NACCHO Aboriginal Health and #NDIS News : 1. Aboriginal people with disabilities and their families need our support and 2. the Ombudsman releases report into the National Disability Insurance Agency’s handling of reviews

 ” In 2014 the Australian government commenced rolling out the NDIS. But Aboriginal participation in the new scheme remains unacceptably low.

This means that despite increases in the funding available, there is a real danger that without culturally appropriate services, supports and pathways the Aboriginal community will not get access to all of the opportunities that the NDIS represents.

Daily our mob lives with the impacts of disability more than any other section of the Australian population: almost half of our Indigenous population aged 15 years and over live with disability or a restrictive long-term health condition and experience disability at more than twice the rate of the general Australian population which increases further with the inclusion of psychosocial disability (mental health).

We need solutions to ensure that all Aboriginal people and their families have access to quality disability services that respect their culture and meet their needs.”

Joseph Archibald is a Gamilario man living on Birpai country mid-north NSW coast. He is manager of Windaan Aboriginal Services. Joseph has worked in the disability sector across areas including sector capacity building for Aboriginal engagement and Aboriginal employment and workforce strategy with industry peak National Disability Services (NDS) and NDIS service development with Galambila Aboriginal Health Service

Read over 20 recent NACCHO Aboriginal Health and NDIS articles HERE

Commonwealth Ombudsman Michael Manthorpe today released a report into the National Disability Insurance Agency’s (NDIA) handling of reviews of decisions under the National Disability Insurance Scheme Act 2013 highlighting complaints and stakeholder feedback including significant backlogs, delays in decision making and poor communication practices.”

In releasing the report, Mr Manthorpe acknowledged the considerable pressure the NDIA has been under to meet bilateral targets since the national rollout of the NDIS, which began in July 2016.

Download a copy of report Here

Report-on-NDIA-administration-of-reviews-under-the-Act_1

However, the Ombudsman stressed this must not be used as a reason to deprioritise or delay other work, including reviews.

“It is clear from this report there are a number of areas in which the NDIA can, and should improve its administration of participant-initiated reviews. Without significant efforts to improve the timeliness of its approach and its communication with participants, there remains a risk that participants’ rights to review will be challenged and the review process will continue to be unwieldy, unapproachable and the driver of complaint volumes” Mr Manthorpe said.

Since mid-2016, complaints to the Commonwealth Ombudsman about the NDIA’s review process have represented around 32 per cent of all NDIA complaints.

The report makes 20 recommendations aimed at improving the NDIA’s administration of reviews, all of which were accepted by the NDIA. The Ombudsman’s Office will continue to monitor the implementation of the recommendations in the report, which is available at:

Media Part 2

People with disabilities are facing delays of up to nine months when they attempt to have their bungled National Disability Insurance Scheme (NDIS) plans fixed, an investigation has found.

From the ABC Report

Key points:

  • NDIS participants seek reviews when their plan does not fit with their needs, for example if they receive funding for fewer hours of care than needed
  • Ombudsman’s report found up to 8,000 people are still waiting for an outcome on their reviews
  • Agency accepted finding that it was not prioritising urgent cases, where people could be at risk of harm or homelessness

People seek reviews for many reasons, including when their plan includes wrong or inadequate equipment and support, for example if they receive funding for fewer hours of care than needed.

“[Delays] pose a particular risk to those who may be at risk of losing services or experiencing deterioration in their capacity if their plan is not adjusted quickly,” the report said.

The Ombudsman said it received 400 complaints about the National Disability Insurance Agency’s (NDIA) review processes over the 18 months to January.Reports to the watchdog included:

“In one case, a participant did not know why her plan was changed because the NDIA had not told her it had accepted (and given effect to) her request for a plan review,” the report said.

“Some participants have told us they have been waiting for up to eight or nine months for a decision on their review request, without any update on its progress or explanation of the time taken.”

The Ombudsman described the review processes as “unwieldy”, “unapproachable”, and lacking “fairness and transparency”.

The Commonwealth Ombudsman’s report into the NDIS’s plan review system has revealed up to 8,000 people are stuck waiting for an outcome.

  • The agency not prioritising urgent cases where, for example, people could be at risk of harm or homelessness
  • NDIA staff and contractors discouraging people from seeking a review
  • The NDIA not acknowledging requests for review or responding to enquiries

The NDIA has accepted the Ombudsman’s 20 recommendations.

“The NDIA has established a dedicated team to manage outstanding reviews.

Social Services Minister Dan Tehan reinforced the message that the NDIA was dealing with the issues outlined in the report.

“Obviously when you undertake a reform of this scale there will always be issues that we need to work through … we’re doing everything we can to speed up the process.

“”These problems need to be fixed, and fixed right now,” Ms Macklin said.

“Get peoples’ plans right the first time so we just don’t need all these reviews done, and people waiting for much-needed support.”

Federal Labor’s social services spokeswoman Jenny Macklin said it was “an absolutely damning report”.

“This was something that was identified some months ago and special teams have been put in place to address this issue,” he said.

“The NDIS is a world-first reform, the size and scale of which means the scheme will not be without challenges.”

“[The agency] has started determining the most practical way to implement responses,” a spokesman said in a statement.

More than 140,000 Australians are now covered by the NDIS — a number expected to reach 475,000 by early next decade.

Example of AWABAKAL ACCHO NDIS Promotion

You are invited to our FREE information sessions to learn more about the National Disability Insurance Scheme (NDIS).

AWABAKAL NDIS GATHERING
14 June 2018
• 10am to 12pm at Wickham Office
• 2pm – 4pm at Cardiff Office

We will explain:
• What is the National Disability Insurance Scheme?
• Accessing the National Disability Insurance Scheme.
• What is funded by the National Disability Insurance Scheme?
• What supports are available if I am not eligible for the National Disability Insurance Scheme?
• Your Consumer Rights when accessing Service Providers
• What is a service agreement?

Yarn to people who have been National Disability Insurance Scheme participants for several years about exercising their rights as consumers.

LOCATION: 10am to 12pm 64 Hannell st Wickham
2pm to 4pm 15 Kelton St Cardiff

For further information contact Suzy Trindall – CDAH
M: 0428 840 953 E: suzy@cdah.org.au

Part 3 Aboriginal people with disabilities and their families need our support

FROM INDIGENOUSX / THE Guardian

Before I worked in the sector, I didn’t know much about disabilities and felt it had little to no relevance to my personal life. How wrong I was. I have been a carer for immediate and extended family and have grown up around family members with disability, but as in many of our Indigenous communities across the country, care and acceptance were our cultural norm and labels were not required.

Pictured above : Editor of NACCHO Communique and Stroke Foundation Consumer Council Co chair & Board Member 2017 Colin Cowell (left ) with fellow stroke survivor Tania Lewis at an NDIS workshop in Coffs Harbour conducted by Joe Archibald (right )

Read Tania’s story HERE

The question of how much of a difference access to quality formal disability supports could have made to the lives of my family members with disability, as well as our lives as carers, is more relevant now then ever.

We need solutions to ensure that all Aboriginal people and their families have access to quality disability services that respect their culture and meet their needs.

The National Disability Insurance Scheme (NDIS) boasts some pretty impressive statistics, including the largest social reform since Medicare, increased funding in the sector from about $8bn per year to $22bn in 2019-20, and providing supports to about 475,000 people.

In 2014 the Australian government commenced rolling out the NDIS. But Aboriginal participation in the new scheme remains unacceptably low. This means that despite increases in the funding available, there is a real danger that without culturally appropriate services, supports and pathways the Aboriginal community will not get access to all of the opportunities that the NDIS represents.

Daily our mob lives with the impacts of disability more than any other section of the Australian population: almost half of our Indigenous population aged 15 years and over live with disability or a restrictive long-term health condition and experience disability at more than twice the rate of the general Australian population which increases further with the inclusion  of psychosocial disability (mental health).

Research and statistics demonstrate the overwhelmingly adverse intersectional impact of being Aboriginal and Torres Strait Islander and having disability across a range of wellbeing and social indicators including health, educational attainment, employment participation, personal safety and exposure to the out of home care and criminal justice systems. Indigenous youth in juvenile detention are recorded as having very high rates of significant intellectual disabilities or mental health conditions.

Aboriginal people living with disability, their carers and families need our support.

Every day Indigenous families enter the NDIS system and service marketplace, many with little support and knowledge of what to do and where to go. This will continue as the NDIS evolves and adapts its generic approach, after having already acknowledged more culturally appropriate strategies and pathways are needed to create equity.

There are cohorts of participants for which supply shortages are high-risk due to the increased cost of service provision and limited availability of workforce, including those who: are in outer regional, remote or very remote areas; have complex needs; are from culturally and linguistically diverse backgrounds; are Aboriginal and Torres Strait Islander Australians; or have acute care needs such as in crisis situations.”

For those who have knowledge of the NDIS space you don’t have to look hard to identify the significant risks in becoming a participant or service provider within an evolving scheme. Acknowledging NDIS is a tough market and costs are yet to reflect the “high risk” and specialist service delivery required to achieve effective outcomes, so it is essential to identify what you do well.

