Inclusion Ireland AGM & ANNUAL

CONFERENCE 2008 From Service User to Citizen

Personalised Budgets for People with Intellectual Disability

How people can have control over their Money?Karina Wallis SCJMSKarina Wallis SCJMS

How can people have control How can people have control over their money?over their money?

►National PolicyNational Policy

Enhancing the partnership Incorporating Enhancing the partnership Incorporating widening the partnership DOH&C 1999widening the partnership DOH&C 1999

The role of HB/HSEThe role of HB/HSE Co – coordinating /consultative Co – coordinating /consultative

committeescommittees Service BidsService Bids Regional Service PlansRegional Service Plans Allocation of FundingAllocation of Funding

How can people have control How can people have control over their money?over their money?

►Role of Service ProviderRole of Service Provider Identification of the service requirementsIdentification of the service requirements

Identification of service user needsIdentification of service user needs

Service bidsService bids

AdvocacyAdvocacy

How can people have control How can people have control over their money?over their money?

► Current PracticeCurrent Practice Funding allocated to service providersFunding allocated to service providers

Spending of Funding received Spending of Funding received

Service DeliveryService Delivery

Monitoring Monitoring

Value for moneyValue for money Who has control?Who has control?

How can people get their How can people get their money?money?

Values/PrinciplesValues/PrinciplesCurrent PracticeCurrent Practice► ExclusionExclusion► Minimum consultationMinimum consultation► Prescribed choicePrescribed choice► Group basedGroup based► Segregation basedSegregation based► Paternalism Paternalism ► InaccessibleInaccessible

Enhancing Partnership:Enhancing Partnership:► Right to quality services Right to quality services

that respect their dignity that respect their dignity in a least restrictive in a least restrictive environment aiming for environment aiming for greatest possible greatest possible inclusioninclusion

► Equalisation of Equalisation of opportunityopportunity

► Equity, quality of serviceEquity, quality of service► AccountabilityAccountability► Health & Social GainHealth & Social Gain

How can people get control of How can people get control of their money?their money?

►Policy DirectionPolicy Direction 11 years since the strategy for equality11 years since the strategy for equality

►11 years since such wide consultation with 11 years since such wide consultation with people with disability on all service levels has people with disability on all service levels has occurred occurred

►Has equality been achieved?Has equality been achieved?►Do the present structures for identifying and Do the present structures for identifying and

allocating funding recognise the service user as allocating funding recognise the service user as an equal partner?an equal partner?

►Are the present structures for identifying and Are the present structures for identifying and allocating funding transparent and fair?allocating funding transparent and fair?

How can people get their How can people get their money?money?

► The FutureThe Future

►Will this model serve us into the future?Will this model serve us into the future?►Will this approach ensure that the needs of Will this approach ensure that the needs of

the service user informs decision making?the service user informs decision making?►Will consultation with the service Will consultation with the service

user/family/advocate be core to the process user/family/advocate be core to the process of planning?of planning?

►Will assessment of need direct allocation Will assessment of need direct allocation and spending of funding resources?and spending of funding resources?

How can people get their How can people get their money?money?

► Best Practice/Policy that needs consideration:Best Practice/Policy that needs consideration:► Assessment of need in context of living a meaningful and Assessment of need in context of living a meaningful and

fulfilled lifefulfilled life► In depth consultation with the service user/family/advocateIn depth consultation with the service user/family/advocate► Person Centred ServicesPerson Centred Services► Informed choiceInformed choice► Shared autonomy/decision makingShared autonomy/decision making► RespectRespect► InnovationInnovation► LeadershipLeadership► MonitoringMonitoring► Accountability and personal responsibilityAccountability and personal responsibility► Levelling playing pitchLevelling playing pitch► Equal CitizenEqual Citizen

Now you have your money – Now you have your money – what next?what next?

