3/17/2018 Getting To Individualised Options in Ireland: The Present Leadership Challenges | Frontline Magazinehttps://frontline-ireland.com/getting-individualised-options-ireland-present-leadership-challenges/ 1/4Getting To Individualised Options in Ireland: ThePresent Leadership ChallengesApr 5, 2017Ireland has adopted a policy in support of individualisationInterested service providers and people with disabilities and families have begun work on itGovernment policy is not keeping up with this workOperational plans and targets and systems governance arrangements are neededThese would enable real individualised options for people with disabilitiesIt is now time for the decision to get down to business.The current policy and programmatic environment in Ireland is transitional, as Ireland beginspreparations for a major shift away from congregate service models towards more individualised andsocially inclusive options for lifestyle and other supports for persons with disabilities. Some of that shift,in the form of an ongoing systematic transformation of service models, has already taken place in arelatively small number of Irish agencies.However, the bulk of change has focused on selected individual changes in support and lifestyle, as isreÛected in the “Next Steps” accounts published by the National Federation of Voluntary Bodies. Evenso, the vast majority of services and service settings are largely congregate in nature, and will likelyremain so for at least a matter of decades. Leadership is needed to provide a clear operationalpathway towards their replacement with the desired individualised options.Under present conditions, even the occasional replacement of congregate models will likely follow thepath of the creation of mini-institutional models to replace the larger congregate settings, therebypostponing for possibly a generation, any sense of widespread access to individualised options calledfor by recent policy. A new pattern of creating dispersed but smaller congregate models will divert anddiÙuse leadership energies, further delaying widespread individualisation. It would be much better tosimply place an indeÚnite hold on the growth of new congregate options, so that always-scarceleadership capacity can be more exclusively focused on generating individualised options.Though there are discussions currently underway to pave the way for some form of formalindividualised funding system to potentially be created, it is not clear at this juncture whether that asyet undeÚned system will be suÜciently broad-based enough to bring into being large numbers ofself-directing individual options. Such an individualised funding system, of a substantial enough scale,would in turn require that the means to pay for it would have to be decisively resolved.There are typically two routes to such an expansion of Individualised funding. The Úrst would be toallocate new monies exclusively for individual funding, and the second would be to reallocate thefunding for congregate models to the exclusive use of these monies for solely individualised supports.Both approaches could be used, but the generation of “new” monies to support solely individualisedoptions would, in all likelihood, be hugely constrained by the State’s Únancial ability to set aside suchmonies for other than pilot-scale demonstration projects. However, a 1% set-aside added over adecade would immediately add approximately 10% to individual options alone. In all likelihood, Irishagencies that favour the continuance of their congregate models would strongly resist any increase inPrivacy & Cookies Paobliscoylute funding directed solely to individualised options. However, there are now enough agencies 3/17/2018 Getting To Individualised Options in Ireland: The Present Leadership Challenges | Frontline Magazinehttps://frontline-ireland.com/getting-individualised-options-ireland-present-leadership-challenges/ 2/4interested in expanding their individual options to generate considerable momentum and scale,particularly over a decade.From the experience of other international jurisdictions, it can be assumed that there are suÜcientfunds already in place in Irish congregate service models to pay for the sizable expansion ofindividualised options in Ireland, without the need for a separate “new“ funding stream forindividualised options. Although, such a dedicated stream would be very helpful in developing thecore of the initial growth of the individualised system sought by progressive interests in Irish society.However, several obstacles requiring decisive leadership need to be engaged and resolved. The Úrst isthe absence of governmental (as opposed to solely HSE) targets for a planned phase-down of thequite massive inventory of now very dated Irish congregate models, including a quite sizable andgrowing number of mini-institutional settings. Without such targets being set and met, there is norealistic hope that funds for individualised options will become available in signiÚcant enough scale toshift the balance of the system. Nor will direct practice advance, given that the opportunities to learnand develop needed capacity will be much too few.The second key obstacle is the current restricted capacity of Irish agencies to transform their servicemodels from congregate to individualised ones. While there is a decided willingness amongst many ofthese agencies to pursue such objectives, the track record “on the ground” with accomplishing suchcompleted service model transformations is quite limited. This lack of performance capacity can beaddressed developmentally, but should it not be engaged eÙectively, this will most certainly delay formany years the emergence of widespread new opportunities for individualised options to becomereliably available. However, we can overcome even this limitation, if there are targeted initiatives ineach interested agency to become more proÚcient, with the process of converting congregateresources to individualised ones.At present Ireland has, at the level of policy, declared that its future must involve a decided growth inself-directed and socially inclusive individualised options. This intention is genuine, but at least for themoment, it is not accompanied