Frequently Asked Questions - April, 2018 Posted by Posted by Loren Savage on 26 April 2018 Posted on: 26 April 2018

What are you changing?

The new disability support system, which will be launched initially in the MidCentral DHB region on 1 October 2018, will enable disabled people and their whānau to have more control and decision making over their lives and support. 

In the new system, the ways disabled people and their whānau get support will change and there will be flexibility about what support they can use. There will be access to a Connector to walk alongside disabled people and their whānau, if they choose.  A Connector will assist disabled people and whānau to identify what they want in their lives, what support they need to get there and advise on what options are available for support.  People will be welcomed into the system in many ways, there will be one place to find out about all disability support across government and there will be connected support across government.  There will be streamlined funding and easy to use information, tools and processes.

There will be a ‘try, learn and adjust’ approach to the new system in MidCentral, which includes Palmerston North, Horowhenua, Manawatu, Ōtaki and Tararua districts.

Why are you changing it?

Disabled people and their whānau have been calling for change for a long time.  Current disability services have become the ‘hub’ of many disabled people’s lives.  There are many eligibility, assessment and planning processes, people are allocated existing services and they have to fit their lives around those, not what works best for them.

Disabled people have poorer life outcomes than many other New Zealanders and want the opportunity to lead lives similar to others, where they can be valued, be accepted, and be recognised for their contribution to the community.

What will the new disability support system look like?

The key features of the new disability support include:

• People are welcomed into the system in multiple ways, and are then provided with information and linked with a Connector and peer network
• Access to Connectors who can walk alongside disabled people and whānau, if they choose, to help them identify what they want in their lives, and the supports available
• Easy to use information/processes to meet the diverse needs of disabled people
• Connected support across government, with people in the background who assist in accessing other government services, ie learning support in school
• Funding is flexible about what support can be purchased and easy reporting on how it has been used
• Capability funding to build the skills of disabled people and whānau
• Greater system accountability to disabled people and whānau who are involved in the monitoring and evaluation of the new system.
  
  

What will it look like on day one? What changes for people in MidCentral?

Whatever support people are getting on 30 September 2018, they will have on 1 October 2018. There will be no change for disabled people and whānau living in MidCentral until either they contact somebody in the new system, ie a Connector or disability information specialist, or someone from the system teams contacts them on their regular review date.

At that point, the Connector will work with disabled people and whānau to identify the supports they require to live the life they are seeking. Even then, if disabled people and whānau like the supports they are getting, they can continue to receive them.

Funding

How is the funding going to work?

The funding, processes and tools are still being developed, and are subject to decisions to be made by Cabinet in June 2018. More information will be provided once decisions have been made.

Will there be additional funding to implement the new system?

The Government has agreed to make additional funding of $23.842 million available to implement the new system in MidCentral, and to continue the Waikato and Christchurch Enabling Good Lives demonstrations.

The majority of the funding will be used to increase direct and indirect support, in the following ways:

•  Direct support, allocated to disabled people and whānau, will mainly fund early interventions and improved access to specialist services. This is expected to improve outcomes and/or reduce costs in the medium to longer term (eg easier access to specialist services and other early intervention could result in whānau with disabled children feeling less stressed)
  
  

• Indirect support will be delivered mostly by Connectors. This support will enable disabled people to identify new possibilities, and build their networks and skills.

Other costs include the back-office team which replaces the current NASC (Needs Assessment and Service Coordination), national and regional governance, and one-off costs such as the co-design team, an interim IT solution, and monitoring and evaluation.

Will the costs of the new system reduce the amount of support disabled people currently receive?

No, current allocations will not be reduced to pay for the new system. The costs of the new system will be met from the additional funding.

Information, tools, pathways and processes

Do disabled people and whānau have to use the system’s tools and resources?

No. People can choose to use the tools and resources that are useful to them.

Who has control over disabled people and whānau information?

Disabled people and/or their whānau will have control over their information. Disabled people will be able to choose what information they want to share. Any information which is collected about disabled people will be stored in a secure place. The Ministry of Health recognises that information belongs to the disabled person and their whānau.

Connectors

What can Connectors do?

Connectors can assist people to think about what they want in their life and how they can achieve this. They can assist disabled people and their whānau to make connections in the community, try new things, and help arrange support across government. The Connector cannot make funding decisions, take over or remove a disabled person’s natural authority, have a vested interest in decisions and choices disabled people and whānau make, provide personal care and home support, or build dependency.

Will disabled people be able to choose their Connectors?

Disabled people and their whānau will be able to choose their Connector. They might find out about them from their profile on the website or hear about them from other disabled people and whānau in the community.

Do disabled people and whānau have to use a Connector? If not, how will they get what they need?

Everybody will have an opportunity to access a Connector if they want to, but they do not have to use a Connector. There will be a process in place so disabled people can access a personal budget without meeting someone face to face.

Who employs or contracts Connectors?

There will be a number of ways Connectors will be employed or contracted:

• Most Connectors will be employed as part of the Disabled People and Whānau supporting team, based in MidCentral.

