Issue 16-Newsletters-News and Publications-Disability

Disability in New Zealand
News and Publications

Disability Services Newsletter - Issue 16 - August 2006

Issue 16 - August 2006
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In this issue:

Environmental Support Services in Action
Marie Manning has been ‘thrilled’ with her daughter’s improvement as a result of something as simple, but important, as modifications to the family bathroom, funded by the Ministry of Health.

Jessica, one of six children in the Manning family, has a rare syndrome resulting in a severe intellectual disability, visual impairment and other serious medical conditions that require constant care by both her family and medical staff. As a result, she cannot manage her own hygiene and requires considerable assistance from her mother. This was extremely difficult in the cramped family bathroom. Showering in the small shower box with a step into it had become especially dangerous as Jessica could slip and fall. Sometimes she would accidentally knock against her mother who would be helping her shower in the small space, and both had been injured. As well, the other teenagers in the family often found it difficult to get to school or work on time because of the amount of bathroom time taken up with Jessica’s care.

Christine Higgins, a Community Occupational Therapist for Waikato DHB, is a specialised housing assessor for Enable New Zealand. When Christine undertook a reassessment recently, she was concerned about both Marie and Jessica’s safety and recommended a wet area shower, which was fully accessible, as an urgent need. With people like Jessica, lucky enough to have a family that is highly committed to caring for her long term, it is a high priority and very cost effective to make sure that both the person and their carers are safe. This helps ensure that the person can remain at home as long as possible. It took only one week for Enable New Zealand to approve the alterations, and the contractor was able to complete the work in 10 days. Marie was amazed at how quickly the bathroom alterations were completed, and grateful that the contractor was sensitive to the family’s needs and did not arrive till Marie had tended to Jessica.

The change has been remarkable. Previously, Marie would worry about Jessica managing the step into the shower, the pressure of the water and the risk of Jessica slipping and hurting herself. ‘Now I don’t worry about her falling because of the non-slip floor, and I know the water pressure and temperature will be correct. Having a modern shower fitting with a flexible hose for someone with a colostomy also makes a wonderful difference.’ In addition, being able to fit a shower chair into the area ‘has just been wonderful’. Jessica is much less reluctant about having to shower twice a day and it doesn’t take as much time. ‘Now she may even initiate it saying, “Oh Mum, I’ll go and have a shower”.’

Christine Higgins considers the improvement to Jessica’s level of personal independence has been ‘the icing on the cake’ as it initially had not been a goal. ‘The goals had been the safety and viability of continuing care by the family and this has been achieved.’

Jessica regularly needs hospital treatment and now that there is a bathroom with better access, she can be discharged earlier. ‘We used to think that we would have saved the hospital money if we could have brought her home earlier. Now we can,’ Marie says. The difference to herself and her family is amazing. ‘I’m just so excited about it. I’m still on a high.’

What are Environmental Support Services?

Environmental Support Services are provided by the Disability Services Directorate, Ministry of Health to support disabled people and older people, and their family or whanau, to live as independently and safely as possible. They include:

equipment, such as wheelchairs, hoists, walking aids, hearing aids and equipment to help with communication and vision
housing modifications, such as door widening, handrails, ramp access and level access showers
vehicle purchase and/or modifications, such as hand controls.

People of all ages who have a disability that lasts for more than six months may be able to access Environmental Support Services. Their disability may be a physical, intellectual, sensory (vision or hearing) or age-related disability (or more than one of these).

Equipment and/or modifications can be provided if a Specialised Assessor has identified that they are essential for the disabled or older person to manage in their home or for their work or tertiary study. Equipment may also be available to support the main carer of a dependent person.

The Ministry of Health is currently preparing a factsheet describing Environmental Support Services. This will be circulated to a wide range of community agencies so that people are more aware of these services and know how to access them.

