Aboriginal Health and the #NDIS #disability debate : Are Aboriginal people being left out of the new @NDIS funding system ?

One year into the national rollout of the NDIS we have 100,000 people with disability living more independent lives, accessing the services and equipment they need, participating in their communities, entering the workforce and contributing to the economy.

To have 100,000 people now receiving reasonable and necessary supports from the NDIS is a major milestone. ”

Minister for Social Services, Christian Porter, said the achievement represented significant progress for the NDIS see Part 1 below for full release

Read over 20 Disability NDIS articles published by NACCHO

 “Nevertheless, the speed of the NDIS rollout, as specified in Bilateral Agreements between governments, has put the scheme’s success and financial sustainability at risk. It has resulted in the NDIA focusing too much on meeting participant intake estimates and not enough on planning processes, supporting infrastructure and market development.

This focus is manifest in poor outcomes such as confusion for many participants about planning processes; rushed phone planning conversations; inadequate pre-planning support for participants; problems for providers with registering, pricing and receiving payment; and a lack of effective communication with both participants and providers.

For the scheme to achieve its objectives, the NDIA must find a better balance between participant intake, the quality of plans, participant outcomes, and financial sustainability.”

From the June Productivity Commission report or Part 4 Below

Download report HERE ndis-costs-position-overview

 

 ” The NSW peak body for Aboriginal children and families is advocating for urgent action to stop Aboriginal and Torres Strait Islander people “being left behind” by the National Disability Insurance Scheme.

Following the recent milestone of engaging 100,000 participants in the scheme, AbSec has raised concerns that only 5 per cent of that number were Aboriginal and Torres Strait Islander people, despite being 70 per cent more likely to experience disability than the general population.

They claim the figures were even more pronounced for Aboriginal and Torres Strait Islander children aged 14 and younger, who are more than twice as likely to have a disability as other children.”

AbSec is calling for long-term funding for Aboriginal community-controlled organisations, to equip them to provide disability services to their local communities.”

See Peak Body Demands Action to Stop NDIS Leaving Aboriginal People Behind Part 2 Below

 ” AbSec project support officer Brian Edwards, who is an NDIS participant himself, having lost his eyesight after developing a brain tumour at just 18 years of age, said it was not acceptable that those who needed the NDIS most were benefiting from it the least.

Aboriginal people experience disability differently to other Australians.

There’s no word meaning ‘disability’ in our languages – it’s not a widely recognised concept in our culture. So there’s a bit of a communication barrier from the start.”

The 27-year-old is currently developing his NDIS disability support plan, which will provide funds to help him access occupational therapy and keep his guide dog healthy see media SBS

” By any measure Aboriginal and Torres Strait Islander people with disability are amongst some of the most disadvantaged Australians; often facing multiple barriers to meaningful participation within their own communities and the wider community.

The prevalence of disability amongst Aboriginal and Torres Islander people is significantly higher than of the general population. Until recently, the prevalence of disability in Aboriginal and Torres Strait Islander communities has only been anecdotally reported. However, a report by the Commonwealth Steering Committee for the Review of Government Service Provision made the following conclusions:

The proportion of the indigenous population 15 years and over, reporting a disability or long-term health condition was 37 per cent (102 900 people). The proportions were similar in remote and non-remote areas. This measure of disability does not specifically include people with a psychological disability. [note 1]

The high prevalence of disability, approximately twice that of the non-indigenous population, occurs in Aboriginal and Torres Strait Islander communities for a range of social reasons “

SEE First Peoples Disability Network Australia (FPDN) Intro and Ten-point plan for the implementation of the NDIS in Aboriginal and Torres Strait Islander Communities VIEW HERE

See Part 3 below FPDN Ten-point plan for the implementation of the NDIS in Aboriginal and Torres Strait Islander Communities

Part 1 NDIS supporting 100,000 Australians : NDIS Press Release

“All Australians should be very proud of this landmark Scheme that replaces a system where the level of support a person with disability received was determined by their postcode and the vastly different funding provided from all levels of government.”

