Presentation by Mattia Corbetta, Policy Analyst, OECD Trento Centre at teh kick-off meeting of the OECD-EC project "Improving the disability assessment and social protection system in Italy" on 6 December 2021. For more info https://www.oecd.org/cfe/leed/dgref-disability-italy.htm

1. @ OECD_Social & @OECD_local https://oe.cd/disability-Italy
OECD | Directorate for Employment, Labour and Social Affairs & Trento Centre for Local Development
HIGHLIGHTS FROM THE
INCEPTION REPORT
06-12-2021
Improving the disability assessment and
social protection system in Italy
INCEPTION PHASE

2. © OECD | Directorate for Employment, Labour and Social Affairs & Trento Centre for Local Development
Comparative overview
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3. © OECD | Directorate for Employment, Labour and Social Affairs & Trento Centre for Local Development 3
INCEPTION PHASE
Public spending on incapacity (total, % of GDP, 2019 or latest available)
Source: OECD (2021), "Public spending on incapacity" (indicator): https://doi.org/10.1787/f35b71ed-en
Public spending on incapacity below OECD mean

4. © OECD | Directorate for Employment, Labour and Social Affairs & Trento Centre for Local Development 4
INCEPTION PHASE
Households at risk of poverty above EU mean

5. © OECD | Directorate for Employment, Labour and Social Affairs & Trento Centre for Local Development 5
INCEPTION PHASE
Disability increases the risk of arrears

6. © OECD | Directorate for Employment, Labour and Social Affairs & Trento Centre for Local Development
Policy issues
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7. © OECD | Directorate for Employment, Labour and Social Affairs & Trento Centre for Local Development 7
INCEPTION PHASE
Policy issues: a complex legal framework
What’s the issue?
 Proliferation of legal sources over time
 Fragmentation: multiple definitions of disability and types of assessment, depending on the purpose (ascertaining
eligibility for benefits, services, employment etc.)
What are the implications?
 Makes it difficult to obtain a clear understanding of the whole picture, particularly the different definition-
assessment-benefit combinations
 Persons with disabilities have to go through multiple assessments, which in some cases are perceived to be
redundant
Hypotheses for discussion
 Would a consolidated act help to address the issue?
 Would it be feasible to unify the existing notions of disability?
 Would it be feasible to reduce the number of assessments one single person has to go through, e.g. by involving
more bodies and/or linking one single assessment to multiple purposes?

8. © OECD | Directorate for Employment, Labour and Social Affairs & Trento Centre for Local Development 8
INCEPTION PHASE
Policy issues: a narrow approach to assessment
What’s the issue?
 Essential type of assessment (i.e. civil invalidity) is purely clinical, in contrast with the UN Convention
 Scoring system increases risks of arbitrariness/randomness in assessment
 Higher scores do not necessarily imply lower functions (e.g. in terms of employability) and higher needs
What are the implications?
 Focus on impairments, rather than needs and functions of people with disabilities, which has both social (i.e.
stigmatisation) and policy (i.e. knowledge gap) negative consequences
 There is a diffused perception that the scoring system may not guarantee full transparency
Hypotheses for discussion
 Would it be feasible to move away from a scoring system (a rather unique case in the OECD landscape)?
 Would it be feasible to establish a (single, see previous slide) multi-dimensional type of assessment that accounts
for all dimensions (i.e. impairments, functions, needs) to ensure consistent results?
 Would it be feasible to foresee a variable-geometry composition for assessment panels (i.e. core members +
variable members, with the latter depending on the needs in question)?

9. © OECD | Directorate for Employment, Labour and Social Affairs & Trento Centre for Local Development 9
INCEPTION PHASE
Policy issues: a fragmented institutional setting
What’s the issue?
 There are multiple bodies involved all along the disability assessment-benefit provision chain, depending on the
various combinations/options available
 Different bodies have different functions distributed across (at least) three levels of government
What are the implications?
 There are concerns that persons with disabilities and their carers may not be aware, fully or in part, of the benefits
potentially available to them, or give them up due to excessive bureaucratic burden
 People with disabilities and their carers are often reported to turn to the “wrong office” (i.e. not in charge of the
specific benefit of their interest); the latter usually redirects them to the right office, but the whole process is time-
consuming and stressful
Hypotheses for discussion
 Would the Constitution allow recentralising the management of part of the procedures?
 Would it be possible to channel different services into fewer bodies, reducing their overall number?
 Would the creation of a one-stop-shop for disability improve the situation?

10. © OECD | Directorate for Employment, Labour and Social Affairs & Trento Centre for Local Development 10
INCEPTION PHASE
Policy issues: a limited evidence base
What’s the issue?
 Rules on privacy appear to prevent the exchange of data between the various institutions involved
 The provision of services at regional and local level is often poorly digitised and reported
 Monitoring reports at national and regional level are still a rare occurrence
What are the implications?
 It is impossible to reliably measure how many persons with disabilities there are in a given region
 It is impossible to track statuses and benefits of single individuals over time and across space
 It is impossible to inform budgeting with a comprehensive and detailed evidence base
 It is impossible to identify determinants of regional variations in disability rates
Hypotheses for discussion
 Would it be useful to request an expert legal opinion to ascertain whether and to what extent current rules on
privacy do prevent data transfer between public administrations?
 Would it be possible to create a national statistical register of disability (on prevalence and services/benefits)?

11. 
Twitter: @OECD_social & @OECD_local
Website: https://oe.cd/disability-Italy
This technical support project is funded by the Technical Support Instrument, and implemented in cooperation with
the European Commission’s Directorate-General for Structural Reform Support (DG REFORM)
mattia.corbetta@oecd.org
Thank you! Q&A