Changes to Funded Family Care, and answers to your questions

On Sunday 19 January 2020 the Government announced timeframes for upcoming changes to Funded Family Care, its payment for family carers.  

Below we provide links to the announcement itself, media interviews with carers, and to Carers NZ’s Facebook page, which is tracking FFC issues as they arise. There is also a link to the Ministry of Health’s FAQs about the payment.

If you are familiar with the issues and have read or listened to the interviews below, you might want to skip to the bottom for new information since the announcement, provided by MoH in response to questions raised by carers this week.

We will continue to feed your questions about FFC to MoH or you can email MoH directly. If you raise a question with MoH please copy Carers NZ into your email (info@carers.net.nz) so we can share any new information with carers.

It is worth following Carers NZ’s Facebook page so you can receive updates about FFC and other issues important to carers. Send your contact details to us so we can ensure you receive our news updates and communications through the year: centre@carers.net.nz

Upcoming FFC changes and timeframes

The Government’s announcement can be found here.

Highlights in a nutshell:

  • From April 2020 spouses and parents of children with disabilities under the age of 18 can be considered for Funded Family Care, if they support someone with high and complex needs. Previously spouses and parents of under 18s were excluded.
  • Young carers aged 16-17 can be considered for FFC from April this year.
  • From April people receiving FFC will receive more money – increasing from the minimum wage per hour to $20.50 – $25.50 per hour, aligning with pay equity rates for the formal workforce. Hourly rates will depend on experience and qualifications but all FFC recipients will get at least $20.50 per hour from April.
  • From April there will be a choice about who is the employer of someone paid via FFC. Employment can be via a provider, or the person with a disability can act as the employer as happens now.
  • The Government has started taking steps to repeal Part 4A of the NZ Public Health & Disability Act 2000, which prevents New Zealanders from taking claims on the basis of unlawful discrimination to the Human Rights Commission or before the courts.

Media coverage of FFC changes

Below is a roundup of links about the announcement – it’s worth spending time reading and listening to these interviews if you are interested in FFC.

Newshub  An interview with carer John Forman who receives FFC, celebrating the announcement and pointing out areas for improvement.

Repeal of Part 4A of the Public Health & Disability Act 2000  The process for the repeal has begun within Government.

TV1 News Kimberly Graham is interviewed about FFC and the pros and cons of the policy from a carer perspective.

Radio New Zealand – Multiple items

Parents and disability advocates react to the FFC announcement. Will the changes make things better?

Corin Dann’s piece about FFC.

Cliff Robinson, who with other families has fought for years for fair pay for family carers without discrimination, welcomes the FFC announcement.

Disability advocate Jane Carrigan says the FFC changes are “lipstick on a pig” – the fight will continue to make employment and pay fairer for carers in areas such as assessing the work and hours they really do.

Wallace Chapman, host of The Panel, talks to John Forman about the FFC changes.

Questions raised by carers with answers from MoH

Part 4A was introduced with urgency by the last government; why will it take until September 2020 to repeal Part 4A – can’t you do the repeal urgently, too?

“The process followed last time did not allow for comments by the sector and did not follow the full legislative process to ensure the proper scrutiny of the Bill. We want to ensure that the process this time is clear and transparent and enables everyone to have their voice heard on the process.”

Why does the policy specify that a carer should work no more than 40 paid hours a week (whether the payment is from FFC or other types of work)? This seems discriminatory – other New Zealanders don’t have restrictions about how many hours of paid work they undertake.

“In order to ensure the safety and quality of care provided to people receiving FFC – the impact of working more than 40 hours can be detrimental to both the disabled person and the carer. We recognise that in some cases it is not possible to have anyone else provide the care so for these situations we have an exceptions process. Information on this can be found in the operational policy.”

Note: We think this is unfair. What do you think?

How will the Ministry ensure a fair, consistent, and transparent assessment process for being considered by NASCs for FFC? There is a perception that most people only get 15 hours or less; the odds of getting 40 even in very complex situations seems high. How will government sustain FFC with a bigger group of eligible people who deserve high allocations of FFC hours? 

