Notice Title

The Funded Family Care Notice 2013

Name
1. This is the Funded Family Care Notice 2013.
Authority
2. This Notice is a legal document issued by the Minister of Health, for the Crown.
3. This Notice is issued under section 88 of the New Zealand Public Health and Disability Act 2000.
4. This Notice is part of a family care policy made under Part 4A of that Act.1 This Notice must be read with that policy.
Parties to the Notice
5. This Notice is between the Ministry of Health and the disabled person; it also recognises the responsibilities of the family carer and Ministry's agents.
Acceptance of terms and conditions
6. The disabled person2 accepts these terms and conditions when they accept their first payment for the funding.3
7. These terms and conditions can only be amended by the Minister of Health; and at any time.4
Effective date and application
8. This Notice is effective from 1 October 2013, and applies to funded family care from that date.
Overview
9. This Notice sets out the funding arrangements of the Government's family care policy5 that are required to enable the Ministry to pay a disabled person to receive funded family care, and for that disabled person to use that funding to employ a family carer.
10. Funded family care is described in the Funded Family Care Operational Policy.6 Essentially it is:
(a) for personal care and household management services;
(b) provided by a family carer to a disabled person who meets the eligibility criteria;
(c) provided to the disabled person up to a maximum of 40 hours a week; and
(d) paid at the rate of the minimum wage for adults.7
11. Funded family care is provided through a 5-way partnering relationship among the disabled person, family carer, Ministry, and Ministry's agents (NASC and Host),8 requiring:
(a) the Ministry to pay the disabled person for funded family care;
(b) the disabled person to use the funding to employ a family carer to provide the funded family care;
(c) the disabled person and the family carer to prepare an individual service arrangement;9
(d) the family carer to provide the funded family care according to the arrangements reflected in the individual service arrangement; and
(e) the Ministry's agent to:
NASC
(i) assess and co-ordinate the disability support services needs of the disabled person;
(ii) monitor the delivery of the funded family care;
(iii) assist with the management of problems; and
(iv) audit the payment and service arrangements.
Host
(v) assist with the set-up of the funded family care;
(vi) help the disabled person and family carer prepare the individual service arrangement; and
(vii) assist with initial and on-going advice on the employment relationship between the disabled person and the family carer.
Principles
12. For the Notice to work effectively in a family care setting, the parties acknowledge that:
(a) the disabled person has the right to accept and manage their responsibilities;10
(b) choices in how disabled people live their lives at home are respected;
(c) the unique dynamics of the home and family/whanau/aiga setting are respected;
(d) the contribution of family carers, with the assistance of other members of the family, is valued; and
(e) a partnering relationship among the parties will better ensure that the interests of the disabled person are promoted.
13. The parties also acknowledge that they must:
(a) act in the best interests of the disabled person;
(b) respect the individual autonomy and choice of the disabled person;
(c) respect the personal privacy of the disabled person;
(d) treat each other with respect, dignity, trust, confidence and in good faith;11
(e) co-operate with the reasonable requirements of any other party;
(f) ensure that communication is open and effective;
(g) ensure that the funding is only used for family care;
(h) recognise the unique dynamics of the home and family/whanau/aiga setting;
(i) comply with monitoring and auditing;
(j) comply with this Notice; and
(k) apply these principles at all times, especially when resolving any problems.
Disability support services
Eligibility criteria
14. A disabled person may receive payments for funded family care if they meet the following requirements:
(a) are eligible to receive disability support services under the Act;12 and
(b) are eligible for funded family care.13
Rate and hours of funding
15. The hourly rate for funded family care is based on the adult minimum wage and other employer obligations.14
16. The maximum allocation of funded family care is 40 hours a week for the disabled person.
Expected benefit
17. The Ministry expects that the funded family care will enable the disabled person to be cared for in their home and take part in family and community life.
18. The funded family care must also respect the specific and cultural needs of Maori, Pacifika and other ethnic groups.15
Responsibilities of the Ministry
19. The Ministry is responsible16 for:
(a) confirming that the family relationship between the disabled person and the family carer is one that is permitted by the funded family care operational policy;17
(b) approving the family carer;18
(c) ensuring that any special legal status between the disabled person and the family carer, to make personal care and welfare or property decisions for the disabled person, does not affect the provision of the funded family care;19
(d) making timely payments;20
(e) minimising, so far as practicable, compliance21 for the disabled person;
(f) assisting the disabled person if they want to change or stop the funded family care;
(g) arranging for assessment, evaluation, monitoring and auditing;
(h) stopping payments where the Ministry is notified and reasonably believes that requirements of the disability support services are not being met; and
(i) stopping payments if requested to do so by the disabled person.
