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 #CarersGateway : Free online resources to support #Aboriginal #carers

It’s rewarding work, but without help Dolly finds herself emotionally and physically drained. Dolly reached out and found that she could get services to help her.

Like Dolly, millions of people in Australia care for others who need help with their everyday lives.

A carer may be someone who looks after their husband or wife, partner, grandparent, uncle, aunty, cousin, child, grandchild or any other family member, a neighbour, a friend or someone in their community who needs help.

Everyone’s situation is different. Some carers look after someone who is an older person or who is unwell or has difficulties getting around. Some carers may look after someone who has a disability, a mental illness or dementia, a chronic condition or a long-term illness or drug and alcohol problems.

Many people looking after someone else don’t think of themselves as carers. They just see caring as what they do to help their families or friends or people in their communities.

Carers need help too – someone they can talk to and find out about services that can help. Carer Gateway is a free, Australian Government funded service that provides information for carers and helps people get in touch with their local services. People can ring up and have a private chat or go online and find out about support in their area, free financial and legal help and what to do in emergencies.  They can also get tips on how to look after themselves so they don’t get burnt out while caring for someone else.

Carer Gateway has short videos about real-life carers in the community – showing how they cope and deal with problems – and how they make the most of the time they spend caring for someone in need.

The videos include Dolly’s story. Dolly is a mother and full-time carer for her two adult daughters, who both need support with their everyday needs.

“It’s pretty much 24/7 around the clock. Four years ago, I realised I was doing a care role and I was also a working mum so quite busy. I thought you know what, it’s time for me to step back and start looking after my own,” she said.

There are free online resources to support Aboriginal carers, including a guided relaxation audio recording and information brochures and posters for use by health and community groups  which can also be ordered from the Carer Gateway ordering form and a Carer Gateway Facebook page to keep up to date on services and supports for carers.

To find out more, Carer Gateway can be contacted on 1800 422 737, Monday to Friday between 8am and 6pm,

or by visiting carergateway.gov.au

You can join the Carer Gateway Facebook community by visiting https://www.facebook.com/carergateway/

 

 

 

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

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

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

The prevalence of disability amongst Aboriginal and Torres Strait Islanders is significantly higher than the general population. The Productivity Commission’s Overcoming Indigenous Disadvantage Report released mid- November 2014, highlighted that almost half of the Aboriginal and Torres Strait Islander population have some form of disability or long term health condition, twice the prevalence of disability experienced by other Australians.

The First Peoples Disability Network (FPDN) welcomes the implementation of the National Disability Insurance Scheme and recognises its huge potential to provide Aboriginal and Torres Strait Islander people greater access to disability support “

Damian Griffis is the CEO of the First Peoples Disability Network, an national organisation of and for Aboriginal and Torres Strait Islander people, families and communities with lived experience of disability.

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

See full article here or 2 below

  ” The National Disability Insurance Scheme (NDIS) is the most significant policy reform for people with a disability since the Disability Services Act 1986 (DSA). The NDIS has proven potential to enable people with disabilities to live good lives.

The National Disability Insurance Agency (NDIA) reports that around 5% of NDIS participants are of Indigenous heritage.

The NDIA has branded the new scheme as a way of expanding individual and family choice in the services and supports people with disabilities can access. As we have noted previously, individual ‘choice’ requires ‘opportunities’ to exist in local communities. The more remote or rural a community the fewer opportunities available. As such, limited ‘opportunities’ in communities lead to limited ‘choice’ for Indigenous people with disability on NDIS plans who live in rural or remote communities.”

Dr John Gilroy and Associate Professor Jennifer Smith-Merry’s 

Originally published in Croakey  see full article 1 below

Dr John Gilroy is a Koori man from the Yuin Nation, and a doctor of sociology in Indigenous health, specialising in disability studies.

Every Australian Counts

NDIS: Your Questions Answered

The NDIS was launched in trial sites on 1 July 2013. The Scheme is being progressively rolled out over the next few years across Australia. In each State or Territory, the roll out will be staged to ensure the transition is as smooth as possible. Everyone who needs the NDIS will have access by 2020.

Download the Every Australian Counts NDIS: Your Questions Answered

NDIS your Questions answered Download

Endeavour Foundation Discover. This guide has been developed for individuals, families and people with an intellectual disability who are about to navigate the National Disability Insurance Scheme (NDIS).Note not an NDIS publication

NDIS 168 Page

What is the NDIS?

The existing disability system throughout Australia is inefficient, fragmented, unfair, underfunded and leaves most people with disability without the support they need. Plus, people with disability and their families don’t get enough say in the type of supports they receive.

The NDIS stands for the National Disability Insurance Scheme. It’s a new government policy that aims to transform the way Australia supports people with permanent and significant disability.

The foundations of the NDIS are built on two key pillars:

It’s a universal system. The NDIS is a national program similar to Medicare. It will provide supports to all eligible Australians ensuring people with disability and their families get the support they need when they need it.

It’s about more choice and control. The NDIS is based on the idea that people with disability and their families should be empowered to set their own goals and choose their own supports. This is achieved by giving them control over their own support budget.

Will the NDIS mean more or less support?

Under the existing disability system around 220,000 Australians receive funded disability supports. Under the NDIS approximately 460,000 people will receive funded supports, and the average support package will almost double from $18,000 to $35,000.

The NDIS is about making sure you have the right support in the right place at the right time to help you participate in the community and economy. If your needs change over time, you can have your plan reviewed and level of support adjusted. You will have complete choice and control over what’s in your plan and who provides your supports so you can make the most of your package.

Is the NDIS diagnosis based or needs based?

Needs based. The NDIS does not have a list of conditions that automatically include or exclude you from support. It’s based on what you need to live a full life, and how much your disability affects your ability to carry out everyday activities. In the case of children, it’s about whether a disability is likely to be permanent or result in a developmental delay.

This is a big change from the existing system where children without a diagnosis often miss out on funding or their parents are forced to lie about their disability to get support.

Am I eligible for the NDIS?