“Allocation for hours will be determined by the NASC. It is based on the level of support required to carry out tasks. It is not based on the amount of funding available. The Ministry and DHBs will work with NASCs to implement changes to FFC.”

Will current FFC funding be increased in the Budget, given many more people will clearly be eligible for FFC but the funding doesn’t seem sufficient to cope with demand? 

“The Ministry will monitor uptake and cost and seek additional funding if required.”

Note: Seeking and getting are two different things, as we are finding with the stalled transition from Carer Support to iChoose. Carers please share your feedback as you go through the NASC process for Funded Family Care. We’ll be monitoring demand and funding closely.

To be considered for FFC a carer needs to be supporting someone who has high or very high support needs. How does MoH define high or very high support needs?

“People are identified as having multiple and significant challenges with daily living activities. The level is identified through the NASC process and based on a facilitated needs assessment. The level was developed as a consistent way to describe a person’s disability support level for their service package allocation.”

Does allocation of FFC affect the supports you already get e.g. personal cares, household management, Carer Support, IF etc? 

“FFC is one of the supports people can choose to receive if they have high or very high needs. It will be included in their overall support package – the support package maybe made up of some hours FFC, some through a formal provider and some respite. OR they may receive all hours through FFC. It will depend on individual circumstances. The local NASC will be able to answer questions relating to support packages.”

What will the process be to determine what hourly band a carer receives e.g. $20.50 up to $25.50 depending on qualifications and experience?

“This is done through the employer. If you choose to go through a provider they will determine the pay equity rate based on length of service and qualifications. If you go through IF you can choose to get payroll support from your Host provider; they will then help you determine the rate. The rate is based on length of service (how long you have been paid under FFC) and your qualifications. There is a table on the Ministry of Health website to help you work out what rate you should get.  Carers will be able to receive the minimum rate of $20.50 without prior experience or any qualifications. Funded family carers employed by providers will need to meet their employment requirements, which may involve entry level training. Current clients of Funded Family Care will automatically receive $20.50 an hour from 14 April 2020. Once a new FFC arrangement is in place such as Individualised Funding or provider employment family carers will be able to receive a comparable rate to that of other care and support workers.”

Will there be a pathway to a qualification for family carers so they can get a higher hourly rate?

“The Ministry is working with Careerforce to establish a pathway to qualifications for carers not employed by a provider. We are aiming to have a pathway developed by 1 July 2020.”

If someone makes the choice to be employed by a provider, is the person with a disability still governing the employment relationship with the carer? 

“People can choose for their FFC carer to be employed through a formal provider. In this situation the employment arrangement is between the provider and the carer; the disabled person is not the employer. Under IF the disabled person is the employer, but can purchase employment support from a Host provider.”

Note: This remains a murky, fraught area that needs more work.

Can someone living in residential care use FFC to reside with family?

“NASCs will work with the disabled person and their family/whanau to determine the best support arrangement for them. If a disabled person wishes to come out of residential care they can receive support in their home depending on their needs. FFC can only be used for the provision of household management and personal cares. It will not be allocated on a 24/7 basis for supervision. Determining the best support arrangement for the disabled person will need to take into consideration their specific circumstances and what they consider a good life to be.

Note: Not including supervision in assessments for consideration for payment remains unfair. It is also unfair in the world of ACC. 

How will FFC be promoted so carers know about it, as it has not been well promoted to date and even DHBs etc do not seem to know much about it. 

“DHBs are updating their policies from June 2020. This will be supported by updated public communications. Your NASC is the best source of information about what support services are available to you.”

Note: Too many carers still don’t know about FFC and are not given good information about their options. We hope the Government will do significantly more to reach family carers so they know about FFC and can be considered for it.

I have another question about FFC not answered here.

Email further questions to the FFC inbox: FFCinfo@health.govt.nz  Please copy your email to Carers NZ so we can share any new information with all carers: info@carers.net.nz

MoH information about FFC

Follow this link

Latest questions and answers Feb 2020

Can a carer be employed by ANY provider or will MoH have a list of preferred FFC providers?

