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Use of personal assistance has gradually increased since this service was laid down in the Social Services Act in 2000. Today, this service is provided for over 2 000 persons. However, there is great variation in the extent of the services offered by municipalities. There are still about one hundred municipalities that do not provide client-managed personal assistance, even though surveys have shown that clients are generally very satisfied with the arrangement.

However, the Offices of the County Governors receive quite a lot of complaints about this service each year. The complaints are mainly about rejection of an application for a personal assistant, and about the number of hours allocated – that the amount of assistance provided is inadequate to meet the client’s needs.

In 2007, the Norwegian Board of Health Supervision collected available information about client-managed personal assistance. At the same time, the Ministry of Health and Care Services has put forward a proposal for changes to the legislation, with the aim of reducing differences between municipalities in the allocation of personal assistance, and of improving the range of services available and client participation.

It is too early to know whether changes will be made to the arrangement, and what kind of changes. A relevant recommendation is that supervision should focus on the following: that client-managed personal assistance should be provided in accordance with sound professional and ethical standards, and that this service should be given high priority.

In many ways, client-managed personal assistance is a special service. The provider and the client are often alone together for many hours in the week in situations that are private and personal. Clients with mental handicaps can be extra vulnerable if the service does not function as intended. Many of these clients are completely dependent on assistance in order to be able to live at home.

Employer and leadership responsibility for client-managed personal assistance can be organized in different ways. However, as provider of the service, the municipality has responsibility for ensuring that these services are provided in accordance with statutory requirements. The municipality also has a duty to ensure that the services meet sound professional standards. The County Governors are responsible for carrying out supervision to see whether the municipalities meet these requirements. The Norwegian Board of Health Supervision will identify areas where there is a danger that the services may be deficient.