 2. Page | 43 Protected Areas System (SNUC) defines as regulates protected areas category at federal and state and municipal levels. Private natural heritage reserves are also included in SNUC. The environmental crime legislation (Law 9,605/98 and Decree 3,179/99) law lays down the criminal and administrative sanctions derived from conduct and activities harmful to the environment, and other arrangements. The National Environmental Crimes Law (Law 9,605/1998) seeks to protect wildlife and plants of the country, particularly the endangered species. This law greatly broadens liability for environmental violators by: improving the ability of administrative agencies to apply administrative sanctions; establishing the responsibilities of corporations for environmental violations and damage; turning more environmental violations, such as illegal logging, into crimes with higher penalties; and providing quicker judicial procedures for many environmental crimes.58 The enforcement of the Environmental Crime Law in Paraná is under the co-responsibility of IAT and the Environmental Police Battalion (Green Force) of the Paraná Military Policy. IAT is responsible for carrying out environmental inspections aimed at preventing the establishment or continuation of actions considered harmful to the environment, or even those carried out in breach of what was authorized in the Licensing. The Green Force works with the prevention and deterrence of actions that represent threats or depredations of nature, ensures compliance with environmental legislation for the defense of wild flora and fauna, and develops environmental education programs with the community. The Green Force was created on April 4, 1957 by State Law nº. 3076 and had its duties defined through Law No. 6774/76. It comprise five regional companies and the current Organizational Chart contains nearly 600 Environmental Military Policemen.59 Some stakeholders suggested the State Government considers the creation of a qualified scientific technical committee to guarantee the effectiveness of a currently non-existent biodiversity conservation policy for the State of Paraná and allocate compensation resources, fines and other assets that are not the responsibility of the State Government to meet the priorities in relation to the conservation of natural heritage • Management of Impacts on Cultural Heritage The Borrower’s environmental and social system comprises a well-developed regulatory framework and robust institutional capacity with respect to the protection of cultural heritage, supporting the implementation of adequate measures to avoid, minimize or mitigate adverse effects. The Borrower’s system is ruled at the federal and state level. At the federal level, the Brazilian Federal Constitution of 1988 (FC 1988, Art. 216) recognizes the existence of material and immaterial cultural heritage and establishes three ways for its preservation: the record, the inventory and the guardianship establishes the concurrent jurisdiction of the federal government, the states, the federal district, and local governments 58 http://www.planalto.gov.br/ccivil_03/LEIS/L9605.htm. 59 http://www.iat.pr.gov.br/Pagina/Fiscalizacao-Ambiental-Atribuicoes and https://www.pmpr.pr.gov.br/BPAmb. Page | 44 to protect documents, works and other assets of historical, artistic and/or cultural value, monuments, noteworthy natural landscapes and/or archeological sites (FC 1988, Art. 23). Assessment of potential adverse impacts of public and private interventions within or nearby legally protected cultural heritage areas as well as over specific types of cultural heritage are part of the environmental licensing process and overseen by the National Historic and Artistic Heritage Institute (IPHAN) and the state’s Cultural Heritage Coordination (CPC) and the State Council for the Historical and Artistic Heritage of Paraná (CEPHA). At the federal level The National Historical and Artistic Heritage Institute (IPHAN) is responsible for the protection of cultural heritage and comprises 27 Superintendencies (one in each Federative Unit), 28 Technical Offices and five Special Units. IPHAN is always preventively consulted in environmental licensing processes conducted by federal, state or municipal agencies (Ministerial Decree 60/2015). The manifestation of the Institute is always requested to ensure that a project or activity in the licensing process will not impact or destroy the cultural heritage assets. During the environmental licensing process, IPHAN analyzes aspects related with the risks and impacts to tangible and intangible resources and the proposed mitigation measures. IPHAN may require Program of Management of Cultural Heritage or the presentation of a Commitment by the entrepreneur for projects with low interference on the land, located in modified habitats that are not coincident to registered archeological sites. IPHAN shall also be consulted on decisions upon guaranteeing or not access of stakeholders to cultural heritage taken during the environmental licensing process (Decree Law 25/1937, Law 3924/1961, Decree 3551/2000, Law 11483/2007, and IPHAN Instruction 001/2015). Consequently, IPHAN`s structure includes a National Licensing Coordination.60 At the state level, the Cultural Heritage Coordination (CPC) is the sector of the Secretariat of State for Culture responsible for matters relating to the preservation of the archaeological, historical, artistic and natural heritage of Paraná (State Law nº 1,211 / 53). Its actions refer to the measures necessary for the listing, restoration, conservation and dissemination of these cultural assets. CPC has professionals from different areas that work in the public and private spheres, coordinating, articulating and supporting actions aimed at the preservation of Cultural Heritage. CPC works in four practice areas: (i) Archive and Documentation that is responsible for the collection, storage and dissemination of the documentary collection on the listed and culturally interesting assets; (ii) Architecture that guides, supervises and develops actions and projects related to historic urban areas, built heritage and those of preservation interest, (iii) History that carries out historical research for the instruction of the registration processes; and (iv) Natural Heritage and Archeology that makes the technical monitoring of the natural heritage areas. The state also counts with the State Council for the Historical and Artistic Heritage of Paraná (CEPHA), which is composed of 10 effective members and 10 consulting members, each qualified in a specific area of knowledge, as well as representatives of different regions of the State. These members are appointed by the Governor of Paraná. CEPHA is consulted in matters related with the registration processes of cultural heritage, 60 http://portal.iphan.gov.br/legislacao. Page | 45 proposals for the use and occupation of protected cultural heritage areas, and proposals that interfere with the listed cultural heritage sites and materials.61 Whenever "chance finds” occur it is mandatory to stop works in the site and make an immediate communication to IPHAN, which nominates an specialist to oversee programs related with the management of impacts on cultural heritage. Existing chance finds procedures include measures of archeological rescue where it is not possible to promote in situ preservation and the identification of institutions able to receive the materials (Law 3,924/1961 and IPHAN Normative Instruction 01/2015).62 Some stakeholders called attention for the need to update the studies about the natural heritage of the Paraná state and carry out specific studies when development projects have a potential impact in areas with karst potential. IV.3 Main Elements of the Borrower System in light of Core Principle #3 The civil renovation of forty small hospitals and their conversion into multidisciplinary health care units (UCM) is the only Program activity requiring construction works. With respect to safe design, construction and operation of health facilities, ANVISA63 RDC 50/2002 sets Technical Regulations for engineering design of physical projects of health care establishments that apply on the whole country.64 It is the guiding instrument for new constructions, renovations and expansions of health care facilities and meets principles of regionalization, hierarchy, accessibility and quality of care to be provided to the population. The National Health Surveillance Agency of the Ministry of Health is required to provide technical cooperation to the State and Municipal Health Secretariats, in order to guide them on the exact compliance and interpretation of this Technical Regulation. The Technical Regulation defines criteria for projects of health care facilities and deals with aspects such as circulation areas, endogenous and exogenous environmental conditions of comfort (hygrothermal and air quality, acoustic and luminous), common and special building installations, fire safety conditions, hygiene and work safety standards. In addition, Paraná State Health Code – which incorporates the requirements of ANVISA RDC 50/2002 – demands that all architectural project for the construction or renovation of a health service facilities must be approved by the Health Surveillance of the State or Municipal Health Secretariat.65 The National Policy of Primary Health Care (PNAB 2017)66 states that the infrastructure of a primary care health units must be adequate to the number of registered population and its specificities, as well as to the teams 'work processes and to the users' health care. The structural parameters must, therefore, take into account the demographic density, the composition, 61 http://www.patrimoniocultural.pr.gov.br/. 62 http://portal.iphan.gov.br/uploads/legislacao/Lei_3924_de_26_de_julho_de_1961.pdf. 63 ANVISA is the federal agency subordinated to the Ministry of Health. ANVISA was established by Law 9.782/1999. 64 https://bvsms.saude.gov.br/bvs/saudelegis/anvisa/2002/rdc0050_21_02_2002.html. 65 Paraná State Code of Health (Law 13,331/2001, art. 421). 66 http://189.28.128.100/dab/docs/publicacoes/geral/pnab.pdf. Page | 46 performance and types of teams, population profile, and the health actions and services to be performed. The primary care health units must be built in accordance with sanitary norms and with reference to the current infrastructure regulations, as well as having identification according to the visual standards of Primary Health Care and SUS. Their physical space must provide a welcoming and humane attention to people, in addition to a healthy environment for the work of health professionals. it is recommended to contemplate: reception without bars (not to intimidate or hinder communication and also to guarantee privacy to the person), identification of existing services, scale of professionals, opening hours and signaling of flows, thermal and acoustic comfort, and spaces adapted for people with disabilities in accordance with current regulations. The Paraná Health Code (Law 13,331/2001 and Decree 5.711/2002)67 requires that all physical reforms, changes in the number of beds or changes in the technical manager of health service facilities require renewal of the hospital record and are equivalent, for inspection purposes, to the construction, installation or operation of a new establishment. Thus, any architectural project for the construction or renovation of a health service establishment must be approved by the Health Surveillance of the State or Municipal Health Secretariat, in accordance with current legislation. Depending on the degree of risk of the health service facility, The Paraná Health Code also requires that the facilities, equipment, instruments, articles, clothing, utensils and foods subject to contact with organic fluids, mucous membranes and/or solution must be discarded or subjected to decontamination, cleaning, disinfection or sterilization continuity of tissues of patients or users. Thus, establishments that provide health services and vehicles for the transportation and prompt assistance of patients, must be kept in strict hygiene conditions, with strict observance of the technical sanitary standards for infection control and biosafety as well as maintain a program of periodic preventive maintenance of equipment and respective records. Furthermore, every establishment that provides health services - even if it does not have hospitalization - must have an infection control commission and/or an infection control program and carry out the actions contained in that program. Finally, every health service facility (public or private) must prepare and implement the Occupational Health Medical Control Program, according to the current legislation. The operation of Basic Health Units is regulated by bodies linked to health surveillance and public health. This regulation aims to confirm the availability of water supply, destination or appropriate sewage treatment and health conditions for students and employees. Connections for water, sewage, electricity and piped gas must be carried out in accordance with technical standards issued by utility companies. Its operation also requires the approval of fire departments. These statewide military entities are responsible for overseeing compliance with legal provisions regarding fire and panic security systems and measures. Firefighters' bodies also standardize, in a complementary manner, fire and panic protection devices. The issue of operation licenses is associated with the inspection and declaration of conformity of buildings, by the fire department, health surveillance agencies (when applicable), and service concessionaires. 67 https://www.saude.pr.gov.br/Pagina/Legislacao-Estadual , https://saude.mppr.mp.br/pagina-14.html and https://www.crefito8.gov.br/portal/legislacao/diversos/codigo_sanitario_estadual.pdf Page | 47 The municipalities generally have codes of works and Secretaries of Works and Urbanism, which analyze and approve architectural projects, issue various permits such as construction permits and letters of habitation, which constitute the authorization of the prefectures for the occupation or use of the city. edification. The projects (architecture, structure and facilities) to be submitted to city halls to obtain construction permits must be prepared by qualified professionals and duly registered with professional councils, such as CREA (Regional Council for Engineering and Agronomy) and CAU ( Architecture and Urbanism Council). In addition, all works and projects must be technically responsible, by means of technical responsibility notes (ART), registered with professional councils. The technicians responsible are legally responsible for the compliance of the projects with the applicable technical standards, which are defined by the Brazilian Association of Technical Standards (ABNT). With respect to environmental conditions of infection control, ANVISA RDC 50/2002 establishes guidelines, procedures and a series of constructive elements in relation to (a) the management of people, utensils, clothing and waste, the treatment of contaminated elements at the source and the transport of contaminated material, (b) the establishment of physical barriers to minimize the entry of external microorganisms, (c) the materials that shall be used to finish walls, floors, ceilings and benches in order to meet the requirements of cleaning and sanitation, (d) the measures to prevent the entry of synanthropic animals. In addition and accordance to Paraná state laws, all health service providers must have an infection control commission and/or an infection control program and perform the actions contained in it.68 Depending on the degree of risk, the facilities, equipment, instruments, articles, clothing, utensils and foods subject to contact with organic fluids, mucous membranes and / or solution must be discarded or subjected to decontamination, cleaning, disinfection or sterilization. continuity of tissues of patients or users. In addition, establishments providing health services and vehicles for the transportation and prompt assistance of patients, must be kept in strict hygiene conditions, with strict observance of the technical sanitary rules for infection control and biosafety. In addition, SESA is responsible for the regulation, inspection and control of public and private facilities providing health services that use, produce and/or transport sources emitting ionizing radiation, for medical purposes diagnostic or therapeutic, industrial, commercial or research, in situations of normality or radiological emergency. All establishments and services that make use of ionizing radiation must have a Technical Responsible and a legal substitute registered with the Health Surveillance service and to provide all occupationally exposed professionals with Personal Protective Equipment and safety materials.69 None of the supported activity will rely or involve the use of forced or child labor. Since the last decade of the previous Century, Brazil has made a strong progress towards the eradication of child labor and forced labor. 68 https://bvsms.saude.gov.br/bvs/saudelegis/anvisa/2002/rdc0050_21_02_2002.html. 69 Furthermore, no establishment that uses ionizing radiation can be built, renovated or expanded, or have its services transferred from its location, without having the architectural and radioprotection project approved by the competent Health Surveillance Service and cannot operate without being properly registered with the State and/or Municipal Health Surveillance (Paraná State Code of Health, art. 424, 425, 429, 431, and 434-437). Page | 48 Brazil has a robust labor relations and working conditions legislation and strong institutional capacity to ensure its enforcement throughout the country. One of the key aspects of this regulatory system is the banishment of forced labor and child labor. The Federal Constitution and the Labor Code prohibit child labor and the minimum age for work is 16 years. Under the Brazilian legislation, the minimum age for work in Brazil is 16 (art. 403 of Labor Code) Minimum age for hazardous work is 18 (art. 2 of the Hazardous Work List, the TIP List instituted by Federal Decree 6481/2008). From the age of 14, the teenager can be an apprentice. An apprentice is the adolescent who studies and works, receiving, at the same time, professional training. The apprentices must attend regular school and be enrolled and attending a professional technical education institution in partnership with the company. The Law of Apprenticeship (Law No. 10097/2000, Federal Decree 5598/2005) determines that all medium and large companies in the country hire a number of apprentices equivalent to a minimum of 5% and a maximum of 15% of their staff. Between 16 and 18 years old, the adolescent cannot work at night, or in dangerous and unhealthy activities as identified in the TIP List, which is divided into work harmful to health and work harmful to morality and list 93 activities as the worst forms of work.70 Forced labor is penalized by the Penal Code, art. 149 (penalties of 2 to 8 years in prison). The country and the state still face a significant parcel of children (5 to 17 years old) working. Thus, between 1992 and 2016, the number of children working in the country dropped 68.9% - from 7.68 to 2.39 million (5.76% of the population under this age). The most recent survey by IBGE (released in December 2020) on child labor identified that there was a reduction of 16.8% of cases between the years 2016 and 2019. Hence, in 2019, there were 1.768 million children between five and seventeen years old identified in a situation of child labor, representing 4.6% of the total number of people in this age group in the Brazilian population.71 According to the National Forum for the Prevention and Eradication of Child labor (FNPETI), 40.8% of the children working were found in rural areas (68.2% of the children age 5 to 13 years old to whom working is forbidden), 16.1% in the South Region (around 385,000 children) and 6.0% in the State of Paraná (around 144,000 children). The number of boys working almost doubles the number of girls (64.9%), who are concentrated on the domestic service sector (94.2% of the domestic child laborers are girls) 72 A number of initiatives contributed to these achievements, including: (i) the definition of the minimum age of 16 years for entering the job market; (ii) the ratification of ILO’s Conventions 138 and 182 and the commitment to adopt immediate and effective measures to guarantee 70 The TIP List includes - among others - works in: spraying, handling and application of pesticides; þ In excavations, underground, quarries, mines, underground and open pit mines; direction and operation of large electrical machines and equipment; with contact with spoiled animal waste, glands, viscera, blood, bones, hides, animal hair or waste; ceramic industries; furniture industries; garbage collection, selection and processing; services provided in any way in brothels, nightclubs, bars, cabarets, nightclubs, massage parlors, saunas, motels, obscene showrooms or venues, gambling rooms and similar establishments; retail sale of alcoholic beverages; civil and heavy construction, including construction, restoration, renovation and demolition; and in mangroves and mudflats. 71 More recent information shows that between 2016 and 2019, the number of child worker dropped to 1,768 million, but 65.1% of the children (5 to 13 years old) still worked in dangerous activities. Among the children and adolescents in child labor, 66.4% are male and 66.1% are blacks or pardos. 72 Sources: https://fnpeti.org.br/cenario/ and Rede Peteca: chega de trabalho infantil. https://www.chegadetrabalhoinfantil.org.br/mapa-do-trabalho-infantil/. Page | 49 the eradication of the worst forms of child labor; (iii) the approval of Decree No. 6481/2012, which sets the List of the Worst Forms of Child Labor (TIP List);73 (iv) the Law of Apprenticeship, which defines the protection for adolescent workers and guarantee of professional training;74 (v) the preparation of three editions of the National Plan for the Prevention and Eradication of Child Labor and Protection for Adolescent Workers; (vi) effective actions to monitor child labor by the Ministry of Economy's Secretariat for Labor Inspection; (vii) the carrying out of effective actions to tackle child labor by the Public Labor Ministry; (viii) the social control of government actions and programs aimed at preventing and combating child labor. The State of Paraná has also observed positive outcomes. In 2015, the last year from which official data is available, Paraná counted 157,693 children and adolescent workers (18% in agriculture and 82% in non-agricultural activities).75 According to FNPETI (the “State Forum for the Eradication of Child Labor and Regularization of Adolescent Labor”), Paraná occupied the 13th position in the ranking of child labor in the age group of 5 to 17 years, with an occupancy rate of 7%, based on IBGE’s PnadC 2016.76 It is also worth mentioning that, between 1995 and 2020, 1,175 people were rescued from forced labor in the state of Paraná (2% of all workers rescued in the country). 77 In 2017, the State of Paraná created the State Commission for the Eradication of Forced Labor (COETRAE/PR) – State Decree 8,460/2017.78 In 2018, only 2 out of the 1,745 people rescued from forced labor in the country where in the State of Paraná.79 The only supported activity that may have an influence on job opportunities in rural areas is the Program of Integrated Productive Regional Development, which adopts four prioritization criteria – namely: (a) territorial scope, (b) contribution to create and improve access and opportunities to jobs and income, (c) contribution to generation of new business opportunities and (d) contribution to the achievement of MDGs on poverty eradication, gender equity, job and economic development, reduction of inequalities. Following these criteria, the activities 73 The TIP list includes, among others: Child labor in agriculture, domestic child labor, child labor in drug production and trafficking, urban informal child labor, child labor in solid waste landfills, sexual exploitation of children and adolescents (available at: https://fnpeti.org.br/media/legislacao/Decreto_n%C2%BA_6.418_de_12_de_junho_de_2008_- _Lista_das_Piores_Formas_de_Trabalho_yOlm94P.pdf). 74 In 2018, 444,189 adolescents and young people between 14 and 24 years old entered the job market through professional learning. The potential for hiring (equaling the minimum quota of 5% set by Law 10097/2000) was 954,823 apprentices across the country. Thus, only 46.5% of the potential has been reached. In the state of Paraná these figures were 28,638 teenagers hired from a potential of 61,112 (46.9%). 75 Rede Peteca: chega de trabalho infantil. https://www.chegadetrabalhoinfantil.org.br/mapa-do-trabalho-infantil/. IBGE has not made public statistics of child labor since then. 76 Source: https://fnpeti.org.br/foruns/parana. 77 SmartLab – Observatory for the Eradication of Slave Labor and Human Trafficking (Observatório da Erradicação do Trabalho Escravo e do Tráfico de Pessoas) - https://smartlabbr.org/trabalhoescravo/localidade/0?dimensao=prioritarias. 78 https://www.legislacao.pr.gov.br/legislacao/exibirAto.do?action=iniciarProcesso&codAto=187078&codItemAto= 1169004. 79 Sources: http://www.aen.pr.gov.br/modules/noticias/article.php?storyid=102547&tit=Parana-vai-instalar- comissao-para-combater-trabalho-escravo--; and https://www.bemparana.com.br/noticia/em-13-anos-foram- resgatados-1.083-trabalhadores-escravos-no-parana#.X7AIyGhKhGM. Page | 50 that will be included in the Regional Productive Development Plans are expected to contribute to ongoing efforts of combat any form of child and forced labor. The operation of UCM and the expansion of the public hospital capacity to treat COVID-19 cases are the only activities that could expose people to hazardous waste and materials. According to ABRELPE’s Panorama of Solid Waste in Brazil 2018/2019, 2,657 tons of solid waste generated by health services (0.234 Kg/inhabitant/year) have been collected in the state of Paraná in 2018. The capacity of treatment of this kind of solid waste (autoclave, incineration and microwave) installed in the state of Paraná of 15,753 Tons/year.80 Data from SNIR are older (2017). This official system shows that, in 2017, the state of Paraná collected 2,470,557 Ton of solid waste, including 17,408 Ton of solid waste generated by health services. In this year, 65% of the municipalities held Solid Waste Management Plans and more than 76% of the municipalities had special procedures for the collection of solid waste generated by health service providers.81 Brazil and the State of Paraná have a robust legislation on the management of solid waste, in general, and waste generated by providers of health services, in particular. The existing legislation on the management of solid waste generated by health service providers covers all stages related to the treatment and final disposal of waste generated by health service providers/facilities. The Brazilian occupational health and safety standards also require that workers involved in the production, procurement, storage, transport, use and disposal of hazardous chemicals are trained and receive the adequate Personal Protective Equipment (PPE). These standards are fully aligned with relevant international guidelines and conventions. The Brazilian National Solid Waste Policy (Law 12,305/2010)82 contains important tools to address the main environmental, social and economic problems arising from the inadequate management of solid wastes. It provides for the prevention and reduction of waste generation, proposing the practice of sustainable consumption habits, a set of instruments to increase recycling and reuse of solid waste and the environmentally sounding disposal of wastes. It calls for adequate disposal of solid wastes, effluents and chemical products during the construction and operation phases of any facilities and sets important goals related with the elimination of dump sites. The first Paraná State Law on the management of solid waste (State Law 12,493/1999) states that solid waste generated by health service providers, with pathogenic agents, must be properly conditioned and, transported as well as receive adequate treatment and final destination, complying with the applicable rules of the Brazilian Association of Technical Standards, respecting other legal norms in force. It also states that the activities that generate any type of solid waste are required to register in the state solid waste inventory and periodically update the required information. Furthermore and without prejudice to civil and 80 Source: Abrelpe, https://abrelpe.org.br/download-panorama-2018-2019/. 81 Since 2013, the Ministry of Environment – through SINIR (the National System of Information on Solid Waste Management) – carries out research on the existence of municipal and state solid waste management plans and on final solid waste disposal. The 2017 research shows that only 54.8% of the municipalities have Solid Waste Management Plans (http://sinir.gov.br). 