To access the NDIS you must:

have a significant and permanent disability – this includes people with psychosocial disability

be an Australian citizen, permanent resident or a New Zealand citizen on a Protected Special Category Visa

enter the Scheme before you turn 65.

If you’re unsure whether you meet the above criteria, a good yardstick is if you’re currently receiving funded support, you can expect to be eligible for the NDIS. For individuals who may benefit from early intervention, the eligibility criteria to access the NDIS is more flexible.

Where is the NDIS available now?

The NDIS is being introduced in stages throughout Australia. Existing service users and new participants will enter the scheme progressively. Full scheme transition began in July 2016 in many parts of Australia. There’s still a few more years until it will be here for everyone. The best way to find out when the NDIS is coming to you is by visiting the government’s website: www.ndis.gov.au

As the NDIS rolls out, local offices will open. Here are the current office locations:

Australian Capital Territory

Offices in:

Belconnen, Braddon, Tuggeranong and Woden

New South Wales

Offices in:

Bankstown, Batemans Bay, Bega, Blacktown, Campbelltown, Charlestown, Chatswood, Gosford, Katoomba, Liverpool, Maitland, Moree, Newcastle, Parramatta, Penrith, Tamworth, Taree and Windsor.

Northern Territory

Office in:

Tennant Creek

Queensland

Charters Towers, Palm Island and Townsville

South Australia

Offices in:

Elizabeth, Modbury, Murray Bridge, Noarlunga, Port Adelaide and St Marys

Tasmania

Offices in:

Devonport, Hobart and Launceston

Victoria

Offices in:

Colac, Corio, Darebin, Geelong and Greensborough

Western Australia

Midland

What supports does the NDIS cover?

The types of supports you might get include therapies such as physiotherapy, mobility and technological aids and home modifications.

And it’s not just about covering the ‘essentials’ – your plan could include things such as recreational activities, developing skills like shopping or cooking and help with finding a job. No two people are exactly the same, so neither are the supports in their plan. The NDIS is about you living the life you want – not just getting by.

Some of the supports the NDIS will cover include:

Transport assistance

Therapies

Guide & assistance dogs

Case management

Crisis/emergency support

Personal care

Support for community inclusion

Respite

Specialist employment services

Specialist housing support

Domestic assistance

Aids, equipment, home & vehicle modifications

How does the NDIS process work?

Step one to accessing the NDIS is to find out if you are eligible. Remember, under the new system more people with disability will receive funded supports than ever before. If you are already using disability services and supports you will be contacted by the NDIS or a representative when it’s time to transition. Others may need to present proof of disability such as a statement from your doctor explaining your disability and how it affects your life. The Access checklist on the NDIS website is a good place to start; http://www.myplace.ndis.gov.au/ndisstorefront/ndis-access-checklist

Step two is to start the planning process by talking to the NDIS or one of their representatives. The idea is to talk through your support needs and goals together and come up with the best ways that are reasonable and necessary to meet these goals. And you don’t have to do it alone – you can invite a family member or friend or support worker to come along too. Together with the planner you will develop a support package.

Every Australian Counts tip: Think about your planning meeting as the chance to get the most out of your NDIS support package – the more time you spend preparing, the better your plan will be. So before your meeting, think about what you’ll need to live the life you want. It can also be helpful to chat to your family and carers about what’s missing in your current supports, activities and plans.

I have an NDIS plan. What’s next?

At your NDIS planning meetings you will come up with how to put your plan into action. Most importantly, that means coming up with the supports and services you need to live your life to the full.

This means that for the first time ever, you can decide exactly where your supports come from. This can be through the service providers you’re using now, finding completely new ones, or even self-managing your supports – it’s completely up to you!

If you disagree with an NDIS assessment or are unhappy with your support package, you have the right to ask for a review from the NDIS. You also have the right to get an advocate, friend or independent representative to help you out in this process.

Every Australian Counts tip: The NDIS was set up to give you the power to choose your own supports and service providers. You can do your own research or get help from advice and advocacy organisations. It can also be useful to talk to other people with disability, family members or carers about what works or doesn’t work for them. Remember, your plan is not a one-off decision. If or when your needs change, so can your plan.

When will the NDIS be here for all Australians?

The NDIS will be here for all Australians who need it (460,000 people) no later than 30 June 2019. Rollout information and timetables can be found online: www.ndis.gov.au

Ten ways the NDIS will benefit all Australians.

It’s a national system. If you, or someone you love, is born with a disability or acquires one later in life, you all no longer run the risk of falling through holes in Australia’s safety net based on what state or territory you live in.

People with a disability and their families and carers can participate in the social, economic, and cultural life of the nation with the supports and programs they choose.

Families will be able to access support and services for assistance in meeting the needs of their family member with a disability, reducing physical, emotional and financial stress.

The NDIS is based on equality. You will be able to equally access existing services regardless of when and where your disability was acquired.

There will no longer be an expectation of unpaid care as the norm.

As a Medicare-type system, the NDIS will provide people with a disability and their families and carers with the regular care, support, therapy and equipment they need from a secure and consistent pool of funds for these services and support.

It focuses on early intervention and delivering supports which produce the best long term outcomes, maximising opportunities for independence, participation and productivity.

Each NDIS plan is individualised and person-centred. Support is based on the choices of the person with a disability and their family.

The NDIS is fiscally responsible. It is not welfare but an investment in individual capacity leading to more positive results for people with a disability, their families and carers.

All Australians benefit from the NDIS because disability can affect anyone, anytime. Everyone will benefit from a more inclusive, more diverse community. Every Australian Counts will keep you up to date with all the NDIS news, information, stories and experience on our website; everyaustraliancounts.com.au

Where can I find out more?

For Aboriginal and Torres Strait Islanders

http://fpdn.org.au/

For everybody

www.everyaustraliancounts.com.au

The Every Australian Counts website is an online hub for the disability community that’s packed with useful information, videos and news.

www.ndis.gov.au

The official NDIS website includes an access checklist, factsheets and information to help prepare you for the NDIS.

For people with disability

www.afdo.org.au

The Australian Federation of Disability Organisations (AFDO) represents people with disability. They can connect you with advocacy support.

