5. Arrangements for the Implementation of Part 2

5.1 Overview of the Provisions of Part 2

This section describes the provisions of Part 2 of the Disability Act 2005. However, it does not purport to be a legal interpretation.

Part 2 of the Disability Act 2005 establishes a system for the assessment of individual health service needs occasioned by the disability and, where appropriate, education needs for persons with disabilities over age 18 years. Part 2 provides a statutory entitlement to:

  • an independent assessment of health and education needs;
  • a statement of the services (Service Statement) which it is proposed to provide;
  • pursue a complaint through an independent redress mechanism if there is a failure to provide these entitlements.

The Act also allows for an employee of the Health Service Executive (HSE) to initiate an assessment of need in certain circumstances. Part 1(3) of the Act provides for Part 2 to be introduced on a phased basis.

5.1.1 Important Terms Defined in Part 2 (section 7)

Persons with a disability entitled to the services in Part 2 are those with a "substantial restriction" which is permanent or likely to be permanent, results in a significant difficulty in communication, learning or mobility or in significantly disordered cognitive processes, and gives rise to the need for services to be provided continually to the person whether or not a child or, if the person is a child, to the need for services to be provided early in life to ameliorate the disability

"health services" in Part 2 are services provided by or on behalf of the Health Service Executive (HSE) and include personal social services.

"education services" covered by Part 2 are education services for persons with disabilities over 18 years. They include schools covered by the Education Act 1998 or certain educational facilities specified by the Minister for Education and Science.

5.1.2 Purpose of the Independent Assessment (sections 8-10)

Any person who considers that he or she may have a disability is entitled to apply for an independent assessment of need. The assessment will be undertaken without regard to cost or to capacity to provide any services identified in the assessment. Arising from the assessment, the person concerned will be given an Assessment Report.

The Assessment Report will indicate:

  • whether a person has a disability;
  • the nature and extent of the disability;
  • the health and education needs arising from the disability;
  • the services considered appropriate to meet those needs and the timescale ideally required for their delivery;
  • when a review of the assessment should be undertaken.

There is provision for a relative, guardian or personal advocate to apply for an assessment on behalf of a person with a disability. Each person with a disability will be encouraged to participate in his/her own assessment while taking account of the nature of his/her disability and his/her age. This will also include taking account of his/her views regarding their needs or preferences in relation to the provision of services.

The Health Information and Quality Authority (HIQA), a new independent body to be established by the Minister for Health and Children, will set appropriate standards for carrying out the assessment process.

5.1.3 Educational Needs of a Child

A child who has a disability may be assessed under the Disability Act or under the Education for Persons with Special Educational Needs Act 2004. If a special educational need is identified as a result of the assessment of a child under the Disability Act, that aspect of the assessment must be referred to the National Council for Special Education or to the Principal of his or her school for the purposes of an assessment under the Education for Persons with Special Educational Needs Act, 2004. Health needs identified in an assessment under the Education for Persons with Special Educational Needs Act 2004 will be dealt with in a Service Statement under the Disability Act.

5.1.4 Service Statements (sections 11)

Each person found to have a need for disability related health and/or education services, as a result of the Assessment Report, will be given a Service Statement. The Service Statement will set out the health and education services that will be provided to the person taking account of:

  • the Assessment Report;
  • eligibility criteria for services;
  • relevant standards and Codes of Practice;
  • the practicability of providing the service;
  • the financial resources available.

A Service Statement may be amended because of a change in the circumstances of the person or a change in any of the above considerations upon which the statement is based. The individual or his/her advocates will be invited to participate in a review of the provisions of services specified in the Statement at intervals determined by regulations.

5.1.5 Exchange of Information (section 12)

There is provision for informing, with the necessary consent of the person concerned, other public bodies about the contents of an Assessment Report so as to facilitate access to assessment for services outside the health and education sectors.

5.1.6 Planning (section 13)

To assist with ongoing planning and improvement of services, the HSE will keep records of assessments and services provided, levels of unmet needs and the numbers of persons involved. The maintenance of these records will be in accordance with the requirements of data protection legislation. A report will be prepared annually by the HSE for the Minister for Health and Children and will be published.