82 http://www.planalto.gov.br/ccivil_03/_ato2007-2010/2010/lei/l12305.htm. Page | 51 criminal sanctions, those activities dealing with the generation, transportation, packaging, treatment and/or final disposal of solid waste that violate its provisions are subject to administrative penalties (simple or daily fines, aggravated in the case of specific recidivism; loss or restriction of tax incentives and benefits granted by the Government; loss or suspension of participation in credit lines at an official credit institution; suspension of activity; embargo of works; and revocation of the environmental license. This legislation was recently updated (State Law 20,607/2021). This law establishes the State Plan for Solid Waste that has an indefinite validity but has to be update every four years. The law envisages the voluntary transfer of resources by the State to municipalities for solid waste management and granting of guarantees to credit operations for solid waste management in all its stages. It requires that companies based in Paraná to present a Reverse Logistics Plan (PLR), approved by SEDEST, as a requirement for obtaining or renewing the environmental license. It also makes mandatory the annual registration of information related to solid waste on a digital platform (called “Contabilizando Resíduos”), classifies the waste in eight groups urban solids (household, urban cleaning and commercial establishments, health, civil construction, transport services, from mining, basic sanitation, industrial and agroforestry) and promotes democratic management through the participation of the population and representative associations. By this law, large solid waste generators – which shall be identified by the municipalities - will be fully responsible for the environmentally sound management of the solid waste they generate and to adopt measures to promote the reduction of waste generation, especially hazardous waste. Finally, consumers are obliged, whenever there is a selective collection system and reverse logistics systems implemented in the municipality, to properly package the solid waste generated and to properly make available for collection reusable solid waste and recyclable.83 Furthermore, the Brazilian occupational health and safety standards include NR-32 - Health and Safety at Work in Health Services, which determines that the segregation of waste must be carried out in the place where it is generated. The manual transport of the segregation container must be carried out in such a way that there is no contact with other parts of the body, with drag being prohibited. The temporary storage room for transport containers must: (a) have washable floors and walls, siphoned drain, water point, light point, adequate ventilation, opening dimensioned to allow the entrance of transport containers; (b) be kept clean and with vector control; (c) contain only collection, storage or transportation containers; (d) be used only for the purposes for which it is intended; and (e) be duly sign-posted and identified. The transportation of waste to the external storage area shall be done by means of cars made of rigid, washable, waterproof material, provided with a top articulated to the body of the equipment and rounded corners and carried out in a single direction with a schedule defined at times coinciding with the distribution of clothes, food and medicines, periods of visit or increased flow of people. The external storage of the residues shall also be done in an appropriate place until they are collected by the external collection system, which is sized to allow the separation of the containers according to the type of residue. A pre-condition for licensing the operation of these facilities is the preparation and implementation of a waste management plan. 83 https://www.aen.pr.gov.br/arquivos/1006lei20607.pdf. Page | 52 With respect to the handling of waste generated by health services, NR-32 - Health and Safety at Work in Health Services defines that it is up to the employer the initial and continued training of the workers regarding: (a) segregation, conditioning and transportation of the waste; (b) definitions, classification and risk potential of waste; (c) management system adopted internally at the establishment; (d) ways to reduce waste generation; (e) knowledge of responsibilities and tasks; (f) recognition of the waste class identification symbols; (g) knowledge about the use of collection vehicles; and (h) the use of Personal Protective Equipment - PPE.84 On the one hand, the verification of compliance with regulatory framework on the management of waste and hazardous materials by health service facilities is overseen and enforced by municipal, state and national agencies of sanitary surveillance. On the other, the inspection of compliance with the OHS standard is a responsibility of the Labor Regional Delegacies (Delegacias Regionais do Trabalho - DRT), which are under the structure of the recently created Ministry of Labor and Social Security (Provisional Measure 1,058/2021).85 Under the terms of Complementary Law 75/1993,86 the Labor Public Attorney Office (MPT) is also responsible for overseeing compliance with labor legislation when there is public interest, seeking to regularize and mediate relations between employees and employers. The MPT is divided into 24 Regional Attorneys, which are subdivided into Municipal Labor Attorneys.87 In the state of Paraná, MPT-PR comprises ten regional offices.88 ANVISA has the competence to regulate the internal procedures of health services, related to the management of waste generated by health service providers/facilities and coordinates the National Health Surveillance System (SNVS), which operates in a decentralized manner comprising state and municipal Health Surveillance agencies. While ANVISA RDC 306/2004 and CONAMA 358/2005 provide the technical regulation for the management of waste from health services, ANVISA RDC 222/2018 sets Good Health Care Waste Management Practices and other measures. ANVISA RDC 50/2002 also set rules about the places intended for external guarding of solid health services waste and the cleaning of the collection containers, equipment and fire safety measures. Non-compliance constitutes a sanitary infraction and subjects the violator to the penalties provided for in Law no. 6,437/1977, without prejudice to the applicable civil and criminal liability. These resolutions determine that every health service waste generator must prepare a Health Service Waste Management Plan, covering the stages of management, segregation, packaging, identification, internal transport, temporary storage, treatment, external storage, external collection and transport, and final disposal. In addition, the Paraná State Health Code (art. 426) rules that establishments providing health services must provide adequate technical procedures, defined in the respective standards, with respect to waste arising from the provision of health services and keep a legally qualified and periodically trained staff.89 84 http://www.fiocruz.br/biosseguranca/Bis/manuais/legislacao/NR-32.pdf. 85 http://www.planalto.gov.br/ccivil_03/_Ato2019-2022/2021/Mpv/mpv1058.htm. 86 http://www.planalto.gov.br/ccivil_03/leis/lcp/lcp75.htm. 87 https://mpt.mp.br/pgt/mpt-nos-estados. 88 https://www.prt9.mpt.mp.br/mpt-pr/procuradores. 89 Paraná State Code of Health, art. 426. In addition, solid waste management rules are set at the State of Paraná in the following main legislation: the State Solid Waste Law 12,493/1999 that establishes principles, procedures, Page | 53 In the state of Paraná, the Health Surveillance Coordination (CVIS) is responsible for the overall coordination of the State Health Surveillance System, which comprises the state health surveillance teams (central team at SESA and 22 Regional Health Departments) and 399 municipal surveillance teams. CVIS is hierarchically linked to the Directorate of Health Care and Surveillance (DAV) of SESA, and is organized into four divisions: Division of Sanitary Food Surveillance (DVVSA); Division of Sanitary Surveillance of Products (DVVSP); Division of Sanitary Surveillance of Services (DVVSS); and Division of Analysis of Projects of Health Establishments (DAPES). DAPES is responsible for the evaluation of projects within the scope of health surveillance as part of the health licensing process and constitutes a fundamental step in ensuring adequate buildings for carrying out health care activities. Supported by the Paraná Health Code, this activity is regulated in the State of Paraná by Resolution SESA 389/2006, and aims to eliminate, reduce or prevent health risks, thus contributing to the promotion and protection of the population's health.90 The preparation of Regional Productive Development Plans is the only activity that may lead to downstream effects related with the use and exposure to pesticides as the plans have rural development as one of their axis. In Brazil, the early regulatory framework for the agricultural pesticides industry dates from 1934 (Decree 24114/1934). It was later replaced by Law 7802/89 (and its regulatory Decree 4,074/2002) that defines the rules for activities such as research, experimentation, production, transportation, storage, marketing, use, import, export, registration, control, inspection and final destination of waste and packaging. This legislation also sets the governance structure for the granting of registrations of pesticides in the country, which is shared by the Ministry of Health (through the National Sanitary Surveillance Agency/ANVISA), the Ministry of Environment (through the Brazilian Institute of Environment and Natural Resources/IBAMA), and the Ministry of Agriculture, Livestock and Supply (MAPA). ANVISA is responsible for verifying toxicological safety issues as well as for the inspection of products and services that involve health risks from pesticides. ANVISA coordinates the Program for Analysis of Agrochemical Waste in Food as well as the National Network of Toxicological Information Centers, and the National Health Surveillance System (SNVS). IBAMA addresses aspects of environmental security and MAPA evaluates the agricultural effectiveness of the products and grants the registration after favorable expression of the other two agencies. Recently, the country adopted the Globally Harmonized System of Classification and Labelling of Chemicals (GHS). Alternative techniques – such as: integrated pest and vector management (IPM and IVM) – are stimulated and there are several research centers in the country that work with biological control applied to crops and forest products. norms and criteria related to the generation, conditioning, storage, collection, transportation, treatment and final destination of solid waste in the State of Paraná, aiming at controlling pollution, contamination and minimizing environmental impacts and adopts other measures; the State Decree 6,674/2002 which approves the Regulation of Law 12.493/1999; and IAP Ordinance 212/2019 that establishes procedures and criteria for requiring and issuing Environmental Authorizations for Solid Waste Management Activities (http://www.iat.pr.gov.br/Pagina/Residuos- Solidos). 90 https://www.saude.pr.gov.br/Pagina/Vigilancia-Sanitaria-VISA Page | 54 Some stakeholders called attention for the need to provide incentives (financing and technical assistance) and give priority to agroecology. In the State of Paraná, the adoption of integrated pest management practices – developed many years ago by Iapar, Embrapa and other technological centers – has been fostered by the Secretary of State for Agriculture and Supply since the 2013/2014 harvest reaching 126 municipalities. Furthermore, since 2010, the state has established a Commercialization and Use of Pesticides Monitoring System (State Decree 6107/2010).91 The Paraná Agricultural Defense Agency (Adapar)92 carries out routine inspections of farmers, cooperatives and resellers of pesticides to verify that use is taking place according to the recommendations contained in the agronomic recipe. On-farm inspections include the collection of vegetable samples for analysis purposes to verify the presence of pesticide residues. When Adapar inspectors find the application of pesticides in a crop different from that recommended in the recipe or in disagreement with the guidelines contained in the agronomic recipe in general, the farmers can be penalized and the crops may be destroyed. And when these inspectors find smuggled pesticides, the products are seized and the sellers, holders or users are reported to the Federal Police Station. This process may culminate in a judicial process, fines and, even, the possibility of imprisonment. Adapar also inspects pesticide resellers and cooperatives, to verify their compliance with the mandatory registration in Adepar, the presence of a technical officer and the licensing of the environmental agency. The standards of pesticide storage in the resellers’ warehouses are also verified, checking the agronomic recipes to ensure correct prescription of pesticides and assuring that the fractional sale of these products is not taking place. In addition to routine inspections, the agency conducts joint operations with the Environmental Military Police, the Federal Police, the Federal Revenue Service and the Ministry of Agriculture. Adapar also provides advice to farmers, agronomists, representatives of cooperatives and resellers – through lectures, newspaper articles, magazines, radio and television – on good practices of pest management and use of pesticides, including: the need to consult an agronomy professional before the application of pesticides to their crops and check the real need to use the product. Farmers are also advised on the correct storage of pesticides on the properties (according to the manufacturers' guidelines contained in the product instructions, as well as in the legislation in force). Thus, the deposits must be ventilated, exclusive for storing pesticides, kept as far away as possible from houses, breeding animals, rivers, and locked to prevent the entry of unsuspecting people avoiding risks to the health of people and animals. The emptied packages must be washed three times and kept in an exclusive place to be returned within the period required by law, at the receiving points for empty packages, according to the address that appears on the invoice of purchase of pesticides. Farmers are also advised with regards to the procedures for application of pesticides, the use of correct 91 https://www.legislacao.pr.gov.br/legislacao/pesquisarAto.do?action=exibir&codAto=55022&indice=1&totalRegis tros=2&dt=13.7.2021.14.23.43.940. 92 https://www.adapar.pr.gov.br/. Page | 55 equipment and PPE according to the product to be used and the assistance of the agronomy professional. Brazil and the state of Paraná have well-developed capacity to address issues related with areas prone to natural hazards such as floods, hurricanes, earthquakes, or other severe weather or affected by climate events. The Program will support activities to enhance the institutional capacity to prevent and minimize the effects of these adverse events. The federal and state regulatory framework applicable to the natural and man-made disaster risk management is extensive. Federal Law 12,608/201293 instituted the National Policy, National System and the National Council of Protection and Civil Defense and authorized the creation of an information and monitoring of natural disasters systems. The policy addresses the aspects of prevention, mitigation, preparedness, response and recovery from natural disasters and confers co-responsibilities to all levels and branches of government. Envisaged by this Policy, the National Plan for Risk Management and Disaster Response comprises 4 axes: (i) mapping (susceptibility, risk sector and geotechnical maps); (ii) monitoring and alerting under the responsibility of the National Network for Monitoring and Alerts of Natural Disasters; (iii) prevention and infrastructure; and (iv) disaster response. CEMADEM (the National Center for Monitoring and Natural Disaster Alerts under the Ministry of Science, Technology, Innovation and Communication) is the federal agency responsible for mapping, monitoring and alerting.94 In the scope of the National Risk Management and Disaster Response Plan, CEMADEN currently monitors 958 municipalities in all Brazilian regions (36 in the state of Paraná). The monitoring team is organized in four nuclei: natural disasters, geodynamics of natural disasters, hydrological extremes and weather extremes. CEMADEM’s Situation Room issues monthly bulletins of impacts in strategic areas.95 In the state of Paraná, the disaster risk management is under the responsibility of the State Coordination of Civil Defense DC, which reports directly to the State Governor and was established by State Law 18,519/2015.96 Recently, the State’s System of Civil Protection and Defense was restructured and strengthened with support of the World Bank through P126343 SWAp for Paraná Multi-sector Development Project), which included the Strengthening of 93 http://www.planalto.gov.br/ccivil_03/_ato2011-2014/2012/lei/l12608.htm 94 Cemaden's mission is to monitor natural threats in risk areas in Brazilian municipalities susceptible to the occurrence of natural disasters, in addition to conducting research and technological innovations that can contribute to the improvement of its early warning system, with the ultimate goal of reducing the number of fatalities and material damage across the country (sources: http://www.cemaden.gov.br/ and http://www.cemaden.gov.br/missao-do-cemaden/). 95 Source: http://www.cemaden.gov.br/municipios-monitorados-2/ 96 Other relevant state legislation includes; The Civil Defense was created by State Decree 3,002/ 1972 and became the Coordination State Civil Defense in 1992. State Decree 9,557/2013 issued the Regulation of the State System for Civil Defense and Protection - SEPDEC. State Decree nº 9,941/2014 instituted the Paraná Information System for the Management of Natural Disaster Risks - SIGRisco PARANÁ. Finally, State Law 18,519/2015 set CEPDEC as the central organ of PEPDEC (State Policy for Civil Protection and Defense). (Source: http://www.defesacivil.pr.gov.br/Pagina/Legislacao-estadual). Page | 56 Paraná Disaster Risk Management Project.97 Since 2013, this system already included a State Council of Civil Protection and Defense with participation of government agencies and civil society representatives and the Center of Studies and Researches on Disasters (CEPED). With the World Bank support, the State Center for Risk and Disaster Management – CEGERD was created and inaugurated in April, 2017 with the main objective is to provide support to municipalities affected by disasters carrying out disaster monitoring and management in a proper way, facilitating the monitoring of meteorological conditions and events that can cause disasters and monitoring the development of response activities in the municipalities.98 All Civil Defense occurrences in the State are monitored in real time by the center’s disaster monitoring and management room and Civil Defense alerts are issued and disseminated via SMS and television networks to the population of Paraná. Indeed, the public sector capacity for disaster risk management was significantly strengthened through the setting up of a highly effective disaster risk monitoring unit, mapping and risk-profiling of high risk areas. IV.4 Main Elements of the Borrower System in light of Core Principle #4 Brazil does not have specific legislation on involuntary displacement, but no activity under the Program is expected to require land acquisition and/or impose restrictions on land use leading to adverse effects related with involuntary resettlement. To legislate on land acquisition through the exercise of the State’s power of eminent domain (land expropriation) is the exclusive competence of the Union and basically set in the Brazilian Federal Constitution (Art 22, III), Civil Code (Federal Law 10406/2002), Federal Decree 3365/1941 and Federal Laws 4132/1962 and 13867/2019. The Brazilian law recognizes both land ownership rights and rights and claims of adverse possession. Adverse possession is recognized under different legal timeframes according to the location (urban or rural areas) and purpose of the occupation of the land as well as the socioeconomic profile of the occupant and it is not be recognized for the same person more than once.99 In the expropriation process, Brazil acknowledges the rights of people who (i) have formal legal rights (property); (ii) can gain ownership of property by adverse possession of it beyond the lapse of a certain period of time (“usucapione”), with the exception of claims over public lands; and (iii) have made improvements in public lands they encroached (they are entitled for compensation of these improvements, but not for the land). 97 This project was conceived at the aftermath of the extreme weather event that became known as Waters of March in 2011, on the coast of Paraná, that displaced 14,000 people and caused economic losses estimated in 200 million Brazilian Reais. Within P126343 arose the opportunity arose to deal with the management of disaster risk in a transversal and broad way. Source: Pinheiro, E. G. and Pedroso, F.F. (org), Construindo um Estado Resiliente: o modelo paranaense para a gestão do risco de desastres (Curitiba: CEPED/FUNESPAR, 2016. 156p.il), available at: http://www.ceped.pr.gov.br/arquivos/File/ContruindoEstadoResiliente.pdf. 98 Source: http://www.defesacivil.pr.gov.br/Pagina/Centro-Estadual-de-Gerenciamento-de-Riscos-e-Desastres- CEGERD. 99 Civil Code (Federal Law 10406/2002), articles 1,237-1,243. Page | 57 The legislation requires fair and prior compensation of expropriated physical and economic assets.100 The amount of compensation for physical assets is not based on replacement costs. This value is determined based on technical standards set by the Brazilian Association of Technical Standards (Associação Brasileira de Normas Técnicas, ABNT), which follows international standards and methodologies.101 Transaction costs are not included in the value and actual profit gains from expropriation processes are subject to taxation, although this can be deferred under certain circumstances.102 With regards to economic assets, all productive inputs and facilities required by different types of economic activities in the primary, secondary and tertiary sectors are assessed and compensated. The compensation also covers for foregone profits, intangible economic assets (“fundo de comércio”)103 and transitional assistance for both business owners and workers. For rural productive activities, compensation is based on the characteristics of the land and its location, the improvements on the land, the productive uses of the land, the machinery, and technology available. The Brazilian regulatory framework related with restriction of access to natural resources within legally designated parks and protected areas has been set by the Brazilian System of Protected Areas (Sistema Nacional de Unidades de Conservação – SNUC, established by Law 9985/2000).104 Under Integral Protection Protected Areas, the law rules that traditional communities inside the areas shall be compensated for the existing improvements and duly reallocated by the Government. However, until resettlement of traditional communities is possible (for which preference is given to land-based resettlement strategies for displaced persons whose livelihoods are land-based), specific rules and actions shall be established to make the presence of traditionally resident populations compatible with the objectives of the protected area, without prejudice to ways of life, sources of subsistence and places of residence of these populations. It is ensured their participation in the elaboration of the 100 Civil Code (Law 4,132/1962) and Federal Decree-law 3,365/1941 101 ABNT has issued and updated a series of norms ruling the process of asset valuation and covering land and economic assets in both urban and rural areas. These norms also define the most adequate methodologies according to the type of asset and its location. The most commonly used methodology for reaching the amount of fair compensation is the Direct Comparative Market Data Method, which aims to find out the potential "market value" of the expropriated land. This methodology takes into consideration several factors (location, type of construction, state of conservation) relies on real estate market researches and applies a depreciation factor. Nevertheless, according to the Brazilian norms, the depreciation factor ranges from zero to 1. Arithmetically, when the evaluator applies a depreciation factor equal to 1, this factor does not depreciate the value reached for the compensation at market value. 102 Federal Decree 9,580/2018, art 504. 103 These intangible assets comprise, among others, the expenses necessary to remove the goods, acquire new commercial points, remodeling and adapting the new location for the activity; disassembly, transport, and installation of equipment at the new location; deactivation of the original location; eventual performance of compromised contracts (fines, inconvenience costs, and others) and maintenance of activities during the reallocation of assets (rent of additional spaces, outsourcing of processes and others). 104 SNUC encompasses two types of protected areas: (i) integral protection protected areas and (ii) sustainable-use protected areas (National Forests, Extractive Reserves, and Sustainable Development Reserves). The primary objective of the former is to preserve nature, being allowed only the indirect use of their natural resources; whereas the basic objective of the latter is to make nature conservation compatible with the sustainable use of part of their natural resources by human populations. Page | 58 referred norms and actions and in the definition of the length of their stay and its conditions (Law 9985/2000, art. 47). Furthermore, traditional communities – whose existence is based on sustainable systems of exploitation of natural resources, developed over generations and adapted to local ecological conditions – do not need to be relocated when Sustainable Use Protected Areas are created. Indeed, these Sustainable Use Protected Areas are created with the primary objectives of protecting the livelihoods and culture of these populations while ensuring the sustainable use of the areas’ natural resources. Land and natural resource use within these protected areas are decided with the participation of the involved traditional communities.105 Preventative resettlement from areas at-risk of disaster is ruled by federal legislation (Law 10,257/2001, Law 12,340/2010, Law 12,608/2012 and Law 12,983/2014). It is based on the guideline of broad community participation and the key role of municipalities. Municipal attributions include: (i) identification and mapping of areas at-risk of disaster; (ii) monitoring and control of these areas preventing new occupations; (iii) inspection of buildings located in these areas and, whenever needed, carry out the evacuation of the population from areas of high risk or endangered buildings; (iv) provide adequate temporary shelter for the displaced population; and (v) prepare and implement the Civil Protection and Defense Municipal Contingency Plan. The legislation requires that municipalities adopt measures to reduce the risk of disaster among settlements located in areas susceptible to the occurrence of high impact landslides, sudden floods or related geological or hydrological processes. These measures include the execution of a contingency plan and safety works and, when necessary, the removal of buildings and the resettlement of occupants in a safe place. Removal can only take place upon on-site surveys and technical reports evidencing the risks of the occupation for the physical integrity of the occupants or third parties, prior notification to the occupants including information on the alternatives offered by the government to ensure their housing rights, and adoption of measures to prevent reoccupation of the area. The National Cadaster of municipalities with areas under risk of geological disasters and flooding covers 821 municipalities in the country (34 located in Paraná). IV.5 Main Elements of the Borrower System in light of Core Principle #5 The Program is not expected to have adverse impacts on land and natural resources subject to traditional ownership or under customary use or occupation of Indigenous Peoples (causing their relocation) or on the exploitation of customary resources and indigenous knowledge. The Borrower’s E&S system gives due consideration to the cultural appropriateness of and equitable access to Program benefits, special attention to the rights and interests of Indigenous Peoples as well as to the needs or concerns of vulnerable groups. Furthermore, it requires that 105 Resettling traditional and vulnerable populations entails a number of additional precautions. The territories traditionally occupied by indigenous peoples and quilombolas are basically protected by the Brazilian Federal Constitution (article 129, V; article 216; article 231; and article 68 of the Act of the Temporary Constitutional Provisions). Resettlement of indigenous peoples requires the involvement of the Indigenous National Foundation (FUNAI). Page | 59 meaningful consultations are undertaken whenever Indigenous Peoples are potentially (positively or negatively) affected by public policies, programs and projects. Finally, the public health care system gives special attention to and aims to promote equitable access to groups vulnerable to hardship or discrimination, including, as relevant, the poor, the disabled, women and children, the elderly, ethnic minorities or other marginalized groups. The Brazilian Federal Constitution of 1988 (FC 1988) recognizes the social organization, customs, languages, beliefs and traditions of indigenous peoples and their rights to occupy their traditional territories. Indigenous Lands are owned by the federal government and the right of Indigenous Peoples to lands of traditional occupation is an original right.106 It states that indigenous lands are to be permanently occupied by indigenous peoples and provides for the exclusive enjoyment of indigenous peoples in relation to their lands and their economic exploitation, the existing soils, rivers and lakes situated therein and safeguarding the right to their traditional social organization and culture. FC 1988 also establishes that the exploitation of water resources (including energy potentials), research and mining of mineral wealth within Indigenous Lands can only be carried out with the authorization of the National Congress, after hearing the affected communities.107 Brazil has also signed all major international agreements and treaties regarding the rights of indigenous peoples, including “The International Labor Organization (ILO) Convention No.169 on Indigenous Peoples and Tribal Populations” and “The United Nations Declaration of Indigenous Peoples’ Rights”.108 The Brazilian legislation stipulates that – for all on-the-ground interventions, legislative and administrative measures that may directly affect Indigenous Peoples – federal, state and municipal governments shall ensure that studies are carried out in consultation with Indigenous Peoples to identify environmental, social, cultural and spiritual impacts on them. The National Indigenous Foundation (FUNAI) is responsible for all technical referrals related with Indigenous Peoples in the Term of References for the elaboration of Environmental Impact Assessments (EIA), has to be heard on impacts and interventions within Indigenous Lands and is required to hold public hearings with potentially affected Indigenous Peoples during the licensing process.109 FUNAI analyzes the EIA and issues technical opinions evaluating whether the enterprise is viable or not and recommending actions that must be performed to mitigate negative impacts and optimize positive impacts on indigenous communities. When there are impacts on indigenous communities and their lands, a Basic Environmental Plan (PBA) for indigenous communities – detailing the programs for each identified impact – has to be 106 Therefore, the administrative procedure for the demarcation of indigenous lands is of a merely declaratory nature as indigenous lands are not created by a constitutive act, but simply recognized based on technical and legal requirements, according to FC 1988 (Art. 231). 