For carers

www.carersaustralia.com.au

Carers Australia is the national peak body representing carers. Through their website you can access carer support and services.

For disability support workers

www.ndp.org.au

Proposed Aboriginal Community Controlled Health Organisation NDIS Network

Localised, community-based services from John Gilroy article

Research shows that Aboriginal community controlled organisations are an essential component of addressing the health and social needs of Indigenous communities. In a recent review of existing community-based mental health services, Jen Smith-Merry found that the services offered for Indigenous people were most successful when developed by local communities or ‘localised’ and adapted carefully (and genuinely) to community needs.

John Gilroy’s research shows the important role of Indigenous community controlled organisations in forming relationships and referral pathways to disability services. These organisations function as the “social glue” between Indigenous communities, and disability and community organisations.

Expressions of Interest

Joe Archibald the NDIS Manager at Galambila ACCHO at Coffs Harbour is looking to establish a network of ACCHO NDIS health workers :

Express interest in this group EMAIL JOE HERE

Contact

NDIS must promote and support community-based programs to meet Indigenous people’s needs.

Dr John Gilroy and Dr Jennifer Smith-Merry write:

The National Disability Insurance Scheme (NDIS) is the most significant policy reform for people with a disability since the Disability Services Act 1986 (DSA). The NDIS has proven potential to enable people with disabilities to live good lives.

The National Disability Insurance Agency (NDIA) reports that around 5% of NDIS participants are of Indigenous heritage.

The NDIA has branded the new scheme as a way of expanding individual and family choice in the services and supports people with disabilities can access. As we have noted previously, individual ‘choice’ requires ‘opportunities’ to exist in local communities. The more remote or rural a community the fewer opportunities available. As such, limited ‘opportunities’ in communities lead to limited ‘choice’ for Indigenous people with disability on NDIS plans who live in rural or remote communities.

Services, supports and capacity building

The original inquiry into the NDIS identified the importance of a balance between an individualised support system and the block-funding of services and programs to ensure efficient and effective roll-out of the NDIS. The work that we have been involved in supports this view, arguing that Indigenous people should be able to utilise services at their own pace that meet their cultural and personal needs rather than being pushed through a government imposed time-frame.

The government has released the policy framework for NDIS Information, Linkages and Capacity Building (ILC), and the subsequent Commissioning Framework. The ILC, formally Tier 2 of the NDIS, provides funding for the development of programs to help connect people with the disability, health and social supports, and services that are appropriate for them. It also supports capacity building for communities, organisations and individuals, that is not tied to a person’s individualised funding package. In doing this, it aims to also offer support for those who are not eligible for individualised funding packages.

Ensuring equal access and resourcing

There is growing concern that services for the most disadvantaged of the population of people with disabilities may become under-resourced or absent in light of the NDIS roll-out. There is much evidence that this disadvantage is heightened by geographic location, such as very remote communities. The ILC has been designed to provide the opportunity for the needs of these groups to be better met, but only if there is a proactive prioritisation of their needs.

Informed by several of our existing research and community projects, below we present some recommendations for the government, regarding the types of block-funded programs and services needed in local Indigenous communities to ensure that they benefit from the NDIS roll-out.

We preface these recommendations with the observation that there is a big problem with the implementation of the ILC, as the funding has been severely curtailed in its first stages. Bruce Bonyhady, former chair of the NDIS, warns that the current funding for community inclusion programs is: “not sufficient and means that one of the key foundations on which the NDIS is being built is weak”. This funding gap needs to be addressed immediately as there will be significant benefit to indigenous communities if the funding targets appropriate areas.

Crisis Intervention Services

Disability services providers have reported that many Indigenous people engage in the formal services system only when the quality or quantity of family and kinship care is depleted. As such, a large proportion of Indigenous people engage in the disability services sector when in a crisis situation.

Crisis services should be made more disability inclusive, and should act as a channel for encouraging the utilisation of appropriate individualised funding package supports. Targeted capacity building programs are also needed, to enable families and kinship groups to provide support. Such programs should be individualised and culturally and contextually appropriate. Block-funded models enable organisations that have established rapport with communities, to deliver such services in a culturally appropriate manner.

Transition support services

While many Indigenous people only engage with services at times of crisis, the impact of the services provided during crises can be sustained as the crisis abates. The most effective way of doing this is by supporting individualised transition support services which help people to re-establish their lives. This could involve connecting people with appropriate individualised support packages or funding of ‘peer support’ or community buddy programs.

Case Management and advocacy services.

Some bureaucrats wrongly use the terms “case management” and “advocacy” synonymously. The major difference between these two service types is that formal advocates are called upon when a person feels that their human rights have been violated. In comparison, case managers are typically called upon to assist people to join up services and supports by navigating the complex bureaucracy of the formal service systems, including health and disability.

It is pivotal to have a balance of these two service types under the NDIS to enable people with disabilities access to supports that foster the protection of their human rights and enable them to navigate the NDIS bureaucracy.

Early Childhood Intervention

There is limited research focused on the needs of Indigenous children with disability. A recent study found that young children with cognitive impairment are at risk of social exclusion, and need interventions to promote inclusion in family and cultural events as they age.

The government has identified early childhood intervention (ECI) as an area for block-funding investment, in recognition that the market-based principles of the NDIS could not work for this service type. ILC block funding can be used for early intervention and allows novel or creative community-based solutions to develop. This will allow the development of services which may meet local needs but are not ‘standard’ service types. Evidence-based practice is great if the evidence is there, but it should not be a straight-jacket, limiting what is possible.

Localised, community-based services

Research shows that Aboriginal community controlled organisations are an essential component of addressing the health and social needs of Indigenous communities. In a recent review of existing community-based mental health services, Jen Smith-Merry found that the services offered for Indigenous people were most successful when developed by local communities or ‘localised’ and adapted carefully (and genuinely) to community needs.

John Gilroy’s research shows the important role of Indigenous community controlled organisations in forming relationships and referral pathways to disability services. These organisations function as the “social glue” between Indigenous communities, and disability and community organisations.

