Unclear legislation leads to unequal support under the LSS
The Act concerning Support and Service for Persons with Certain Functional Impairments (LSS) aims to ensure that people with extensive disabilities can live their lives like anyone else. However, municipalities interpret and apply the Act differently, leading to a lack of equivalence and legal certainty. The Swedish National Audit Office therefore recommends that the Government take measures to amend and clarify parts of the Act.
The Act concerning Support and Service for Persons with Certain Functional Impairments (LSS) is a rights-based law that aims to ensure that people with severe disabilities are afforded good living conditions and full participation in society. For municipalities to fulfil this responsibility, the central government draws up laws and regulations, provides support and conducts oversight.
The Swedish National Audit Office has audited the central government’s measures regarding municipalities’ exercise of public authority under the LSS. The main conclusion is that parts of the LSS need to be amended and clarified.
“Numerous provisions of the LSS are broadly worded, allowing them to be adapted to people’s varying needs. While there are advantages to this, it also leads to municipalities interpreting and applying the LSS differently. This means that access to support is partly determined by where you live,” says Auditor General Christina Gellerbrant Hagberg.
The problem is exacerbated by the lack of guiding case law in the field. In addition, the open wording of the legislative history limits the National Board of Health and Welfare’s ability to provide guidance and support to municipalities.
All in all, these factors are deemed to have contributed to disparities in application and, in some cases, to persons with disabilities not receiving adequate support.
The Swedish National Audit Office also notes that municipalities need more central government guidance on legal requirements pertaining to the handling of LSS cases. Therefore, the National Board of Health and Welfare should do more to increase municipalities’ awareness of regulatory requirements and of how LSS cases ought to be processed.
“When support provided under the LSS doesn’t function as intended, it can have major implications for persons with disabilities and their families. It can also lead to increased costs in other sectors of society, such as health care, social services and schools,” says Karin Gavelin, Project Leader for the audit.
Furthermore, the Swedish National Audit Office notes that the Health and Social Care Inspectorate’s (IVO) oversight of municipalities’ handling of LSS cases is very limited. Increased oversight by IVO would help ensure that problems in this field are identified and remedied, while also raising awareness of legal requirements. In the long term, this could lead to improved legal quality of municipalities’ handling of LSS cases.
Recommendations
The Government is recommended to take steps to amend and clarify certain provisions of the LSS to create conditions for greater equivalence and better quality in municipalities’ implementation of the Act and to ensure that the support provided is fit for purpose.
The National Board of Health and Welfare is recommended to improve support for municipalities’ implementation of the LSS, for example by completing the planned handbook for the processing of LSS cases for adults, and to provide more support to municipalities in interpreting applicable law under the LSS.
LSS: The Act concerning Support and Service for Persons with Certain Functional Impairments (1993:387)
The LSS is a rights-based law that aims to ensure that people with severe disabilities are afforded good living conditions and full participation in society.
There are ten forms of assistance under the LSS: advice and other personal support, personal assistance, companion service, a contact person, relief service in the home, short-term stays outside the individual’s own home, short-term supervision for school-age children over 12, accommodation in family homes or housing with special services for children and young people, housing with special services for adults or other specially adapted housing for adults, and daily activities.
Support measures under the LSS are carried out by municipal, regional or private providers. The central government provides direction through laws and regulations, knowledge resources and oversight.
Assistance in the form of advice and other personal support and personal assistance have not been in focus in this audit.