Government promised protocol to let disabled people access HSE-funded services at 18

Tusla continues to fund placements on ‘humanitarian and exceptional basis’

It took the case of “Mary”, an intellectually disabled woman left in a foster home for over two years after sex abuse allegations were levelled against her foster father, to reveal the serious gaps in protection for some of the most vulnerable young people in the State.

Because Mary had turned 18, Tusla, the child and family agency providing for her care, felt hamstrung in relation to what action might be taken to protect her. Mary was no longer under a statutory care order, so while younger foster children were removed, she remained.

This case and others highlighted the risk faced by young people transitioning from State care into adult disability services.

Responding to a critical report on the affair in 2017, the Government promised a new disability protocol between State agencies would enable disabled people to access HSE-funded services when they reached 18.

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The Department of Health and the Department of Children agreed at a meeting in February 2017 that responsibility for the young people turning 18 would pass to the HSE from January 1st, 2018. An eight-week transitional period was agreed, during which Tusla would continue to fund the placements.

The meeting was attended by Minister for Health Simon Harris and Minister for Children Katherine Zappone, along with three junior ministers.

‘Vulnerable adult’

The minutes, obtained under Freedom of Information (FoI), state: “It was agreed to by Minister Harris that where a vulnerable adult, who has remained in a Tusla placement, needed to be moved, the HSE would arrange a move as a matter of urgency to a HSE adult placement.”

Despite the agreement, the transfer of responsibility never took place. The HSE sought €9 million in funding for the placements in the estimates process in 2018 but was turned down. It gave this as the reason for not proceeding with the deal, though this was not a condition in the agreement.

Minister for Disability Finian McGrath suggested in correspondence to Ms Zappone “the funding currently allocated to the Department of Children for this purpose will need to be transferred to the Department of Health”.

Ms Zappone responded by saying Tusla was never funded for “such supports”.

Tusla has continued to fund the placements on what it says is a “humanitarian and exceptional basis”, including one for a person who is now aged 26.

Uncertainty

The specialist care required mean placements can cost up to €400,000 a year.

Uncertainty over the number of children involved, and the cost of their placements, has compounded the issue; the HSE has pointed out that once it assumes responsibility for the young adults, this responsibility will remain with the agency for the duration of their lives.

In some cases, the HSE is already part-funding placements through local arrangements.

Last March, an internal briefing suggested there were 14 young adults requiring support from the HSE’s disability services who are currently in Tusla-funded placements. Another 20 young adults require support but are not in Tusla-funded residential placements.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times