Autonomy and Community Inclusion through French Disability Rights Law: Contrasting the Rights Paradigms of France and the U.S

Background and Purpose:  Adults with disabilities who require support for daily living have often been segregated and socially isolated in institutions, unable to choose their living circumstances. Disability rights laws enacted in France (2005) and the U.S. (1990) identify self-determination and community living as rights. However, with the same goal, the implementation structure of the laws is different. Using Alsace, France as a case example, the primary focus of this study is the structure and local implementation of the community living component of the French law, with attention to paradigm and cultural context. The secondary focus is comparison with U.S. disability policy with the same aim. The main questions were: (1) how are autonomy for housing and community inclusion defined in the law and by key local stakeholders? (2) what techniques are used to facilitate autonomy and community inclusion? (3) what are the facilitators and barriers to achieving the goals? and (4) which differences between French and U.S. approaches offer useful insights to both countries?

 Methods:  The policy analysis uses a review of literature and key informant interviews. Published articles, French and EU government documents, reports by French disability associations, and news reports were gathered and synthesized. In Alsace, 19 key informants were interviewed using an interview guide. Informants represented local government offices responsible for implementation, social service personnel in agencies that operate different types of residential settings or support people in their homes, and advocates who also are people with disabilities or family members. Interviews were conducted in French with two interviewers present. Afterward the interviewers compared and discussed their notes for consistency. Similar U.S. materials were reviewed, and 4 key informant interviews in New York State were conducted by one of the authors. Interview notes were shared and discussed with the other author. The analysis triangulated across the information from interviews and the literature.

 Results:  The consensus from respondents and the literature indicated that in France autonomy is defined by the ability to determine living circumstance, not by the living setting. Congregate living is used, but the focus is on creating smaller settings. The French disability rights law includes non-income tested money for accommodations, home modifications, and personal assistance to realize the right to live in the community. Eligibility and benefit amounts are controlled by Départementale offices. Concerns about insufficient openings to meet needs, limits on authorized benefits, and inaccessible housing and transportation are present, but activism is not a common tactic for change.

 Conclusions and implications:  The French rights law creates the means to exercise choice; in the U.S. the right to inclusion is not coupled with financial means to facilitate it. In France, there is less focus on advocacy to push government and private compliance; in the U.S. government enforcement is evident, and activists engage in advocacy and legal action. The differences reflect national cultures, but stimulate consideration of methods to achieve community living for people with disabilities. The different roles of social workers in each nation suggest alternative ways to provide support.