Workforce Training and Development

The efficiency and effectiveness of the NDIS requires a healthy, vibrant workforce. There are many reports examining what the disability services workforce looks like. However, the roll out of the NDIS will completely reshape the workforce.

National Disability Services are managing a workforce development fund to explore ways to build a workforce that can sustain the NDIS. NDS will need to explore ways to build the number and proportion of Indigenous people working in the sector and also explore successful ways to build a workforce that is culturally competent in supporting Indigenous people and their families.

The CEO of First Peoples Disability Network, Damian Griffis, told ABC Lateline in 2015 that Indigenous people are already working as informal disability workers, stating “There are a lot of Indigenous people that by any other definition would be called support workers today, but they need to be valued and respected for that work and they are already in existence.”

Research shows that over 10% of Indigenous people have provided unpaid assistance to a person with a disability. Agencies could pilot approaches to recruit and train family members that balance people’s human rights with individual duty-of-care in the context of the NDIS.

Translation and Interpreter Services

There are many regions of Australia where the English is a second or third language. Notwithstanding that, there are many Indigenous peoples who require hearing or communication supports. Interpreter and translation services are under-resourced and in high need across the country. It would be discriminatory for NDIS users to have to use their packages to access these service types as this would deplete the funding available for other services in comparison with other NDIS participants. These services should instead be funded at a community level either through the ILC or a specialised program.

Foster Social and Cultural Capital Building

There exists plethora of research showing the important role played by Indigenous community controlled organisations in the health and community services sector. Such organisations provide the opportunities needed to bring together Indigenous people with disability to have their voices heard as a collective. For example, the many NDIS specific gatherings around Australia have brought together Indigenous people with disability to share their stories and experiences. This knowledge should be valued and harnessed. One way that this could take place is through ILC funding of community-based peer-support programs.

The roll out of the NDIS has enabled Indigenous community controlled organisations and services to continue working in local communities. Such organisations and services are being supported to provide services and supports under the NDIS in NSW. Block-funding will enable Aboriginal community controlled organisations to continue their role in representing their communities whilst supporting NDIS participants.

Interagency Networks and Engagement

Jen Smith-Merry’s Research to Action Guide produced for the Centre for Applied Disability Research showed that interagency forums do help with linking across organisations and sectors, but that this is most effective when it happens organically and collaboratively rather than being mandated. Through sharing stories and good practice, interagency forums help disparate actors to understand the different practices and knowledges operating in sectors outside of their own.

 There is evidence of a conflict at the interface of the formal service system and Indigenous communities in how disability is defined and conceptualised. A recent report concluded that many Indigenous people find the definition of disability to be stigmatising. Rather than trying to ascertain how Indigenous peoples define disability, the focus of scholarly exploration should be on ways to bridge the cultural interface in how disability is defined and embodied as a social construct.

Great work has been undertaken by National Disability Services, to foster relationship building between the disability services sector and local Indigenous programs, by implementing the principles of interagency commissioning. Sadly, the government did not extend the funding for these networks to continue. This is a significant problem that won’t be immediately fixed by an underfunded ILC.

A healthy balance

The NDIS is a huge win for the disability rights movement. The new scheme provides an opportunity to address the equality and equity gaps between Indigenous and non-Indigenous people with disabilities. However, there needs to be a balance between block-funding and the individualised packages provided by the NDIS, so that the scheme can meet its full potential. The examples given here provide some ideas for how ILC funding might work, but only dialogue with consumers and communities will point us truly in the right direction.

*Dr John Gilroy is a Koori man from the Yuin Nation, and a doctor of sociology in Indigenous health, specialising in disability studies. He is a Senior Lecturer and Indigenous Stream Lead at the Centre for Disability Research and Policy, University of Sydney

*Associate Professor Jennifer Smith-Merry’s research focuses on the implementation of policy in service settings, and consumer experiences of this. She is Mental Health Stream Lead at the Centre for Disability Research and Policy, The University of Sydney.

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

Introduction

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 #IWD2017 Aboriginal Women’s #justjustice :Indigenous, disabled, imprisoned – the forgotten women of #IWD2017

 

” Merri’s story is not uncommon. Studies show that women with physical, sensory, intellectual, or psychosocial disabilities (mental health conditions) experience higher rates of domestic and sexual violence and abuse than other women.

More than 70 per cent of women with disabilities in Australia have experienced sexual violence, and they are 40 per cent more likely to face domestic violence than other women.

Indigenous women are 35 times more likely to be hospitalised as a result of domestic violence than non-Indigenous women. Indigenous women who have a disability face intersecting forms of discrimination because of their gender, disability, and ethnicity that leave them at even greater risk of experiencing violence — and of being involved in violence and imprisoned

Kriti Sharma is a disability rights researcher for Human Rights Watch

This is our last NACCHO post supporting  International Women’s Day

Further NACCHO reading

Women’s Health ( 275 articles )  or Just Justice  See campaign details below

” In-prison programs fail to address the disadvantage that many Aboriginal and Torres Strait Islander prisoners face, such as addiction, intergenerational and historical traumas, grief and loss. Programs have long waiting lists, and exclude those who spend many months on remand or serve short sentences – as Aboriginal and Torres Strait Islander people often do.

Instead, evidence shows that prison worsens mental health and wellbeing, damages relationships and families, and generates stigma which reduces employment and housing opportunities .

To prevent post-release deaths, diversion from prison to alcohol and drug rehabilitation is recommended, which has proven more cost-effective and beneficial than prison , International evidence also recommends preparing families for the post-prison release phase. ‘

Dying to be free: Where is the focus on the deaths occurring post-prison release? Article 1 Below

Article from Page 17 NACCHO Aboriginal Health Newspaper out Wednesday 16 November , 24 Page lift out Koori Mail : or download

naccho-newspaper-nov-2016 PDF file size 9 MB

As the world celebrates International Women’s Day, this week  I think of ‘Merri’, one of the most formidable and resilient women I have ever met.

A 50-year-old Aboriginal woman with a mental health condition, Merri grew up in a remote community in the Kimberley region of Western Australia. When I met her, Merri was in pre-trial detention in an Australian prison.