107 FC 1988, Art 231, paragraph 3. 108 ILO Convention 169 was made effective through Legislative Decree No. 143/2003 and Federal Decree 5,051/04. 109 FUNAI’s manifestation in the scope of the environmental licensing process of works that directly or indirectly affect lands and indigenous communities is required and ruled by FC 1988 (articles 225 and 231), Laws 5,371/67 and 6,001/73, CONAMA Resolution 237/97, Inter-Ministerial Ordinance 060/2015 and Normative Instruction 02/2015. FUNAI's manifestation is generally required in all three phases of the environmental licensing process. Page | 60 developed in consultation with the affected indigenous communities and technically analyzed by FUNAI.110 Additionally, Federal Decree 6,040/2007 established the National Policy for the Sustainable Development of Traditional Peoples and Communities. This policy incorporates – among others – the principles of: (i) recognition and consolidation of the rights of traditional peoples and communities; (ii) promotion of the necessary means for the effective participation of Traditional Peoples and Communities in instances of social control and in decision-making processes related to their rights and interests; (iii) eradication of all forms of discrimination, including the fight against religious intolerance; and (iv) preservation of cultural rights, the exercise of community practices, cultural memory and racial and ethnic identity. It aims to promote the sustainable development of Traditional Peoples and Communities, with emphasis on the recognition, strengthening and guarantee of their territorial, social, environmental, economic and cultural rights, with respect and appreciation for their identity, their forms organization and their institutions. Among its specific goals, it shall be highlight the guarantees given to traditional peoples and communities with regards to: (a) the territories and natural resources that they traditionally use for their physical, cultural and economic reproduction; (b) to quality health care services that are adequate to their socio-cultural characteristics, needs and demands, with an emphasis on the concepts and practices of traditional medicine; (c) access to public social policies and the participation of representatives of traditional peoples and communities in social control instances; and (d) access to productive inclusion with the promotion of sustainable technologies, respecting the social organization system of traditional peoples and communities, valuing local natural resources and traditional practices, knowledge and technologies. The National Commission for the Sustainable Development of Traditional Peoples and Communities, the Sustainable Development Plans for Traditional Peoples and Communities, the regional and local forums, and the Multiannual Plan are the main instruments of implementation of this policy. The public health care network is organized under the Unified Health System (Sistema Unificado de Saúde – SUS). SUS cornerstones comprise the principles of universalization, equity and social participation and control. Health is conceived as a right of citizenship and it is up to the State to ensure this right. Access to health services must be guaranteed to all people, regardless of sex, race, occupation or any other social or personal characteristics. SUS aims to reduce inequalities and is based on the conception that – despite the fact that everyone has the right to health services – people are not equal and, consequently, have different health needs. Thus, SUS aims to reduce inequalities by investing the most where the needs are greatest. The operationalization of these principles is put in place through three key elements: 110 Traditional knowledge associated with the genetic heritage held by indigenous peoples (as well as of traditional communities and traditional small farmers) is also legally protected. The law assures the right of these social groups to participate in national decision-making on matters related to the conservation and sustainable use of their associated traditional knowledge; access to it is conditional upon obtaining free, prior and informed consent; and Indigenous peoples are entitled to a share of the benefits from the economic exploitation of their associated traditional knowledge (Law 13.123/2015 – The Biodiversity Law). Page | 61 (a) the National, State and Municipal Health Councils, (b) the National, State and Municipal Health Conferences and (c) the SUS’s and State Health Secretariat’s Ombudsman offices. Furthermore, in response to the demands of Indigenous Peoples, Brazil has established the Indigenous Health Care Subsystem (SasiSUS) as part of the SUS (Law 9,836/1999) and instituted the National Policy of Attention to the Health of the Indigenous Peoples (PNASPI) that integrates the National Policy of Health, in 2002. SasiSUS is coordinated by the Indigenous Peoples Care Secretariat (SESAI) under the Ministry of Health and obliged to take into account the local realities and the specificities of IPs cultures. PNASPI determined the creation of a health service network in indigenous lands, which is structured around 34 Special Indigenous Peoples Sanitary Districts (DSEI). The geographic delimitation of each DSEI considers demographic and ethno-cultural aspects. Participation of IPs in SasiSUS is provided through the organization every four years of local, district and national Conferences of Indigenous Health. Five National Conferences have been held since 2002. It also occurs on a more frequent basis through the well-established institutional channels of Local Indigenous Health Councils (CLSI) and Indigenous Health District Councils (CONDISI). In 2020, the Indigenous District Health Council Chairmen's Forum (FPCONDISI).111 In Paraná, the State Health Secretariat (SESA) works in articulation and partnership with the DSEIs and the municipalities with indigenous lands and the current State Health Plan includes actions aimed at contributing to address some of the main challenges faced by Indigenous Peoples’ health: the socioeconomic conditions prevailing within their villages, the abusive use of alcohol, violence, suicides, and precarious maternal and child health.112 The Paraná Health State Plan 2020-2023 (PES)113 sets priority lines of primary care: (a) Women's Health; (b) Maternal-Child, Child and Adolescent Care; (c) Health of the Elderly; (d) Attention to Chronic Conditions; (e) Attention to People with Disabilities; (f) Mental Health; and (g) Oral Health. Furthermore, PES also establishes a set of special policies and programs aiming to promote equity and expand access for vulnerable populations in SUS. PES considers these populations are under higher risk of illness in view of factors such as social inequalities and income distribution, sexual orientation, race and ethnicity, migratory flow, low education and difficulty in accessing the main public policies. Thus, there are special programs for: the Afro- Brazilian population; indigenous peoples; migrants; the homeless population; 114 people deprived of liberty;115 countryside, forest and water populations; Gypsy People; Lesbian, Gay, Bisexual, Transvestite and Transsexual Populations (LGBT+QIA). 111 FPCONDISI was established as SESAI’s advisory body with the objective of participating and monitoring the execution of PNASPI 112 PARANÁ. Secretaria de Estado da Saúde do Paraná. Plano Estadual de Saúde Paraná 2020-2023 - Curitiba: SESA, 2020, p. 130. 113 Available at: https://www.saude.pr.gov.br/sites/default/arquivos_restritos/files/documento/2020-09/PES- 24_setembro-vers%C3%A3o-digital.pdf. The Plan was devised based on the principles of SUS, the situational diagnosis of Health in Paraná and the guidelines approved at the 12 th State Health Conference. It was prepared through a participatory, collective and bottom-up process of construction process in which the strategic agendas defined through an Integrated Regional Planning process. PES was approved by deliberation of the full State Health Council. 114 Paraná is estimated to have a population of 6,905 people living in the streets (Source: PES 2020-2023). 115 In Paraná, there are approximately 28,540 people (27,162 men and 1,378 women) in detention in 65 closed units and 5 semi-open units (Source: PES 2020-2023) Page | 62 Social inclusion is also a tenet of the State of Paraná Covid-19 Contingency Plan,116 which calls for the strengthening of intra and intersectoral articulations to guarantee access and health care for vulnerable communities: rural, forest and water resources dependent populations (quilombolas, Indigenous Peoples, riverside dwellers, artisanal fishermen, islanders), the gypsy people and migrant populations, persons deprived of their liberty, homeless people, black people, and LGBTI minorities, among others. The municipal governments are requested to (a) organize the work of Community Health Agents so they can actively reach out the vulnerable social groups and (b) ensure their access to the Health Care Network taking into consideration their cultural specificities and particular health needs. The plan also supports the public dissemination of documents prepared at the national level on the specificities of vulnerable populations to face COVID-19 and the articulation of health actions with the policies of Public Security, Food Security, Education, Social Assistance for the care of vulnerable populations. It requires the inclusion in the state notification system of COVID-19 of information on race, ethnicity and other conditions that may increase vulnerability and exposure to the virus (such as liberty deprivation) in the perspective that these data enable the knowledge of the epidemiological profile of vulnerable populations. With regards to Indigenous Peoples, it calls specifically for the maintenance and intensification of the partnership between the State Health Secretariat and the Litoral Sul Indigenous Special Sanitary District (DSEI LSUL) to ensure the care of Indigenous Peoples. Some stakeholders highlighted the need to give priority to Traditional Communities in vaccination against Covid-19. In the state, the measures taken to prevent and respond to COVID-19 among the population in a situation of social vulnerability comprised the inclusion of Indigenous Peoples, quilombola and traditional communities in the at-risk group (State Decrees 4,959/2020 and 5,881/2020), the distribution of food baskets, the suspension of the charge of water and energy tariffs, the monitoring of cases of Covid-19 among traditional and quilombola communities and the engagement of the State Department of Health with several instances of social control, including the State Council of Indigenous Peoples and Traditional Communities, the Traditional Peoples and Communities Working Group of Paraná and the State Council for the Promotion of Racial Equality, which are described below. The Government of Paraná has in place several instances to ensure participation of Indigenous Peoples, traditional communities and vulnerable social groups in state policies, programs and projects that may potentially affect (positively or negatively) them. These participatory bodies include: • The State Council of Indigenous Peoples and Traditional Communities of the State of Paraná (CPICT/PR) was established by Law 17,425/2012 as a consultative, deliberative and social control entity for public policies related with the sustainable development of 116 Available at https://www.saude.pr.gov.br/sites/default/arquivos_restritos/files/documento/2020- 04/planocovid19final.pdf. Page | 63 indigenous peoples and traditional communities. It is a collegiate body that is part of the organizational structure of the Secretariat of Justice, Citizenship and Human Rights - SEJU. CPICT/PR convenes representatives of Indigenous Peoples and other interested parties for deliberation on public policies related with the sustainable development of indigenous peoples and traditional communities. It is composed by 24 members evenly representing the State Government and traditional communities. Its main attributions included inter alia: the proposal of the State Policy of Indigenous Peoples and Traditional Communities and the State Policy of Sustainable Development of Indigenous Peoples and Traditional communities; the monitoring and evaluation of relevant policies and legislation for these social groups, ensuring their participation; and promote channels of dialogue with the civil society, public and private agencies, national and international organisms.117 CPICT/PR has played a relevant role reaching out Indigenous Peoples and traditional communities.118 • The Working Group of Traditional Peoples and Communities of Paraná was created under the coordination of SUDIS. This Working Group (created in January 2020) is composed by representatives of indigenous peoples, quilombolas and eight other traditional communities (benzedeiras, cipozeiros, faxinalenses, riverside dwellers, islanders, religions of African origin, gypsies and artisanal fishermen). This Working Group was convened to design an unified policy for traditional communities covering emergency care, income generation, land tenure regularization, education, cultural appreciation and development of community citizenship.119 One of its initial tasks should be the carrying out of a social census and mapping of all traditional communities within the state, that should serve as the basis for outlining a unified policy for traditional communities covering emergency care, income generation, land tenure regularization, education, cultural appreciation and development of community citizenship. Due to the outbreak of Covid-19, this working group has played a relevant role reaching out Indigenous Peoples and traditional communities. • The State Council for the Promotion of Racial Equality (CONSEPIR) was established by Law 17,726/2013 as a deliberative, advisory and supervisory body of government actions. It is composed evenly by28 representatives of state agencies and the organized civil society entities (active in promoting racial equality in the State of Paraná, with legal personality and in operation for at least two years.) and aims to on public policies that promote racial equality to combat ethnic-racial discrimination, reduce social, economic, political and cultural inequalities, acting in the monitoring and inspection of these 117 http://www.dedihc.pr.gov.br/arquivos/File/2017/RegimentoInternoCPICT.pdf and https://cpisp.org.br/lei-n-o- 17-425-de-18-de-junho-de-2012/. 118 During the preparation of this assessment, a meeting was held with the members of CPICT/PR (March 8, 2021). The Program was presented and concerns were raised by the representatives of Indigenous Peoples, quilombolas and Traditional Communities with regards to the digitalization of public services and the preparation of the Integrated Productive Regional Development Plans – as they shall involve selection and prioritization of rural productive chains, rural extension and technical assistance. These stakeholders highlighted issues related with digital exclusion and the need to foster engagement and participation of their constituencies in the planning activities. 119 http://www.aen.pr.gov.br/modules/noticias/article.php?storyid=105513&tit=Governo-fortalece-atencao-a- povos-tradicionais-do-Parana. Page | 64 public policies sectors, in accordance with the provisions of the Racial Equality Statute (Law No. 12,288, of 20 July 2010). The State of Paraná has a State Fund for Policies to Promote Racial Equality (FUNDEPPIR) approved by Decree 11958/2018. • the State Council for Women’s Rights (CEDM) was created by Law 17504/2013 and aims to enable popular participation and to propose guidelines for government action on the promotion of women's rights. CEDM has also the attribution of social control of public policies on gender equality, exercising normative and consultative roles on women's rights in the State of Paraná. The Second State Plan of Women’s Rights (2018- 2021) – approved by CEDM Deliberation 002/2018 – adheres to three guidelines: (i) promotion of gender equality and equity, facing prejudices, for women’s agency, including activities of economic empowerment and income improvement, political and community participation, and access to information on women’s rights; (ii) institutional strengthening and social participation for universalization of policies, addressing issues related to women’s health and access to public services; and (iii) elimination of all forms of violence against women, preventing and deterring violence and recidivism. These three guidelines represent, in essence, the vision of the state policy regarding gender issues and priorities for the next quadrennium.120 • The State Council for the Rights of Children and Adolescents of Paraná (CEDCA/PR) is a collegiate public body composed on an equal basis by governmental and non- governmental representatives. The Council meets monthly to formulate, deliberate and control actions related to children and adolescents at all levels, according to federal, state and municipal laws. These meetings are open to the community. Its functions include inter alia: (i) to formulate a policy for the promotion, protection and defense of the rights of children and adolescents, in compliance with the Federal Constitution and the Child and Adolescent Statute; (ii) to monitor the preparation and evaluation of the State’s Annual budget, and (iii) to deliberate on the priorities for governmental action in regards to child and adolescents and to control the execution of such actions. • The State Council for the Rights of Persons with Disabilities (COEDE) is an advisory, deliberative, supervisory body and coordinator of public policies aimed at ensuring the rights of persons with disabilities. COEDE is responsible for monitoring the planning and execution of public policies, sectoral programs and the implementation of the National Policy for the Integration of this public and its objectives are to propose studies, research, campaigns and projects with the aim of improving the quality of life, protection and social integration, in addition to guaranteeing the rights of these people. • The State Council for the Rights of the Elderly (CEDI) aims the defense of the rights of the elderly, bringing together and combining the efforts of public agencies, private entities and organized groups in favor of the full insertion of the elderly person in the socioeconomic, political and cultural life and eliminating all forms of prejudice. It is responsible for the implementation of the Elderly Statute (Law 10741/2003) and the 120 Available at: http://www.cedm.pr.gov.br/sites/cedm/arquivos_restritos/files/documento/2020- 11/planomulher_2019_aprovacao.pdf. Page | 65 State Plan for the Rights of the Elderly (launched in 2014). The state of Paraná keeps a State Fund for the Rights of the Elderly (FIPAR) that aims to raise and invest resources in actions aimed at developing policies, programs and actions to promote, protect and defend the Rights of the Elderly as well as operates since 1997 a free-toll phone number (Call Elderly Paraná: 0800-41-0001) that provides information and guidance on the rights of the elderly, receives suggestions on / intermediates access to public services available in the community, receives and forwards complaints of violence against elderly people.121 • The State Council on the Rights of Refugees, Migrants and Stateless Persons from Paraná (CERMA) was established by Law 18465/2015 with a consultative and deliberative character and integrated evenly by representatives of state agencies and civil society entities (obligatorily linked to the protection and defense of the rights of refugees, migrants or stateless persons). It aims to enable and assist in the implementation and inspection of public policies aimed at the rights of refugees and migrants, in all spheres of the Public Administration of the State of Paraná, aiming at guaranteeing the promotion and protection of the rights of refugees, migrants and stateless persons. • The State Council for the Protection of Victims of Sexual Abuse (COPEAS) was established by Law 14648/2005 with the primary objective of implementing an adequate policy that allows the attendance, referral and assistance to victims. It is composed by representatives of State Secretariats, the Public Attorney Office and The Brazilian Bar Association (OAB). • The Intersectoral Committee for Monitoring and Monitoring the Policy of Homeless People that aims to enable and assist in the implementation and monitoring of public policies aimed at the homeless population, in all spheres of Public Administration in the State of Paraná, in order to guarantee the promotion and protection of human rights.122 • Finally, in the health sector, social participation is provided in Paraná through the State Health Council (CES) is ruled by State Law no. 10,913/1994. In total, CES comprises 36 members and 36 alternates. It is composed by 18 representatives of health users, 9 of representatives of health professionals, 6 representatives of health service providers and 3 representatives of State institutions. In its current composition, CES counts with the membership of representative of labor unions, women organizations, Afro-Brazilian women organizations, church organizations working with child health, and organizations of people with disabilities, among others. CES is a higher, deliberative, permanent, representative, normative, consultative and supervisory body of health actions and services. CES keeps regional advisors for social control who act as facilitators between the Municipal Health Councils and CES. National, State and 121 Available at: http://www.justica.pr.gov.br/Pagina/Disque-Idoso-Parana. 122 All these participatory bodies are integrated in the functional structure of the State Secretariat of Justice, Citizenship and Human Rights (SEJU) and SUDIS. Sources: http://www.sudis.pr.gov.br/Pagina/Superintendencia- Geral-de-Dialogo-e-Interacao-Social# and http://www.aen.pr.gov.br/modules/noticias/article.php?storyid=105513&tit=Governo-fortalece-atencao-a-povos- tradicionais-do-Parana. Page | 66 Municipal Health Conferences occur periodically (ordinarily every four years) and are organized to formulate strategies, control and evaluate the execution of health policies. Since 1991, 12 State Health Conferences have been convened in Paraná. The last one occurred in June 2019, following the realization of 371 Municipal Health Conferences. The total audience of the 12th State Health Conference was 1,174 participants (including 121 observers and 38 guests).123 IV.6 Main Elements of the Borrower System in light of Core Principle #6 The Program will not be implemented in areas of recognized fragility, or in post-conflict zones, or areas subject to territorial or jurisdictional dispute. The Program is not expect to exacerbate underlying tensions or civil strife by reinforcing inequities or grievances too. It will not in any way prejudice one party’s claims in land or territorial disputes and there is no history of unrest in the area of the Program or the sectors it embraces. The legal and regulatory framework bestows certainty about the jurisdiction of the implementing agencies and adequately addresses potential environmental and social risks and impacts of complex projects. The enforcement of this framework is strong. There are no significant concerns related to the Borrower’s capacity, commitment for, and track record in relation to stakeholder engagement. The Program agencies have shown to be open to discussions with the Bank and consultations with stakeholders. The sectors included in the Program have well-established multi-stakeholder consultative and/or deliberative councils with representation of disadvantaged and vulnerable social groups (as mentioned above). These councils ensure participation of disadvantaged and vulnerable social groups in the discussion and social control of state policies that address issues related with: Indigenous Peoples and Traditional Communities; children and adolescents; women, persons with disabilities and the elderly; migrants, refugees and stateless people; and homeless people and victims of sexual abuse. The State's Comptroller General – CGE (which houses the OUV), SUDIS and SEJU have the complementary attributions of (a) promoting the participation of civil society in transparency and the encouragement of citizen participation in social control and (b) specifically promoting the dialogue with the civil society organization and representative organizations of traditional communities (including Indigenous Peoples) and disadvantaged and vulnerable groups. The main duties of OUV comprise among others124: (a) the establishment of communication channels to meet the demands of the population, aiming to receive and forward requests, suggestions, complaints, denunciations and compliments about the actions and government programs; (b) the establishment of effective mechanisms that allow effective popular participation and daily exercise of citizenship; (c) the processing of information obtained through the manifestations received and satisfaction surveys carried out with the purpose of evaluating the services provided, especially regarding the fulfillment of the commitments and 123 http://www.conselho.saude.pr.gov.br/Pagina/12a-Conferencia-Estadual-de-Saude. 