An innovative toolbox to develop and evaluate a Personal Budget system together with chronic care stakeholders in Flanders and in Europe

Abstract

In Flanders (the northern part of Belgium), as in many other countries, care and welfare policy for people with chronic care and support needs, such as people with disabilities (PwD), is undergoing a large-scale transformation from a service-centred to a more user-centred approach. This transformation is largely driven by the United Nations Convention on the Rights of People with Disabilities (UNCRPD), which promotes the autonomous practice of decision-making by PwD and the self-management of their care and support.
 An innovative way to foster this self-management is through user-centered funding models, such as Personal Budgets (PB), in which a public authority distributes funds directly to PwD, thereby helping them to personalize and actively organize the services they need for their own care and support needs. Flanders is considered a pioneer in such a PB system, which has been implemented since 2017, after a participatory process involving various stakeholders, such as PwD. The Flemish system consists of 2 stages: a first stage of directly accessible support and/or a care budget for people with relatively limited support needs. And a second stage for people with higher support needs that can apply for a PB. This budget allows them to self-manage their support, with access to both regular and disability-specific services.
 Following the implementation of PB the Flemish Agency for People with Disabilities (in Dutch: VAPH) is currently searching for both objective and participatory approaches to evaluate this system. This is why VAPH has been an active partner in the European UNIC project since 2020. The UNIC project is developing, with the financial support from the European Union Programme for Employment and Social Innovation, a toolbox to support the design, implementation, evaluation and compliance of PB. The toolbox consists of three online tools that use the UNCRPD as a framework for the goals of long-term care and support. The tools are developed with three target groups in mind, namely:
 1) Quality Monitoring Tool (QMT) to support PwD to self-assess the impact of their personal budget on their quality of life and to evaluate the PB system they receive.
 2) Service Delivery Tool (SDT) to help service providers evaluate the services they provide, and work towards the delivery of more rights-based and person-centred services.
 3) Compliance Assurance Tool (CAT) to help public authorities improve their policies around long-term care using PB systems.
 During the development phase in 2022, the tools were piloted in Flanders through interactive workshops with participants from the three different target groups who were encouraged to provide extensive feedback. The VAPH is thus co-producing the system of PB as well as its evaluation together with relevant stakeholders. In this presentation we want to present the UNIC toolbox as an example of how stakeholders can be included in a process of mutual learning to support the take-up and scale-up of personal budgets. This presentation aligns with conference theme 2 “Person-centred care: focus on integration of goals and needs”.