Disability Support Services

Behaviour Support Services

Behaviour Support Services (BSS) aim to improve the life of a person with an intellectual impairment whose behaviour is challenging for their support networks and potentially harmful for themselves or others.

For example, the behaviour may be of such intensity, frequency or duration that the physical safety of the person or those around them is likely to be at risk. The behaviour may make it difficult for a person to access everyday settings, activities and relationships.

Additionally, the behaviour may make it difficult for support people to know how to respond and maintain safety. The focus of BSS is on assisting a person to develop skills to enable participation in the community.

What do Behaviour Support Services do?

BSS work with a person, their family/whänau and friends, and support networks at home and work, to develop and carry out a plan to lessen challenging behaviours or situations that trigger the behaviour. This plan also defines support needed to help a person be independent and participate in their community.

To understand a person's situation, the BSS gathers information from different people and looks at what has prompted the referral. This information is written up into a specialist assessment report. On the basis of this report an individual behaviour support plan is agreed. The plan identifies goals and outcomes, and the strategies to achieve these. Ways of managing possible crises are also written down.

How do Behaviour Support Services help a person?

An individual behaviour support plan details the activities, common tasks and resources required to help a person change their behaviour or the situation causing the behaviour. After the plan has been agreed, education and training is provided to the person and their support networks. The focus is on supporting a person in the environments where they live, work and socialise.

How does a person get Behaviour Support Services?

A person can be assessed for behaviour support services by a Needs Assessment and Service Coordination (NASC) agency or a Regional Intellectual Disability Care Agency (RIDCA). A person or their support networks can contact a behaviour support service directly. In this instance the behaviour support service then makes contact with NASC or RIDCA.

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Community Residential Support Services

Community Residential Support Services (CRSS) provide 24-hour support to enable an intellectually or physically disabled person to have a safe and satisfying home life. This support is provided in a range of community settings such as small or large sized homes, or groups of small homes or flats.

The support provided by CRSS, which the Ministry of Health provides funding for, also helps a person to carry out everyday activities, including personal care, social and recreational activities. This could include supporting a person to develop the skills for everyday living such as looking after themselves, preparing a meal or doing the housework. A needs assessment determines what support is required to meet a person's needs.

What is a Community Residential Support Service?

CRSS support people in an accessible, safe, homelike environment that allows for privacy and independence. This includes having individual bedrooms and a place for personal belongings. The support is aimed at enhancing personal growth and development, and enabling the person to have control over their life. A home is situated in a community and people are supported to take part in the community.

A person's support needs and how these will be met are described as goals in an Individual Plan (IP). A community residential support service is responsible for ensuring that each person has an IP and a Primary Support Worker.

What support is provided?

Within 2 months of a person moving into their new home in a CRSS an IP is developed with the person (and family or support people). An IP is a written document that identifies a person's support needs and their short and long term goals. The services, activities and timeframes required to help a person achieve their goals and participate in the community are clearly described. The IP is reviewed every 6 months or if a person's needs change significantly.

A Primary Support Worker assists in developing the plan and carrying it out. This includes supporting the person to meet their needs and goals, and liaising with other support workers and services for the person as needed.

How to find a Community Residential Support Service?

To find out about CRSS a person can contact a Needs Assessment & Service Coordination (NASC) agency. NASC will determine if a person is eligible for services according to the Ministry of Health definition of disability, and assess if the level of support provided by a CRSS is appropriate for the person.

Who pays for this service?

When a person moves into CRSS they make a contribution of a set amount from the benefit they receive from Work and Income. The remaining amount is referred to as a Personal Allowance. Work and Income have information about how much contribution a person makes for CRSS and how much is regarded as a personal allowance payment.

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Disability Information and Advice Services

Disability Information and Advisory Services (DIAS) are provided by many organisations in New Zealand. Some organisations are funded by the Ministry of Health, while others are funded privately or by grants and fundraising activities. Some DIAS organisations provide a service to one region while others provide disability information through a national network with branches and local contacts.

