Written Answers. - Personal Assistance Service.
Charles Flanagan
Question:
115
Mr. Flanagan
asked the
Minister for Health and Children
if his attention has been drawn to a pre-budget submission made by the Independent Living Network in relation to putting personal assistant funding for people with physical and sensory disabilities on a permanent and secure basis; and if he will make a statement on the matter.
[24504/00]
Ulick Burke
Question:
178
Mr. U. Burke
asked the
Minister for Health and Children
if he has made a request to the Department of Finance for funding to establish an independent fund to provide personal assistants for people with a physical disability as requested by the Independent Living organisation; and if he will make a statement on the matter.
[24083/00]
Jim Higgins
Question:
188
Mr. Higgins (Mayo)
asked the
Minister for Health and Children
if he has received a pre- budget submission from a group (details supplied); and if he will make a statement on the matter.
[21241/00]
Dan Neville
Question:
409
Mr. Neville
asked the
Minister for Health and Children
if he will provide the necessary financial support to establish permanent personal assistants for people with significant disabilities.
[24353/00]
John Perry
Question:
444
Mr. Perry
asked the
Minister for Health and Children
the estimated cost of extending the independent living fund to all persons on disability benefit whose disability inhibits their mobility; the steps he has put in place to ensure that funding is made available to establish an independent living fund to enable people with a disability to employ a personal assistant on a permanent basis; and if he will make a statement on the matter.
[24019/00]
Michael Finucane
Question:
462
Mr. Finucane
asked the
Minister for Health and Children
if he will provide funding, on an ongoing basis, to an independent living fund for the employment of personal assistants on a permanent basis; if he has met a group representing the Independent Living organisation with the objective of providing appropriate funding; and if he will make a statement on the matter.
[24086/00]
Michael D. Higgins
Question:
497
Mr. M. Higgins
asked the
Minister for Health and Children
if he will fund the personal assistants service as requested by the Centre for Independent Living; and if he will make a statement on the matter.
[24217/00]
I propose to take Questions Nos. 115, 178, 188, 409, 444, 462 and 497 together.
I would like to clarify the situation in relation to the provision of services generally and personal assistance services in particular.
The provision of health related services to people with physical and sensory disabilities is the responsibility of the Eastern Regional Health Authority and the health boards in the first instance. All additional funding made available for the development of such services is provided to the authority and the health boards to allocate on a priority basis, in consultation with their regional co-ordinating committees for physical and sensory disability services. Voluntary sector service providers, including CILs and consumers of service, are represented on these co-ordinating, committees.
The personal assistant provides assistance at the discretion and direction of a person with a disability, who is called a leader, with everyday tasks, such as personal care and household tasks, which the person is unable to do for him or herself. A full personal assistance service has been defined by the Centre for Independent Living as a need for at least 20 hours service per week.
There are currently two types of personal assistance service being provided, one by the Irish Wheelchair Association in conjunction with the Eastern Regional Health Authority and the other by the Centres for Independent Living throughout the country.
The Irish Wheelchair Association/Eastern Regional Health Authority personal assistance service was started by CIL as INCARE, an EU funded pilot project, which was taken over by the Irish Wheelchair Association in October 1995. The IWA and health board personnel are involved in the interviewing and assessment of individuals requesting a personal assistance service. Of the applications received by the IWA for assisted living services, approximately 80% are identified as having their service needs most appropriately met by forms of home support other than the personal assistant service. The IWA currently provides a service to 53 individuals, employing some 90 personal assistants working a 35 hour week at cost of £1.2 million per annum – an average cost of over £22,000 per annum for each leader or recipient of service.
The Centres for Independent Living provide personal assistance services mainly through the FÁS community employment scheme, with the trainees acting as personal assistants. The FÁS funding also enables the centre to pay an administrator, a leader co-ordinator and a research officer. CILs also access health board funding for the provision and development of their services and are represented on the regional co-ordinating committees for physical and sensory disability services. CILs currently provide a service to 308 "leaders" throughout Ireland.
A joint CIL/Rehab. Group company, Independent Living Community Services – ILCS – was set up to administer these schemes. With effect from 1998, ILCS has been receiving an annual grant of £100,000 from the Eastern Regional Health Authority for the provision of its services. This is in addition to the Centre for Independent Living in Dublin, which was the original centre and had on overall umbrella role in the past. The CIL in Dublin receives a grant of £50,000 per annum from the Eastern Regional Health Authority. A new organisation, the Independent Living Network – ILN – has recently been set up to act as an umbrella organisation for all 26 branches of CIL throughout the country.
Part of an ongoing campaign conducted by the Centres for Independent Living in the past and now being conducted by its new umbrella organisation, the Independent Living Network, is that the personal assistant service be funded by an independent living fund. Basically, this means that some agency would be given a sum of money to administer, paying it to individual people with disabilities to hire personal assistants. In its recent pre-budget submission, the ILN have based its proposal on an expansion of services, to 750 leaders, at a total cost of £10,804,594 per annum – an average of £14,330 per annum per leader. This estimate of cost would also cover the existing service being provided by the CILs using the FÁS community employment scheme.
Various reports in relation to disability recommend that a PA service be funded in the medium-long term by way of a cost of disability payment, paid by Department of Social, Community and Family Affairs or by a Department of health and social services, but by the Department of Health and Children, through the health boards, in the short term. Officials from my Department have recently met the Department of Enterprise, Trade and Employment to discuss the mainstreaming of the community employment essential services, including the mainstreaming of the 253 individuals providing supervisor and personal assistance services under the FÁS community employment scheme to the Centres for Independent Living.
The independent living fund is no more than a particular model for funding a personal assistance service. The important thing is that the service itself be provided to those needing it. The personal assistance service is one of a range of support services designed to enable people with disabilities to live in the community with the maximum degree of independence possible for each individual. The range includes home helps, home care attendants, respite care, day care etc.. The provision of a service is most appropriately based on the individual's needs, which may not always be best met by a personal assistance service. The objective of policy is to develop the range of services as a whole in accordance with the amount of funding allocated for the development of services for people with physical and sensory disabilities and having particular regard to the desirability of taking an equitable approach in addressing the needs of all people with disability who require various levels of support. The amount allocated by an individual health board in any year is decided in the context of local needs and in consultation with the regional co-ordinating committee for physical and sensory disability services. It is my view that this approach should continue rather than establishing a separate independent living fund.
A properly structured PA service needs to have a formal assessment procedure to assess the level of dependency of the individual with a disability and the suitability of the person to manage a PA. This might be done by the health boards as part of a structure for assessing the precise service needs of each individual with a physical or sensory disability, with perhaps a further assessment carried out jointly with the agency providing the PA service to the health board. It is envisaged that the health boards would broker the service, contracting with one or more service providers in each board's area. The service provider would hire, train and pay the PA, as the IWA does at present for the ERHA.
Expansion of PA services for personal social services must be funded out of moneys allocated for the development of services for people with physical and sensory disabilities. This year £3 million, with a full year cost of £6 million in 2001, has been allocated to health boards to develop home support services, including personal assistance services.
