Outcome 3: Health and Wellbeing

Goal: we have the highest attainable standards of health and wellbeing.

This Outcome has seven work programmes:

Ministry of Health: Improving health outcomes and access to healthcare for disabled people

Status update: Off track - but low risks/issues

Progress against Plan for the period: 

Actions that were planned for 1 January 2020 to 30 June 2020

Actions completed in the period

Note any impacts from COVID-19

Scope actions and deliverables for this work programme by:

 

Ministry resources were reprioritised to deal with COVID-19, and this work programme did not progress until June 2020. The Disability Directorate led the COVID-19 response for disabled people to ensure that it was accessible and inclusive. COVID-19 highlighted the inequities in the health system for disabled people particularly in terms of a lack of accessible information and communications and mixed capability of the workforce to respond appropriately to disabled people.

1 - Developing a statement of the key problems to be solved

In progress

2 - Describing the strategic context and health stewardship role

In progress

3 - Reviewing recent public consultation on the Disability Action Plan, Carers’ Strategy Action Plan and recommendations of reference groups for relevant themes, issues and recommendations

Not started

4 - Identifying key stakeholders

In progress

5 - Identifying key levers for system stewardship and delivery

In progress

6 - Determining priorities

In progress - we had an initial meeting with People First (DPO) to understand what was expected of this work programme, and what happened under DAP 2014-2018. We have requested a further meeting with the DPO Coalition to discuss.

7 - Developing an overall work programme and workstream projects for:

In progress - we have done a stocktake of work completed to date, including collating all of the proposed actions to be discussed with the DPO Coalition.

a - health system disability data

In progress

b - health workforce disability awareness and capability

In progress

c - access to quality healthcare

In progress

d - monitoring and reporting

Not started

Narrative – Any celebrations? What is going well? What is being learned? Any impacts?

Staff changes and COVID-19 meant that this action did not progress from February 2020 - June 2020. COVID-19 did however bring many opportunities, and a number of actions during this time helped to progress this work programme - but in different ways than were originally planned. For example:

  1. 293 artefacts in alternate formats were created during the COVID-19 response, and considerable efforts were made to make the COVID-19 website accessible
  2. NZSL interpreters supported the Director-General’s daily stand-up
  3. An accessibility communications group was established to work with disabled people to prioritise and translate messaging into alternate formats directly. This work was recognised by the Office of the United Nations High Commissioner for Human Rights as ‘promising practice’
  4. The 'bubble' was a disability concept that served to be universal in design and practice
  5. Clinical guidance for responding to patients with an intellectual (learning) disability during COVID-19 was created.

We also learnt some lessons through COVID-19, including that in future we need to ensure that:

  1. There is a strong understanding of the disability sector, and the type of work/supports that people receive so that Ministry policy works for disabled people (i.e. PPE caused a lot of anguish for the community) 
  2. Cultural information, communication and public health messaging are also available accessibly in Te Reo or Pacific languages. The disability community is widely diverse
  3. Technology that we utilise, such as apps, are accessible for all, as well as videos having captions.

We have been able to include some of our learnings from COVID-19 into our work (including a greater focus on the need for accessible information and communications, ensuring that there is an equitable focus is maintained throughout our actions).

Ministry of Health: Funded Family Care policy change

Overall status: On track or ahead 

Progress against Plan for the period

Actions that were planned for 1 January 2020 to 30 June 2020

Actions completed in the period

Note any impacts from COVID-19

Repeal Part 4A of the New Zealand Public Health and Disability Act 2000.

The Bill to repeal Part 4A was introduced on 21 January 2020. Health Committee received submissions and completed report 24 July 2020. Expect a decision before the House rises on 6 August 2020.

N/A

FFC policy changes: transition of current FFC clients to Individualised Funding or Home and Community Support Services options.

Transition began 2 June 2020.

Deferred from 14 April 2020.

FFC policy changes: new eligible clients choose to pay family carers through Individualised Funding or Home and Community Support Services options.

Commenced 2 June 2020.

Deferred from 14 April 2020.

FFC policy changes: lifted pay rates for family carers from the minimum wage to between $20.50 - $25.50 per hour.

Commenced 14 April 2020.

N/A

FFC policy changes for payment of family carers to provide care to people with high and very high support needs: 1) expanded carer eligibility to spouses and partners and 16-18 year old family members; 2) expanded client eligibility to include under 18 year olds with high or very high support needs; 3) removed requirement for an employment relationship between a disabled person and their resident family member in order to receive paid care for disability support services.

