Personalized budgets and direct payments

Personalized budgets and direct payments Conference Sofia May 2007

Aspects • First ideas and first reactions • Payment and bottlenecks • Positions and discussions • Stake-holders views • Accepted models • Perspectives

First ideas and first reactions • Panacea • Threat • Black economy • Grandma in the coal-shed • Unemployment • Overspending • Cost-reduction

Payments and bottlenecks(1) • Services paid by governments • Part of social security • Based on: bed, place • Three parties: user, provider, third paying • Own contribution • Limited or no influence

Payment and bottlenecks (2) • Paradigm changes to be cashed • Specialised services • Differentiation • One bed: 15 users • Increasing special needs • Governments stepping back • Market-orientation

positions • No patronizing • Jetzt entscheide ich selbst • I am the boss • Wie betaalt bepaalt • The might is the right • Avoir c’s pouvoir

Discussions • No doubt about the paradigm • Equal rights and participation accepted • But what about the consequences • Are we ready for changing the system

Stake-holders (1) Service providers: • We know what is needed • Mission impossible • Complicated • Not a free market • Users capable? • Staff?

Stake-holders (2) Governement: • Support service-users • Market • Black money • Employment • Cost-reduction

Accepted models • Own budget • Voucher system • In natura • Payment on the basis of assessment • Care weight as basis • Integration budget

Perspectives • Accepted as consequences of the paradigm change • Increasing interest from all stake-holders • Challenging providers

Perspectvies • Inclusive services • Service providers as specialist • Special attention for special needs • Increasing number of participants • With drawing governments • More market regulation

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Personalized budgets and direct payments