MSD Disability Support Services
Operational Policy
Disability Support Services Eligibility
Date inherited
from Ministry of
01/07/2022
Health:
Tigga Taylor, Advisor Operational Policy, DSS;
Internally
Rebecca Livingston, Senior Advisor Operational
reviewed by:
Policy, DSS
Anne Shaw, Associate Deputy Chief Executive,
Sponsor:
DSS
Date reviewed:
13/12/2024
Date of future
13/06/2026
review:
Whaikaha – Ministry of Disabled People inherited this operational
policy from the Ministry of Health when Whaikaha was established on
1 July 2022. From 16 September 2024, the Disability Support Services
business group, within the Ministry of Social Development, is now
responsible for this policy.
We have adjusted the language, roles, and responsibilities in this
policy to reflect these changes. Please note that Disability Support
Services will be undertaking a more substantive review of this
policy in the future.

1

link to page 3
IN-CONFIDENCE

Purpose
The purpose of this operational policy is to define eligibility for disability support
services funded by Ministry of Social Development (MSD) Disability Support
Services (DSS). This policy is intended to support Needs Assessment and
Service Coordination organisations (NASCs) contracted by DSS to apply a
nationally consistent approach to implementing eligibility criteria.
This operational policy explains the process for eligibility determination, presents
the definitions of physical, sensory, and intellectual disability and clarifies cross-
funder relationships.
The policy also includes information about the NASC process, high level guidance
for NASCs on funding relationships with Health New Zealand | Te Whatu Ora
(Health NZ) and descriptions of the disability support services that can be
accessed without a NASC assessment.
This operational policy is for DSS and NASCs.
This operational policy must be read in conjunction with the:
•  ‘Operational Policy and Guidelines 2024/25: Freeze on residential
care funding and management of NASC indicative budgets and EGL site
fixed budgets’.
•  Through this policy, MSD DSS is actioning fiscal sustainability
recommendations from the 2024 Independent Review of disability
support services. The above policy implements a freeze on residential
service admissions and mandates using prioritisation and overarching
criteria for service access, funding access, and funding increases.
Scope
This is a national operational policy.
Background
In 1992, under the “New Deal”1 the Government realigned responsibilities and
funding for disabled people and tāngata whaikaha Māori (tāngata whaikaha).
Between 1993 and 1995 most Department of Social Welfare disability-related
programmes and services progressively transferred and were consolidated with
existing Ministry of Health (MoH) services under the regional health authorities
(RHAs) and Vote: Health. The basis of access to services was shifted from

1 The New Deal: Support for Independence for People with Disabilities, Ministers of Social
Welfare and Health, 1992.
3
MSD DSS Operational Policy | Disability Support Services Eligibility

link to page 17 link to page 4 link to page 4 link to page 4 link to page 4 link to page 4 link to page 4
IN-CONFIDENCE

nationally specified 'entitlements' to individually assessed needs, within available
or capped funding.
In 1994, The New Zealand Framework for Service Delivery (the DSS Framework)
was put in place by the RHAs under MoH’s direction. Under the DSS Framework,
to access a range of MoH funded support services, an individual had to first meet
MoH’s definition of disability, and then have their needs assessed and undergo
service coordination or planned allocation of services, within available resources.
Assessment and allocation of services required an auditable separation from the
provision of services, which in most instances was by contracted providers.
The definition of an eligible person was outlined in the Government’s definition of
a ‘person with a disability’ for the purpose of accessing disability support
services [CAB (94) M 3/5 (1a)] (see Appendix 1: Definitions).
People identified as having a physical, psychiatric, intellectual, sensory or age-
related disability (or a combination of these) fell under the 1994 definition.
Since the 1994 definition the responsibility and funding for psychiatric2 and age
related3 disability was devolved to District Health Boards4. There has been
further clarification of responsibility and funding for people with Long Term
Support needs resulting from Chronic Health Conditions5 (LTS-CHC) and people
diagnosed with Autism Spectrum Disorder (ASD)6.
Responsibility and funding for people with physical, sensory, and intellectual
disabilities remained with MoH.
From 1 July 2022, responsibility and funding for these groups of people moved
to Whaikaha — Ministry of Disabled People (Whaikaha). From 16 September
2024, DSS and related funding and service delivery responsibilities were
transferred from Whaikaha to the new DSS business unit within MSD7.
Service description
Eligibility means the right to be considered for publicly funded health and
disability services. It is not an entitlement to receive any particular service. If a
person wishes to access disability support services funded by DSS, they are
required to meet access criteria. If a person is not eligible for publicly funded