Commenced 2 June 2020.

Deferred from 14 April 2020.

Narrative – Any celebrations? What is going well? What is being learned? Any impacts?

  • Good progress with transition of current clients to new options despite COVID impact on planned work.
  • Repeal of Part 4A supported and expected.
  • Dissatisfaction continues with assessment process, non-inclusion of supervision, 40-hour cap and general allocation of hours.
  • More and clearer information is essential as people have difficulty understanding eligibility, options and responsibilities.

 Ministry of Health: Reduce the use of seclusion and restraint

Status update: Off track – but low risk/issues  (The DPO Coalition assessment disagreed with this status and proposed Off track – with significant risks/issues. The report notes actions to eliminate seclusion were deferred due to COVID-19)

Progress against Plan for the period

Actions that were planned for 1 January 2020 to 30 June 2020

Actions completed in the period

Note any impacts from COVID-19

The scope of the work programme will be informed through 1) the development of a shared understanding and agreed baseline of practices that constitute seclusion and restraint across sectors; and 2) subsequent work on priority settings and areas of action.

 

Deferred due to COVID response.

Ara Poutama Aotearoa, Corrections: Reduction of the use of segregation and restraint

Overall status: On track or ahead

Progress against Plan for the period

Actions that were planned for 1 January 2020 to 30 June 2020

Actions completed in the period

Note any impacts from COVID-19

Move to an early intervention and a multi-disciplinary approach when responding to risk of self-harm and suicide in prison.

The Intervention and Support project has developed initiatives for people in prison who are vulnerable to self-harm and suicide through a new model of care at three pilot prison sites.

 

Reduce forms of segregation and restraint

The use of tie-down beds have been removed from all prisons

 

Ministry of Health, Mental Health and Addiction Directorate: Repeal and Replace the Mental Health (Compulsory Assessment and Treatment) Act 1992

Overall status: Off track – but low risks/issues (The DPO Coalition assessment disagreed with this status and proposed Off track – with significant risks/issues. The Assessment noted concerns regarding feedback on the draft guidelines although this may be a result of timing when the report was submitted)

Progress against Plan for the period

Actions that were planned for 1 January 2020 to 30 June 2020

Actions completed in the period

Note any impacts from COVID-19

Publication of revised Guidelines to the Mental Health Act following public feedback

Public feedback reviewed and incorporated. Finalisation of revisions progressed.

Publication has been slightly delayed due to COVID-19. The Ministry of Health needed to focus efforts on developing advice and guidance for the operation of the Mental Health Act under each COVID-19 Alert Level. 

Provision of advice provided to the Minister of Health

Advice provided

The need to prioritise COVID-19 work has delayed the progression of actions requiring Ministerial decisions.

Narrative – Any celebrations? What is going well?  What is being learned? Any impacts?

A multi-pronged work programme has been developed focusing on both short-term actions to improve experiences under the current legislation, as well as a longer-term policy development process to create new legislation.  The impacts of COVID-19 have slightly delayed achievements of some planned milestones; however activities have resumed and will be progressed over the next six months. 

Sport NZ: Sport NZ Disability Plan 

Overall status: On track or ahead

Progress against Plan for the period

Actions that were planned for 1 January 2020 to 30 June 2020

Actions completed in the period

Note any impacts from COVID-19

Work with Sport NZ staff to put a disability lens on their work. 

Presentations made to Sport NZ staff on the progress of the Disability Plan; presentations to the Health Active Learning workforce and the play workforce on the importance of being inclusive and universal design.  The new Sport NZ website will demonstrate our commitment to accessibility in content, imagery and accessibility.

 

 

Ensure that ParaFeds were eligible and aware of the Community Resilience Fund and that National Disability Sports Organisations were eligible for and aware of the Exceptional Systems Support Fund

With a significant amount funding secured for the Sport and Recreation sector in Budget 2020 it was important that these were equally made available to the disability sport sector and they were aware of the funding available. 

Development of a scoping exercise to meeting commitment 4 (understand roles/responsibilities of agencies in disability sport sector) of the Disability Plan

Project plan developed and first phase underway.

 

Evaluation options for the Disability Fund

 

 

Gather and share insights, data and case studies

Changes have been made to the question in the Active NZ survey, Voice of the Participant survey to gain further information on the participation of disabled people and their motivations.  Similar changes will also be made to the Voice of Rangatahi survey.

