After more than four decades of providing unique and successful care and supports to people with special needs, Camphill Communities of Ireland are facing the very real prospect of having to cut their services for the first time. There is even a question over the future of the Camphill operation here, which serves some 275 people in a range of ages, most of them full-time residents in 18 locations. Camphill provides secure home environments for its residents in its urban, suburban, and rural locations. A funding issue with the HSE which has remained unresolved despite protracted negotiations going back more than a decade to 2004, now threatens the sustainability of the Camphill model.
Camphill Communities of Ireland continues to be frustrated at what they see as a 'stonewalling' attitude in the HSE towards dealing with this situation. At a national level meeting in December between the HSE and a delegation of a number of senior Camphill people, it was stated bluntly that one “example Community” simply couldn't survive past the end of 2015 without additional funding.
In that particular example, of an urban Camphill Community which supports 20 people with special needs, 16 of them full-time residents, the recommended funding according to the HSE's target rates published in their own "Value for Money Review" of disability services is in the region of €1.2m. The actual funding received is between 49% - 58% of the VFM recommendations. In the example Community, when compared to the funding provided by the State in 2008, there has been an equivalent 8 - 14% cut in funding.
Joe Lynch, National Governance Coordinator with Camphill will tell TDs and Senators today, “We offered the HSE an independent assessment of need for all individuals we support linked to the HSE’s own “Value for Money Report” in order to arrive at a fair fee for each resident, but they declined the offer. This leaves us with the present arrangements that are unsustainable. The shocking result is that vulnerable individuals with intellectual disabilities are now threatened with losing their homes and supports. Some day placements have fallen as low as €20 per day and some residential placements have fallen to €27,000 per annum - €74 per day.”
The vocational volunteer element of some of those who work in Camphill means that the 'wage' element of a Camphill Community can be as low as 45% of the total cost of running the Community, compared to the typical 80% in more mainstream organisations. It is accepted that the savings to the State from the activities of Camphill are currently in the region of €5m annually.
Some individuals supported by the charity may lose their homes because their care and support fees are unsustainable. Camphill has traditionally provided its excellent care and supports to people with intellectual disabilities, receiving below average fees from the HSE - many individuals supported by Camphill receive less than half the average fee for a person with similar needs in other services. Over the past five years as disability sector cuts were applied across the board it has hit these individuals hardest resulting now in their care being unsustainable. Camphill, their residents, day attendees and their families do not want these individuals to lose their supports and to have to leave their homes. The HSE acknowledge they may be forced to pay a new provider much larger fees for the care if the individuals had to move from Camphill. HSE officials argue, however, that they have no pot of money available for increasing existing placement fees and therefore cannot resolve the problem.
When the HSE completed a Value for Money (VfM) pilot study, it invited Camphill to be part of the pilot so that it could address the funding issue. This study found very large discrepancies between the costs involved in the various agencies. Camphill was very much at the bottom end of the list on a costs per resident basis, so much so that it was in part considered an outlier in statistical terms. The pilot however was subsequently rolled into the report on Value for Money and Policy Review of Disability Services. This report came up with a programme to achieve a 5% reduction in annual funding per placement from the 2009 level. Instead of the Value for Money Review being used to address the huge discrepancies in the system, Camphill's funding was targeted to achieve the same cost savings as everyone else's.
In the face of the HSE stonewalling, Camphill has been forced to undertake a political lobbying exercise to try and bring pressure on the situation, to break the log-jam. If this doesn't succeed, a major shift looks inevitable. A shift which would mean increased costs for the taxpayer and an undeserved end to four decades of hard work, good will and obvious achievements of those who have lived and worked with residents and day attendees with intellectual disabilities. But worst of all, some 275 people who have been able to live much more successfully than they or their families could ever have expected, will face an uncertain future.
‘We are calling on the Minister for Health and the Minister for Disabilities to intervene in this ten year ongoing struggle and address the massive underfunding issues through real and fair assessments of needs and fair economic fees for capitation for our service users. There must also be a mechanism to ensure sufficient funding for capital expenditure on a regular and sustained basis to ensure safe and fit for purpose homes.’
For further information please contact Mr. Joe Lynch, National Governance Coordinator, Camphill Communities of Ireland. 087-8154467, firstname.lastname@example.org.
The Camphill operation is a relatively small but none the less important component of the matrix of service providers to around 8,000 people with special needs in residential services in Ireland. Its principles also differ, in that the concept is based on the principles of Rudolf Steiner, underpinned on the acceptance of the spiritual uniqueness of each human being. When Camphill was established in 1972, in Gorey, Co Wexford, almost all of its workers were long-term vocational volunteers, known as co-workers. They live as part of the Community, providing 24/7 family-type care for the residents. Modest living expenses are shared, and many co-workers have raised their own families within Camphill Communities. They have traditionally been helped by short-term volunteers, such as students from Ireland and abroad who take the equivalent of a Gap Year working with CCoI. Small numbers of local volunteers are also involved. In all three elements, there's a large component of altruism. There are 17 centres in Ireland in both urban and rural settings.
Virtually all of Camphill's income is from the public purse. When the operation was established, it was paid in the form of initial block grants to meet minimum estimated needs, to be topped up if necessary. In the early 1990’s the system was changed to a Capitation Fee basis, a more transparent way of funding, which initially worked out well even though typically the Camphill communities were getting Capitation Fees of around 50 percent those paid to other organisations in the same field.