It was the first time she had been to prison and it was clear she was still reeling from trauma. But she was also defiant.

“Six months ago, I got sick of being bashed so I killed him,” she said. “I spent five years with him [my partner], being bashed. He gave me a freaking [sexually transmitted] disease. Now I have to suffer [in prison].”

I recently traveled through Western Australia, visiting prisons, and I heard story after story of Indigenous women with disabilities whose lives had been cycles of abuse and imprisonment, without effective help.

For many women who need help, support services are simply not available. They may be too far away, hard to find, or not culturally sensitive or accessible to women.

The result is that Australia’s prisons are disproportionately full of Indigenous women with disabilities, who are also more likely to be incarcerated for minor offenses.

For numerous women like Merri in many parts of the country, prisons have become a default accommodation and support option due to a dearth of appropriate community-based services. As with countless women with disabilities, Merri’s disability was not identified until she reached prison. She had not received any support services in the community.

Merri has single-handedly raised her children as well as her grandchildren, but without any support or access to mental health services, life in the community has been a struggle for her.

Strangely — and tragically — prison represented a respite for Merri. With eyes glistening with tears, she told me: “[Prison] is very stressful. But I’m finding it a break from a lot of stress outside.”

Today, on International Women’s Day, the Australian government should commit to making it a priority to meet the needs of women with disabilities who are at risk of violence and abuse.

In 2015, a Senate inquiry into the abuse people with disabilities face in institutional and residential settings revealed the extensive and diverse forms of abuse they face both in institutions and the community. The inquiry recommended that the government set up a Royal Commission to conduct a more comprehensive investigation into the neglect, violence, and abuse faced by people with disabilities across Australia.

The government has been unwilling to do so, citing the new National Disability Insurance Scheme (NDIS) Quality and Safeguard Framework as adequate.

While the framework is an important step forward, it would only reach people who are enrolled under the NDIS. Its complaints mechanism would not provide a comprehensive look at the diversity and scale of the violence people with disabilities experience, let alone at the ways in which various intersecting forms of discrimination affect people with disabilities.

The creation of a Royal Commission, on the other hand, could give voice to survivors of violence inside and outside the NDIS. It could direct a commission’s resources at a thorough investigation into the violence people with disabilities face in institutional and residential settings, as well as in the community.

The government urgently needs to hear directly from women like Merri about the challenges they face, and how the government can do better at helping them. Whether or not there is a Royal Commission, the government should consult women with disabilities, including Indigenous women, and their representative organizations to learn how to strengthen support services.

Government services that are gender and culturally appropriate, and accessible to women across the country, can curtail abuse and allow women with disabilities to live safe, independent lives in the community.

Kriti Sharma is a disability rights researcher for Human Rights Watch

 

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How you can support #JustJustice

• Download, read and share the 2nd edition – HERE.

Buy a hard copy from Gleebooks in Sydney (ask them to order more copies if they run out of stock).

• Send copies of the book to politicians, policy makers and other opinion leaders.

• Encourage journals and other relevant publications to review #JustJustice.

• Encourage your local library to order a copy, whether the free e-version or a hard copy from Gleebooks.

• Follow Guardian Australia’s project, Breaking the Cycle.

Readers may also be interested in these articles:

Aboriginal Health Events / Workshops #SaveADate : #NDIS ,#Disability #Leadership, #Rural, #Kidneys , #RHD, #Ears

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February – May   : NEW : Get NDIS Ready with a Roadshow NSW Launched

2 March  : Disability research within Aboriginal communities : Alice Springs

3 March: AMSANT: APONT Innovating to Succeed Forum – Alice Springs

3 March : The National Indigenous Youth Parliament (NIYP) applications close

5 March: Kidney Health Week Starts

14 March : Western Sydney : Aboriginal Health Services Community Forum –  Rooty Hill NSW

16 March: National Close the Gap Day

16 March Close the Gap Day VISION 2020

22 March: 2017 Indigenous Ear Health Workshop  Adelaide

29 March: RHD Australia Education Workshop Adelaide SA

26- 29 April The 14 th National Rural Health Conference Cairns

29 April:14th World Rural Health Conference Cairns

10 May: National Indigenous Human Rights Awards

26 May :National Sorry day 2017

2-9 July NAIDOC WEEK

If you have a Conference, Workshop or event and wish to share and promote contact

Colin Cowell NACCHO Media Mobile 0401 331 251

Send to NACCHO Media mailto:nacchonews@naccho.org.au

save-a-date

February – May   : Get NDIS Ready with a Roadshow NSW Launched

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The Every Australian Counts team will be hitting the road from March – May presenting NDIS information forums in the NSW regional areas where the NDIS will be rolling out from July.

We’ll be covering topics including:

  • What the NDIS is, why we need it and what it means for you
  • The changes that the NDIS brings and how they will benefit you
  • How to access the NDIS and get the most out of it

These free forums are designed for people with disability, their families and carers, people working in the disability sector and anyone else interested in all things NDIS.

Please register for tickets and notify the team about any access requirements you need assistance with. All the venues are wheelchair accessible and Auslan interpreters can be available if required. Please specify any special requests at the time of booking.

Find the team in the following locations: 

Click on a link above to register online now! 

Every Australian Counts is the campaign that brought about the introduction of the National Disability Insurance Scheme.

Now it is a reality, the team are focused on engaging and educating the disability sector and wider Australian community about the benefits of the NDIS and the options and possibilities that it brings.

 2 March  : Disability research within Aboriginal communities : Alice Springs

Dr John Gilroy, a Koori man from the Yuin Nation of the the South Coast of New South Wales, will be presenting a seminar on disability research in Aboriginal communities in the Rubuntja Building, at the Alice Springs Hospital, Northern Territory (NT), on Thursday 2 March 2017 from 12pm – 1pm.

John, a senior lecturer at the University of Sydney (USYD) and a member of the Poche research family will present his journey from being a client of disability services to becoming one of the leading scholars in disability research within Aboriginal communities. His discussion will touch on disability research and scholarship undertaken with Aboriginal people and its implications for the National Disability Insurance Scheme, including the current disability research projects underway with the Anangu of the Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) lands

There are limited seats and registration is required, so book by email using contact below.