5.1.7 Complaints (sections 14-15)

A person may make a complaint to the HSE about:

  • a finding by an assessment officer that he or she does not have a disability;
  • the failure of the assessment to meet the standards set by the Health Information and Quality Authority;
  • the contents of the Service Statement;
  • the failure to start or complete an assessment within the required timescales;
  • the failure of a health or education service provider to provide a service set out in the Service Statement or to provide it within any timeframes prescribed.

Complaints will be heard by a Complaints Officer. The complaint will be resolved informally, if possible. If informal resolution is not possible, the complaint will be investigated and a recommendation will issue, which will include a timeframe for the action directed. The recommendation will have regard to the outcome of the investigation as well as other considerations, including the eligibility of the person for the service, the practicality of providing the service and the resources available to the service provider.

5.1.8 Appeals (sections 16-20)

A person may lodge an appeal against a recommendation of a Complaints Officer. The HSE or education service provider can also appeal a recommendation in relation to the provision of a service.

Appeals will be investigated by an independent Appeals Officer. If the parties to the appeal agree, an appeal may be resolved by mediation. Otherwise, an appeal hearing will take place and a formal determination will issue.

The Appeals Officer's determination is final and may only be appealed on a point of law to the High Court.

A determination and a mediated settlement can both be enforced in the same manner.

5.1.9 Enforcement (sections 22-23)

Where a recommendation, a mediated settlement, or an Appeals Officer's determination are not implemented, the applicant or the Appeals Officer can apply to the Circuit Court for an enforcement order. The Circuit Court may then order the HSE (or the head of an education service provider) to implement the relevant decision.

5.1.10 Regulations (section 21)

The Minister for Health and Children may, by regulation, establish procedures relating to the matters covered in Part 2, including the assessment process, service statements and the redress procedure.

5.2 Challenges for the Disability Services

The structure and models underpinning services provision within the disability sector have developed differently due in part to the former health board structure. There has not been a consistent national approach and service developments have often been driven by factors other than client need. Inconsistent approaches have developed in different areas based on geography, voluntary or statutory sector service provision, type of disability or emphasis on specific types of service development. Specialist or exclusive service provision has on occasion led to inequities with some people being unable to access services in their local areas.

To ensure a consistent, equitable and inclusive approach using service need as the evidence base, a reconfiguring of service provision is required so that all people with a disability have access to services consistent with their assessed need, irrespective of voluntary sector agency attachment, geographical location or type of disability. Part 2 of the Disability Act presents an opportunity to develop service delivery systems that are user friendly and fully accessible and requires a commitment from contracted services providing agencies as well as the HSE to engage in a process to maximise this.

The human resource difficulty in meeting the demands of service provision continues and is particularly evident in the disciplines of speech and language therapy, occupational therapy, physiotherapy and psychology. Steps to address this issue are being taken but achieving required levels will take a number of years.

The HSE has a particular obligation to ensure that the potential of the roles of assessment and liaison officers is achieved and that these roles bring added value to people with disability availing of specialist disability services as well as meeting the statutory requirements relating to information provision.

5.3 Timeframe for the Phased Introduction of Part 2

When the Disability Bill was before the Oireachtas it was widely understood that, having regard to resource and capacity issues within the health services and to the complexity of the delivery system, the provisions of Part 2 of the Disability Act would have to be implemented on a phased basis. It was less widely recognised that the implementation of the provisions of the Education for Persons with Special Educational Needs Act, 2004 (henceforth referred to as "the EPSEN Act") over a broadly similar timeframe would have a significant impact on the plans for the implementation of Part 2. The arrangements for the implementation of one Act cannot be considered in isolation from the arrangements for the other, as the same health service staff, mainly in the areas of disability and mental health services, will be called upon to provide assessments and services under both Acts. Close collaboration and cross-sectoral working will be required at local and national level, involving the HSE, NCSE and both Departments concerned.

Having considered the matter in detail and following consultation with the HSE, the Department of Education & Science, the National Council for Special Education (NCSE) and other stakeholders, it has been agreed that, in the phasing arrangements for the implementation of Part 2, priority will be given to the needs of young children.

Among the factors underlying this decision are:

  • the importance of intervention early in life, which can have a significant impact on the disabling effects of a condition/impairment;
  • the fact that the EPSEN Act, which will affect all school-going children, will be implemented over a five year timeframe from October 2005;
  • the existence of a range of early intervention services and models which, though fragmented, can be developed into a cohesive Early Intervention Framework and rolled out nationally within a relatively short timeframe;
  • the Government's commitment to the provision of pre-school services for children with a disability.