2 Devolved 2001.
3 Devolved 2003.
4 Health NZ was established on 1 July 2022 and took over the responsibilities and
services previously provided under the District Health Board (DHB) structure.
5 Devolved to DHBs in 2011.
6 Clarification that disability related support needs resulting from ASD may be supported
through MoH DSS from 2014.
7 See Improving the sustainability of Disability Support Services | Whaikaha.

4
MSD DSS Operational Policy | Disability Support Services Eligibility

link to page 5 link to page 5 link to page 5 link to page 5 link to page 5 link to page 17 link to page 5
IN-CONFIDENCE

services8, they are liable for the full cost of the services they receive and will
access these independently.
Service access
Most disability support services funded by DSS are accessed through NASCs. A
list of NASCs can be found on the DSS website9.
Process for determining eligibility
To be considered for most disability support services10 funded by DSS, a disabled
person may self-refer or is referred to a NASC contracted by DSS.
The NASC screens the referral11 to confirm that the disabled person referred:
•  can be considered for the full range of publicly funded health and
disability services under the current Eligibility Direction12
•  is likely to meet the Government’s definition of a ‘person with a disability’
for the purposes of accessing disability support services (CAB (94) M 3/5
(1a) (see Appendix 1: Definitions)
•  is likely to have a physical, sensory, or intellectual disability, or a
combination of these after provision of equipment, treatment, and
rehabilitation
•  does not have an injury that is likely to meet ACC’s cover and entitlement
criteria under the Accident Compensation Act 200113.
The NASC may request a specialist assessment or clinical reports to help confirm
eligibility for disability support services funded by DSS.
If a person meets the above criteria, this triggers a needs assessment to confirm
that they meet the criteria to receive disability support services funded by DSS.
Disability support services inclusions funded by MSD DSS
DSS funding for disability support services includes disabled people who:
•  are eligible for publicly funded health and disability services

8 Refer Eligibility explained on Health NZ website
9 See Needs assessment services | Disability Support Services.
10 Refer section Other Information – DSS that do not require a NASC assessment.
11 This is the general practice; however, some NASCs move directly to determining
eligibility at the time of the needs assessment.
12 Refer Eligibility for publicly funded health services.
13 Some people are eligible for supports from both DSS and ACC, such as those with pre-
existing disabilities who have an accident that results in additional support needs. DSS
funds supports received for any pre-existing disability. Where it is too difficult to
determine which support needs are due to a pre-existing disability and which to an
accident, a pragmatic joint funding/shared services arrangement will be negotiated.
5
MSD DSS Operational Policy | Disability Support Services Eligibility

