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What are the important features of a national policy on personal assistance that is to promote "living independently and being included in the community" "with choices equal to others" and to enable persons with disabilities to fulfill their duties and to enjoy their rights as citizens? The presentation identifies the elements of the Swedish Personal Assistance Act of 1994 that have contributed most to the outcome of this widely acclaimed legislation.

I: Institutet för Independent Living. 1993. "Hemtjänst i omdaning - möjligheter och decentraliseringens och privatiseringens tid, Dokumentation av STIL-hearing Stockholm 1993." Internet publication URL: www.independentliving.org/docs3/stil1993.html#vad (In Swedish.)

Direct Payments for Personal Assistance make demand-driven services possible that promote freedom of choice and quality. Supply-driven services, on the other hand, are often monopolistic in-kind services that force users to adapt their lives to the needs of the service provider. The Swedish Personal Assistance Act of 1994 is an example of a Direct Payments policy. Its outcome is discussed as well as its implications for the national economy in times of economic crisis.

In his keynote address Adolf Ratzka delineates the origins of STIL, the Stockholm Cooperative for Independent Living owned and mainly run by Personal Assistance user themselves providing services to its members. Personal Assistance is here depicted as an example of demand-driven as opposed to supply-driven services which, according to the text's analysis, would explain the differences between these services in terms of quality and cost efficiency.

Presentation at National Conference, Commission for Equal Rights of Persons with Disabilities, Beer Sheba, Israel, December 1 2010

 Ansökan till Arvsfonden, inskickad juli 2016. Det finns mindre revideringar och kompletteringar som gjordes senare. Vi har inte översatt denna till engelska än (There is currently no english translation). 

Ledare ur STILETTEN Nr. 1 1993. I: Institutet för Independent Living. 1993. "Hemtjänst i omdaning - möjligheter och decentraliseringens och privatiseringens tid, Dokumentation av STIL-hearing Stockholm 1993." Internet publication URL: www.independentliving.org/docs3/stil1993.html#11 (In Swedish.)

Against the backdrop of the impact of the current economic crisis on persons who depend on practical assistance by other persons with the activities of daily living the author outlines arguments for direct payments for Personmal Assistance services. These services are demand driven, superior in quality and cost-efficiiency to supply driven services such as residential institutions and support the United Nations Convention Article 19 "living independently and being included in the community".

Människor som förvärvar sitt funktionshinder efter 65 år missgynnas i jämförelse med de som får en funktionsnedsättning i yngre år: enligt den nuvarande lagen om assistansersättning (LSS) kan de inte få assistansersättning som skulle förbättra deras livskvaliet enligt Adolf Ratzka, verksamhetsledare för Independent Living Institute. Personlig assistans är så mycket billigare per timme än kommunal hemtjänst och andra kommunala insatser och samtidigt så mycket effektivare, hävdar debattartikelns författare, att man borde räkna på de samhällsekonomiska effekterna av att utöka rätten till assistansersättning till alla människor med assistansbehov oavsett ålder eller personkrets.Artikeln publicerades först i Social Vetenskaplig Tidskrift Årgång 21, Nummer 3-4, 2014

Open mic event on the Rights of Persons with Disabilities ”Human Rights: a reality for all persons with disabilities?” European United Left/Nordic Green Left European Parliamentary Group European Parliament, Brussels October 17, 2018

Adolf Ratzka, Independent Living Institute, presented at the Second International Conference on Personal Responsibility on the Way to Social Change organized by Jerusalem Center for Independent Living December 2, 2010

I: Institutet för Independent Living. 1993. "Hemtjänst i omdaning - möjligheter och decentraliseringens och privatiseringens tid, Dokumentation av STIL-hearing Stockholm 1993." Internet publication URL: www.independentliving.org/docs3/stil1993.html#13 (In Swedish.) 

United Nations Human Rights, Office of the High Commissioner, Europe Regional Office convened a meeting in Brussels on May 7 2012 "CRPD and EU Structural Funds: The way ahead for Independent Living" to raise awareness about the violation of CRPD Article 19 "Living independently and being included in the community" by using EU Structural Funds for the construction and maintenance of residential institutions. The paper shows how demand-driven direct payments for Personal Assistance services, not only achieve far superior quality of services than residential institutions resulting in higher quality of life for service users at lower costs but also affect a country's economy more favorably. Thus, violating Article 19 of the CRPD is not only illegal but also wasteful in terms of human and monetary capital.

For the "International Survey of Personal Assistance Schemes." Internet publication URLs: www.independentliving.org/docs1/ratzka1998lass.html and www.independentliving.org/panetwork/questionnaire.html

Internet publikation URL: www.independentliving.org/taxi/ratzka20031005.html (In Swedish).  

In this presentation Dr. Adolf Ratzka emphasizes that city and housing planners still do not pay sufficient attention to barrier-free housing for people with disabilities and proposes the goal of general accessibility in the housing stock, in both new construction an renovation. Drawing on Swedish experience he claims that general residential accessibility would also imply savings to society in the form of lower costs due to fewer residential accidents particularly in the older population.

I: Institutet för Independent Living. 1993. "Hemtjänst i omdaning - möjligheter och decentraliseringens och privatiseringens tid, Dokumentation av STIL-hearing Stockholm 1993." Internet publication URL: www.independentliving.org/docs3/stil1993.html#1 (In Swedish.)

Given the increasing number of older persons relative to the working age population, record level taxes and baby boomers’ demands for self-determination and quality of life, which changes might the Scandinavian welfare model have to undergo in order to deliver long term care to all who need it? In Sweden, direct payments for personal assistance are paid to mainly younger persons with extensive disabilities. In terms of perceived quality and cost per hour of service, direct payments have been found to be more efficient than traditional local government services. But would this favorable experience hold for all persons in need of assistance with the activities of daily living – regardless of age, diagnosis and minimum needs? What would be such a policy’s cost and effects on the labor market? How could it be financed? Would it threaten younger disabled persons’ relative favorable present situation? Today’s Swedish policy of cash payments for the purchase of personal assistance services might be of interest as a long term care solution for tomorrow’s older persons.

Persönliche Assistenz ist eine hochqualitative und kostengünstige Alternative zu Wohneinrichtungen und ambulanten Diensten, laut Adolf Ratzka - eine Behauptung, die er mit den über 20-jährigen schwedischen Erfahrungen mit persönlicher Assistenz belegt. Den Hauptwiderstand gegen persönliche Assistenz in Deutschland sieht er in den Eigeninteressen der Wohlfahrtsverbände und dem noch weitverbreiteten medizinischen Bild von Behinderung.