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Posted by Philip on 3 September 2015, 6:06 pm in , , , , , , , , , , , , , , , ,

NASC from a client’s perspective

This week the Needs Assessment and Service Co-ordination Association (NASCA) held its national forum. According to its website, "NASCA provides leadership, assistance and peer support to NASC agencies throughout Aotearoa/New Zealand. NASC services are contracted by the Ministry of Health or District Health Boards to serve people with disabilities, people with mental health issues and older people needing age-related support."

I was invited to present the keynote plenary session on the first morning, providing a client's perspective. This, I explained in my introduction, was interesting given my well-known disdain for the NASC process. I assumed therefore, that I hadn't been invited to give a pep talk  — instead, I offered some critical analysis, drawing on the following model:

  • curiosity  — an eagerness to gather information and be open-minded
  • skepticism  — the comitment to question the information gathered
  • humility  — the willingness to change one's view

I asked my audience to embrace this mindset, as well as promising to do the same.

personal reflection

My disclaimer was that my presentation was a personal reflection. I wasn't representing others' views and I acknowledge I am, comparatively, privileged in terms of my situation. I pointed out though, on the back of NASCA's president's congratulatory introduction acknowledging the hugely beneficial impact NASC has on people's lives that, based on my work with the Proteus Initiative, "lightness" (providing beneficial impacts) always creates a shadow.

For me, the shadow is prominent. Every three years I have to spend three hours justifying my needs to a stranger. In each year between the three, I have to have a phone conversation with a stranger to confirm my needs haven't changed. For me, this is billable time, even though I ironically need the support to be in a position to run a viable business. In a world of acronyms, I posited, to me NASC meant:

NOT
A
S
ENSIBLE
C
ONCEPT

or, even

NUISANCE
ANNOYING
SILLY
CONVOLUTED

opinion — relevance and importance

NASC, a needs-based model of allocating support services, was established in 1994. It involved, I believe, a legislative change which stoped people being "entitled" to services. I'm not a fan of entitlement but, in the spirit of critical analysis, the question has to be asked, is NASC still relevant and important 20 years on? Particularly in this age of hyper-connectivity and rapid change, my doubts lie in the process  — ten-page, hand-written forms  — and the cost of the infrastructure, which takes funds away from the provision of actual support services.

services? OR…?

So I asked my audience, is NASC a service? A few thought, by raise of hands, yes, an equivalent few thought, no, and the majority didn't know. So I povided this definition of "service" and asked again:

service, n. an act of helpful activity; help; aid:to do someone a service.

the supplying or supplier of utilities or commodities, required or demanded by the public. [my emphasis]

Fascinatingly, this definition increased the number of people who thought NASC was, in fact, a service. So I had to resort to my second strategy:

"Is registering your car," I asked, "a service?"

Most agreed no, except one person who, unwittingly, proved my point: "It stops me getting fined for not registering my car," they said.

So we were getting to my point: NASC is not a service but a process through which you have to go to access support services. Like car registration, it is something through which you gain a benefit. If you avoid it, you lose that benefit.

strengths and weaknesses

So how does NASC serve and limit? Certainly, for people new to support needs, it offers assistance to identify needs and how to meet them. It also offers employment to everyone who works in this industry. Furthermore it provides Government with a system of budget management and justification.

The latter is NASC's biggest weakness  — it simultaneously ascertains needs and solutions while managing a State budget. This is a clear conflict of interest. A further weakness is its mandatory status, which has two repercussions. Firstly, it forces the likes of myself to perpetually justify my need (I said I feel constantly scrutinised). Secondly, it wastes resources, which could be applied directly to support provision, by requiring everyone (including the likes of me who, on Individualised Funding are simply negotiating a yearly budget) to engage in the same process.  

benefits and risks of changing

I pointed out that latest statistics show 24% (1 in 4) NZers identify as having a disability. As of 2013 our population was 4.471m. That means NASC potentially is required to engage with 107,304 people per year. On average there are 261 working days per year  — that means engaging with 411-412 people per working day. Spread over 65 NASC agencies throughout NZ that's 6-7 people per day.

Taikura Trust, Auckland's main NASC agency has 10,000 clients. That equates to engaging with 38-39 people per day.

Clearly, Taikura shows the unsustainability of the current model. My suggestion was to separate the functions: create a system of negotiation of resource allocation, and a separate, true service of assisting people who needs it to ascertain their needs and solutions.

Vision for THE FUTURE

Part of my inspiration for this presentation was watching Apple's Steve Jobs in 1997 describe the connectiveness of our cloud-based computing system today. Steve had a 20 year vision of how he wanted computers to be. Do we have an idea of how disability support will be allocated and provided in 2035?

Probably not.

I do. I envisage a budget-driven system. I know how much I've paid for my support over the last five years and I know it varies based on how much I travel for work. I know I have a basic need of 21 hours per week (3 hours per day). I know I currently pay people $22-25/hour based on the length of time they've worked for me. I know I need to pay this rate because the work is casual and I need a calibre of person to ensure reliability, competence and aptitude.

I don't need NASC. But some people will, so let's make it really useful.

My final words were to suggest a new meaning for the NASC acronym:

NURTURING
AUTONOMY
SUPPORTING
CHOICE
CAPACITY

I couldn't stick to one C, and I added a third based on TED speaker Brené Brown's work on vulnerability and shame:

COURAGE (WHOLEHEARTEDNESS)

Brown describes wholeheartedness as:

“The capacity to engage in our lives with authenticity, cultivate courage and compassion, and embrace — not in that self-help-book, motivational-seminar way, but really, deeply, profoundly embrace — 
…who we really are.”

A system that enables people to engage in their lives with authenticity, cultivate courage and compassion, and deeply, profoundly embrace who they really are.

That's what NASC needs to become.

View my slides:

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