ABSTRACT

In direct-funded attendant services, public funds are transferred to service users to recruit, hire, train, and manage support staff. An outcome of activist efforts to deinstitutionalize support services, direct funding models are often said to increase the choice and control that disabled people have in their attendant services and in everyday life. Focusing on one direct funding program in Ontario, Canada, the overarching reflexive ethnographic study explored the work that physically disabled adults contribute to organize and manage their own attendant services. In this paper we present a secondary analysis of qualitative interview data, examining the impact of participation in direct funding on service users’ occupational engagement. The results of this analysis suggest that direct funding promotes occupational rights by providing supports needed to participate in a range of meaningful occupations. At the same time, occupational engagement was found to be constrained at individual and group levels. In this paper we apply occupational justice concepts to analyze systemic constraints on occupational engagement and occupational choice, including program eligibility criteria and societal factors that condition access to and use of public resources. The discussion highlights how direct funding can support occupational engagement and constrain occupational choice, illuminating the complexity of occupational justice as a dynamic concept that may be promoted and obstructed simultaneously within a given context. We situate direct funding within an ongoing history of institutionalized supports for disabled people and identify specific factors that may promote or inhibit the occupational rights of disabled people who use direct-funded attendant services.

摘要

在直接资助的陪同服务中，公共资金被转移给服务用户，以招募、雇用、培训和管理支持人员。作为将支持服务去机构化的激进主义努力的结果，人们通常认为直接资助模式增加了残疾人在其服务和日常生活中的选择和控制。以加拿大安大略省的一项直接资助计划为重点，这项全面的反思民族志研究探索了身体残疾的成年人为组织和管理他们自己的服务人员所做的工作。在本文中，我们对定性访谈数据进行了二次分析，研究了参与直接资助对服务使用者职业参与的影响。该分析的结果表明，直接资助通过提供参与一系列有意义的职业所需的支持来促进职业权利。同时，发现职业参与在个人和群体层面受到限制。在本文中，我们应用休闲正义概念来分析对休闲参与和休闲选择的系统性约束，包括计划资格标准和限制公共资源访问和使用的社会因素。讨论强调了直接资助如何支持休闲参与和限制休闲选择，阐明休闲正义作为一个动态概念的复杂性，在给定的背景下可以同时得到促进和阻碍。