DIAS are free to anyone. Information and advice could be about a type of impairment or the impact of disability on a person and their family/whanau. It may also include information about disability support services and how these can be accessed, for example, how to get equipment or support at home.

DIAS aim to provide accurate, up to date and objective information and advice about disability and support services, in a way appropriate for the person needing it.

What do disability information and advisory services do?

DIAS commonly provide printed information in the form of pamphlets and newsletters. Most printed information contains an organisation’s contact details including phone, email and fax details. Many organisations, especially national providers have a website. Some have an information library service and hold information seminars and disability awareness activities. Most disability information and advisory services will provide information over the phone or face-to-face.

Where to get disability information and advice?

Thirteen organisations have a contract to provide disability information and advice in New Zealand.

In Auckland and Northland DIAS agencies include Vaka Tautua, Te Roopu Waiora, NorthAble, Disability Connect, Carers New Zealand, Age Concern, Blind and Low Vision NZ, and Deaf Aotearoa.

Most DIAS provide their information in a range of ways to suit people with different needs, such as large print or Plain English. Some organisations aim to support the information needs of a specific population i.e. Pacific peoples, Māori, children, parents, older people, blind and vision impaired, and Deaf and hearing impaired.

Organisations providing disability information and advice receive funding nationally or regionally/locally from either Disability Services or a District Health Board.

What about other relevant services?

DIAS create networks, links and working relationships with a number of disability support services and funding agencies.

They also have a general understanding of how the disability sector works, and where to find Needs Assessment and Co-ordination Services (NASC), support services, vocational, and educational services, Māori advisors, support groups, etc.

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Equipment and Modification Services

Equipment and Modification Services (EMS) is the system by which people of all ages, with a long term impairment, get equipment or modifications to their home or vehicle to enable them to be safe and independent in every day living activities. Equipment may include shower chairs, wheelchairs, walking frames, mobility canes, communication devices and hearing aids. The equipment is on loan to the person for as long as it continues to meet their needs.

Funding or part funding is also available for housing modifications (such as ramps and level access showers), and vehicle purchase and modifications (such as van hoists and hand controls).

Who can get equipment through EMS?

EMS funding is available to people of all ages who live in New Zealand, meet the Disability Services definition of disability, and are unable to do some everyday activities safely and independently. An assessment by a specialised assessor is required to determine what equipment or modifications are necessary to meet a person's needs. A specialised assessor can provide information about EMS funding and other sources of funding available.

Equipment and modifications may also be funded by organisations such as ACC, Ministry of Education, Workbridge, etc. For further information on funding see Funding and Disability.

How does a person get equipment through EMS?

An assessment of equipment, housing or vehicle needs is required and an application made to Accessable, the EMS agency. This must be done by a specialised assessor. Specialised assessors can be occupational therapists, physiotherapists, speech language therapists, audiologists and vision and hearing professionals. Assessors are often employed by hospitals and community health services, or can be sourced through a GP or a NASC agency. A specialised assessor helps a person to identify equipment or modifications needed and determines eligibility for EMS funding. Applications are prioritised to identify those people with a high need.

What happens after an application is sent?

Accessable manages the EMS budget for the Auckland and Northland areas to ensure those with the highest need receive EMS support. Approved applications with a high priority rating are processed first and equipment delivered to the person's home or to the assessor. Some complex equipment may need to be trialled so that the person can determine what is most suitable, with input from the assessor. Income and Asset testing through Work and Income may be required for some housing and vehicle modification applications.

Approved applications with a lower priority rating are added to a waiting list and equipment is supplied when the funding is available.

The equipment is on loan to the person for as long as they need it. If the equipment requires repairs or maintenance Accessable can be contacted to organise this. When the equipment is no longer required Accessable will collect it from the person on request.

What if a person is ineligible for EMS funding?

If a person is ineligible for EMS funding or their application is declined a review of the decision can be requested or a second assessment sought. Alternatively a person may meet criteria for funding from another Government or non-Government organisation. A specialised assessor will be able to advise a person on their options.

Where can I find more information on EMS?