All Home and Community Support service providers will be able to employ family carers.

What training is being given to providers so they understand carers, their perspective, etc? Our experience of some providers is that this could wind up being an area of concern for carers.

The Ministry is continuing to work with providers as we plan for implementation of the policy changes. Anyone who does not wish to work with a Home and Community Support Service provider is able to use Individualised Funding instead.

If a child is under 18 will they have to go through a provider? Or how does the employment relationship work in IF?

Operational guidance will be provided prior to April 2020.

“As a parent of a 21 year old I have been paid FFC since my daughter was 18. I hold a level 5 ECE qualification and have cared for her for all her life. I don’t have time to go back to school and gain further qualifications. Will my experience and years of service be considered when deciding my pay rate?”

Depending on exact dates of entering into an FFC agreement the rate would be paid at $21.50 recognising 3 – 8 years of service. While ECE qualifications have been achieved, they are not considered a relevant qualification under the provisions of the Care and Support Workers (Pay Equity) Settlement Act 2017.

Will we lose hours from our package to cover the increase in hourly rates for carers?

No. The hours will remain the same allocated and be funded at a rate that will enable you to pay the appropriate rate under the pay equity framework. If you choose to pay a higher rate than the identified pay equity rate then this can be done under IF but additional funding for the higher rate will not be provided.

“My NASC was unprepared when I tried to discuss FFC. How can policy be announced but NASCs not be able to answer questions when carers get in touch? If we are unhappy with a lack of information from our NASC, or any delays in getting answers, what should we do? I received a follow up email from my facilitator confirming that he can’t answer my questions today as promised because he still has not brought himself up to date on the changes on FFC! Unbelievable.”

All NASCs are aware of the changes to FFC. Further detailed operational guidance on FFC will be provided to NASCs before April 2020. You can contact FFCinfo@health.govt.nz if you would like more information about FFC.

If Funded Family Care it is paid via IF, will any leftover unspent funds be lost at the end of the year, as they are currently?

Allocations of all supports are made on an annual basis. Any unused allocation cannot be brought forward into a new allocation period.

The changes come in during April. We would like to anticipate how our package might change as we will be eligible for FFC after that time. If we wait until April it will take time for an assessment and changes that might be beneficial for our family. Are the NASCs ready for inquiries now so we will know what changes might be available to us after 14 April? It would not be fair for us to have to wait for the system to catch up and delay access to FFC for families like ours.

All NASCs are aware of the changes to FFC. Your NASC will be able to advise when they will be able to complete an assessment for you. Further detailed operational guidance on FFC will be provided to NASCs before April 2020. You can also contact FFCinfo@health.govt.nz if you would like more information about FFC.  Carers NZ: We are getting feedback from carers that their NASC is indicating they will not bring forward a review to take account of the FFC change. This is unfair to carers and we have raised it with MoH – it is government’s responsibility to handle inquiries in advance of the policy change.

I currently receive FFC and the increase in my hourly rate is welcome. I only intend to provide care for my son for another three or four years, due to my age and health issues. What is the process for ending my FFC arrangement, and what should people like me be thinking about?

Your NASC will be able to work with you to identify when you want to finish FFC and plan for what support services would work best following FFC.

As a family carer it is good I will be eligible for FFC after April this year. I don’t have Kiwisaver and it will be amazing to begin saving for my retirement, something I have worried about. Who gives advice about Kiwisaver decisions for people receiving FFC?

All carers employed under FFC are able to be enrolled in Kiwisaver. If you choose to go through IF your Host agency can provide support for Kiwisaver; if you choose to go through a provider, the provider will manage the Kiwisaver contributions.

What are providers being paid to act as the employer for family carers? Will it be a costly overhead for FFC and will this be announced so it is visible to us?

The cost of using a provider has been factored into budget considerations.

