Individualised Funding Policy

Transcription

1 POLICY NO: SP-34 VERSION NO: 1 DATE OF IMPLEMENTATION: August 2013 APPROVED BY: REVIEW DATE: August Introduction: Individualised Funding Policy Many people with disabilities and their families are demanding a greater voice in determining how their needs are met. Families, carers and service providers have advocated that government provide the option of individualized funding. Individualised funding is a term used to describe a funding model that places the person at the centre of decision making and offers choice and control in planning reasonable and necessary supports. Individualised funding is allocated to a specific person and only transferred to the service provider when that person chooses to receive eligible services and supports from the provider. The current service delivery system creates a number of frustrations for many individuals and families receiving or trying to receive supports and services through traditional organisational funded programs. This includes a lack of independent planning, limitations in choosing services, a lack of flexibility in service delivery, little or no control over how supports and services are provided and limitations to the portability of services. For some individuals and families, the flexibility and portability provided by individualised funding contribute to a greater sense of empowerment, self-determination and control over their lives. This contributes to a better quality of life, overall health and greater opportunity for community inclusiveness. For individualised funding to succeed, it is essential that government commit to supporting a quality service delivery system that is responsive, flexible; and, accountable to the people it serves. As a response to sector changes that incorporates the formalisation of individualised funding for participants ConnectAbility Australia is committed to ensure that each person with a disability receives a service that is designed to meet his or her individual needs and personal goals. 2.0 Purpose of the Policy: The purpose of this policy is to implement an overarching framework for the use of individualised funding. ConnectAbility Australia will use this policy to identify its position on individualised funding as a particular model for the provision of supports and services to all participants. ConnectAbility Australia will identify what it considers imperative to ensuring fair and equitable access, and service provision for people who are receiving individualised funding. Date: August 2013 Review Date: August 2015 Page 1 of 8

2 3.0 Definitions: Choice and control: Where people know what supports are available, how effective they are, their price, how to access them and they can decide where they obtain their supports and services. Disability support: Supports that specifically meet the needs and goals of a person with disability to reduce the impact of disability on their life. Individualised funding: A funding model through which a package of funds are allocated to a person with disability and are portable. Individual plan: A document that describes the life a person would like to lead, how they will achieve this and who and what will help them achieve this. The plan will focus primarily on the natural supports which will contribute to achieving personal goals and, if required, it will include details of financial resources needed to implement the plan s strategies. It will clearly state how the person and the service will know they have achieved the desired results. This may include formal supports. Person centred approach: A way of supporting and working with people with disability that keeps the person at the centre of decision making, across planning, funding and support and service arrangements. Self-directed supports and services: An approach which is characterised by people with disability, their families and carers having genuine choice and control over the planning, design and implementation of the supports and services they require. This includes access to personalised support arrangements and, where required, flexible funding that is tailored to the needs of the individual. Natural supports: Family, friends, neighbours or organisations (for example, volunteer networks) that surround and support a person. Financial intermediary: Means a service that holds the funds, pays the bills and provides regular accounts but does not make planning decisions or provide other support services. 4.0 Policy Statement: This policy provides ConnectAbility Australia s overarching framework for the use of individualised funding. People with specialist disability funding are able to self-direct their supports and services, have flexibility in how their allocated funding is used and have genuine choice and control over the design, planning, scheduling and delivery of supports and services they require. This is intended to lead to better outcomes for people with disability, their families and carers. The policy framework prioritises the empowerment of participants in the planning, design, scheduling and delivery of supports and services. Date: August 2013 Review Date: August 2015 Page 2 of 8