• In some situations, there will be contracts with non-government organisations (who do not provide other disability services) for Connectors, eg Whānau Ora providers.

• Disabled people and whānau might choose an individual. This is a really important role and we will need to check the person chosen has the right skills.
  
  

Teams

What will the team look like on day one?

There will be two teams set up and based in MidCentral. This is a temporary and practical arrangement while we work through a process for how the future organisation is set up.
The two teams are:

• The Disabled People and Whānau supporting team will be a new team made up of Connectors and a network builder. The team will be established within the Ministry of Health, reporting to a manager in MidCentral, who will operate as if they were the manager of a separate organisation.
  
  

• The System Enabling team will be made up of government liaisons, disability information specialists, and business and administration roles. This will be delivered through Enable - the existing NASC (Needs Assessment and Service Coordination). The new team will be made up of a mix of current employees and new staff who are recruited.

Both teams will report to a governance board with disabled people and whānau representation.

Why are there two teams?

There has been a lot of feedback from the disability sector about the need to separate the Connector role from funding decisions.

Why is Enable, the current NASC, continuing to be involved?

This is a temporary and practical step ahead of the set-up of the future organisation. It does not create a precedent for the future roll-out of the system around the country. There will be a process in which Ministers will receive advice about the options for a future organisation.

 To make sure true change occurs, there will be:

• National and Regional Enabling Good Lives Leadership group representation on recruitment panels and involvement in the induction of key roles

• Disabled people and their whānau on governance groups

• A contract between the Ministry of Health and Enable that sets out expectations, outcomes, processes for decision making, and includes the voice of disabled people and whānau

• Frequent feedback about the experience of disabled people and whānau

• An independent complaints process
  
  

What is the process for setting up the future organisation?

• There will be a review, known as a Machinery of Government Review, which would be led by a working group with officials from the State Services Commission, Ministry of Health, Ministry of Social Development, Ministry of Education, and Treasury, and representatives from the disability community. It is expected there will be consultation with the wider disability community generally as part of the review.

   

Roll Out  

When will it be available in other regions?

There will be a ‘try, learn and adjust’ approach taken when the new system is up and running in MidCentral. Feedback from disabled people and whānau will help improve and finalise the system before it is rolled out across New Zealand.  

Decisions on the final model and expansion beyond MidCentral will be sought from Cabinet in 2020.

Providers

Will providers still have contracts with the Ministry of Health?

Providers will have contracts; either individual contracts with disabled people and their whānau or with the Ministry for those disabled people and whānau who do not wish to be on an individual agreement.

This is what we think might happen and will be tested:

• A high number of disabled people are expected to choose to continue with government-contracted supports, at least to begin with

• We expect the number of disabled people who choose to make major changes to their support to be between 10% and 30% of the disabled population by the end of two years

• As well, a number of support types are unlikely to be wholly purchased through personal budgets. The details of how those supports will be purchased are being developed for Cabinet decisions in June. Those mixed models of funding will be made available once those decisions have been made.

Will the Ministry of Health continue to contract residential services?  

The Ministry has given an undertaking that disabled people and their whānau can continue accessing their current support, including residential services.

Will the Ministry continue to audit services?  

There is a ‘safe guarding’ framework in development and this will include an evaluation component of any contracted service/support. 

System responsiveness

How can a complaint about the new system be made?

There will be an independent complaints process. Information about who to contact with any concerns will be widely available. One of the key goals of the new system is to be responsive to disabled people and whānau.

Will legislation be changed due to the new system?

The new system will create the need for policy and legislative changes across government. The Cabinet paper in June 2018 will seek agreement to policy work, for example, changes to the Protection of Personal and Property Rights Act.

Monitoring and evaluation

How will the new system be monitored and evaluated?

There will be a baseline study, outcomes evaluation, impact evaluation, system-level evaluation and cost-benefit analysis.
This will help find out if the new system leads to improved lives for disabled people and their whānau, where changes are needed, and how to make the system better.
This means, from time to time, disabled people and their whānau may be contacted to be asked how they are finding the new system and what could make things better. If disabled people are contacted, they do not have to answer questions if they do not want to. If they do agree to speak, they will not be identified in any reporting and everything that is said will be kept safe and secure.

How will disabled people be involved in the monitoring and evaluation?

• Disabled people and whānau are part of the group designing the framework
• Disabled people are on the panel deciding the contract for the evaluation work
• Disabled people will be part of the teams doing the evaluation work
• Disabled people will be involved in deciding what needs to change and how.

Safeguarding

What will be the safeguarding approach in the new system?

Disabled people and their whanau will be assisted to make informed choices, including taking risks and having opportunities like other people, and there will be safeguards put in place to protect people against abuse.

Disabled people and their whanau will be supported to strengthen their personal relationships, expand their networks of support and increase their community connections. These provide natural safeguards with people looking out for those in their lives. There will also be formal safeguards, ie standards, regulations and quality assurance for the support and systems in place.