Opportunità e limiti dell’applicazione del Personal Budget per persone con disabilità in prospettiva internazionale

The aim of this paper is to discuss the efficacy of the welfare action commonly known as the «Personal Budget», which stands for the development of reforms reorganizing the funds for social and health benefits, allocated directly to people with disabilities, allowing them to choose and pay for needed supports. The goal of this policy is to put people back in the center of the care process, releasing them from the passive role of «assistance receivers» in exchange for a pro-active role with broader decision-making margins. Achieving, therefore, the empowerment of the person with disabilities, who is given full control over the structuring and quality of the supports to be received. To discuss the efficacy of this welfare action, we conducted a systematic literature review of the topic, selecting both scientific articles and reports produced by national stakeholders. We thus analyzed to what extent, according to the explored literature, the Personal Budget is succeeding in making the health and social support for people with disabilities more individually tailored, in empowering them and thus, improving their quality of life. The scrutiny of the selected scientific literature highlights how the Personal Budget does not merely correspond to a reallocation of the economic resources available in favor of disability within a «cash-for-hire» care scheme, based on the liberal assumption that funding individuals directly gives them agency and that being a client is somehow more empowering than being a patient, but at the same time it does not seem to comply with the fundamental change in the paradigm of taking care of people with disabilities which was aimed for. Moreover, the empirical research articles published so far seems to suggest that the implementation of the Personal Budget determines a more precise needs-assessment for people with disabilities, allowing a personalized organization of supports, but does not ease the burden on their families.