Contacts

Poche Centre for Indigenous Health and Well-being
Ph: (08) 8951 9601
Email:

3 March : The National Indigenous Youth Parliament (NIYP) applications close

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Is your chance to come to Canberra, meet Australia’s leaders, learn about democracy and have your say on important issues. Fifty young Aboriginal and/or Torres Strait Islander people will be selected, six from each state and territory and two from the Torres Strait, to come to Canberra for the week-long program

Aboriginal and/or Torres Strait Islander people aged 16 to 25 years who are willing to stand up and speak about important issues, work as part of a team, travel to new places, meet new people and learn.

How do I apply?

Complete and submit the online application form below. Applications close Friday 3 March 2017.

Please contact us if you do not receive an email confirmation of your application within 3 days. The AEC accepts no responsibility for lost, damaged or late applications.

All information you provide in your application is managed and stored appropriately in accordance with the Privacy Act 1988.

Letter of support

All applications must include a letter of support from your teacher or tutor, employer, coach, youth worker, community leader, family friend or other referee. The letter of support should support the claims made in your application and explain why you are suitable for the NIYP.

Tips for completing this form

  • Write your answers on a document saved to your computer first in case your connection is lost.
  • Have a scanned copy of your letter of support ready to upload with your application.
  • Contact us if you don’t receive an email confirmation within 3 days of submitting this form to make sure we received it.
Apply online now

3 March: AMSANT: APONT Innovating to Succeed Forum – Alice Springs

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Following our successful 2015 AGMP Forum we are pleased to announce the second AGMP Forum will be held at the Alice Springs Convention Centre on 3 March from 9 am to 5 pm. The forum is a free catered event open to senior managers and board members of all Aboriginal organisations across the NT.

Download the Program

program-apont-innovating-to-succeed-forum-3-mar-2017

Come along to hear from NT Aboriginal organisations about innovative approaches to strengthen your activities and businesses, be more sustainable and self-determine your success. The forum will be opened by the Chief Minister and there will be opportunities for Q&A discussions with Commonwealth and Northern Territory government representatives.

To register to attend please complete the online registration form, or contact Wes Miller on 8944 6626, Kate Muir on 8959 4623, or email info@agmp.org.au.

5 March: Kidney Health week

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is nearly here! Learn how you can get involved this 5-11 March, and order your free event pack:

14 March : Western Sydney : Aboriginal Health Services Community Forum –  Rooty Hill NSW

WACHS invites Aboriginal community representatives from Western Sydney and the Nepean Blue Mountains region to meet to discuss future directions for Aboriginal health.

Topics will include:

  • Wellington Aboriginal Corporation Health Service (WACHS)
    – History and background
    – Service support
    – Service programs
  • Western Sydney and Nepean Blue Mountains Project: Service Delivery
    – Funding agreement
    – Structure and staffing
    – Financial and risk management
  • Western Sydney and Nepean Blue Mountains Project: Service Support
    – Community engagement and consultation
    – Infrastructure
    – Identity and recognition

pdfDownload flyer

More information: Anthony Carter, anthonyc@wachs.net.au

Forum transport registration: Rita McKenzie, rita.mckenzie@swahs.com.au

Source

Wellington Aboriginal Corporation Health Service
Aboriginal Health Services Community Forum
14 March 2017, 10.00am–1.00pm
Novotel Hotel, 33 Railway St, Rooty Hill

Cost: Free

16 March Close the Gap Day

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Aboriginal and Torres Strait Islander Peoples die 10-17 years younger than other Australians and it’s even worse in some parts of Australia. Register now and hold an activity of your choice in support of health equality across Australia.

Resources

Resource packs will be sent out from 1 February 2017.

We will also have a range of free downloadable resources available on our website

www.oxfam.org.au/closethegapday.

It is still important to register as this contributes to the overall success of the event.

More information and Register your event

16 March Close the Gap Day VISION 2020

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Indigenous Eye Health at the University of Melbourne would like to invite people to a two-day national conference on Indigenous eye health and the Roadmap to Close the Gap for Vision in March 2017. The conference will provide opportunity for discussion and planning for what needs to be done to Close the Gap for Vision by 2020 and is supported by their partners National Aboriginal Community Controlled Health Organisation, Optometry Australia, Royal Australian and New Zealand College of Ophthalmologists and Vision 2020 Australia.

Collectively, significant progress has been made to improve Indigenous eye health particularly over the past five years and this is an opportunity to reflect on the progress made. The recent National Eye Health Survey found the gap for blindness has been reduced but is still three times higher. The conference will allow people to share the learning from these experiences and plan future activities.

The conference is designed for those working in all aspects of Indigenous eye care: from health workers and practitioners, to regional and jurisdictional organisations. It will include ACCHOs, NGOs, professional bodies and government departments.

The topics to be discussed will include:

  • regional approaches to eye care
  • planning and performance monitoring
  • initiatives and system reforms that address vision loss
  • health promotion and education.

Contacts

Indigenous Eye Health – Minum Barreng
Level 5, 207-221 Bouverie Street
Melbourne School of Population and Global Health
The University of Melbourne
Carlton Vic 3010
Ph: (03) 8344 9320
Email:

Links

22 March2017 Indigenous Ear Health Workshop  in Adelaide

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The 2017 Indigenous Ear Health Workshop to be held in Adelaide in March will focus on Otitis Media (middle ear disease), hearing loss, and its significant impact on the lives of Indigenous children, the community and Indigenous culture in Australia.

The workshop will take place on 22 March 2017 at the Adelaide Convention Centre in Adelaide, South Australia.

The program features keynote addresses by invited speakers who will give presentations aligned with the workshop’s main objectives:

  • To identify and promote methods to strengthen primary prevention and care of Otitis Media (OM).
  • To engage and coordinate all stakeholders in OM management.
  • To summarise current and future research into OM pathogenesis (the manner in which it develops) and management.
  • To present the case for consistent and integrated funding for OM management.