Whilst this milestone is significant, we know there is much more to do to ensure the best NDIS possible is delivered during the three-year transition to full scheme.”

Assistant Minister for Disability Services, Jane Prentice, said the NDIS was transforming people’s lives.

“In my discussions across Australia with NDIS participants, and their families and carers, it is clear that they believe the NDIS is making their lives better,” Assistant Minister Prentice said.

“The NDIS is focussed on building capacity and delivering outcomes so more people with a disability can participate in their community and enter the workforce and live the life they choose.”

The NDIS commenced on 1 July, 2013 in several trial locations across the country. During the three-year trial period, 30,000 Australians with disability entered the Scheme.

Following the successful trial, the national rollout commenced on 1 July, 2016. The NDIS is being introduced in stages around the country over three years, reflecting the scale and complexity of the reform and the need to ensure it delivers positive outcomes for participants. .

The NDIS will provide about 460,000 Australians under the age of 65 with a permanent and significant disability with the reasonable and necessary supports they need to live an ordinary life, including personal care and support, access to the community, therapy services and essential equipment

Part 2 Peak Body Demands Action to Stop NDIS Leaving Aboriginal People Behind

Following the recent milestone of engaging 100,000 participants in the scheme, AbSec has raised concerns that only 5 per cent of that number were Aboriginal and Torres Strait Islander people, despite being 70 per cent more likely to experience disability than the general population.

They claim the figures were even more pronounced for Aboriginal and Torres Strait Islander children aged 14 and younger, who are more than twice as likely to have a disability as other children.

The organisation is now calling for long-term funding for Aboriginal community-controlled organisations, to equip them to provide disability services to their local communities.

AbSec senior project officer for sector capacity Mick Scarcella told Pro Bono News there were a number of reasons Aboriginal people were not engaging with the scheme, which needed to be addressed.

“In Aboriginal communities, ‘people who are different’ are looked after by family with the minimum of fuss, they do not see them as disabled,”  Scarcella said.

“For example, little Johnny in a wheelchair wants to play at the beach, the local kids being family and friends will pick him up in his wheelchair and throw him into the water with the wheelchair so they can all play together. They see him as Little Johnny in the wheelchair, not Johnny with a disability.

“The other reasons for the low engagement comes to trust issues of government agencies and injustices of the past.

“Access to services is an issue as well. Many Aboriginal people have never accessed disability services because there is none in their local area.”

Scarcella, who said the figures quoted erred “on the conservative side” due to undiagnosed cases and lack of engagement, said it was important Aboriginal people had Aboriginal-run services to turn to.

“It has proven repeatedly that self-determination works in the Aboriginal Community,” he said.

“Aboriginal people need to be listened to and become part of the solution and not be told what their problem is and how to fix it, by people who have no idea of the significant cultural differences and family dynamics Aboriginal people have.

“Establishing a system that enables people to recruit family members needs more discussion as well. The way family members rally around a person with disability and focus on their positives instead of believing they are a burden to society is something mainstream Australia can learn from us.”

He said while a commitment to tailored Aboriginal services already existed in the NDIA’s Aboriginal and Torres Strait Islander Engagement Strategy, the reality on the ground showed “little reflection” to the strategy.

“All of these reports are being generated and are coming back showing all of this information we already knew but very little is being done to reflect the report findings and address the recommendations,” he said.

“One of these reports, without mentioning any names, is a 17-page document and the word Aboriginal or Indigenous is not even mentioned in it at all, not once which is very alarming, considering the fact of the low engagement so far to date with the Aboriginal communities.

“We need transparency and accountability for measurable outcomes not token promises and feel good gestures.”

AbSec project support officer Brian Edwards, who is an NDIS participant himself, having lost his eyesight after developing a brain tumour at just 18 years of age, said it was “not acceptable” that those who needed the NDIS most were “benefiting from it the least”.

