Support services

---

Ministry of Health, Disability Support Service (DSS)

DSS funds support services for all disabled children and young people under 65yrs who are not funded by ACC. To be able to access DSS funding your child/young person must have a physical, sensory (vision, hearing), or intellectual impairment that is likely to last for more than 6 months. In order to access DSS funded services you must first have an assessment by the Needs Assessment Service Co-ordination (NASC) service.

 

---

NASC Services

You can make a referral yourself to your local NASC service or you can be referred by your doctor or other health professional or support agency. If your child meets the DSS criteria (see above) arrangements will be made for a person from the NASC to visit with you to find out what support is needed.

The assessment can be arranged at a place and time to suit you and your family. It can seem quite intimidating being asked in depth and personal questions about your family’s life and how you cope and it’s often a good idea to have a support person with you, someone not as emotionally involved in the situation who can act more objectively.

You can request that the assessor is knowledgeable about your culture and if you require it an interpreter or sign language facilitator can be made available. If you don’t feel comfortable with the assessor or feel that they don’t understand your situation you can ask for a different person to attend. If at any time you want to stop the assessment you can do that. You may need to take a break for a while or continue it on another day.

Be well prepared before the assessment, by thinking about what support you and your family really need.  Ask that the completed assessment you are required to sign be left with you so that you can ensure it has fully captured what you have said and is correct. Remember that the funded services you receive will be based on this document.

To find out where your nearest NASC office is go to The Ministry of Health’s NASC page.

 

---

Community Day services

DSS funds day services for people with complex needs who have an intellectual disability in which employment is not an option.

To access a community day programme the young person will need to have a needs assessment through the NASC service who will determine how many half day sessions per week can be funded, with a maximum of ten half-day sessions. Your needs assessor will tell you about appropriate services in your area.

The community day service providers may offer a range of activities and all will work with you to develop an individual plan. Activities may include:

• Daily living skills
• Education and learning activities
• Social activities
• Recreation and leisure services

The Ministry of Social Development (MSD) funds community participation for other disabled adults not receiving funding from ACC. (see under Transition).

Community Day services funded by MSD are dependent on the level of ORS funding your child has when they leave school. It can be difficult to access a day service through MSD if your child does not have very high ORS funding. For this reason it is important that you advocate strongly with the school to apply for this if you believe that your child has very high and complex needs. The level cannot be changed after they leave school even if their needs increase.

To get into a Ministry of Health funded community day programme, you’ll need to be assessed by a Needs Assessment and Service Coordination organisation (NASC). The NASC works out with you how many sessions (half days) you can use each week. The maximum is 10 half days per week. This is reassessed annually, though it’s unusual that more sessions would be allocated.

 

---

Equipment and Modification services

If your disabled family member requires equipment or modifications to your home to help them do everyday activities and be safe, the Equipment and Modification services may provide you with free or subsidised equipment, depending on your needs and situation. They do not cover equipment that would be covered by ACC and you must live in NZ, be a NZ citizen or from a country that has a funding agreement with New Zealand.

Some items are not available from DSS funding:

• Items costing less than $50 (see Low-cost equipment and where to buy it)

• Those for medical or health needs, incontinence or therapy.

If you need equipment for less than six months you may need to borrow it from your district health board or hire it.

Equipment and Modifications Service (EMS) can support you by:

• providing advice on the best equipment or modifications to your home and/or vehicle to suit your particular needs
• providing equipment on long-term loan
• helping pay all or part of the costs of modifications to your home or vehicle.

Find out more about the support that can be provided go to The Ministry of Health’s Equipment and Modification services page.

---

How can I get equipment

If you want to get ministry-funded equipment, you’ll need to talk to an assessor. They’ll complete an assessment of your needs and look at ways to help you do your everyday tasks. With your help, the assessor identifies the equipment you need to be safe and independent at home, at work or study. For more information on the assessment process, go to Accessing Equipment and Modification Services.

 

---

Behavior Support

Behaviour support services are for people with an intellectual disability whose behaviour makes it difficult for them to engage in everyday activities and relationships. The Behaviour Support Service will work with your child/young person, family and support network.

Your NASC agency can talk to you about this service and arrange for a referral if appropriate.

 

---

Child Development services

These services are provided to help your disabled pre-schooler. They include a non-medical, multidisciplinary team of health and community based services who will work with you to encourage your child’s development. They can provide a specialist developmental assessment for your child and organise appropriate services to ensure that your child has the opportunity to enjoy life as best they can.

Talk to your GP, well child nurse or specialist if you would like further information about services in your area and the possibility of a referral.

