Foreword
Disability policy is a priority for the Government of Italy. Reform of disability support is envisaged in the 2020 National Reform Programme, and the need to improve the social protection framework was reiterated by the Constitutional Court in July 2020. Disability reform is also necessary to align the medical definition of disability in use in Italy today with the functional definition in the United Nations Convention on the Rights of Persons with Disabilities, which Italy ratified in 2009. A framework law in late 2021 (the Enabling Act) sketches out the direction of forthcoming reform and entrusts the national government with the preparation of the reform. Designing an effective multi-level governance system is essential to this effort because in Italy, key elements of disability policy such as disability services, some disability benefits and the assessment of disability are under regional and local competence.
This report is the outcome of a two-year project, funded by the European Union and implemented by the OECD, aimed at supporting Italy in its reform journey. The most distinctive part of the project was the planning and execution of a pilot of a new disability assessment tool, which looks at peoples’ performance and functioning capacities driven by the environment in which they life, i.e., their actual life situation, in addition to their health conditions and impairments. Four regions that reflect the diversity of the country volunteered to participate in the pilot and the project more generally: Campania, Lombardy, the Autonomous Region Sardinia, and the Autonomous Province of Trento. The conclusions and recommendations in this report build on the analysis of the situation in Italy and in these four regions, and on the evaluation of the assessment pilot conducted in the four regions between November 2022 and April 2023.
The project supported the government in four ways, i.e. through: i) an analysis of the system of disability assessment in Italy and selected countries in OECD Europe; ii) an analysis of the system of social protection for people with disability in Italy and selected countries in OECD Europe; iii) the organisation of assessment pilots in four regions of Italy, whose specificities in disability assessment and social protection had been previously investigated; and iv) ongoing support to the legislative reform process.
The preparation of this report involved several steps that contributed to shaping its conclusions:
A series of online meetings with national key stakeholders and institutions responsible for the management of disability policy in Italy, including ministries, public institutions such as INPS and ISTAT which also provided essential data, and the main disability federations.
A series of face-to-face meetings in the four participating regions with the authorities responsible for implementing disability policies and providing disability services. In an early phase, the project also included a similar series of meetings in a fifth region, Umbria, which helped shaping the project and the later discussions with the four participating regions.
The provision of standardised online training and ongoing support to the four regions and the regional assessors, in preparation for and during the assessment pilot, the collection of harmonised pilot data, and the preparation of a robust statistical evaluation of the pilot results.
A series of meetings to discuss the findings of the analysis and the pilot evaluation with key stakeholders, including the parliamentary committee responsible for drafting the new legislation.