Responsibilities of the disabled person
20. The disabled person is responsible for:
Managing the services
(a) agreeing with the family carer their individual service arrangement;
(b) ensuring that the family carer provides the funded family care;
(c) ensuring that all payments22 are paid to the family carer and made only to the family carer;
(d) ensuring that payments are made for replacement care when the family carer is unable to provide funded family care;
(e) notifying the Ministry of any problems that affect delivery, safety or quality;
(f) notifying the Ministry (urgently) if the disability support services become unsafe or are harmful to them;
(g) notifying the Ministry of any change in the disabled person's circumstances that makes them not eligible for funded family care.
Complying with employment requirements
(h) employing the family carer;
(i) paying the family carer;
(j) complying with all laws as an employer;23
(k) ensuring that payments relating to employment obligations are made;24
(l) resolving any employment problems;25
(m) ensuring that the family carer does not carry out any other paid work, outside the agreed hours of the disability support services, if that work is likely to affect the provision, safety or quality of those services;26
(n) ensuring that the employment contract covers at least the following matters:
(i) the family carer has the necessary skills and experience, and can successfully deliver the funded family care;
(ii) funded family care must be delivered according to the individual service arrangement, and in a safe and acceptable manner to the disabled person;
(iii) funded family care must be delivered in a manner that is culturally appropriate for the disabled person;
(iv) the Ministry's agent must be notified of any change in the family relationship between the disabled person and family carer (if it may affect eligibility);
(v) the Ministry must be notified (urgently) if the family carer is unable or unwilling to continue providing the disability support services;27
(vi) funded family care must continue during any period of transition to other disability support services; and
(vii) that the family carer must comply with monitoring or auditing processes, and with any requirements following those processes.
Complying with the Notice
(o) advising the Ministry of their family relationship to the family carer;
(p) advising the Ministry of any change in their family relationship to the family carer;
(q) advising the Ministry of any special legal status with the family carer;28
(r) using the funding only for the purpose of paying the family carer;
(s) using the funding only for the purpose of paying for replacement care (when required);
(t) agreeing to allow the Ministry or the Ministry's agent to visit the home for any assessment, evaluation, monitoring and auditing; and
(u) notifying the Ministry (in advance) if they wish to change or stop receiving funded family care.29
Responsibilities of the family carer
21. The family carer is responsible for:
(a) providing funded family care of the required standard30 to the disabled person; and
(b) complying with any responsibility that involves them.
Responsibilities for replacement care
22. The person providing replacement care is responsible for:
(a) providing funded family care to the disabled person; and
(b) complying with any responsibility that involves them.
Responsibilities of the Ministry's agent
23. The Ministry's agent is responsible for the following respective matters:
NASC
(a) assessing the disability support service needs of the disabled person;31
(b) reviewing information that is provided about the disabled person;
(c) conducting a review if they decide that the disabled person may not be eligible, or if the disabled person requests a review;32
(d) monitoring the delivery of the funded family care;
(e) assisting with requests for exceptions to the eligibility for funded family care; and
(f) advising the Ministry, disabled person and family carer of any matter that the Ministry's agent reasonably believes is not in the best interests of the disabled person.
Host
(g) providing:
(i) assistance with the set-up of the funded family care;
(ii) assistance to the disabled person and family carer to develop an individual service arrangement; and
(iii) initial and on-going advice on the employment relationship.
Collective responsibility of all parties
24. All parties are responsible for complying with this Notice (as appropriate to them).
25. All parties are responsible for complying with the Ministry's Funded Family Care Operational Policy (as appropriate to them).
26. All parties are responsible for notifying the Ministry when any circumstance occurs where the Ministry may decide to stop payment; notification must be made as soon as reasonably possible.33
Individual service arrangement and back-up arrangement
27. The disabled person must have an individual service arrangement.34
28. The individual service arrangement must be:
(a) discussed with the Ministry's agent before it is completed;
(b) specific to the disabled person in their home;
(c) kept up to date;
(d) kept at home; and
(e) provided (copy only) to the Ministry's agent after it has been signed.35
29. The disabled person must have a back-up arrangement that:
(a) ensures the continued delivery of the funded family care;36 and
(b) notes any change to the employment relationship.
