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Open Access Kiezen voor een persoonsgebonden budget

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Choosing a personal budget: do differences in local policy concerning personal budgets lead to access inequalities?

Dutch municipal authorities have a statutory duty to offer people who apply for support (by way of the Social Support Act) a choice between receiving support in kind or in the form of a personal budget, but are free to set their own policy regarding who is offered a personal budget and how attractive the personal budget option is. This policy freedom may manifest itself in how actively local authorities inform applicants about the possibility of a personal budget, the level of personal budget rates and the support local authorities offer in administering the personal budget.

Earlier research has focused mainly on the characteristics of personal budget-holders (the micro-level). The present study not only considers the impact of those individual characteristics, but also investigates what impact differences in the policy on personal budgets between local authorities (the meso-level) has on how well informed people are about personal budgets and on the extent to which this form of support is chosen. In a structured verbal interview, we interviewed 1,026 applicants who had been ruled eligible for domestic help. Choosing a personal budget was an option for these applicants. The applicants lived in 70 municipalities for which we also had policy data, and we were therefore able to relate the data across the municipalities. Since we used a clustered sample (first selecting municipalities and then applicants within them), multilevel analyses were performed.

Older persons and people with a sudden onset disability were less often informed about the possibility of a personal budget than younger people and people with a gradually deteriorating disability. Higher educated people were more often informed than low-educated people. Other characteristics at individual and policy level had no influence on the extent to which people were informed about the personal budget. The degree to which people opt for a personal budget is explained mainly by the degree to which applicants were informed about this possibility. The inequality in choosing a personal budget between municipalities could be reduced relatively simply, by ensuring that people are properly informed.
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Keywords: Social Support Act; information provision; people with disabilities; personal budget

Document Type: Research Article

Affiliations: 1: Anna Maria Marangos is als wetenschappelijk medewerker verbonden aan het Sociaal en Cultureel Planbureau. 2: Mirjam de Klerk is als senior wetenschappelijk medewerker verbonden aan het Sociaal en Cultureel Planbureau. 3: Jurjen Iedema is als statistisch adviseur en wetenschappelijk medewerker verbonden aan het Sociaal en Cultureel Planbureau. 4: Peter Groenewegen is directeur van het NIVEL en bijzonder hoogleraar aan de Universiteit Utrecht, met als leeropdracht sociale en geografische aspecten van gezondheid en gezondheidszorg.

Publication date: September 1, 2014

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