Offering Circular. - SFM

Employees of the Region
Year ended 31 December
1998 1999 2000 2001 2002 2003
Staff (number) 4,415 3,988 3,815 3,817 3,523 3,463
Cost (millions of euro) 161.1 164 176 177 199 200
As a result of the implementation of the Legge Bassanini (which will transfer to the Region significant
functions previously performed by the Central Government) a number of personnel previously employed by
the Central Government were transferred to the employ of the Region. In February 2001 approximately 320
employees were transferred from the Central Government to the Region. This transfer was partially offset by
the effect of the Region’s incentive programme for early retirement as well as, to a lesser extent, the transfer
of employees to provinces and municipalities. It is not currently expected that any further employees will be
transferred. Due to applicable accounting procedures, the costs of employees of the Region is slightly timedelayed
with respect to the changes to the numbers of staff.
Major Activities
Regions are empowered to address general economic and social issues and are responsible for co-ordinating
local administration through the provinces and municipalities and providing resources to finance provincial
and municipal investment programmes. The Region’s primary role is to allocate regional funds and funds
transferred from the Central Government to specific sectors and among the provinces and municipalities. See
“Financial Information of the Region of Lazio”. These functions have been expanded due to the
implementation of the Legge Bassanini. See “Relationship between the Central and Local Governments”.
Healthcare. The primary sector in which the Region is involved is healthcare. The Region established
Aziende Unità Sanitarie Locali (“ASLs”) and Aziende Ospedaliere (“AOs”) pursuant to Legislative Decree
No. 502 of 30 December 1992, as amended (“Decree No. 502”), to oversee the administration of the
Region’s public and private hospitals and health service providers. These entities succeeded the unità
sanitarie locali and other entities referred to in Decree No. 502 and became autonomous aziende with public
legal status and commercial autonomy. The capital of an ASL/AO consists of a fund (fondo di dotazione)
funded by the Region. The Region is responsible for setting guidelines for health services and planning and
implementing certain healthcare related programmes and initiatives, such as emergency transportation
services, within the framework set forth by the Central Government.
ASLs and AOs must operate efficiently and in compliance with the applicable budgetary constraints. ASLs
and AOs are obliged to, inter alia, prepare annual and multi-year forecast financial statements and historical
financial statements, which are subject to control by the Region, as well as an annual budget. In addition,
ASLs and AOs are required to maintain accounting records to enable a comparative analysis of their
expenses, income and results of operations; and allocate their own resources and determine means to cover
their deficit.
ASL/AO’s bodies include the general manager and a board of auditors, both of which are composed of three
members, which are appointed by the Regional Board, the Ministry of the Economy and Finance and the
local conference of municipalities for the healthcare matters established pursuant to Regional Law No. 18,
respectively.
The Central Government requires that funds transferred to the Region be utilised in three general healthcare
categories (prevention, hospitals and healthcare services). As in other regions, in recent years the Region of
Lazio has expended amounts on healthcare greater than its expected healthcare expenditures (see “Financial
Information of the Region of Lazio – Healthcare Deficits”). Attempts to control healthcare costs commenced
in 1995, following the introduction of different reforms which required healthcare pricing and
reimbursement to follow prescribed prices for specific services. As a result of the reforms, the Region was
given the responsibility for the planning of the healthcare budget, which is now calculated based on preestablished
prices for health services. This represents a change from prior budget planning by the Central
Government which was typically based on a region’s historic expenditures. In addition, the Region of Lazio
42