Section 1(3) of the Disability Act, 2005 allows the Minister for Health & Children, after consultation with the Minister for Education & Science, to commence the provisions of Part 2 with reference to persons of different ages. It has been agreed, therefore, to commence the provisions of Part 2 in respect of all children under 18 on a phased basis. Part 2 will commence for children aged under 5 years old with effect from 1st June 2007.

Part 2 will be commenced in respect of children aged 5-18 in tandem with the implementation of the EPSEN Act. In preparation for its implementation, health related support services for children aged 5 to 18 will continue to be enhanced to enable the HSE to meet needs identified for this group. Under the terms of that Act, the National Council for Special Education (NCSE) is required make a report to the Minister for Education & Science outlining the steps that must be taken to implement the Act within a five-year timeframe from October 2005 to October 2010. This report is to be prepared by October 2006 and will specify dates for the commencement of the provisions of the EPSEN Act. The Department of Health & Children and the HSE are closely involved with the NCSE and the Department of Education & Science in the preparation of that implementation report to ensure that the necessary arrangements for health and education services are aligned.

"A Vision for Change" has been accepted by the Government as the basis for the future development of the mental health services. The re-organisation of the mental health services proposed therein, particularly in relation to the development of multi-disciplinary community mental health teams and the planned expansion of children and adolescent mental health services, will enable the mental health services to align themselves to the requirements of the Disability Act.

Services for adults with a disability will continue to be developed over the coming years. The primary focus of many of the elements of the Multi-Annual Investment Programme is on meeting the identified needs of adults with disabilities. For example, adults will be the primary beneficiaries of the bulk of

  • the new residential and day places for persons with intellectual disability or autism;
  • all of the new places for people with intellectual disabilities to be transferred from psychiatric hospitals and other inappropriate placements;
  • the residential places for persons with significant physical disabilities; and
  • much of the additional community based mental health facilities

to be developed over the life span of the programme. Enhancements in multi-disciplinary support services for both adults and children will also be put in place progressively over the coming years.

The HSE intends to commence the changes necessary to deliver on the structures provided for in Part 2 in advance of full implementation. This will include changes in the manner in which services are commissioned by the HSE, both internally and from the non statutory sector, with an increasing focus on meeting individual needs.

The HSE will be promoting the practice of assessment of individual needs and the provision of service statements for all service users in advance of the commencement of the Act, as capacity permits. The statutory requirements of Part 2 of the Disability Act will be extended to adults as soon as possible but no later than the end of 2011.

Over the next 12 months, the Department of Health & Children will:

  • put in place a Cross-Sectoral team consisting of senior officials from the Departments of Health and Children and Education and Science, the HSE and the NCSE, to ensure that arrangements for the implementation of Part 2 of the Disability Act and the EPSEN Act are progressed in tandem, having due regard to the resources and capacity of both sectors concerned;
  • commence Part 2 of the Act in relation to children aged under 5 years old with effect from 1st June 2007.

5.4 Arrangements for Assessment of Need

5.4.1 Applications for Assessment

Section 9 of the Disability Act provides that a person with a disability may apply for an assessment of need or, if he or she is unable to do so because of the nature of his/her disability, the application may be made by a spouse, parent, relative, guardian, legal representative or advocate. Details of the application procedure will be laid down in regulations.

Clear, easy to understand information will be provided by the HSE to people with disabilities and other relevant parties to assist them in making an application for an assessment. People will be informed of their right under the Act to apply either for a full assessment or for an assessment in relation to a specific need or a particular service identified by the person him/herself.

5.4.2 Role of Assessment Officers

Assessment Officers will oversee and co-ordinate the assessment process and ensure that a report on results of the assessment is provided as required by the Act. The Assessment Officer will be the first point of contact for the person with a disability (or the parent of a child with a disability) who makes an application for an assessment under Section 9 of the Act. He or she will be a resource for the person concerned, ensuring that the appropriate assessments are carried out. Part of his or her role will be to guide that person through the process of assessment, to keep the person informed of progress and, at the end of that process, to complete the assessment report as required by Section 8(6). The Assessment Officer will be statutorily independent in the performance of these functions.

Section 8(1) of the Disability Act, 2005 provides that the HSE shall appoint Assessment Officers. It is clear, therefore, that the assessment function rests with the HSE. The role of the Assessment Officer in the context of the provisions of Part 2 is critical.