The Disability Funding Information website contains a large amount of regularly updated information describing the EMS system. This website is funded by the Ministry of Health and managed by Enable New Zealand.

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Home Based Support Services

Home Based Support Services (HBSS) assist a person to be independent within their home. Support workers spend an agreed number of hours in a person's home providing personal support and household management services. The number of hours and type of tasks to be done by the support worker is identified during a needs assessment.

What is home based support services?

Support is usually provided on a one to one basis to assist with personal support and household management. This may mean supporting a person to do the task themselves or doing the task for them if they are unable to. Personal support includes things like showering and bathing, dressing and undressing, getting up and going to bed. Household management (often referred to as home help or domestic help) assists a person to maintain and organise their home environment. This includes things like housework, laundry and shopping.

HBSS also provide social support, caregiver support and information on other services and support groups. HBSS are mainly provided in a person's home whether rented or owned.

How does a person access home based support services?

Firstly a person must be assessed by a Needs Assessment & Service Coordination (NASC) agency. NASC will determine if a person is eligible for funded home based support services. To be eligible a person must meet the Ministry of Health's definition of disability and financial eligibility criteria.

To get funding for support with household management tasks a person needs to have a Community Services Card or have been assessed by Work and Income as meeting the household management income and asset level criteria. Income and asset testing does not apply to personal care services.

How much support will a person get?

The needs assessment will determine the tasks a person requires support with i.e. vacuuming, help with bathing, and the number of hours that will be funded to provide the support. The number of hours allocated is how long a support worker will be in your home each week.

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Individualised Funding

Individualised Funding (IF) assists people to be in control of their disability-related support. This means that a person is able to hire, manage, pay, train and make their own contracts with their support workers or choose to manage parts of this process. The Individualised Funding Agency appointed by the Ministry of Health to arrange and support people with individualised funding is Manawanui.

What is involved in holding your own budget?

To become an IF budget-holder (also referred to as an IF Manager) a person has an assessment by a NASC agency. People willing to take on the responsibilities of being an IF budget holder must meet the Ministry of Health's definition of disability, and have high support needs which have remained stable for at least the past year. People considered eligible to manage their own budgets are referred to Manawanui by NASC.

Manawanui has Management Service Coaches who support people with moving on to Self-Directed Funding. They assist people to make the necessary arrangements to manage their budgets and workers successfully. There are important administrative responsibilities that accompany taking on the task of self-managing support workers. Manawanui offers information and support with managing payments, keeping records, writing job descriptions and employment agreements, recruiting staff, and advises on the requirements and responsibilities of being an employer.

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The National Intellectual Disability Care Agency

The National Intellectual Disability Care Agency (NIDCA) is a specialist needs assessment and service coordination agency for people with an intellectual impairment who have high and complex behavioural needs. NIDCA replaced the previous 5 regional RIDCA's in 2013 and this contract is held by Capital and Coast DHB.

What does NIDCA provide?

NIDCA has Compulsory Care Coordinators, statutory appointments under the IDCC&R Act, and Intensive Service Coordinators who provide needs assessment and work closely with organisations to ensure specialised services are provided.

As well as those people covered by the IDCC&R Act, NIDCA also provides services to those who have an intellectual disability and whose behaviour may pose serious risk of physical harm to themselves or others. Access to mainstream residential services must also have been exhausted. The local NASC is responsible for these referrals to NIDCA.

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Needs Assessment and Service Coordination

Needs Assessment and Service Coordination (NASC) helps people get the support they need to be as independent as possible in their home or community. It is often called "the Gateway" to Government-funded disability support services.

What is NASC?

Needs Assessment and Service Coordination (NASC) is the first step for a person to get Government-funded disability support services, except in some cases (see below). Services may include help with personal support, meals, household management, carer support, day programmes, and the support provided by rest homes and private hospitals.

If a person's needs change, NASC will re-assess and re-coordinate services.

NASC agencies must make sure that a person is eligible to receive Government-funded support services according to the Ministry of Health's definition of disability. NASC agencies ensure that people with the most urgent needs receive support first within the available budget.