 

---

Home and Community Support Services (HCSS)

DSS funds agencies to help with personal care and “managing” the home (household management). Funded hours are allocated in these two areas:

Personal care includes:

• Showering/dressing

• Eating/drinking

• Getting up and going to bed

• Toileting

Household management includes:

• Meal preparation

• Washing and drying clothes

• Vacuuming, dusting, cleaning the bathroom etc.

Household management is only available for disabled people with a Community Services card or for parents of children under 16yrs who have a Community Services Card.

A needs assessment from your NASC agency will determine if HCSS can help your family. Disabled children/young people can get support to help them with daily activities. Your NASC assessor can give you a list of suitable HCSS providers in your area. Once you have decided on an agency, they will develop a plan with you and discuss what qualities the support worker may need to best meet your needs.

 

---

Supported Living

Supported Living is available to any person with a mild to moderate disability who is 17yrs or older. It provides some assistance where there is a need for shopping, budgeting, accessing the community or dealing with agencies such as banks and Work and Income.  It cannot be used for personal care, managing the household, rehab or vocational services. A Needs Assessor will help to determine whether this service would be appropriate to meet the needs of the disabled person. It is funded by DSS and not means tested.

 

---

Community Residential Support Services (RSS)

DSS funds Community Residential Support to assist disabled adults to live in a community environment while receiving support for up to 24 hours a day. Services are provided in a range of settings from small to larger homes, group homes or flats. You need to be a NZ resident, under 65yrs, have a long-term disability and not be funded by ACC to receive residential services. Your needs assessor can tell you if this service would be right for the young disabled person in your family.

RSS is funded from the disabled person’s benefit and by DSS. A set amount from the disabled persons benefit towards the cost is determined by Work and Income and a small portion is retained for personal needs. DSS provides funding for the remainder of the cost. Work and Income can provide updated information regarding the amount of the personal allowance. Visit the Work and Income New Zealand website or phone 0800 559 009.

 

---

Carer Support (soon to be IChoose)

The Carer Support Subsidy subsidises some of the costs of having someone care for your disabled child/young person so that you can have a break. It is funded by DSS and the number of hours/days is determined by your needs assessment.

The Ministry is replacing Carer Support with a more flexible type of respite support called IChoose which is also known as a “flexible respite budget” which should make it easier for you to have a break from your caring responsibilities IChoose is not ready yet. When it is ready, we will advise you about the changes around the time of the disabled person’s review or reassessment. IChoose is a once or twice per year cash payment into your bank account. You will be able to use the money that we pay into your bank account to buy any respite support or service you want, as long as it gives you a break from your caring role.

The rates may vary in different regions but are around $75.00/24 hrs. There is only one rate in each area and depending on the complexity of your child/young person’s disability you may have to top up this rate to be acceptable or to attract skilled people. You can pay friends or family members (excluding parents or partners) who don’t live at the same address as the full time carer. You can’t go to work when you are using Carer Support payments. You can use it to pay a respite facility. The support payments received by the person giving you a break may be subject to income tax depending on the individual circumstances. They may wish to get further advice from Work and Income New Zealand website or phone 0800 559 009.

For more information on the subsidy, read How to Claim Carer Support and download a sample copy of the claim form.

 

---

Respite Care

A ‘respite option’ is any support or service that helps you to have a break from caring for a person with a disability.

Respite options can include:

• asking friends and family to hang out with the disabled person you care for while you take a break
• employing a support worker to spend time with the person with a disability
• paying for the person with a disability to do an activity or programme that they enjoy
• having an overnight break while the person with a disability stays with a friend, family member, support worker or an organisation with skills in caring for people with disabilities.

A Needs Assessment and Coordination Service or NASC can help you get funding for respite and find respite options that will work best for you.

The respite supports or services that are allocated by NASCs and funded by the Ministry include:

• Carer Support
• I Choose (flexible respite budgets)
• Individualised Funding
• Family Whānau Home Support
  (a ‘buddy’ or support worker for a few hours per week)
• Facility-based respite
  (an overnight stay at a respite house or other facility).

 

---

Individualised Funding

IF is available throughout New Zealand for eligible people who have either a Home and Community Support Services or Respite allocation. IF gives disabled people more choice in how they are supported. Home and Community Support Services include help with household management and personal care. Respite includes Facility Based Respite, Carer Support and In-Home Support.

IF gives you increased choice and control to choose who provides this support, and how and when you use it. Your options range from engaging support workers and planning how your supports used, to employing your own care providers and managing all aspects of service delivery.

IF can be used to:

• purchase Household Management, Personal Care provided by support workers (employees, contracted personnel or organisations) and pay costs relating to the employment of support workers
• purchase Respite through support workers or other opportunities where the full time carer is able to have a break (including school holiday programmes or facilities).

