KEY MESSAGES FROM CABINET PAPER, JUNE 2017
A high-level design of a transformed disability support system has been finalised by a group of disabled people, whānau, service organisations and officials who have worked together since April 2017. This has led to a co-design that reflects the wide diversity among disabled people and their families/whānau, and is more likely to be effective.
The transformed system seeks to deliver the experiences disabled people and their whānau are looking for by increasing choice and control over their lives and their supports.
The new system will include:
- Multi-channel disability information: The front end of the system is a responsive and accessible multi-channel system that provides information about disability and the support available. There will be national branding and consistent quality of response. This will provide support and connections beyond those disabled people who are currently eligible for the new disability support system. It includes:
- proactive outreach to disabled people and whānau who do not currently access disability support or are unaware of the possibilities
- follow-up/proactive contact with someone when an impairment is first identified
- peer and whānau networks
- face to face local options, communication by phone or email and
- an accessible digital hub that is available on a range of devices.
2. Investment in the capability of disabled people and whānau: Funding will be available at a national and regional level to build the capacity, capability and leadership of disabled people and whānau.
3. Disabled people and whānau determine their pathway: Disabled people and whānau will decide when and how they will engage with the system. There will be a range of pathways, based on the pace the disabled person and whānau want to progress through the system, the strength of their networks, the support required for decision making and their cultural preferences. Disabled people and whānau will be able to choose, if they wish, to have an EGL connector walk alongside them to develop their vision for their life and how they want to get there.
4. Self-managed information and resources: Disabled people are able to manage and access their own information and have a range of tools available to them. This includes tools for creating their vision and how they want to get there; for finding out what support is available in their community; for recording information about outcomes; and managing their support and recording the resources they have used.
5. Funding model and allocation process: This includes the funding model and processes to access disability support funding. Funding will be available for:
- disabled people and whānau capability building
- support for disabled people and whānau
- investing to improve longer-term outcomes or reduce longer-term costs
- to support a disabled person and whānau to move out of a crisis.
6. Creating the Enabling Good Lives’ Team, which includes:
- EGL Connectors or Tūhono: who, when invited, walk alongside disabled people and their whānau on their journey towards planning and building the life they are seeking.
- Government connectors: back-office workers who work with EGL Connectors and other government agencies to assist disabled people and whānau to access the full range of government services and support in a seamless way.
- A regional funding management team: which gathers the information needed for, and make, decisions on funding allocations with disabled people and their whānau (including social investment funding), and monitors individual and system-level expenditure; and
- Network builders who work with EGL Connectors by providing tools and guidance for growing and developing networks, supporting EGL Connectors to find advocates and provide support to rebuild connections with whānau.
7. Investing in provider, workforce, NASCs and system capability and capacity so they can work in ways that are consistent with the EGL vision and principles.
UNDERPINNING SYSTEM ELEMENTS
There are a range of underpinning elements needed to build the system. They are:
8. A distinctive identity ( a ‘brand’) that the disability community identifies with, feels ownership of, and will contribute to its success. The brand – which is likely to reflect the strong ownership of EGL within the disability community – will build awareness of the system and of the disability community, and provide a platform for messages, news and information, as well as helping create connections within the disability community and across government systems.
9. Cultural responsiveness, which is about the system valuing, respecting and responding to the cultural identity of disabled people and their whānau so everyone feels welcome. Particular significant elements include a recognition that the Treaty underpins the relationship with Māori, the strong cultural identities of some, particularly the Deaf community, and the need to reach out to Pasifika peoples, migrants, refugees, and the Asian community, who use the current system less than other groups.
10. Safeguarding arrangements, which is about disabled people taking opportunities and calculated risks. There are a wide range of possible safeguarding mechanisms including regulation, building and supporting relationships, education and awareness raising, independent advocacy services and contractual safeguards.
11. Outcomes monitoring, which involves gathering and analysing qualitative (rich and in-depth about individual disabled people and whānau) and quantitative (summary information across population groups) information about the system’s impacts on the lives of disabled people and whānau. This would be complemented by the collection and analysis of information about how well the system delivers the experience being sought and how other government agencies are engaging with the transformed system.
12. A responsive system where national and local governance groups, with disabled people and whānau representation, use data analytics and system insights to monitor outcomes for disabled people and whānau, and to identify and continually improve the system.