Authorisation and payment
30. Before the disabled person can receive payment, the Ministry must be satisfied that:
(a) they are eligible to receive Ministry funded disability support services;
(b) they are eligible to receive funded family care;
(c) their documentation is completed properly;
(d) the family member is eligible to be a family carer;
(e) the individual service arrangement has been completed, and signed;
(f) the disabled person and the family carer understand all their responsibilities; and
(g) there is an employment agreement in place.
Invoicing and payment
31. The Ministry will, each fortnight, use buyer created tax invoices.37
32. Payment will be made fortnightly in arrears.38
33. The first payment must be backdated to the start date.39
34.To receive payment, the disabled person must:
(a) provide the Ministry with:
(i) details of their bank account;40 and
(ii) their goods and services number (if they are registered for GST); and
(b) notify the Ministry of any changes to those details immediately they occur.
35. If the disabled person dies while receiving funded family care, the Ministry must pay the family carer directly; payment will be for 28 days.41
Stopping payments or imposing conditions
36. The Ministry must stop payments:
(a) if the disabled person requests;
(b) if the funded family care is not being provided by the family carer;
(c) if the disabled person is in hospital, overseas, or is otherwise temporarily not receiving the funded family care;42
(d) if the Ministry's agent notifies the Ministry (after first discussing the matter with the disabled person and family carer);
(e) if the disabled person, family carer or person providing replacement care fails to co-operate with any monitoring or audit process;
(f) if the funded family care is not being provided by the family carer during an employment dispute;
(g) if there is a breach of the individual service arrangement;
(h) if there is a breach of this Notice by the disabled person or the family carer; or
(i) if the disabled person dies while receiving funded family care.
37. Instead of stopping payment, the Ministry may require the disabled person or family carer to comply with conditions before payment will be made.
38. The Ministry must discuss those conditions with all parties before they are required.
Recovering over-payments
39. The Ministry must recover, where reasonable, any over-payments:
(a) firstly, from other payments (that the Ministry may make to, or on behalf of, the disabled person); and
(b) secondly, as an amount due and owing from the disabled person.
Resolving problems
40. The disabled person must try and resolve any problems in the following order:
(a) directly with their family carer;
(b) with the assistance of any other member of the family/whanau/aiga;
(c) with the assistance of any friend; and
(d) with the assistance of the Ministry's agent.
41. The resolution of problems must take account of the principles and (if helpful to the parties) follow the complaints procedure.43
42. If the problem is an employment one, the disabled person and the family carer must try to resolve the problem themselves.44
Changing or stopping the funded family care
43. The disabled person, or the family carer, may request that:
(a) the funded family care be stopped; or
(b) the funded family care be stopped and an alternative disability support service be provided.
44. Requests for changes to, or stopping, the disability support services must be agreed to or acknowledged by the Ministry.
Review
45. The NASC must conduct a review:
(a) when requested by the disabled person; or
(b) if the NASC reasonably considers that a review is appropriate.
46. A review may cover:
(a) the number of hours initially allocated, if they were less than 40 a week;
(b) whether the funded family care is appropriate to the needs of the disabled person;
(c) whether the funded family care is being delivered according to the individual service arrangement; and
(d) any other matter directly related to funded family care as agreed by the parties.
47. The review must be done according to the Needs Assessment and Service Coordination operational policy and the manager's manual.45
Information and records
48. The disabled person must keep, at home, a copy of the individual service arrangement.
49. The disabled person, family carer or Ministry's agent must provide, to the Ministry, the information in the Appendix.
50. The Ministry must ensure that it protects and keeps confidential all information held about the disabled person and family carer.46
51. The Ministry must only use information about the disabled person and family carer for any matter relevant to the funded family care.
Monitoring, auditing and stopping payment
52. The Ministry must monitor and audit the delivery, safety and quality of the funded family care.47
53. Monitoring and auditing may be carried out either following the Ministry's own decision, or at the request of any other party.
54. Monitoring and auditing may:
(a) appraise the individual service arrangement;
(b) verify that payments are accurate, have been received, and are being used properly; and
(c) confirm that all requirements have been complied with.
