This report provides a stocktake and gap analysis of current disability Behaviour Support Services (BSS), including data from interviews with current service providers and their clients.
The Report on the Provision and Funding of Specialist Behaviour Support Services provides a comprehensive overview of these services to the Ministry, along with recommendations to improve services. The Ministry has carefully considered these recommendations, and the best way to engage with the sector about how to use the recommendations to make changes to the services.
Along with agreeing the engagement process, the Ministry spent time considering the priority of each piece of work. Behaviour Support Services for people with autism spectrum disorder (ASD) is considered a high priority and a process to purchase ASD specific behaviour support will take place alongside the engagement process for the recommendations related to the broader Behaviour Support Services.
Disability Support Services (DSS) purchases Behaviour Support Services for people under 65 with an intellectual disability. The core activity of BSS is assessment, development, implementation, monitoring and review of a plan that successfully minimises the impact of challenging behaviours exhibited by a person, enabling them to develop maximum levels of independence and positive participation in the community.
The report's key recommendations are:
- Regional Specialist Behaviour Support Services be established and distributed regionally (Northern, Midland, Central and Southern) across the country. Each team to be led by clinicians and underpinned by joint governance arrangements between District Health Boards (DHBs) and Non-Government Organisations (NGOs) with a focus on building consistent clinical and service capacity across the service continuum.
- Develop and implement a nationally consistent service pathway, including a prioritisation tool, and revised service specifications with performance based criteria, to be adopted and applied by the Regional Specialist Behaviour Support Providers.
- Develop a separate service specification for people with Autism Spectrum Disorder, in accordance with the New Zealand Autism Spectrum Disorder Guideline.
- Establish Consumer Advisory Groups (including specific representation for Māori and Pacific People) and allocate resources so that consumers, families and significant others can contribute to and participate in the service.
- Establish a consistent dataset and reporting system that reports on actual utilisation and outcomes, based on agreed key performance indicators.
The Ministry consider the proposed role of a Centre for Excellence in the New Zealand context, with a focus on:
- creating training and clinical internship opportunities
- developing relevant research to support New Zealand-specific evidence-based practice
providing a forum for clinical leadership and perhaps being a vehicle to host the establishment of a formal national behaviour support network with a focus on shaping processes and interventions that give value to clients, providers and funders.
- The Ministry engage with Health Workforce NZ, the various professional and regulatory bodies and training providers.
- The Ministry considers, for the longer term, some form of clinical integration between the Community Liaison Team service and the proposed Regional Specialist BSS.
That relevant changes are made to other specifications in contracts that relate to behaviour support such as:
- Needs Assessment Service Coordination (NASC)
- Residential Services
- Community Liaison Teams.
The Ministry of Health will engage with DHBs, current BSS providers, and disabled people and their families and whanau to discuss the recommendations and how we can progress the proposed service improvements.