 

Narrative – Any celebrations? What is going well?  What is being learned? Any impacts?

The launch of the Disability Plan in October 2019 and the employment of a Disability Consultant in December 2019 were significant milestones to ensuring the play, active recreation and sport sector are inclusive of disabled people, especially disabled tamariki and rangatahi. The Disability Consultant has focused on gaining an understanding of the internal workings of Sport New Zealand and how they can assist other staff and programmes of work to be inclusive. The philosophy is that by become inclusive, that we can show leadership to the sector and be a role model for inclusive practices. The staff at Sport New Zealand have been very welcoming of the work to ensure disabled tamariki and rangatahi are participating in play, active recreation and sport. Through the changes that have been made since December we recognise that there is a great opportunity to increase the participation of disabled people. The major impact has occur internally within Sport New Zealand and some of the changes that have been made such as Sport New Zealand administering No Exceptions Investment for National Sports Organisation has reinforced to the sport sector that Sport New Zealand is committed to ensuring disabled people have the opportunity to participate play, active recreation and sport of their choice.

Ministry of Health: Safeguarding bodily integrity rights - Explore the framework that protects the bodily integrity of disabled children and disabled adults against non-therapeutic medical procedures

Overall status: Off track - but low risks/issues

Progress against Plan for the period: 

Actions that were planned for 1 January 2020 to 30 June 2020

Actions completed in the period

Note any impacts from COVID-19

1. a) Minister's sign off on a report to progress the Ministry of Health's four-year work programme to strengthen the safeguarding framework for disabled children, including disabled children and minors, against bodily integrity abuses, including non-consensual sterilisation. b) proactively release

a)    February 2020 - Hon Jenny Salesa agreed to progress the unfinished work on Action 7B on Non-Consensual Sterilisation in the new Disability Action Plan 2019–2023.

b)    has not yet been proactively released.

none

2. Project reset to restart this work programme

In progress

Project initiation work was delayed during COVID-19 and has yet to be reactivated

3. Discuss the new action at the scheduled March 2020 meeting of the DPO Coalition.

Meeting did not take place

The DPO meeting was cancelled due to COVID-19

4. Update key disability stakeholders on Minister's decisions

The planned update was not provided

Work was interrupted by COVID-19 and has not reactivated due to resource constraints

5. Reconvene a small working group to scope the work required for 2020

Scoping work has not been undertaken

Work was interrupted by COVID-19 and has not reactivated due to resource constraints

6. Align the bodily integrity action to other relevant actions in the Disability Action Plan 2019-2023

Mapping work to the health improvement and disability data improvement actions has commenced

No impacts as this work was started post COVID-19

Narrative – Any celebrations? What is going well?  What is being learned? Any impacts?

Health Ministers are fully supportive of the Ministry working with disabled communities and stakeholders to progress the bodily integrity work over the next four years.

Office for Seniors: Better Later Life - He Oranga Kaumātua 

Overall status: On track or ahead 

Progress against Plan for the period: 

Actions that were planned for 1 January 2020 to 30 June 2020

Actions completed in the period

 

Establish a ministerial steering group to oversee the implementation of the Better Later Life Strategy

Established a ministerial steering group to oversee the implementation of the Better Later Life Strategy. The first meeting was in February 2020 with a second meeting planned for 20 July 2020.

Finalise an outcomes framework to measure the progress of the Better Later Life programme

  • The Office for Seniors has developed initial indicators for each key area of action in the Better Later Life – He Oranga Kaumātua strategy.
  • The initial indicators have been published on the SuperSeniors website.

Develop the Better Later Life Action Plan

  • The Office for Seniors has started working on the development of the Better Later Life – He Oranga Kaumātua Action Plan 2021 to 2024.
  • Work was delayed due to COVID-19. Completion is now expected in 2021 for launch from 1 July 2021
 

Narrative – Any celebrations? What is going well?  What is being learned? Any impacts? 

  • The COVID-19 pandemic (in particular, the nationwide lockdown periods) has highlighted many of the social issues impacting on older people’s wellbeing (especially for those with a disability). The Office for Seniors developed some indicators which will help to measure the impact of COVID-19 on older people over time and there is a link to these on the SuperSeniors website.
  • The impacts of COVID-19 pandemic on older people such as increased un and underemployment and social isolation will inform the development of the action plan.
  • The Office for Seniors will soon publish an age friendly toolkit on its website to support local bodies and other groups to create and implement age friendly initiatives and plans.

Read the full report for January to June 2020

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