The family caregiver officially enters San Marino’s legal system. This is one of the most significant developments approved yesterday by the Grand and General Council (Consiglio Grande e Generale) during its examination of the law on new measures to support families, motherhood and the birth rate.
The bill, which reached article 25 out of a total of 36, will return to the chamber on the morning of Tuesday, 15 September. Among the issues still on the table will be the baby bonus. Yesterday’s session ended with several articles already approved, in what was overall a calm and cooperative atmosphere.
Among the measures given the green light is one dedicated to those who care every day for a family member unable to live independently. In simple terms, the law formally recognises care work carried out within the family and, depending on the amount of time required, offers financial subsidies, pension contributions, leave from work, part-time arrangements and flexible working hours.
Who can become a family caregiver
The scope includes those who care for a spouse, civil union partner, cohabiting partner, relative or in-law up to the second degree. In certain cases provided for by the law, this can extend up to the third degree.
The person being cared for must be in a condition of dependency — due to illness, including cancer, infirmity or a chronic or degenerative disability — that requires comprehensive and continuous assistance.
Simply declaring that one is caring for a relative is not enough, however. The level of care required must be certified by the Commission for Individual Health Assessments (Casi), based on reports drawn up by the relevant departments of the Social Security Institute (ISS).
It is also the person requiring assistance who, in accordance with their right to self-determination, designates the caregiver. The law also regulates cases involving legal incapacitation, supported administration and care for minors.
Four tiers, from 18 to more than 36 hours a week
The system provides for four levels, calculated according to the amount of care provided each week.
The highest tier is that of the primary family caregiver, who devotes at least 36 hours a week to care duties. In this case, continuing to work is not possible. The employee is placed on leave, for up to five years with the possibility of a further five-year extension, and may receive a subsidy of up to twice the social pension, in addition to notional pension contributions for the entire period of care.
The second tier applies to those providing care for at least 30 but fewer than 36 hours a week. Here too, employment is not permitted, and employees are entitled to leave. The subsidy amounts to 80% of twice the social pension, again with recognition of notional pension contributions.
The rules change for the tier covering 24 to 30 hours a week. In this case, the caregiver may continue working and, if employed, may request a switch from full-time to part-time work. For those working part-time, the subsidy is equal to 50% of twice the social pension.
Finally, there is the tier covering 18 to 24 hours of care per week. Here too, it is possible to continue working, either by requesting part-time status or by making use of the flexible working arrangements provided for by law. For those working part-time, the financial support is equal to 30% of twice the social pension.
Only one caregiver per person assisted
As a general rule, the status cannot be granted to more than one person for the same care recipient at the same time. A special provision, however, applies to minors: both parents may be designated, alternating care duties for periods of no less than three months. The subsidy and related benefits go to whichever parent is actually providing care at that time.
Recognition of caregiver status may end, among other circumstances, at the request of the caregiver or the person being cared for, upon the death or institutionalisation of the person receiving care, or when the condition of dependency certified by Casi no longer applies.
A cap of 50 caregivers or one million euros a year
The law also sets a spending limit, at least in this initial phase. To assess the measure’s economic impact, no more than 50 family caregiver statuses may be granted each year, or a number equivalent to a maximum annual expenditure of one million euros. These parameters may be adjusted by the State Congress through a delegated decree.
The law also opens the door to the possibility — again through a future decree — of providing a caregiver or family assistant, funded by the ISS, to people with disabilities who require the highest level of care and have no relatives able to provide it.
To make the new system operational, a regulation from the State Congress will be required, setting out the procedures and requirements for obtaining caregiver status and accessing the subsidy.
Financial support will not be the only measure introduced. The Social Security Institute will be required to organise training courses for those taking on this role, covering topics such as home care, dementia, first aid and self-care, with the aim of also helping to prevent burnout and social isolation.
The examination of the law is not yet complete, however. The Council suspended proceedings yesterday at around 1:30pm, at article 25. Discussion of the bill will resume on Tuesday, 15 September, with the baby bonus among the next issues to be addressed.
