Presuming or Building Capacity? Contractualisation, Matrices of Agency and the Position of Recipients in Local Welfare

This paper compares two sociomedical rehabilitation devices based on cash transfers, introduced in Italy under Law 328/2000, the voucher of Lombardy and the care budget of Local Health Authority Caserta 2 in Campania, and shows that in local welfare the same contractual form places recipients in opposite positions depending on the regulatory role of local public administration. Drawing on the sociology of policy instruments and on the economies of worth, it treats agency as a conventional criterion of evaluation and distinguishes four matrices of agency, market, domestic, civic and projective, each giving activation and contractualisation a different meaning. The voucher presumes the capacity to choose, grants exit without voice and lets providers turn away difficult cases, so it works for recipients who already have autonomy or family support. The care budget treats capacity as the goal of intervention and keeps a public third party inside an incomplete, continuously renegotiated contract. Administrative responsibility by process is the mechanism behind the difference; without a floor of enforceable rights, it slides into discretion and personal dependence. A postscript reads four later forms of contractualisation through the matrices: conditionality pacts in minimum income schemes, payment by results, personal and health budgets, and the coprogramming of services with the third sector. Whether a contract presumes or builds the capacity of recipients depends on three conditions: capacity treated as goal rather than premise, a public third party inside the contract, and a floor of rights beyond negotiation. The argument applies to recipients with low levels of autonomy in regionalised welfare systems.