Breda CrehanRoche Chief Executive Ability West Transferring Power

Breda Crehan-Roche Chief Executive, Ability West

Transferring Power from the Service Provider to the Individual Breda Crehan-Roche CEO Ability West

Intellectual Disability • Strategic Direction • Service Providers • HSE– Block Funding • Contractual Service Level Arrangements • New Policy -VFM & Policy Review Report for consultation mid Oct 2011

Disability Services • Legislation • Currently no mandatory standards • HIQA Residential Standards yet to be implemented • Traditionally Health Service did everything • Cross sectoral approach required

What do individuals want? • Flexible supports to meet needs • Local services • Get different elements of service from different providers • Budget - choose and manage • Families want to play their part in supporting their family member

Public Consultation Key Issues Report of Public Consultation Efficiency & Effectiveness of Disability Services in Ireland (December 2010) Department of Health & Children • Quality of Life Issues – determined by exercise of choice and control achieving and maintaining independence and community participation • Organisation & Delivery of Services – importance of consultation, individualised funding, control over money, flexible and person centred services, access to healthcare, transport, housing, education and employment

Challenges • Economic Climate • Government Plans -Public Sector Reform • Budget Cuts- more for less • Increasing demand for services • Monitoring of Quality & Standards • New Policy & Implementation of this Policy

Challenges ( Contd. . ) • New Directions Report Day Services • Roll out of Progressing Disability Services for Children & Young People • Congregated Setting Report • Staffing Moratorium – Vacant Posts • Efficiencies through increased collaboration & sharing of resources

Transformational Shift Required • Self-direction and determination, opportunities for inclusion and participation, achieve good outcomes in a cost effective manner • Shift to individualised budgets and transfer the balance of power

Changes Required • • • Legislative & Administrative Changes Structure for Decision Making Agreed Costing Methodology Mainstream Agenda Role of Sectors Self- managed / directed budgets Commissioning

Types of Individualised Funding • Direct Payments • Personal Budgets • Individualised Ringfenced Funding

Direct Payments • Individual employs people • Commission services for themselves • May require support from organisations

Personal Budgets • Funding allocated to service user • Personal Budget as a Direct Payment • Or they can choose to engage with a service provider

Individualised Ringfenced Funding • Funding ringfenced to the service user • Requirement to hold as ringfenced fund in organisations accounts

Individualised Funding • Better relationships & collaboration • Greater accountability to the service user and citizens • Increased choice and greater control • Increased public participation in decision making

New Funding Arrangements • Reduction in block funding • Multiple Funding Sources • Introduction of Commissioning

Current Work • NDA Study on Commissioning • Some non-statutory service providers involved in developing and piloting resource allocation models • Need agreed costing methodologies

Commissioning Potential Advantages • Align needs with service provision • Transparency - costing • Opens the market • Drives innovation & improvements • Greater choice • Monitoring

Potential Risks & Disadvantages • Disruption of services • Commissioners Experience • Competition & cost • Onerous reporting requirements • Sustainability of Service Providers • Could Lead to Cherry Picking • Competition – Equal Footing

What is required? • Active Partners in Decision Making • Structure for Decision Making • Existing and Future Employment • TUPE* * European Communities (Protection of Employees’ Rights on Transfer of Undertakings) Regulations 2003 (“the TUPE Regulations”).

Other Issues • Person must know what services they want and need • Have a clear desire to take responsibility for improving their services • Direct Payments may not be for everyone • Empower to be Active Partners

Conclusion • The future will challenge, but also provide opportunities for service providers to be more creative, flexible, to be truly person centred and to empower service users to have more control and choice in their daily lives. After all that is why we exist.

Further Information Resource Allocation Models Supports Intensity Scale www. siswebsite. org The American Association on Intellectual & Developmental Disabilities www. aaidd. org In Control UK - http: //www. in-control. org. uk/

Thank You for your attention Ability West Blackrock House, Salthill, Galway. Tel: 091 540900 Email: enquiries@abilitywest. ie Web: www. abilitywest. iecom/abilitywest