124 https://www.legislacao.pr.gov.br/legislacao/listarAtosAno.do?action=exibir&codAto=243137&indice=1&totalRegis tros=84&anoSpan=2021&anoSelecionado=2020&mesSelecionado=0&isPaginado=true Page | 67 standards of quality of service and monitoring the performance of the sectorial units of the System of the manifestations received; (d) the definition of mechanisms and standards for measuring the level of satisfaction of citizens using public services; and (e) the proposal and adoption of measures to defend the rights of users of public services. As mentioned, SUDIS was recently created with the attributions of ensuring the dialogue between the State Administration agencies and organized civil society, promoting transparency, visibility and access to information, and developing studies and research on social participation and social dialogues125. SEJU coordinates the large network of participatory instances through which civil society (and, notably, the most vulnerable social groups within the Paranaense society) is consulted on public policies and state interventions (as described above) – including in the Health and Environment sectors126. Early meaningful consultations (leading to incorporation of stakeholders’ feedback) have been carried out about the State of Paraná Multi-Year Plan (PPA 2020-2023). Between May and August 2019, the consultation process included six public hearings that were regionally held (in the cities of Curitiba, Ponta Grossa, Apucarana, Umuarama, Cascavel and Guarapuava). These hearings convened about 800 people and were transmitted alive through Facebook. A broadly-advertised dedicated webpage remained open to collect citizens feedback on the PPA 2020-2023 till September 2019: http://www.planejaparana.pr.gov.br.127 PPA 2020-2023 was then approved by the State House of Representatives in December 2019 (State Law 20,077, December 18, 2019). The overall program and sector specific activities will be consulted with the pertinent key stakeholders as requested by state and federal legislation. Some of these sector specific consultations are already ongoing. The Regional Productive Development Plans will follow a participatory approach on the process of planning and on the governance of its implementation, including several workshops for mobilization of stakeholders and diagnostic of regional realities as well as identification and prioritization of opportunities of investments. This participatory approach will include an online platform for information dissemination and stakeholder engagement. However, the expansion of the digitalization of governmental services and the need to prioritize virtual channels for consultation with these representative bodies during the outbreak of Covid-19 generates some concerns due to the “digital divide” (access to technologies and “digital illiteracy”) as some of these disadvantaged and vulnerable groups may face disproportionate challenges and barriers. These vulnerable potential users of e-governance and their representative on the social participation instances may need additional assistance to get access to virtual/digital platforms. The digital gap has been steadily reduced in Brazil during the last years. In 2018, official data show that 79.1% of the households and 83.3% of the population had access to internet in the country. Access to internet is much higher at urban than at rural areas (83.8% and 49.2%, 125 http://www.sudis.pr.gov.br/Pagina/Superintendencia-Geral-de-Dialogo-e-Interacao-Social 126 https://www.justica.pr.gov.br/Pagina/Secretaria-da-Justica-Familia-e-Trabalho Indeed, this website continues running and citizens continue to be able to comment on each of the 21 programs 127 and its activities. Page | 68 respectively). Income, education, and age continue to be other relevant drivers of the use of the internet. In Brazil, the average income of the population with household access to internet was 88% higher than the average income of those without it. While 91.0% of the people in the 20-24 years of age group accessed and used internet, this rate fell to 64.2% among those in the 55-59 years of age and 38.7% among the 60 years and older population. According to the level of education, the use of the internet raises from 12.1% among the people without school education up to 98.3% among those who reach graduation schools. Women use the internet slightly more than men (75.7% and 73.6%, respectively). The digital gap is narrower at the Southernmost Region of the country and in the state of Paraná. in the South Region the parcel of households and population with household access to internet equaled 81.1% and 86.2%, respectively. In the state of Paraná, these ratings equaled 80.5% and 85.5%, respectively. In the South Region, the income gap between those with and without access to internet was also narrower than in the country, equaling 58%.128 Many stakeholders called attention for digital gap and digital exclusion of rural areas and traditional communities. Addressing the risks created by the digital gap, the State of Paraná has developed actions to promote digital inclusion and literacy through Citizen Spaces, 399 Network - Internet for All and Celepar’s Social and Digital Inclusion Program. Citizen Spaces are public offices where citizen can have access to internet. According to the latest Information there are 400 offices in 338 municipalities. 399 Network - Internet for All aims to disseminate the use of broad band internet services allowing the offer of municipal services online and the coverage of district areas and rural communities. In 2019, Celepar offered classes and workshops for the social and digital inclusion with a focus on the elderly (the “Smartphone and Internet Access and Social Networks course”) in 30 municipalities, enrolling nearly 3,000 people who, at the end of the training, learned how to use Smartphones, held an electronic address (e-mail) and a profile on social networks.129 Program dissemination among and consultation with the representative bodies of vulnerable social groups that are active in the state may ensure that issues related with the digital gap are minimized and Program benefits reach the constituencies they represent. 128 IBGE, PNAD Contínua TIC 2018. Information available at: https://www.ibge.gov.br/estatisticas/sociais/trabalho/17270-pnad-continua.html?edicao=27138&t=resultados. Data on TIC 2019 show that 65% of the Indigenous Peoples in the country have access to internet and that 68% of internet users have used e-government services (https://cetic.br/media/analises/tic_domicilios_2019_coletiva_imprensa.pdf). 129 Celepar, Relatório de Sustentabilidade 2019, available at http://www.celepar.pr.gov.br/sites/celepar/arquivos_restritos/files/documento/2020- 06/relatorio_de_sustentabilidade_2019_versaofinal.pdf. Page | 69 Section V. Stakeholder Consultations V.1 Consultation Process In preparation of this report, the task team carried out consultations with key stakeholders. The task team participated with the client in virtual meetings with the State Council of Indigenous Peoples and Traditional Communities (March 8, 2021) and the State Council of Environment (March 11, 2021). In total 110 people took part in these two meetings. Afterwards, the task team communicated with the members of these bodies using questionnaires that could be filled using a digital platform (Kobo Toolbox) or sent by e-mail. In total, using this digital platform and e-mail address, the task team received 25 contributions.130 In addition, at May 20, 202, 1a virtual meeting was held with representatives of Civil Society Organizations (OJC, Mater Natura, SPVS and Cedea) in the State Council of Environment by request of these organizations and counting with the participation of the state government representatives of SEPL, SEDEST and IAT. The consultation process addressed the following issues: • Environmental and Social Risks and Impacts that may be associated with the activities included in the Paraná Eficiente Program; • Capacity of the Paraná State Environmental and Social Risk and Impacts Management System to deal properly with risks and adverse impacts; and, • Critical measures needed to strengthen it and recommendations. V.2 Views expressed by the consulted stakeholders: Overall the people consulted expressed a positive view of the activities included in the results areas. However, they highlighted that Traditional Communities had not received a special treatment with regards to Covid-19 and called for the inclusion of Indigenous Peoples, Quilombola Communities and Traditional Communities as priority groups for vaccination. They also showed a concern with the digitalization of governmental services, as it may have an adverse impact on these traditional communities because they ordinarily do not have access to Internet. Opposite views were expressed with regards to the capacity of the State’s Envir onmental and Social Risks and Impacts Management System were expressed. On the one hand, it was highlighted the robust regulatory framework and the exemplary performance of the long-term permanent technical staff and pointed out that the recent and planned hiring processes carried by the State will provide the State’s environmental agencies with the human resources they need. They also agreed that the use of images of satellites can 130 These contributions were sent by 12 non-governmental, civil society organizations and academia members, 7 other members of the State Environment Council and 6 other people who preferred not to identify themselves. The task team is deeply grateful for the contributions received and the Client’s support throughout this process of consultation. Page | 70 have a deterrence effect on the illegal activities, but would only be effective when combined with on-the-ground activities. On the other, many stakeholders pointed out some fragilities the State of Parana EMS: • The lack of transparency and effective social participation in the environmental licensing processes; • The lack of coordination between the agencies responsible for management of environmental risks; • The ongoing debate on the municipalization of the environmental licensing process (review of CEMA’s Resolution 88/2013); • The lack of discussion of the environmental innovation (I-9) project with environmental oversight and control agencies (State Environmental Police Squad). These stakeholders have pointed out three main reasons for this fragility: • The downgrading and downsizing of the State agencies responsible for environmental risk and impact management and the reduction of their contingent of technical staff throughout the years; • the political and economic pressures made by actors with vested interests over SEDEST in the environmental licensing processes and technical decisions; and, • the lack of commitment of governmental authorities with oversight, control and management of the state’s natural heritage. Thus, the following measures to strengthen the system seem to be widely shared among the stakeholders consulted: (i) hiring on a more permanent-basis skilled technical staff to carry out on-the-ground work of environmental oversight and screen the self-declared information provided by project developers during the environmental licensing process to ensure a more sustainable, standardized and coherent operation of the system as the stability of the public servants career is a protection against the political and economic pressures made by agents with vested interests over the system; (ii) providing the responsible environmental State agencies with the means needed for carrying out on-the-ground activities; (iii) guaranteeing transparency and accessibility to information allowing effective social control of environmental licensing and monitoring processes; (iv) enhancing coordination between the different government agencies responsible for environmental risk and impacts management and control of environmentally illegal activities; and, (v) improving the scientific evidence-basis on the processes of decision-making about policies, programs and projects of environmental conservation. Few stakeholders also emphasized the needs of: (a) acknowledging the historical environmental legacy issues on the management of the environmental heritage and (b) guaranteeing that some aspects of environmental risk and impacts management (such as the management of conservation units, management of the state’s natural heritage, respect for the territories and Page | 71 livelihoods of traditional communities, and programs of environmental education) have been relegated on the daily operation of the responsible environmental agencies. V.3 Recommendations from the Stakeholders The following measures were recommended as necessary to strengthen the State’s Environmental and Social Risk Management System and make it capable of addressing the environmental and social risks that may be associated with the implementation of the Program for Results component of the project: • Guarantee free, prior and informed consultation of Indigenous Peoples, Quilombola and Traditional Communities in all activities that may have an impact on their communities such as the Regional Productive Development Plans; • Include the access of traditional communities to technical assistance, financing, and institutional markets aiming the development of agroecology, organic agriculture, artisanal fishery as part of the Regional Productive Development Plans; • Improve the access of Indigenous Peoples, Quilombola and Traditional communities to the Internet – for instance, opening new Citizen Spaces, mapping of the digital needs in these communities and overcoming the digital divide that is particularly present in the rural areas of the Paraná state; • Recruit and hire on a permanent basis skilled technical staff for the ranks of the State’s environmental agencies; • Rigorously monitor and evaluate the outcomes from the implementation of the technological innovation in the environmental licensing and management processes; • Apply in the licensing and management processes a set of biodiversity and nature conservancy international standard indicators that ensure compliance of the Paraná Eficiente program with the World Bank’s Environmental and Social Standards; • Promote on-line accessibility and transparency of all environmental licensing procedures to all stakeholders; • Full disclosure of all costs related with the Paraná Eficiente Program; • Implement an Integrated Health Management Information System; • Ensure the State Environmental Policy Squad is involved in the planning process to ensure the new environmental licensing and management processes and procedures ensure its effective oversight and control due diligence; • Examine the possible interactions between changes in management resulting from the Program and the recent changes in the environmental legislation, in order to capture loopholes that may generate inappropriate approvals in environmental licensing processes; • Review the allocation of the Green ICMS (state tax on commercial and services) listening the traditional communities; • Require during the licensing process, speleological studies from enterprises to be located in areas with karst potential (in accordance with Decree No. 99.556 / 1990, Decree No. 6.640 / 2008, Normative Instruction MMA No. 2/2017 and CONAMA Resolution No. 347/2004); Page | 72 • Consider the creation of a qualified scientific technical committee to guarantee the effectiveness of a currently non-existent policy aimed at the conservation of biodiversity for the State of Paraná and allocate compensation resources, fines and other assets that are not accountable to the State Government to meet priorities for the conservation of natural heritage; • Review the licenses of SHPs and CGHs that were issued, suspending them until an Environmental Impact Study is carried out for all Small Hydro-Power Plants and Hydro- Power Generation Plants across the state; • Address issues related with animal health as Covid-19 is a zoonosis and as at least 5 zoonoses appear per year in the world and there must be active epidemiological surveillance; • Involve Civil Defense more actively in handling Covid-19 as a disaster, in addition to the work of assistance in delivering basic baskets and escorting vaccine trucks; • Prioritize the traditional communities in the vaccination against Covid-19. These inputs have been analyzed and incorporated in the current report and in the Environmental and Social Risk Management Action Plan of the Program for Results component of the Paraná Eficiente Project as appropriate and feasible. Page | 73 Section VI. Overall Findings, Recommendations and Actions: VI.1 Overall Findings The overall conclusions of the Borrower’s Environmental and Social System Assessment are two-fold: • First, the assessment concluded that the Program will be developed in a legal or regulatory environment where there is significant certainty about the jurisdiction of the implementing agencies, where the legislation and regulatory framework do adequately address potential environmental and social risks and impacts of complex Projects, and where enforcement is strong. The legal and regulatory authority of all Programs are clearly established. • Secondly, the past experience of The Borrower and the implementing agencies past experience in developing programs and projects of the same level of complexity is relevant and their track record regarding environmental and social issues is good. There are no significant concerns related to their capacity and commitment for, and track record in relation to stakeholder engagement. The technical and institutional capacity of the Borrower, its track record and the financial and human resources available for management of the Program and its environmental and social risks and impacts are adequate. No critical changes to the legal or regulatory framework is needed before the operation can proceed. VI.1.1 On the Adequacy of the Environmental Management Systems Environmental Management Systems (or EMSs) have become an important tool for those governments looking to manage environmental issues such as protection of biodiversity, deforestation, pollution prevention, legal compliance, water management, environmental management of land use, environmental management of parks and forest reserves, and many other management modalities including environmental aspects. Well-functioning environmental systems and institutions must be able to pick-up signals about environmental problems and understand their causes. In particular, institutions shall be able to gather and disclose information about environmental trends; provide mechanisms of public participation and respond to feedback; and work with stakeholders and ministries to understand the causes of problems (WBG, 2010. Report 70219). The State of Paraná has well-established regulatory framework in the environmental sector. The environmental governance arrangement enjoys stability, strong oversight by judicial and extra-judicial bodies (including mass media and public opinion). The Paraná EMS includes an integrated environmental water right system [Sistema Integrado de Gestao de Recursos Page | 74 Hidricos – SIGARH]; 131 tools of intelligence electronic data and devices; a land use management system [Sistema de Gestão Ambiental – SGA]. Despite of the robustness of the Paraná State EMS, the Government of Paraná has recognized that there was a weakening of the institutions responsible for environmental management, due to the reduction of the workforce of the responsible environmental agencies, the misalignment of processes and procedures and the non-modernization of existing systems, especially in information technology, in consequence of which (a) government services have been provided in an anachronistic, time-consuming manner, with a significant lack of standardization and little transparency and (b) environmental inspection and monitoring are carried out below desirable. To answer such weakening of the responsible environmental agencies and its consequences on the environmental licensing, inspection and monitoring processes, the Government of Paraná is investing (partially with support of P126343 SWAp for Paraná Multi-sector Development Project) on technological innovation,132 digital transformation,133 and the enhancement of evidence-based geospatial information,134 aiming to improve and integrate its environmental management systems. These investments aim to foster agile environmental licensing processes and robust systems to access compliance with environmental rules. 131 SIGARH was initiated through the previous World Bank SWAp operation with the State of Paraná, which supported the establishment of a module for granting water resources. 132 Thus, the State of Paraná is investing on the enhancement of an online geographic platform with applied intelligence for access to environmental services (IDE – Spatial Data Infrastructure – “Infraestrutura de Dados Espaciais”). IDE is an online geographic platform with applied intelligence for access to environmental services, aiming to facilitate access and availability of updated spatial land official information produced by the state and to give transparency and publicity to environmental processes. IDE will facilitate access to information for entrepreneurs and control bodies (Geo Portal). Furthermore, it will also contribute for agility in the licensing process, through improvements in the implementation of SIGARH (the Environmental and Water Resources Management System) by improving and expanding the use of technological tools to give agility, standardization and efficiency to the request processes, automatized analysis and licensing issuance for low an medium risk enterprises. 133 Thus, the State of Paraná is fostering digital transformation through the implementation of (a) the Environmental Monitoring System and (b) the improvement of the Environmental Monitoring Networks. Through the Environmental Monitoring System based on the use of technologies such as remote sensing, automatic transmission of data and mobile devices in the field, the state agencies will be able to monitor the integrated systems and the geo portal and through the use of satellite data the physical networks for monitoring air quality, hydro meteorological and hydro geological will be expanded and modernized. 134 Thus, the State of Paraná is investing on the preparation of the Planialtmetric Base of the Paraná territory, at scale of 1:50000, flood risk maps in urban perimeters of 12 municipalities (Morretes, Rio Negro, Curitiba, Pinhais, Piraquara, São José dos Pinhais, Araucaria, Campo Largo, Fazenda Rio Grande, Colombo, Almirante Tamandaré and Balsa Nova) prioritized based on the history of occurrences and intensity of the phenomenon, and Geological Risk Maps (Gravitational Mass Movements - MGM; Carstic Reliefs; Soil Collapse / Erosion) of 40 municipalities (Antonina, Adrianópolis, Almirante Tamandaré, Araucaria, Bocaiuva do Sul, Campo Magro, Carambeí , Campina Grande do Sul, Campo Largo, Campo Mourão, Castro, Cerro Azul , Colombo , Curitiba, Francisco Beltrão, Fazenda Rio Grande , Guaraniaçu , Guaratuba, Inácio Martins, Itaperuçu, Irati, Mandirituba, Matelândia, Morretes, Ponta Grossa, Pato Branco, Piraquara, Pitanga, Pinhão, Prudentópolis, Rio Branco do Sul, Quatro Barras, São Jose dos Pinhais, São Pedro do Ivaí, São Jeronimo Da Serra, Telêmaco Borba, Três Barras do Paraná, União da Vitoria and Vitorino). Additionally, the availability of geospatial information will also allow the use of geographic intelligence as a decision support tool for analysis in environmental licensing processes and improvements in the Environmental Enforcement System and Infraction Notices, which will be integrated with the geo portal and with the system of the Military Police of the State of Paraná and will develop and implement the system of environmental inspection and management of infringement notices based on the use of mobile devices in the field. Page | 75 These state investments on the EMS aim: (i) to foster agile environmental licensing processes and robust systems to access compliance with environmental rule, by generating (a) the necessary information for the monitoring systems and for the environmental regularization process, (b) a better understanding of the spatial distribution of threats related to the various types of geological risks recognized in the selected municipalities, (c) the identification, quantification and assessment of the elements at risk (physical structures and population health and safety), (d) the improvement of the quality of alerts, contributing to minimize the economic and social damage caused by landslides, and (e) the increase of the municipal capacity to develop instruments for regulating urban occupation in areas susceptible to landslides; (ii) to improve the efficiency of these agencies and processes and to facilitate access and availability of updated spatial land official information produced by the state and to give transparency and publicity to environmental processes further contributing for (a) agility, standardization and efficiency in the environmental licensing process, (b) the enforcement of the environmental legislation and (c) avoidance of overuse of natural resources, conversion and degradation of critical natural habitats; (iii) to enhance the institutional capacity of the responsible state agency’s to enforce the environmental regulatory and disaster risk management framework and to reduce the costs of environmental monitoring and disaster risk management, while bring positive impacts for biodiversity protection, compliance with environmental rules and avoidance of pollution as well as of adverse impacts from productive activities. The main conclusion drawn by the assessment with respect to the adequacy of the Environmental Management System (EMS) of the State of Paraná is that the legal framework is robust and adequately address potential environmental and social risks and impacts of complex projects. The assessment also founds that there is significant certainty about the authority and jurisdiction of the responsible governmental agencies, which enjoys stability, strong oversight by judicial and extra-judicial bodies (including mass media and public opinion). The representatives of NGOs and Academia listened during the consultation process argue that although technological innovation is important, it will be necessary to increase the number of technical staff working hired on a permanent basis and strengthening the state environmental agencies to ensure the quality and efficiency of the environmental licensing and risk management processes and compliance with the regulatory framework. Some stakeholders also called attention for the need to monitor and evaluate the outcomes from the implementation of the technological innovation in the state’s environmental licensing and management processes. Page | 76 VI.1.2 On the Adequacy of the Social Management Systems Taking in consideration the activities to be supported by the Program, the first conclusion of the assessment is that they are not expected to involve works under significant risky and unsafe workplace conditions and the Borrower’s Social System is well-developed an able to deal with the risks associated with occupational health and safety conditions. Health sector activities within UCM and existing hospitals to respond to Covid-19 may expose health workers to health hazards. These risks are not unprecedent and can be managed by well-known standard procedures. The protocols that rule the operation of health service facilities in Brazil are rigorous and strongly enforced across the State of Paraná. Furthermore, the Brazilian labor regulatory framework comprises proper standards of occupational health and safety for the operation of health service facilities. These workplaces are ruled and managed according to restricted, well-implemented and closely oversighted occupational health and safety standards and measures. Such measures are in alignment with international best practices and, therefore, in ways that the risk of exposure to unsafe and unhealthy conditions is not only avoided and minimized, but also not expected to be significant. Brazilian occupational health and safety standards require the use of adequate personal protective equipment (PPE) to each different workplace conditions. For instance, the standards define specific protocols and PPE for working with x-ray equipment, hazardous materials, electricity and heavy machinery, in confined spaces and heights. Compliance with these occupational health and safety standards and protocols are overseen by labor surveillance agencies and the Labor Courts. These rules require public and private employers to develop and provide training to their employees on preparedness and response to emergency plans, environmental risk prevention programs, and occupational health and medical control programs. A second conclusion is that the supported activities are not expected to have significant direct adverse impacts related with land acquisition and involuntary resettlement, but the Borrower’s Environmental and Social System shows a few gaps with the World Bank’s principles related with land acquisition and compensation of affected people. These gaps are: (a) Compensation of adverse possession under conditions in which usucapione rights are recognizable because there are different understandings in the Brazilian jurisprudence about the amount of compensation that must be paid for land. Although there is no provision under the legislation, the jurisprudence has ordinarily set the compensation of the land under this condition at 60 percent of the value of land under full ownership rights. This jurisprudence is not fully aligned with the entitlements envisaged by the Environmental and Social Standard 5 – Land Acquisition, Restrictions on Land Use and Involuntary Resettlement for those who do not have formal legal rights to land at the time the census begins but have a claim to such land or assets--provided that such claims are recognized under the laws of the country). (b) The Brazilian legislation has no provision with regards to resettlement assistance for tenants and co-inhabitant families. (c) The Brazilian legislation does not make a difference on entitlements to compensation between persons who encroach on the area before or after a cut-off date. Page | 77 (d) There is no provision for the establishment of a grievance mechanism to deal exclusively with claims on involuntary resettlement in the Brazilian legislation. In the scope of the proposed Program, land acquisition may be envisaged as a potential downstream effect of the preparation of Regional Productive Development Plans as they may support some infrastructure works (such as the rehabilitation of vicinal roads). With regards to the potential downstream effects of the preparation of the Regional Productive Development Plans, institutional capacity building on this topic for the agency implementing this activity is recommended. Hence, the Action Plan includes the provision of training on appropriate measures, best practices and lessons learned to address (avoid, minimize and mitigate) adverse impacts related with land acquisition, restrictions on land use and involuntary resettlement to the staff engaged on the preparation of the plans. A third conclusion is that the supported activities are not expected to cause relocation of Indigenous Peoples or have adverse impacts on (a) land and natural resources subject to traditional ownership or under customary use or occupation; or (b) Indigenous Knowledge; or (c) on Indigenous Peoples cultural heritage that is material to their ethnic identity; or (d) cultural, ceremonial, or spiritual aspects of their lives. Additionally, the Borrower’s Environmental and Social System comprises robust measures to ensure not only meaningful consultation with and participation of Indigenous Peoples so devising opportunities to their benefit from the Program, but also appropriate attention to groups