“Aboriginal people experience disability differently to other Australians,” Edwards said.

“There’s no word meaning ‘disability’ in our languages – it’s not a widely recognised concept in our culture. So there’s a bit of a communication barrier from the start.”

He said said lifting the number of Aboriginal and Torres Strait Islander people accessing the NDIS was “absolutely vital” to closing the gap in health and wellbeing.

“The NDIS is being billed as a revolution in social services – but its impact can’t be truly revolutionary unless all of us are on-board,” he said.

Part 3 Ten-point plan for the implementation of the NDIS in Aboriginal and Torres Strait Islander Communities

Introduction

We are First Peoples Disability Network Australia (FPDN) – a national organisation of and for Australia’s First Peoples with disability, their families and communities. Our organisation is governed by First Peoples with lived experience of disability

By any measure Aboriginal and Torres Strait Islander people with disability are amongst some of the most disadvantaged Australians; often facing multiple barriers to meaningful participation within their own communities and the wider community.

The prevalence of disability amongst Aboriginal and Torres Islander people is significantly higher than of the general population. Until recently, the prevalence of disability in Aboriginal and Torres Strait Islander communities has only been anecdotally reported. However, a report by the Commonwealth Steering Committee for the Review of Government Service Provision made the following conclusions:

Ten-point plan

  • Recognise that the starting point is the vast majority of Aboriginal people with disability do not self-identify as people with disability. This occurs for a range of reasons including the fact that in traditional languages there are no comparable words for disability. Also, many Aboriginal people with disability are reluctant to take on the label of disability; particularly when they already experience discrimination based on their Aboriginality. In many ways disability is a new conversation in many communities. In these instances the NDIS is starting from a baseline position. As a consequence change in this area is likely to happen on a different timeline to that of the mainstream NDIS.
  • Awareness raising via a concerted outreach approach informing Aboriginal and Torres Strait Islander people with disability, their families and communities about their rights and entitlements, and informing Aboriginal and Torres Strait communities about the NDIS itself and how to work this new system effectively. There is no better way to raise awareness then by direct face-to-face consultation. Brochures and pamphlets will not be appropriate as this is a new conversation in many communities.
  • Establish the NDIS Expert Working Group on Aboriginal and Torres Strait Islander People with disability and the NDIS. In recognition of the fact that there is a stand-alone building block for the NDIS focused upon Aboriginal and Torres Strait Islander people with disability, FPDN views it not only as critical but logical that a specific Expert Working Group be established to focus on Aboriginal and Torres Strait Islander people with disability. The new working group would operate in the same way the four current working groups do, that is it would be chaired by two members of the National People with Disability and Carers Council. To ensure its effectiveness but also critically to influence prominent Aboriginal leaders as well as the disability sector, members would be drawn from Aboriginal and Torres Strait Islander people in community leadership positions, as well as involving prominent disability leaders. The FPDN believes such an approach is warranted not only because of the degree of unmet need that is well established but also because this has the potential to be a very practical and meaningful partnership between government, the non-government sector, and Aboriginal and Torres Strait Islander communities.
  • Build the capacity of the non-Indigenous disability service system to meet the needs of Aboriginal people with disability in a culturally appropriate way. Legislate an additional standard into the Disability Services Act focused upon culturally appropriate service delivery and require disability services to demonstrate their cultural competencies.
  • Conduct research on the prevalence of disability and a range other relevant matters. Critically, this work must be undertaken in partnership with Aboriginal and Torres Strait Islander people with disability to ensure a culturally appropriate methodology. There remains very little reference material about disability in Aboriginal and Torres Strait Islander communities. This needs to be rectified to ensure that we are getting a true picture of the lived experience of Aboriginal and Torres Strait Islander people with disability.
  • Recognise that  a workforce already exists in many Aboriginal and Torres Strait Islander communities that does important work, often informally. This work needs to valued and recognised, with the potential for employment opportunities in some communities.
  • Recognise that it’s not always about services. Many communities just need more resources so that they can continue to meet the needs of their own people with disabilities. There may be perfectly appropriate ways of supporting people already in place, however what is often lacking is access to current technologies or appropriate technical aids or sufficient training for family and community members to provide the optimum level of support.
  • Recruitment of more Aboriginal and Torres Strait Islander people into the disability service sector.
  • Build the capacity of the social movement of Aboriginal and Torres Strait Islanders with disability by supporting existing networks and building new ones in addition to fostering Aboriginal and Torres Strait Islander leaders with disability. These networks play a critical role in breaking down stigma that may exist in some communities but are also the conduits for change, and will be integral to the successful implementation of the NDIS in Aboriginal and Torres Strait Islander communities.
  • Aboriginal and Torres Strait Islander ‘Launch’ sites focused upon remote, very remote, regional and urban settings. It is critical that this major reform be done right. Therefore it is appropriate to effectively trial its implementation. To this end, FPDN can readily identify key communities that would be appropriate as trial sites.

