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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".

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.

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.

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.

This article introduces blind and sighted men and women who developed education and employment for blind people in China and in India from the 1830s onward, and whose pioneering efforts have disappeared from later accounts of blind people's history. This revised and much extended online version is published in April 2011: www.independentliving.org/docs7/miles201104.html and www.independentliving.org/docs7/miles201104.pdf

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

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.

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

[This article cites and quotes historical materials first collected in: M. Miles (1996) Pakistan's microcephalic chuas of Shah Daulah: cursed, clamped or cherished? History of Psychiatry 7: 571-589, from Taylor & Francis, www.tandf.co.uk/] Evidence on microcephalic children (chuas) at the shrine, and how some of them developed a capacity for independent living. Internet publication URL: http://www.independentliving.org/miles201005.html

Internet publikation URL: www.independentliving.org/docs7/anderberg200710b.html (In Swedish.)

This article and the review comment were first published in “EPICADEC News” (from the Foundation Epilepsy Care Developing Countries, Leiden), October 2000, pp. 9-10, titled “Imran’s Djinn”. They are here reproduced with permission, after slight revision. The article concerns an Asian boy living in UK. His family had trouble using the health services, because of different concepts of Imran’s illness. One of Imran’s teachers met the family half way, respecting their beliefs and giving them time to digest a different approach to epilepsy and its treatment. A scientific reviewer comments on the story. Internet publication URL: www.independentliving.org/docs7/miles-christine2000.html

Revised version of a paper first published in the Zeitschrift Behinderung und Dritte Welt, 3/2003, pp. 96-106, and here reproduced with permission. International strategies concerned with disability in developing and transitional countries (DTC) are scrutinised critically, with an historical focus on beneficial traditions and practices in Asia and Africa, attesting the variety and complexity of social responses to disability. Internet publication URLs: www.independentliving.org/docs7/miles200701.html and www.independentliving.org/docs7/miles200701.pdf (112 KB).