In considering the arrangements for the assessment of need, it is important to bear in mind that the assessment process is not an end in itself. The ultimate objective is to complete an assessment report which will identify the needs of a person with a disability which will, in turn, facilitate the preparation of a service statement. Assessment Officers will commence the assessment process as soon as possible after applications have been received, but no later than 3 months after receipt, and complete them without undue delay, as required by Section 9(5).

5.4.3 Assessment Process

The independence of the assessment is guaranteed by subsections (4) and (5) of Section 8, which provide respectively that an Assessment Officer "shall be independent in the performance of his or her functions" and that an assessment shall be carried out "without regard to the cost of, or the capacity to provide, any service".

It will be for the Assessment Officer to determine the scope of assessment required for the person concerned and to arrange with the appropriate professionals to have it carried out.

In keeping with the definition of assessment in Section 7(1), the focus of the assessment will be on health and education needs occasioned to the person by the disability. If in the course of an assessment, it appears to the assessment Officer or the professional that the person may also have other health needs (for example oral health or primary care), an appropriate referral to the relevant service within the HSE will be arranged, in consultation with the person concerned and/or his/her parent, carer, or advocate as appropriate.

The following principles and values identified by stakeholders will guide the assessment process.

  • Outcome focus

    The assessment must be outcome focused. The outcome will be different for each person but should result in improved quality of life for the individual and his or her family or carer. It should enable that person to achieve the highest possible level of independence and participation.

  • Empowerment focus

    The assessment should be empowering, person and family centred, conducted in a spirit and practice of partnership and collaboration with all stakeholders. The approach should be holistic, covering all key aspects of the person's life.

  • Respect

    The assessment should be based on respect for the individual and the family and should be culturally appropriate.

  • Quality

    The assessment process should reflect a commitment to quality through evidence-based practice. It should be timely, accessible, flexible, dynamic and responsive.

  • Social values

    The assessment process should be designed to reflect the commitment to equity, transparency, and fairness in the use of resources.

  • Value

    The assessment process should represent best use of the people skills and other resources invested in it.

There will be a two stage assessment process. The first stage will involve an initial review of the person's case by the Assessment Officer. This will include an interview with the person concerned and/or his/her parent, carer or advocate, to elicit his/her own assessment of what they perceive his/her needs might be. This is widely acknowledged as a very crucial element of the assessment process. Under the provisions of the Citizens Information Bill 2006, persons with disabilities may be entitled to a personal advocate

The Assessment Officer will also review any existing reports or recent assessments carried out on the person concerned, to inform his/her decision-making regarding what type of further assessment (if any) is required.

Taking all of the information thus obtained into account, the Assessment Officer will determine whether the person concerned meets the criteria for assessment under Part 2 of the Act. Particular attention will be given to the training of Assessment Officers in this matter, which involves the interpretation of the legal definitions in the Act. In this regard, the HSE will develop national protocols and guidelines to ensure that a uniform approach is adopted. Appropriate professional input, particularly in relation to diagnosis and prognosis will be sought as required. However, the Assessment Officers will have the discretion to judge each case on its merits, in accordance with their independent function.

The second stage of the assessment process will entail referral of the person for professional assessment by an individual or a team, as deemed appropriate by the Assessment Officer. Protocols and criteria for how this will operate will be developed by the HSE. If appropriate, professional assessment may include a diagnosis which may inform future needs. In keeping with the principles outlined above, the main focus of assessment will be on improving the participation in society and general quality of life of the person concerned.

Section 8(3) provides that, if there appears to be a need for an education service to be provided, the Assessment Officer will contact the NCSE, who will nominate an appropriate person to carry out an assessment of that need.

5.4.4 Assessment Report

On receipt of the assessments carried out by the professional or professionals involved, the Assessment Officer will compile the Assessment Report, following the requirements of Section 8(7), setting out -

  • Whether the person concerned satisfies the criteria for assessment under the Act, and if so-
  • The nature and extent of the disability;
  • The health and education needs (if any) occasioned by the disability;
  • The services considered appropriate to meet the needs of the person and the time ideally in which they should be provided; and
  • The period within which a review of the assessment should be carried out.

In accordance with the Act, the Assessment Officer will provide copies of the assessment report to the person concerned, his/her parent, carer or advocate (if appropriate) and to the Liaison Officer for the preparation of the service statement.

