Flanders’ Personal Assistance Budget
- FLEMISH GOVERNMENT DECREE ON THE PROCEDURES FOR GRANTS (PERSONAL ASSISTANCE BUDGET) TO PERSONS WITH DISABILITIES
- VAPH - Flemish Agency for Persons with Disabilities
- Country of Implementation
- Western Europe
- First published
“Only thanks to my personal assistance budget am I able to keep on doing what I do now: going to work and being a father and a husband.” Peter, a PAB user
Context: In general, the Flemish Government funds licensed service providers for the number of persons with disabilities they assist, treat, and care for. Service users have no influence or control over the support and its organization. If the service user wants to leave the service, he or she loses funding and support, and is put on a waiting list. In 1987 some Flemish pioneers with disabilities founded Independent Living Flanders, which raised awareness about the abilities of individuals with disabilities and their need for personal assistance. In 1997 the first pilot Personal Assistance Budget project was started in Flanders with 15 persons with disabilities. As a result, in 2000 the Flemish Parliament approved the PAB decree. In 2000, the Belgian Flemish Region approved Personal Assistance Budgets (PAB). Similar to Swedish law, the most important feature of a PAB is that the person with disabilities (or their representatives) controls both the assistance and the assistance budget, not the assistance provider. The budget holder decides who works as an assistant, for which assignments, at what time, and where and how the assistance will take place.
The support that persons with disabilities receive is often based on the charity model and not on human rights. In Flanders persons with disabilities can chose to receive a Personal Assistance Budget, which allows them to fully control the support they receive.
Solution, Innovation and Impact
The Flemish Agency for People with a Disability (VAPH) administers the Personal Assistance Budget, which is financed by the Flemish Ministry for Welfare. Unlike Sweden, the application for a PAB is open to all persons with disabilities below the age of 65 who are on file at the VAPH. However, the yearly budget allocated by the Ministry limits the total number of PAB users. A multi-disciplinary team assesses and decides the yearly budget each user receives, depending on his or her support needs. Reassessments are possible once a year. The person concerned has freedom of choice in whom and how to employ assistants, in respect to relevant laws and regulations. The VAPH monitors correct spending of the PAB and has the power to inspect the use of the budget. An alternative to institutionalization Personal Assistance Budgets provide an alternative to the institutionalization of children and adults with disabilities and enable these individuals and their families to live and participate in the community, as set out in article 19 of the UN Convention on the Rights of Persons with Disabilities. Self-determination Since PAB users are free to determine and organize their own assistance and care corresponding to their needs and preferences, the budget enables them to make their own life choices and to develop their personal talents. - The PAB has greater cost-effectiveness and a better impact on quality of life compared with care-in-kind, according to existing research. - 6,000 people are currently on the PAB waiting list. -Parliament recently approved a decree whereby financing follows the service user, which expands the self-determination of the PAB to all people with disabilities, including those receiving care-in-kind.
Funding, Outlook and Transferability
The PAB is transferable to all countries. It has been successfully used by persons with a variety of disabilities, with support from disability organizations. Similarly to Sweden, existing research indicates that the PAB has a greater cost-efficiency than supply-driven support.