13. Social investment arrangements, which are about encouraging decisions that better meet immediate needs and achieve benefits across a person’s life course e.g. early investments may lead to better outcomes, better support might lead to a person getting a job and moving off benefit. The transformed system will devolve most commissioning decisions to individual disabled people or their family/whānau representatives. Some capacity will be maintained for regional funding managers to suggest or further invest in services to intervene early where analytics suggest there would be significant future benefits.
14. Financial management arrangements, which provides assurance the system is being managed in a financially sound and sustainable way, and resources are being used cost-effectively to improve outcomes for disabled people and their whānau.
MONITORING AND EVALUATION
There will be ongoing monitoring and evaluation of the new system.
15. Officials from the Ministries of Health, Social Development and Education, the Ministry for Vulnerable Children Oranga Tamariki, and representatives of the disability community, are developing a monitoring and evaluation strategy and intervention logic for the disability system transformation. Disabled people and whānau will continue to be involved in all aspects of the evaluation process, including planning, design, interviewing, analysis and review. It is envisaged there will be ongoing evaluation throughout the transformation process.
INITIAL ASSESSMENT OF IMPACTS
The new system will involve significant change for:
16. The role and approach of DSS, NASCs, Equipment and Modification Service organisations, and other organisations which allocates resources within the current system will change substantially. While the changes are still being worked through, it is clear the approach to allocating resources will be significantly different and that organisations’ roles and structures, and the required behaviours will be different.
17. Providers will need to learn new ways of supporting disabled people, and develop new business models, if they are to succeed within the transformed system. The available evidence suggests that some will make this transition well and thrive, but others will struggle – and some may even go out of business.
18. Government agencies will need to go on a journey of change. They will need to move from operating within the current ‘needs-based’ purchaser-provider’ framework, under which they have considerable control, to one where authority is shared with disabled people and whānau. Moving away from contracted providers being the primary mechanism for delivering support will be a particularly big change.
The next stage involves a substantial amount of work in the more detailed design and testing of the proposed high-level design, through:
19. Getting ready for implementation in MidCentral, including: the detailed design of the system building blocks and underpinning system requirements, and the interface with other government agencies; creating the EGL Team; establishing and working with the MidCentral leadership group; and engaging with the local disability community.
20. Work to support the implementation, which includes testing whether the proposed transformation will be effective for particular groups such as Maori, Pasifika and Asian peoples, migrants and refugees, children and young people; addressing strategic and policy issues; and preparing for evaluation including gathering baseline data on outcomes and costs.
21. Reviewing the high-level design, which involves testing the end to end processes with specific groups from the disability community, including the EGL National Leadership Group and the MidCentral Leadership Group.
22. Change management, which is about developing the capacity and capability of various groups – disabled people and whānau, contracted providers, system administrators (e.g. NASCs) and government officials – to support and benefit from the transformation.
23. Communications with the local and national disability community through mainstream and social media.
ENGAGEMENT WITH THE DISABILITY COMMUNITY
24. With the move to more detailed development, officials will need to take on significantly greater responsibility for the day to day work. The co-design approach will, however, continue. This includes officials’ analysis and proposals being brought back to the disability community through the following forums:
- The Co-design Group, which will review the analysis and proposals to check they are consistent with the high-level design and its underlying intentions.
- The National EGL Leadership Group, which will review the analysis and proposals against the EGL vision and principles.
- A MidCentral Leadership Group, which will be actively engaged in the co-design and implementation of the transformation prototype.
25. In addition, groups of people from the disability community will work with officials on the detailed design of particular elements of the work programme they have an interest in and/ or testing whether the system design is suitable for the diversity of disabled people.
26. Each of these groups will be subject to confidentiality arrangements which means that agreed messages are distributed, but the proceedings are otherwise confidential. Feedback on those key messages will continue to be sought through social media.
CO-DESIGN GROUP DISABILITY SECTOR REPRESENTATIVES – COMMENT
27. The co-design process worked well for the sector representatives. Early on we requested a co-management process so we could have confidence in the approach taken. From there, we were fully included in the entire design process. The ThinkPlace way of operating was new to all of us and it took some time for us to be comfortable with it. By the end though, we consider we have developed a creative, sustainable and inclusive design for the disability support system. Much of our ongoing confidence will rely on the need to have sector representatives, including those on this design group, continuing with the design development and the implementation process. It is vital to have disabled people and families continuing to input at all phases and to have a continuing role in governance at all levels so this design can continue to develop well in the years to come.