Part 4 From the June Productivity Commission report

Key points
·      The National Disability Insurance Scheme (NDIS) is a complex and highly valued national reform. The scale, pace and nature of the changes it is driving are unprecedented in Australia. If implemented well, it will substantially improve the wellbeing of people with disability and Australians more generally.

·      The level of commitment to the success and sustainability of the NDIS is extraordinary. This is important because ‘making it work’ is not only the responsibility of the National Disability Insurance Agency (NDIA), but also that of governments, participants, families and carers, providers, and the community.

·      Based on trial and transition data, NDIS costs are broadly on track with the NDIA’s long‑term modelling. While there are some emerging cost pressures (such as higher numbers of children entering the scheme), the NDIA has put in place initiatives to address them. The benefits of the NDIS are also becoming apparent. Early evidence suggests that many (but not all) NDIS participants are receiving more disability supports than previously, and they have more choice and control.

·      Nevertheless, the speed of the NDIS rollout, as specified in Bilateral Agreements between governments, has put the scheme’s success and financial sustainability at risk. It has resulted in the NDIA focusing too much on meeting participant intake estimates and not enough on planning processes, supporting infrastructure and market development.

–     This focus is manifest in poor outcomes such as confusion for many participants about planning processes; rushed phone planning conversations; inadequate pre‑planning support for participants; problems for providers with registering, pricing and receiving payment; and a lack of effective communication with both participants and providers.

·      For the scheme to achieve its objectives, the NDIA must find a better balance between participant intake, the quality of plans, participant outcomes, and financial sustainability. Steps are now being taken by the NDIA to better balance these aspects. Greater emphasis is needed on pre‑planning, in‑depth planning conversations, plan quality reporting, and more specialised training for planners. The Commission is unable to form a judgment on whether such a refocus can be achieved while also meeting the rollout timetable.

·      The interface between the NDIS and other disability and mainstream services is also critical for participant outcomes and the financial sustainability of the scheme. Some disability supports are not being provided because of unclear boundaries about the responsibilities of the different levels of government. Governments must set clearer boundaries at the operational level around ‘who supplies what’ to people with disability, and only withdraw when continuity of service is assured.

·      A significant challenge is growing the disability care workforce required to deliver the scheme — it is estimated that 1 in 5 new jobs created in Australia over the next few years will need to be in the disability care sector. Present policy settings are unlikely to see enough providers and workers as the scheme rolls out. Some emerging shortages need to be mitigated by better price monitoring and regulation; better tailored responses to thin markets; formal and informal carers allowed to provide more paid care; and a targeted approach to skilled migration.

·      NDIS funding arrangements could better reflect the insurance principles of the scheme, including by allowing more flexibility around the NDIA’s operational budget and providing a pool of reserves. Funding contributions made ‘in‑kind’ must be phased out.

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