Official guidance checked on 23 October 2026
Many Sri Lankans in Italy already work as caregivers (badanti) in Italian homes. The OSS qualification turns that experience into a recognised profession.
With it, you can work in hospitals, care homes and home-care services. This article explains who can become an OSS, what you need from Sri Lanka, how the course works and what you can expect to earn.
What is an OSS?
An operatore socio sanitario (OSS, social and health care worker) helps people who cannot fully look after themselves: elderly people, sick people and people with disabilities.
The OSS works together with nurses. Typical tasks are helping people wash, dress, eat and move, keeping the patient's room clean and safe, and supporting the person and their family.[2]
An OSS is not a nurse. It is a care role with its own national profile. The rules were updated by a national agreement in October 2024, which became law through a government decree published in the Gazzetta Ufficiale (Official Gazette) on 21 June 2025.[1]
The OSS qualification is issued by your Regione (region), but it is valid in the whole of Italy.
Is there demand for OSS workers?
Yes, and it is growing. Italy has one of the oldest populations in Europe. About one in four residents is 65 or older.[7]
Employers say they find it hard to hire. In the national Excelsior survey (a hiring forecast by Unioncamere and the Ministry of Labour), health and social care workers were among the hardest qualified service workers to find in May 2025. In the same month, 18.4% of all planned hires were foreign workers.[8]
In practice, trained OSS workers usually find work quickly, especially in northern Italy and in care homes.
Who can join an OSS course?
Each region organises its own training, so details change from region to region. The national minimum rules from 2025 are these:[1][3]
You must be at least 18 years old when you enrol and hold at least a diploma del primo ciclo (Italian lower-secondary certificate, also called "licenza media") or a foreign equivalent. Regions such as Emilia-Romagna ask foreign students for Italian at level B1.
Some regions ask for more. For example, the official Lombardy page (updated August 2026) asks for an upper-secondary diploma (diploma di scuola secondaria di secondo grado) or a three-year vocational qualification. Foreign students also need a translated certificate with a dichiarazione di valore.[2]
| Requirement | National rules (2025) | Lombardy (official page) |
|---|---|---|
| Minimum age | 18 | 18 |
| School level | Lower-secondary certificate or equivalent | Upper-secondary diploma or 3-year vocational qualification |
| Italian language | B1 in regions such as Emilia-Romagna | Good spoken and written Italian; many schools ask for B1 |
| Foreign certificate | Translation and dichiarazione di valore | Translation and dichiarazione di valore from the embassy |
Check the requirements of your own region and course before you pay any fee. The rules differ, and a school cannot give you the qualification if you do not meet them.
Your Sri Lankan school certificate
Your O/L or A/L certificate must be translated into Italian and described in a dichiarazione di valore (declaration of value). This is an official document issued by the Italian Embassy or Consulate in the country where you studied. For Sri Lanka, this is the Italian Embassy in Colombo.[5]
The declaration is not a recognition of your certificate. It only tells Italian schools what your certificate is worth in Sri Lanka. The course provider then decides if it is enough.[5]
If you do not have your certificates, or getting them from Sri Lanka is too difficult, you can earn an Italian licenza media at a CPIA (Centro Provinciale per l'Istruzione degli Adulti, a free state school for adults). CPIAs also teach Italian to foreigners.[6]
Italian language
You will study anatomy, hygiene and patient care in Italian. You will also speak with patients and nurses every day. Most courses test your Italian before you start.
If you have a recognised B1 certificate (for example CILS, CELI or PLIDA), bring it, and ask the school which certificates it accepts. Reaching B1 before the course makes the theory lessons much easier.
Step by step
- Make sure your permesso di soggiorno (residence permit) is valid. Course providers ask for it.[13]
- Get your school certificate translated and request the dichiarazione di valore, or get a licenza media at a CPIA.
- Reach Italian level B1 and get a certificate.
- Find an accredited course. Lombardy lists courses in its regional training catalogue; other regions publish lists on their websites.[2]
- Pass the entry test and the medical check, then enrol.
- Attend the lessons and the tirocinio (internship).
- Pass the final exam and receive your attestato di qualifica (qualification certificate).