Where the assessment of a child has indicated an educational need, the Assessment Officer will refer the matter to the relevant school principal, or to the NCSE if the child concerned is not attending school.

Additional information indicating needs which are outside the remit of health or education (e.g. housing, transport) may be provided by the Assessment Officer along with the assessment report for the purposes of assisting the Liaison Officer to carry out his or her functions under section 12 (see below).

5.4.5 Standards

The Act provides that assessments of need will be carried out in accordance with standards which are to be developed by a body nominated by the Minister for Health & Children (Section 10). It is envisaged that this body will be the Health Information & Quality Authority (HIQA), which is due to be established on a statutory basis later this year. The same standards will apply to assessments conducted under Part 2 of the Disability Act and to assessments for health-related educational supports under the provisions of the EPSEN Act.

Pending the establishment of HIQA, it is proposed that the Department of Health & Children will initiate work on the development of standards, in conjunction with the interim HIQA and in consultation with the National Disability Authority and other relevant stakeholders, including the Department of Education & Science and the Mental Health Commission, with a view to HIQA assuming responsibility once it is legally established. The necessary order specifying HIQA as the relevant body referred to in Section 10 will be made at that time also.

5.4.6 Qualifications of Assessment Officers

Having regard to the role and functions described above, Assessment Officers will require the following competencies:

  • a thorough understanding of the provisions of the Disability Act 2005 and the Education for People for Special Needs Act 2004 which will underpin their work, and a familiarity with the provisions of the Mental Health Act, 2001 and the Health Act 2004;
  • an excellent knowledge and understanding of disability and service issues;
  • strong organisational and interpersonal skills;
  • an ability to work with multi-disciplinary teams; and
  • good report writing skills.

The HSE will arrange for the appointment of Assessment Officers around the country based on estimated need, as indicated by population profiles.

Over the next 12 months, the HSE will:

  • appoint Assessment Officers;
  • provide appropriate training for Assessment Officers;
  • disseminate information to all relevant stakeholders (including service users, their families and carers) on the assessment process proposed;
  • develop protocols and criteria to guide assessment process locally and nationally.

Over the next 12 months, the Department of Health & Children will:

  • prepare regulations governing the assessment of need process, in line with the proposals outlined above and consult with stakeholders on the draft regulations;
  • draw up standards for the assessment of need, in conjunction with the interim Health Information and Quality Authority and in consultation with the National Disability Authority and other relevant stakeholders.

5.5 Service Statements and Liaison Officers

5.5.1 Service Statements

Section 11 of the Disability Act provides for Service Statements, which will be prepared on receipt of the assessment reports described above. The purpose of a service statement is to describe what health and/or education services will be provided to the person on foot of the assessment report and to set out the timeframe for the delivery of those services. Where the person concerned is a child, education services will not be included in the service statement, as in general the child's educational needs will be dealt with under the provisions of the EPSEN Act. Where needs are indicated which do not come within the remit of either the health or education services, these will be communicated by the Liaison Officer to the relevant authorities, in accordance with the provisions of Section 12.

5.5.2 Liaison Officers

Service statements will be drawn up by Liaison Officers. In accordance with the Act, Liaison Officers will be employees of the HSE. The primary role of the Liaison Officer will be to arrange appropriate service provision for the person with a disability, in accordance with the assessed needs and having regard to available resources. The Liaison Officer can request assistance in the preparation of the service statement from others, such as family members or appropriate professionals. In addition, he or she can request the NCSE to assist in the identification of an appropriate education service provider or in the provision of an education service, if such is required.

The Liaison Officer will provide the service statement and he or she will also ensure that the services committed to in the service statement are delivered within the timeframes specified. In this respect, the Liaison Officer will be a key link between the person with a disability (or their parent/carer) and the service provider(s). Section 11(11) requires the Liaison Officer to invite the person concerned to meet with them for the purposes of reviewing the provision of the services specified in the service statement.

In addition, the Liaison Officer will keep the service statement under review, to ensure that any additional health and personal social services which it may not have been possible to provide in the first instance are kept in mind and provided in due course, as resources permit. This could involve, for example, placing a person on a waiting list for services and checking back regularly with service providers on availability of places.

