OBJECTIVE OF THE MEASURE
Promoting the well-being and quality of life of people with very severe disabilities assisted at home.

ADDRESSEES
Beneficiaries of this measure are persons of any age in a condition of very severe disability assisted at home, who meet the following requirements: 

• recipients of an accompaniment allowance or defined as non-self-sufficient 
• residence in Lombardy; 
• member of local social and healthcare unit ISEE up to € 50,000.00 (for adults and elderly) or ordinary ISEE up to € 65,000.00 (for minors). 

Presence of at least one of the conditions listed below, the severity and extent of which must meet the criteria of the legislation in force: 

1. persons in a coma, vegetative state or minimally conscious state; 
2. persons dependent on assisted mechanical or continuous non-invasive ventilation; 
3. people with severe or very severe dementia; 
4. persons with spinal injuries between C0/C5, of any nature; 
5. people with very severe motor impairment due to neurological or muscular pathology; 
6. people with complex sensory deprivation understood as a combination of total visual impairment or residual visual field not exceeding 1/20 in both eyes or the better eye and hearing loss; 
7. people with very severe behavioural disabilities within the autism spectrum; 
8. people diagnosed with severe or profound mental retardation; 
9. any other person in a condition of vital dependence who requires continuous assistance and monitoring 24 hours a day, seven days a week, for complex needs resulting from their severe psychophysical condition.

TYPE AND CHARACTERISTICS OF THE CONTRIBUTION
The measure provides for the disbursement of monthly economic contributions (vouchers) and services in (socio-medical vouchers) disbursed by the ATS after verification, multidimensional assessment and drafting of the individual project by the reference ASST.

The disbursement of monthly vouchers ranges from a basic level of EUR 650 up to a maximum of EUR 1300. The amount of the voucher varies according to the type of need and whether or not caregivers are regularly employed.

For Measure B1 beneficiaries aged between 18 and 64 who intend to implement an independent living project, who have a socio-medical ISEE of less than €30,000.00 and find themselves without the support of a family caregiver but with the help of an independently chosen and regularly hired family assistant, in addition to the Measure B1 voucher, an autonomy allowance is also provided. This is an additional share of up to a maximum of EUR 800 granted to the beneficiary who activates an independent living project to contribute to the expenses incurred for regularly employed care staff.

SOCIO-MEDICAL Voucher
It is a non-cash purchase order that can only be used to purchase socio-medical services from accredited providers under contract with the ATS. With DGR 6003/2022, the Lombardy Region remodelled the socio-medical Voucher for severe disabilities and introduced the socio-medical Voucher for Autism.

Types of SOCIO-MEDICAL Vouchers

• Socio-medical vouchers for adults/elderly people: 
  • 250.00 € to which correspond the number of interventions/hours (range7-12) provided by the professional figure as indicated in the Individual Project formulated by the ASST;
  • 460.00 € to which correspond the number of interventions/hours (range13-18) provided by the professional figure as indicated in the Individual Project formulated by the ASST.
• Socio-medical vouchers for minors:
  • 350.00 € to which correspond the number of interventions/hours (range10-14) provided by the professional figure as indicated in the Individual Project formulated by the ASST;
  • 600.00 € to which correspond the number of interventions/hours (range15-22) provided by the professional figure as indicated in the Individual Project formulated by the ASST.
• High-profile socio-medical vouchers for people with very severe disabilities who have special needs because they are dependent on assistive technology: 
  • continuous assisted or non-invasive mechanical ventilation (minimum 16 hours/day) and/or
  • parenteral-only feeding via central venous catheter and/or
  • situations of particular severity and intensity, with a need for continuous and justified assistance assessed by the ASST to the value of €1,650.00.

AUTISM voucher
This is a specific experimental title for people with very severe behavioural disabilities of the autism spectrum with level 3 in the DSM-5 classification. 

The Autism Voucher is part of the interventions implemented to support people with very severe disabilities to stay at home and in their living environment.

In detail, no. 5 voucher levels with an indication of the average number of treatments per week are provided.

The protocol related to the Autism Voucher follows the same operating procedures activated by the ASSTs for the provision of the socio-medical voucher Measure B1.

METHODS OF ACCESS
Applications may be submitted to the territorially competent ASST from 1 January to 31/12/2022 (D.G.R. no. 6574 of 30/06/2022);

The contribution is paid from the first day of the month following the month of assessment.

INFORMATION AND CONTACTS
More information can be found on the ATS website at the following address: https://www.ats-valpadana.it/misura-b1-contributo-per-disabili-gravissimi.

Information on the criteria for accessing the measure, the complete forms and the procedures for submitting applications for continuation and new access can be found on the dedicated pages of the institutional websites of the ASST and at the offices of their territorial services.

Please note that the regulations governing Measure B1 are updated annually according to ministerial and regional indications.