We need culturally appropriate services with sustainable models that can compete in the NDIS open market and be around for our communities for the long term.

Seek to collaborate with existing culturally appropriate services.

Our mob still requires a lot of advocacy in the disability space, and services cannot meaningfully address the needs of Aboriginal communities alone. Adopting models that work closely with Aboriginal families and local partner organisations is important, such as our partnership with Galambila Aboriginal Health Services. It complements existing strengths and services pathways to provide comprehensive care coordination across disability, primary health and allied health services. We know that isolating disabilities from our other services does not work in achieving the positive engagement and outcomes for overall health and wellbeing of our communities.

Historically culture and community supports have been excluded from formal disability service provision, but the right supports and services can empower our families to maintain community and culture in services as much as possible.

At Windaan we have made a commitment to weather the storm of NDIS service delivery and seek out partners where our values and vision align. This allows our Indigenous communities to receive services they’re entitled to and deserve.

  • Guardian Australia is proud to partner with IndigenousX to showcase the diversity of Indigenous peoples and opinions from around the country.

NACCHO Network Submission to the Parliamentary Inquiry into #NDIS National #Disability Insurance Scheme Readiness from the Aboriginal Community-Controlled Health Sector @NDIS

 ” NACCHO lodged a submission to the Parliamentary Inquiry into NDIS Readiness on 22 February 2018.

When appropriately resourced, Aboriginal Community Controlled Health Services (ACCHSs) are uniquely placed to support Aboriginal people through the NDIS to improve health and wellbeing outcomes.

However, there are barriers for ACCHSs becoming providers of the NDIS including cost, thin markets as recognised by the Productivity Commission and limited Aboriginal workforce.

The submission also highlights the barriers many Aboriginal people face in accessing NDIS services which include not fitting the assumed client model, limited NDIS service providers in rural and remote areas and not catering for the specific needs of Aboriginal culture.

NACCHO is supportive of the NDIS and understands it is a complex and highly valued national reform.

If implemented well, the NDIS will substantially improve the health and wellbeing of people with a disability and Australians more generally.

We are keen to collaborate with the Commonwealth Government to develop better solutions for Aboriginal people with a disability.

From the Aboriginal Community-Controlled Health Sector comprising

Download the full NACCHO Submission HERE or extracts below

NACCHO-NDIS-submission

Read over 27 NACCHO Aboriginal Health #Disability #NDIS articles here

Executive Summary

The Aboriginal community controlled health sector provides primary health care services to almost half of all Aboriginal people. This paper draws on experience from across our Sector and finds the following.

1.There are problems for many Aboriginal people accessing NDIS services:

  • Some people struggle because they do not fit the assumed NDIS client model, given that they do not have access to online services, transport or someone who can advocate on their behalf;
  • Some find the system does not always provide for needs specific to Aboriginal culture (such as sorry business and interpreter services) and is not always welcoming to and respectful of Aboriginal people, and:
  • Some Aboriginal people, such as those living in remote areas and many regional areas find there are no disability services available at all, let alone the choice of an Aboriginal organisation.
  1. Our members, the Aboriginal Community Controlled Health Services (ACCHSs) are experienced at providing extra assistance to Aboriginal people as needed. They fill out forms on behalf of some clients, help them with housing and justice issues, and provide outreach services and transport. Our members are also well-established and reliable, with some operating for as long as 40 years, and many are accustomed to dealing with multiple different and complex funding arrangements (one Member Service in Western Australia reported they were managing applications and reporting requirements for over 100 State, Commonwealth and private funding agreements).
  2. Many of our ACCHSs are attracted to providing NDIS services to assist the most vulnerable Aboriginal people in their communities and to help reduce the cost-shifting they are currently experiencing (when NDIS services are not working for Aboriginal customers, they often seek (unfunded) help from their local ACCHS).
  3. However, there are barriers to our ACCHSs becoming service providers including:
  •  Given the extra costs associated with providing some Aboriginal people with the extra support that they need to interact with the existing NDIS system, the pricing for funded services is too low. It is so low that ACCHSs are choosing not to be providers so that they do not endanger the viability of their existing health services.
  • There are also problems with the market (the number of participants) being too small to support the competitive provision of services to Aboriginal clients. The problem of ‘thin markets’ was identified by the Productivity Commission some time ago, but this problem has yet to be addressed by the NDIA.
  • There is insufficient workforce. If our ACCHSs want workers, they find that they need to train their own. Again, this is at cost to the ACCHS.
  • We also anticipate that many ACCHSs would struggle with the upfront investment needed to start providing NDIS service delivery.
  1. The NACCHO network is very supportive of the NDIS. We understand it is a complex and highly valued national reform that if implemented well, it will substantially improve the wellbeing of people with disability and Australians more generally. We are keen to collaborate with the Commonwealth Government to develop better solutions for Aboriginal people which may include increased NDIS service delivery by our members.

1.Introduction

The Aboriginal community controlled health sector

There are 143 Aboriginal Community Controlled Health Services (ACCHSs) who are members of NACCHO. Our members provide services through over 300 clinics. We offer three million episodes of care each year to about 350,000 people, servicing over 47% of the Aboriginal population. About 1 million episodes of care are delivered in remote areas. We employ 6,000 staff, the majority of whom are Aboriginal.

In fact, we are the largest single employer of Aboriginal workers in the country

Aboriginal people are more likely to have a disability but are less likely to access disability services

Aboriginal people are more than twice as likely to experience a disability than non-Indigenous Australians (9% with a severe condition compared to 4% for non-Indigenous).1 Around 60,000 Aboriginal people in Australia have significant disability that could make them eligible for NDIS support, representing 12.5% of potential NDIS participants (while Aboriginal people only represent 3% of the total Australian population).2 We note that currently 5% of NDIS participants are Aboriginal or Torres Strait Islander3, which some consider to be ‘about right’ but we suspect this is far too low.

The percentage of NDIS participants who are Aboriginal is indicative of the numbers of Aboriginal people with plans, but is not necessarily indicative of the extent to which Aboriginal people are receiving assistance under those plans (see box in Section 2 on Indications of under-supply of NDIS services for Aboriginal people).

We welcome the introduction of the NDIS, but are concerned that consistent with previous experience, Aboriginal people may not benefit from the NDIS to the same extent as non-indigenous people.

2.The appropriateness of NDIS arrangements for Aboriginal participants

Based on our experience providing health services, we suspect that Aboriginal people are less likely to use disability services than non-indigenous people owing to:

  • lack of available disability services, especially in remote areas
  • lack of available disability services that are culturally competent
  • lack of accessible disability services (owing to barriers faced by some Aboriginal people including the need to use interpreters, lack of access and skills to use on-line information, needing to travel long distances, not having transport, unstable housing and many other potential issues).

State Governments are withdrawing supports faster than the NDIS can replace them

People who were previously receiving disability support services under State Government schemes are sometimes finding it difficult to obtain replacement services under the NDIS.

NDIS participant planning process is inappropriate for many Aboriginal people

There are significant issues with the NDIS planning process, where participants work with an NDIS planner (who may be either a Local Area Coordinator or an NDIA representative) to develop their care plan based on their ‘reasonable and necessary needs’. NDIS planning conversations are brief and in the past, have sometimes been conducted over the phone and participants were not given adequate time or resources to prepare for their conversations. We understand that some of the issues around the planning process have already been addressed by the NDIA, with the possible exception of the need to provide more pre-planning support by LACs.

It has been reported by our Member Services across the country that NDIA planners are not always sufficiently culturally aware to assist participants appropriately, to understand their goals or to offer them the supports that they need or are entitled to. One example given is that the NDIS is supposed to fund participants’ ability to participate in social and cultural life. Without a proper understanding of Aboriginal culture, planners do not offer or allow for Aboriginal people to choose supports to participate in family, spiritual and traditional cultural practices that are of significant benefit to them

There is a lack of culturally appropriate resources to assist participants and providers. Other services routinely provide interpreters for Aboriginal people but there appears to be no allowance for this under the NDIS. NDIS resources are often in technical language, can require a high degree of computer literacy (and a good internet connection, not always available in remote areas). There are few informational or planning resources specifically tailored to Aboriginal people and their needs.

Lack of case coordination for NDIS participants

Another concern is a lack of organisations who are willing to take on case coordination roles. Where case coordination is funded under an NDIS plan, there is often inadequate allocation of hours in a plan to reflect the amount of support required.

As a result, many Affiliates and Members Services have reported cost shifting to ACCHSs. NDIS participants who have difficulty in the planning process or who cannot access services, often seek help from their local ACCHSs. They trust their local ACCHS to ensure quality, cultural safety and advocacy for Aboriginal people and families that is not adequately provided/funded under the NDIS. ACCHSs are taking on this role at cost to themselves.