The Liaison Officer will also be the key person with regard to linkages with other sectors, most notably the education sector. Liaison Officers will work very closely with Special Educational Needs Organisers (SENOs) and the NCSE in the provision of health-related education supports. He or she will also be responsible for the sharing of relevant information with local authorities and other relevant Government departments or agencies, in accordance with Section 12. This could include contacting a local authority with regard to a housing need, or statutory training and employment services where the need relates to vocational training or employment. Section 12 provides that, when a Liaison Officer has made such a contact with a public body, officials of that body must respond by contacting the person concerned to facilitate the co-ordination of services to which they may be entitled.

5.5.3 Qualifications of Liaison Officers

The functions of Liaison Officers as described above - engaging with service providers around the delivery of services within certain budgets and timeframes - require the following competencies.

The Liaison Officer will be required to have an excellent overview of the health sector and proficient knowledge of the local service sector in which he or she will operate.

The Liaison Officer will have a thorough understanding of the provisions of the Disability Act 2005 and the Education for People for Special Needs Act 2004 which will underpin their work, and a familiarity with the provisions of the Mental Health Act, 2001 and the Health Act 2004.

The Liaison Officer will have sufficient authority to direct service provision. This will facilitate links to the service development process where identified gaps in service can be evaluated and addressed.

To support the above, the Liaison Officer should possess excellent report writing and communication skills.

The HSE will arrange for the designation of Liaison Officers at senior service management level in each Local Health Office (LHO) area based on estimated need, as indicated by population profiles.

Over the next 12 months, the HSE will:

  • designate Liaison Officers at senior service management level in each LHO;
  • provide appropriate training for Liaison Officers;
  • agree protocols for liaison with the NCSE with regard to educational needs for adults;
  • agree protocols with local authorities and relevant Government Departments and agencies for the sharing of information in relation to assessed needs which are outside the remit of the health or education sectors.

Over the next 12 months, the Department will:

  • agree with the HSE and other stakeholders on a format for service statements, to be inserted in the regulations.

5.6 Complaints Procedures

Section 15 of the Act provides for the complaints system. The HSE is required to designate Complaints Officers from within its own employees to deal with complaints which may be made in relation to the various functions exercised under Part 2.

The Health Act, 2004 requires the HSE to establish a statutory complaints system in relation to health services generally. It is proposed, therefore, that the complaints procedures required under Part 2 will be incorporated into the statutory complaints mechanisms which are currently being developed within the HSE.

From the point of view of the service user, therefore, one single complaints mechanism will apply for health services. From an administrative point of view, however, complaints officers in the HSE will be given specific training in the provisions of Disability Act in order to ensure that any complaints made in relation to functions exercised under Part 2 are processed in accordance with the procedures laid down for such complaints in Part 2 and in the relevant regulations.

Over the next 12 months, the HSE will:

  • put in place the administrative structures necessary for the processing of complaints under Part 2 within the new statutory complaints framework currently being developed for the HSE;
  • develop simple, easy to understand information for service users wishing to make a complaint.

Over the next 12 months, the Department will arrange for:

  • insert provisions in relation to the making of complaints into the regulations prepared under section 21 of the Disability Act 2005.

5.7 Appeals

Section 16 requires the Minister for Health & Children to appoint an Appeals Officer who will consider and determine appeals under Part 2. The Appeals Officer will be independent in the exercise of his or her functions under the Act.

Appeals can be brought by a person with a disability (or their parent/carer) in relation to a recommendation of a complaints officer or in relation to the non-implementation by the HSE of a recommendation of a complaints officer. Appeals can be brought by the HSE or an education service provider against a finding by a complaints officer that they failed to provide a specified service. In each case, the parties must be given an opportunity to be heard by the Appeals Officer. If the person making the appeal consents, an appeal may be resolved by mediation. Appeals must be brought within 6 weeks of date of the relevant decision by the complaints officer.

Having heard all the parties to an appeal, the Appeals Officer will make a determination in writing affirming, varying or setting aside the finding of the complaints officer. If the HSE or an education service provider fails to comply with a determination of an Appeals Officer within 3 months, the person with a disability concerned may apply to the Circuit Court for an order compelling them to do so.

Detailed provisions in relation to the Appeals Officer are set out in the schedule to the Act. The Appeals Officer is required to be a civil servant, selected by competition. He or she will have his or her own staff and budget.

Over the next 12 months, the Department of Health & Children will:

  • appoint an Appeals Officer and staff;
  • allocate resources from within the Department's Vote for the appeals function.