If you would like more information about Environmental Support Services please contact:

Accessable (for people living in the Auckland/Northland region), freephone 0508 001 002, www.accessable.co.nz
Enable New Zealand (for people living in the rest of New Zealand), freephone 0800 17 1995, www.enable.co.nz

Environmental Support Services Review Summary Report

This report summarises the findings from the Review of Environmental Support Services funded by the Ministry of Health. It provides a summary of how the review was carried out, and lists key findings and recommendations for the future provision of environmental support services.

In 2004, the Ministry’s Disability Services Directorate commissioned an independent national review of the provision of Environmental Support Services (the Review). The objective of this Review was to provide information, analysis and recommendations for improving Environmental Support Services service provision to ensure that it is, ‘disabled and older person centred, efficient and makes effective and fair use of available funding’. A key focus of the Review was to identify ways to improve access and eligibility criteria, making them easier to understand and ensuring that they work better for disabled people, their families and whanau.

People throughout the country participated in the Review, including disabled people, older persons, Maori, Pacific peoples, health professionals, families, carers, Environmental Support Services providers, non-government organisations and representatives from government agencies.

In response to the key findings and recommendations from the Review, the Disability Services Directorate and the Health of Older People have prepared an outline of how the recommendations from the Review will be addressed. Some work has already started, and progress will be regularly updated on-line at http://www.moh.govt.nz/disability.

This report is not available in hard copy but you can read it or print a copy from http://www.moh.govt.nz/disability where it is available as a Word or PDF document.

If you would like more information you can look under Programmes/Projects on-line at http://www.moh.govt.nz/disability or email ESS@moh.govt.nz.

Geraldine’s update
Geraldine Woods
Deputy Director-General, Disability Services Directorate

Well, we are in the full swing of winter, with the cold, wet conditions providing a challenge to many of us. Our round of consumer forums, hui and fono have now finished for this year and these have been a valuable experience for everyone in the Directorate who was involved. We are finalising a report on the meetings and looking at how we can use our 2006/07 work plan to address isssues raised. I enjoyed getting out around the country and meeting as many disabled people, their families, whanau and carers as I did.

As many of you may know there is a Parliamentary Select Committee Inquiry into the quality and care of service provision for disabled people. The Social Services Committee has called for submissions on this inquiry. The terms of reference can be found at http://www.clerk.parliament.govt. nz/Programme/Committees/Submissions/ ssinqdisabled.htm. If you wish to make a submission, and I encourage you to do so, the closing date for these is Friday 25 August.

The Government has once again increased funding for disability support services for the 2006/07 financial year. An extra $63m has been appropriated to bring the Directorate’s total funding for 2006/07 to $757.2 million. In particular, the Government has identified home based support services and residential care as service areas to be given funding increases as a priority. Specific extra funding has also been allocated for services associated with the Intellectual Disability Compulsory Care and Rehabilitation (IDCCR) Act 2003. Other service areas will also receive funding increases this year. As we complete our planning for these increases over the next week or two, providers will be notified directly.

Home Based Support Services Training Initiative

The Disability Services Directorate, in conjunction with the Community Support Services Industry Training Organisation (CSSITO), has implemented a national training initiative designed to boost the number of home-based support workers with foundation level training.

The training initiative aims to address the basic training of workers who provide support services in the home, which was highlighted as an issue in a Disability Services Directorate-led Quality and Safety project completed last year.

The training initiative will assist Home Based Support Services (HBSS) support workers to complete the National Certificate in Community Support Services (Foundation Skills) Level 1.

Three-phase programme
A three-phased approach is being used to recruit the target of 1,200 HBSS support workers into the project.

Phase One has eight providers that are getting their training and assessment materials analysed against the qualification requirements. This analysis will then be used to establish training plans for each support worker recruited for the trial.

Phase Two sees the remaining providers that were training ready and want to participate in the trial starting the process. All of these providers have had the opportunity to attend their first meeting about the initiative. Meetings were held in July in Auckland, Tauranga, Wellington and Christchurch.

Phase Three has one provider that completed the self review by the first cut-off date, but was not training ready. This provider is currently receiving provider development support so they can participate.