Even when Aboriginal people have plans under the NDIS, many are still not receiving the supports to which they are entitled, due to a lack of available providers. There are two aspects to this: a lack of Aboriginal specific or otherwise culturally appropriate disability providers in general, and a lack of any providers at all in parts of regional and remote Australia where Aboriginal people are over-represented and disproportionately suffer from a lack of services.

Thin markets for disability service providers for Aboriginal people

In its recent enquiry into NDIS costs, the Productivity Commission reported on the existence of ‘thin markets’, where the market-based model of the NDIS does not work because there is insufficient supply of participants or disability service organisations to provide a genuine market.

While the Productivity Commission particularly found regional and remote Australia is likely to have thin markets, it also noted that there may be thin markets for Aboriginal specific providers all over Australia, even in urban areas. As an example, one of our members reports that in the ACT, only around 10% (20-40 of 250-300) of eligible Aboriginal people within ACT were accessing NDIS supports under their plans in 2016, in part due to the lack of any Aboriginal specific or culturally safe providers in Canberra.

There are few, if any incentives within the NDIS for service providers to actively work to build community capacity or show that they are able respond to the unique cultural, social and health needs of Aboriginal people. Competitive market models may in fact discourage this. Smaller ACCHSs and other Aboriginal organisations, and particularly those operating in remote areas with thin and fragmented markets, will be unfairly disadvantaged when compared with the economies of scale of larger mainstream providers, including those who operate for profit.

3.Benefits associated with ACCHSs becoming providers of NDIS services

Many of the problems discussed in the previous sections could be addressed if Aboriginal Community Controlled Health Services became providers of NDIS services such as:

  • Undertaking Local Area Coordinator roles (i.e. developing client plans)
  • Providing support coordination (i.e. linking up clients with plans to service providers)
  • Becoming a NDIS registered service provider (i.e. providing disability and allied health services consistent with a client’s plan)
  • Receiving block grant funding for community engagement and participant access support (including identification and engagement, as well as practical support through eligibility and assessment, pre-planning and planning processes)

As far as we can tell:

  • Up to 40 ACCHS are providing allied health services to clients paid for by NDIS packages (this is effectively a new source of fee-for-service funding for service delivery already undertaken by ACCHSs). We are unsure how many are registered providers.
  • Only a few ACCHSs provide the remaining possible services (e.g. LAC services, support co-ordination services or the extensive range of disability services that do not require an allied health professional).

Provision of more disability services by ACCHSs would have the following advantages:

  • Our Member Services already have a relationship with many Aboriginal people who are or will become NDIS clients.
  • We specialise in providing services that are accessible.
  •  For those people who need it, we undertake home and community visits, we use available opportunities to treat people (e.g. we treat all attending family members as needed when they visit the clinic), we provide transport and make specialist appointments on behalf of our clients. We also provide wrap around care relating to other services such as housing and justice.
  • Our Member Services are culturally safe for Aboriginal people.
  • Our Member Services are reliable. Some of our members have been in operation for over 40 years. Our services have been maintained in rural and remote areas in which other services often fail.
  • We are accustomed to dealing with funding complexity, with some of our larger ACCHSs juggling requirements from over 100 funding agreements.

4.Barriers to ACCHSs providing NDIS services

However, our ACCHSs are choosing not to become registered providers of NDIS services owing to issues relating to:

i) pricing of services below cost to the provider

ii) lack of available disability workers

iii) need for upfront investment

Pricing of services below cost to the provider

Only a few ACCHSs are becoming registered NDIS providers, as it is not financially viable for most of them to do so and they are not willing to put at risk their organisational viability and/or existing service delivery.

  • One of the major problems identified is that NDIS funding support is priced at a level that in practice only pays for costs at the point of care as it is based on assumptions about wages, organisational overheads, supervision and billable time that are completely unrealistic and inadequate. In addition, it does not cover holistic care and participant support.
  • Training and recruitment costs for staff are also problematic for organisations, as training is not funded under the NDIS.
  • Transport for participants, disability workers and other sundry costs are not sufficiently considered or provided for, especially for regional and remote participants and workers who must travel long distances to access or deliver services.
  • In general, the remote 25% loading provided by the NDIA is simply inadequate and does not reflect the true costs of providing services in these locations. Our members and other organisations on the ground suggest that 80-100% loading might be more appropriate, given experience in the cost differentials for very remote services.

5.Suggested solutions

1.As recommended by the Productivity Commission (2017) in their report, National Disability Insurance Scheme (NDIS) Costs, the National Disability Insurance Agency should address thin markets with a focus on thin markets for disability services suited to the needs of Aboriginal people by:

  • Considering a range of approaches, including block-funding
  • A possible funding model could be a case-based model, akin to the model being trialled under the ‘Health Care Homes’ program. Under this model ACCHSs would receive direct funding based on the number of participants they enrol for care and the assessed needs of those participants, along with an amount of block funding to cover organisational transformation and overheads.
  • As a matter of urgency, publicly releasing its Provider of Last Resort (POLR) policy and Market Intervention Framework discussed in the NDIS Market Approach: Statement of Opportunity and Intent
  • Collecting and making publicly available disaggregated data, feedback and reports on thin markets, including when POLR arrangements are used.

2.Devote significant investment into training to grow the Aboriginal disability and allied health workforce.

  • We note that the Government has recently announced the appointment of a consortium led by Ernst and Young to implement its $33 million measure announced in the 2017-18 Budget, Boosting the Local Care Workforce Program. Minister Jane Prentice’s media release (20 December 2017) notes that the consortium includes the First Peoples’ Disability Network. We are keen to know more about the governance of this scheme, what services will be available and whether these will be sufficient.
  1. That the NDIA develop and implement specific processes/standards and training regarding interactions and engagement with Aboriginal and Torres Strait Islander people that respect their cultural practices and ways of doing business, both for planning staff and local area coordinators. Again, NACCHO and the sector could assist.
  2. That the NDIA develop improved pre-planning and reference tools and resources suitable for Aboriginal participants and providers. NACCHO and the sector would be able to assist with the development of these materials (but need to be funded for the capacity to do so).
  3. That the NDIA fund dedicated project officer positions within the sector to assist clients to access the NDIS and advocate for them during interactions with planning officers. These positions must be dedicated within the ACCHO sector to support community engagement and funded on an ongoing basis to have real long-term benefits. Furthermore, positions within the Affiliates are required.
  4. Introduce Aboriginal Cultural Support as a funded support category under the NDIS and/or introduction of weighting of packages for Aboriginal people. This will help ensure the cultural needs of Aboriginal people with disability can be taken into account when planning for access to an ‘ordinary life’. It will also improve the incentives and financial viability of organisations that are Aboriginal specific, or who invest in becoming culturally safe providers.
  5. We need revised standard to become providers as these are complex and administratively onerous.
  6. Undertake an independent review of the impacts of NDIS on Aboriginal and Torres Strait Islander people and how to build an effective system to meet the needs of Aboriginal people.
  7. That DSS consider providing funding to the NACCHO network to help fund the development of policy advice specific to each State on Aboriginal NDIS services.

NACCHO Aboriginal Health : @LowitjaInstitut #Disability #NDIS Research opportunities Closes 27 November

Adis

  ” The Lowitja Institute Aboriginal and Torres Strait Islander Health CRC (Lowitja Institute CRC) is seeking applications for research projects under the theme of ‘Understanding disability through the lens of Aboriginal and Torres Strait Islander people – challenges and opportunities’.

The research questions identified for funding are part of the Institute’s Community Capability and Social Determinants of Health program, and build on its current work. The work includes the positive impacts of cultural determinants, gender, and relationships on the health and wellbeing of Aboriginal and Torres Strait Islander peoples (for further details see www.lowitja.org.au/research-programs).”

Please note that applications may only be submitted by Lowitja Institute CRC Participant Organisations. Applications close 27 November 2017

Regional and remote communities background added by NACCHO for discussion

 ” We argue that two schemes may emerge under the NDIS “one in urban areas with robust markets, and a second (lesser) scheme subsidised by government in rural and remote areas that continues to offer little choice.”

Attention should be focused on the way that the NDIS works in remote and regional areas, and how to ensure that government subsidised care (which may prevent people with disability from being forced to relocate) remains of good quality and continues to offer choice and control to people with disability in remote and regional areas, many of whom are Aboriginal and Torres Straight Islander people.”

Eleanor Malbon and Gemma Carey write in The Mandarin see Part 2 Below:

Funding

 While other institutions may partner in the research team, if successful, the Research Activity Funding must be administered by a Participant Organisation (the Administering Institution).

The Lowitja Institute recently held a workshop comprising of Aboriginal and Torres Strait Islander people with lived experience of disability, as well as policymakers, disability organisations, researchers, and advocates.

Background and literature scan

Aboriginal and Torres Strait Islander disability was identified as a high priority at a meeting of the combined Lowitja Institute Program Committees in December 2016. This priority covers all research program areas of the Institute, aligning closely with the social determinants of health program, particularly in the realm of agency and control at all levels for Aboriginal and Torres Strait Islander peoples.

