Snapshot of flexible funding outcomes in four countries

This article reviews social participation outcomes identified in discrete studies of flexible funding programmes across four countries. The outcomes of an Australian flexible funding support programme were studied in 2007; a study tour of independent living programmes was conducted in England and Scotland during 2005; Swedish co-operatives and government administrators providing personal assistance to live independently were visited in 2006 and Australian independent living support groups operating for over 20 years were visited in 2008. Fifty-six interviews were conducted with people with a disability, families, support services, government administrators and researchers. A structured interview schedule was used in the 2007 Australian study and a semi-structured format was used in all other studies. Notes from the interviews were reviewed for themes related to social participation and their contributing factors. Ecological systems theory was used to identify what factors from the micro to the macro system level facilitated or hindered social participation. The key finding is that flexible funding did result in a range of social participation activities in each setting studied. The studies also indicate that social participation increases when people have access to information and support services; can choose their individual workers and move to a new agency if need be; and have adequate resources to meet their needs. The cultural and political context plays a large part in determining these factors. The implications of this study are that adequate resources are needed and the complex systems impacting on flexible funding need to be understood to achieve the intended outcomes

Choice, Control and Individual Funding: The Australian National Disability Insurance Scheme

The book concludes with implications for policy and practice. Topics featured in this book include: Supported decision making for adults with intellectual disabilities or acquired brain injury

Analysing choice in Australian individual funding disability policies

The Australian National Disability Insurance Scheme (NDIS) will allocate funding packages to people with disability who are assessed as needing paid support. The NDIS is an example of individual funding, which is currently not the dominant way of organising disability support in Australia. Individual funding aims to increase opportunities for personal choice. We present a framework for understanding current individual funding policies in each Australian jurisdiction according to two policy dimensions that potentially enable greater personal choice for people with disability: who holds their allocated funds and where support can be purchased. The findings show wide disparities in choice across the country, particularly due to constrained funds and the shortage of support to purchase in regional areas. The analysis demonstrates that NDIS implementation will need to consider that, while individual funding can be empowering for some people with disability, enabling choice can be challenging for administrators and service provider

Increasing consumer choice in the aged care services

The Brotherhood of St Laurence is committed to ensuring that all older Australians age well with dignity and security. Consumer-directed care offers new opportunities to achieve this goal. This paper reviews international and national literature on consumer-directed care and argues that evidence of improved outcomes for consumers and cost efficiencies warrants a trial of this approach in aged care in Australia

A framework for providing information in individualised funding programmes

The need for all people with disability to have access to reliable information before they can make informed choices in individualised funding programmes is well documented. However, little guidance exists on how information can be provided to ensure it reaches its target audience.While information provision is important everywhere, there is a pressing need in the Australian context to ensure all people have access to information as the National Disability Insurance Scheme is designed and introduced. The authors identified key principles of information provision documented in the literature and used these to analyse their data from Australian studies of individualised funding programmes. The data came from 143 transcripts and records of interview in five studies conducted from 2011 to 2013. The analysis confirmed the importance of the principles previously documented and identified two additional principles, these being related to gender and 'hard to reach' groups. This analysis informs a new framework to increase equity and improve people's access to information in individualised funding programmes. Information needs to be: (i) accessible and diverse in format, mode, source and location; (ii) personalised and targeted; (iii) accurate, consistent and timely; (iv) from a trusted source; (v) independent; (vi) culturally appropriate; (vii) actively promoted to 'hard to reach' groups and (viii) gender appropriate. This paper provides a new framework to guide information in individualised funding programmes for professionals in roles ranging from policy makers to service delivery

Individual funding for people with mental health issues: Opportunities, tensions, and outcomes

This chapter outlines the key features of individual funding programs and examines their suitability for people with mental illness. This is a contested area with some writers concerned that mental illness is different from other types of disability and unsuitable for individual funding. The recovery model and the episodic nature of mental illness are seen as conflicting with individual funding eligibility criteria for consistent and permanent disability. The counter view is that flexible individual funding is ideally suited to meeting the fluctuating needs of people with mental illness: its key principles of empowerment and self-direction being consistent with the recovery paradigm. Evidence from Australian and international studies is reviewed, suggesting that successful outcomes can be achieved if the necessary supports and resources are available to meet people's needs

Succeeding through service innovation: Consumer directed care in the aged care sector

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Evaluation of Alzheimer's Australia Services to Improve Access for Special Needs Groups

This evaluation reports on the achievements of 11 Service Access Liaison Officer projects implemented by Alzheimer's Australia to improve access to dementia services for specific needs groups. The projects, which have been implemented in all states and territories, have focused on the needs of Aboriginal and Torres Strait Islander people; people from Culturally and Linguistically Diverse backgrounds (CALD); Gay, Lesbian, Bi-Sexual, Transgender and Intersex people (GLBTI); people with Younger Onset Dementia (YOD); and people in rural and remote locations (R & R). Relevant literature has been reviewed to identify issues for specific groups and work being undertaken to address these issues. The projects formally commenced in late 2010 but some projects which needed to recruit staff, only began in January 2011. Projects were designed to suit their particular demographic, geographic, organisational and service system context; they developed and implemented clear and credible strategies for achieving the objective of increased access to services

Australia's individualised disability funding packages: when do they provide greater choice and opportunity?

Australia's new National Disability Insurance Scheme (NDIS) uses individualised funding packages instead of tradi-tional block-funded disability services to support people with disability. The NDIS works with the person and theirfamily to assess the person's needs and develop a plan that determines their funding allocation. Funding can be used topurchase support from a disability service or from the open market. People can purchase support that suits their cul-tural and personal preferences. This paper examined whether individual funding packages met their aims in WesternAustralia, where they had been the primary mechanism of disability support for over 25 years. An exploratory casestudy was conducted consisting of face-to-face, in-depth interviews with 11 key participants: people with disability,senior government administrators, service provider managers, and a support worker. Complex systems theory was usedto review the data and findings showed that individualised funding packages did not automatically result in more choiceand greater opportunities. People needed information to make informed decisions; supportive and creative supportfrom social workers and other professionals; and welcoming communities. The findings can inform policies and assistsocial workers facilitate maximum choice and opportunities for people with disability and their familie

Support as a complement, intrusion and right - evidence from ageing and disability support service users in Sweden and Australia

Support as a complement, intrusion and right - evidence from ageing and disability support service users in Sweden and Australia How service users conceptualise their personal support services is under researched, even though this understanding is important for responsive policy development and service implementation. This paper tests the proposition that service users understand formal support in three ways: support is a complement to their other arrangements, an intrusion into their personal life and a right. These three concepts were identified using discourse analysis in a Swedish study of older people wanting in-home support services. To test generalisability of these concepts, they were applied to data from an Australian study of people using disability personal support. The analysis found that the three concepts were core to people's views of their support, although the construction of the concepts differed in the two countries. Service users in Sweden asserted their right to services more forcefully than those in Australia, and they had higher expectations that their support needs would be met. These differences reflect the impact of each country's social policy environment on service users' expectations. The analysis suggests that service users and their families want to control their formal support arrangements to complement their informal care and their life preferences and to minimise the intrusive aspects of formal support. The findings imply that the three concepts have utility for theorising service users' perspectives, informing policy and developing implementation strategies which enhance peoples' quality of life