Tracing the refinement of policy tools for disability rights : a content analysis of how the granting process of state-funded personal assistance in Sweden is aligned with the LSS Act

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.