3 This policy is based upon the principles outlined in New South Wales Disability Services Act 1993 and in accordance with the New South Wales Disability Service Standards. The principles for the use of individualised funding will be congruent with the Living Life My Way framework and Stronger Together 2 reform implemented by the New South Wales Government, and the National Disability Insurance Scheme (NDIS) legislation. The Department of Family and Community Services, Ageing Disability and Home Care is currently removing limitations and boundaries for individualised funding so participants have greater control over their funding and choice over supports. This allows people to determine how individualised funding is used to address needs and goals and produce the outcomes they want to achieve, within what is deemed to be reasonable and necessary (a description of reasonable and necessary supports is provided in Attachment 1). This will be achieved by a more holistic planning and service delivery process. 5.0 Principles: Principles for the use of individualised funding have been drawn from the United Nations Convention on the Rights of Persons with Disabilities (2006), the Disability Services Act (2006) and the Disability Service Standards NSW. These principles are important because individualised funding is not just a funding mechanism. Individualised funding promotes the independence and well-being of the person concerned. The key principles for each person are: Rights and Inclusion ConnectAbility Australia will promote the rights of people with disabilities and their inclusion and acceptance in the community as equal members of society. Individualised funding and associated planning supports must be flexible and responsive to the culture, values and preferences of each person and their family. Information and Access Provide opportunities for participants that will ensure participants of ConnectAbility Australia and their families have information about the range of supports and services available and equitable, fair access to supports and services that they require to meet their current reasonable and necessary needs. Choice and Self-Determination Maximise opportunities for people and their families, by maximising their involvement in the planning, development and evaluation of individual services and as a way to meet their needs for services and supports more effectively, and to achieve greater self-determination. ConnectAbility supports the human rights basis underpinning this funding model with its fundamental emphasis on individual choice and self-determination. Personalised Supports and Services Ensure services provided to people and their families enhance their independence and are delivered in a sensitive, coordinated and timely manner. Supports and services must be underpinned by personalised schedules/plans which determine goals, specific service and support elements and appropriate levels of funding tailored to individual recipients, and should Date: August 2013 Review Date: August 2015 Page 3 of 8

4 cover all reasonable service and support elements identified as necessary to achieve the stated goals. Supports and Service Systems Develop and support an effective service system which will: - provide participants and their families with equitable access to services; - focus on individuals and is responsive to their needs; - collaborate effectively with other key service providers; and - provide stability and continuity of care to participants and their families. 6.0 Implementation Guidelines Detailed processes to implement individualised funding participants, their families and carers are being developed nationally. ConnectAbility Australia has identified the key features of individualised funding, which need to be included to ensure that the principles outlined above are enacted. 6.1 Support and Information The participant, their family and carers are supported to make their own decisions as much as possible; Ongoing support is available as required by the person, their family and others who represent them to plan, schedule, review and manage supports, services and funding to meet the needs and goals of the participant identified in their support plan and to maintain accountability and legislative requirements; ConnectAbility can provide information in relation to individualised or self-directed funding to the person and their family and others responsible or involved in the provision of supports and services; ConnectAbility Australia is able to provide Independent advice regarding supports, resources and options available. ConnectAbility acknowledges that it does not stand to make gain from any independent advice provided; Information and advice provided is timely and appropriate considering all communication and cultural needs; Support is available to the participant, their family and others who represent them to be active partners with Government in developing individualised funding options. 6.2 Individualised Planning and Scheduling Planning is directed by the individual or those close to the person and is central to the individualised funding approach. ConnectAbility Australia recognises that planning is based on the person s needs as well as their aspirations and goals, as much as possible, and takes into account the likely available resources; It is important for planning discussions to occur prior to any assessments or reviews taking place to determine what reasonable and necessary supports are required and that this considers all aspects of the person s life. This will assist in determining more accurate and appropriate individual funding allocation for supports and services required; Planning involves others as appropriate who are responsible or involved in the person s care and well-being, such as family, carers, advocates, friends and professionals. Planning and scheduling of supports should, where possible, strengthen and build capacity of natural supports to provide the support role to the participant; Date: August 2013 Review Date: August 2015 Page 4 of 8