vulnerable to hardship or discrimination. However, due to the digital divide, Indigenous Peoples and disadvantaged and vulnerable groups face some constraints related with access to technologies and “digital illiteracy”, may have different needs and preferences for accessing e-services and may need additional assistance to benefit from the expansion of the digitalization of governmental services. Hence, an additional social risk management measure has been required and included in the Program’s Environmental and Social Risk Management Action Plan (please refer to the next section). Finally, the assessment concludes that the Program is not expected to lead to marginalization of social groups, the exacerbation of conflicts among social groups, or social unrest. On the contrary, some activities are socially inclusive and have positive distributive effects. Improvements in the public health sector may also benefit the most the poor and most disadvantaged and vulnerable people who rely the most on these public services and particularly the growing number of elderly people in the state population. The Government of Paraná focus on disadvantage and vulnerable social groups on the provision of access to Covid-19 response initiatives reduces the risk that certain groups could come to believe they are underserved and marginalized due to their identities and status. To ensure opportunities different stakeholders (particularly these social groups vulnerable to hardship or discrimination) may have to fully benefit of supported activities of Covid-19 response, a few additional social risk management measures have been recommended and included in the Program’s Environmental and Social Risk Management Action Plan (please refer to the nex t section). However, due to the “digital divide” (access to technologies and “digital illiteracy”), some of these disadvantaged and vulnerable groups may face disproportionate challenges and barriers with the expansion of the digitalization of governmental services. Hence, vulnerable Page | 78 users will have different needs and preferences for accessing e-services and may need additional assistance to transition to digital government services. VI.2 Program Action Plan The Program Action Plan for enhancing the Borrower’s system of environmental and social risks management includes two types of actions: required and recommended. VI.2.1 – Required Actions Considering the findings of the ESSA, four actions are required for adequate management of environmental and social risks associated with the Program. The first action required refers to the works for the reforms and the operation of the forty new UCM and expanded hospitals to respond to Covid-19. The operation of these health service facilities requires attention with the management of solid waste generated by health services, measures relating to occupational health and safety – to protect workers from injury, illness, or impacts associated with exposure to hazards encountered in the workplace or while working – and exposure of patients to health and safety risks. The regulatory framework on these issues is robust. A requisite of the operation of health service facilities is to have in place a Health Services Solid Waste Management Plan and the Paraná Health Code requires the adoption of strict measures of occupational safety and health to allow the operation of health service facilities. The agencies responsible for the enforcement of these measures have a strong capacity in the state of Paraná. To ensure the adequate management of such risks, it is required that the Project Management Unit records the evidence of compliance with the environmental, health and labor measures the 40 selected hospitals that will be converted in UCM and hospitals with an expanded number of beds to respond to Covid-19. A second action is required with regards to the management of working environment and solid waste in health service facilities. Thus, the Project Management Unit will be responsible to (a) report on compliance with the measures provided for in SESA Resolutions 544/2020 and 1268/2020 to evidence the environmental and social eligibility of expenses related to the expansion of the number of beds to respond to Covid-19 in contracted hospitals submitted for retroactive financing and to (b) report on (i) the publication of the SESA Resolution that will establish the Multiprofessional Care Unit – UCM in the State of Paraná and will set the guidelines and criteria for adherence and structuring, as well as funding and investment resources, and (ii) the compliance with this Resolution to evidence the environmental and social eligibility of expenses related to the conversion of the 40 selected hospitals into UCMs. To ensure that social groups vulnerable to deprivation and discrimination are not excluded from opportunities to benefit from the Program, it will be carried out (i) a broad process of dissemination of information about the Program among representatives of the existing State Councils and Committees of vulnerable social groups and (ii) their consultation on (a) the level of satisfaction of its constituents with the Program and (b) the design of additional measures that may be necessary to ensure that its constituents may have enhanced access to digital services, platforms and channels - such as those used during the workshops and trainings that Page | 79 will be held for the elaboration of Regional Productive Development Plans - and may benefited by the Program. Overall and to ensure the Paraná Eficiente Project complies with the environmental and social risk management standards set by the World Bank for both Program for Results Financing and Investment Project Financing (IPF), the final required action is that Project Management Unit keeps one social and one environmental risk management specialist throughout the project life cycle. These two specialists will be responsible for overseeing project activities ensuring the Program’s Environmental and Social Risk Management Action Plan is implemented in a timely and effective manner and the environmental and social risks associated with the technical assistance activities supported by the IPF component are managed according to the World Bank’s Environmental and Social Standards. In addition, all implementing agencies will keep focal points on environmental and social risk management. These required actions and measures are legally binding. VI.2.2 – Recommended Actions To address issues related with limitations faced in the environmental licensing and risk management processes in the State of Paraná, it is recommended the definition of measurable and attributable indicators to monitor the results achieved in terms of improving the performance and effectiveness of the agencies responsible for environmental licensing and management as a result of environmental innovation. Two actions are recommended with regards to the preparation and implementation of the Regional Productive Development Plans, which may lead to downstream and future effects on the environment and society that are not foreseeable. The activities supported by these plans will have very positive environmental and social impacts – conducive to a green development path – as far as they are based on principles of environmental and social sustainability. Thus, the second action required is the preparation of these plans incorporate criteria related with (i) avoidance, reduction and mitigation of environmental and social risks and impacts, (ii) protection and conservation of biodiversity and critical and natural habitats, (iii) pollution prevention and sustainable and efficient use of resources, (iv) community health and safety, (v) protection of cultural heritage, (vi) broad consultation with stakeholders (including traditional communities and Indigenous Peoples as they are present in the area of influence of the Plans), and (vii) social inclusion. And the third action required is the provision of training sections on appropriate measures, best practices and lessons learned to address (avoid, minimize and mitigate) adverse impacts related to land acquisition, restriction on land use and involuntary resettlement to the staff engaged with the preparation and implementation of Regional Productive Development Plans, ensuring these plans are consistent with core principle 4.135 135 It is worth mentioning that the IPF TA component will support a multidisciplinary consultancy envisaged to strengthen SEAP’s institutional capacity on this issue (which includes the mapping of the uses and occupations of state properties, the definition of standards of occupation of state properties, a proposal of relocation of public administration agencies). It has been recommended this consultancy incorporates an assessment and a proposal of Page | 80 Additionally five measures are recommended to help improve the performance of the existing Environmental and Social System following its own defined procedures may include: • Implementation of an information dissemination campaign of Program supported activities, relying on mass media and the creation of a dedicated official webpage of the Program within the official state website (including a citizen information service and FAQs) and social media; • Continued dissemination of OUV among project’s beneficiaries and stakeholders, its attributions and channels to lodge complaints; • Continued monitoring of requests of information, suggestions and compliances related with Program supported results areas and activities that reaches OUV • Retrofitting of the Program’s implementation on the basis of the analysis of these citizen’s claims to OUV. • Finally, considering the challenges faced by the State of Paraná EMS and, it is recommended that (a) the outcomes of the measures the government is taking to revert its weakening are monitored through attributable indicators. guidelines for ruling the relocation of occupants of the state properties that are able to achieve development outcomes that are materially consistent with the objectives of the World Bank Environmental and Social Standard 5 – Land Acquisition Restrictions on Land Use and Involuntary Resettlement. These guidelines must be used for training the staff engaged on the preparation of the Regional Productive Development Plans. Page | 81 VI.3 Action Plan Summary Matrix The matrix below sets the actions and measures the Borrower is required and recommended to take during implementation of the Program to improve the effectiveness and performance of its Environmental and Social Management System. Issues addressed Actions / Measures to be taken Type of Action Institutional Timeline Completion Responsibility Indicators Environmental and Social The PMU will include one environmental and Required SEPL By Project’s Environmental and Risks Management social risks management specialist UGP Effectiveness Social Risks throughout the Program life cycle. This and Management staff specialist will be responsible for ensuring this throughout assigned Action Plan is followed, monitoring and Project’s reporting on its achievements. Each implementatio executing agency will keep a focal point for n the management of E&S risks of its activities according to the relevant ESS Management of working The PMU will submit a Report on compliance Required SESA Within 60 days PMU Report on environment and solid with the measures provided for in SESA UGP of project compliance with the waste in health service Resolutions 544/2020 and 1268/2020 to the effectiveness measures provided facilities World Bank. for in SESA Resolutions 544/2020 and 1268/2020 submitted to the Bank. The Project Management Unit will report on Required SESA Recurring and PMU Report on the (a) the publication of the SESA Resolution UGP following the publication of SESA that will establish the Multiprofessional Care calendar of Resolution and on Unit – UCM in the State of Paraná and will set works the signing of the guidelines and criteria for adherence and implementatio Commitment structuring, as well as funding and investment n Agreements by the resources and (b) compliance with this selected Resolution to evidence the environmental municipalities as and social eligibility of expenses related to required by SESA. the conversion of the 40 selected hospitals into UCMs. Potential constraints that A broad process of dissemination of the Required UGP Second year Number of meetings Indigenous Peoples and Program among the representatives of the of with the State Health other disadvantaged and existing State Councils and Committees that implementatio Council and the vulnerable groups may face have broad representation of vulnerable n and annually State Council of in terms of access to digital social groups and their consultation on thereafter Indigenous Peoples Page | 82 Issues addressed Actions / Measures to be taken Type of Action Institutional Timeline Completion Responsibility Indicators platforms and channels – measures that might be taken to ensure that and Traditional such as those used during the constituencies they represent are Communities. the workshops and benefitted by the Program. trainings that will be carried Satisfaction Surveys out for the preparation of Monitoring of accesses and level of completed. the Productive Regional satisfaction of Indigenous Peoples and other Development Plans or by disadvantaged and vulnerable social groups the digitalization of with governments’ digital services. governmental services – due to the digital divide as well as to fair and equitable access to health services and facilities supported by the Program (including those related with Covid 19 response) due to their identities and status. Limitations faced in the Definition of measurable and attributable Recommended IAT Biannual I9 Performance environmental licensing indicators to monitor the results achieved in UGP Monitoring System and risk management terms of improving the performance and operational and processes in the State of effectiveness of the agencies responsible for submitting biannual Paraná. environmental licensing and management as reports a result of environmental innovation. Regional Productive Adoption of principles and criteria of Recommended SEPL Second Number of Plans Development Plans environmental sustainability and social UGP semester of completed contribution to sustainable inclusion in the selection of activities to be the second according to development. supported from the Regional Productive year of principles of Development Plans, , based on the implementatio environmental Sustainable Development Goals. n sustainability and social inclusion Training on appropriate measures, best Recommended SEPL First semester Number of public practices and lessons learned to address SEAP of the second servants trained (avoid, minimize and mitigate) adverse UGP year of impacts related to land acquisition, restriction implementatio on land use and involuntary resettlement for n Page | 83 Issues addressed Actions / Measures to be taken Type of Action Institutional Timeline Completion Responsibility Indicators the teams working on the preparation of the Productive Regional Development Plans.136 Transparency, stakeholder Implementation of an information Recommended UGP First year of Project-related engagement, citizen dissemination campaign of Program implementatio website operational engagement and social supported activities, relying on mass media n and accountability in the and the creation of a dedicated official thereafter management of Program webpage of the Program (including a citizen supported activities. information service and FAQs) and social media. Continued dissemination of the State Recommended UGP First year of Project-related Ombudsman System, its attributions and implementatio webpage channels to lodge complaints. n and operational with a thereafter link to the Ombudsman website Continued monitoring of requests of Recommended UGP Biannually Updated information information, suggestions and compliances Ombudsman on the Projects related with Program supported results areas Office Progress Reports and activities that reaches this System. Retrofitting of the planning and Recommended UGP Annually Updated information implementation of Program supported on the Projects activities on the basis of the analysis of these Progress Reports citizen’s manifestations. 136 This action aims to address the gaps between the Environmental and Social Management System of the State of Paraná and the requirements defined by the Core Principle 4 of environmental and social risk management in PforR operations as well as the World Bank Environmental and Social Standard 5 – Land Acquisition Restrictions on Land Use and Involuntary Resettlement. The training may be open to the teams of all agencies involved in the implementation of the Project. Page | 84 VI.4 Implementation Support Plan In support to the Program’s implementation, the Bank Task Team will: (i) Review implementation progress and achievement of Program Results; (ii) Monitor the performance of the Program Environmental and Social Management System, including the implementation of the Environmental and Social Program Action Plan; (iii) Assess potential changes in the Environmental and Social Risks of the Program as well as adapting the Program Action Program in a manner consistent with the core principles as necessary to (a) improve Program implementation or (b) respond to unanticipated implementation challenges. Page | 85 Section VII. Supporting Annexes and Reference Documents. ANNEX 1 – Detailed Description of the Implementation Partners The Water and Land Institute (Instituto Água e Terra – IAT) was created in 2019 (State Law 20,070/2019) merging three state bodies the Land, Cartography and Geology Institute, the Paraná Waters Institute and the Paraná Environmental Institute. The mission of IAT is the protection, preservation, conservation, control and restoration of the natural capital of the state, aiming to promote sustainable development and to improve quality of life with the participation of society. The institutional structure of IAT comprises seven departments organized by thematic areas. They are: • The Licensing and Granting Department, which has the objective of granting and monitoring the Environmental Licensing, Environmental Authorization and Water Resources Granting of undertakings and activities that use environmental resources considered effective or potentially polluting or those that, in any form, may cause environmental degradation and comprises three units: Licensing Management, Grant Management and Monitoring and Inspection Management. • The Natural Heritage Department, which (a) prepares, executes and monitors plans, programs, actions, technical projects and policies to encourage the conservation and restoration of biodiversity, (b) manages Conservation Units, (c) carries out environmental inspection, and (d) manages native and exotic fauna, among other activities. It comprises three units: Biodiversity Management, Environmental Restoration Management and the Protected Areas Management. • The Environmental Sanitation and Water Resources Department, which is responsible for preparing, executing and monitoring plans, programs, actions, technical projects and policies for the preservation, conservation, recovery and management of the state's Water Resources and Solid Waste. It comprises two units: Sanitation Management and Water Basin Management. • The Territorial Management Department, which is responsible for preparing, executing and monitoring plans, programs, actions, technical and political projects in the mineral, geological, agrarian, land, cartographic, geoprocessing areas, as well as the territorial zoning of the State. It comprises two managerial units: Geosciences Management and Land Regularization Management. • The Administrative and Financial Department that is responsible for the management of human resources, financial planning, contracts, policies and administrative processes. It comprises three managerial units: Planning Management, Financial Management, Administration Management. • The Geographical Intelligence and Information Center. Page | 86 • The Technical Assistance Department. In addition, IAT counts with 21 Regional Offices, located in the cities of Curitiba, Campo Mourão, Cascavel, Cianorte, Cornélio Procópio, Foz do Iguaçu, Francisco Beltrão, Guarapuava, Irati, Ivaiporã, Jacarezinho, Londrina, Maringá, Paranaguá, Paranavaí, Pato Branco, Pitanga, Ponta Grossa, Toledo, Umuarama e União da Vitória. Finally, IAT also counts on: (a) a Social Communication Office that is responsible for publicizing the actions of IAT and SEDES; (b) a Transparency Portal (http://www.transparencia.pr.gov.br/pte/orgao=IAT) where mandatory matters (such as Expenses, Contracts, Agreements, Organizational Structure, Bids, Payments, List of Servers, Remuneration, Suppliers and Travel Status) are disclosed to the society; and (c) a website to answer questions and complaints from citizens and interested parties (http://www.iat.pr.gov.br/Pagina/Fale-Conosco), which is integrated to the State’s network of sectoral Ombudsman Offices. The State's Comptroller General and General Ombudsman Office – CGE is the central body of the State System for the Control of the Executive Branch and was instituted by Law 17,745/2013. The CGE regulation was approved by Decree 2,741/2019. Pursuant to Law 19,848/2019, CGE directly advises the State Governor for the purpose of planning, coordination, control, evaluation, promotion, formulation and implementation of mechanisms and guidelines for preventing corruption. Its field of action includes among others: (i) the development of actions that contribute to the consolidation of a culture of ethics, probity and transparency in the state public service; (ii) the promotion and participation of civil society in transparency and the prevention of corruption; (iii) the encouragement of compliance with legal norms, administrative guidelines, normative instructions, regulations, statutes and regulations, and other acts issued by the Government; (iv) the monitoring of legal and constitutional limits for the application of resources under the responsibility of the bodies and entities of the State Public Administration; (v) the conduction of studies and establishment of strategies to support legislative and administrative proposals within the scope of its activities; (vi) the carrying out of inspections and audits in the accounting, financial, budgetary, equity, personnel and other systems that integrate the state public management; (vii) the monitoring and evaluating compliance with the principles and rules that guide the conduct of Public; (viii) the administration, especially in relation to legality, impersonality, economy, publicity and administrative morality, and also in the defense of individual and collective rights and interests against acts and omissions committed by the State Public Administration and the investigation of facts considered as irregularities within the scope of the State Executive Branch; (ix) the receipt and investigation of substantiated complaints or denunciations addressed to it, in particular the injury or threat of injury to the state public assets, ensuring its full service and resolution, including consultations and requests made by the Legislative, Judiciary and Ministry Public of the State of Paraná; (x) the maintenance and publication in the Transparency Portal of the State Executive Power, of the register containing the data of the suspended civil society organizations or declared ineligible, due to the rejection of the accountability of partnerships entered into with the State Public Administration; and (x) the zeal for compliance with the rules regarding the simplification of the service provided to users of public services and the adoption of measures for the accountability of civilian and military civil servants, and Page | 87 their hierarchical superiors, who practice acts in disagreement with its provisions.137 In its basic organizational structure, CGE comprises at the level of programmatic execution: (a) an Internal Control Coordination, (b) an Integrity and Compliance Coordination, c) and Internal Affairs Coordination, (d) a Coordination of Ombudsman, (e) a Transparency and Social Control Coordination, and (g) a Public Expenditure Observatory. And, at the systemic execution level, CGE counts on Sector Integrity and Compliance Centers (NICS).138 The General Superintendence of Dialogue and Social Interaction -SUDIS is a State Governance body, with top management with a level of advisory and direct strategic and highly specialized support to the State Governor. It is responsible to ensure the dialogue between the State Administration agencies and organized civil society, social movements, NGOs and other collectives from the third sector. Thus, it shall ensure transparency, visibility and access to information to the organized civil society, particularly in areas of social and popular interest as well as promote social participation in conjunction with other state entities. SUDIS is also in charge of receiving and forwarding complaints, denunciations, representations and suggestions regarding State’s procedures and actions, programs and policies as well as to keep the interested parties informed on the progress and the results of the measures adopted in relation to the comments received from them. It is also responsible for the presentation of recommendations to the Government, aiming at the improvement and correction of situations of inadequate functioning of activities under the competence of the units of the Government structure and its related entities. Finally, SUDIS coordinates the Committee and the State Commission for Urban and Rural Conflicts. The institutional structure of SUDIS comprises seven coordination units (Technical Assistance, Reception and Mobilization, Institutional Affairs, Internal Management, Information and Action, Projects and Public Policies, and Treatment and Analysis), a Social Communication Advisory and four collegiate bodies: the State Land Conflict and Mediation Commission (formed by twenty members from different areas), the Conjunctural Analysis Group, the Conflict Management Group and the Inter-Councils group (which is responsible for monitoring, observing and issuing reports with reference to the Councils existing in the different state management bodies). The Health Surveillance Coordination (CVIS) is responsible for the general coordination of the State Health Surveillance System of Paraná, constituted by the state health surveillance teams, both at the central level of SESA-PR and the 22 Regional Health Departments of the state and the health surveillance of 399 municipalities in Paraná. CVIS has as its main attributions the formulation, definition of general guidelines and organization of the functioning of health surveillance in the State of Paraná. CVIS is hierarchically linked to the Directorate of Health Care and Surveillance (DAV) of the State Health Secretary and is organized into four divisions: (i) the Division of Sanitary Food Surveillance (DVVSA); (ii) the Division of Sanitary Surveillance of Products (DVVSP); (iii) the Division of Sanitary Surveillance of Services (DVVSS) that aims to promote the safety of services provided to users of hospitals, clinics, primary health care centers and other health services through evaluations of the structures, processes and results; and (iv) the Division of Analysis of Projects of Health Service Facilities (DAPES). 137 Paraná State Decree No. 2,741/2019, Annex I, Article 1. 