Aboriginal and Torres Strait Islander people with disability are often further disadvantaged by experiences of systemic and ongoing racism and ableism. Current government policies, particularly the implementation of the National Disability Insurance Scheme (NDIS), are driving significant change by re-defining interactions and relationships between services and clients. This climate adds to the uncertainty and complexity of an already challenging reality for many Aboriginal and Torres Strait Islander people with a disability.

Below is a summary of themes and issues that are particular to Aboriginal and/or Torres Strait Islander people with a disability:

Five research questions were identified as key research priorities for Aboriginal and Torres Strait Islander peoples with a disability. More information is available in the overview document below.

Question 1

How are disability services and supports delivered to Aboriginal and Torres Strait Islander people with a disability?

– What type of supports are available (formal or informal)?

– What is the composition of the workforce (Aboriginal and/or Torres Strait Islander staff /non-Indigenous staff)?

– What is the value in Aboriginal and Torres Strait Islander organisations delivering disability services? What lessons can be taken from these to mainstream services?

Question 2

What are the lessons that can be learned from past and/or current supports and services that have attempted to shape the lives of Aboriginal and/or Torres Strait Islander people with a disability?

– What were their outcomes?

– What impact has this had on self-agency and individual control over one’s life?

Question 3

How do we support the agency and leadership of Aboriginal and Torres Strait Islander people with a disability?

– What are past and current cases of Aboriginal and Torres Strait Islander people with a disability that demonstrate agency and leadership?

– What external factors have shaped their contribution or roles?

– How can these stories be shared?

Question 4

What are the concepts of health and wellbeing for Aboriginal and Torres Strait Islander people with a disability?

Understanding disability through the lens of Aboriginal and Torres Strait Islander people – challenges and opportunities Call for research funding – October 2017 10

– What are their expectations, aspirations and definitions of success?

Question 5

How can Aboriginal and Torres Strait Islander peoples’ values and knowledges be optimised and inform a policy system for people with a disability?

Research aim

To understand how disability intersects with broader health and wellbeing for Aboriginal and Torres Strait Islander peoples.

Objective

Understanding the enablers and barriers that exist for Aboriginal and Torres Strait Islander people with a disability.

 

Please note that applications may only be submitted by Lowitja Institute CRC Participant Organisations.

While other institutions may partner in the research team, if successful, the Research Activity Funding must be administered by a Participant Organisation (the Administering Institution).

Apply

Resources

Part 2 Discussion Paper added by NACCHO Originally published The Mandarin and CROAKEY

Eleanor Malbon and Gemma Carey write:

The NDIS has the potential to secure gains in health and wellbeing for thousands of Australians living with disability, but this can only be achieved with careful attention to the inequities that arise in the scheme. The NDIS has been beset with implementation issues due to a rushed implementation that has been noted by the Productivity Commission, amongst others.

New research, supported by the NHMRC Centre for Excellence in Disability and Health, shows that the use of the NDIS market to enable choice and control for people in the NDIS is vulnerable to unequal distribution. As the NDIS is structured, choice and control is reliant on the ability for participants to have new and better service providers to choose from. However the rushed implementation means that the danger of ‘thin markets’ – areas with only one or two providers of a disability service – is acute.

The NDIS is not one market, but rather a set of markets in different geographic locations, meaning that the health of markets in regional and remote areas is not reliant on market performance in cities. Markets in remote and regional communities are most at risk of becoming thin markets:

“Thin markets are also susceptible to market failure, where no new providers enter the market place due to high costs of entry or lack of business prospects, and existing providers are challenged by being paid retrospectively for business, gaining the necessary breadth and depth of expertise and business costs running higher than the funds collected via individuals.” (Carey et al., 2017).

The Productivity Commission’s position paper on costs in the NDIS also discusses the dangers of poor implementation for market failures. The Productivity Commission lists the groups that are mostly likely to experience persistently thin markets as people:

  • living in outer regional, remote and very remote areas
  • with complex, specialised or high intensity needs, or very challenging behaviours
  • from culturally and linguistically diverse backgrounds
  • who are Aboriginal and Torres Strait Islander Australians
  • who have an acute and immediate need (crisis care and accommodation).

These are the people for whom the NDIS will not enable equitable access to choice and control of services.

Indigenous people may have to relocate from their homelands

Alarmingly, by analysing past documents the new research found that the original blueprint for the NDIS by the Productivity Commission (written in 2011) explicitly states that Indigenous people with complex needs will have to relocate from their communities – and geographical connections to kin and country – in order to receive care in metropolitan areas where the service market is stronger:

“…the diversity and level of care and support available in major cities cannot be replicated in very remote areas. In some cases, Indigenous Australians with complex needs will have to move to regional centres or major cities to receive appropriate care and support (as is also the case with non-Indigenous Australians)”

For the design of the NDIS to call for the relocation of Aboriginal and Torres Strait Islander people with disabilities from their country and communities is unacceptable in terms of health equity and fairness.

If the goal of the NDIS is to offer empowerment to Australians with disability through increased choice and control there must be a recognition that not all individuals will have access to robust or well functioning markets.

Our research notes that there is the suggestion that the federal government may provide continued block funding, contracts, or be a provider of last resort in areas that are facing thin markets or market failure.

We argue that two schemes may emerge under the NDIS “one in urban areas with robust markets, and a second (lesser) scheme subsidised by government in rural and remote areas that continues to offer little choice.”

Attention should be focused on the way that the NDIS works in remote and regional areas, and how to ensure that government subsidised care (which may prevent people with disability from being forced to relocate) remains of good quality and continues to offer choice and control to people with disability in remote and regional areas, many of whom are Aboriginal and Torres Straight Islander people.

 

*Eleanor Malbon is a faculty member at UNSW Canberra in the Public Service Research Group. On Twitter @Ellie_Malbon Dr Gemma Carey is an National Health and Medical Research Council Fellow and Senior Lecturer at UNSW Canberra in the Public Service Research Group. On Twitter @gemcarey

This article was first published on November 8, 2017, at The Mandarin

*Eleanor Malbon is a faculty member at UNSW Canberra in the Public Service Research Group. On Twitter @Ellie_Malbon Dr Gemma Carey is an National Health and Medical Research Council Fellow and Senior Lecturer at UNSW Canberra in the Public Service Research Group. On Twitter @gemcarey

This article was first published on November 8, 2017, at The Mandarin

NACCHO Aboriginal Health and #Disability : Can #NDIS Agency Actions Improve #Indigenous Participant Experience ?

 ” Participants by Indigenous and CALD status : The number of NDIS participants who identify as Aboriginal and Torres Strait Islander is broadly in line with estimates of disability prevalence for Aboriginal and Torres Strait Islander Australians. Aboriginal and Torres Strait Islander people represent 3 per cent of the population (ABS 2017a), and estimates of disability prevalence range from between 1.5 to 2 times the prevalence of the non-Indigenous population (ABS 2016a, 2016b; AIHW 2016).

The NDIS data indicate that about 5 per cent of NDIS participants identify as Aboriginal and Torres Strait Islander.

However, some caution is warranted as it is not clear how the rollout schedule has influenced the number of Aboriginal and Torres Strait Islander participants in the scheme and there are some factors that may make it difficult for the NDIS to engage with Aboriginal and Torres Strait Islander people (many Aboriginal and Torres Strait Islander people with disability are reluctant to identify as people with disability and have only had a limited interaction with the disability service system (FPDN 2016)).

Download the NDIS Summary Report  ndis-costs-overview

Download the full NDIS Report ndis-costs2

Read over 25 NACCHO Aboriginal Health and Disability NDIS articles

 ” The NDIA said work was also underway to develop tailored pathways to ensure the NDIA had the right response for all participants, including people with psychosocial disability, children, people from Aboriginal and Torres Strait Islander communities, those from culturally and linguistically diverse backgrounds and people with more complex needs.”

NDIS Agency Takes Action to Improve Participant Experience

Download 9 Page New-pathway-experience-combined

 ” It is [also] anticipated that the capacity for outreach will be significantly diminished due to the NDIS pricing structure. The most marginalised and vulnerable groups (eg homeless, CALD [culturally and linguistically diverse] communities, young people, Aboriginal and Torres Strait Islanders), and those who are particularly unwell, often need assertive and active outreach to engage.

With a framework based on individual choice and control, consumers who don’t have knowledge of the NDIS, the ability to advocate for themselves or connections with support services (eg people who are homeless or socially isolated) may miss out on the benefits of the NDIS. It is critical that existing services and supports continue to be funded to ensure supports are provided to the most vulnerable groups. (sub. 50, p. 13) “

NACCHO has #NDIS questions for our ACCHO member discussion

1) Are any of your members approved providers of disability services under the NDIS? What services do they provide?

2) What is your members’ experience of accessing the NDIS, both as providers and assisting potential participants? What works, and what needs improving?

3) What accessible and culturally appropriate resources and documents are available for ACCHS and participants seeking to access the NDIS? Have you developed any resources for your members that you would be willing to share with the network? 

