The move towards a model of funding which is linked to individual need is encompassed by the recommendations in the Value for Money (VFM) and Policy Review of Disability Services which I published last year. The Department of Health and the Health Service Executive (HSE) will pursue the issue of individualised budgeting in the context of the implementation of the recommendations contained in the VFM Review. A Steering Group which is representative of the major stakeholders has been set up to oversee the VFM implementation process and the first meeting of this Group was held in September.
Individualised budgeting is an umbrella term that may take many forms, ranging from a method of determining resource allocation to agencies based on assessed client need and actual costs, to a 'money follows the client' model, a brokerage system or a personal budget model administered by the individual service user. The essence of individualised budgeting is that the individual is given more choice and control over how the money allocated to meet their needs is utilised. This might or might not involve the transfer of actual funds to the individual. This approach must be underpinned by a standardised needs assessment to ensure fairness and transparency in the way in which funding is allocated. The move towards an individualised budgeting framework raises legal and practical issues, and will require careful consideration and possibly legislation.
The priority is to further improve current services, while expediting the analysis of the benefits to be gained from newer models of individualised supports through demonstration projects which will be evaluated for wider applicability. The balance and emphasis will shift firmly and comprehensively towards these new models of individualised supports once sufficient analysis of the benefits is carried out in the Irish context and adequate financial management, resource allocation and governance structures are in place to ensure their long-term viability.
Demonstration projects are already underway to examine the practical aspects of introducing this major change and to establish the costs and benefits. The projects will be analysed in 2014 to determine their wider applicability, clarify the issues which must be resolved before the projects can be scaled up, and identify the best way forward. Work is also underway to identify a standardised national assessment tool and resource allocation model which will form the basis of the individualised budgeting framework. Other essential elements of the new model of service delivery and funding, such as a commissioning strategy and an outcome measurement framework, are also in development.