Strategies of austerity used in needs assessments for personal assistance – changing Swedish social policy for persons with disabilities

Abstract

The austerity measures in social welfare implemented by street-level bureaucrats in their practice are changing the direction of social policy. This article examines the strategies used by public officials in implementing austerity measures in needs assessment for personal assistance in Sweden. The article is based on a document study with N = 100 records of needs assessment for personal assistance for persons with serious functional disabilities. Findings show that the public officials at the Swedish Social Insurance Agency either limit or extend their discretion as a strategy, as well as use weak warrants as strong warrants in recommending decisions. Other strategies involve the organisational logic, fragmentation of the content in the needs assessment and division of work among the public officials. Implementing the costcutting goals causes severe consequences for persons with disabilities who bear the brunt by being excluded from participation in society. The social policy values of fifty years, emphasising the right to equal participation in society, are traded for economic austerity goals.

Disability, Justice and Freedom as Non-Domination

“…Although the law remained unchanged in Sweden, the number of people being granted personal assistance has dropped in recent years, following a stricter interpretation of the entitlement criteria stipulated by the law. 62 Similarly, few plaintiffs in the U.S. have won their cases under the ADA because of the court's narrow interpretation of the term 'disability'. 63 As indicated by these examples, the definition of the category 'disabled people' is a hot potato in disability politics and interpretations can vary if they are not guided by clear principles of justice.…”

”Tur att jag inte blev omprövad i år” – Samtal om ett villkorat liv med personlig assistans

“…Den nya definitionen av grundläggande behov har medfört att personlig assistans kommit att framstå som ett kroppsligt och medicinskt inriktat stöd (Brennan et al 2016). Därtill har personlig assistans har kommit att konstrueras som ett kostnadsproblem vilket legitimerat nedskärningar och besparingar (Altermark, 2017;Berggren et al, 2019).…”

“…Personlig assistans är centralt för att förverkliga mänskliga rättigheter (Brennan et al, 2016). Förändringar av rättspraxis, medicinska tolkningar av stödbehov och återkommande omprövningar äventyrar rättssäkerheten och är inte i linje med gällande konventioner och funktionshinderpolitiska mål (Brennan et al, 2016;Berggren et al, 2019;Bäckman, 2013). År 2018 stoppades de så kallade tvåårs-omprövningarna.…”

“…Diskursen om personlig assistans som ett kostnadsproblem har växt sig stark under det senaste decenniet, med neddragningar som följd (Altermark, 2017). Denna diskurs har också påverkat handläggningen och Berggren et al, (2019) finner att försäkringskassan vägleds av besparingsmål snarare än funktionshinderpolitiska mål. Vidare har krav på besparingar föranlett omprövningar som innebär att rättssäkerheten brister (Bäckman, 2013).…”

Crip-femme-ininity

“…My reasoning on the critical potential of crip femme-ininity takes its painful points of departure from austerity politics in Sweden and the U.K., which has rendered dis/abled people poor, housebound, dependent on family and friends and in the worst case dead. Järkestig Berggren et al 2019;Ryan 2019). From this point of departures, access to adequate support for performing the techniques of everyday life, such as dressing and undressing and personal hygiene, are human rights for dis/abled people under the UN Convention on the Rights of Persons with Disabilities (2007) (cf., Ryan 2019).…”