Self Directed Support for All Kate Fulton

Self Directed Support for All 2

•Explore Self Directed Support internationally

•Demonstrate how Self Directed Support can be beneficial to all Citizens

•Consider elements that help

Today

The world according to me – Kate Fulton

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• Self-directed support is about people being in control of the support they need to live the life they choose.

In Control 2011

What is Self Directed Support?

Individual funding has been growing for 50 years

Many different words, many models

A significant shift in thinking

•What are your needs?

•How do you want your life to be and what is going to work?

Our Jenny

• Jenny’s own home• Team that shared our vision (not a

Providers vision) • Exploration of what a good life

could look like • Flexibility in approach and use of

budget• Within budget and we could bank

money to reward and recognise the team

Supporting Citizenship

• You are the expert of your life

• You are in control of your life and your supports

• Your life is part of a community of friends and family

• Resources need to be transparent and best used for you

Your contextYour solutions

Institution Care Citizenship

The context of Human Services

Service Land

WorkColleague

sMoney

HomeNeighbours

Pets

FriendsHobbies

Parties

Being ME!

LoveMarriage

College

Special Bus

Special Swimmin

g

Special College Courses

Special homes

Special Schools

Day Centres

Service Land• The systems offer can isolate people from their peers, families and community connections

• Services may be in the community, but don’t draw on it’s resources

• People’s ‘label’ or deficit becomes the most important thing, not their capacities and resources (their real wealth)

• Power and autonomy - There is a tendency for staff to take over decision-making and to make the rules

• People’s needs are seen through the service ‘frame’ and service solutions become the only solutions.

Building centred, system centred, service centred NOT person centred

Service solutions become the solutions

• Placements – Young people• Care Homes – Older people• Day Centers – People with a disability or mental ill health • Groups homes – people with intellectual disabilities• Programs not entitlements

Needs V Outcomes

Our starting point makes a difference

Citizenship

Solutions to achieve the outcomes

Needs

Human Services / Supports

What if we focused on…• You as a citizen not a service user or system recipient • Your expertise on your own life in your context of

community and relationships • Your idea of what a good life could look like is the one that

matters • You know all of your resources to make the best use of• Your vision of a what a good life looks like determines the

support network • You have active partnerships with people / organisations

who can support you on your journey

How do we focus on the right stuff…• You as a citizen not a service user or system recipient - Respected

Expert • Your expertise on your own life in your context of community and relationships

- Real wealth• Your idea of what a good life could look like is the one that matters –

Planning and exploration• You know all of your resources to make the best use of – Individual

allocation alongside all other resources • Your vision of a what a good life looks like determines the support network –

Good design and in your community• You have active partnerships with people / organisations who can support you

on your journey – A partner of your choosing

Self Directed Support for all Citizens

• People with disabilities • People who experience mental ill health • Young people and families• Early intervention • Children in the looked after system• People with significant health issues• People who experience homelessness • Older People who are frail • Families• Women who are victims of domestic violence

Worry less about the mechanism

It will change

Mechanisms can constrict our thinking

UK Model

Western Australia – HACC SDS

National Disability Insurance Scheme Australia

Line Item $$

Agreed Plan• Outcomes• Strategies

= Budget

Planning

Sho

ppin

g

Reasonable & necessary

Features of other models

• Individual plans – Independent Facilitators / Brokers (independent of the system – long term connection / problem solving)

• Support Providers individualizing block contracts - good planning and individual design

• Focus on building connection and individual capacity • Individualize existing system - using existing costs as the benchmark

and planning with families best use of it

Homelessness and SDS

• People who had been sleeping rough for between 4 and 45 years. • Supports and a personal budget of up to £3000 / $6000• Chosen Broker to hold your budget • Good planning – what makes sense for you• Trusted to make decisions on how to use the money responsibly • Outcomes included contact with family, caravan, visits to

accommodation before taking up a tenancy , mobile phone to reconnect

Children in the looked after system

• Amy and Mum long term contact with Child Protection

• Amy maintained contact with Mum• Regular breakdown of placements • Incidents in residential accommodation

• What would it take to support Amy and Mum to have a good life and what would good support look like? (Good Design)

• Outcomes – money to pay bond on decent flat, support for Mum with parenting (Mum’s choice of worker), Amy taking control of her travel (and money)

• Cost £120k to £11,960k

• Support provided by kids critical • Supporting the kids essential

• Flight for Daughter every month • Support for others to attend retreat centre

• Mr Mandel and his family are the experts and designed a solution that works for them

Click icon to add picture

Mr Mandel and his family

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• Eamon was living in a group home • Family desperate for a different future• Family wanted more control but scared of

responsibility • Saw other people and were inspired but

didn’t want to go it alone• Looking for a partner • Shared Management partnership -

designed support, built team, supported Mum to manage what she could over time

• Active partnership

Eamon and his family

Context

OVERVIEW

Money to Agency

Employer / Purchaser

All management responsibilities

Contractual relationship is with the

Agency

Money to approved Partner

Person manage day to day support

Responsibility is shared Contractual

relationship with partner – based on a

partnership agreement

Money to Person

Employer or Purchaser

All management responsibilities

Contractual relationship is with the

person

A partnership

• Design• Set Up & Establish • Management • Development• Monitoring • Acquittal & Accountability

• Share Manages with Avivo to direct and manage most aspects of his wife's support

‘shared management works for us because we are not controlled but we are not alone’

• Avivo supports over 1000 older people to direct their supports. Third of this population share manage

Robert

Robert

‘

NDIS NDIA SUPPORT

CATALOGUE

Incentives

• UK Management Options- Choice & Control - Economic benefits – individual and Government level

• WA Management Options- Choice & Control- Economic benefits – addition / negotiation

• Early data suggests a reduction in overall costs over time – more control & better outcomes

Human Services

NDIA SUPPORT

CATALOGUE

Building capacity

Personal Capital

Knowledge Capital

Material Capital

Social Capital $$$

Worth remembering

• People can and do direct their supports outside of human services

• If it’s easy to navigate • If the assistance makes sense – timely • If we expect and treat people like they can • If it’s based on real choice and control

What people and families want will shape the future of human services

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www.avivo.org.au

Kate.fulton@avivo.org.au

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