link to page 10 link to page 10 link to page 6
IN-CONFIDENCE

•  present for assessment for DSS before the age of 65
•  have a physical, sensory, or intellectual disability or a combination of
these, which is likely to:
o  remain even after provision of equipment, treatment and
rehabilitation
o  continue for at least six months, and
o  result in a need for ongoing support.
•  do not meet the exclusion criteria (refer to section DSS disability support
services funding exclusions).
In addition, DSS funds Environmental Support Services (ESS) for a broader
group of people. This includes those outlined above, people with disabilities
associated with ageing, people first referred over the age of 65 and people aged
under 65 with disabling chronic health conditions.
A person’s diagnosis is a factor in determining eligibility for disability support
services funded by DSS but is not the main determinant. It provides a guide as
to whether a person is:
•  likely to have, or likely to develop (in the case of young children), a
physical, sensory, and / or intellectual disability and also whether the
person is likely to have ongoing support needs mainly due to this
disability
•  likely to have primarily personal health needs that could be significantly
ameliorated by treatment and / or that are likely to require ongoing
clinical intervention.
Applying the definitions of physical, sensory, and intellectual
disability
The DSS definition of tāngata whaikaha who receive disability support funding is
informed by the disability type definitions in “Support for Independence for
People with Disabilities: A New Deal”14 (refer Appendix 1 for a list of these
definitions).
The sub-groups within the broader group of tāngata whaikaha accessing DSS
individualised services are listed below. Impairments under each sub-group are
accompanied by examples of conditions that may result in these types of
impairments, but this is not intended to be a diagnostic ‘in’ and ‘out’ list.
Physical disability

14 Minister of Social Welfare and Minister of Health. Support for Independence for People
with Disabilities: A New Deal. 1992. Wellington: Parliament Buildings.
6
MSD DSS Operational Policy | Disability Support Services Eligibility

link to page 7 link to page 7 link to page 7
IN-CONFIDENCE

People who have physical disabilities accessing DSS support services includes
people with impaired limb function affecting independence in activities of daily
living and / or mobility15.
Physical disability may be due to (but is not limited to):
•  partial / total absence or loss of limbs (e.g., at birth or following
amputation because of diabetes)
•  structural impairments of limbs (e.g., achondroplasia)
•  paralysis (e.g., hemiplegia following a stroke or brain tumour; paraplegia
due to spina bifida; tetraplegia due to debulking of a spinal tumour)
•  reduced muscle strength (e.g., following Guillain-Barre)
•  ataxia16 (e.g., with cerebral palsy or multiple sclerosis)
•  muscle wasting (e.g., with muscular dystrophy or motor neurone disease)
•  muscle tone abnormalities (e.g., due to acquired brain injury not covered
by ACC)
•  limited range of movement (e.g., juvenile rheumatoid arthritis,
osteoarthritis).
Some impairments arising from significant skeletal malformations (e.g., severe
scoliosis) may also meet the physical disability eligibility criteria, depending on
the nature of the resulting impairment.
Sensory disability
People who have sensory disabilities accessing DSS support services includes
people with the following types of long-term sensory impairments that are
generally not responsive to treatment and affect independence in activities of
daily living and / or mobility17:
•  blind
•  deaf
•  deafblind
•  significant visual impairment

15 This group includes people with chronic medical conditions who, following active
treatment and rehabilitation, are assessed as having a long-term physical disability and
an ongoing support need where physical disability (as opposed to physical incapacity)
is the primary reason for support.
16 Ataxia is a lack of muscle co-ordination during voluntary movement, such as walking
or picking up objects, generally due to disorders in the brain or spinal cord.
17 This group includes people with chronic medical conditions who, following active
treatment are assessed as having a long-term sensory disability and an ongoing support
need where sensory disability is the primary reason for support (e.g. blind due to
diabetes).
7
MSD DSS Operational Policy | Disability Support Services Eligibility