55. The disabled person, the family carer, and the person providing replacement care (if applicable) must co-operate with proposed monitoring or auditing by:
(a) allowing access (on reasonable notice48) to their home, and any other location where funded family care is being provided;
(b) producing the individual service arrangement;
(c) producing any other relevant documents (listed in the Appendix as appropriate); and
(d) being available for interview.
56. The Ministry must ensure that monitoring and auditing does not unreasonably disrupt the provision of the funded family care.
57. The Ministry must allow a reasonable opportunity for the disabled person, family carer and person providing replacement care (if applicable) to comment on any draft monitoring and auditing reports, and take account of those comments in the final report.
Emergency and exceptional circumstances
58. This Notice does not apply to the delivery of funded family care in any circumstances which are an emergency or are exceptional.49
59. Where those circumstances do occur, all parties may take any action that they consider is reasonable in the circumstances and which is in the best interests of the disabled person.50
Construction (aids to reading this Notice)
60. Parts of this Notice are called:
(a) Clauses (eg 1, 3, and 8);
(b) Paragraphs (eg (a), (b), and (c)); and
(c) Subparagraphs (eg (i); (i)i; and (iii)).
61. References to funded family care have been kept to a minimum; if the term is not used, it is implied where appropriate.
62. References to funded family care mean disability support services under this Notice (for example, the phrases "provided to the disabled person" or "provided by the family carer" have not been expressly used, and are implied).
63. References to rights, responsibilities and requirements relate to those required by this Notice (for example, the phrases "of this Notice", "under this Notice" or "in accordance with this Notice" have not been expressly used in most places, and are implied).
64. There are no cross references to other clauses, it is intended that the Notice be read as a whole.
65. Requests to the Ministry can be made:
(a) by the disabled person at any time, and verbally;
(b) by the authorised representative; or
(c) by the Ministry's agent.
66. Notification between the disabled person and the Ministry should preferably be in writing51 and to:
(a) the Ministry's contact point on the individual service arrangement; or
(b) the Ministry's agent on the individual service arrangement.
67. All references to steps which the Ministry may take are at the Ministry's discretion.
68. The singular includes the plural, and vice versa.
69. Endnotes are part of this Notice but are intended only to assist in the explanation of a specific matter in the text.
70. Definitions apply to the endnotes where applicable.
71. Any term not defined has its meaning in the New Zealand Public Health and Disability Act 2000.52
Definitions
72. The following terms have the meanings given to them:
all parties - Ministry, disabled person, family carer, Ministry's agent, and person providing replacement care (if applicable), together or separate where appropriate;
authorised representative - the person who has the legal authority to make personal care and welfare decisions, or property decisions, or both, for the disabled person under the Protection of Personal and Property Rights Act 1988; or other legal authority (this person may also be called the advocate in the Ministry's Funded Family Care Operational Policy);
disability support services - disability support services under section 6(1) of the New Zealand Public Health and Disability Act 2000;
disabled person - a person who is 18 years of age or over receiving the funded family care;
family carer53 - the family member54 who is approved by the Ministry, and employed by the disabled person, to provide the funded family care;
funded family care - the policy made by the Government under Part 4A of the New Zealand Public Health and Disability Act 2000; and includes the Ministry's Funded Family Care Operational Policy, this Notice, guidelines and related resources referring to funded family care,55 which is published on www.health.govt.nz;
home - the disabled person's usual place of residence, or any other place where the disability support services are regularly provided (including outdoor activities and community based activities that are directly related to the funded family care);
Host - the Ministry's agent providing assistance with the set-up of the funded family care arrangements and initial and ongoing advice on the employment relationship;
individual service arrangement - the arrangement of personal care or household tasks, or both, for the disabled person, recorded in the template in the Ministry's Funded Family Care Operational Policy, guidelines, and related resources, (the individual service arrangement is called the Individual Service Plan in that Policy);
Ministry - Ministry of Health (representing the Crown);
Ministry's agent56 - the Ministry's contracted service provider including:
(a) the NASC, which work with disabled people to help identify their needs and coordinate their disability services; and
(b) the Host;
Monitoring - as set out in the Ministry's Funded Family Care Operational Policy;
NASC - Needs Assessment and Service Co-ordination agencies; and
replacement care - funded family care, provided by another person when the family carer is unable to provide that care, for example when the family carer is on leave.