5.8 Information Management

Section 13 of the Disability Act, 2005 imposes significant requirements on the HSE to keep and maintain detailed records in relation to the provisions of Part 2. The information to be collected includes -

  • the numbers and identities of people to whom assessments and services were provided;
  • the services provided and the persons providing them;
  • the aggregate needs identified in assessment reports which have not been included in service statements;
  • the numbers of applications for assessment and the number of assessments completed;
  • the numbers of people to whom services have not been provided and the age and disability categories of such persons.

The Act requires that a report containing the above information be compiled by the HSE and submitted to the Minister each year, indicating what additional services are required to meet identified needs, what the ideal timeframe for delivery of such services would be and the estimated costs involved. The report must be published by the HSE within one month of its submission to the Minister.

Both the Assessment Officer and the Liaison Officer will have an important role in overseeing the gathering and compilation of the statistical information required for the annual report.

The current information sets available for disability and mental health services would not facilitate the collection of data in the format required under the Disability Act 2005. The existing National Disability Databases include demographic information and information regarding current and future service needs over a five year period. Registration on the National Disability Databases is voluntary and access to services is not contingent on the individual being registered. In the case of the mental health services, there is no similar existing information system.

There is a need to build on and expand the current data set to include the additional requirements set out under the Act. The position regarding data protection will also have to be explored given the statutory obligation now placed on the HSE in relation to reporting on activity under the Act. There is also a need for a collaborative approach between the HSE and the NCSE in relation to the information required by the NCSE under the EPSEN Act 2004.

Given the nature of the roles of the Assessment and Liaison Officers, it is also vital that any information system used should have the capacity to manage caseloads, in addition to providing aggregate information on a national level.

Issues related to the identification, for service planning purposes, of the needs of people with physical or sensory disabilities or mental illness aged over 65 years will be examined as part of the development of an expanded information system and in the context of the delivery of integrated community based services.

Over the next 12 months, the HSE will:

  • review the existing information management systems within the disability and mental health services, to identify what additional resources and infrastructure would be required to meet the obligations under section 13.

The Health Information and Quality Authority (HIQA) will be requested to set standards in relation to the information and data requirements under this Part.

5.9 Resources

It is clear that the arrangements described above for the implementation of Part 2 will have resource implications. The costs involved and the numbers of additional personnel required are being calculated and will inform the negotiation of the estimates for the health and education services for 2007 and subsequent years.

The arrangements for the implementation of Part 2 will also have considerable implications for workforce planning for the health services, and in particular the disability and mental health services, for years to come.

Over the last two years, posts funded under the National Disability Strategy have been additional to the previously approved staffing levels with consequent adjustment to the approved employment ceiling for the health services. This has facilitated both the delivery and monitoring of agreed service developments in the disability and mental health services.

While not underestimating the challenges that lie ahead, significant steps have been taken to date to meet these challenges. These include:

  • The Government's commitment, through the Multi-Annual Investment Programme which the Government has put in place for 2006 - 2009, to progressively address identified needs;
  • The increased availability over the coming years of key allied health professional personnel as a result of additional training places;
  • Targeted recruitment drives in Ireland and internationally which are planned for 2006 and 2007;
  • Measures which have been taken in relation to retention of personnel and enhanced career progression;
  • The National Human Resource and Workforce Planning Unit of the Department, together with the Older Persons Services Division and the Disability and Mental Health Divisions, is establishing a joint workforce planning group with the HR Directorate of the HSE to ensure appropriate and integrated workforce planning activity;
  • The Department is working closely with the HSE Employers Agency and SKILL to address skill mix issues and to ensure that appropriate education is provided to all assistant grades. (The grades of Physiotherapy, Occupational Therapy, Speech and Language Therapy and Rehabilitation Assistants were established in June 2005 and an educational programme for same is currently being finalised).

5.10 Monitoring Arrangements

It is proposed that the implementation of Part 2 will be monitored in the context of the overall monitoring arrangements for implementation of the Disability Act, 2005 within the health services. Briefly, these will consist of -

  • a National Disability Advisory Committee, under the auspices of the Department of Health & Children;
  • local, regional and national consultative fora which will be developed by the HSE and whose remit will include reporting to the national advisory committee on the implementation of the Act in respect of their geographic areas.

Each committee will be representative of all stakeholders.

Further information on the role of the National Disability Advisory Committee is included in Chapter 8.