In 2023, the New Zealand Government received a report from the United Nations, examining New Zealand’s position on residential support for disabled Kiwis, generally recommending that all residential services should be shut down in favour of other community support options.
So, let’s examine that recommendation against the Enabling Good Lives (EGL) strategy, that calls for disabled people to have control and choice in their lives. Is it a fair assumption that some disabled Kiwis will choose a form of residential support to best meet their needs? I believe so. Is it likely that some disabled Kiwis in residential support found themselves there because there were no other options available and could have benefited from a community-based support solution? I believe that too. So, it doesn’t make sense to reduce the available options for disabled people, when EGL seeks to increase them. What does make sense is how disabled people find their way into a residential support service and is/was that appropriate?
Many people I speak to feel like I do, that there’s room in our sector for a range of residential support options, so long as they’re supported by systems and processes that respect the right of disabled people to have choice and control, a la EGL.
With that practical thinking in mind, why wasn’t there push-back on the UN recommendation?
Instead, the Ministry of Disabled People – Whaikaha’s approach is seeking out any residential support resident who might harbour a desire to escape to the community. One Needs Assessment and Service Co-ordination service we know of has hired an individual specifically to approach disabled people in residential settings to facilitate transitions wherever they can.
There are pros and cons with this strategy- on the one hand, identifying people who might experience a better life in the community with appropriate levels of support is a good thing – and there are some who fit that image. On the other, there’s no guarantee that appropriate support is available throughout the country, in the current environment of support worker shortages and service limits driven by decades of underinvestment. And what of those who make the transition, only to find problems like a favourite support worker leaving, unstable residential support, or a lack the social interaction with their friends and so on?
Which brings me to the Ministry of Disabled People-funded ‘My Home, My Choice’ project. This project, we were assured in the early stages, involved working with the provider sector to develop a process and plan to identify and manage these transitions, making sure that future residential support placements echoed the EGL goals of choice and control.
The goal, we’re told, is supporting leaders in the disability sector with learning and facilitated conversations, focused solely on transforming residential support services to sustainable person-directed services. Or to put it plainly, moving from Group Homes to Shared Living. It’s unclear what the difference is, apart from branding.
Certainly, from the NZDSN point of view, chances to input into this project have dried up for several months, which increases my concern about its direction.
So, what is the driver for this?
On the one hand, officials would likely argue (and have done) that this is all about the rights of disabled people – choice and control. The trouble is, that the concept of choice and control is looking more and more like Henry Ford’s first car– you can have any form of choice and control you like, so long as it’s black (or the form of choice and control the government gives you).
The reality now, for disabled people is that existing residential support services are full. A big example is the non-availability of residential respite opportunities and underfunding for residential support services. The Ministry is concerned with the growth of residential placements, subject to individual packages of support. Obviously. That’s because the base rate funding doesn’t cover most facility’s costs, as the demand for residential support is driven significantly by people with increasingly complex needs.
A recent question from the Ministry to the CEOs’ Forum asked if the Ministry should put a cap on residential support placements, to get costs under control, totally ignoring the root cause of the problem. And after more reviews of the residential support funding model involving both the sector and the Ministry, what has been implemented? Nada. Nothing. No action to address the root cause issues.
It comes down to money, the ultimate driver for disability support services – the sector needs more, and the government wants to spend less. That’s the clash point!
The best we can hope to do is to work with government on the fiscal restraint ideas they want to impose, but in such a way that aims to minimise adverse effects on the disabled people we serve, and the viability of the services we offer.
This is where NZDSN comes in – we can say things to government many individual providers will be thinking but can’t say themselves. We can voice providers’ concerns and opinions, but without the risk that it blows back on your contracts. We’ll come to you for examples and issues but raise them with decision makers. Together, we can make change, that’s the benefit of a combined voice.
Peter Reynolds, NZDSN CEO