Colm Burke (Cork North Central, Fine Gael) | Oireachtas source

I thank Senator Clonan for raising this important matter today, which I am taking on behalf of the Minister of State, Deputy Rabbitte. The personal assistant service was developed to provide a service for adults with physical disabilities that enables them to live their lives as independently as possible and take decision-making control. Persons with a disability determine the support they need and the activities with which they need support. Typically, personal assistant services are delivered through some section 38, but mostly section 39, organisations that have service-level agreements with the HSE.

As part of the HSE-wide requirement to ensure appropriate governance arrangements that underpin the release of the funding of agencies, a governance framework for funded agencies has been developed which ensures a consistent approach in this regard. The HSE must have in place appropriate contractual arrangements, service arrangements and grant aid agreements with all agencies that have funding released to them for the provision of services, in accordance with sections 38 and 39 of the Health Act 2004 and NFR B6. The framework was established to implement the legislative provisions of the Health Act 2004 and to reflect the requirement for public accountability whereby the HSE is legally obliged to account for all public expenditure on health and personal social services. The framework seeks to provide a level of governance which links funding provided to a quantum of services and provides for these services to be linked to quality standards, with continuous monitoring to ensure equity, efficiency and the effective use of available resources.Home Care Direct Limited is a private company set up in 2012 and operates a recruitment platform for disability service users to access personal assistants - home care staff. The Minister of State, Deputy Rabbitte, met Home Care Direct in May 2023 with regard to personal assistants. At that meeting personalised budgets were also discussed as a small number of individuals are availing of personal assistant services outside the traditional service providers pathway as part of the personalised budget plan.

The pilot is trialling three different models of how personalised budgets may be accessed by people with disabilities. Model A is a person-managed fund, often referred to as a direct payment model. This payment option attracts particular legal and financial responsibilities for the individual, including administrative and employee management responsibilities. Model B is a co-managed fund with a service provider where the funding is paid directly to an existing HSE contracted service provider with services provided based on an individual's choices and decision as detailed in their personal support and spending plan. Model C is a broker-managed fund where a broker would support a person to manage their personalised budget with terms and conditions set out in a contract between the person and the broker. In practice, this model would also require a service agreement to facilitate the disbursement of funds.

Home Care Direct confirmed at that meeting that it did not wish to enter into a service-level agreement with the HSE and it was agreed that its business model fell more in line with a direct payment model.

I understand that the Senator met the HSE in February and it was confirmed that the only mechanism for the disbursement of Exchequer funds to provide a private service provider was via the service arrangement process. If Home Case Direct wishes to engage the personalised budget pilot outside of the direct payment model the Minister of State, Deputy Rabbitte, would encourage it to liaise with the HSE once again which will be happy to support it in developing documentation to ensure it meets the standard of a service arrangement.