Invited speakers will include paediatricians, public health physicians, ear nose and throat surgeons, Aboriginal health workers, Education Department and a psychologist, with OM and hearing updates from medical, audiological and medical science researchers.

The program will culminate in an address emphasising the need for funding that will provide a consistent and coordinated nationwide approach to managing Indigenous ear health in Australia.

Those interested in attending may include: ENT surgeons, ENT nurses, Aboriginal and Torres Strait Islander health workers, audiologists, rural and regional general surgeons and general practitioners, speech pathologists, teachers, researchers, state and federal government representatives and bureaucrats; in fact anyone interested in Otitis Media.

The workshop is organised by the Australian Society of Otolaryngology Head and Neck Surgery (ASOHNS) and is held just before its Annual Scientific Meeting (23 -26 March 2017). The first IEH workshop was held in Adelaide in 2012 and subsequent workshops were held in Perth, Brisbane and Sydney.

For more information go to the ASOHNS 2017 Annual Scientific Meeting Pre-Meeting Workshops section at http://asm.asohns.org.au/workshops

Or contact:

Mrs Lorna Watson, Chief Executive Officer, ASOHNS Ltd

T: +61 2 9954 5856   or  E info@asohns.org.au

29 March: RHDAustralia Education Workshop Adelaide SA

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Download the PDF brochure sa-workshop-flyer

More information and registrations HERE

26- 29 April The 14 th National Rural Health Conference Cairns c42bfukvcaam3h9

INFO Register

29 April : 14th World Rural Health Conference Cairns

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The conference program features streams based on themes most relevant to all rural and remote health practitioners. These include Social and environmental determinants of health; Leadership, Education and Workforce; Social Accountability and Social Capital, and Rural Clinical Practices: people and services.

Download the program here : rural-health-conference-program-no-spreads

The program includes plenary/keynote sessions, concurrent sessions and poster presentations. The program will also include clinical sessions to provide skill development and ongoing professional development opportunities :

Information Registrations HERE

10 May: National Indigenous Human Rights Awards

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” The National Indigenous Human Rights Awards recognises Aboriginal and Torres Strait Islander persons who have made significant contribution to the advancement of human rights and social justice for their people.”

To nominate someone for one of the three awards, please go to https://shaoquett.wufoo.com/forms/z4qw7zc1i3yvw6/
 
For further information, please also check out the Awards Guide at https://www.scribd.com/document/336434563/2017-National-Indigenous-Human-Rights-Awards-Guide
26 May :National Sorry day 2017
 
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The first National Sorry Day was held on 26 May 1998 – one year after the tabling of the report Bringing them Home, May 1997. The report was the result of an inquiry by the Human Rights and Equal Opportunity Commission into the removal of Aboriginal and Torres Strait Islander children from their families.
2-9 July NAIDOC WEEK
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The importance, resilience and richness of Aboriginal and Torres Strait Islander languages will be the focus of national celebrations marking NAIDOC Week 2017.

The 2017 theme – Our Languages Matter – aims to emphasise and celebrate the unique and essential role that Indigenous languages play in cultural identity, linking people to their land and water and in the transmission of Aboriginal and Torres Strait Islander history, spirituality and rites, through story and song.

More info about events

save-a-date

NACCHO Aboriginal Health Newspaper and NDIS : National Disability Insurance Scheme (NDIS) set to transform the lives of Aboriginal people living with a disability.

ndis

It’s great to be employed here because having a disability, I have a lot of knowledge to offer and I can be a strong advocate for locals because everyone knows me around here,” she said with a laugh.

This job means a lot to me. I really feel like I’m contributing. “

Stella Raymond, a proud Indigenous woman born and raised in Alice Springs, is the ‘face’ of the NDIS office in Tennant Creek.  See Case Study Below :

Articles are from Page 19  NACCHO Aboriginal Health Newspaper out Wednesday 16 November , 24 Page lift out Koori Mail : or download

naccho-newspaper-nov-2016 PDF file size 9 MB

The National Disability Insurance Scheme, commonly referred to as the NDIS, is set to transform the lives of Aboriginal and Torres Strait Islander people living with a disability.

The NDIS will provide all Australians under the age of 65 who have a permanent and significant disability with the reasonable and necessary supports they need to enjoy an ordinary life. NDIS participants include people with intellectual, physical, sensory and psychosocial disabilities.

It will help people with disability achieve their goals; whether it be greater independence, community involvement, employment and improved wellbeing.

Supports funded by the NDIS may include personal care and support, access to the community, therapy services and essential equipment.

The NDIS will progressively roll out across Australia over the next three years to ensure the Scheme is successful and sustainable. People will move to the NDIS at different times depending on where they live.

The NDIS is already transforming lives in the Barkly region in the Northern Territory, and from January 2017, will start to roll out in East Arnhem. Ultimately the Scheme will support more than 6,500 people across the Territory.

Once fully implemented , the NDIS is expected to support 460,000 people nationwide.

Staff from the National Disability Insurance Agency (NDIA) have worked with Aboriginal elders and community members to roll out the Scheme in Indigenous communities, which has been vital to building local understanding and ownership. Seventy five per cent of NDIA staff working in the Barkly region are Indigenous, including Stella Raymond.

National Disability Insurance Agency Chief Executive Officer David Bowen, said that the Scheme was much-welcomed by people with disability, their families and carers.

“The NDIS is exciting because, at long last, people with disability will have choice and control over the supports they need to live an ordinary life,” Mr Bowen said

“The Scheme is revolutionising the way we support people with disability in Australia – for the first time, all Australians with disability will have equity of access to support, no matter where they live.”

To become an NDIS participant, you must meet certain access criteria. For more information, contact the NDIS on 1800 800 110 or visit www.ndis.gov.au

Case study: Stella Raymond

Stella Raymond, a proud Indigenous woman born and raised in Alice Springs, is the ‘face’ of the NDIS office in Tennant Creek. Known for her smiling and welcoming demeanour, Stella was one of the first NDIS participants in the Northern Territory and later got a job with the NDIA.