4) If insufficient resources exist, would you be willing to lead a network collaboration to develop some?

5) What other assistance can NACCHO and affiliates provide in supporting ACCHS to access NDIS funding?

NACCHO  welcomes your feedback and comments

NACCHO Contact

Paul Gardner NACCHO Policy Officer Ph: (02) 6246 9314 Email

OR  leave comments below

 ” Thin markets need more attention .When creating a new market for disability supports, there is a risk that, in some areas, or for some types of supports, the market (the number of providers or participants) will be too small to support the competitive provision of services (‘thin market’).

Thin markets are not new — they have been, and will continue to be, a persistent feature of the disability support sector.

In the absence of government intervention, there will be greater shortages, less competition, and ultimately poorer outcomes for participants. Participants at most risk are those who:

  •  live in outer regional, remote or very remote areas
  •  have complex, specialised or high intensity needs, or very challenging behaviours
  •  are from culturally and linguistically diverse backgrounds
  •  are Aboriginal and Torres Strait Islander Australians
  •  have an acute and immediate need (crisis care and accommodation).

NDIS timetable won’t be met, Productivity Commission warns

The federal government will not meet its target of 475,000 national disability insurance scheme participants by 2019-20, and is failing to grow the disability workforce fast enough to meet the looming demand, the Productivity Commission has warned.

From The Guardian

The commission releases its report on the costs of the $22bn NDIS on Thursday, and offers a bleak assessment of its chances of meeting the tight deadlines set out in a series of bilateral agreements between the commonwealth and the states and territories.

About 100,000 people have already been signed up but the government must develop support plans for at least 475,000 by 2019-20.

To meet that deadline, the NDIS – the biggest social reform since Medicare – is being implemented at a dizzying speed. Advocates have long voiced concerns that the pace of the rollout is compromising decision making and leaving people with a disability with inadequate support packages.

Those fears were confirmed by the Productivity Commission’s report, which said the “[National Disability Insurance Agency’s] focus on participant intake has compromised the quality of plans and participant outcomes”.

“Quality plans are critical, not only for participant outcomes but also for sending the right signals to providers about demand for supports and containing long-term costs of the scheme,” the Productivity Commission said.

The report described the pace of change brought by the NDIS as “unprecedented”, and warned meeting the intake targets would require the approval of hundreds of plans a day, and the review of hundreds more.

In the final year of the transition, it would require the approval of 500 plans – each complex and tailored to the needs of the individual – every day.

“The reality is that the current timetable for participant intake will not be met,” the report said. “Governments and the NDIA need to start planning now for a changed timetable, including working through the financial implications.”

The timetable would be pushed out by at least a year, the report warned, or possibly longer, if the rollout continues to fall behind.

The commission also recommended that states and territories increase their funding to the scheme by 4% from 2019-20, rather than 3.5%.

The growth of the disability workforce was found to be “way too slow”. At full operation, the scheme will require 70,000 additional disability support care workers. That means one in every five jobs created now need to be in the disability sector.

The Productivity Commission recommended the looming shortages be addressed by a targeted approach to skilled migration, intervention in thin markets, and independent price monitoring and regulation.

The report also urged for state and territory funding to be restored to disability advocacy groups.

Advocacy groups fight for the rights and interests of people with a disability and their carers, families and providers, a service particularly important during the complex and confusing NDIS transition.

But in NSW alone, 50 groups are facing closure as the state pulls funding and puts the onus on the NDIS and Commonwealth to replace it.

“As advocacy remains important over the transition period, the commission recommends that funding be restored by jurisdictions that have ceased or reduced funding, and data collection and evaluation of disability advocacy be increased,” the report said.

But the overall message of the report was positive. The NDIS, if implemented well, would greatly improve the lives of people with a disability, it found. The support for the scheme was described as “overwhelming” and “extraordinary”.

The costs were broadly in line with what was expected, although that was largely because not all supports were being used by participants.

The report called for greater attention on the pre-planning and planning phases of the NDIS, which help determine what supports an individual is eligible for and for how long.

It comes just a day after the NDIA announced an overhaul of the way it interacts with people with a disability, promising more face-to-face planning conversations, and simpler and clearer communications.

The NDIA chief executive, Robert De Luca, conceded there had been flaws in the early implementation of the scheme, which were being learned from and addressed.

“What we’ve heard through the process is that the phone conversation hasn’t always been as engaging as it could have been in a face-to-face environment,” De Luca told Guardian Australia.

“The capability of the people on the phone wasn’t at the right level to understand the needs of the people that we’re helping.”

 

Aboriginal Health and #Disability #NDIS : $3 million plan to address the cultural barriers and disadvantage

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Aboriginal and Torres Strait Islander people are 1.8 times more likely to have a disability than other Australians

“We are announcing today up to $3 million in funding over three years for two targeted projects that will support the Plan; a research project to support Aboriginal and Torres Strait Islander prisoners and ex-prisoners with disability as well as a trial on integrated health and education approaches to support students with disability in remote communities.”

Federal Government Press Release 17 October 2017

Read 23 NACCHO Aboriginal Health and Disability Articles

Read 18 NACCHO Aboriginal Health and NDIS Articles

A $3 million plan has been unveiled to address the cultural barriers and disadvantage faced by Aboriginal and Torres Strait Islander people with disability.

Minister for Social Services, Christian Porter, Assistant Minister for Disability Services, Jane Prentice and Minister for Indigenous Affairs, Nigel Scullion, said the Australian Government Plan to Improve Outcomes for Aboriginal and Torres Strait Islander People with Disability (the Plan) will drive better outcomes for Aboriginal and Torres Strait Islander people with disability, their families and carers.

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“We are announcing today up to $3 million in funding over three years for two targeted projects that will support the Plan; a research project to support Aboriginal and Torres Strait Islander prisoners and ex-prisoners with disability as well as a trial on integrated health and education approaches to support students with disability in remote communities.”

Assistant Minister Prentice said consultations over the last three years show that Aboriginal and Torres Strait Islander people with disability face unique challenges.

“The Plan recognises the importance of supporting Aboriginal and Torres Strait Islander people with disability, particularly in remote locations.

“We need to ensure services are delivered within a cultural framework that is appropriate for the community’s customs and practices.”

The plan identifies five key priority areas for action:

  • Housing – access to appropriately designed shelter and accessible, well-designed communities that are fully inclusive of all residents.
  • Justice System – the right to be free from racism and discrimination and a disability-inclusive justice system
  • Education – an inclusive high quality education system that is responsive to the needs of Aboriginal and Torres Strait Islander people with disability
  • Economic security – including employment and business ownership opportunities
  • Health Services – that meet the needs of Aboriginal and Torres Strait Islander people with disability to ensure the highest possible health and wellbeing outcomes.

See Detail Below or in the Plan

“By addressing these issues head on, this Plan aims to achieve improved outcomes and overall social, emotional, cultural, and economic wellbeing for Aboriginal and Torres Strait Islander people with disability and their families and carers,” Minister Porter said.

Extract- Executive Summary

The Australian Government is committed to building an environment that enables Aboriginal and Torres Strait Islander people with disability to achieve improved life outcomes and overall social, emotional, cultural and economic wellbeing.

The development of a dedicated Australian Government plan to improve outcomes of Aboriginal and Torres Strait Islander people with disability seeks to build the capacity of service systems, including disability services and Indigenous programs, to better meet the needs of Aboriginal and Torres Strait Islander people with disability in a culturally safe and appropriate way. The Plan also aims to support workers and carers in their continuing efforts in Aboriginal and Torres Strait Islander communities.

The Plan acknowledges that disability is everyone’s responsibility:

• Australian Government

• state/territory government

• local government

• business and industry sectors

• not–for–profit and community organisations

• Aboriginal and Torres Strait Islander people, communities and organisations.

The Plan is the first of its kind and will be built on over time. The Plan will build on significant work currently being undertaken by the Australian Government to improve outcomes for Aboriginal and Torres Strait Islander people with disability. Consultations on the Plan have been undertaken over the last three years across government agencies together with community stakeholders, including Aboriginal and Torres Strait Islander people with disability, their representative organisations, researchers and community organisations.

The Plan highlights five key areas that stakeholders view as priorities for future consideration by the Australian Government, highlighting work that is already underway in these areas, along with potential strategies to address each of the areas:

1. Aboriginal and Torres Strait Islander people with disability have access to appropriately designed shelter and live in accessible, well designed communities that are fully inclusive of all their residents.

2. Aboriginal and Torres Strait Islander people with disability have the right to:

• be free from racism and discrimination

• have their rights promoted

• a disability inclusive justice system.

3. Aboriginal and Torres Strait Islander people with disability achieve their full potential through participation in an inclusive, high quality education system that is responsive to their needs. People with disability have opportunities for lifelong learning.

4. Aboriginal and Torres Strait Islander people with disability, their families and carers have opportunities to gain economic security through employment and business ownership, enabling them to plan for the future and exercise choice and control over their lives.