link to page 8
IN-CONFIDENCE

•  significant hearing impairment
•  significant other sensory loss (e.g., no taste or touch — rare)18.
Intellectual disability
People with learning or intellectual disabilities accessing DSS support includes
people with intellectual disability present at birth or generally acquired in the
development years (before age 18) (e.g., due to Angelman’s syndrome,
microcephaly, or meningitis).
A NASC may request a specialist assessment to confirm a person has an
intellectual disability. This may include a cognitive assessment (generally, an IQ
test score of up to 70 indicates a limitation in intellectual functioning) and
standardised assessment of adaptive functioning in the areas of conceptual
skills, social skills, and practical skills.
Eligibility for DSS funded Intellectual Disability Compulsory Care and
Rehabilitation services is legislatively mandated (Section 7 of the Intellectual
Disability [Compulsory Care & Rehabilitation] Act 2003 refers).
Where a person has been assessed as eligible for disability support services
based on a physical or sensory disability and the person has a co-existing
significant intellectual impairment that was acquired at age 18 or older and is
not covered by another funder (e.g., ACC), DSS may fund the full package of
support.
Other eligible groups
There are certain other groups that DSS funds support services for whose
impairments do not strictly meet the DSS definition of physical, sensory, or
intellectual disability. Their inclusion generally reflects long-standing practice.
Disability in young children where presence of a physical, sensory and / or
intellectual disability is not yet confirmed
DSS funds disability support services for children who are medically stable and
have significantly delayed physical, intellectual, and / or sensory development
(often global developmental delay) for whom there are indicators of likely long-
term physical, sensory, and / or intellectual disabilities and where clinical or
rehabilitative intervention is not expected to significantly reduce the need for
long-term support. Eligibility is on an interim basis until a long-term disability
(usually an intellectual disability) with associated ongoing support needs is
confirmed (generally by age 7).
If the presence of a long-term disability and ongoing support need is not
confirmed, the NASC Service Coordinator facilitates the gradual withdrawal of

18 Note, sensory impairment does not include hypersensitivity or perceptual impairments
such as auditory processing disorder.
8
MSD DSS Operational Policy | Disability Support Services Eligibility

link to page 9 link to page 9
IN-CONFIDENCE

DSS funded supports. Health NZ specialist clinical and allied health services may
continue to be available to these children.
Disability associated with acquired brain injury and certain neurological
conditions
DSS has funded disability support services for some people who have acquired
brain injuries and certain neurological conditions that do not result in a physical
or sensory disability or an intellectual disability that meets the intellectual
disability criteria described above19.
This included some people who, after treatment and rehabilitation, have long-
term significant cognitive impairment (e.g., due to multiple sclerosis, a stroke,
or a benign brain tumour). Clinical reports were generally required to support
the referral to NASC. Eligibility decisions took into consideration the age of the
person, whether the person has any significant co-existing medical conditions
and the nature of the person’s support need.
DSS does not fund disability support services for people who require support:
•  due to cognitive impairment arising from a mental illness or addiction or
due to the consequences of treatment for these conditions (e.g., people
with Korsakoff’s psychosis or other substance induced brain damage)
•  solely due to behavioural problems.
Autism Spectrum Disorder (ASD)
Effective April 2014 the Ministry of Health’s DSS and Mental Health groups
jointly agreed a national position with respect to people diagnosed with ASD20.
This enabled people with ASD to be considered for DSS regardless of whether
they also have a co-existing physical, intellectual, or sensory disability.
The clarification was made to:
•  address inconsistent access and practice across the country
•  recognise there are still service gaps requiring service development
•  commit to a joined-up solution where organisations and funders work
together in finding pragmatic and sustainable solutions for this group of
people.
Needs assessment and service co-ordination process

19 When LTS-CHC devolved to DHBs in 2011 clarification was made that people with
cognitive impairment without a physical, sensory, or intellectual disability would remain
part of LTS-CHC client group. Funding was devolved accordingly.
20 From its establishment on 1 July 2022, Ministry of Disabled People – Whaikaha
(MoDP) continued with this national position. From 16 September 2024, DSS and
related funding and service delivery responsibilities were transferred from MoDP to the
new DSS business unit within MSD.
9
MSD DSS Operational Policy | Disability Support Services Eligibility

