Residential and semi-residential health and social care

In the Italian health system, various categories of assisted individuals with clinical conditions are guaranteed residential and semi-residential health and social care. Following a multidimensional assessment, assisted individuals are classified under the following types:

• those suffering from highly complex pathologies who need to be on life support and/or have extremely severe disabilities;
• dependent persons;
• people at end-of-life stage;
• minors with neuropsychiatric and neurodevelopmental disorders;
• people with mental disorders;
• people with disabilities;
• people with pathological addictions.

In line with the individualised treatment programme drawn up following the multidimensional assessment, services may be provided in a residential setting on an intensive care, extensive care or maintenance basis, and in a semi-residential setting on an extensive care or maintenance basis.

Access to residential and semi-residential services is governed by the general principles of universal access, equity and appropriateness.

Because the system covers services with various levels of treatment intensity, access to those services and ongoing treatment will be consistently verified against the effective appropriateness of the recommendation, on the basis of objective criteria for the multidimensional assessment (MDA) of the assisted individual’s needs.

To obtain more detailed information about access criteria, organisation and cost-sharing for residential and semi-residential care, you should contact your local health authority.

Financial contribution requested for public/state care homes and who pays

The Italian National Health Service (SSN) only covers the cost of healthcare. The cost of services not non-healthcare-related and accommodation services (meals, cleaning, leisure activities, etc.) is borne by the assisted individual or, in the case of financial hardship, by the municipality where that individual resides.

Intensive care and extensive care therapies are therefore fully covered by the SSN, while social care and rehabilitation costs are borne by the SSN as a variable fee in accordance with Articles 30, 31, 32, 33 and 34 of Prime Ministerial Decree of 12 January 2017.

Provisions governing rates that can be charged by accredited private care homes

The rates that can be charged by accredited private care homes are determined by the provisions enacted by the various regions. The relationship between these facilities and the SSN is governed by a contractual agreement, which stipulates precisely the number of services that can be provided by the facility and the corresponding fee-based remuneration.

Financial aid to pay the cost of residential care

SSN funding is provided through the National Health Fund (FSN) and is distributed among the various regions each year.

The regions assign financial resources to the local health authorities on the basis of various parameters, which they use to ensure citizens are provided with the services for which they are responsible according to the essential levels of care (LEA), including services provided in residential and semi-residential facilities.

Relevant legislation

Prime Ministerial Decree of 12 January 2017 (Articles 29, 30, 31, 32, 33, 34)