Concerns an unregulated "second-class" carer workforce is being created by the burgeoning "individualised funding" (IF) scheme for the disabled are revealed in an evaluation commissioned by the Ministry of Health.
Completed in October last year, the evaluation released this week to the Otago Daily Times reveals financial sustainability and workforce issues.
Seen by many as the future of disability support, individualised funding allows disabled people to employ their own carers, and choose the type of care.
"Host providers" - usually established care agencies - provide employment support, oversight and coaching.
The ministry commissioned the evaluation to assess how the scheme fared when it was ramped up in 2010 from one host provider to a dozen.
The number of recipients rose from 421 to 934 between 2010 and 2011.
Some providers feared they were losing employees, who were moving to IF clients.
"Some of the host providers interviewed felt that they were already losing staff to IF clients and that a greater shift towards IF would cause them to 'bleed out' and lose their employees."
They were concerned IF clients were "poaching" their workforce.
Attempts at "locking in" employees for a minimum period had been considered.
Some were concerned the system was producing a second-class workforce, because agency-employed carers were subject to standards, expectations and ongoing training.
"A number of IF host providers were concerned about the workforce implications of a large number of disabled people shifting to individualised funding and employing their own support workers."
A financial analysis revealed cost concerns: funding for those moving from traditional support to IF increased 14.9% ($21,624 per year to $24,840).
Funding for those on the scheme increased from one year to the next by 25.5% ($27,445 a year to $34,456).
The average annual support package for IF in 2011 was $26,546, 108% higher than non-IF recipients, who got $12,736.
"These trends are of concern and are indicating that those moving on to IF are, on average, receiving larger support packages than they received previously. These trends should be monitored closely by the [ministry]."
A potential conflict of interest was identified for host providers as both service providers and overseers of individualised funding, and there was concern there were too many host providers.
Concerns the funding model was not "fit for purpose" should be addressed by the ministry, the evaluation said.
A spokesman for the ministry said this week it was increasing the availability and flexibility of IF, and was addressing issues raised in the report.
The ministry was considering the right number of host providers and was exploring training for carers, and employment management training for IF clients to help them understand employer obligations.