When does a person need to contact a NASC service?

Although NASC is the usual way to access Government-funded disability support services, it is not always necessary. For example, equipment assessments and disability information and advice (DIAS) can be accessed by contacting the relevant organisation directly. However, it may be a good idea to involve NASC to make sure all needs are being met in the best way.

What does NASC do?

A Needs Assessor meets with a person (and their support people) to carry out a needs assessment. The main purpose of a needs assessment is to find out what is needed to help a person be as independent as possible in their home and community. The assessor will ask for information about what the person can and can't do, what they would like to be able to do, and what help or resources they currently have. The Assessor will also ask about a person’s recreational, social and personal development needs, their training and education needs, their vocational and employment needs and where appropriate, the needs of their family/whanau and unpaid support people.

Options for support are discussed and agreed by all involved. Then a Service Coordinator works out what can be provided by Government-funded services and what can be provided by other services to meet the needs identified. This means looking at a range of options for meeting a person's needs, including helping them to access other services that may be useful.

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Rehabilitation Services

Rehabilitation can help a person to overcome difficulties in every day living as a result of an impairment or injury. This may include finding new ways of doing tasks, learning new skills or maintaining the skills a person already has. Rehabilitation is aimed at restoring or maximising function, communication and social skills. The type and amount of rehabilitation depends on the needs of the person.

What is Rehabilitation?

Rehabilitation means different things to different people. For a person with an injury rehabilitation could be help from a health professional, such as a physiotherapist, to get back lost function and lessen permanent impairment. For a person wanting to continue to be as independent as possible, or return to employment, the focus may be on social or vocational rehabilitation. Rehabilitation focuses on helping a person to minimise the disability that results from impairment.

People live in a range of environments. The rehabilitation process will also consider what support and resources are needed within a person's environment to be successful. These could include housing and vehicle modifications, personal support, educational support and workplace modifications.

What does Rehabilitation involve?

Rehabilitation services generally focus on restoring function and achieving agreed goals. A number of sessions are planned and may include activities, exercises and other interventions to help a person reach their goals and be as independent as possible. The number of sessions and desired outcome will be agreed at the start, but may change over time. Rehabilitation is often undertaken by health professionals but there are a number of people and resources that may also be involved.

Where does Rehabilitation take place?

Rehabilitation can occur in a variety of places. Inpatient rehabilitation is usually provided in a health setting by a District Health Board (DHB). The DHB has a contract with the Ministry of Health to provide rehabilitation services to people who are eligible for funding. ACC also contracts services in this way. Residential rehabilitation is where a person receives rehabilitation in a funded community residential setting. Community rehabilitation is where a person is neither an inpatient or in a residential setting, and gets rehabilitation from a community organisation.

How does a person get rehabilitation?

For residential and community-based rehabilitation a person is assessed by a Needs Assessment and Service Co ordination (NASC) agency. Inpatient rehabilitation services funded by the Ministry of Health may also require the involvement of a NASC agency. When it is first identified that a person needs rehabilitation NASC determines who will fund it. The NASC will also find out from the rehabilitation provider when rehabilitation is likely to be completed, what the goals of rehabilitation are, and how the person is progressing towards the goals.

Who provides rehabilitation?

Rehabilitation services are mainly funded by ACC and the Ministry of Health. ACC funds rehabilitation for people who have had an injury or impairment as a result of an accident. The contact details of Ministry of Health funded rehabilitation providers, and some ACC-contracted rehabilitation providers, in Auckland and Northland have been included on this site.

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Respite and Carer Support

Respite and Carer Support are different types of support which are closely related.

Respite Support is a short-term break for people and their carer/support person. A short-term break is usually away from home and overnight. Respite services are equipped to meet the needs of a disabled person while away from home and their usual support, and aim to create a positive experience for the person.

Carer Support enables a usual caregiver to take a break from supporting a person by providing an alternative carer.

What is Respite Support?