Issued at Wellington on 23 September 2013.
HON TONY RYALL, Minister of Health.
Appendix (clause 49)
Information to be provided to the Ministry
The following information must be provided to the Ministry:
(a) the identity and age of the family carer;
(b) the relationship of the family carer to the disabled person;
(c) confirmation that the family carer is physically capable of providing the services;
(d) that the family carer has the necessary skills, qualifications and or experience to provide the services;
(e) bank account details of the disabled person;
(f) the GST number of the disabled person (if they are registered for GST);
(g) individual service arrangement; and
(h) any written record of any assessment, evaluation, monitoring, and auditing.
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Endnotes
1 See in particular sections 70A to 70D in Part 4A (inserted by section 4 of the New Zealand Public Health and Disability Amendment Act 2013). Part 4A commenced on 21 May 2013. Its purpose is to provide a framework to enable the Crown to fund disability support services within sustainable limits
2 Or their legally authorised representative
3 Section 88(1)(a) of the New Zealand Public Health and Disability Act 2000
4 After 12 weeks' public notice is given of any amendment (section 88(2) of the New Zealand Public Health and Disability Act 2000)
5 Funded Family Care is a Disability Support Services operational policy under the Ministry's Paid Family Carers policy; see www.health.govt.nz
6 The Ministry's Funded Family Care Operational Policy is published on www.health.govt.nz
7 The annual rate of the adult minimum wage (and other employer obligations) is published on www.dol.govt.nz/er/pay/minimumwage
8 The person providing replacement care is also a member of the partnering relationship when such care is required
9 The template for the individual service arrangement is included as an appendix to the Ministry's Funded Family Care Operational Policy
10 United Nations Convention on the Rights of Persons with Disabilities 2006 in particular Articles 3 (General Principles); 4 (General Obligations);
5 (Equality and non-discrimination); and 12 (Equal recognition before the law); www.un.org/disabilities/convention/conventionfull.shtml
11 Good faith generally means to discuss with each other any matter which affects the delivery of the disability support services in an open way so that all matters are "on the table", to be active and constructive in establishing and maintaining a good relationship, being responsive, providing information, and not doing anything that might mislead or deceive each other
12 Under the Health and Disability Services Eligibility Direction 2011; published on www.health.govt.nz
13 18 years of age or older; assessed as eligible for Home and Community Support Services; have high or very high disability needs; and would not be able to remain at home if they could not employ a family carer; in accordance with the Ministry's Funded Family Care Operational Policy is published on www.health.govt.nz
14 This includes provision for such matters as annual leave, sick leave, Kiwisaver, Accident Compensation contributions, and funding replacement care
15 It will address the needs by contributing to achieving appropriate disability outcomes, by facilitating access to disability support services, ensuring good pathways through those services, and by being delivered in a manner that is culturally appropriate for all people
16 The responsibilities are set-out in more detail in the Ministry's Funded Family Care Operational Policy
17 This is evaluating the disabled person's eligibility to ensure that the person is not a spouse, civil union partner, or de facto partner of the family member despite the reference to those family relationships in section 70B(2)(a) of the New Zealand Public Health and Disability Act 2000
18 The family carer must be physically capable, and have the necessary skills, qualifications and/or experience to provide the disability support services
19 Disclosure of legal status between parties is a requirement of law in many situations and expected best practice in others, particularly when they involve positions of trust
20 This includes payments to the estate of the disabled person, if they die while receiving funded family care, for entitlements that have accrued to the family carer - such as annual leave. Payment in these circumstances is at the discretion of the Ministry for any period up to 28 days
21 Such as "paperwork and red tape"
22 Wages (because payment is an hourly rate, can be up to 40 hours a week, and is based on the adult minimum wage)
23 This includes obligations such as those under the Employment Relations Act 2000, Health and Safety in Employment Act 1992, Holidays Act 2003, Wages Protection Act 1983, and all other laws relating to being an employer - see www.dol.govt.nz/ [Ministry of Business, Innovation and Employment]
24 For example under the Income Tax Act 2007, and Accident Compensation Act 2001
25 To avoid any delay or disruption to the provision of funded family care
26 For example if the other work was full-time, demanding, or at hours which meant that the funded family care was unlikely to be delivered in the best interests of the disabled person. Further, no family carer can provide funded family care to more than one disabled person at a time, unless specifically approved in writing by the Ministry. If that occurs, the total number of hours must not exceed 40 a week
