Limits of Current Funding Model for Disability Services Tagged to Organisation Rather Than Beneficiary

Mr Kenneth Tiong Boon Kiat asked the Minister for Social and Family Development (a) whether the current funding model for disability services, where per-capita funding follows the organisation rather than the beneficiary, prevents families from accessing services across multiple providers; and (b) whether the Ministry has considered (i) portable funding that empowers families to choose and (ii) how such alternative funding would affect service quality through competition.

The Ministry of Social and Family Development (MSF) aims to provide persons with disabilities (PwDs) access to safe and effective disability services appropriate for their needs, while keeping service costs sustainable and fees affordable for families with PwDs.

Our approach to providing Government support for disability services, such as Day Activity Centres and Adult Disability Homes, achieve these objectives through the appointment of disability providers and the use of enrolment-based subsidies.

First, MSF appoints disability service providers to deliver Government-funded services based on various factors. These factors include their capabilities and track record in delivering safe and effective specialised intervention and care services for PwDs, while keeping service costs reasonable through the selection process. Appointed service providers are required to abide by service model requirements and standards and are subject to regular audits. In addition, MSF, together with SG Enable and the National Council of Social Service, works closely with the disability sector to enhance the range of disability services, build capabilities and encourage fundraising and volunteer participation from the wider community to ensure that PwDs' needs can be met sustainably.

Second, PwDs enrolling in Government-supported disability services are provided with means-tested subsidies to defray the cost of services. This enrolment-based subsidies will follow the beneficiary, should they enrol with a different appointed service provider. Instead of having to take on the burden of searching and assessing the disability services and providers in the market, PwDs and their caregivers can also receive support via SG Enable to navigate the range of services and be referred to the Government-supported disability services appropriate to the PwDs' need from the pool of appointed service providers.

Providing disability services through portable subsidies and free market competition among service providers alone may lead to suboptimal provision of services and cost escalation. This is because not all PwDs and their families have the professional knowledge or the bandwidth to determine the specialised interventions they need from the services offered by service providers.

We may also see inequitable access to disability services especially for PwDs with more complex or specialised needs, as service providers will find it more efficient to serve larger segments of PwDs with lower or common support needs due to the specialised capabilities and costs involved in serving smaller segments of PwDs with more complex or specialised needs.