5. Aboriginal and Torres Strait Islander people with disability attain the highest possible health and wellbeing outcomes throughout their lives, enabled by all health services capabilities to meet the needs of people with disability.

6 .To ensure that the Plan leads to substantive and meaningful change for Aboriginal and Torres Strait Islander people with disability, any actions or strategies under the Plan must be:

Measurable The priorities and actions outlined in the Plan must be measurable to track progress and outcomes.

Replicable While Aboriginal and Torres Strait Islander people and communities are diverse, there needs to be some consistency in approach and general principles for success that can be applied across different communities.

Sustainable The Plan represents a starting point in the development of a new approach for improving the lives of Aboriginal and Torres Strait Islander people with a disability. The Plan seeks to outline reform and action that will be sustainable over the long-term.

Flexible The Plan recognises that different people and different communities have different needs. While adhering to principles of sustainability and best practice in the delivery of services, implementation needs to be responsive to the unique requirements of individuals and communities.

Cultural The Plan recognises that Aboriginal and Torres Strait Islander people with disability will have similar physical and structural requirements as non–Indigenous people, but that service delivery needs to be undertaken in a cultural context to achieve success.

Area 5: Aboriginal and Torres Strait Islander people with disability attain the highest possible health and wellbeing outcomes throughout their lives, enabled by all health and disability services having the capability to meet their needs.

Why is it important?

Holistic health care and coordination between health and disability services are paramount for those with disabilities. Many Aboriginal and Torres Strait Islander people, those with a disability and those without, access Aboriginal and Torres Strait Islander community controlled health services as they deliver holistic, comprehensive and culturally appropriate health care, and have an understanding of the cultural needs of Aboriginal and Torres Strait Islander people.

While these services meet general health needs through comprehensive primary health care, there is still a need for health workers to receive appropriate training on disability issues. Workers aware of disability needs are able to facilitate appropriate referral pathways for clients to receive any required additional disability services and supports.

Access to disability services is limited by cultural considerations as well as by geographical location, environmental factors, capacity and level of need. Cultural safety can be at risk where the only service within geographic reach is designed for the general population without achieving cultural competency for Aboriginal and Torres Strait Islander care.

Summary of press release

The Australian Government is committed to working in a spirit of collaboration with states and territories, local government, Aboriginal and Torres Strait Islander people, and communities and organisations to deliver real outcomes and foster greater opportunities for Aboriginal and Torres Strait Islander people with disability, their families and carers.

 

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.

NACCHO Aboriginal Health #Strokeweek : #Fightstroke Aboriginal people are up to three times more likely to suffer a stroke than non-Indigenous

 

” Aboriginal and Torres Strait Islander people are up to three times more likely to suffer a stroke than non-Indigenous Australians and almost twice as likely to die, according to the Australian Bureau of Statistics. It’s an alarming figure and one that  prompted the National Stroke Foundation in 2016 to urge the Federal Government to fund a critical $44 million awareness campaign in a bid to close the gap .

The good news is most strokes are preventable and treatable.

However communities need to be empowered to protect themselves from this insidious disease.”

Sharon McGowan, Stroke Foundation CEO ( see full Aboriginal Stroke statistics part 2 below

Download the 48 Page support guide :

journeyafterstroke_indigenous_0

Read over 75 Stroke related articles published by NACCHO over past 5 years

“Never had I ever come across one ( stroke ) or heard much about them. I had nothing to do with them,”

When I woke up, I didn’t know what was going on. I couldn’t communicate. I couldn’t tell anyone I was still here. It was really scary. I’d never seen the effects of a stroke.

First, I lost my voice, then my vision, my [ability to] swallow and my movement of all my body parts. I lost all my bowel and bladder function. I’ve still got bad sight but I can see again. My speech took about six months.

With help from the Aboriginal Disability Network, they advocated to get me out and get the right support equipment at home “

For Tania Lewis, an Awabakal woman, stroke was something that only happened to older people. But in 2011, Tania suffered a severe stroke at the age of 39 that would leave her with permanent right-sided hemiplegia – paralysis of one side of the body.

Pictured above : Editor of NACCHO Communique and Stroke Foundation Consumer Council Board Member Colin Cowell (left ) with fellow stroke survivor Tania Lewis at an NDIS workshop in Coffs Harbour conducted by Joe Archibald (right )

Part 1 Stroke Foundation in 2016 called on government to close the gap

Originally published here

A stroke occurs when supply of blood to the brain is disturbed suddenly. The longer it remains untreated, the heightened the risk of stroke-related brain damage.

Medical treatment during the first onset of symptoms can significantly improve a sufferer’s chance of survival and of successful rehabilitation.

In Australia, stroke is the leading cause of long-term disability in adults, accounting for 25 per cent of all chronic disability. The NSF reports that roughly 50,000 strokes occur per year with over 437,000 people living with stroke across the country. While severity varies, two thirds of victims, like Tania, are left with impeding disabilities

But in 2011, Tania suffered a severe stroke at the age of 39 that would leave her with permanent right-sided hemiplegia – paralysis of one side of the body.

The burden of stroke doesn’t just fall on the patient, but can take a significant toll on family and carers.

“The doctor at the hospital tried to take Power of Attorney and Guardianship away from me and give it to the Guardianship Board, because he didn’t believe that [my husband] Len or anyone could look after me,” Tania recalls.

“I was put through hell. I figured life wasn’t worth living anymore because they took everything away from me. I couldn’t go home to my family. So I tried to off myself.

“Then all of a sudden, one day the doctor said, ‘You can go home. We can’t rehabilitate you anymore’. At home, I was having seizures for a while. My hubby wouldn’t sleep. He and his mum would take shifts looking after me. We tried to get assistance but there was nothing for young people. So one day, my husband collapsed on the lounge room floor from exhaustion. It was just a nightmare. That’s how I ended up in aged care.”

Tania spent the next two and a half years between three aged care facilities.

“I wouldn’t wish it upon nobody,” she says.

It was during her nightly ritual of chatting with her daughter via Facebook that Tania typed “young people in nursing homes” into Google. The search engine’s results would lead to her life-changing encounter with the YPINH.

“With help from the Aboriginal Disability Network, they advocated to get me out and get the right support equipment at home. Whatever I need, physio, OT – they’ve got my back. I can’t thank them enough for what they’ve done for me.”

Today, Tania is working with the Aboriginal Disability Network, helping Indigenous Australians navigate their way through the National Healthcare System.

It has long been recognised that Aboriginal and Torres Strait Islander people have a life expectancy that is approximately 20 years less than non-Indigenous Australians (Australian Bureau of Statistics). Recent data from the ABS shows that up to 80 per cent of the mortality gap can be attributed to chronic diseases such as heart disease, stroke, diabetes and kidney disease.

For many Aboriginal communities, especially those in remote regions, socio-economic factors play an important role. Kerin O’Dea from Darwin’s Menzies School of Health Research cites unemployment, poor education outcomes and limited access to fresh foods as key factors in her paper, Preventable chronic diseases among Indigenous Australians.

Lifestyle related risks such as smoking, alcohol misuse, stress, poor diet, and inadequate physical activity also need to be addressed, according to the Australian Institute of Health and Welfare .

But the first step, McGowan says, is for indigenous stroke sufferers to recognise the signs of a stroke in themselves and their family members. The NSF recommends the F.A.S.T. test as the most effective way to remember the most common signs of a stroke.

Face: Check their face. Has their mouth drooped?
Arms: Can they lift both arms?
Speech: Is their speech slurred? Do they understand you?
Time: Is critical. If you see any of these signs call 000 straight away.

“If I had known that because I’d lost my vision I had suffered a stroke, I could’ve put two and two together and got help, but I didn’t know anything,” Tania says.

“I was a heavy smoker, but not anymore – no way. Life’s too important. I didn’t ever know anything about a stroke – I was more thinking when you smoke, you can have lung problems and lose your fingers, like on the packets. But they don’t say anything about a stroke – they don’t advertise that stuff.”

The Stroke Foundation called on the Federal Government to fund an urgent $44 million campaign to address the gap in stroke care. For more information on stroke and the campaign, visit strokefoundation.com.au.

Part 2 Aboriginal Stroke Facts

From here

  • The incidence rate of stroke for Aboriginal and Torres Strait Islander Australians has been found to be 2.6 times higher for men and 3.0 for women (Australian Institute of Health and Welfare, 2008; Katzenellenbogan et al. 2010) compared to non-Aboriginal and Torres Strait Islander Australians and many suggest that these figures may in fact be underestimates (Thrift et al 2011).
  • Aboriginal and Torres Strait Islander Australians are known to experience stroke at a younger age than their non-Aboriginal and Torres Strait Islander counterparts, (Katzenellenbogen et al., 2010; Australian Institute of Health and Welfare, 2004) with 60% of Aboriginal and Torres Strait Islander non-fatal stroke burden occurring in the 25-54 year age-group compared to 24% in the non-Aboriginal and Torres Strait Islander group (Katzenellenbogen et al., 2010).
  • The prevalence of stroke is similarly significantly higher at younger ages among Aboriginal and Torres Strait Islander people (Katzenellenbogen 2013), with a significantly higher prevalence of co-morbidities among Aboriginal and Torres Strait Islander patients under 70 years of age, including heart failure, atrial fibrillation, chronic rheumatic heart disease, ischaemic heart disease, diabetes and chronic kidney disease. This reflects the increased clinical complexity among Aboriginal and Torres Strait Islander stroke patients compared with non-Aboriginal/Torres Strait Islander patients.
  • Aboriginal and Torres Strait Islander stroke patients aged 18–64 years have a threefold chance of dying or being dependent at discharge compared to non-Aboriginal and Torres Strait Islander patients (Kilkenny et al., 2012).

