A/HRC/34/58 59. Decentralizing the provision of support is a major challenge for many States. Contributions to the present report illustrate that where responsibility for the provision of support has been delegated to regional or local authorities, support is often underfunded and fragmented, allowing for regional disparities and inequitable access within the country. This situation gives persons with disabilities little certainty and limited choice of or control over support services and arrangements. States should enhance their internal coordination mechanisms to address support needs in a comprehensive manner, ensure that regional and local authorities receive adequate budget, and implement and monitor the provision of support services effectively. Persons with disabilities should be able to retain the support they receive when they move to another region in their country. 2. Service delivery arrangements 60. Support is usually delivered by a mixture of providers, including State agencies, private organizations, non-profit organizations, charities and families. In high- and middleincome countries, States have traditionally been the main source of formal support, either through their centralized health-care or social protection systems or through local authorities. In many cases, States fund and contract non-profit organizations and private organizations to carry out these interventions. In low-income countries, charities and international non-governmental organizations are the main providers of formal support, often with limited sustainability and low standards of quality. Regardless of the type of service delivery arrangement, States have an obligation to ensure that persons with disabilities have access to and receive quality services and adequate support, including when service provision is delegated to non-profit organizations and private actors. In such cases, States must adopt a comprehensive regulatory and monitoring framework that involves a due diligence obligation. 61. In the light of article 19 of the Convention on the Rights of Persons with Disabilities, States must adopt a community-based approach to the provision of support, either directly or through intermediaries. Such an approach enables stakeholders — family, friends, neighbours, peers and others — to play a significant role in supporting persons with disabilities in daily life activities and participating in the community. This allows the provision of culturally sensitive services in the communities where persons with disabilities live, building on existing social networks and community resources. In the case of indigenous peoples, for example, community-based approaches could reduce the risk of assimilation. When services are not made available within the community, there is limited participation by persons with disabilities in their design and provision, and there is an increased risk of segregation and institutionalization. Importantly, by benefiting from local skills and resources, community participation in the provision of support facilitates the optimal and efficient delivery of services, enabling a cost-effective policy response in countries with limited resources. 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 decisionmaking); 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 15