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Purpose. To explore whether the personal assistance (PA) activities provided by the Swedish Act concerning Support and Service for Persons with Certain Functional Impairment in 2010 and 2015 promote participation in society according to Article 19 of the United Nations’ Convention on the Rights of Persons with Disabilities (UNCRPD). Methods. Register data and data from two questionnaires were used (N = 2565). Descriptive statistics and chi-square (McNemar’s test) were used to describe the basic features of the data. Mixed binominal logistic regression was used to examine correlation between gender and hours of PA between 2010 and 2015. Results. Despite an increase in the number of PA hours, more care activities and a reduction of most PA activities representing an active life were found. The result was especially evident for women, older people, and for a particular person category. Conclusions. The results offer evidence of a shift to a medical model and indicate a risk of social exclusion due to fewer activities representing an active life. An increase on average of 16 h of PA over the period studied does not guarantee access to an active life and may indicate a marginal utility. The noted decline of PA for participation in society enhances the importance of monitoring content aspects to fulfil Article 19 of the UNCRPD.

Purpose. To explore whether the personal assistance (PA) activities provided by the Swedish Act concerning Support and Service for Persons with Certain Functional Impairment in 2010 and 2015 promote participation in society according to Article 19 of the United Nations’ Convention on the Rights of Persons with Disabilities (UNCRPD). Methods. Register data and data from two questionnaires were used (N = 2565). Descriptive statistics and chi-square (McNemar’s test) were used to describe the basic features of the data. Mixed binominal logistic regression was used to examine correlation between gender and hours of PA between 2010 and 2015. Results. Despite an increase in the number of PA hours, more care activities and a reduction of most PA activities representing an active life were found. The result was especially evident for women, older people, and for a particular person category. Conclusions. The results offer evidence of a shift to a medical model and indicate a risk of social exclusion due to fewer activities representing an active life. An increase on average of 16 h of PA over the period studied does not guarantee access to an active life and may indicate a marginal utility. The noted decline of PA for participation in society enhances the importance of monitoring content aspects to fulfil Article 19 of the UNCRPD.

Purpose. To explore whether the personal assistance (PA) activities provided by the Swedish Act concerning Support and Service for Persons with Certain Functional Impairment in 2010 and 2015 promote participation in society according to Article 19 of the United Nations’ Convention on the Rights of Persons with Disabilities (UNCRPD). Methods. Register data and data from two questionnaires were used (N = 2565). Descriptive statistics and chi-square (McNemar’s test) were used to describe the basic features of the data. Mixed binominal logistic regression was used to examine correlation between gender and hours of PA between 2010 and 2015. Results. Despite an increase in the number of PA hours, more care activities and a reduction of most PA activities representing an active life were found. The result was especially evident for women, older people, and for a particular person category. Conclusions. The results offer evidence of a shift to a medical model and indicate a risk of social exclusion due to fewer activities representing an active life. An increase on average of 16 h of PA over the period studied does not guarantee access to an active life and may indicate a marginal utility. The noted decline of PA for participation in society enhances the importance of monitoring content aspects to fulfil Article 19 of the UNCRPD.

Purpose. To explore whether the personal assistance (PA) activities provided by the Swedish Act concerning Support and Service for Persons with Certain Functional Impairment in 2010 and 2015 promote participation in society according to Article 19 of the United Nations’ Convention on the Rights of Persons with Disabilities (UNCRPD). Methods. Register data and data from two questionnaires were used (N = 2565). Descriptive statistics and chi-square (McNemar’s test) were used to describe the basic features of the data. Mixed binominal logistic regression was used to examine correlation between gender and hours of PA between 2010 and 2015. Results. Despite an increase in the number of PA hours, more care activities and a reduction of most PA activities representing an active life were found. The result was especially evident for women, older people, and for a particular person category. Conclusions. The results offer evidence of a shift to a medical model and indicate a risk of social exclusion due to fewer activities representing an active life. An increase on average of 16 h of PA over the period studied does not guarantee access to an active life and may indicate a marginal utility. The noted decline of PA for participation in society enhances the importance of monitoring content aspects to fulfil Article 19 of the UNCRPD.

