The challenge for providers is that they have traditionally been restricted to providing services which fulfil their contract rather than meeting the specific needs of the disabled person. In MidCentral many providers have moved to a ‘flexible disability support contract’. This means they can shift their business model towards providing a ‘tailored-made’ approach to supports and services for disabled persons and whānau.
As we go through System Transformation providers will need to shift their thinking. There will be new contracts that the government will have with providers that emphasises the EGL principles and the need for flexibility. There will also be a new set of evaluation tools that the Ministry of Health will use to evaluate providers and monitor their change process.
Providers need to think about designing services person by person:
who the person is (really know the person)?
what their needs are?
how would that need be best met?
where would it be best met?
who should be involved – who would meet it?
They will also need to think about how they will:
increase choice and control for the disabled person and whānau
be flexible to meet the needs of the disabled person and whānau
provide a tailor-made service that meets the needs of the disabled person and whānau
have the disabled person and whānau direct decision-making
be transparent about funding and how service delivery will be provided
involve the disabled person and whānau in reviews and reporting
Most importantly families, particularly those with personal budgets – can shop around – you don’t have to take up the first offer – open-up your thinking – what is it you need and want?
In the ‘new system’ providers will need to:
Align to the EGL approach and principles
1. Align service delivery to the EGL principles (ie. choice and control).
2. Ensure the disabled person and whānau are in the driver’s seat with decision making.
3. Tailor supports and services to the person.
4. Work from one plan – one approach across services (no needs assessment!).
5. Ensure there is transparency around funding.
6. Support the person to ‘have a life’ (there needs to be a balance between safety vs restrictive practice).
7. Work to ensure the person has access to, and involvement with, generic community supports and services.
Provide flexible service delivery
1. Be flexible and responsive to the needs of the disabled person and whānau.
2. Be able to provide the service that the disabled person or whānau want by tailoring supports rather than the provision of a set range of service types.
3. Have flexible contracts in order to make this work.
4. Negotiate how they work on a person by person and/or family by family basis.
Note: This will initially be informed by the individuals or families “plan”.
Provide Choice and Control
1. Understand that funding sits with the disabled person and/or his or her family.
2. Understand the different purchasing options families have (ie. have someone else manage the funds through to managing the funding themselves).
3. Understand that the disabled person and whānau do not have to use disability specific services – they can approach whoever they feel is best able to meet their needs (they can choose one service, multiple services, a ‘mainstream’ provider, or look to set up a purpose-built service).
4. Understand that the ‘transformed system’ is about shifting power and control – ensuring the disabled person and whānau are the key decision makers. This is a complete shift in thinking for everyone (from the old system to the new).
5. Understand the disabled person and whānau are customers looking to purchase the right supports and services for their situation.
1. Keep up-to-date with what is happening.
2. Provide the ‘right’ information to the disabled person and whānau.
3. Some people may need advice or guidance around what they can do ‘differently’.
4. Not everyone is going to be up to speed on what they can or cannot do.
Build Partnerships and Trusting Relationships
1. Develop good working partnerships (think about what makes a good partnership and how to makes this work well in practice).
2. Build trusting relationships – this is a key value that builds long term success for all involved.
3. Ensure roles and responsibilities are well defined.
4. Have respect for each other’s roles and ideas.
5. Always ensure confidentiality.
6. Listen to families.
Keep it real
1. Don’t overpromise and under deliver.
3. Provide a responsible service based on supporting the family member to ‘have a good life’.
5. Operate with a clear set of principles and expected outcomes.
2. Follow up with timeframes.
4. Ensure there is clear, transparent and open communication between all parties.
6. Be clear about what you can and cannot do (your parameters as a service provider).