I have a Level 4 qualification but the FFC announcement says everyone will change over to $20.50 in April, the lowest ‘base’ rate, and then your host (if you receive payment via IF) will help determine what hourly rate you might receive if you have qualifications and experience for a higher rate. Why if you have a relevant qualification that justifies the highest hourly rate do people have to wait for this to be verified? Also are there costs in the process to have your skills and correct hourly rate assessed? Carers shouldn’t have to pay for this to be done.

Under the current FFC arrangement it is paid through a notice issued under Section 88 of the New Zealand Public Health and Disability Act 2000. This notice sets the pay rate for all FFC carers. After April you will be able to transition off this arrangement into another arrangement – once you are under either IF or a provider you will be able to receive the appropriate rate according to the pay equity guidelines. Carers NZ: This question hasn’t been fully answered re costs to carers. We will ask again.

IF allows disabled people to pay workers more than the pay equity rates if they wish. We do this for workers with our IF hours. How will this work for FFC – I am highly qualified and already earn more than the highest FFC hourly rate. Can I be paid more than the FFC rates, as happens with other workers we employ? If this is not allowed, is it not discriminatory, given we can pay other qualified, key workers more than the baseline hourly rates?

The pay equity guidelines set a minimum rate of pay. Disabled people are able to set the rate of pay they want to pay under IF. This will be the same for those moving from FFC to IF. If a disabled person chooses to pay a higher rate than the identified pay equity rate then this can be done under IF but additional funding for the higher rate will not be provided.   This is consistent with how IF currently operates.

This is a welcome improvement for carers, despite the unfair assessment process. I have also been waiting for MoH to introduce iChoose. Between the improvements for FFC, and being able to get iChoose, this would make a material difference for me. I have been told iChoose is on ice. Can you tell us what is happening with iChoose?

The Ministry of Health will continue to consider I Choose alongside other disability support funding priorities. Carers NZ: This is an unacceptable response about the future of iChoose which had been announced and the rollout planned. To simply consider it alongside other funding priorities bodes poorly for this much anticipated and positive change for carers. 

We are all getting our heads around the FFC changes. How is the Ministry going to consult with us and what information is it going to provide? What has been provided is not detailed enough. We are all going to get ‘lost in space’ trying to get answers one by one from NASCs, IF Hosts, providers, etc. I have so many questions.

The recent announcements were about the overall changes and timing. Further detailed operational guidance on FFC will be provided to NASCs and other agencies to assist eligible people and their families before April 2020. You can also contact FFCinfo@health.govt.nz if you would like more information about FFC.

NASCs do not seem prepared for this policy in DHBs. Our nationwide group of carers has many examples of people not being told about it in assessments for older people, mental health, chronic conditions etc. How will MoH ensure DHBs have a consistent approach to assessment and informing people about this payment? The answers so far from MoH are not good enough.

The recent announcements were about the overall changes and timing. Further detailed operational guidance on FFC will be provided to NASCs and other agencies to assist eligible people and their families before April 2020. You can also contact FFCinfo@health.govt.nz if you would like more information about FFC. The Ministry is working closely with DHBs to ensure national consistency of allocation of FFC.

DHBs have not, I believe, been given any new funding for paid family care. Everyone sees the headlines about DHB budget blowouts. How can they afford to allocate FFC when they have not been given any funding? There are so many DHBs that inconsistencies won’t be obvious in the big picture of FFC. Carers in every area of New Zealand deserve to receive the same consistent information and allocation process. Funding may be a barrier with DHBs, and also their ability to administer this payment.

DHBs are already able to allocate FFC. The allocation process will not change under the new policy. Eligible people who were previously receiving services through a contract support worker, will be able to choose to have their family member provide these cares instead. FFC can form part of the hours allocated, it is not in addition to allocated hours.

What will the role of FASS be in FFC?

Operational guidance on FFC will be provided before April 2020. Carers NZ: This question has not been answered. We are seeking further information from MoH.

We are still receiving questions and passing them on to MoH. There are gaps in the responses – let’s all keep asking the questions and getting answers in the coming weeks. We will post to Facebook each time we add to the Q&As – be sure to follow us at www.facebook.com/carersnz