The course: hours, cost and attendance
The course lasts at least 1,000 hours, normally about one year. In Lombardy this means 450 hours of theory, 100 hours of practical exercises and 450 hours of tirocinio (unpaid internship) in hospitals or care homes.[2]
Some regions now allow part of the theory online. Emilia-Romagna, for example, allows up to 225 hours at a distance.[3]
Attendance is compulsory. Most courses require at least 90% of the hours; if you miss more, you cannot take the final exam. Plan your work shifts before you enrol.
In many regions, courses for unemployed people are free because public funds pay for them. Friuli Venezia Giulia is one example.[4] Private courses in Lombardy usually cost around €1,800–2,000, often paid in instalments.[13][14]
How much does an OSS earn?
Pay depends on the CCNL (contratto collettivo nazionale di lavoro, national collective agreement) that your employer applies. All figures below are gross, which means before tax and contributions.
| Employer | Contract | Basic gross pay |
|---|---|---|
| Public hospitals and local health authorities | CCNL Comparto Sanità 2022–2024, "area degli operatori" | About €21,545 a year from 1 January 2024, plus a 13th month and allowances[10][11] |
| Social cooperatives (many care homes and home-care services) | CCNL Cooperative Sociali, level C2 | €1,591.06 a month from October 2025, paid 14 times a year[12] |
| Private RSA (residenza sanitaria assistenziale, care home) and clinics | Various contracts | Ask which CCNL applies and read your lettera di assunzione (job offer letter) |
Example: an OSS on level C2 in a social cooperative earns at least €1,591.06 × 14 = €22,274.84 gross a year, before extra pay for nights, Sundays and public holidays.
Shift work, night work and work on public holidays add allowances. Net pay (the money that reaches your bank) is lower than gross pay. How much lower depends on your tax situation and your family.
Contracts are renewed every few years, so always check the latest pay tables.
Job security
Public hospitals
Permanent public jobs (tempo indeterminato) come through a concorso (public competition). Non-EU citizens can apply if they hold a permesso di soggiorno UE per soggiornanti di lungo periodo (long-term EU residence permit), or refugee or subsidiary protection status.[9]
With an ordinary work permit you usually cannot take part in public concorsi. Apply for the long-term permit as soon as you meet its conditions.
Public jobs give strong protection: fixed working hours (36 a week under the health contract), paid leave and career steps.[11]
Private sector
Care homes, cooperatives, private clinics and home-care services can hire you with any valid permit that allows work. First contracts are often fixed-term, but because of staff shortages, many employers offer permanent contracts to keep good workers.
Keep copies of your attestato and all your contracts. They prove your experience when you apply for better jobs or for the long-term permit.
Career growth: assistente infermiere
In 2025 Italy created a new role, the assistente infermiere (nursing assistant). It is open to qualified OSS workers who complete extra training, and it allows some additional health tasks under a nurse's direction.[15]
Regions are still setting up these courses. Getting your OSS qualification now prepares you for this next step. Some OSS workers with an upper-secondary diploma later study nursing at university.
Official sources
- Gazzetta Ufficiale – DPCM 25 March 2025, revision of the OSS profile (GU no. 142, 21 June 2025)
- Regione Lombardia – Operatore socio-sanitario (OSS)
- Regione Emilia-Romagna – Implementing rules for OSS training under the 3 October 2024 agreement
- Regione Friuli Venezia Giulia – OSS initial training courses (1,000 hours) 2025/2026
- Ministero degli Affari Esteri – Recognition of foreign qualifications and Dichiarazione di valore
- Ministero dell'Istruzione – CPIA adult education courses (public notice)
- Conferenza delle Regioni – Document on demographic change (February 2026, ISTAT data)
- Ministero del Lavoro – Excelsior bulletin, May 2025
- ATS Brescia – Public competition notice showing access rules for non-EU citizens
- CCNL Comparto Sanità 2022–2024 – full text signed at ARAN on 27 October 2025
- Money.it – Summary of the CCNL Sanità 2022–2024 pay tables (press source)
- Dequo – CCNL Cooperative Sociali levels and pay tables (press source)
- ENGIM Lombardia – OSS course information sheet (example of a Lombardy course)
- Fondazione Enaip Lombardia – OSS course information (example of a Lombardy course)
- Conferenza delle Regioni – DPCM 28 February 2025 creating the assistente infermiere profile
This article is general information, not legal advice. Rules and pay change, so always check with your region, your course provider and your employer.