Provider development programme
The remaining three providers that completed the self review by the second cut-off date, and who required provider development in order to be ready for the wider roll out, are in the process of having provider development plans completed. A provider development plan outlines all the requirements of a HBSS provider and steps to undertake to be training ready.

A stakeholder meeting will be held on 16 August, at the Terrace Conference Centre (Te Aro Room) St John House, 114 The Terrace, Wellington.

For any enquires or information, please contact:

Diana Allardyce, CSSITO
Ph: 03 374 1308
Email: dianaa@cssito.org.nz

Anne Bell
Disability Services Directorate
Ph: 04 496 2122
Email: anne_bell@moh.govt.nz

Or you can look under Programmes/Projects online at: http://www.moh.govt.nz/disability

Introducing New Staff

Rowanne Janes Quality Analyst, Quality and Audit Team I joined the Quality and Audit Team in May as a quality analyst. I have been involved in the disability sector in New Zealand for a number of years. During this time I have gained a wide range of experience and knowledge in a variety of different roles, from supporting people with disabilities and their families, to working with disability service providers in the ongoing development of services. More recently, I worked as a team leader and team member on numerous quality audits/evaluations of a range of residential, supported independent living and vocational services for people with disabilities. In addition to this work, I managed a successful project to implement ongoing nationwide support workshops for families providing support to a family member with an intellectual and/or physical disability.

My qualifications include a Bachelor of Social Sciences in Human Services (Disability) and Diploma of Teaching People with Disabilities. Outside of work I enjoy being with family and friends, and have a strong interest in creative work, the arts and theatre.

Disability Allowance for People in Community Residential Services

In the 2006 Budget the Government announced that it is investing $60 million over five years in Disability Allowance.

This means people with physical, sensory, intellectual and psychiatric disabilities living in community residential services and who receive a Residential Support Subsidy can now apply to Work and Income for a Disability Allowance. The Social Security (Long Term Residential Care) Amendment Bill, introduced into Parliament on 9 May 2006, and later amended via a Supplementary Order Paper, will confirm their eligibility for Disability Allowance.

People receiving a Residential Support Subsidy can apply for a Disability Allowance on the same basis as other people living in the community. A Disability Allowance will help with residents’ ongoing disability-related costs, such as medical and dental fees, pharmaceutical and some other costs that are not covered in their service providers’ contracts with the Ministry of Health or a District Health Board.

The Disability Services Directorate (DSD) asks all its residential providers to encourage clients to apply for disability-related costs which are clearly not covered by residential support contracts or other Vote Health funding. Work and Income’s Residential Subsidy Unit, which is processing all applications, knows what is covered by DSD’s various contracts for the different client groups.

The Residential Subsidy Unit has sent letters to key stakeholders and all Residential Support providers and clients to tell them about the change. If you have further questions on what the Disability Allowance covers or how to apply, you should contact the Residential Subsidy Unit on Freephone 0800 999 779 or you can write to them at Private Bag 9032, Whangarei.

Check out the Disability Services’ Directorate webpage www.moh.govt.nz/disability for more information on the eligibility of Residential Support Subsidy clients.

Funding Increases

Home Based Support Services (HBSS)
We are currently implementing a $1.50 an hour increase for HBSS providers who have established an agreed travel reimbursement policy for their care workers. To date, the majority of our HBSS providers have agreed policies with the various funders and these are now being incorporated into contracts along with the increased funding. Further HBSS increases are likely later in the financial year following service development work by the Directorate. The first stage of implementation will be completed by mid August 2006 with the second stage occurring in February 2007.

Residential
Extra funding will be allocated to residential contracts in the first half of this financial year to continue the move to greater national consistency in the funding of providers. Significant progress was made with increases put into place for 2005/06, and will continue with new funding from Government. With over 400 contracts in place for residential services, the work required to implement these increases is considerable for the Directorate. These increases will be implemented by 1 October 2006 (or the closest payment period to this).