by a feasible operational plan from the state that would generate theseoutcomes. Typically, such operational plans are multi-year, i.e. 5- to 10-year plans that involveincremental annual system change targets, such that congregate models decline and individualisedoptions proportionately replace them. These targets would need to be deÚned nationally incooperation with the sector and then translated into annual regional and “agency by agency” work andfunding plans. At the same time, it is not realistic to expect that the HSE can readily lead atransformation of this long-term kind, as its primary experience base has been with fundingcongregate models and not with creating individualised alternatives.This lack of experience, and possibly the will to champion such diÜcult changes, given the alreadysizable and pressured workload of the HSE, suggests that a diÙerent approach to systems governancemay be needed at the overall governmental level, rather than in the HSE. This might ensure suÜcientpolitical commitment to launch and sustain a comparatively long-term transformation, of the kindimplied in the creation of widespread socially inclusive and self-directed individualised options as thecore of the system of support for people with disabilities. Such a new governance entity shouldemphasise the presence of leadership from people with disabilities, their families, progressiveprofessionals and agencies with actual experience of gradually turning worthy but challenging aimsinto reality. However, the state must do its part by putting in place the structural and policycommitments that can enable this job to progress to completion.Privacy & Cookies Policy3/17/2018 Getting To Individualised Options in Ireland: The Present Leadership Challenges | Frontline Magazinehttps://frontline-ireland.com/getting-individualised-options-ireland-present-leadership-challenges/ 3/4Ideally, such governance should be supported by a multi-party political agreement. This could ensurethat the Irish State is held politically accountable for the performance of this new governance andmission, rather than saddling the HSE with more responsibilities without the resources, political will andhuman resources to ensure that the job can get done. A careful selection of public service leadership,that has actual proÚciency with the programmatic content of these changes, would complement theother sources of broader community leadership, rather than relying as we do today on policy withoutan operational plan that can over time, generate actual outcomes in people’s lives “one person at atime”.It is useful to note that Ireland would not need to single-handedly pioneer these changes, as much ofthat work has already been undertaken over at the least the past quarter century in many countries.For instance, the US has in place well over 300 diÙerent individual funding streams targeted at speciÚcsub-populations. Australia is well into the process of making nationally portable individualised fundingavailable to 460,000 Australians with a disability. New Zealand has generated and expanded individualfunding going back a decade, the UK pioneered individual budgets several decades ago and variousCanadian provinces have established long-term individual funding arrangements. Scotland hasrecently made it a right for people to have individualised options if they so choose. Consequently,Ireland is not starting in an experiential vacuum, as it can readily draw upon the work of many othercountries, as well as the many notable accomplishments by small numbers in Ireland in the lastdecade.That process of borrowing from the experience of others has been occurring informally for some timenow in Ireland, and accounts for much of the appetite for progress on creating individualised options inthe country. However, what is now lacking is a governmental decision to operationalise its existingpolicy into a workable multi-year plan that can incrementally build the individual options that the Irishpublic increasingly favours. If individualised options were to increase by 3-4 % per annum, then it isquite realistic to expect that 30-40% of persons with disabilities could conceivably enjoy individualisedlifestyle and support options within a decade. That would also mean that Ireland would no longerstruggle with 30%-40% of out-of-date congregate and mini-institutional models. Together, these twotrend lines would mean almost doubling the actual hands-on level of experience in successfullycreating good lives in the community “one person at a time”, for Irish people who live with a disability.This approach assumes the freezing of any new funds to expand congregate and mini-institutionalsupport arrangements so that individual options become the preferred operational choice goingforward.Most importantly, it means that the government of Ireland must come to decision at a political level sothat the work to accomplish the policy can begin and gradually expand in coming years. There is nodoubt that the will to do so exists within broad aspects of the community and the service sector.Naturally, there is a wide range of complex problems to tackle and resolve in getting this process tomove to beneÚt greater numbers. These challenges will become even more evident as experience isgained with greater numbers. However, addressing the predictable implementation problems willinevitably be incremental. Thus, the key at this point is to ensure that the operational process belaunched and once that is done, the outcomes will gradually appear as the work gets done.Michael J. Kendrick of Kendrick Consulting International is a frequent visitor toIreland. He works on emerging best practice in the sector in many countries.Michael has provided leadership, writings, consultation, evaluation and indepth teachings on how to develop personalised opportunities for peoplewith disabilities. He has contributed writings to Frontline on various otheroccasions. [email protected] Privacy & Cookies Policy 3/17/2018 Getting To Individualised Options in Ireland: The Present Leadership Challenges | Frontline Magazinehttps://frontline-ireland.com/getting-individualised-options-ireland-present-leadership-challenges/ 4/4Privacy & Cookies Policy