NACCHO @FPDNAus Aboriginal Health @NDIS 2016 progress report survey The National #Disability Strategy

 ” 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 or Below

Read over 15 NACCHO NDIS Articles published

 See Background 1 below

The DSS need to improve under the National Disability Strategy.

We want to hear your thoughts about disability policy in Australia!

Are you a person with disability, a family member, a carer, or are you just interested in the rights of people with disability?

Tell us what you think about the lives of people with disability in Australia. This may include questions about things like health care, employment and access to the local community for people with disability.

Answer this survey and tell us how things have improved in the last two years. This feedback will help us understand what areas need to improve under the National Disability Strategy.

The National Disability Strategy

The National Disability Strategy 2010-2020 (the Strategy) helps us to create better policies, programs and communities so people with disability are able to lead happy and fulfilling lives.

The Strategy identifies six areas that people with disability are concerned about.  They are:

  1. Taking part in the in the community
  2. Your rights to fair treatment
  3. Work and money
  4. Personal and community support
  5. Learning and Skills
  6. Health and Wellbeing

What will my feedback be used for?

Your feedback will help inform the 2016 Progress Report.  Reporting is an important part of the Strategy.  Every two years we develop a progress report that looks at the achievements of the Strategy.  An important part of the report is finding out what people with disability, their families and carers think.  We also work with other government agencies and state and territory governments to collect feedback and data to help inform the 2016 Progress Report.

How can I access the survey?

The survey can be completed online via the 2016 Progress Report Stakeholder Survey page.

If you would like a hard copy of the survey to complete, please email nationaldisabilityst@dss.gov.au or ring (02) 6146 2507.

Please note: Requests for a hard copy of the survey must be made by 4 August 2017.

Completed hard copy surveys can be mailed to:

National Disability Policy Team
The Department of Social Services
Reply Paid
GPO Box 9820
Canberra ACT 2601

When will the survey open/close?

The survey will be open from Monday 17 July 2017 and will close on Monday 21 August 20

Background 1 of 2

What is the NDIS?

Will the NDIS mean more or less support?

Is the NDIS diagnosis based or needs based?

Am I eligible for the NDIS?

Where is the NDIS available now?

What supports does the NDIS cover?

How does the NDIS process work?

I have an NDIS plan. What’s next?

When will the NDIS be here for all Australians?

Where can we get more help

Full details below or download Help Guide Here :

NDIS your Questions answered Download

NACCHO Aboriginal Health #disability and @NDIS : Your Top 10 Questions answered about the National Disability Insurance Scheme

BACKGROUND from FPDN

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:

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, including poor health care, poor nutrition, exposure to violence and psychological trauma (e.g. arising from removal from family and community) and substance abuse, as well as the breakdown of traditional community structures in some areas. Aboriginal people with disability are significantly over-represented on a population group basis among homeless people, in the criminal and juvenile justice systems[note 2], and in the care and protection system (both as parents and children).[note 3]

The advent of the National Disability Insurance Scheme (NDIS) presents an opportunity for Aboriginal and Torres Strait Islander people with disabilities to engage – many for the first time – with the disability service system in a substantive way. Currently, most Aboriginal and Torres Strait Islander people with disabilities remain at the periphery of the disability service system. This continues to occur for a range of reasons some of which are well established. However, one factor that remains little understood is the reluctance of Aboriginal and Torres Strait Islander people with disabilities to identify as people with disability. This preference to not identify presents a fundamental barrier for the successful implementation of the NDIS. The First Peoples Disability Network (Australia) (FPDN) argues that it has a central role in addressing not only this fundamental barrier but also in facilitating the roll out of the NDIS more broadly into Aboriginal and Torres Strait Islander communities.

FPDN argues passionately that for positive change to happen in the lives of Aboriginal and Torres Strait Islander people with disability, the change must be driven by community itself. It cannot be imposed, implied, intervened or developed with well-meaning intention from an external service system that the vast majority of Aboriginal and Torres Strait Islander people with disabilities have little or no experience of in the first place.

Throughout many communities across the country, Aboriginal and Torres Strait Islander people with disability are supported and accepted as members of their communities. However, many communities lack the resources to adequately support people with disability. Furthermore, the service system tends to operate from a ‘doing for’ as opposed to ‘doing with’ approach, which only further disenfranchises communities because they simply do not feel that they can self-direct their future. The NDIS does have the potential to address some of these concerns by giving Aboriginal and Torres Strait Islander people with disability the opportunity to self-direct their funding, for instance. The challenge in this area will be that many Aboriginal and Torres Strait Islander people with disability have had little or no experience in self-managing funds.

It must be remembered that in many ways the social movement of Aboriginal and Torres Strait Islander people with disability is starting from an absolute baseline position. This is reflected, for example, by the fact that few Aboriginal and Torres Strait Islander people with disability have an understanding of the language of the disability service system. It is the view of FPDN that the application of the NDIS in Aboriginal and Torres Strait Islander communities will need to have a different look and approach to what is advocated for with regard the rest of the Australian population. It may be that the application of the NDIS in Aboriginal and Torres Strait Islander communities takes a longer process. But the FPDN argues that it is critical to get it right as it is the experience of many Aboriginal and Torres Strait Islander people that they are usually the first to be blamed when new programs are not taken up by Aboriginal and Torres Strait Islander people.

FPDN has developed a 10-point plan for the implementation of the NDIS in Aboriginal and Torres Strait Islander people with disabilities. The development of this 10 point plan is based upon extensive consultation as well as drawing upon the decade long experience of the FPDN in advocating for the rights of Aboriginal and Torres Strait Islanders people with disabilities.

The plan was launched in May 2013 at Parliament House, Canberra.

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.

NACCHO Aboriginal Health #Disability #NDIS : ACCHO Submissions to #NDIS close 12 July 2017

 ” This position paper outlines the Productivity Commission’s early thinking on NDIS costs. The purpose of this position paper is to seek feedback on the Commission’s preliminary conclusions, and on any additional issues that should be considered before the public release of the final study report.

This position paper was released on 14 June 2017. You are invited to examine the paper and to make a written submission or comment by Wednesday 12 July 2017.”

People who want to comment or make a submission for the final report, due to be released in September, can do so at pc.gov.au

Download the PC Overview and Position paper here

ndis-costs-position-overview

ndis-costs-position

or Download MS Word copies here

‘The National Disability Insurance Scheme (NDIS) is a major, complex national reform — the largest social reform in Australia since the introduction of Medicare,’

Social Policy Commissioner Richard Spencer

 ” For Aboriginal and/or Torres Strait Islander people living with disability and their carers, this is a much-needed conversation.

FPDN estimates 60,000 Aboriginal and/or Torres Strait Islander people will potentially be eligible for NDIS. Whilst there might be new opportunities for First Peoples through the NDIS, such as a growth in Aboriginal and/or Torres Strait Islander health and disability services workforce, valid concerns are being raised.

Some of these include how effective NDIS rollout will be in rural and remote Aboriginal and Torres Strait Islander communities, and concerns of eligibility criteria not being inclusive or culturally relevant for First Peoples living with disabilities ”

See all NACCHO posts Disability NDIS

OR

NACCHO Aboriginal Health #disability and @NDIS : Your Top 10 Questions answered about the National Disability Insurance Scheme

 ” For many, language barriers can prevent meaningful engagement with planning processes. Neami National (sub. 63, p. 6) said that ‘consumers without English as their first language describe difficulties in participating in planning and in getting plans that they can fully implement on account of their language needs’.

This is an issue which disproportionately affects Aboriginal and Torres Strait Islander communities: English is a second language for many Indigenous people in remote communities. The majority of participants in Barkly identify as being Aboriginal or Torres Strait Islander and for 67% English is not their first language. Many have limited capacity to understand or read it.

This has a significant impact on their ability to have genuine input into the formulation of their plans and also impacts on decision making and choice. (Brain Injury SA, sub. 116, p. 3) “

From Page 172 Submission

.

In 2020, when the NDIS is fully rolled out, around 475 000 people with disability are expected to receive individualised supports, at an estimated cost of $22 billion per year.

In a position paper released today, the Commission finds that while it is early days in the transition to full scheme, the NDIS is on track in terms of costs.

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.