IDCC&R Act 2003
Services established to support the needs of people falling under the Act has received further Government funding for 2006/07 for the continued development and strengthening of services to ensure the Ministry can meet its obligations under the Act. Increases will be implemented from 1 July 2006.

Supported Independent Living (SIL)
DSD is in the process of implementing funding increases for some of its contracted SIL providers. The injection of extra funding, mainly to South Island and lower North Island providers, will largely bring national consistency of pricing to this sector. The quantum of new funding is $1.3 million and will mean that the new benchmark hourly rate for the ‘community support worker’ component of the service will be $24 an hour (up from $17 in the South Island and lower North Island). Total budgeted expenditure for SIL in 2006/07 is $16 million. Increases will be implemented in September 2006.

Respite Services
The Directorate has prioritised extra annual funding of $2 million for respite services. The majority of this funding will go to increase the number of respite services, recognising the shortages existing in some parts of the country. As new services will need to be tendered for in some areas, implementation of this extra funding will take time to complete and will continue throughout the year.

Environmental Support Services
The Directorate is increasing overall funding to this vital service area by $9 million which equates to an overall funding increase of 14.9 percent over 2005/06 expenditure. Most areas of environmental support should receive some increase in funding over the 2006/2007 quarter.

Disability Information and Advisory Services (DIAS)
Most DIAS providers should have received, or be in the process of receiving, a 5 percent increase in contract funding.

Other
In addition to these increases, the Directorate is planning (and in some cases already implementing) funding increases for needs assessment and service co-ordination, child development (both DHB delivered and community delivered), behaviour support, day programmes and community rehabilitation.

Having their Say on Disability Support Services

Disabled people, their families, whanau and carers have recently participated in a series of consumer forums run by the Disability Services Directorate throughout the country.

The forums, hui and fono were held in rural and urban centres as well as at marae and fale, and follow on from meetings held last year in the main centres. The forums offered an opportunity for disabled people to meet Ministry staff and voice concerns they may have with the services they receive. It also provided an avenue for the Directorate to outline what we are currently doing and a vision for future provision of Disability Services Directorate-funded disability support services. Deputy Director-General of Disability Services, Geraldine Woods, attended many of the meetings to hear first hand what was happening for the people who use the services we fund. Participation of consumers in service development and provision is a key objective of the New Zealand Disability Strategy and a critical part of the Directorate’s work programme. Running the consumer forums on an annual basis will foster this.

The main themes identified were that the current system of support is not flexible enough (including access to funding and availability of services), support for families is limited, there is a lack of information available in an accessible and appropriate format and there are concerns about the availability and quality of the disability support workforce.

A report on the feedback from these meetings, will be available online at www.moh.govt.nz/disability.

For further information please contact

Cathy Dymond
Project Leader
Email: cathy_dymond@moh.govt.nz

Julz Britnell
Communication Advisor
Email: julz_britnell@moh.govt.nz

Consumer Consortium

The Disability Services Directorate of the Ministry of Health held its second Consumer Consortium meeting in Auckland in June this year. The consortium is a group of 18 disabled people and/or family members of disabled people, who meet twice yearly to advise and provide input into the planning and development of disability support services.

At this meeting, Geraldine Woods, Deputy Director-General of the Disability Services Directorate, discussed feedback from the consumer forums held to date throughout the country, and sought input into developing the next stage of the Directorate’s vision.

The draft Directorate work programme for 2006/07 was outlined to the group and specific advice and comment was requested from members on some of our key projects.
These include the Environmental Support Services Development Programme and implementation of the Needs Assessment and Service Co-ordination Development Programme.

Discussion was also held and feedback sought on communication, the consumer consultation process and the proposed website restructure.

The agenda for the next meeting, scheduled for November, includes planning for the next round of consumer forums, with keen interest from the group to be involved in planning and running these meetings.

For further information on the Consumer Consortium contact Cathy Dymond, Project Leader, on cathy_dymond@moh.govt.nz