WHERE WILL THE RESIDENTS GO?
Residents will go into community residential houses around the country, depending on their wishes and needs. These houses will provide 24-hour care and support. Some existing houses may be used, new houses may be built and cluster housing will be explored as an option.

Funding has been allocated for transitional staff training to assist new community service providers.

WHAT IS CLUSTER HOUSING?
Cluster housing is a purpose-built group of homes, each operating individually on one site to provide residential services for people with an intellectual disability. A cluster would generally comprise three to eight houses. Like community residential housing, clustered housing provides 24-hour support so people have a safe and satisfying home life.

WHO WILL PROVIDE SPECIALIST SUPPORT SERVICES?
The Ministry of Health will identify the requirements for specialist support services depending on the preferred future locations of residents. It may contract with existing services or carry out a contestable process for the range of services required.

HOW LONG WILL THIS PROCESS TAKE?
A further period of planning will start immediately. This planning is expected to take eight months before the first group of people will move into their new homes in June 2002. Following that, the Ministry of Health expects everyone to be resettled by March 2005.

WHAT WILL HAPPEN TO THE STAFF?
There are 378 full-time equivalent staff working at the Kimberley Centre. MidCentral District Health Board will establish a workforce development group as part of the transition arrangements. Retention of skilled and competent staff is an important factor.

WHO WILL MANAGE THE CHANGES?
The Ministry of Health will manage the process of resettling residents in the community. As soon as possible it will engage a project team to manage the service co-ordination and planning for each individual. This will include a review of individual needs assessments, planning and development of individual support plans for each resident, transition planning and day-to-day communications with principal stakeholders.

A steering group - including representatives of the Kimberley Parents and Friends Association, independent advocates and Maori - will advise and oversee the project team.

WHO LIVES AT KIMBERLEY?
There are 375 people with intellectual disabilities currently living at the Kimberley Centre. Kimberley residents range in age from 16 to 77, and have varying levels of support needs. About two-thirds of the residents are male. Fifty-two residents are identified as Maori.

There are a range of reasons why people have intellectual disabilities. Some have congenital conditions (existing from birth), others suffered birth trauma and some residents have been in an accident. Intellectual disability results in developmental delay and difficulties in learning and is generally a life-long condition. It is not a mental illness.

Kimberley has a high proportion of residents with complex needs. Some are medically fragile and, for example, are unable to eat and require tube feeding. Some have severe epilepsy. Those with medical conditions requiring constant care will be relocated into a service which meets those needs. All residents, including those with challenging behaviours, will be very carefully assessed before decisions are reached about the most safe and appropriate new homes for them.

WHAT PRINCIPLES AND VALUES UNDERPIN TODAY'S DECISION?
During the past 20 years people with intellectual disabilities, relatives, carers and researchers internationally have worked together to establish the most important and valuable things in life for people with a intellectual disabilities. This has resulted in widespread agreement on the following principles:

• The principle of normalisation: People with an intellectual disability have the right to live as near to a normal life as possible;

• The least restrictive alternative: People with an intellectual disability are able to develop and enjoy their maximum level of independence. This principle recognises the right of an individual to live in an environment that is most supportive and least restrictive of his or her freedom;

• The right to live in the community: People with an intellectual disability belong in their community; and

• Inclusion: People with an intellectual disability should be accepted and valued as part of an inclusive society.

In response to a 1996 consultation with relatives of Kimberley residents, the following two principles were added:

• The right to choose: People with an intellectual disability have the right to choose the accommodation and services that best meet their needs. Where a person is unable to choose, friends, relatives and independent advocates will be available to assist in making the most suitable choice for them and their assessed needs.

• The need for support and security: The principles must be balanced with the need for support and security. This requires a range of quality services that provide support and security and use well-trained and supported staff.

The plan for Kimberley is not a cost-saving exercise. It is anticipated that it will cost more to better meet the needs of residents in the community in future.

WHAT HISTORIC SHIFTS IN THINKING HAVE LED TO TODAY'S DECISION?
Twenty-six years ago the Royal Commission on Hospital and Related Services rejected the medical model for the care of people with an intellectual disability, except where they had other conditions requiring medical or nursing care. It proposed instead the expansion of community-based services for them.

Two years later the United Nations promulgated a declaration of rights for disabled persons, making explicit their entitlement to "a decent life, as normal and full as possible".

Since 1997, seven institutions in New Zealand for people with intellectual disabilities and mental illness have closed (eg Templeton). Kimberley, which opened in 1945, is the last remaining large institution to provide residential care for people with intellectual disabilities.

WHAT HAS BEEN THE EXPERIENCE OF FAMILIES REGARDING EARLIER DEINSTITUTIONALISATION PROGRAMMES?
Families have generally felt increasingly positive about community residential care for their family member after deinstitutionalisation has occurred.

A study* by the Donald Beasley Institute in Dunedin found that 86 per cent of families of Templeton residents felt positive about the resettlement of their family member after it had occurred. This represented a substantial shift from attitudes expressed before resettlement, when only 37% of families felt positive about the planned move.

Families identified the relationships they developed with management and direct care staff in the new community-based services as being particularly rewarding.

* Templeton Resettlement Family Experiences Project, Progress Report - Phase Two, Donald Beasley Institute Inc 2000.

WHAT HAS HAPPENED IN THE LAST TWO YEARS FOR TODAY'S DECISION TO BE REACHED?
In early 2000 Minister of Disability Issues Ruth Dyson directed that comprehensive needs assessments be undertaken for all residents at Kimberley to determine the specific support needs of each resident in consultation with their relatives and significant other people.

The Minister also directed the then Health Funding Authority to form a working group to consider three options for the future of the Kimberley Centre. The three options were (i) status quo - continued delivery of services from the Kimberley site, (ii) partial deinstitutionalisation of the Kimberley Centre, (iii) full deinstitutionalisation and closure of the Kimberley centre.

The working group was made up of representatives from the Kimberley Parents and Friends Association, Maori, community providers, MidCentral District Health Board and Kimberley Centre, advocacy services, specialist services and the Ministry of Health.

The working party, as part of its consideration, held 14 meetings around the country to discuss options and hear the views of families.