138 Paraná State Decree No. 2,741/2019, Annex I, Article 3. Page | 88 ANNEX 2 – Most Relevant Pieces of the Legal and Regulatory Framework Environmental Licensing e Sanctions for Environmental Crimes: • Law No. 6,938, of August 31, 1981. (Amended by laws No. 7,804/89; 8,028/90 and regulated by Decree No. 99,274/90) lays down the National Environment Policy, its purposes and its mechanisms for formulation and application, and makes other arrangements. • Law No. 7,804, of July 18, 1989, amends Law No. 6,938, of August 31, 1981, which lays down the National Environment Policy its purposes and its mechanisms for formulation and application, Law No. 7,735, of 22 February 1989, Law No. 6,803, of July 2, 1980, and makes other arrangements. • Law No. 9,605, of February 12, 1998, lays down the criminal and administrative sanctions derived from conduct and activities harmful to the environment, and other arrangements. • CONAMA Resolution No. 368, of March 28, 2006, alters some provisions on Resolution 335/2003 that lays down the environmental licensing process. Protection of Natural Habitats: • Law No. 6.902, of April 27, 1981, lays down the guidelines for the creation of Ecological Stations and Environmental Protection Areas • Law No. 6,938, of August 31, 1981, establishes the National Environment Policy. • Decree No. 99,274, of June 6, 1990, regulates Law No. 6,902/81 and Law No. 6,938/81. • CONAMA Resolution No. 369, of March 28, 2006, lays down the exceptional cases of public utility, social interest or low environmental impact, which enable the intervention or removal of vegetation in the Permanent Preservation Area/PPA. • Decree No. 5,758, of April 13, 2006, institutes the National Strategic Plan for Protected Areas - NSPPA and defines its principles, guidelines, objectives and strategies. • Law 12.651/2012 (new Forest Code), defines the criteria that are nowadays countrywide adopted for the protection of natural habitats. • Decree No. 8,972, of January 24, 2017, institutes the National Policy for the Recovery of Native Vegetation - PROVEG, lays down its objectives and guidelines, establishes its instruments and defines its governance. PROVEG aims to articulate, integrate and promote policies, programs and actions that induce the recovery of forests and other forms of native vegetation and to promote the environmental regularization of Brazilian rural properties. Solid Waste Management and Health Service’s Waste Management : • Regulatory Standard (RS)-32 - Health and Safety at Work in Health Services. Addresses the issue of waste generated by health services. As for the handling of this waste, it defines that it is up to the employer to train, initially and on a continuous basis, the workers regarding: (a) segregation, conditioning and transportation of the waste; (b) definitions, classification and potential risk of waste; (c) management system internally adopted at the establishment; (d) ways to reduce waste generation; (e) knowledge of responsibilities and tasks; (f) recognition of the waste class identification symbols; (g) knowledge about the use of collection vehicles; and (h) guidance on the use of Personal Protective Equipment - PPE. It also determines that: (i) the segregation of waste must be carried out in the location where it is generated; (ii) the manual transport of the segregation container must be carried out in such a way that there is no contact with other parts of the body, with dragging being prohibited; (iii) the temporary storage room for transport Page | 89 containers must: (a) have washable floors and walls, siphoned drain, water connection, light connection, adequate ventilation, access size dimensioned to allow the entrance of transportation containers; (b) be kept clean and with vector control; (c) contain only collection, storage or transportation containers; (d) be used only for the purposes for which it is intended; and (e) be duly signposted and identified; (iv) the transportation of waste to the external storage area is done by vehicles made of rigid, washable, waterproof material, provided with the top articulated with the body of the equipment and rounded corners and carried out in a single direction with a schedule defined at times that must not coincide with the distribution of clothes, food and medicines, periods of visit or increased flow of people; (v) the external storage of the residues is done in an appropriate place until they are collected by the external collection system, which is sized to allow the separation of the containers according to the type of waste. • Decree No. 50.877, of June 29, 1961 lays down the regulation of the dumping of toxic or oily residues in the interior or coastal waters of the country and provides other arrangements. • Law No. 7,802, of July 11, 1989 (Regulated by Decree No. 4,074/2002 and amended by Law 9,974/2000) lays down the guidelines for pesticides, their components and the like regarding research, experimentation, production, packaging and labeling, transportation, storage, marketing, commercial advertising, use, import, export, the final destination of waste and packaging, registration, classification, control, inspection, and other arrangements. • Brazilian Normative (BRN) 11,174, of August 30, 1990 establishes what are the minimum required conditions for the storage of class II waste - non-inert and III - inert, in order to protect public health and the environment. • BRN 11,175, of August 30, 1990 establishes the equipment performance conditions required for the incineration of hazardous solid waste, except those so classified only by pathogenicity or flammability. • Law No. 8,080, of September 19, 1990 (known as the Organic Health Law/OHL) establishes the Municipal Health Surveillance agencies (HSAs) as a specific action in the health sector, and among its guidelines, the decentralization of actions to states and municipalities stands out, which was later regulated by the Basic Operating Standards (BOSs) and the Health Care Standards (HCSs). • CONAMA Resolution No. 006, of September 19, 1991 lays down the regulation of the incineration of solid waste from health establishments, ports and airports. • State Law 20,607, of June 10, 2021 establishes the norms for the preparation, revision, complementation, operation and inspection of the State Plan for Solid Waste of the State of Paraná – PERS/PR, a planning instrument designed to organize and establish solid waste management in the State of Paraná. • BRN 8,419, from April 1992 establishes the minimum conditions required for the presentation of urban solid waste landfill projects. • BRN 12.235, of May 30, 1992 sets out the conditions required for the storage of hazardous solid waste in order to protect public health and the environment. • BRN 12,810, from April 1, 1993, establishes the required procedures for the internal and external collection of waste from health services, under hygiene and safety conditions. • CONAMA Resolution No. 005, of August 5, 1993, lays down the regulation for the management of solid waste from health services, ports and airports, rail and road terminals. • BRN 12,980, of September 30, 1993 defines the terms used in the collection, sweeping and conditioning of solid urban waste. Page | 90 • BRN 12.808, of 1993, classifies Health Services Waste regarding its potential risks to the environment and public health, so that they can be properly managed. • BRN 13.463, of October 30, 1995, classifies the collection of solid urban waste, the equipment destined for this collection, the types of work system, the conditioning of this waste and the transshipment stations. • BRN 13,896, of July 30, 1997, establishes the minimum conditions required for the design, implementation, and operation of non-hazardous waste landfills, in order to adequately protect the nearby surface and underground water collections, as well as the operators of these facilities and neighboring populations. • Law No. 9,974, of June 6, 2000. Amends Law No. 7,802, of July 11, 1989, that lays down the guidelines for pesticides, their components and the like regarding research, experimentation, production, packaging and labeling, transportation, storage, marketing, commercial advertising, use, import, export, final destination of waste and packaging, registration, classification, control, inspection and inspection of pesticides, their components and the like, and other arrangements. • CONAMA Resolution No. 275, of April 25, 2001, establishes the color code for the different types of waste, to be adopted in identification of collectors and transporters, as well as in information campaigns for selective collection. • Decree No. 4,074, of January 4, 2002, regulates Law No. 7,802, of July 11, 1989, which lays down the guidelines for pesticides, their components and the like for research, experimentation, production, packaging and labeling, transportation, storage, marketing, commercial advertising, use, import, export, the final destination of waste and packaging, registration, classification, control, inspection, and other arrangements. • CONAMA Resolution No. 308, of March 21, 2002, rules the environmental licensing process of final disposal systems for solid urban waste generated in small municipalities. • RDC ANVISA Resolution No. 342, of December 13, 2002, approves the terms of reference for the elaboration of Health Services Waste Management Plans. • BRN 13,221, of March 31, 2003, specifies the requirements for the land transport of waste, in order to avoid damage to the environment and to protect public health. • BRN 10004, of May 31, 2004, classifies solid waste according to its potential risks to the environment and public health, so that it can be properly managed. • BRN 10,007, of November 31, 2004, establishes the requirements for the sampling of solid waste. • RDC ANVISA Resolution No. 306, of December 7, 2004, lays down the technical regulation for waste management from health services, whose non-compliance constitutes a sanitary infraction and will subject the violator to the penalties provided for in Law no. 6,437, of August 20, 1977, without prejudice to the applicable civil and criminal liability, and determines that every health service waste generator must prepare a Health Service Waste Management Plan, covering the stages of management, segregation, packaging, identification, internal transport, temporary storage, treatment, external storage, external collection and transport, and final disposal. • CONAMA Resolution No. 358 of April 29, 2005, lays down the regulations for the treatment and final disposal of waste from health services and other arrangements. • Decree No. 5,940, of October 25, 2006, institutes the need for separation of recyclable waste by agencies and entities of the direct federal public administration, at the generating source, and its destination to collector associations and cooperatives of recyclable material. Page | 91 • CONAMA Resolution No. 386, of December 27, 2006, amends Article 18 of Conama Resolution No. 316/2001, which deals with the thermal treatment of waste. • Law No. 11,445, of January 5, 2007 (Regulated by Decree No. 7,217 / 2010), establishes national guidelines for basic sanitation; changes Laws 6,766, of December 19, 1979, 8,036, of May 11, 1990, 8,666, of June 21, 1993, 8,987, of February 13, 1995; repeals Law No. 6,528 of May 1978; and makes other arrangements. • BRN 13.334, of October 15, 2007, specifies the requirements for metal containers of 0.80 m³, 1.2 m³ and 1.6 m³, intended for storing solid waste applicable to rear-loading collector- compactors, equipped with tilting devices. • BRN 9.191, of June 26, 2008, establishes the requirements and test methods for plastic bags destined exclusively for packaging waste for collection. • CONAMA Resolution No. 404, of November 11, 2008, establishes criteria and guidelines for the environmental licensing of small landfills for urban solid waste. • BRN 13.221, of April 16, 2010, specifies the requirements for the land transportation of waste, in order to avoid damage to the environment and to protect public health. • Law No. 12,305, of August 2, 2010 (Regulated by Decree No. 7,404 / 2010), institutes the National Solid Waste Policy; amends Law No. 9,605, of February 12, 1998; and makes other arrangements. • Decree No. 7,404, of December 23, 2010, regulates Law No. 12,305, of August 2, 2010, which institutes the National Solid Waste Policy, creates the Inter-Ministerial Committee for the National Solid Waste Policy and the Orientation Committee for the Implementation of Reverse Logistics Systems, and takes other measures. • NBR 15.849, 2010, establishes guidelines for the location, design, implementation, operation and closure of small landfills for urban solid waste. • NBR 14,879, of February 6, 2011 establishes the criteria for defining the geometric volumes of the cargo boxes and the cargo compartments of the rear-loading solid waste compacting collectors. • CONAMA Resolution No. 430, of May 13, 2011, lays down the conditions and standards for the discharge of effluents, complements and amends Resolution No. 357, of March 17, 2005, of the National Environment Council-CONAMA. • CONAMA Resolution No. 452, of July 4, 2012, lays down procedures for controlling the import of waste, in accordance with the rules adopted by the Brasiléia Convention on the Control of Transboundary Movements of Hazardous Waste and its Deposits. Repeals Resolutions No. 08/1991, No. 23/1996, No. 235/1998 and No. 244/1998. • BRN 12,807, of May 15, 2013, defines the terms used in relation to waste from health services. • BRN 12,809, of May 19, 2013, establishes the necessary procedures for the intra-establishment management of waste from health services which, due to their biological and chemical risks, require specific forms of management, in order to guarantee hygiene conditions, safety and protection to health and the environment. • BRN 14.652, of July 11, 2013, establishes the minimum construction and inspection requirements for collectors transporting health service waste. • BRN 14.599, of November 24, 2014, establishes the safety requirements for mobile, solid waste, rear and side loading compacting collectors. Page | 92 • RDC Resolution No. 222, of March 28, 2018, regulates Good Health Care Waste Management Practices and other arrangements. User’s Safety at Health Care Facilities: • ANVISA Resolution RDC 50, of February 21, 2002 lays down the guidelines for the Technical Regulation for planning, Programming, elaboration and evaluation of physical projects of health care facilities. It is the guiding instrument for new constructions, renovations and expansions, installations and the operation of Health Care Facilities that meet the principles of regionalization, hierarchy, accessibility, and quality of care provided to the population. This regulation applies to the new construction of health care facilities across the country, to the expansion of existing health care facilities, to the reforms of existing health care facilities and those not previously intended to serve as health facilities. The National Health Surveillance Agency of the Ministry of Health will provide technical cooperation to the State and Municipal Health Secretariats, in order to guide them on the exact compliance and interpretation of this Technical Regulation. The technical regulation adopts an approach where pre-elaborated programs and projects are not used, which are often unrelated to local-regional realities, but the various attributions of a health care facility are presented, which, in addition to local characteristics and specificities, will define the Physical-functional program of the facility. It does not, therefore, establish a typology of health buildings, but generically treats all these buildings as health care facilities, which must adapt to the epidemiological, population and geographical peculiarities of the region where they are located. Its architectural program will vary from case to case, as distinct activities occur in each one of them, but it establishes criteria for projects of health care facilities, which deal with aspects such as circulation areas, endogenous and exogenous environmental conditions of comfort (whose purpose is to create desirable salubrious conditions - hygrothermal and air quality, acoustic and luminous - and exogenous, which observes the impacts caused by buildings in the external environment, changing, positively or negatively, their natural climatic conditions), ordinary and special building installations as well as fire safety conditions. The endogenous dimension of the environmental control systems of buildings is supported by technical standards of hygiene and work safety. In this sense, the resolution considers that in the location of the building on the ground, must follow the requirements of the local construction code, using as a basic rule the requirements of hygrothermal and luminous comfort for all establishments providing health services. The standards for acoustic control are: (i) the Ministry of Labor Ordinance of 06/08/78, which defines regulatory standards for Occupational Safety and Medicine (NR 15), which sets the tolerance limits for continuous or intermittent noise and tolerance for impact noise; (ii) the Brazilian Standard NB-95, which establishes acceptable noise levels for different activities; and (iii) the NB-101, which sets noise levels compatible with acoustic comfort in different environments. Regarding luminous comfort from a natural source, the standard to be followed is NR-15 - Ordinance of 06/06/78 from the Ministry of Labor, which defines minimum levels of illumination in lux per activity. Finally, on environmental conditions of infection control, the RDC establishes guidelines, procedures and a series of constructive elements in relation to the management of people, utensils, clothing and waste, the treatment of contaminated elements at the source and the transport of contaminated material , on the establishment of physical barriers to minimize the entry of external microorganisms, materials used to finish walls, floors, ceilings and benches in order to meet the requirements of cleaning and sanitation, measures to prevent the entry of synanthropic animals, environments intended for external guarding of solid health services waste (garbage) and cleaning of the collection containers, equipment and fire safety measures. The exogenous dimension of these systems is covered by some legal instruments, such as the Construction and Posture Codes of most Brazilian municipalities, which establish limits on the implantation of buildings (permitted and prohibited activities, construction and use of the lot, Page | 93 etc.) and address the relationships between buildings and the local climate. More recently, federal legislation has supplemented these statutes with urban, environmental and sanitation standards; among them, the Federal Constitution of 1988, in its articles 200 and 225, laws 6938/81 and 6667 and the Forest Code (Law 4,771/65, updated by Law 7803), are cited. The regulation expressly prohibits the placement of facilities providing health services in areas close to garbage dumps and to noisy and/or polluting industries. Community Safety and Disaster Risk Management: • State Decree 5,670/2020 that institutes the Paranaense Dam Safety Security Committee with the objective of discussing issues related to Dam Safety in Paraná, in accordance with the National Dam Safety Policy; • State Decree 10,859/2018 that institutes the Prevention of Fires in Nature Program – PREVINA and provides mechanisms for preventing and fighting forest fires in State Conservation Units, guaranteeing the preservation environmental assets in the state; • State Decree 7,337/2017 that institutes the Task Force Regime for Disaster Response in Paraná; • State Law 17,424/2015 and the State Decree 4,587/2016 that instituted the School Brigades Program - Civil Defense at School – PBEDCE; • State Decree 3,158/2015 that regulates access to housing by families to a greater degree of social vulnerability or victims of natural disasters; • State Law 18,519/2015 that establishes the Civil Defense and Protection Policy of the State of Paraná; • State Decree 12,445/2014 that establishes the State Network for Research, Teaching, Extension and Technological Innovation aimed at disaster risk reduction – REDESASTRE; • State Decree 11,126/2014 that provides for the execution of the Community Firefighter Program; • State Decrees 7,117/2013 and 9,747/2013 that establishes the State Commission for Prevention, Preparation and Rapid Response to Environmental Emergencies (P2R2 State Commission) involving Hazardous Chemicals and defines its Internal Regulations; • State Decree 4,223/1998 that creates the State Plan for the Prevention of Forest Fires. Cultural Heritage: • Decree-law 25/1937 established the first legal instrument for the protection of the Brazilian Cultural Heritage. Its fundamental precepts remain current and in use until today. It defines Built Heritage as a set of movable and immovable property existing in the Country and which conservation is of public interest. Built heritage, natural monuments, sites and landscapes are also subject to tombing. • Law 3924/1961 established IPHAN as grantee of the right to carry out excavations for archaeological purposes in public or private domain lands, prohibited and criminalized the economic exploitation, destruction or mutilation for any purpose of archaeological and known prehistoric. Excavations in archaeological sites shall be necessarily carried out under the guidance of IPHAN and its progress reported quarterly to IPHAN. It also requires that any chances finding of any elements of archaeological or prehistoric, historic, artistic or numismatic value be straightaway reported to IPHAN. • Brazilian Constitution of 1988. In article 216, it expanded the concept of heritage established by Decree-Law nº 25, of November 30, 1937, replacing the name Historical and Artistic Heritage, by Brazilian Cultural Heritage. This change incorporated the concept of cultural reference and the definition of goods subject to recognition, especially those of an immaterial character, Page | 94 including, therefore, ways of creating, making and living, scientific, artistic and technological creations, works, objects, documents, buildings and other spaces for artistic and cultural events; and also urban complexes and historical, natural, artistic, archaeological, paleontological, ecological and scientific complexes. The Constitution maintains the management of assets and documentation related to assets under the responsibility of the public administration. In Articles 215 and 216, the Constitution recognizes the existence of culture of material and immaterial nature and establishes ways to preserve this heritage: registration, inventory, and guardianship. • IPHAN Ordinance No. 127/2009 instituted the Scenery of Cultural Landscape as an instruments used by IPHAN for the protection of material assets, recognizing the cultural importance of peculiar portions of the national territory, representative of the process of human interaction with the natural environment, to which human life and science have imprinted or assigned values. • IPHAN Ordinance No. 420/2010 defines procedures to be observed for the granting of authorization to carry out interventions in listed buildings and in their respective surrounding areas. • Inter-Ministerial Ordinance 60, of March 24, 2015 determines that IPHAN should always be consulted preventively in environmental licensing processes conducted by federal, state or municipal agencies because cultural heritage is one of the environmental dimensions considered. The Institute's statement is always requested to ensure that a project or activity in the licensing process will not impact or destroy cultural heritage assets. Consequently, the structure of IPHAN includes a National Licensing Coordination with the main responsibilities of coordinating the relevant activities, promoting links between the Institute and other bodies and agencies involved in the licensing process and consolidating the final manifestations of IPHAN in environmental licensing processes. • IPHAN Ordinance 396/2016 and IPHAN Ordinance 114/2017 rule the commercial use of cultural heritage and require that projects that intend to use cultural heritage of project affected parties for commercial purposes: inform the project affected parties of their rights under national law, the scope and nature of the commercial development and the potential impacts, and the potential consequences of such development and impacts. They also require that the project does not proceed with such commercial use unless meaningful consultation with stakeholders are carried out, fair and equitable benefit sharing agreements over the profits of the commercial use of the cultural heritage are agreed upon, and mitigation measures to any adverse impacts are identified. • IPHAN Ordinance 275/2018 addresses issues related with Physical and Cultural Resources held by Indigenous Peoples, Afro-Brazilians and quilombola communities. • IPHAN Ordinance 375/2018 establishes a Policy on Physical Cultural Resources aimed at the implementation of practices and procedures for the participatory preparation of protection measures and the enhancement of the protection of Physical Cultural Resources held by traditional peoples and communities. It supports actions related with heritage education, identification, recognition, protection, surveillance (including standardization, authorization, oversight, conservation and impact evaluation) and dissemination of the Physical Cultural Resources. • Paraná State Law 38/1935 created the Superior Council for the Defense of the Cultural Heritage of Paraná intended to collaborate – as an advisory body to the Government – in the defense of the cultural heritage of Paraná and in stimulating all intellectual activity and artistic of the State, with the objective of elevating its culture from all points of view. Revised by the State Law 1,211/1953. Labor and Health and Safety for Workers: Page | 95 • Paraná Health Code – Law 13,331, of November 23, 2001, provides for the organization, regulation, inspection and control of health services actions in the State of Paraná and Decree 5,711, of May 5, 2002, regulates the organization and functioning of the Unified Health System within the State of Paraná, establishes rules for the promotion, protection and recovery of health and provides for sanitary infractions and the respective administrative process. • Consolidation of Labor Laws (CLL – Decree-Law No. 5,452, May 1, 1943 and Law No. 13,467, July 13, 2017.) governs labor relations both in the private sector and in indirect public administration. • Law No. 8,112, December 11, 1990 and Law No. 9,527, December 10, 1997 regulate labor relations and working conditions applicable to effective civil servants. It lays down the legal regime of civil servants of the Union, municipalities and federal public foundations. For the purposes of this Law, a civil servant is the person legally invested in public office and this is the set of duties and responsibilities foreseen in the organizational structure to which a civil servant must be committed to. Public positions are created by law, to be filled on an effective basis or on a commission basis, and are accessible to all Brazilian citizens who: are in the enjoyment of their political rights, have settled with their military and electoral obligations, are at least eighteen years old, are physically and mentally fit for the position, as well as have the level of education required to exercise the position. Persons with disabilities are guaranteed the right to enroll in a public competition to fill a position whose duties are compatible with the disability they have and up 20% (twenty percent) of the vacancies offered in the competition must be reserved for them. • Law No. 8,745/1993, of December 9, 1993, regulates labor relations applicable to temporary public servants. It lays down the guidelines for hiring for a fixed period of time to meet the temporary need for exceptional public interest (among which are included activities “within the scope of cooperation projects with a fixed term, implemented through international agreements, provided that there is, in its performance, subordination of the contractor to the public agency or entity”). The recruitment of personnel to be hired temporarily is done through a simplified selection process, in the form established in the public notice, and does not require a public competition. The remuneration of the temporarily hired personnel is fixed in an amount not exceeding the amount of the remuneration fixed for the end-of-career employees of the same categories in the remuneration plans or in the positions and salaries of the agency or contracting entity. • Regulatory Norms on Occupational Health and Safety - Brazilian Association of Technical Norms (BATN). Bearing the Program sector and activities in mind, the Regulatory Norm RN-32 - Safety and Health at Work in Health Services deserves highlighting. This standard establishes the basic guidelines for the implementation of measures to protect the health and safety of health service workers, as well as those who carry out health promotion and assistance activities in general. It applies to any building designed to provide health care to the population, and all actions of promotion, recovery, assistance, research and teaching in health at any level of complexity. It governs the procedures that must be adopted to: (i) prevent, minimize and mitigate the probability of occupational exposure to biological agents (“biological risks”), such as microorganisms, whether genetically modified or not; cell cultures; parasites; toxins and prions; (ii) prevent, minimize and mitigate the likelihood of exposure to chemical risks; (iii) carry out the handling, storing and transporting of medicinal gases, medications and risk drugs, anesthetic gases and vapors, antineoplastic chemotherapy and ionizing radiation; and (iv) carry out the handling, storing, transporting and final disposing of waste (as previously presented in the section “Main Legal Provisions on Solid Waste Management and Health Service’s Waste Management”). Page | 96 The two main instruments it foresees to ensure protection, health and safety at work in health services are: (i) the Program or Plan for the Prevention of Accidents with Sharps - PPAS and (ii) the Program for Occupational Health Medical Control - POHMC. The purpose of the PPAS is to establish guidelines for the elaboration and implementation of a plan to prevent the risks of accidents with sharp materials with probability of exposure to biological agents, but also addresses other risks. For its elaboration, health service employers must establish a multidisciplinary management commission, which aims to reduce the risks of accidents with sharp cutting materials, with probability of exposure to biological agents, through the elaboration, implementation and updating of a health plan for prevention of risks of accidents with sharp materials. The Management Committee must develop and implement procedures for the registration and investigation of accidents and risk situations involving sharps, taking into account risk and accident situations, the frequency of their occurrence, cleaning, decontamination or disposal procedures that contribute to a high occurrence of accidents and the number of workers exposed to situations of risk of accidents with sharp cutting materials. The PPAS must contain: (i) identification of the most likely biological risks, depending on the geographical location and the characteristics of the health service and its sectors (considering sources of exposure and reservoirs, transmission and entry routes, transmissibility, pathogenicity and virulence of the agent; persistence of the biological agent in the environment; epidemiological studies or statistical data; (ii) assessment of the workplace and worker (considering the