link to page 10 link to page 10 link to page 10 link to page 10
IN-CONFIDENCE

Any person assessed by a NASC as likely to meet the DSS eligibility criteria is
entitled to have a needs assessment to identify disability support needs and
assessed goals. This does not confer an automatic entitlement to services as the
provision of services is prioritised based on the person’s level of assessed need
related to their disability.
The needs assessment includes assessing, wherever possible, what is primarily
driving the person’s support need. Support needs that are not primarily
attributable to an ongoing physical, sensory, and / or intellectual disability or an
impairment included in sections 1 to 4 above (denotes disability support services
eligibility) are not the funding responsibility of DSS21. Where a DSS eligible
disability is contributing to broader support needs, DSS will negotiate joint
funding or joint service package arrangements with the relevant other funder.
When a person presents for assessment for disability support services between
the ages of 50 and 65, the DSS NASC also screens the referral to determine
whether the person is likely to meet the ‘close in interest’ criteria22. If screening
indicates that the person is likely to meet these criteria, the NASC forwards the
referral on to a Health NZ needs assessment service.
If the needs assessment confirms that the person has disability support needs, a
service co-ordination process follows to determine:
•  what natural supports the person has to meet these needs23
•  which needs can be fulfilled within the range of services DSS funds within
its capped budget
•  where other avenues of support are indicated (with a view to referral to
appropriate services).
For people assessed as eligible for disability support services funded by DSS, the
services available to meet their support needs are services that already exist
within the DSS service framework24.
DSS disability support services funding exclusions
DSS does not fund support services for people with conditions or situations
covered by other funders including:

21 In practice, some funding for supports needed due to co-existing conditions does
occur.
22 Refer to the ‘MSD DSS Operational Policy: Close in Interest’.
23 In the case of young children, this includes taking account of the level of support a
parent would normally be expected to provide for a child of that age.
24 This is the current arrangement, however the Demonstration Projects to implement
the New Model for Disability Support and Enabling Good Lives includes expanding the
range of services that people under Individualised type funding arrangements can
purchase with their allocated support funding, through contracted and non-contracted
providers.
10
MSD DSS Operational Policy | Disability Support Services Eligibility

link to page 11 link to page 11 link to page 11 link to page 11
IN-CONFIDENCE

•  support to address short-term needs (i.e., less than six months’
duration), for example following surgery or medical events25 (Health NZ’s
Personal Health)
•  support for people who first present for assessment for long-term
supports at age 65 or over (Health NZ’s Health of Older People - CAB Min
(03) 5/5 refers)
•  support for people who first present for assessment for long-term
supports between ages 50 and 65 who are clinically assessed by a Health
NZ clinician or needs assessor as being ‘close in interest’ to older people26
(Health NZ’s Health of Older People - CAB Min (03) 5/5 refers). Refer to
the ‘MSD DSS Operational Policy: Close in Interest’.
•  aged residential care for disabled people funded by DSS who have been
reassessed by a Health NZ needs assessor as requiring this service
(Health NZ’s Health of Older People - CAB Min (03) 5/5 refers)
•  support for people who first present for assessment for long-term
supports before the age of 65 whose support need is due to impairments
that do not meet the DSS operational definition of physical, sensory, or
intellectual disability. This includes people who will be referred to Health
NZ’s Long Term Supports – Chronic Health Conditions services.
•  support for ‘medically fragile children’. These are children with high
health needs and/or multiple impairments whose health status has not
yet stabilised and for whom a physical, sensory and/or intellectual
disability with associated ongoing support needs has not been identified
(Health NZ’s Personal Health / Long-term Supports – Chronic Health
Conditions [LTS-CHC], Primary Care)
•  support for needs arising primarily from physical incapacity (e.g.,
shortness of breath, fatigue, or pain) due to a chronic health condition
(Health NZ’s LTS-CHC / Personal Health, Primary Care)
•  support for additional care needs arising from a condition in the palliative
stage27 (Health NZ’s Palliative Care)
•  support for needs arising from a mental illness and / or addiction28
including physical, sensory, and cognitive impairments attributable to this

