Non-self-sufficient elderly population: Caritas and Italian Bishops' Conference, “we welcome the creation of a single support scheme. Appropriate resources must be made available now.”

The fragmented nature of elderly care has been successfully overcome, while the innovative approach and the concern for ageing adults with disabilities is to be applauded. However, a number of recommendations remain: to continue working together, to put the reform into practice and increase funding with the allocation of EUR 5/7 billion per year, as provided for in the 2024 Budget Law. In a nutshell, these were the observations set forth in a document presented today by Caritas Italy, the National Service for the Pastoral Care of People with Disabilities, and the National Office for the Pastoral Care of the Disabled during a hearing at the Council of Ministers' consultation and discussion panels on the implementing acts and questions concerning Enabling Law 33/2023 on non-self-sufficient elderly population. Under this law, the Italian government is mandated to adopt, no later than 31 January 2024, one or more legislative decrees designed to support elderly persons and to promote their dignity and autonomy, social inclusion, active ageing, preventing vulnerabilities, providing assistance and care for the elderly, including non-self-sufficient elderly persons, in connection with their condition as disabled persons.

Pact for a New Welfare on Non-Self-Sufficiency. Caritas, the Italian Bishops' Conference and numerous Catholic organisations (including ACLI, ARIS, UNEBA) have all adhered to the Pact for a New Welfare on Non-Self-Sufficiency - which brings together 58 civil society organizations involved in assistance for the non-self-sufficient elderly. They cooperated in a participatory manner, and submitted a set of shared proposals to the government. Many of them were adopted. They are now reviving the debate with an assessment of the measures adopted so far along with recommendations to ensure that

“The enabling act will effectively comprise and implement solutions appropriate to the situation of dependent persons and their families, a rapidly growing phenomenon that poses serious challenges to households, local communities and institutions.”

Positive aspects. The creation of a single system for providing care for the elderly - SNAA - hitherto highly fragmented among social, socio-healthcare, and health care measures, is noteworthy, reads the statement: “The creation of an Interministerial Committee for policies in support of the elderly (CIPA), tasked with promoting the coordination and integrated planning of national policies in support of the elderly, envisaged by the new Law, is thus remarkable.” A favourable assessment is likewise expressed with regard to the development of new intervention schemes providing a comprehensive picture of the condition of the non-self-sufficient elderly along with increased customised care services.

 Ageing Adults with Disabilities. Acknowledging the question of ageing adults with disabilities is extremely important, thereby ensuring their “right to receive, and be guaranteed over time, all forms of assistance linked to their previous condition, and to continue benefiting from services destined for the non-self-sufficient elderly, as smoothly as possible (i.e. without having to repeat previously conducted evaluations or procedures).” Caritas and the two offices of the Italian Bishops' Conference highlighted the importance to continue working together (Pact and Institutions) to ensure the successful outcome of the reform.
“This challenge is made especially difficult by a tight timeframe".
Job prospects and healthcare budgets.  The paper provides some methodological advice on caring procedures for the non-self-sufficient elderly population: “to thoroughly re-examine the procedures for accessing care services, starting at the initial stage right up to personalised planning, including an assessment of individual needs (this involves the following: single access points' (PUA), standardised multidimensional assessment according to nationally homogeneous and standardised criteria, personalised Plan, cost of care and graded universal benefit).”  The need to include the option of "spending according to need”, rather than being based on pre-established algorithmic criteria and formulas, is strongly recommended.

Funding. The document calls for increased funding in the 2024 Budget Law, in order to start concretising the reform. For Caritas and the Italian Bishops' Conference,
the allocation of adequate resources, ranging from EUR 5 to 7 billion per year,
"sustainable for public finances, while simultaneously allowing for a phased implementation of the reform, with a gradual increase in dedicated spending - for both healthcare and social expenditure”, is of the utmost importance. “In 2024,” reads and concludes the document, “some of the recommendations of the reform could start to be implemented, whilst respecting the underlying rationale of the system and thus with measures in the key areas of care: home care services, residential services and monetary transfers.”
Patrizia Caiffa