Purpose. To explore whether the personal assistance (PA) activities provided by the Swedish Act concerning Support and Service for Persons with Certain Functional Impairment in 2010 and 2015 promote participation in society according to Article 19 of the United Nations’ Convention on the Rights of Persons with Disabilities (UNCRPD). Methods. Register data and data from two questionnaires were used (N = 2565). Descriptive statistics and chi-square (McNemar’s test) were used to describe the basic features of the data. Mixed binominal logistic regression was used to examine correlation between gender and hours of PA between 2010 and 2015. Results. Despite an increase in the number of PA hours, more care activities and a reduction of most PA activities representing an active life were found. The result was especially evident for women, older people, and for a particular person category. Conclusions. The results offer evidence of a shift to a medical model and indicate a risk of social exclusion due to fewer activities representing an active life. An increase on average of 16 h of PA over the period studied does not guarantee access to an active life and may indicate a marginal utility. The noted decline of PA for participation in society enhances the importance of monitoring content aspects to fulfil Article 19 of the UNCRPD.

Purpose: To examine how the right to participation according to Article 19 of the United Nations’ Convention on the Rights of Persons with Disabilities (UNCRPD) is promoted by personal assistance use in Sweden across age, gender and eligible person categories. Method: Register data and data from a questionnaire were used (N¼15,289). Principal component analysis was performed and the internal consistency was tested. Descriptive statistics (v2 test) were used across age, gender and eligible person categories and components. Results: An uneven distribution of personal assistance across the components Health and Care; Home, Leisure and Social Interaction; and Daily Occupation was found. Significant differences in personal assistance reported were found between children and adults, men and women and between the three eligible person categories. Conclusions: The discrepancy between reported and expected outcome of personal assistance indicates that Article 19 of the UNCRPD has not been met. The unequal access to participation across age, gender and eligible person categories would seem to further signify that the Act concerning Support and Service for Persons with Certain Functional Impairments is promoting activities of a caring nature rather than fulfilling Article 19 of the UNCRPD, i.e. ensuring full participation in society., Avhandlingsarbete; Att styra rättigheter rättsäkert: Har socialförsäkringens implementering av personlig assistans uppfyllt LSS värdegrund för goda levnadsvillkor?

According to the Swedish LSS Act concerning Support and Service for Persons with Certain Functional Impairments, personal assistance (PA) aims to promote good living conditions for persons with disabilities. The Act is operationalised by a policy tool, i.e. an instruction by the Swedish Social Insurance Agency (SSIA) to grant PA-allowance. This study explores how this instruction is aligned with the LSS rationale and policy goals. Qualitative content analysis was conducted on a government bill preceding the LSS Act and the SSIA instruction of 1994 and 2019. The result shows that the SSIA instruction deviates from the LSS Act as follows: decreased access to community life, shift towards PA for basic health and care, lack of recipient support, and also increased requirements for control and granting criteria. The results also show that the medical and legal professions have a decisive and strengthened influence on the design of the SSIA instruction while the applicant’s ability to influence the PA-allowance granting process was weakened over time. Thus, the refinement procedures over time that may result in deviations from the original rationale and policy goals. This paper therefore illustrates the importance of maintaining continuous calibrations of policy tools towards original rationale and policy goals of social reforms to uphold compliance.

Personal assistance (PA) in Sweden, regulated by the Act concerning support and service for persons with certain functional impairments (LSS) aims to provide good living conditions for persons with severe functional disabilities. However, studies show increased support for medical and nursing care, i.e. a medicalisation of PA, instead of providing support to promote the PA user to live like others, namely working or studying. This paper aims to understand how this medicalisation of PA has developed. Thematic reflexive analysis of 15 interviews was conducted with public officials at the Swedish social insurance agency, responsible for developing and managing the PA-allowance granting-process. The results reveal that the medicalisation of the PA-allowance granting process has been possible because of external factors, including legal changes in the LSS Act, marketisation of PA services, changed policy priorities, inadequate monitoring of PA outcomes, as well as internal factors, e.g. the extensive complexity of the PA-allowance granting process and organisational pressure on the SSIA officials. This paper demonstrates that the PA medicalisation process constitutes a precarious risk of undermining the LSS policy goals; moreover, it states the importance of maintaining continuous understanding and discussion of the policy outcome over time to calibrate implementation efforts.