25 This includes ‘topping up’ existing DSS support packages for disabled people supported
by DSS funding in these situations.
26 People with long-term conditions more commonly experienced by older people and
requiring integrated health and disability support services.
27 This includes specialist palliative care services for people receiving DSS disability support
services.
28 Responsibility for planning and funding disability support services for people with
psychiatric disabilities was devolved to DHBs in 2001 (CAB Min (01) 12/12 refers). All
residual contracts and funding were devolved in 2003 (CAB Min (03) 23/8 refers).
11
MSD DSS Operational Policy | Disability Support Services Eligibility

link to page 12 link to page 12 link to page 12 link to page 12
IN-CONFIDENCE

underlying condition, for example: tardive dyskinesia due to long-term
use of psychotropic medication, cognitive impairment due to alcohol or
other substance abuse, impaired mobility due to alcohol related
peripheral neuropathy or functional difficulties due to conversion disorder
(Health NZ’s Mental Health and Addiction / LTS-CHC, Primary Care)29
•  support services needed primarily because of dementia or substance
abuse (Health NZ’s Health of Older People / Mental Health of Older People
/ LTS-CHC, Primary Care)
•  support services needed primarily because of behavioural problems (e.g.,
associated with Foetal Alcohol Syndrome or substance abuse) except
where the person has a co-existing disability that meets DSS eligibility
criteria30 (some services are funded by other government agencies, in
other situations this is a funding gap)
•  support due to an injury that meets ACC’s cover and entitlement criteria
under the Accident Compensation Act 200131
•  support for situations covered by other central government agencies such
as the Ministry of Education and MSD (beyond services provided by the
DSS business unit)32.
•  support needs solely due to social/environmental factors (e.g., housing or
where parents need support for their own health needs). [Some services
are funded by other government agencies, in other situations this is a
funding gap.]
Cross-funder relationships
Shared arrangements for people with DSS eligible disabilities and
other conditions
Joint funding or shared service arrangements may apply where a person
assessed as needing formal support:
•  meets DSS eligibility and access criteria, and has a personal health
condition, chronic health condition, condition in the palliative stage,
mental illness and / or addiction, and / or injury.

29 People who have a mental illness and/or addiction and a co-existing physical, sensory
or intellectual disability that meets DSS eligibility criteria may receive both Health NZ
and DSS funded supports.
30 Where a person has behavioural issues due to an acquired brain injury or certain
degenerative neurological conditions (e.g., Huntington’s disease) secondary to a co-
existing physical, sensory, or intellectual disability, DSS may fund the full support
package.
31 Refer to footnote 13.
32 Some people will receive supports from both DSS and another agency or agencies.
12
MSD DSS Operational Policy | Disability Support Services Eligibility

link to page 13
IN-CONFIDENCE

Where a person has support needs arising from both a DSS eligible disability
type and a co-existing condition or situation for which another funder (e.g.,
Health NZ, ACC, or Ministry of Education) has support funding responsibility,
DSS will negotiate joint funding or shared service arrangements with the
relevant other funder. DSS contributes to the person’s support package by
funding the disability support services required because of the DSS eligible
disability.
In complex situations where the cause of impairment is unclear (e.g., injury vs
acquired) or a person has multiple impairments or causes of impairments, DSS
works with other funders to determine a pragmatic joint funding or shared
services arrangement to support prompt access to essential supports. Further
work is needed across funders to agree consistent and efficient pathways for
resolving funding responsibility in these situations.
Resolving funding responsibility between DSS and Health NZ
Where there is disagreement between funders over whether a person’s support
needs are the funding responsibility of DSS or Health NZ, it is important that the
interests of the person needing support are protected in the first instance.
The following resolution procedures apply:
•  any disagreement about access to DSS or Health NZ funded services will
be resolved in the first instance by discussion between the relevant needs
assessment services
•  where resolution cannot be achieved through discussion between DSS
and Health NZ needs assessment services, the first level of escalation will
be to the operational management within DSS.
Transferring funding responsibility
In respect of moving people receiving disability support between DSS and Health
NZ Health of Older People funding (CAB (03) M 23/8 refers), disabled people
receiving disability support from DSS can move to receive support from Health
NZ, but Health NZ-supported people cannot move to being supported by DSS33.
A disabled person receiving support funded by DSS will move to be supported by
Health NZ funding only if they are reassessed as requiring aged residential care.
Transfers between DSS and Health NZ Long-term Support Chronic
Health Conditions funding