5 Each person receiving an individualised funding package will have a plan that documents their outcomes and strategies and will be linked to the funding provided to the participant; Any informal, family and community supports should be explored and supported in the planning or review process prior to consideration of any funded supports; The person, their family and important stakeholders is central to the review and decisionmaking process for future supports and services; ConnectAbility Australia will ensure planning is conducted in a transparent and person centred manner. Planning and scheduling of supports and services will encompass the person s rights, their well-being, opportunities available and promote access to community and universal services; ConnectAbility Australia recognises a reasonable balance is needed between safeguarding the person s wellbeing and the right of the person to choose to participate in activities involving a degree of risk; The person s plan will outline schedules of support, outcomes and strategies that are achievable and sustainable, reviewable and renewable; ConnectAbility Australia recognises that a participants plan can be reviewed and changed as required. At a minimum an annual review will be implemented to ensure that the needs of the person with a disability are being met, quality outcomes are being achieved and the person s well-being is safeguarded; A review schedule will be implemented based on the needs and requirements of the person at any given time. It is essential the planning and review process is a consultative and collaborative process involving all stakeholders in a holistic approach; ConectAbility Australia acknowledges planning facilitation will be funded by Government and recognises it will be offered to participants independent of service providers, including ADHC and others with a potential conflict of interest. 6.2 Individualised funding: Levels of funding for services and supports covered by individualised funding must consider the nature, frequency and intensity of an individual s functional need at any stage of a person s life, and be sufficient to meet an appropriate standard benchmark of support, without the requirement for user co-contribution; Will provide opportunity for people and their families to maximise choice and control over reasonable and necessary supports and services required by the person, their families and carers to achieve the outcomes, goals and needs identified in their plan; ConnectAbility Australia will work with the person and their family to determine the appropriate use of their individualised funding allocated to achieve outcomes, rather than working within defined programmatic guidelines determined by funding providers; Individualised funding should increase opportunity to access and participate in valued roles and opportunities for community inclusive outcomes; People and their families will be provided assistance to have access to information relating to expenditure used for supports and services provided by ConnectAbility Australia. 6.3 Individualised funding scope: The following will guide individuals, families and carers in determining how funding can be used to achieve desired outcomes: Funding is allocated to the person and not allocated as a block amount to a disability support provider; Funding will support incurred costs that are directly related to the additional costs of the impact of the person s disability on their life; Date: August 2013 Review Date: August 2015 Page 5 of 8

6 Funding will be used to purchase supports and services from ConnectAbility Australia deemed to be reasonable and necessary to achieve outcomes identified in the individual plan (refer to Attachment 1); Funding can be used flexibly and tailored to the individual but spent in accordance with an approved support plan; Funding can be used for activities, supports and services from informal networks, community services and from the formal disability service sector; Any formal supports are complementary to, and supportive of, the primary role of family, friends, networks and community in ensuring a good life for the person and will not replace these more natural supports; The participant, their family or their representative, can choose to manage their individualised funding package in one of four ways. Funding can be held by the person or their representative, by a financial intermediary service, by Disability Care Australia or by a disability service provider. Funds are portable and can be moved from one financial intermediary service or one disability service provider to another; Where ConnectAbility Australia is the fund s manager or a proportion (no greater than 5%) of unspent funds can be rolled over from one financial year to the next; Where ConnectAbility Australia is the financial intermediary and holding the person s funds it will provide monthly accounts for all expenditure; Funding will be reviewable and renewable at any time based upon the outcomes in the individual plan or the changing needs of the individual; Funding is used for purposes which are consistent with the person s choices and decisions, and balances the dignity of risk with duty of care. 6.4 What individualised funding will not fund or provide replacement or supplementary income for family members (except in special circumstances approved by Disability Care Australia); for purposes that are likely to cause harm to the person or pose a risk to others; for purposes that are inconsistent with the best interests of the person; illegal activities and / or gambling; income replacement for individuals with disability; costs not related to a person s disability support needs such as day-to-day living costs that are incurred by general members of the community (e.g. standard rent, groceries, utility fees); and for purposes that duplicate other supports delivered under alternative funding through Disability Care Australia. 6.5 Support Worker Engagement Participants engaging ConnectAbility Australia to purchase supports and services can utilise Support workers in one of three ways: (1) Recruited from the open market by the person, or their representative, who becomes their legal employer; (2) Recruited by the person or their representative and legally employed by a third party agency (a disability service provider or cooperative); or (3) Supplied by a disability servicer provider who is the legal employer. Support workers will be employed in accordance with relevant industrial awards and conditions. Presently there are potential system, procedural and resource implications attached to the implementation of ConnectAbility Australia s Individualised Funding Framework. It is expected that Date: August 2013 Review Date: August 2015 Page 6 of 8

