出版社：Utrecht University, Maastricht University, Groningen University
摘要：Introduction : The Lifetime Care and Support Authority, NSW Australia (icare lifetime care) aims to enhance opportunities for people with spinal cord injury and traumatic brain injury to have increased choice and control over the way their supports are delivered and managed. Description of policy context and objective : The objectives of this project were to: Develop a service model which provides opportunities for icare lifetime care participants to have increased choice and control over the management of their care and supports. To identify and manage risk to participants and to the scheme associated with icare lifetime care entering into direct funding agreements with an increased number of participants. Provide an approach for icare lifetime care to manage requests for direct funding by participants or their nominees, including planning for appropriate safe guarding strategies prior to approving direct funding agreements. Target population : icare lifetime care funds treatment, rehabilitation and care for people who have been catastrophically injured in a motor vehicle accident in NSW, Australia. Injuries sustained include severe traumatic brain injury, spinal cord injury, multiple limb amputations, burns and blindness. Highlights (innovation, impact and outcomes) : The presentation will outline how icare lifetime care developed, and now applies, a safeguard planning approach to participant requests to manage their own supports through a direct funding arrangement. Participants may have cognitive and behavioural disability following their injury, or may have complex social histories. The safeguard planning approach considers individual participant risk and their skills to manage the tasks involved in self-management. Capacity building and other risk mitigation factors are considered as part of the plan. Comments on sustainability : The self-management service model became available for participants in late 2016. Growth is currently slow but steady. To date, 20 participants are self-managing their care, with an annual cost of $3.3mil. icare lifetime care is working with another 40 participants who are interested in moving to self-management. Comments on transferability : The presentation will explore opportunities which will support increased numbers of participants benefitting from self-management, including sharing participant stories, peer support and future online payment systems. The safeguarding approach has been successful in identifying participant risk, skills and strategies to develop capacity and to mitigate risk to participants and the scheme, enabling participants to achieve their goal of self-management. Conclusions (comprising key findings, discussion and lessons learned) : icare lifetime care’s self-management service model is presented including the ways participants are currently using the service options within the model to meet their needs. The safeguarding approach will be discussed including the role of monitoring risk to ensure participants achieve successful outcomes. Case examples will be used to demonstrate the model and the application of the safeguarding approach.