27 Such as health issues, losing a driving license or being charged with an offence
28 For example a personal order (such as a welfare guardian), or enduring power of attorney under the Protection of Personal and Property Rights Act 1988, or any other "authority" that might impact on the relationship of the disabled person and the family member. This is to ensure that any relationship issues that the family member may have with the disabled person are "on the table" and can be managed in the best interests of the disabled person
29 The disabled person can notify the Ministry for any reason, including if the family carer is unable or unwilling to continue providing that care
30 The standard for the delivery of disability support services is: NZS 8158:2012 Home and Community Support Sector Standard
31 The assessment is to determine if the disabled person has a qualifying impairment or condition, and make a decision to proceed with funded family care, including (if necessary) through the assistance of an advocate
32 The review process will follow standard Needs Assessment and Service Coordination operational policy and the manager's manual, and the Ministry's Funded Family Care Operational Policy
33 Responsibility only occurs when a party becomes aware of any circumstance where payment may be stopped; notification should preferably be at least 7 days before the next payment date
34 This is called the Individual Service Plan in the Ministry's Funded Family Care Operational Policy
35 This does not have to be a statutory declaration under the Oaths and Declarations Act 1957 (Schedule 1), but uses the term "declare" so that both parties understand and fully accept the significance of their respective responsibilities
36 The back-up arrangement must allow for certainty and for any contingency to be dealt with as quickly as possible if such events do occur. Examples of situations when a back-up arrangement may be required are illness, injury, bereavement leave, annual leave, or any other reason (agreed between the disabled person and the Ministry's agent) for absence
37 This is an automated invoice that the Ministry creates for the regular fortnightly payment for the funded family care. The disabled person is not required to issue invoices
38 Pro-rated payments must be made if the first and last payments fall within a fortnight
39 The start date is the date included in the individual service arrangement; backdating payment is up to a maximum of 28 days
40 This will usually be by verification such as a bank deposit slip (or a bank deposit slip of the authorised representative)
41 The Ministry's agent will arrange for a bank deposit slip to be provided to the Ministry
42 The disabled person must notify the Ministry's agent within 14 days of being in hospital, overseas or temporarily not receiving funded family care; payments will be stopped by the Ministry if funded family care has not resumed within 28 days
43 See www.health.govt.nz/your-health/services-and-support/disability-services/contact-disability-support- services
44 The employment relationship is between the disabled person and the family carer, therefore the Ministry or the Ministry's agent cannot become involved in any employment problems
45 A copy of the relevant NASC review process is published on: www.health.govt.nz/system/files/documents/pages/nasc.doc?
46 The information must be kept in accordance with the Privacy Act 1993 and the Health Information Privacy Code 1994; the Ministry must comply with this legislation
47 This is necessary for the Ministry to meet its accountability requirements for the payment of public monies for the funded family care; and to ensure that the funded family care is effective and that payments are being made correctly
48 No notice will be given if the Ministry has reasonable grounds to consider that the health and safety interests of the disabled person may be affected, or where there may be fraud involved in receiving payments
49 This will depend on the circumstances of each individual case
50 The Ministry may continue making payment or stop payments. The Ministry may allocate payment in exceptional circumstances in terms of paragraph 5.2 of the Ministry's Funded Family Care Operational Policy
51 Including email and text
52 Especially sections 6 and 70B(1)
53 There may be more than one family carer if the role is to be shared
54 A "family member" is defined in sections 70B(1) and (2) of the New Zealand Public Health and Disability Act 2000, and is related to the disabled person as one of the following persons:
(a) parent, step-parent, or grandparent;
(b) child, step-child, or grandchild;
(c) sister, half-sister, step-sister, brother, half-brother, or step-brother;
(d) aunt or uncle;
(e) nephew or niece; or
(f) first cousin
55 The home and community support services in the individual service arrangement, eg personal care - assistance with showering and dressing; household support - helping to prepare meals or home cleaning; and help for the disabled person through natural networks such as family/whanau/aiga, friends, marae, neighbours and others, which ensures the disabled person has the appropriate quality of family care, and can access and attend services such as medical, dental, and personal grooming services when required
56 This is a general term, the Ministry's actual agent in any particular circumstance will depend on what services are being provided