► Consider type of service provision that will Consider type of service provision that will give you maximum control over your money:give you maximum control over your money:

► Individual Service Design – Best Individual Service Design – Best Practice ModelPractice Model

►Designed from scratchDesigned from scratch►Person CentredPerson Centred►Assessment of need in the context of Assessment of need in the context of

leading a meaningful and fulfilled lifeleading a meaningful and fulfilled life► Informed choice & decision makingInformed choice & decision making

Now you have your money – Now you have your money – what next?what next?

► Consider type of service provision that will Consider type of service provision that will give you maximum control over your money:give you maximum control over your money:

► Presumes competencePresumes competence►Respect & dignityRespect & dignity►Natural networks of supportNatural networks of support► Individualised safeguardsIndividualised safeguards►Service is uniquely attuned to the Service is uniquely attuned to the

personperson►Flexible & ResponsiveFlexible & Responsive►Move from Service user to citizenMove from Service user to citizen

Now you have your money what Now you have your money what next?next?

Individual Service DesignIndividual Service Design►Vision Vision ►Assumptions Assumptions ►PlanningPlanning►DesignDesign► Implementation & ReviewImplementation & Review►Control of your moneyControl of your money► Is this possible?Is this possible?

Now you have your money what Now you have your money what next?next?

►Yes!Yes!

►Change in current structures & Change in current structures & supportssupports

►PartnershipPartnership

►FlexibilityFlexibility

Now you have your money what Now you have your money what next?next?

►New structures & Supports:New structures & Supports:

►FundingFunding

►Level of decision makingLevel of decision making

►Level of AuthorityLevel of Authority

Now you have your money what Now you have your money what next?next?

► New Structures:New Structures:

► Governance Governance

► Definition Of Delegated Program Governance For Definition Of Delegated Program Governance For Consumers & Families (& Allies) Consumers & Families (& Allies)

Delegated program governance constitutes the Delegated program governance constitutes the assignment of specific oversight authority over assignment of specific oversight authority over service design and implementation to service users service design and implementation to service users and families, either individually or collectively or and families, either individually or collectively or both, and may include the delegated conditional both, and may include the delegated conditional power to design and guide service developmentpower to design and guide service development

((Kendrick)Kendrick)

Now you have your money what Now you have your money what next?next?

► New Structures:New Structures:► GovernanceGovernance

► Definition Of The Self-Management Of Service Definition Of The Self-Management Of Service By Service Users, Families (And Allies) - By Service Users, Families (And Allies) - The The self-management of services involves a direct self-management of services involves a direct operational management/administrative role operational management/administrative role by service users and families (and allies). This by service users and families (and allies). This role may be in regards to some or all aspects role may be in regards to some or all aspects of service and may be shared in any of service and may be shared in any combination of others including staff.combination of others including staff.

((Kendrick)Kendrick)

So now you have your money So now you have your money what next?what next?

► Some international Examples:Some international Examples:

► Consumer & Family Support NetworkConsumer & Family Support Network

► Consumer & Family Governance Hosting Consumer & Family Governance Hosting ArrangementArrangement

► Purchase Service from service providerPurchase Service from service provider

So now I have the money what So now I have the money what next?next?

►Some Irish examples Some Irish examples

►MicroboardMicroboard

►Hosted modelHosted model

► I.S.D.I.S.D.

So now you have your money So now you have your money what next?what next?

►Pioneering road to have control of my Pioneering road to have control of my money requires:money requires:

►VisionVision►LeadershipLeadership►CourageCourage►PartnershipPartnership► InformationInformation►CreativityCreativity

How can people have control How can people have control over their money ?over their money ?

► Pioneering road to have control of my money Pioneering road to have control of my money requires:requires:

► SupportSupport► SharingSharing► AdvocacyAdvocacy► EmpowermentEmpowerment► ResponsibilityResponsibility► AccountabilityAccountability► FlexibilityFlexibility► MutualityMutuality► OpennessOpenness► Equal CitizenEqual Citizen