The Ministry of Social and Family Development (MSF) announced today new initiatives to (1) enhance the quality and affordability of disability care services; and (2) improve case management support for persons with disabilities with high support needs. This will help families who are caring for persons with disabilities and give them greater assurance that their loved ones will be well-supported. These efforts further the vision set out in Singapore’s Enabling Masterplan to enable all persons with disabilities to fulfil their potential and participate as integral and contributing members of society.
Enhanced resourcing for Adult Disability Care Services
2. MSF will be enhancing funding support for two adult disability programmes – Day Activity Centres (DACs) and Adult Disability Homes (ADHs) – from 1 Oct 2021 and 1 Jul 2021 respectively, to raise their quality of care and service standards. The increased funding for DACs will also improve their affordability for persons with disabilities and their families.
DACs
3. DACs provide day care and skills training for adults with disabilities. MSF will increase the funding to DACs to enable them to hire more care staff to improve the quality of care for DAC clients. Currently, there are more than 1,300 DAC clients. Starting from 1 Oct 2021, MSF will also introduce a cap on the fees for DAC clients from households with gross per capita household income of $2,800 per month or less. With these enhancements, about half of existing DAC clients, who currently pay a monthly fee of between $106 and $754, will see their fees reduced, with reductions ranging between 6% and 81%1, translating to monthly fees of between $20 and $710. Details of the enhancements and worked examples can be found in Annex A-1. MSF will also continue to work with DAC service providers to extend additional financial support to families who may require more help, such as those with multiple family members requiring DAC services.
4. MSF will invest an additional $3 million on average a year to bring about these enhancements to the DACs, an increase of over 20% from the current annual funding. All DAC clients and their families will benefit from the improved quality of care, and more than 500 clients will benefit from fee reductions.
ADHs
5. ADHs provide long-term residential care and short-term respite care to adults with disabilities who have no alternative accommodation. To improve the quality of care for residents, MSF will introduce a new tiered funding model that will see increased resourcing provided for the residents. Currently, there are more than 900 ADH clients. With the increase in funding, ADHs will be able to hire more care staff and psychologists to better support their residents. MSF will invest an additional $6 million on average a year, for the ADH tiered funding, an increase of over 25% from the current annual funding. All ADH clients will benefit from the improved quality of care.
New pilot to improve case management support for persons with disabilities with high support needs and their families
6. MSF has also launched a Disability Case Management Programme pilot with the Movement for the Intellectually Disabled of Singapore (MINDS) to further strengthen support for persons with disabilities with high support needs and their caregivers (refer to Annex B for definition of persons with disabilities with high support needs).
7. Under the pilot, a multi-disciplinary nine-person team of social workers and allied health professionals trained in disability care will help each family better access the ecosystem of disability and social support services, and coordinate the interventions and services that the family requires.
8. The pilot was launched on 1 April 2021 and will run for three years. As a start, the pilot aims to support up to 100 cases of persons with disabilities and their caregivers. Existing agencies serving such families2 requiring specialised advice and support may refer their cases to the pilot team for assistance.
9. Mr Masagos Zulkifli, Minister for Social and Family Development and Second Minister for Health, said, “We want to support not just persons with disabilities with high support needs, but also their caregivers. We will facilitate stable caregiving arrangements for persons with disabilities, so that they can continue to live with and be cared for by their families and in the community. We will work closely with our partners, MINDS and the Tote Board on this pilot to provide customised, client-centric and integrated support to families, keeping the caregiver and the person with disability always at our centre of focus.”
10. These initiatives are part of a suite of new initiatives to enhance the support for persons with disabilities and their families, across their life stages. On 14 April 2021, MSF announced that the Government had begun working with partner agencies to implement 21 recommendations and related initiatives from the Third Enabling Masterplan (EMP3) Workgroups on Preparing Persons with Disabilities for the Future Economy, and on Promoting Independent Living of Persons with Disabilities through Technology and Design (a summary of the suite of initiatives can be found at Annex C). MSF will also announce further initiatives later this month to enhance support for children with developmental needs.
11. These measures underscore MSF’s commitment to support and empower persons with disabilities at every stage of life. Through the collective effort and close partnership of the people, private and public sectors, we can build a stronger, more inclusive and caring society in Singapore.
1 The reductions will depend on the gross per-capita household income tier of the client. About half of existing clients will benefit from fee reductions as some DAC clients in the lower income tiers are already paying a nominal fee that is below the fee cap
2 These agencies would include the Family Service Centres, Social Service Offices, Agency for Integrated Care, disability social service agencies, and SG Enable.
ANNEX A-1 FEE CAPS FOR DAY ACTIVITY CENTRE (DAC) SERVICES
ANNEX A-2 MORE INFORMATION ON ENHANCED RESOURCING FOR ADULT DISABILITY CARE SERVICES
ANNEX D LIST OF TRANSLATED TERMS
ANNEX A-1 FEE CAPS FOR DAY ACTIVITY CENTRE (DAC) SERVICES
| Gross Per Capita Household Income (PCI) Tiers | Average Monthly DAC fees (after subsidies) | Fee Caps (after subsidies, wef 1 Oct 2021) | % Reduction in OOP fees |
|---|---|---|---|
$0 - $800 | $106 | $20 | 81% |
$801 - $1,200 | $140 | $60 | 57% |
$1,201 - $1,900 | $323 | $210 | 35% |
$1,091 - $2,000 | $452 | $420 | 7% |
$2,001 - $2,800 | $754 | $710 | 6% |
Worked examples
1. If a person with disability comes from a family with PCI between $801 - $1,200, the DAC fee after subsidies, for the person with disability would be reduced by 57% from the current average DAC fee of $140/month to $60/month.
