62. In recent decades, many high- and middle-income countries have shifted their support policies towards personalization, to enable persons with disabilities to hire the support they require within the existing market. Different models of personalization have been implemented, including direct payments and personal budgets. While these models can potentially empower persons with disabilities, States need to adopt a set of measures to enhance their effectiveness. Such measures include, for instance, building the capacities of beneficiaries to manage their own funding and support (including supported decision-making); having a wide range of providers that respond to the diversity of support needs, particularly for those who live in rural and remote areas; preventing precariousness in the work conditions of supporters; and avoiding channelling personal budgets through the family rather than directly to the persons with disabilities, and the feminization of support.¹⁹ It is important to note that allowances that are paid directly to “informal carers” of adults with disabilities can compromise the capacity of persons with disabilities to exercise choice and control over their support. Support to families should never replace support to individuals.
¹⁹ Evidence also shows that, if well designed, personalization schemes can increase the protection of those who provide support, both in the formal and informal sector. See Kirstein Rummery, “A comparative analysis of personalisation: balancing an ethic of care with user empowerment”, Ethics and Social Welfare, vol. 5, No. 2 (2011), pp. 138-152.