Lombardy Extends Primary Care Rights to Homeless Citizens
The Lombardy Regional Council has unanimously approved a law granting homeless individuals the right to register with a primary care physician or a pediatrician. Proposed by the Democratic Party (PD) regional group, the measure ensures universal access to the Essential Levels of Care (LEA) for citizens currently lacking a fixed address and formal health registration.
Establishing a Pathway to Enrollment
Under the new official legislative proposal, the Lombardy Region must now recognize the right of homeless Italian citizens to enroll in the patient lists of their local Territorial Socio-Health Agencies (ASST).
The process prioritizes inclusivity. Registration may be initiated by the individuals themselves or via referrals from social services and socio-health organizations. To manage this influx, the regional government will designate “Case di Comunità” (Community Houses) as primary hubs for these health services. An oversight committee—comprising representatives from the Welfare Department, ASST, ATS, Anci Lombardia, and the third sector—will monitor the effectiveness of the rollout.
Addressing a Systemic Healthcare Gap
Regional councilor Angelo Orsenigo, a primary signatory of the proposal, stated that the law addresses a significant gap in civil rights by restoring health access to thousands of residents. Without a fixed residence, these individuals were frequently excluded from standard primary care registration.
This exclusion forced many to rely solely on hospital Emergency Departments (Pronto Soccorso) for non-urgent care. The regional government estimates that a homeless individual without a primary doctor accesses emergency services ten times per year. At a cost of 250 euros per emergency visit, the region expects the new policy to reduce the financial burden on the public health system while ensuring continuity of care.
Budgetary Commitment to Public Health
The implementation is backed by a dedicated financial commitment from the regional budget. The law allocates 125mila euros for the current year, followed by an annual investment of 500mila euros for the next two years.
Operational Framework for Care
- Eligibility: The law applies to Italian citizens without a fixed address who currently lack any form of public health registration.
- Registration: Enrollment can be facilitated through social services, socio-health services, or direct application at designated ASST offices.
- Service Delivery: Care will be coordinated through the regional network of Case di Comunità to ensure a standardized approach to health management.
- Oversight: A dedicated steering committee will track the integration of these citizens into the primary care system to ensure the policy meets its stated objectives.
This legislative change marks a transition in how the Lombardy region manages health equity, shifting from emergency-based interventions toward a model of proactive, primary care.