33 Note that even if the person had previously been supported by DSS funding, having
moved to being funded by Health NZ they cannot return to DSS for funding. All
movements are one way, from DSS to Health NZ, unless both funders agree that the
funding associated with that person has been incorrectly devolved or incorrectly
assessed.
13
MSD DSS Operational Policy | Disability Support Services Eligibility

IN-CONFIDENCE

People supported by Health NZ Long-term Support Chronic Health Conditions
(LTS-CHC) can move to be supported by DSS funding (or to shared funding
arrangements) if they acquire a disability that meets DSS eligibility and access
criteria, and this disability is now the main reason why the person needs ongoing
support.
Further information
Disability support services that do not require a NASC assessment
While most disability support services are accessed through a NASC process,
some services can be accessed on self-referral, GP referral or referral by a
qualified person.
Services that can be accessed on self and/or GP referral include:
•  Disability Information and Advisory Services (DIAS)
•  some services supporting people with hearing or visual impairments.
Services generally accessed through referral by a qualified person (often a
health professional) include:
•  Child Development Services (CDS)
•  Assessment Treatment and Rehabilitation (AT&R) Services
•  most Environmental Support Services.
Disability Information and Advisory Services (DIAS)
DIAS provide information for disabled people and other members of the
community on how to find support and advocacy groups, NASC services or
community support organisations, specific information related to particular
disabilities, and other topics related to disability.
Child Development Services (CDS)
CDS are multidisciplinary community-based services that provide specialist
assessment, intervention, and management services for young children (mostly
pre-schoolers) who have disabilities or who are not achieving developmental
milestones. DSS funds the allied health component of these services. CDS work
with other agencies to support children to achieve their potential.
Assessment, Treatment, and Rehabilitation Services (AT&R)
Health NZ-funded AT&R services are Health NZ District-provided
multidisciplinary services delivered in a range of settings for disabled people
under the age of 65. They include specialised and clinical assessment,
treatment, and rehabilitation to enable people to participate in daily activities
and fulfil valued roles in their home and community.
Environmental Support Services (ESS)
14
MSD DSS Operational Policy | Disability Support Services Eligibility

IN-CONFIDENCE

Environmental Support Services are a range of services and supports funded by
DSS that are available to a broader group than disability support services
accessed via DSS NASCs. They include:
•
Equipment and Modifications Services (EMS) — such as equipment, housing
modifications and vehicle purchase and modifications)
•
supports and services for people with hearing loss (e.g., hearing aids,
hearing aid subsidies, cochlear implants and services, New Zealand Sign
Language (NZSL) interpreter services, and hearing therapy)
•
supports for people with vision loss (such as spectacle subsidies, and
services for blind and deafblind people)
•
some specialised assessment services (such as wheelchairs, seating and
postural management and communication assistive technology) and
assessor training.
ESS are funded through DSS for:
•
people with physical, sensory, and intellectual disabilities
•
people with disabilities associated with ageing
•
people aged under 65 with disabling chronic health conditions.
People access EMS and hearing aid and spectacle subsidies via a specialised
assessment with a Health NZ assessor or a private assessor (the person may
pay for services such as audiology) who is a suitably skilled or qualified person
(e.g., an allied health professional or an audiologist who is an approved or
credentialed EMS Assessor as described in the DSS Accreditation Framework).
Access to services is prioritised so that people with the most urgent needs
receive services first. A prioritisation tool for EMS has been developed which
prioritises access to resources based on a person’s ability to benefit from the
service and other relevant factors.
Health and disability services funded in New Zealand
The ‘Health and Disability Services Eligibility Direction 2011’ (the Direction) sets
out the groups of people eligible for publicly funded health and disability services
in New Zealand. This direction was made by the Minister of Health under section
32 of the New Zealand Public Health and Disability Services Act 2000. The
direction became effective on 16 April 2011, and applies from that date forward.
Part B1 states that a person is eligible under the Act if the person is in New
Zealand when the services are received.
A person must meet one of the criteria in the Eligibility Direction to be
considered for these publicly funded services. If the person is not eligible, they
are liable to be charged for the full costs of any medical treatment or disability
support service received.
15
MSD DSS Operational Policy | Disability Support Services Eligibility