IF cannot be used to employ or contract support workers who are:

• the spouse/partner or parents of the disabled person; or
• family members who live in the same house as the disabled person. A family member is defined as a grandparent, grandchild, daughter, son, sister, brother, aunt or uncle.
• IF doesn’t cover costs related to medical supplies, equipment, home renovations, leisure, recreation and personal or family costs, and can’t be used to increase the personal income of an individual or family.

If you can manage your own services, or have someone in your support network willing to do so, then IF may be right for you. Talk to your local Needs Assessment and Service Coordination (NASC) service to learn more. They’ll do a needs assessment, which takes into account essential need and natural supports available to you.

You can get IF if you are eligible for Ministry-funded services, have talked to a NASC to see if IF is suitable for you and have been allocated a support that is able to be managed using IF.

The following combinations of contracted services can be transferred into IF budgets. Home and Community Support services (HCSS) Respite (either facility based and/or home support, Respite care and Carer Support

If you want to use IF to manage your support allocations, you must do this through an IF Host organisation. These are organisations contracted by the Ministry of Health to support people using IF. IF Hosts will help you understand IF, help you learn how to organise, setup and manage your supports, administer payments for the support services, help you manage your responsibilities – this includes reporting back to them on the support hours used, so that they can be paid for. IF Hosts are also required to ensure that the service is working well and report back to the Ministry.

All IF Hosts provide this level of service for a fee set by the Ministry. If you want IF Hosts to take on the responsibility for recruiting, training and paying your support workers and possibly managing the legal aspects of your service, your IF Host may do so for an extra fee determined by them and paid by you.

 

---

Hearing and Vision Services

The Ministry of Health funds a range of Hearing and Vision Services. These services can help with the cost of:

• hearing aids
• cochlear implants
• children’s spectacles
• contact lenses.

Children’s spectacle subsidy

Children with vision problems may be able to get this subsidy for examinations, frames, lenses, eye patches and repairs.

Equipment for people who are blind or have reduced vision

If you are blind or have reduced vision, the Ministry can help with equipment like mobility canes, screen-reading software, magnifiers and glasses.

Hearing services

If you or your child has hearing loss, find out what services are out there to help.

For more information go to the Disability Support Services website

 

---

Autism spectrum disorder support

People with autism spectrum disorder (ASD) can access a range of disability support services to enable them to live everyday lives and to connect with the wider community.

The following ASD-specific support services are available:

• ASD-specific Disability Information and Advisory Services (DIAS)
• ASD parent education (ASD Plus, TIPS for Autism, Growing up with Autism)
• ASD Communication and Behaviour Support
• ASD Developmental Coordination.

There is also a range of other disability support services which include such services as home and community supports, supported living, respite and carer support.

Disability Support Services (DSS) has developed a clear, nationally consistent approach to accessing disability support services for people with ASD. From 2 April 2014:

• people with a sole diagnosis of ASD as well as people with ASD and another co-existing physical, intellectual or sensory disability can access disability supports through DSS
• people who currently access disability support services will have no change to their level of support.

To find out more about ASD see Your Health guide to Autism Spectrum Disorder

---

The New Model

Between 2006 and 2008 the Government’s Social Services Select Committee heard from disabled people, their families/whānau and service providers that they were generally unhappy with how services were being delivered. Services weren’t coordinated and were often difficult to access; existing services and support were inflexible; and there was little choice about how support was delivered.

In response, the Government recommended a new way of providing support so disabled people could have the life they aspire to like other New Zealanders. It proposed a model for more choice, control and flexibility over support and funding in disability support that would be focused on giving disabled people and their families/whānau their everyday lives.

The New Model for disability support is made up of four elements which focus on:

• information and personal assistance
• support through funding rather than only services
• greater choice, control and flexibility
• stronger accountabilities.

Local Area Coordination

Local Area Coordinators work with disabled people to plan for a good life and be connected with their own communities.

LAC is available to people living in the Bay of Plenty (including the Lakes Region), Hutt Valley and Otago/Southland regions.

Enhanced Individualised Funding

Enhanced Individualised Funding enables disabled people to have more choice and control over funding. And includes funding for respite.

This is being demonstrated in the Eastern and Western Bay of Plenty.

Choice in Community Living

This is an alternative to residential services for disabled people. It offers more choice and control over where they live, who they live with and how they are supported

Choice in Community Living is being demonstrated in the Auckland, Waikato, Hutt, Otago and Southland regions. The demonstration has been evaluated to identify the key aspects of Choice in Community Living that have proved to be successful as well as identifying barriers that have impacted on its effectiveness eg. accessing affordable housing.