purpose and description of the workplace, the organization and work procedures, the possibility of exposure, the description of the activities and functions of each workplace and the applicable preventive measures and their monitoring.) The PPAS must provide for control measures for the prevention of accidents with sharp cutting materials, the adoption of which must obey the following hierarchy: a) replace the use of needles and other sharps when technically possible; b) adopt engineering controls in the environment (for example, waste collectors); c) adopt the use of sharp cutting material with a safety device, when existing, available and technically possible; and d) changes in the organization and work practices. The PPAS must also contain protective measures against biological risks, which include: (i) in every place where there is a possibility of exposure to the biological agent, there must be an exclusive hand hygiene washbasin with running water, liquid soap, disposable towel and trash bin provided with an opening system without manual contact; (ii) rooms or wards for the isolation of patients with infectious diseases must contain a washbasin; (iii) the use of gloves does not replace the hand washing process, which must occur, at least, before and after using them; (iv) workers with wounds or injuries in the upper limbs can only start their activities after a mandatory medical evaluation with the issue of a release document for work; (v) the prohibition on the use of work sinks for purposes other than those foreseen, smoking, the use of ornaments and the handling of contact lenses at work stations, the consumption of food and drinks at work stations, storage of food in places not intended for this purpose and the use of open shoes; (vi) all workers with the possibility of exposure to biological agents must wear appropriate work clothes and in comfortable conditions, which must be provided free of charge to the employee, and the worker must not leave the workplace with personal protective equipment and clothing used in their work activities; (vii) appropriate places must be provided for the provision of clean clothing and for the disposal of used clothing; (viii) Individual Protection Equipment - PPE, disposable or not, must be available in sufficient quantity at the work stations, so that immediate supply or replacement is guaranteed; and (ix) written instructions, in accessible language, of the routines performed at the workplace and measures to prevent accidents and work-related illnesses must be provided to workers. In case of accidental or incidental exposure, protective measures must be taken immediately, even if not provided for in the PPAS. Page | 97 The PPAS should include the provision of the training of workers before adopting any control measure and on a continuous basis to prevent accidents with sharp cutting materials. Training for workers must take place before the start of activities and on a continuous basis, and must be adapted to the evolution of knowledge and the identification of new biological risks and include: (a) the available data on potential health risks; (b) the control measures that minimize exposure to agents; (c) the hygiene rules and procedures; (d) the use of collective and individual protective equipment and work clothes; (e) the measures for the prevention of accidents and incidents; and (f) the measures to be taken by workers in the event of incidents and accidents. The PPAS must also contain a timetable for its implementation, as well as include systematic monitoring of the exposure of workers to biological agents in the use of sharp cutting materials, using the analysis of risk situations and occupational accidents that occurred before and after its implementation, monitoring indicators. The plan must be evaluated every year, at least, and whenever there is a change in working conditions and when the analysis of risk situations and accidents so determines. The documents that are part of the PPAS must be available to workers. The schedule and proof of implementation must be available to the Ministry of Labor and Employment and to workers or their representatives. The POHMC should include: (a) the recognition and assessment of biological risks; (b) the location of the risk areas; (c) the list containing the workers' nominal identification, their function, the place where they perform their activities and the risk to which they are exposed to; (d) the medical surveillance of workers potentially exposed; and, (e) the vaccination program. Regarding the possibility of accidental exposure to biological agents, the POHMC must include: (i) the procedures to be adopted for diagnosis, monitoring and prevention of seroconversion and diseases; (ii) the measures for decontamination of the workplace; (iii) the emergency medical treatment for workers; (iv) the identification of those responsible for applying the relevant measures; (v) the list of health facilities that can provide assistance to workers; (vi) the forms of removal to assist workers; and (vii) the list of health care facilities that deposit immunoglobulins, vaccines, necessary medications, materials and special supplies. The POHMC must also be available to workers, as well as to labor inspections for consultation. Chemical Risks: The PPAS of health services must also include the inventory of all chemical products, including intermediates and debris, with an indication of those that imply risks to the health and safety of the worker. The legislation requires that the employer assigns an appropriate place for the handling or fractioning of chemicals that pose risks to health and safety of the worker. This location must have at least: (a) an easy-to-view graphic signs to identify the environment; (b) equipment that guarantees that the concentration of chemicals in the air is below the tolerance limits; (c) equipment that guarantees the suction of chemical products so as not to increase the exposure of any worker, involved or not, in the work process; (d) shower and eye washing fountain, which must be activated and sanitized weekly; (e) personal protective equipment, suitable for risks, available to workers; and (f) an adequate disposal system. The transportation of chemical products must be carried out considering the risks to the health and safety of the worker and the environment. Where flammable products are used and stored, the fire prevention system must foresee special safety measures and emergency procedures. The chemical storage areas must be ventilated and signposted. Provision should be made for storage areas suitable for incompatible chemicals. Other risks: The PPAS must describe the inherent risks of the activities of receiving, storing, preparing, distributing, and delivering of medications and risk drugs (those that may cause genotoxicity, carcinogenicity, teratogenicity and serious and selective toxicity on organs and systems ). Finally, the PPAS must also contain, when appropriate, a Radiological Protection Plan. Other Aspects of Health Services Regulation: RN-32 – Health and Safety at Work in Health Services requires that an active immunization program against tetanus, diphtheria, hepatitis B and those established in the POHMC be provided free of charge to every worker in the health Page | 98 services. Whenever there are effective vaccines against other biological agents to which workers are, or may be, exposed, the employer must provide them free of charge. The employer must ensure that workers are informed of the advantages and side effects, as well as the risks to which they will be exposed to due to lack or refusal of vaccination, in which case they must keep supporting documents and keep them available for labor inspection. In addition, in every occurrence of accidents involving biological risks, with or without removal of the worker, the Work Accident Report - WAR must be issued. Employers and workers must immediately report any accident or incident, with possible exposure to biological agents, that could cause the spread of a biological agent that could cause serious diseases in humans, its causes and the measures taken or to be taken to correct the situation. The standard also defines: (i) the characteristics and comfort conditions of the cafeterias in health services facilities; (ii) the characteristics of the laundries; (iii) the working conditions and training of workers who clean health services facilities, regarding the principles of personal hygiene, biological risk, chemical risk, signaling, labeling, PPE, CPE (Collective Protection Equipment) and procedures in emergency situations; (iv) the procedures for maintaining machinery and equipment and specific training for the workers who handle them. Citizen Engagement and Access to information: • Law No. 8,142, of December 28, 1990. Lays down guidelines for community participation in the management of the Unified Health System (UHS) and for intergovernmental transfers of financial resources in the health area and creates Health Councils and Conferences. Health Councils are composed of government representatives, service providers, health professionals and users. They act in the formulation of strategies and in the control of the execution of the health policy in the corresponding instance, including in the economic and financial aspects, whose decisions will be ratified by the head of power legally constituted in each sphere of the government. Health Conferences are convened by the Executive Branch or, extraordinarily, by the Health Council, in order to assess the health situation and propose guidelines for the formulation of health policy at the three levels of management. Their deliberations should serve to guide governments in the elaboration of health plans and in the definition of actions that are a priority at the state, municipal and national levels. According to this law, the National Health Conferences must take place every four years, with the representation of the various social groups. • GM/MS Ordinance No. 3,027, of November 26, 2007. Institutes the National Policy for Participatory Strategic Management/Participa SUS that covers mechanisms for participatory management and social control, including the Councils and Health Conferences - which are essential instruments for the formulation of the State and Municipal Health Policy - as well as Committees and Working Groups aimed at the search for equity (such as, for example, the Technical Committees on Health Equity, Afro-Brazilian Population, LGBT, Homeless Population, Rural Population, Forest and Waters). • Law No. 12,527 / 2012 and Decree No. 7,724 / 2012. They regulate the constitutional right of citizens to access public information under the custody of the State and establish procedures for the administration to respond to requests for information from citizens. LAI states that all information produced and held by public agencies must remain accessible to the citizens, unless they are subject to some legally defined restrictions.139. LAI ensures access to public information 139 There are three restrictions on access to the information laid down by the law: (i) information classified as reserved, secret and/or top secret; (ii) personal information related to citizens' privacy; and (iii) information protected by other relevant legislation, such as information related to the confidentiality of tax and banking information. The procedures related to the availability, classification, treatment and management of information of a restricted and confidential nature within the scope of the Comptroller General of the Union were regulated by Ordinance CGU 1.613/2012, available at Page | 99 through the creation of a citizen information service, in government agencies and entities and through public hearings or consultations, encouraging popular participation or other forms of information disclosure. The procedures for accessing information must be executed in accordance with the basic principles of: observance of advertising as a general precept and secrecy as an exception, disclosure of information of public interest, regardless of requests; use of means of communication made possible by information technology; fostering the development of a culture of transparency in public administration and the development of social control in public administration. • Ordinance No. 1,583, of July 19, 2012. Instituted the Ministry of Health's Citizen Information Service (CIS). The main activities of the CIS are aimed at providing information to citizens regarding the services offered by the Ministry of Health. It acts according to the demands received. They are processed and sent to the relevant sectors for the preparation of the appropriate responses. Citizens receive feedback on their questions through the e-SIC system. In 2018, 4,987 requests for information were registered, an increase of 19% compared to 2017. • Law No. 13,460, of June 26, 2017. Lays down guidelines for the participation, protection and defense of the rights of users of public services offered directly and indirectly by public administration at all levels, in accordance with what is provided for in the Federal Constitution of 1988 (Art. 37 and Art. 74) and Constitutional Amendment 19/1988 on the participation of users in the provision of public services and the creation of Ombudsmen Offices at all levels of government. These rights include, among others: (i) participation in the supervision and evaluation of service provision, (ii) access and use of services without discrimination and with freedom of choice between the different means they are offered, (iii) the access to personal information in public records and databases, (iv) the protection of personal information, (v) access to accessible and correct information in the places where services are provided and through the Internet, and (vi) access to the public agent or the agency in charge of receiving manifestations. In order to guarantee the fulfillment of these rights, the law establishes that users of public administration services can address service providers and present their manifestations (including complaints, grievances, suggestions and compliments about the provision of public services and the conduct of public servants). According to Law 13.460/2017, users' statements must be treated (received, acknowledged, analyzed, deliberated and answered) in a quick and effective manner. The ombudsmen of government agencies (at all levels of public administration) are responsible for: (a) promoting the participation of users in public administration; supervise the provision of services and propose improvements, (b) receiving, analyzing and sending users' statements to the competent authorities; supervising the resolution of cases; (c) proposing the adoption of measures to defend the user's rights; and (d) promoting the adoption of mediation and conciliation measures between users and public bodies or entities, without damage to other relevant bodies. Government agencies' Ombudsmen are obliged to publicly release annual management reports, covering the number of manifestations received, a description of the reasons for the manifestations, the analysis of recurring points and a description of the measures adopted by the public administration in the solutions presented. Finally, “user councils” are instituted as consultative bodies with the task of monitoring the provision of public services, participating in their assessment and proposing improvements, contributing to the definition of guidelines for adequate user service and monitoring and evaluating the performance of the Ombudsman. The composition of these boards must observe criteria of representativeness and plurality of thttp://pesquisa.in.gov.br/imprensa/jsp/visualiza/index.jsp?data=30/07/2012&jornal=1&pagina=13&totalArquivo s=260. Page | 100 stakeholders, whose representatives must be chosen in a process open to the public and differentiated by type of user to be represented. This law made the feedback survey a mandatory procedure in all UHS ombudsmen. The UHS Ombudsman's Department (DOGES) has a group to carry out the research requested by the minister's office, by the secretariats of the Ministry of Health and by the Ombudsman itself, in partnership or not with other bodies. These surveys are not restricted to assessing users' satisfaction with UHS services. Some of them aim to control and monitor specific Programs, to raise situations that require immediate government action and to disseminate information of interest to the Ministry. Recently (December 3, 2019), a Decree was signed and it establishes rules for safeguarding the identity of the whistleblower who addresses organs and entities of the federal Executive Branch. Through this decree, the ombudsman's offices that make up the Federal Executive Branch's Ombudsman System will be required to adopt a series of additional measures to safeguard the identity of whistleblowers, including the obligation to request the whistleblower's consent to transfer their complaint to another competent ombudsman in an anonymized manner (that is, remove all information that could reveal your identity), whenever consent is denied or when it is sent to the verification units. • Normative Instruction of the Ministry of Transparency, the Union Controller General and the Union General Ombudsman No. 5/2018.140 It establishes guidelines for the performance of the ombudsman units of the federal Executive Branch and determines that the ombudsman units will act in accordance with the following guidelines: (i) acting promptly and impartially; (ii) collaborating with the integration of ombudsmen; (iii) ensuring the autonomy of the ombudsmen; (iv) promoting social participation as a method of government; and (v) contributing to the effectiveness of public policies and services. According to the instruction, the Ombudsman's duties include: (i) proposing actions and suggesting priorities in the ombudsman activities of the respective area of activity, monitoring and evaluating the Programs and activities and organizing and disseminating information about ombudsman activities and operational procedures; (ii) promoting the adoption of mediation and conciliation between users of public bodies and entities, with the purpose of expanding and perfecting the spaces of relationship and participation of society with the public administration; (iii) processing the information obtained through the comments received and satisfaction surveys carried out with the purpose of evaluating the services provided, especially regarding the fulfillment of the commitments and the quality standards of service in the User Service Letter; (iv) producing and analyzing data and information on the activities of the ombudsman, supporting recommendations and proposals for improving the provision of services and correct flaws; (v) promoting articulation, on a permanent basis, with instances and mechanisms of social participation, in particular, public policy councils and commissions, national conferences, discussions, forums, hearings, public consultations and virtual environments for social participation; (vi) exercising the duties of Citizen Information Service,141 when so designated; and (vii) receiving treatment and responding to requests submitted through the ‘Simplify! form.142 The Ombudsman cannot, under any circumstances, refuse to receive statements made under the terms of this Normative Instruction. The procedures are free of charge, and the collection of any amount from the user is prohibited. Any requirements related to the reasons that determined the presentation of manifestations before the ombudsman are also prohibited. The request for certification of the user's identity can only be required when the response to the statement implies access to personal information of the user or third parties. Access to the system is available on the main page of the Ministry of Economy portal. Among the 140 http://www.in.gov.br/materia/-/asset_publisher/Kujrw0TZC2Mb/content/id/27128217/do1-2018-06-25-instrucao- normativa-n-5-de-18-de-junho-de-2018-27128190. 141 Law nº 12,527, of November 18, 2011 (https://www.gov.br/acessoainformacao/pt-br). 142 Joint Normative Instruction MPDG/CGU nº 1, of January 12, 2018 (http://www.simplifique.gov.br/). Page | 101 Ombudsman's obligations, it should be noted that it must: (i) respond to statements in clear, objective, simple and understandable language; (ii) prepare and submit a conclusive response to the statements received within thirty days of receipt (extendable for an equal period upon express justification); (iii) proceed to the prior analysis of the statement as soon as it is received and, if necessary, forward it to the areas responsible for adopting the necessary measures; (iv) request the user to provide information whenever the information that has been presented is insufficient for the analysis of the statement and not make successive requests for complementation, except if referring to the situation that arose with the new documentation or information presented; (v) request information from the areas responsible for taking action, which must respond within twenty days from the receipt of the request in the competent sector, which can be justified once for an equal period; (vi) ensure the protection of the identity and elements that allow the identification of the user or the author of the event; 143 and (vii) receive and collect information from users of public services in order to evaluate the provision of such services and to assist in the detection and correction of irregularities. No manifestation received may be closed without producing a conclusive answer, unless the author fails to comply with the duties of: (a) exposing the facts according to the truth; (b) acting with loyalty, good manners and good faith; (c) acting in a reckless manner; or (d) failing to provide the information requested to clarify the facts. The Federal Ombudsman's Office may be reached in the event of non-compliance with the established deadlines and procedures. The Federal Ombudsman's Office, which maintains a computerized system on the receipt and treatment of complaints received by all ombudsmen from the federal executive branch and an electronic website that promotes interaction between society and the federal public administration, as well as the dissemination of information and statistics on services provided by federal public ombudsmen. Land Expropriation: • Brazilian Constitution 1988 provides for the property right as an individual right that assures its holder the powers to enjoy, recover, use and dispose of the property, in an absolute, exclusive and perpetual way. However, the Brazilian Federal Constitution (art. 170, III) also states that right to property is not an absolute and unrestricted right, as it is necessary to fulfill the social function, and envisages that the State can intervene in private property in a restrictive or suppressive manner. It also establishes that: i) only the Federal Government can legislate on expropriation (article 22); ii) land expropriation must meet a social and/or public interest purpose (Articles 5 and 6); (iii) land expropriation requires fair and prior pecuniary compensation (Article 5, item XXIV; Article 182, §3). In the case of expropriation, there is the withdrawal of the individual's property with the objective of fulfilling a public interest (utility or need) purpose or adjusting property to the social function (Art. 5, XXIV), after carrying out an administrative procedure, through the prior payment of compensation as a form of compensation. • Civil Code (Law 10,406/2002) the landowner can be deprived of the land, in cases of expropriation, for public interest (need or utility) or social interest, as well as in the case of requisition, in case of imminent public danger. 144 The Civil Code also recognizes adverse possession. Anyone who actually has the exercise of any of the powers inherent to ownership is considered to hold possession rights when the possession that is not violent, clandestine or 143 If essential to the verification of the facts, the name of the whistleblower will be forwarded to the investigating body, which will be responsible for restricting access to the identity of the demonstrator to third parties. 144 The landowner can also be deprived of the land if the claimed property consists of an extensive area, in uninterrupted possession and in good faith, for more than five years, of a considerable number of people, and these have carried out, together or separately, works and services considered by the judge of relevant social and economic interest. The judge will determine the fair compensation due to the landowner and after this compensation is paid, the sentence will be valid as a title for the registration of the property in the name of the early squatters. Page | 102 precarious is considered just. Furthermore, the law establishes that possession in good faith only loses this character in the case and from the moment when circumstances make it presume that the owner does not ignore that he unduly owns. Possessory rights are transmitted by inheritance. Holders of possessory rights acquired and kept in good faith have the right to indemnification of the necessary and useful improvements they did on the assets and may exercise the right of retention by the value of necessary and useful improvements. Adverse possession is recognized under different legal timeframes according to the place and type of occupation of the land and will not be recognized for the same person more than once. 145 • Federal Decree-law 3,365/1941 describes the procedures for expropriation according to public interest. Among other cases defining public interest, article 5 of this Decree includes: (i) government assistance in case of emergencies or disasters; (ii) public health; (iii) the opening, maintenance, and improvement of public streets or roads; (iv) the execution of urbanization plans; (v) the allocation of land, with or without buildings, for better economic, hygienic or aesthetic use; and (vi) the construction or enlargement of industrial districts. This law establishes that all assets may be expropriated by the Union (Federal Government), States, Municipalities, and the concessionaires of public services or entities that carry out functions delegated by governments. Expropriation may include the area adjacent to where the actual project will take place as well as areas that may extraordinarily increase in value as a result of the underlying project. The declaration of public interest is valid for five years. • Law 4,132/1962 defines the cases when land expropriation can occur on account of social interest. These situations include: (i) The installation or expansion of crops in areas where land exploration is not in compliance with the agricultural zoning plan; (ii) the maintenance of squatters in urban terrain where, with the express or tacit consent of the owner, the squatters had built residential areas for ten families or more; (iii) the construction of public housing; (iv) lands and waters subject to extraordinary appreciation in value, owing to the completion of public infrastructure and services, such as sanitation, ports, transportation, electrification, water storage and irrigation, in cases where such lands are not being utilized by communities; and, (v) the protection of soil and the preservation of water and forest resources. The declaration of social interest is valid for two years. • Law 13,867/2019 amends Federal Decree-Law 3,365/1941 and establishes that, after issuing the Decree of Expropriation for Public Utility, the public authority must notify the affected parties, sending an offer of compensation and if they choose to negotiate, they shall appoint a body specialized in mediation or arbitration previously registered by the agent responsible for the expropriation. The Law aims (i) to create a faster process to be followed by the government in proposing the values of the compensation offer and (ii) to allow the expropriated parties to choose mediation or arbitration to discuss the compensation amounts instead of following the judicial process. • Brazilian Association of Technical Standards (Associação Brasileira de Normas Técnicas – ABNT) regulatory norms NBR 14,653 set the methods for evaluation of assets that are object of expropriation. Indigenous Peoples: • Brazil Federal Constitution 1988 recognizes the social organization, customs, languages, beliefs, and traditions of indigenous peoples and their rights to occupy their traditional territories. Article 231 of the Constitution of 1988 recognized for the first time, the indigenous peoples of 145 When the owner of the land grants to others the right to build or plant on his land, for a determined time, by means of a public deed duly registered with the Real Estate Registry Office, in the event of expropriation, the compensation must be shared between the owner and the occupant in the amount corresponding to the real right of each. Page | 103 Brazil had the right to be and remain different. The Constitution also assures indigenous peoples the right to use their languages and own processes for education at the primary school level (Article 210, § 2º). Furthermore, the Constitution rules that indigenous lands are to be permanently occupied by indigenous peoples who can enjoy exclusive use of the existing soils, rivers, and lakes situated therein. It also allows the indigenous peoples, their communities, and organizations, just as any individual or corporate entity in Brazil, the right to file suit in court in defense of their rights and interests. Finally, the Constitution rules that the exploitation of water resources, including energy potentials, research and mining of mineral wealth in indigenous lands can only be carried out with the