The provision of high quality health and disability support services is essential to ensure that disabled people can achieve optimum participation in their community and have an ordinary life. Objective 7 of the Disability Strategy aims to create long-term support systems that centre on the individual, ensures their participation and are easy to access. Central government agencies involved in implementation activities are primarily the Ministries of Health and Social Development, and the Accident Compensation Corporation (ACC). These agencies fund service provision through District Health Boards and non-governmental organisations.

Deinstitutionalisation

• Deinstitutionalisation, begun in the 1980s, was completed in October 2006 with the closure of Levin’s Kimberley Centre.

Independent living

• Since 2001, an across-government review of long-term disability supports has focused on improving the non-ACC government-funded system so that the best outcomes are achieved for disabled people receiving supports. Disabled people, disabled people’s membership organisations, family caregivers and their organisations, and service providers have been involved.
• Since 2001, the Ministry of Health has provided additional funding to:
• Increase access to support services for people under 65 years of age with disabling chronic health conditions.
• Provide greater and fairer access to equipment and modifications.
• Increase funding for Ministry of Health and District Health Board funded home-based support services, to improve rates of pay for home-based support workers.
• Provide more respite services.
• The 2006 and 2007 Budgets allocated funding for long-term support services for people with chronic health conditions, which includes people with respiratory diseases, long-term cancer, organ failure such as renal or heart failure, dementia, obesity, epilepsy, and chronic fatigue syndrome.
• Since 2006 the Ministry of Health, District Health Boards and ACC have been working to improve the quality and safety of home based support services, in collaboration with providers and unions.  The focus was initially on pay and conditions but has broadened to career pathways, competencies, training, and quality and safety.
• A prioritised routine audit programme was undertaken over 2004/2005.  The Ministry of Health commissioned 158 routine audits of contracted providers of residential services and Supported Independent Living Services.  All audits included a consumer representative as part of the audit team.
• At the end of 2006 the Ministry of Health began trialling a Personal Outcome Measure evaluation tool in community homes for persons with an Intellectual disability.  Feedback to date has been positive and the tool is giving a much better picture of the quality of life for those living in the services.
• Work began in August 2005 to create an assessment and training framework for the national certificate for home based support service workers. The first phase, which concluded in June 2007, established, implemented and trialled the framework with targeted workers employed in home based support services funded by the Ministry and District Health Boards.
• The Ministry of Health began contracting in 2005 with a disability organisation, Manawanui-In-Charge, to provide an individualised funding service. This is an administrative arrangement for some disabled people that allows them to hold, manage or govern their own needs-assessed disability support budgets.
• In the past year the Ministry of Health has focused on adopting a nationally consistent approach to purchasing supported independent living. This has resulted in the introduction of a national service specification and guidelines.
• From August 2006, ACC began to put in place a new rehabilitation framework, to ensure its approach was client centered and more integrated with other agencies and the community.

Partnership with disabled people

Activities which involve disabled people and the wider sector include:

• The Ministry of Health’s Consumer Consortiums, to provide advice and input into disability services planning and work activities and then Ministry of Health’s Non-Government Organisation Forum, ACC’s Serious Injury Reference Group and District Health Boards’ Disability Support Advisory Committees.

Score card for improving disability supports

The outcomes framework developed for this review has been used to measure progress in improving disability supports.  Since 2001, implementation activities by central government agencies to improve disability support services have focused primarily on increasing understanding. There is some evidence of involvement of disabled people and removing barriers to participation, but further work can be done. In terms of maximising opportunities for disabled people, it is expected that the findings of the Review of Long-term Disability Supports will inform this area.