7 continued review and implementation will continue to occur at a government level. The administration of individualised funding in the new procurement environment will continue to be movable and changeable. As individualised funding projects for people with an intellectual disability expand and develop in New South Wales, it is expected that new and improved ways of implementing these guidelines will become available. 7.0 Formalising Supports With ConnectAbility Australia ConnectAbility Australia recognises and acknowledges that participants, their families and carers who are provided supports and services may want to create a written host agreement. A host agreement will help to ensure that the participant and ConnectAbility Australia have an agreed set of expectations of how supports and services will be delivered. The host agreement will also outline what each party s responsibilities and obligations are, and how to resolve any problems should they arise. Some things that may be specified in a host agreement are: The supports that will be provided; The cost of supports; How ConnectAbility Australia will be engaged to provide supports and services to be delivered; The duration the supports will be provided; When and how the host agreement will be reviewed, and who will be involved in the review; How the participant, their family and carers will deal with any issues or grievances should they arise; What the participant, their families or carers responsibilities are in relation to supports and services being provided - for example, cancellation of support; What ConnectAbility Australia s responsibilities are in the agreement for example to work with you to provide services that suit your needs; What procedure is needed to end or exit the agreement. 8.0 Consultation This is a new policy introduced to increase flexibility and innovation in supports and services for ConnectAbility Australia participants, their families and carers. As a response to changes to the disability sector ConnectAbility Australia has been proactive in its consultation mechanisms to develop and implement an effective Individualised Funding Framework. Consultation has occurred with a number of peak bodies in the disability sector, namely National Disability Services New South Wales (NDS NSW), Ageing Disability and Home Care (ADHC), and Disability Care Australia (DCA). The NDIS legislation and draft rules have been researched to determine alignment of this policy and framework. It also draws on the direct experiential knowledge of staff, and research and consultation within the organisation, including participant s families and carers of ConnectAbility Australia. 9.0 Quality assurance mechanisms Individualised funding must be underpinned by a quality framework that ensures consistency and a high level of quality care and support for participants, their families and carers. Such a framework must be informed by human rights principles, contain nationally consistent standards, clear accreditation mechanisms, sound compliance and monitoring systems, and information readily available to participants, families and carers to inform them of minimum quality expectations. Date: August 2013 Review Date: August 2015 Page 7 of 8

8 10.0 Related policies, guidelines and legislation Living Life My Way consultation papers NDIS Legislation NDIS Draft rules June 2013 NSW Disability Services Standards Disability Services Act Service Standards Policy Code of Ethics and Practice Policy 11.0 Communication This policy will be: communicated to the key internal and external stakeholders; communicated to ConnectAbility Australia staff through professional development opportunities; accessible through ConnectAbility Australia s internal intranet and website Training ConnectAbility Australia Senior Management will identify staff responsible to implement the policy and /or who will be affected by the policy, and provide information and training as necessary to enable staff to comply with all areas described within this policy Evaluation and review This policy will be regularly reviewed as contextual drivers within the disability services sector continue to evolve. The move to individualised, self-directed funding is a priority of the National Disability Agreement (NDA). The continued implementation of Stronger Together 2 and introduction of the Disability Care Australia scheme will provide evidence as to the planning and future direction of individualised funding implementation for ConnectAbility Australia. This policy is not intended to be a static document and ConnectAbility Australia will make a commitment to its ongoing development. Version Date Author Reason Sections 1 July 2013 Scott Harvey New policy All Date: August 2013 Review Date: August 2015 Page 8 of 8