Supported Self-Assessment

Supported Self-Assessment – Understanding You and Your Situation is a new self-assessment form which assesses disabled people’s needs based on their strengths and capabilities. It helps the Needs Assessment and Service Coordination organisation learn more about the person and work out what disability supports you require to meet your goals.

This currently applies only to people living in the Bay of Plenty and Lakes regions.

 

---

Enabling Good Lives (The next “new” initiative)

In August 2011, the Minister for Disability Issues invited an independent experts group to advise on a ‘clean sheet’ design of supports for disabled people during the day. The group’s report, entitled ‘Enabling Good Lives’, recommended change to the whole system of supports for disabled people. It went further than the Ministry of Health’s New Model by drawing in a range of agencies and giving disabled people a stronger role in decision-making.

Over 2012, the Ministries of Health and Social Development worked with the disability sector and families to identify how to progress the Enabling Good Lives approach in the Waikato, Wellington, and Christchurch.

In September 2012, the Ministerial Committee for Disability Issues agreed:

• A vision for the future disability support system to support disabled people

• An agreed long term direction for change

• Principles to guide decisions on the changes.

These reflect the approach and focus for change described in the Enabling Good Lives report.

Enabling Good Lives is a new way of supporting disabled people that offers them greater choice and control over the supports they receive and the lives they lead. Christchurch school leavers with disabilities will be the first to benefit from it.

A three year demonstration of Enabling Good Lives has been approved by Cabinet in July 2013 to begin in Christchurch immediately. The demonstration will involve the Ministries of Health, Education and Social Development. Disabled people will have a strong role in governance. The demonstration will build on the Ministry of Health’s New Model for Supporting Disabled People.

The Enabling Good Lives Cabinet paper can be found on the Office for Disability Issues website. A link to the national Enabling Good Lives Leadership Group can also be found here.

 

---

Disability support System Transformation (the latest “new” initiative)

A nationwide transformation of the existing disability support system is under way.

The aim of the transformed system is to ensure disabled people and their families have greater choice and control in their lives.

The disability sector has been calling for change for a long time. In 2011, a group from the sector presented a vision and principles called Enabling Good Lives (see above) to the government.

The vision is based on disabled people having greater choice and control. The principles of how disabled people would like to live their lives include self-determination, with the system investing early, being person-centred, being easy to use, supporting disabled people to live an everyday life like others at similar stages, able to access mainstream services, being mana enhancing, and building and strengthening relationships between disabled people, their whānau and community.

You can find out more about the principles on the Enabling Good Lives website.

 

Based on the Enabling Good Lives’ vision and principles, a high-level design has been created which will form the basis of the transformed system. A team, including disabled people, worked intensively for several months on the co-design.

There will be an information hub, capability funding for disabled people and whānau to build their skills, support to expand peer and whānau networks, and a new funding model.

Mana Whaikaha was implemented in MidCentral, on 1 October 2018, on a try, learn and refine approach, and will then be rolled out across the country.

The MidCentral Governance Group members were appointed by the Minister for Disability Issues, and Associate Minister of Health, This group is made up of disabled people, whānau, provider and workforce representatives alongside people with governance experience.

Disabled people and whānau living in the MidCentral region can get in contact with Mana Whaikaha by phone, email, web and Connector hubs in this area. Their locations can be found at on the Mana Whaikaha website.

 

---

Payment to Family Carers (FFC)

Funded Family Care allows payment of people to care for resident family members assessed as having high or very high needs relating to disability, long term chronic health conditions, mental health and addiction and aged care needs. Funded Family Care policies are administered by the Ministry of Health (Disability Support Services) and District Health Boards.

In September 2018, the Government announced plans to change health service Funded Family Care, including the intention to repeal Part 4A of the New Zealand Public Health and Disability Act 2000.

Funded Family Care allows payment of people to care for resident family members assessed as having high or very high needs relating to disability, long term chronic health conditions, mental health and addiction and aged care needs. Funded Family Care policies are administered by the Ministry of Health (Disability Support Services) and District Health Boards. Part 4A of the New Zealand Public Health and Disability Act 2000 provides that the Ministry of Health and District Health Boards have family care policies allowing persons to be paid for providing health and/or disability services to family members. It also limits the ability for complaints to be made to the Human Rights Commission and the Courts regarding breaches of the Human Rights Act 1993 relating to family care policies.

Since the Government’s September announcement of change to Funded Family Care, there has been intensive targeted stakeholder engagement with and independent facilitator.Engagement included meetings and an online survey. The survey attracted over 900 responses.