Improving disability supports
Read about what the government is doing to improve disability supports used by disabled people.
Enabling Good Lives - the independent working group report on 'Day Options' to the Minister for Disability Issues August 2011
In 2011, the Minister for Disability Issues, Hon Tariana Turia, invited the Ministries of Social Develoment and Health to work with an independent working group of disability sector stakeholders to develop a ‘clean sheet‘ approach to community participation and day services for disabled people. The process of meetings and discussions over several months was facilitated by the Office for Disability Issues. The report from the independent working group was completed in August 2011. In October 2011, Minister Turia asked officials to engage with the disabiltiy sector on how to take the "Enabling Good Lives" approach further.
The Ministries of Social Development and Health have been developing ways to test the "Enabling Good Lives" approach in Wellington, Christchurch and Hamilton in consultation with disability sector organisations.
Ministry of Health's new model for disability supports
In July 2010, Cabinet approved the Ministry of Health's new model for disability supports. The Ministerial Committee on Disability Issues expects that other government departments providing or funding disability supports will align their services with the new model over time.
Social Services Select Committee report - inquiry into the quality of care and service provision for disabled people
In September 2008, the Social Services Select Committee concluded its inquiry into the quality of care and service provision for disabled people.
The inquiry was prompted by concerns raised in the media about two major residential service providers and by more generally expressed dissatisfaction with current service provision. The issues raised with the Committee were not new.
The Committee has made a number of recommendations that can be grouped under the following themes:
- enhancing leadership and accountability structures
- improving advocacy and complaints processes
- improving the monitoring of services
- improving the way people access information and supports
- ensuring services fill identified gaps, are age-appropriate, and enhance consumer choice
- developing a disability sector workforce strategy.
The Committee recommended a lead agency be appointed to provide leadership and accountability. Another idea canvassed by the Select Committee was Local Area Co-ordination, which operates in Western Australia. This model is based on principles relating to self-sufficiency, self-determination, and relationships with family, whanau, friends and the community. Once a person's requirements for a 'good life' are established, they are helped to access services to help them live that life, rather than determining and providing specified services for disabled people. This approach is demonstrably capable of achieving significant benefits for a large number of people, while having relatively low infrastructure and operational costs. Its application could be explored further.
Government's response to the Inquiry's recommendations
On 9 February 2009, the Government released its response to the Select Committee's report.
There are two broad approaches to the Government’s response. For the majority of recommendations the response indicates that further work is required before the Government can make decisions on the particular steps it will take, as the recommendations are wide ranging and have significant implications for a range of government agencies and disabled people. The Government’s ability to respond to some of these recommendations is also affected by the need to consider the results of consultation processes before taking decisions. This particularly affects the recommendations relating to the Health and Disability Commissioner and the Health and Disability Services (Safety) Act 2001.
In other cases, however, the Government has already implemented several responses that are consistent with the Select Committee’s recommendations, or is expanding and modifying its existing work programmes so that they are consistent with the Select Committee’s recommendations.
The Government expects to progress the substantial work programme outlined in this response during 2009. The scope of issues to be considered, however, means that the Government will need to prioritise the order in which it considers issues. In doing so, the focus will be on steps that make the biggest difference to disabled people through enabling them to live an everyday life and to have increased control and choice over what they do. The current fiscal climate means that the immediate focus must be on using existing resources in more cost-effective ways rather than on major structural change or increased levels of funding.
The Government Response to Report of the Social Services Committee on Inquiry into the Quality of Care and Services Provision for People with Disabilities, presented to the House of Representatives.
Review of long-term disability supports
The Office for Disability Issues completed a review of long-term disability supports in August 2007. The review looked at how to enhance the provision of disability support services so they improve the outcomes for disabled people and their families. A particular focus was on how to make such services simple to access, seamless and more equitable.
Consultation around the development of the New Zealand Disability Strategy in 2000/2001, and since then, has raised many issues about the way disability supports are provided. From government's point of view there are overlaps, gaps and areas for improving administrative efficiency. From the perspective of disabled people and their families disability supports are complicated to access, inflexible and inequitable (across age groups, geographical areas, cause of impairment, type of impairment, and funders).
We can make good gains by improving access to services, by simplifying assessment processes, and by replacing rigid service categories (for example, 'gardening' or 'home help') with services determined by whatever the person wants support with.
The review noted the issues described above stem from incremental service and policy development and from differences in the fundamental purposes and philosophy of the various sector agencies. Responding coherently and consistently to the large and changing demand for support has also been hampered by disjointed planning activity.
There is already significant work underway across government to implement the recommendations from the review to improve the focus on outcomes, to enhance consumer choice and service flexibility, to build capability, and to improve co-ordination and contracting practices. This work includes:
- expanding supported independent living
- increasing access to individualised funding
- moving to outcomes-focused funding
- simplifying and better aligning assessment processes
- costing of a single, highly visible and accessible entry point to all government disability support information
- a greater focus on preparing and supporting disabled people entering paid employment or leaving school
- ensuring services for all children and young people include a focus on disabled children and young people
- longer-term planning for priority areas including disability supports, making targets and achievements more transparent.
Funding injections, mainly through the Ministries of Health and Social Development, have allowed for higher contract rates to service providers and improved terms of employment for the lowest paid support workers, and enhanced the provision of some disability supports such as equipment and housing modifications.
Making progress in these areas will improve access to disability supports and will address many of the sector's concerns. There are opportunities for agencies to improve services within current funding. Other areas for action, however, will advance more quickly if additional funding is secured.