Respite Support is designed to provide short-term breaks for carers, whilst providing a positive experience for the disabled person.

A respite service provides a safe, alternative environment for a disabled person, with support staff who are able to meet the person’s disability needs. Respite support is in general designed to be:

• of a short term duration and intermittent
• a positive, stimulating and worthwhile experience
• available in community settings
• part of the support network available to a person and their carers/family/whanau
• accessed when a carer or family/whanau member requires a short term break from their normal support/care role.

How does a person get Respite Support?

An assessment by a Needs Assessment Service Coordination (NASC) agency is completed to determine whether a person meets the eligibility criteria for disability support services. The needs of the disabled person are identified, the amount of respite support is determined and support is provided to help those involved to find a suitable respite service.

Use of respite support may be planned so that it is used on a regular basis for a pre-arranged time period, for example, overnight once a week or every third weekend. Respite support may also be unplanned and is available in times of emergency or unforeseen event.

What is Carer Support?

Carer Support is a service funded by the Ministry of Health to help full-time unpaid carers and support people. This service offers the carer/support person a break by helping to pay for an alternative carer to support a person for an agreed number of days. The number of days is based on an assessment of need.

Carer Support is available to the person or people providing full-time unpaid support to a person in their own or the family home. An assessment by a Needs Assessment Service Co-ordination Service (NASC) Agency will determine if the carer is eligible for Carer Support. Any full-time unpaid carer may contact a NASC agency for an assessment. An assessment of a carer's need for support will be considered alongside the needs assessment of the person they support.

How is Carer Support arranged?

Based on the needs assessment, a NASC Service Coordinator will allocate the full-time carer with a number of Carer Support Days. There is a maximum number of Carer Support Days that the full-time carer can use for a one-year period from the date of the needs assessment. The full-time unpaid carer, assessed as needing Carer Support, is generally able to choose how they use their support days, and, in most instances, co-ordinate their relief support. A person can get relief support from a respite service.

Carer Support payments are intended to be a reimbursement towards the costs of providing relief support and are not regarded as a salary or wage.

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Supported Living

Supported Living (SL) gives a person choice about where and how they live. It provides a person with the opportunity to use their skills or learn new skills to live more independently and participate in their community.

What are Supported Living services?

Supported Living (SL) services provide a means of supporting a person who wishes to live in their own home or in a flat by themselves or with others. The person usually needs a level of support or supervision that is beyond what is provided by personal support and household management services. SL is not intended to be a 24-hour support service.

These services may also be appropriate for people who wish to move from their parental home or residential care into a supported living environment. SL services are also available to people who wish to stay in their own home but require more support because of increased needs.

Who is eligible for supported living services?

People who are eligible according to the Ministry of Health definition of disability may be able to access SL. An assessment of needs is required by a Needs Assessment and Service Coordination (NASC) agency. Options for supported living are discussed with the person.

How is the support provided?

People receive services and support that meet their individual needs and preferences. The goal of SL services is to help a person to take command of their life and to have a central role in deciding the types of services and supports they want. This information is written in a personal plan, which outlines goals and aspirations.

The support required to meet the goals in the personal plan is then documented in a Supported Living Package (support package). The support package focuses on those goals that are needs based and funded by the Ministry of Health, and this is sent to NASC for funding approval.

A key worker, also known as a Community Support Worker, is responsible for a personal plan.

How does a person obtain SL services?

Following an assessment by NASC a person will be referred to an organisation who provides the type of SL services the person needs. The referral will be based on the support needs identified through NASC. The referral outlines ways that the person can be supported i.e. assisting a person to find an appropriate living arrangement, assisting a person to develop skills so they can cope with day-to-day situations at home and in the community, and providing contact with the person to help them maintain independence and a life-style of their choice.

The Ministry of Health has contracts with community based organisations to provide SL services.

Can a supported living provider also provide accommodation?

In some situations organisations have entered into tenancy arrangements with Housing New Zealand for a house in the community. If a person lives in this house they can be charged rent, or a board payment. These payments are not part of the support package determined by NASC.

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