 

‘While there are some emerging cost pressures, such as higher than expected numbers of children entering the scheme, the National Disability Insurance Agency (NDIA) has put in place initiatives to address these cost pressures,’ Commissioner Angela MacRae said.

‘Given the extraordinary scale, pace and nature of the changes the scheme is driving, we are seeing some big challenges. A key concern is the speed of the rollout and its impact on the experience of participants and providers through the planning process, plan quality and market development,’ Mr Spencer said.

‘A real challenge is growing the disability care workforce needed to deliver the scheme. As many as one in five new jobs created in Australia over the next few years will need to be in the disability sector. There are unlikely to be enough providers and workers as the scheme rolls out under current policy settings,’ Mrs MacRae said.

The paper finds that the NDIA must place greater emphasis on pre-planning, in-depth planning conversations, plan quality reporting, and more specialised training for planners. And governments must set clearer boundaries around who supplies what, so that people with a disability are assured of continuity of service.

‘Everyone wants the NDIS to work, but there are challenges to be overcome and work is needed by all governments. Putting the enormous goodwill behind the NDIS into action is needed now more than ever,’ Mr Spencer said.

The Productivity Commission’s position paper is National Disability Insurance Scheme (NDIS) Costs.

People who want to comment or make a submission for the final report, due to be released in September, can do so at pc.gov.au

NACCHO Aboriginal Health: 10 Key #disability #NDIS priorities and strategies for #LivingOurWay Conference

Important questions about the impacts of the National Disability Insurance Scheme (NDIS) upon Aboriginal and Torres Strait Islander people will be addressed during a conference hosted in NSW this week by the First Peoples Disability Network Australia.

As many Australians prepare for the rollout of the National Disability Insurance Scheme (NDIS), some are asking: will it fit our way of living?

For Aboriginal and/or Torres Strait Islander people living with disability and their carers, this is a much-needed conversation.

FPDN estimates 60,000 Aboriginal and/or Torres Strait Islander people will potentially be eligible for NDIS. Whilst there might be new opportunities for First Peoples through the NDIS, such as a growth in Aboriginal and/or Torres Strait Islander health and disability services workforce, valid concerns are being raised.

Some of these include how effective NDIS rollout will be in rural and remote Aboriginal and Torres Strait Islander communities, and concerns of eligibility criteria not being inclusive or culturally relevant for First Peoples living with disabilities.:

Writer Karen Wyld is covering the event for the Croakey Conference News Service, see full report HERE

Download the 3 day program

Conference-Program-First-Peoples-Living-Our-Way-3 

On 2 May 2017 the first of the Redfern Statement alliance workshops was held on the land of the Gadigal People of the Eora Nation. We were welcomed to Gadigal land by Ms Yvonne Weldon. We acknowledged the traditional owners of the Gadigal lands, and paid our respects to Elders past and present.

The Redfern Statement workshop was hosted by the First Peoples Disability Network (FPDN), the peak organisation of and for Aboriginal and Torres Strait Islander people with disability, in collaboration with The National Congress of Australia’s First Peoples.

Community Elders and representatives from First Nations and Disability peak organisations participated, including representatives of First Peoples community controlled health, justice, housing, family violence, and community service organisations, alongside representatives from the Department of the Prime Minister and Cabinet and the Department of Social Services and other key government agencies involved in setting Australian government disability policy.

Senator the Hon. Nigel Scullion, Minister for Indigenous Affairs was unable to attend but provided a statement of support, describing the workshop as “an important step in our genuine and ongoing discussion to work in partnership with Aboriginal and Torres Strait Islander people on real practical solutions”. The full statement was read to attendees by Uncle John Baxter during the morning session.

The Hon. Jane Prentice MP, Assistant Minister for Social Services and Disability Services, attended the afternoon session and discussed the outcomes with participants. We welcomed the opportunity to provide the Assistant Minister with an overview of the major themes, issues, and priorities that emerged throughout the workshop.

Background

In June 2016, in the lead up to the Federal Election Campaign, Aboriginal and Torres Strait Islander leaders from health, justice, children and families, disability, and family violence prevention sectors united to call upon Australia’s political leaders to recognise the aggravated disadvantage of Australia’s First Peoples, and the fundamental role of Australia’s First Peoples and their community-controlled organisations in solving the root causes of this disadvantage, known as the The Redfern Statement.

The Redfern Statement calls for changes across these sectors through structured engagement with Aboriginal and Torres Strait Islander people, and is supported by more than 30 major mainstream organisations. The disability workshop is one of five workshops that will be conducted this year. The relevant sector peak organisation will collaborate with the National Congress of Australia’s First Peoples to produce the remaining workshops. Each workshop will focus on a particular service sector.

This Workshop was convened with the financial support of the Australian Government to enable us to deliver on the promise of The Redfern Statement – to articulate the solutions to the disadvantage experienced by our people with disability and our role in overcoming this disadvantage.

The workshop also responds to the Government’s commitment in the National Disability Strategy 2010-2020 (the Strategy) Second Implementation Plan: Driving Action 2015-2018  to hold an annual solutions-focussed workshop focussed on improving outcomes for Aboriginal and Torres Strait Islander people with disability.

Key issues and concerns

During our discussions we identified the following key issues and concerns:

  • The prevalence of disability among Aboriginal and Torres Strait Islander population groups is substantially higher than that for the general population. The best available data would suggest it is at least twice that of non-Aboriginal population groups.
  • There are at least 60,000 Aboriginal and Torres Strait Islanders across Australia who live with a severe or profound disability and who thus are part of the core target group for the National Disability Insurance Scheme.
  • The disadvantage experienced by Aboriginal and Torres Strait Islanders with disability and their families is intersectional. It arises because of the systemic barriers they face as a person who is both Aboriginal or Torres Strait Islander AND a person with disability. Intersectionality compounds the disadvantage, in that the systemic barriers accumulate across a person’s life. Aboriginal and Torres Strait Islanders with disability are, for example, many times more likely than other Indigenous persons, and many more times likely than non-Indigenous persons to experience family violence, removal from their families, and to be in contact with and incarcerated in the criminal justice system.
  • The effect of intersectionality on the health and social outcomes of Aboriginal and Torres Strait Islander people with disability can now be quantitatively demonstrated using data from the Australian Bureau of Statistics (ABS).
  • There is a serious problem of under-reporting of impairment and disability in mainstream service systems. Therefore, Aboriginal and Torres Strait Islanders with disability do not always receive appropriate supports and opportunities, even in circumstances where these supports would be readily available.
  • A major contributing factor in the under-reporting of Aboriginal and Torres Strait Islanders with disability is the entrenched distrust of mainstream service systems within our communities, and the subsequent reluctance of our families and communities to engage with these systems out of fear that this will result in unwanted surveillance and intrusion, including the removal of our children from our families.
  • Australia’s First Peoples have a strong positive tradition of inclusion of persons with disability within our families and communities. We have never, and do not now, see our family and community members with disability as outsiders. This is a major source of strength. The inclusion of people with disability within Aboriginal and Torres Strait Islander communities can be demonstrated in the ABS data.
  • We are capable of, and ready to do, the work that is necessary to overcome the disadvantage experienced by Aboriginal and Torres Strait Islanders with disability. We call upon government and the wider Australian community and our governments to recognise and support our capabilities to do so.

Key priorities and strategies

We also agreed as a collective to formulate a new national 10-point plan to address the unmet needs of our people with disability. The plan will be launched later in the year and the basis of this plan is:

  1. The establishment and resourcing of an Aboriginal Community Controlled Disability Service Sector for the provision of disability supports by Aboriginal and Torres Strait Islander people with disability for their communities;
  2. Address the systemic barriers facing Aboriginal and Torres Strait Islander people in accessing the National Disability Insurance Scheme (NDIS);
  3. Prioritise early intervention to ensure supports and services are available over the long-term;
  4. Recognise and acknowledge emerging skills and capacity within community;
  5. Resource a community-directed research strategy which specifically focuses on Aboriginal and Torres Strait Islander disability;
  6. Peer to peer leadership; that is Aboriginal and Torres Strait Islander people with disability leading the engagement with community themselves;
  7. Develop and implement an access to justice strategy for First People with disability, particularly those with cognitive impairment and intellectual disability;
  8. Creating an inclusive education, employment and economic opportunity for Aboriginal people with disability as well as creating opportunities for employment for Aboriginal people more broadly in the disability sector;
  9. Recognising that not all people with disability will be eligible for the NDIS, and ensuring that appropriate companion schemes and services are available and accessible for Aboriginal and Torres Strait Islander people over the long-term;
  10. Develop strategies to address the detrimental effects upon the health and wellbeing of Aboriginal and Torres Strait Islander people with disability who experience the combined effects of racism and ableism.

In conclusion, we acknowledged that common goals, and respectful partnerships such as those within the Redfern Statement alliance and between FPDN and governments are key to achieving the outcomes outlined above. Together we must stay the course.

Documents in PDF format:

Redfern Statement Disability Workshop Communique May 2017.