What will system transformation mean for disabled people?
Disabled people and their families/whānau will have a very different experience in the transformed system, which aims to ensure they feel welcomed and valued. There are options and possibilities to plan the lives they would like, and more choice and control. There will be a number of elements including:
Disability information hub: The front-end of the system will welcome disabled people and their families/whānau by providing accessible information about disability and the support available in a number of ways:
– Proactive outreach to disabled people and families/whānau
– Follow up when someone is first identified as having an impairment
– Local face-to-face options and/or communication by phone or email
– Peer and whānau networks
– An accessible digital hub available on a range of devices
Disabled people and their families/whānau will be able to decide when and how they engage with the system. This will depend on the pace they want to progress, the strength of their networks, the support required for decision-making and their cultural preferences. For example, disabled people and families/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.
Capability building: There will be funding, at a national and regional level, to increase the capability of disabled people and families/whānau. This will open up options and possibilities.
Self-managed information: Disabled people will be able to manage and access their own information and have a range of tools available to them.
Information collection tool: An easy to use information collection tool which tracks how things are going for disabled people, whānau, providers and the system.
Funding allocation model: The funding process will reduce assessment and provide opportunities for investment.
Expanded networks: Support to expand networks including supported decision-making to enable all disabled people to express their will and preferences.
Monitoring: An approach which reduces compliance for disabled people, whānau, providers and government agencies, and is proportionate to the amount of funding people receive.
National and local governance groups: With disabled people and whānau representatives which monitor outcomes and suggests improvements to system.
The team will be working to understand the costs of the new elements of the system during the next stage of the work. We will also be looking at what specialist disability support funding might come across from other agencies, what could be used to purchase support centrally and what would be available for personal budgets.
A social investment approach is being taken. Social investment is about spending/investing money up front/early to produce better life outcomes for people and potentially reduce long-term costs to government. Better support earlier on might lead to a person getting a job and moving off a benefit, while a lack of support might contribute to poor life outcomes generally.
Who will be eligible?
Anyone in the MidCentral area who meets the Ministry of Health’s Disability Support Service eligibility criteria. People with intellectual, physical or sensory disabilities, which occur before they turn 65-years-old will be eligible to access support under the transformed model.
What does it mean for families?
The transformed system will have a number of elements to improve the experience for disabled people and their families/whānau. These include:
- Access to crisis support up front
- An EGL connector or Tūhono who, when invited, can walk alongside disabled people and their families/whānau to help plan and build the life they want
- Increased flexibility, more choices and reduced assessment
- A digital hub, local face-to-face support and peer and whānau networks, among other options, will make it easier for families/whānau to access information and support
- Investment in the capability of disabled people and families/whānau so they can think about the options and possibilities
When will this start in Mid-Central?
The plan is to go live on 1 July 2018 but this will depend on how much progress is made on the detailed design. There is a lot of work still to do. It will be a process of ‘try, learn and adjust’ as we learn about what works.
When will the transformed system be rolled out nationally?
The initial roll-out will be in MidCentral, an area which includes Palmerston North, Horowhenua, Manawatu, Otaki and Tararua districts. During its first year, the ‘try, learn and refine’ approach will be used and changes will be made as we learn about what works. Cabinet will make decisions about when and where to roll out to new regions.
Will anything change for me before 1 July 2018?
We will start communicating with people in MidCentral about what it means for them from October 2017.
What will this mean for providers, and how will they find out about it?
Disabled people and families/whānau will have more flexibility and choice in the new system. This will create opportunities and challenges for providers. 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 system transformation team will be working with MidCentral providers. It will brief provider umbrella groups and send out messages monthly to providers.
Will there be changes to existing contracts?
There are no changes planned to contracts at this stage. Over the next six months, we will be working through any funding implications and then identifying possible changes to contracts in the future.
If I’m happy with my existing services/support, will I be able to keep them?
The system transformation team is committed to working with providers/service organisations so disabled people and their families/whānau can continue having the support that works for them.
Who did you work with on the high-level design?