2. If a person with disability comes from a family with PCI between $1201 - $1,900, the DAC fee after subsidies, for the person with disability would be reduced by 35% from the current average DAC fee of $323/month to $210/month.
ANNEX A-2 MORE INFORMATION ON ENHANCED RESOURCING FOR ADULT DISABILITY CARE SERVICES
1. What are the admission criteria for Adult Disability Homes (ADHs) and Day Activity Centres (DACs)?
| Adult Disability Homes (ADHs) | Day Activity Centres (DACs) |
|---|---|
Admission of persons with disabilities into an ADH should be considered as a last resort and only when it is in their best interest. Otherwise, persons with disabilities should be encouraged and assisted to live in the community for as long as possible. | DACs are best suited for persons with disabilities whose family members are unable to take care of them during the day. |
The applicant should be | The applicant should be
|
a. Between 183 and 55 years old (applicants above age 55 will be considered on a case-by-case basis); | a. Between 183 years old and above |
b. A Singapore Citizen or Permanent Resident4; and | b. A Singapore Citizen or Permanent Resident4; and |
c.Diagnosed with disabilities of the following nature
| c.Diagnosed with disabilities of the following nature
|
The applicant may not be eligible if he/she has one or more of the following a. He/she has an untreated infectious disease; and b. He/she is suffering from serious psychotic disorders and/or serious behavioural problems that require he/she to be under close individual supervision or nursing care. | d. Not suffering from any communicable disease that is still contagious |
2. What is the demand and supply situation like for ADHs and DACs?
There are currently 10 ADHs and 31 DACs, which provide more than 1,200 places and 1,700 places respectively to cater to persons with different disabilities. As at Jan 2021, the overall utilisation rate was 75% for ADHs and 77% for DACs. MSF will continue to monitor the demand for places at ADHs and DACs and work with providers to increase their capacity where necessary.
3. What is the financial support available to families with higher household incomes / families who do not meet the household income criteria?
Caregivers who face difficulties paying fees or have extenuating circumstances (e.g. multiple dependents within the family requiring long term care) can approach their service providers for financial assistance. Service providers will conduct a detailed assessment for financial assistance and provide support on a case-by-case basis.
4. Why are the fee caps implemented only on 1 October 2021?
The fee caps will be implemented on 1 Oct 2021 to give the DAC service providers enough time to review their fee frameworks and make the necessary adjustments. In the meantime, DAC clients who face difficulties in paying the fees may approach their service providers for financial assistance.
5. How will families of DAC clients know if they will benefit from the fee reductions?
DAC service providers will inform their clients’ caregivers of fee changes in writing by Sep 2021.
3 Persons with disabilities who are below age 21 would need the consent of parents or legal guardians for their application
4 For Permanent Residents, at least one immediate family member must be a Singapore Citizen. Immediate family member refers to spouse, parents and children of the applicant, including step-parents and step-children.
ANNEX B MORE INFORMATION ON PILOT TO IMPROVE CASE MANAGEMENT SUPPORT FOR PERSONS WITH DISABILITIES WITH HIGH SUPPORT NEEDS AND THEIR FAMILIES
1. Which persons with disabilities have high support needs?
Persons with disabilities with high support needs tend to be those with moderate to severe intellectual disability and / or autism, coupled with high behavioural needs, whose caregivers are under significant caregiver strain. These persons with disabilities may face challenges in communication (e.g. have limited verbal communication ability), and would benefit from the support of disability-trained professionals
2. What kind of customised case management would the pilot team provide to persons with disabilities with high support needs and their families?
The pilot team will help each family better access the ecosystem of disability and social support services, and coordinate the interventions and services the family requires. They will work with families and service providers to develop a case plan, track the progress of the person with disability and adjust strategies as needed, and ease him/her into services if needed. The team will make referrals to other relevant agencies as needed, and work with these agencies to put in place coordinated support to address the family’s disability, financial, emotional and psychological support needs, in line with the overall case plan.
The pilot team will also provide advice to caregivers, to improve their capacity to care for the person with disability with high support needs and reduce caregiver stress.
3. How will cases be referred to the pilot team?
MSF will work closely with touchpoints such as Family Service Centres, Social Service Offices, Agency of Integrated Care (AIC), disability social service agencies, and SG Enable to refer relevant cases to the MINDS pilot team. These agencies can contact dcmp@minds.org.sg to find out more about the programme.
ANNEX C SUMMARY OF SUITE OF MEASURES TO SUPPORT PERSONS WITH DISABILITIES ACROSS DIFFERENT STAGES OF THEIR LIVES
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MSF has announced a suite of new initiatives to enhance the support for persons with disabilities and their families, across their life stages. These include recommendations by the EMP3 Workgroup on Inclusive Preschool to enhance inclusion and support for children with developmental needs, for which more details will be released this month. The EMP3 Workgroup on Employment issued 10 recommendations across three themes – Expand opportunities for persons with disabilities to build capabilities at all life stages, Create and sustain work opportunities, Recognise and incentivise inclusive employers. The EMP3 Workgroup on Independent Living issued 11 recommendations across four themes – Improve accessibility in the built environment, Ensure access to information and services, Increase adoption of assistive technology, Raise awareness of disability and promoting inclusion. MSF also announced new measures to improve disability care services and case management support for persons with disabilities with high support needs.