authorization of the National Congress, after hearing the affected communities (Art 231, paragraph 3). Above all, the Constitution establishes that the Rights of the Indigenous Peoples to the lands they traditionally occupy are of an original nature. Hence, these rights are original to the land, prior to the formation of the Brazilian state or government, and exist independently of any official recognition. The text in force gives a constitutional category or status to the concept of indigenous lands, which is defined as follows in paragraph 2 of Article 231: “Lands traditionally occupied by the Indians are those that they have inhabited permanently, used for their productive activity, their welfare and necessary for their cultural and physical reproduction, according to their uses, customs, and traditions." Once these characteristics are present and are verified in accordance with the uses, customs, and traditions of indigenous people’s right to the land by the community that occupies it is an existing right and its legitimized independently of any constitutional act. Therefore, the demarcation of indigenous land as a result of recognition by the State is an act that merely states or declares that said land is indigenous, and its objective is simply to delineate the geographical extension of their title to ensure the full efficacy of the constitutional ruling and the State has the obligation to protect these indigenous lands. • International Labor Organization (ILO) Convention No.169 on Indigenous Peoples and Tribal Populations and The United Nations Declaration of Indigenous Peoples’ Rights and regulated its provisions. ILO Convention 169 was regulated and made effective in Brazil with the publication of Decree 5,051/04. This ILO Convention stipulates that governments should ensure that studies are carried out with the peoples concerned to identify impacts on these peoples, be they of a social, spiritual, cultural or environmental. This ILO Convention also obliges governments to consult the peoples concerned whenever legislative or administrative measures are envisaged that may directly affect them. The ILO Convention 169 also rules on Free, Prior and Informed Consent (FPIC). Aligned with ILO Convention 169, FUNAI promotes training and information the right to participation and consultation and accompanies specific processes of consultation in administrative or legislative measures, under the responsibility of the decision- making bodies, advising Indigenous Peoples and public entities in intercultural dialogue. Quilombola Communities: • Federal Constitution 1988 (Article 68 of the Transitional Provisions Act) states that the remnants of quilombo communities that are occupying their land are recognized as definitive land holders and the State must issue their respective titles. • Decree 3,912.2001, regulates the provisions relating to the administrative process for identifying the remnants of quilombo communities and for the recognition, delimitation, demarcation, titling and real estate registration of the lands they occupy. • Decree 4,886/2003, institutes the National Policy for the Promotion of Racial Equality - PNPIR and makes other provisions. Page | 104 • Decree 4,887/2003, regulates the procedure for identification, recognition, delimitation, demarcation and titling of lands occupied by remnants of quilombo communities referred to in art. 68 of the Transitional Constitutional Provisions Act. • Decree 6,040/2007, institutes the National Policy for the Sustainable Development of Traditional Peoples and Communities. • Decree 6,872/2009, approves the National Plan for the Promotion of Racial Equality - PLANAPIR, and establishes its Articulation and Monitoring Committee. • FCP Ordinance 40, of July 13, 2000, establishes norms that will govern the work for the identification, recognition, delimitation and demarcation, notary survey, and titling of the lands occupied by remaining quilombo communities. • FCP Ordinance 98/2007 establishes the General Register of Remnants of Quilombos Communities of the Fundação Cultural Palmares for the purpose of the regulation provided for by Decree No. 4,887 / 03. • FCP Normative Instruction 1/2018 establishes administrative procedures to be observed by Fundação Cultural Palmares in the process of environmental licensing of works, activities or undertakings that impact quilombola communities. • FCP Ordinance 123/2018 institutes the Working Group for the purpose of revising Normative Instruction 01/2015, which establishes administrative procedures to be observed by Fundação Cultural Palmares in the environmental licensing processes in which it participates. • INCRA Ordinance 307/1995, determines that the remaining quilombo communities, as such characterized, inserted in federal public areas, collected or obtained by expropriation process, under the jurisdiction of INCRA, have their areas measured and demarcated, as well as titled. • INCRA Normative Instructions 16/2004, 20/2005, of September 19, 2005, regulates the procedure for identification, recognition, delimitation, demarcation, des-intrusion, titling and registration of lands occupied by remnants of quilombo communities referred to in Article 68 of the Transitional Constitutional Provisions Act of the 1988 Federal Constitution and Decree no. 4,887, of November 20, 2003. • INCRA Normative Instructions 49/2008, 56/2009 and 57/2009 regulate the procedure for identification, recognition, delimitation, demarcation, des-intrusion, titling and registration of lands occupied by remnants of quilombo communities referred to in Article 68 of the Transitional Constitutional Provisions Act of the 1988 Federal Constitution and Decree No. 4,887, November 20, 2003. • INCRA Normative Instruction no. 73/2012, establishes criteria and procedures for the indemnification of improvements in good faith erected on public land aiming at the des- intrusion in quilombola territory. Health Care of Disadvantaged and Vulnerable Social Groups: • Law No. 10,098, of December 19, 2000. Establishes general standards and main criteria to promote accessibility for people with disabilities through the elimination of obstacles and barriers in public spaces, urban facilities, transportation modals and communication. • Ordinance No. 1,060, of June 5, 2002. Institutes the National Health Policy for Persons with Disabilities aimed to include people with disabilities in the entire UHS service network. • Law No. 10,741, of October 1, 2003 (with amendments proposed by Laws 11,765/2008, 12,461/2011, 12,419/2011, 12,896/2013, 12,899/2013, 13,466/2017 and 13,535/2017). It institutes the Elderly Statute, designed to regulate the rights guaranteed to people aged 60 or over. In terms of health, comprehensive health care for the elderly is ensured through the UHS, guaranteeing universal and equal access, in an articulated and continuous set of actions and Page | 105 services, for the prevention, promotion, protection and recovery of health, including special attention to diseases that preferably affect the elderly. It defines how the prevention and maintenance of the health of the elderly will be carried out and it is the Government’s responsibility to provide medication to the elderly, free of charge. • GM/MS Ordinance No. 992, of May 13, 2009. Instituted the National Policy for Integral Health of the Afro-Brazilian Population. • Decree No. 7,053, of December 23, 2009. Creates and defines the National Policy for the Homeless Population. • Ordinance No. 940, of April 28, 2011. It waives Gypsies, nomads and homeless people the requirement to present the address of the permanent home for the acquisition of the UHS Card. On this subject, it is important to emphasize that anyone has the right to be served in health facilities, regardless of presentation of documentation. • Ordinance No. 2,836, of December 1, 2011. Institutes the National Policy for the Comprehensive Health of Lesbians, Gays, Bisexuals, Transvestites and Transsexuals (LGBT) and defines its principles and guidelines, as well as the competences of federated entities. • Ordinance No. 2,866, of December 2, 2011. Instituted the National Policy for Integral Health of the Populations of Rural Areas and of the Forest (NPIHPRAF) within the scope of UHS. The NPIHPRAF aims to improve the health status of rural and forest populations, through actions and initiatives that recognize the specificities of gender, generation, race/color, ethnicity and sexual orientation. • Law No. 13,146, July 6, 2015 (Statute of The Person with Disabilities). It lists issues of accessibility to the human rights of people with disabilities, aiming to ensure and promote the exercise of freedom and human rights on equal terms by people with disabilities, contributing to social inclusion and citizenship. It imposes compliance with accessibility rules that establish a large number of procedures for planning, licensing and regulating public space - including: the approval of architectural and urban projects; the granting and renewal of operating licenses; municipal master plans, urban mobility and cultural heritage plans; municipal codes of works and postures; land use and occupation laws, neighborhood impact studies and fire prevention legislation; the approval of public financing and federal guarantees for international financing for public and private institutions. • Ordinance No. 344, of February 1, 2017. The Ministry of Health adopts the self-declaration criterion, that is, the user defines his/her race/color, with the exception of cases of newborns, deaths or when faced with situations in which the user is unable to do so, and family members or guardians are responsible for declaring their color or ethnic-racial belonging. • Law No. 9,836, September 23, 1999. Institutes the Indigenous Health Care Subsystem and establishes that it will be up to the Union, with its own resources, to finance the Indigenous Health Care Subsystem. The States, Municipalities, other governmental and non-governmental institutions will be able to complement each other in the funding and execution of actions. It establishes that the Indigenous Health Care Subsystem will be decentralized, hierarchical and regionalized and will be based on Special Indigenous Health Districts (SIHD). The UHS will serve as a back-up and reference to the Indigenous Health Care Subsystem, for which, there must be adaptations in the structure and organization of SUS in the regions where indigenous populations reside, to provide this integration and the necessary care at all levels, without discrimination. Indigenous populations must have guaranteed access to UHS, at the local, regional and specialized centers, according to their needs, including primary, secondary and tertiary health care. Indigenous populations will have the right to participate in collegiate bodies for the formulation, monitoring and evaluation of health policies, such as the National Health Council and the State and Municipal Health Councils, when applicable. Page | 106 • Decree No. 3,156, August 27, 1999. Lays down the conditions for the provision of health care to indigenous peoples within the scope of UHS, observing guidelines aimed at promoting, protecting and restoring the health of the Indigenous person, aiming at achieving biopsychosocial balance, with the recognition of the value and complementarity of indigenous medicine practices, according to the peculiarities of each community, the epidemiological profile and the health condition. These guidelines include: (i) the development of efforts that contribute to the balance of the economic, political and social life of indigenous communities; (ii) the reduction of mortality, especially maternal and child; (iii) the interruption of the cycle of communicable diseases; (iv) the control of malnutrition, dental caries and periodontal disease; (v) the restoration of environmental conditions, the violation of which is directly related to the appearance of diseases and other health problems; (vi) comprehensive medical and dental assistance, provided by public institutions in partnership with indigenous and other civil society organizations; (vii) the guarantee of access to primary, secondary and tertiary actions of the Unified Health System – UHS to the indigenous person and indigenous communities; (viii) the participation of the indigenous communities in the elaboration of the indigenous health policy, its Programs and implementation projects; and (ix) the recognition of the social and political organization, customs, languages, beliefs and traditions of the Indigenous Populations. It defines that the SIHD has the health responsibility indigenous territories and the organization of hierarchical health services, with the participation of the user and social control and that each SIHD will have a District Council for Indigenous Health (DCIH) and Local Health Councils may also be created. DCIH's duties are the approval of the District Plan, the evaluation of the execution of the planned health actions and the proposal, if necessary, of their partial or total reprogramming, and the assessment of the accountability of the agencies and institutions that execute the actions and services of health care for the Indigenous Peoples. The composition of DCIH will be equal among user representatives, appointed by the respective communities and representatives of the governmental organizations involved, service providers and health sector workers. Local Health Councils will be composed of representatives of indigenous communities, with the duties of (i) expressing themselves about the health actions and services needed by the community; (ii) evaluate the execution of health actions in the area covered by the Council; (iii) appoint advisers to the District Council for Indigenous Health and to Municipal Councils, if applicable; and (iv) make recommendations to the Special Indigenous Health Districts, through the appointed counselors. • Ordinance No. 254, of January 31, 2002. Institutes the National Policy on Health Care for Indigenous Peoples, which is coordinated and implemented by the Ministry of Health, through the Special Secretariat for Indigenous Health (SSIH), as the manager of the Care Subsystem Indigenous Health (SasiSUS) in the Unified Health System (UHS). The Indigenous Health Care Subsystem must be financed by the Union, which directly invests resources for comprehensive health care for this population. The management and care model within this subsystem is decentralized, has administrative, budgetary and financial autonomy, and has the health responsibility of the 34 Special Indigenous Health Districts (SIHDs). The SIHD is responsible for developing actions of integral attention to indigenous health and health education, in line with UHS policies and programs and observing traditional indigenous health practices; as well as for carrying out sanitation actions and indigenous health buildings.146 • Law No. 9,836/1999 and LAW No. 10,683/2003. They establish that it is the responsibility of the Union to ensure national indigenous populations the right to health, by exercising the superior management of national public health care policies and by financing actions developed within its scope, implemented in articulation with other organs and entities responsible for indigenous and health policies in the country. Law No. 9,836/99 established, within the scope of SUS, the 146 Available at: http://bvsms.saude.gov.br/bvs/publicacoes/politica_saude_indigena.pdf. Page | 107 Indigenous Health Care Subsystem, based on the basic concept that each Indigenous People has their own conceptions, values and ways of experiencing health and disease and that prevention, promotion, protection and health recovery actions must consider these aspects, highlighting the contexts and the impact of the interethnic contact relationship experienced by each People. It confirms the obligation of the Public Power to consider, in the formulation and implementation of indigenous health policies, the local reality and the specificities of its culture, especially in the definition of the health care model, which must be guided by a differentiated and global approach, that includes aspects of health care and its physical structures, basic sanitation, nutrition, housing, environment, land demarcation, indigenous education and institutional integration. • MH Ordinance No. 70, of January 20, 2004. Approves management guidelines for the National Policy for Indigenous Health Attention and the competencies of the bodies responsible for its implementation. • MH Ordinance No. 2,656, of October 17, 2007. Lays down the responsibilities in providing health care to indigenous peoples in the Ministry of Health and regulates the Basic and Specialized Care Incentives Program for Indigenous Peoples. • Decree No. 7,336, October 19, 2010. Approved the Regulatory Structure of the Ministry of Health, defined the nature and competence of the institution, its organizational structure, the competence of each of its bodies - those of direct and immediate assistance to the Minister; those specific and singular; as well as the collegiate bodies - and the duties of their leaders. It also established the matters within the Ministry's area of competence (including: national health policy; coordination and inspection of the Unified Health System; environmental health and promotion, protection and recovery of individual and collective health, including that of workers and that of Indigenous Peoples; health information; critical inputs for health; preventive action in general, surveillance and sanitary control of borders and sea, river and air ports; health surveillance, especially regarding drugs, medications and food, and scientific and technological research in the health area. It transferred the management of the indigenous health subsystem to the newly created Special Secretariat for Indigenous Health (SSIH), which received the assignments previously developed by FUNASA.147 • Ordinance No. 2,446, of November 11, 2014. Establishes the National Policy for Health Promotion that brings as a guiding principle to “respect for diversity, which recognizes, respects and makes explicit the differences between subjects and collectives, covering ethnic and age diversity , capacity, gender, sexual orientation, between territories and geographic regions, among other forms and types of differences that influence or interfere with health conditions and determinations ”(art. 3, item IV). This principle was already embodied in Ordinance 1.820, of August 13, 2009, which lays down the rights and duties of health users and affirms the principle of "non-discrimination in the health service network." 147 Available at: http://bvsms.saude.gov.br/bvs/publicacoes/estrutura_regimental_ms_decreto_7336.pdf Page | 108 ANNEX 3 -List and Brief Description of Environmental and Social Studies Required during the Licensing Process in the State of Paraná Type of Study When they are required The Solid Waste Management Plan aims to establish the In accordance with the provisions of State management of solid waste in an enterprise. In this study, a holistic Law 12493/99 and State Decree 6674/02, view of the enterprise should be reported, among other basic sanitation, treatment and / or final information regarding solid waste management processes. Thus, destination of industrial, health, commercial information regarding the characterization of the enterprise, and service provision projects that generate quantification and classification of each type of waste generated, hazardous wastes or those defined as diagnosis of the current management situation, forms of private responsibility for their composition, temporary packaging and storage, transportation, treatment and nature or volume, must carry out a SWMP final disposal proposed for each type of waste must be presented. prepared by a qualified technician. The plan also consists of planning solid waste management activities, identifying improvements and goals, developing a training and capacity building program. The Construction Waste Management Plan is a technical It is requested with the environmental document that characterizes and quantifies the typology of each licensing requirement in the Simplified waste generated during the construction works of the project, as Environmental License and Installation well as establishes the procedures for segregation, packaging, License modalities of some types of specific transport, treatment and final disposal. activities. The Health Service Waste Management Plan is a document that According to RDC Resolution nº 222/2018, points out and describes all actions related to the management of this plan must be prepared by the Health waste from health services, observing their characteristics and Service Waste generators, which activities risks, contemplating aspects related to the generation, involve any stage of waste management. identification, segregation, packaging, collection, storage, transportation, destination and final disposal environmentally as well as actions to protect public health, workers and the environment. The Environmental Control Plan is a study prepared according to This plan comprises the necessary guidelines established by IAT, with the general basic content, the documentation for requesting the characterization of the enterprise, environmental diagnosis of the Installation License, of some types of areas of direct and indirect influence, characterization of the specific activities such as: water supply and generated environmental impacts, description of the mitigating sewage collection and treatment systems, and compensatory measures and the list of the technical team landfills, cemeteries, mining enterprises, responsible for the plan. truck yard / parking lots. The Environmental Pollution Control Plan is a technical study, This plan comprises the necessary which minimum general content presents the characterization of documentation for requests for an the enterprise and the process developed by the specific activity, Installation License, Simplified a descriptive memorial of the sources of water intake, sewage Environmental License and its renewals, of treatment, non-domestic liquid effluent, air emissions and solid some types of specific activities such as: waste and a technical memorial with the calculation routines for industrial enterprises, poultry enterprises, dimensioning environmental pollution control systems for cattle farming projects, pig farming industrial and sanitary liquid effluents, atmospheric emissions and enterprises, pesticide storage facilities, fuel solid waste to be generated by the activity. distribution bases, resellers and retailers. The Basic Environmental Control Plan is a technical report that This plan comprises the necessary presents a simplified environmental diagnosis of the area of the documentation for applying for the enterprise, its impacts on water resources, atmosphere and soil, Simplified Environmental License for some and proposes control measures for such impacts. types of specific activities, such as: sanitation projects, cemeteries, industrial enterprises and truck yard and parking lots. The Preliminary Environmental Report makes up the list of IAT requests this report prior to the issuance documents necessary for the issuance of a Prior Environmental of the licensing of real estate projects, License by IAT. It presents the environmental feasibility of projects sanitation and landfills. and activities with a potential or effective polluting impact; considers the physical, biological and socioeconomic aspects, urban design and the impacts that can and will be caused with the Page | 109 Type of Study When they are required implementation of the enterprise; it also proposes mitigation measures for impacts. The Simplified Environmental Report addresses the environmental IAT requests this report to compose the aspects related to the location, installation and operation of new necessary documentation for prior housing developments, including infrastructure, basic sanitation, environmental licensing of real estate and road and energy activities. It is presented as a subsidy for the energy generation projects. granting of the required license, which will contain, among others, information related to the environmental diagnosis of the region where the enterprise is located, its characterization, the identification of environmental impacts and the control, mitigation and compensation measures. It must be prepared by a multidisciplinary technical team. The Detailing Report on Environmental Programs is a technical It is a legal requirement for obtaining an document that must present, in detail, the environmental Installation License (LI), for some types of programs and all measures to control the environmental impacts specific activities, such as power generation that were proposed in the Simplified Environmental Report and projects. that must be carried out in the enterprise. The Degraded and/or Altered Area Recovery Project is a detailed This Project is required from any project that description of the set of measures necessary for the recovery or causes disturbances, changes in the restoration of the degraded and/or altered area, based on the environment, degradation of soil and water biotic and abiotic characteristics of the area and on secondary quality, among others. It is also required knowledge about the type of impact caused by the previous use from all projects that are intended for the of the area, the resilience of vegetation and secondary succession exploitation of mineral resources must (State Decree No. 11515/2018). It is also an instrument of the submit a plan for the recovery of degraded Environmental Regularization Program (PRA), defined by Federal areas. Decree No. 7830/2012, which comprises a set of actions or initiatives to be developed by rural landowners and squatters in order to adapt and promote environmental regularization. The Risk Management Program is a technical report that aims to It is a program that is valid for all enterprises identify the possible risks to the environment and to the health of which activities may result in accidents with the internal and external public of any enterprise, resulting from an impact on the environment and on the the various activities it develops. This program shall also include surrounding population and that comprise items related to operational rules and procedures, information on the storage of any chemical substance the chemicals handled, maintenance of critical equipment and considered dangerous. instruments, systematic investigation of accidents/incidents in the operation, employee training plan, emergency management procedures and the contingency plans to be adopted. The Environmental Liability Studies are a set of technical studies IAT can request these in cases of accidents related to the management of contaminated areas. Its purpose is with spills and/or leaks of dangerous liquid to ensure knowledge of the characteristics of the impacted areas products, when implementing new projects and the definition of appropriate intervention measures, in order in a place where potentially polluting to eliminate or minimize damage and/or risks to the environment activities were carried out, in situations of and the population involved, arising from the existence of irregular deposition of solid waste. contaminants in the contaminated area. They comprise: (a) a miscellaneous, inspections have identified Preliminary Assessment to identify the facts or evidence that an area suspected of contamination or due indicate or make it possible to suspect the presence of to the requirement to request contaminating substances in the area; (b) a Confirmatory environmental licensing of some types of Investigation to confirm or not the existence of contaminants in specific activities. concentrations above the intervention values established in federal and/or state regulations; (c) a Detailed Investigation to characterize the impacted physical environment in detail, determine the concentrations of the chemical substances of interest in the different media evaluated, define the limits of the plumes of contamination in three dimensions, quantify the chemical substances of interest, considering the different phases in which they are (soil, water and air), and consolidate the exposure routes and the identified receptors, in the internal and Page | 110 Type of Study When they are required external areas of the impacted area; (d) a Risk Analysis for Human Health in order to define what would be the maximum acceptable concentrations for the contaminants of interest and what do not constitute risk, in the event of an exposure situation of an individual or a population; and (e) an Intervention Plan to identify, evaluate and propose engineering, institutional control and remediation measures aimed at controlling the sources of contamination identified, eliminating or minimizing the risks assessed in the previous stage. The Environmental Contingency and Emergency Plan is a technical Retail stations or systems with their own report that (a0 identifies emergency scenarios capable of transportation of fuel must present the triggering dangerous or harmful incidents and (b) proposes Environmental Emergency Plan for actions to mitigate the incident. The plan consists of a set of handling accidents involving the transport guidelines, data and information that provide the necessary of dangerous products in the Operation conditions for the adoption of logical, technical and administrative License. Health service facilities must also procedures, structured to be triggered quickly in emergency present this emergency plan that will be situations, to minimize impacts to the population and the used in case of failure or lack of external environment. waste collection. Page | 111