There was a co-design group of 13, which included five disabled people, two representatives with disabled family members, two from disability service organisations, and four officials. The National Enabling Good Lives Leadership Group was consulted on the high-level design and Disabled People’s Organisations were kept informed. For more information about the co-design group, go to http://www.enablinggoodlives.co.nz/system-transformation/meet-the-team/
How will the disability sector be involved in the next phase?
There will be opportunities for disabled people, their families/whānau, providers and others in the disability sector to work on the detailed design of particular elements of the new system and/or testing whether it is suitable for the diversity of disabled people.
During the first phase of the high-level design, the participation was limited to the co-design group. We are looking to take that wider in this next phase and will be developing social media and other opportunities to provide feedback. If you have an area of particular interest, be it funding allocation, Maori cultural values or other areas, and would like to take part, get in contact via STfeedback@moh.govt.nz
As the detailed design is developed, it will be reviewed by the co-design group to ensure it aligns with the high-level design. It will also be reviewed by the National EGL Leadership Group for alignment to EGL vision and principles. The MidCentral Regional Leadership Group (which will be established over the next three months) will be actively engaged in the co-design and implementation.
How will the MidCentral regional Leadership Group (RLG) be chosen?
Local community forums are being held in Palmerston North for disabled people, family and whānau, local Iwi, providers and other interested parties. The local community will decide how the forums will be structured – and the best way to identify and appoint people onto the Regional Leadership Group. This may include engaging with the National Leadership Group who supported the process to mandate leaders onto the RLG in Waikato.
Who will be on the regional LG?
It’s anticipated the MidCentral Regional Leadership Group will involve:
- Disabled people
- Family/whānau members
- Service organisation and workforce representatives
- Iwi representation
If you think other people should be included, please contact STfeedback@moh.govt.nz
What work still needs to be done?
Work will now begin on the detailed design of the system. There is a lot to do and it includes:
Getting ready for MidCentral implementation, including the detailed design of the system and how it will work with other government agencies, creating the EGL Team, gathering data on costs and outcomes, testing the design’s effectiveness for particular groups, establishing and working with the MidCentral Leadership Group, and engaging with the local disability community.
Policy and Operational work, which will look atwhat existing government funding is included, what is required to free up funding from existing uses, the transition plan from current to new funding arrangements, how funding will be allocated between people, what governance arrangements are appropriate for the new system, and how to connect seamlessly with other government systems, for example, education and health.
Engagement, which involves working with the disability sector on the next phase of design and testing the way it will work in practise with specific groups from the disability community, including the EGL National Leadership Group and the MidCentral Leadership Group.
Change management, which is about developing the capacity and capability of various groups — disabled people and whānau, service organisations and workforce, system administrators (e.g. NASCs) and government officials.
Communications with the local and national disability community through mainstream and social media.
Is there further work in specific areas?
There is still further work to be done to ensure the system will work for Maori and the diversity within their population, that it takes into account the strong cultural identities of some disabled people, particularly the Deaf community, and that it reaches out to groups such as Pasifika peoples, migrants and refugees, and the Asian community, who use the current system less than other groups. There is also further work to ensure the new system works for people with high and complex needs and people with autism.
I’m a support worker, what will it mean for me?
Disabled people and families/whānau will have more flexibility and choice in the new system. This will create opportunities and challenges. Support workers will need to learn new ways of supporting disabled people, and may need to develop different skills in the new system.
The team will start communicating with service organisations and support workers in Mid-Central in October about what the new system might mean for them.
What form will the new organisation take?
No decision has been made on the form of the organisation at this stage. This will be worked through as part of the next phase of design.
What does it mean for Disability Support Services (DSS)?
The new organisation will have much broader responsibilities and funding than the Ministry of Health’s DSS currently has.
DSS has been working within the scope of the existing system and has made a number of improvements for disabled people, for example, supported independent living, individualised funding, flexible respite. DSS has also undertaken a demonstration in the Bay of Plenty (New Model for Supporting Disabled People) testing a number of components the new system will build on.
The implications for DSS in the longer term are still to be worked through.
What does it mean for Needs Assessment Service Coordination (NASC) organisations?
NASCs have been working within the constraints of the existing system and Ministry guidelines. Changes to the system will enable more flexible, client-directed ways of working. The implications for NASCs in the longer term are still to be worked through.