Improving the disability assessment and social protection system in Italy

This project aimed to support Italy in the design, development and implementation of reforms that will increase the adequacy of disability assessment and protection system in Italy, allowing for greater participation and inclusion of people with disabilities.

The project was developed by the OECD Directorate for Employment, Labour and Social Affairs and the OECD Trento Centre for Local Development at the OECD Centre for Entrepreneurship, SMEs, Regions and Cities, as well as funded by the Technical Support Instrument, and implemented in cooperation with the European Commission’s Directorate-General for Structural Reform Support (DG REFORM) and the Office for policies in support of people with disabilities of the Italian Presidency of the Council of Ministers.

Implementation period: 2021-2023

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(Italian version)

Access the final publication (Italian version)

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What's the issue?

Fragmented legislation affects Italy’s ability to recognise functioning capacities of persons with disabilities, to provide adequate support and to develop effective inclusive policies across sectors, such as in labour market, education, health and social policies. Various attempts undertaken in the past decade to fix these problems have been unsuccessful. In the absence of up-to-date national reference legislation, regions have adopted their own approaches, further contributing to large differences across the country.

Disability assessment is outdated, with a number of definitions of disability in place all based on a medical concept. Through the UN Convention on the Rights of Persons with Disabilities, ratified in 2009, Italy is expected to align its definition of disability to ICF standards and harmonise the assessment across systems and regions. The fragmentation of disability assessment is mirrored in a complex and equally fragmented system of social protection for persons with disabilities, with a large number of different tax deductions and welfare benefits, depending on the type and degree of disability and the region in which people live. This system fragmentation results in considerable inequalities across types of disabilities and regions, with inadequatly low benefits in some and undesirable duplication of entitlements in other cases.

Also for these reasons, disability reform is now a priority for the Italian Government, which has obtained the technical support of the European Commission’s Directorate-General for Structural Reform Support together with the Organisation for Economic Cooperation and Development (OECD) to:

improve the legal definition of disability so as to comply with the International Classification of Functioning, Disability and Health (ICF);
increase the capacity of social assistance to reduce poverty and ensure adequate standards of living for people with disabilities.

Project activities

The OECD developed the project in 4 phases and performed the following activities:

‌ Improving the disability assessment and social protection system in Italy - activities

Outputs
Final Publication
Disability, Work and Inclusion in Italy: Better Assessment for Better Support 29 November 2023 One in seven working age adults identifies as having a disability in OECD countries. Many of them are excluded from meaningful work and have low levels of income and social engagement. Governments can help create an environment that supports social and labour market integration for people with disability. This report reviews the effectiveness of the social protection system for people with disability in Italy and summarises the results of a pilot carried out in four regions testing an alternative disability assessment. The current assessment process can sometimes deny services to people in need of support while being generous to people with significant health problems but who are not experiencing severe disability. A disability assessment that takes medical and functional aspects into account helps to direct services and resources to those most in need and to harmonise access to disability support across the country. Implementing disability reform has proved to be difficult in Italy in the past decade. This report provides evidence that reform can improve outcomes for people with disability. Italian version Publication launch & project closure Agenda \| 29 November 2023, online (IT version)
Reports
‌ Improving the disability assessment and social protection system in Italy Inception report (Output 1)	Mapping and understanding disability assessments in Italy and its regions Diagnosis report (Output 2.1)	Disability assessment in Lithuania, France, Latvia and Denmark. A brief overview Diagnosis report (Output 2.2)	In-depth analysis of the system of social protection for people with disability in Italy Diagnosis report (Output 3.1)

A brief overview of social protection interventions for persons with disabilities in Lithuania, France, Denmark, and Latvia Diagnosis report (Output 3.2)	Including functioning into the assessment of civil invalidity and handicap in Italy. A Strategy for Piloting World Health Organization’s Disability Assessment Schedule (WHODAS) in four regions of Italy Piloting strategy report (Output 6)	WHODAS disability assessment pilot in four regions of Italy Evaluation report (Output 7.3 mid-pilot)	WHODAS disability assessment pilot in four regions of Italy Evaluation report (Output 7.3 full-pilot)
Other materials Inception phase \| Kick-off meeting agenda and presentations (EN/IT) \| 6 December 2021 Action phase \| Training agenda: Piloting World Health Organization’s Disability Assessment Schedule (WHODAS) in four regions of Italy (EN/IT) \| 3-12 October 2022 Recommandation phase \| Translating findings from a disability assessment pilot into policy reform: Considerations and experiences in selected countries \| 4 July 2023, Rome, Italy Contacts If you are interested to learn more about the project or to get involved, please contact Christopher Prinz, OECD Directorate for Employment, Labour and Social Affairs and Alessandra Proto, OECD Trento Centre for Local Development.