Evidence to inform the next stage of System Transformation Posted by Posted by Default Admin on 12 February 2021 Posted on: 12 February 2021

The Enabling Good Lives (EGL) demonstration sites in Christchurch, Waikato and Bay of Plenty and the Mana Whaikaha MidCentral prototype have tested several carefully designed services and supports. These include elements such as self-directed planning, which means disabled people and their families lead their supports and services according to their preferences, strengths, aspirations and needs.

The three demonstration sites and the Mana Whaikaha prototype have been evaluated to look at the overall results as well as how the design elements contributed to the results. This article summarises the key themes from the evaluations, participant’s feedback and staff and leadership reviews.

Overall, there is good evidence to support short and medium-term progress in improving people’s lives.

Key results:

The qualitative (measured by quality outcomes reported, not numbers) evidence from the evaluations suggests the demonstrations and Mana Whaikaha have influenced people’s ability to build aspirations, set goals, participate socially, improve their social skills and participate in education. The demonstrations also supported people in important life change transitions.

At the various sites there is qualitative evidence that suggests improved wellbeing, reported improved access to supports and services, when assisted by a facilitator/connector or Government Liaison person. The outcomes also apply outside of the health system. Educational institutions have revised how they engage with disabled children and young people disabled people have identified service and curriculum needs when transitioning from school isolated disabled people have engaged more with community organisations to improve their social participation a joined-up approach between government agencies which has enabled quick solutions for disabled people and removed the stigma of having to re-tell the same story to a number of agencies.

The Government Liaison Roles in Midcentral aimed to address any system barriers to the implementation of EGL principles and practices. These roles were very successful and for disabled people provided a link with agencies in the system who administer key resources. For example: housing, employment, income support, transport, and education (Mana Whaikaha Evaluation 2019).

The Government Liaison Roles assisted several people who previously had difficulty navigating systems for example income support and education. These roles are an important component of system change and ensure that disabled people can be easily linked to supports that currently exist. The roles also help government agencies to work more closely together to determine the disabled person’s support needs.

There is qualitative evidence which suggests that early engagement can divert people from funded support.

For example, a disabled person was suspended from school, the sole parent was unable to negotiate the person’s return to school. The parent had to give up their employment and take a benefit to be at home to support their son. An intervention by a Government Liaison person led to the disabled person being allowed back into school and adequate support being provided so he could stay at school, which allowed the sole parent to return to work (MidCentral, Mana Whaikaha Evaluation 2019).

Immediate resourcing, or providing crisis-funding, has allowed people to meet their immediate needs and for some this has meant a longer-term reduction in the need for Disability Support Services (DSS) funding. There is also some evidence crisis funding has led to solutions which mean DSS funding is no longer necessary (site visits and case reviews).

Young people aged 16-21 years can continue to receive their Ongoing Resourcing Scheme (ORS) funding while they are transitioning from school. Even if the young disabled person is not attending school it allows more options and choices. The Christchurch EGL experience suggests that future system transformation could consider looking at planning and curriculum options within schools which would help with transitioning to tertiary level training or pre-vocational courses. The demonstration worked with the local polytechnic, Workbridge, schools, providers, and employers to foster a greater range of options of young people and prepare young people for employment.

Examples of employment innovation:

An enterprise was established by a participant of the demonstration and their family/whānau called Clean Green Laundry https://clean-green-laundry.co.nz/ which is a micro enterprise business with competitive pricing, eco-friendly and quality laundry service; and a young Deaf woman returned to school to gain English NCEA credits where she used her EGL funding to pay for an interpreter in English class, passed with Merit, and is now employed as an NZSL teacher in several local (mainstream) primary schools.

Flexible funding options

There is emerging evidence that Flexible Disability Support contracts enable a disabled person to work with a provider who can provide flexible support and budget management assistance. For those that need this assistance the supports help them to achieve the outcomes they have identified for themselves. Flexible Disability Support suits those who do not want to carry the full responsibility of standard hosted services, for example being an employer, but who wish to be able to have flexibility to work with a provider of their choice and be supported in a way they choose (Boxall, et al.).

Choice, control, and flexibility at the same or lower cost

Giving people more choice, control and flexibility does not necessarily cost more e.g. the cost of supporting people through Choice in Community Living, where people decide where to live and who they live with, was less than the total projected cost for supporting people within a residential service;

People are not always spending all their allocated budget (e.g. in Christchurch, 78% utilisation).

There is also some evidence that early engagement/investment results in diverting people from funded support that is not required but that may otherwise have been implemented.

All of the evidence above, evaluations we are doing will help with the next stages of System Transformation, we are grateful to the people who have made themselves available.