IN-CONFIDENCE

Useful documents
•  Guide to Eligibility for Publicly Funded Services | Health NZ
•  Health and Disability Services Eligibility Direction 2011
•  MSD DSS Operational Policy: Close in Interest
16
MSD DSS Operational Policy | Disability Support Services Eligibility

link to page 17 Appendix 1: Definitions
Government’s definition of ‘person with a disability’ for the
purpose of accessing disability support services [CAB (94) M 3/5
(1a)]
A person with a disability is a person who has been identified as having a
physical, psychiatric, intellectual, sensory or age-related disability (or a
combination of these), which is likely to continue for a minimum of six
months and result in the reduction of independent function to the extent
that ongoing support is required.
Where a person has a disability which is the result of a personal injury by
accident which occurred on or after 1 April 1974, it should be determined
whether they are eligible for cover under the Accident Rehabilitation and
Compensation Act.
Where a person’s level of independent function is reduced by a condition
which requires ongoing supervision from a health professional (e.g. in the
case of renal dialysis), that person is considered to have a personal health
need rather than a disability.  Where a person has both a disability and a
personal health need, the services provided to address those needs are
disability support services and personal health services respectively.
After this definition being agreed by Cabinet, Cabinet decided to transfer
responsibility for some disability groups to DHBs. Funding responsibility for
disability support services for people with psychiatric disability transferred to
DHBs in 2001 and for people with age-related disability in 200334. The latter
group included:
•
people who first present for assessment for disability support services at
age 65 and over, and
•
people aged between 50 and 65 who are clinically assessed as ‘close in
interest’ to older people (having poorer health and disability status than the
general population and conditions/disabilities normally acquired at age 65
or over).
Definitions in “Support for Independence for People with
Disabilities: A New Deal”
[Minister of Social Welfare and Minister of Health. 1992.  Support for
Independence for People with Disabilities: A New Deal. Wellington: Parliament
Buildings]

34 Note, this devolution also included residual MoH funded long-term support services for
people with personal health conditions, mental illnesses, and palliative care needs.
17

IN-CONFIDENCE

•  “Physical disability - reduced physical capacity (for example, through
loss or impaired use of limbs)
•  Sensory disability - impairment of the senses (mostly sight and
hearing)
•  Intellectual disability - permanently impaired learning ability (usually
from birth) which prevents or inhibits people from developing the
range of physical and social skills usually found in a person of that age
•  Psychiatric disability - disability arising from continuous or intermittent
disorders related to thinking, feeling, volition, or behaviour (for
example, schizophrenia, severe chronic depression, or long-term
addiction to alcohol and drugs
•  Age-related disability - physical, intellectual, or psychiatric conditions
related to the onset of old age. This includes conditions that can affect
younger people, such as Alzheimer’s disease or stroke, but which are
more often found amongst older people”.
18
MSD DSS Operational Policy | Disability Support Services Eligibility

Glossary: Terms and definitions
Term
Description
ASD
Autism Spectrum Disorder
AT&R
Assessment, Treatment and Rehabilitation services
CDS
Child Development Services
DIAS
Disability Information and Advisory Services
DSS
Disability Support Services (business unit)
ESS
Environmental Support Services
Health NZ
Health New Zealand | Te Whatu Ora
LTS-CHC
Long Term Support needs resulting from Chronic Health
Conditions
MoH
Ministry of Health
MSD
Ministry of Social Development
NASC
Needs Assessment and Service Co-ordination
NZSL
New Zealand Sign Language
RHA
Regional Health Authority
Tāngata whaikaha   Disabled people and tāngata whaikaha Māori
Whaikaha
Whaikaha — Ministry of Disabled People

19

Document Outline