Oifig an Taoisigh
Office of the Taoiseach

9th November 2011

Mr. Finian McGrath T.D.
Dail Eireann
Leinster House
Kildare Street
Dublin 2

Dear Finian,

Further to your query regarding St. Michael's House, please see attached a briefing note from the HSE on St. Michael's House.

I understand that Minister Lynch is meeting a delegation from St. Michael's House next Wednesday.

With best wishes.

Enda Kenny T.D.
Taoiseach

Oifig an Taoisigh, Tithe an Ria ltais, Baile Atha Cli ath 2.
Office of the Taoi seach, Government Buildings, Dublin 2.

Feidhmeannacht na Seirlillse Slainte
Health Service Executive

8th November 2011

Briefing note- Leaders Questions on St Michael's House

Introduction
The Health Service Executive funds St Michael's House to provide health care services to those with an Intellectual Disability on its behalf.

St. Michael's House provides a range of community-based day, respite, residential and early services for people with an intellectual disability. The services provided by the organisation cover all ages from young children to older persons.

Clinical support services include psychiatry, medical, nursing, occupational therapy,

physiotherapy, speech and language therapy, social work, psychology and nutrition services.

Services are located both on the Northside and Southside of Dublin and in 2007 the service extended to provide residential care for children in Navan, Co. Meath.

St Michael's House provides these services on behalf of the Health Service Executive to clients, based on individual assessed clinical need and health care is provided in the most appropriate setting to meet the client's individual needs.

In 2006 St Michael's House took over the operation of Baldoyle Hospital at the request of the Health Service Executive.

Core Funding
The following table provides information on the level of funding provided to St. Michael's House in the years from 2007 - 2011 . Figures are taken from HSE Annual Reports and National Register.

New Service Developments Approved for St Michael's House
While there has been a reduction to core funding in line with government policy, there has been significant development in services for persons with an Intellectual Disability in recent years with the introduction of the Disability Act 2005 and the Joint Department of Health and Children and Health Service Executive Multi-Annual Investment Plan 2004-2009.

In 2011 the HSE provided funding to St. Michael's House for 33 new Adult funded day places.

Despite the impact of a reduction in budget and staffing, St. Michael's House is endeavouring to maintain the same level of services for all of its service users.

Under the Croke Park Public Service Agreement, through a programme of service efficiencies, reconfiguration and greater flexibility, St Michael's House has been able to increase services within the allocated funding and staff. No cuts in services have been made by St. Michael's House in 2011 .

Reflecting the current economic situation the HSE must manage service levels within the fixed financial allocation provided by Government. This includes a value for money reduction of 1.8% in the funding provided in 2011 to Disability and Mental Health Services. It should, however, be noted that all other care groups had a 5% reduction. We acknowledge that voluntary organisations face challenges in delivering efficiencies to ensure that services are delivered within the allocated budget, and the impact of the moratorium on service provision.

In 2011 these agencies were asked to see if there could be synergies with other similar agencies in their locality particularly in relation to the sharing of administrative services and premises.

In 2011 the total investment in specialist Disability Services, as outlined in the HSE National Service Plan 2011 is €1.554bn reduced from €1.582 in 2010. This allocation is spent in line with nationally agreed policy for disability services whilst at the same time maximizing value.

Engagement
The Health Service Executive meets with St Michael's House on a regular basis:

• A quarterly Integrated Management Return (IMR) meeting is held between the CEO, Finance and HSE Area Manager, Financial Accountant and the local HSE Disability Manager attends this meeting and feeds back relevant issues in relation to clients/services to the Disability Managers.
• There are quarterly meetings with the Assistant CEO, the Regional Managers and HSE Disability Managers in relation to operational issues.
• Bi-annually the Health Service Executive Disability Managers review the new places sought by St Michael's House and validate as needs indicate with relevant HSE primary care services.
• On an ongoing basis the Disability Managers meet with the regional managers St Michael's House and relevant staff around priority case issues to address the needs of clients on an individual basis and to date this has worked well.
• St Michael's House are also represented at the Children's Disability Forum.

Challenges for St Michael's House
The majority of clients with an intellectual disability would, in the main, be linked into services such as Day Care and/or residential services and as they age would be maintained in these services.

In 2010 the Health Service Executive adopted the National Policy in relation to emergency residential places and will work closely with St Michael's .House to address any issues.

Funding 2012
Until we are notified of the overall health funding and specifically the disability funding for 2012, it is not possible to identify how services will be impacted in 2012. Service provision continues to be a challenge for all of us in the current environment, however by working together through the National Consultative Forum and finding innovative ways to maximise how we use resources we can help to appropriately protect front line services.

The HSE is committed, in partnership with all non-statutory organisations, to the maintenance of the excellent services provided, and views these developments as an opportunity to continue our close working relationships and perhaps develop more innovative, new, and efficient ways of promoting and delivering the service to fit with clients needs.

Yours sincerely,

Cate Hartigan
Assistant National Director Disability Services