“I’ve been an NDIS participant since the Scheme started here in the NT two years ago, and I’ve been working for the NDIS for 11 months now,” Stella said. “It’s been great. I’m a Business Support Officer. I do all the receptionist/admin work – I answer phones, check emails and I help my colleagues out when they need a hand.’

“The NDIS has helped me out with my new wheelchair. It will have automatic wheels and it’s going to make it a lot easier to get around,” Stella said.

“It’s great to be employed here because having a disability, I have a lot of knowledge to offer and I can be a strong advocate for locals because everyone knows me around here,” she said with a laugh.

“This job means a lot to me. I really feel like I’m contributing.

“At home, and right through school, I’ve been treated just like everyone else,” Stella said. “I’ve had a really great life and I have no regrets but it’s nice to have a great job at the NDIS and to know, as a participant, I’m covered by the Scheme for li

Learn more about these NACCHO programs  at the  NACCHO Members Conference in Melbourne

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1. NACCHO Interim 3 day Program has been released -Download
2. The dates are fast approaching – so register today

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NACCHO #NTRC Royal Commission and Aboriginal Health : #FASD , Malnutrition, hearing and #mentalhealth are major factors

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 ” The profoundly damaging consequences of heavy drinking by pregnant women, malnutrition in early childhood and intergenerational “psychic trauma” are neither properly diagnosed nor treated in Aborigines coming into contact with the law, a royal commission has heard.

The effects of these conditions, which can stunt a child for life, meant affected youngsters were both more likely to become involved in criminal activity and less likely to benefit from punitive forms of rehabilitation.”

As reported in the Australian today

 ” Studies linked FAS-D to a “profound level of social morbidity in terms of violence, engagement in the justice system, depression, suicidal thoughts, suicide, very low chance of meaningful occupation and a very high risk of being in prison as adults requiring mental institution and support with drug addiction

Professor Boulton and NACCHO FASD Articles

 ” Most infants with FASD are irritable, have trouble eating and sleeping, are sensitive to sensory stimulation, and have a strong startle reflex. They may hyperextend their heads or limbs with hypertonia (too much muscle tone) or hypotonia (too little muscle tone) or both. Some infants may have heart defects or suffer anomalies of the ears, eyes, liver, or joints.

Adults with FASD have difficulty maintaining successful independence. They have trouble staying in school, keeping jobs, or sustaining healthy relationships. They require long-term support and some degree of supervision in order to succeed. “

Make FASD History  Image above a full story see below

 “Many boys caught up in the Northern Territory’s juvenile justice system suffer a “disease of disadvantage” that has crippled almost every aspect of their lives, the Northern Territory’s royal commission into youth detention and protection has heard.

Jody Barney, who works as a deaf indigenous community consultant, told the inquiry she has spoken to several young Aboriginal people with hearing impairments who have had their faces covered by spit hoods and bound behind bars.

News Report

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The Royal Commission website is available at https://www.childdetentionnt.royalcommission.gov.au.

Moreover they were perpetuating, meaning the effects could be passed through neurological and genetic means from generation to generation, the Royal Commission into the Protection and Detention of Children in the NT heard today.

The Commission looks likely to probe these effects more deeply, following depressing but insightful evidence given by University of Newcastle professor of pediatrics John Boulton, who clearly captured the commissioners’ interest.

“I think the Foetal Alcohol Spectrum Disorder issue, together with the evidence that we have had this afternoon about deafness, throws such a complexion upon the participation of so many of these children in the criminal justice system, not to mention the child protection system, that we need to look at this carefully,” Commissioner Margaret White said.

“I think it’s fairly original inasmuch as the other many reports that we’ve been exposed to … have not had an opportunity to consider these areas of study.”

Professor Boulton told the Commission there was an urgent need for FAS-D and to be recognised under the National Disability Insurance Scheme. He said estimates in Canada of the lifelong cost of treating the condition reached into the millions of dollars.

“If there are one or two per cent of the total population of whom a fraction are severely affected with FASD, and therefore suffer the huge mental health and other subsequent complications and disabilities with FASD, then we are talking about an enormous burden to the overall Australian community in the tens of millions of dollars,” he said.

Studies linked FAS-D to a “profound level of social morbidity in terms of violence, engagement in the justice system, depression, suicidal thoughts, suicide, very low chance of meaningful occupation and a very high risk of being in prison as adults requiring mental institution and support with drug addiction” Professor Boulton continued.

He likened FAS-D to the thalidomide disaster, heavy metal poisoning or radiation sickness.

Professor Boulton said progress had been made through alcohol restrictions brought about in the Kimberley towns of Halls Creek and Fitzroy Crossing by local women. He said the restrictions had produced a “massive reduction in the amount of violence and of women seeking refuge”, and that there was evidence young children were growing better.

Earlier in the day the Commission was told many Aboriginal youngsters from the remotest areas suffered hearing problems related to ear infections in early life. In one example retold before the Commission, a boy before court had been crash tackled by a guard who thought he was trying to escape, when in fact the boy simply hadn’t heard an instruction.

Deafness holding NT’s indigenous kids back

Many boys caught up in the Northern Territory’s juvenile justice system suffer a “disease of disadvantage” that has crippled almost every aspect of their lives, the Northern Territory’s royal commission into youth detention and protection has heard.

Jody Barney, who works as a deaf indigenous community consultant, told the inquiry she has spoken to several young Aboriginal people with hearing impairments who have had their faces covered by spit hoods and bound behind bars.

“Taking away another sense from a person who already has a limited sense is frightening. And that fear stays forever… long after their sentence,” she said.

Footage of boys being tear gassed, shackled and put in spit hoods at Don Dale Youth Detention Centre was aired on national television in July, sparking the royal commission

Psychologist Damien Howard told the inquiry a chronic housing shortage is creating an “epidemic” of hearing loss in indigenous children that leads to learning difficulties, family breakdown and criminal involvement.

“It’s very much a disease of disadvantage,” Dr Howard told Darwin’s Supreme Court.

Crowded housing overwhelms a child’s capacity to maintain hygiene, allows infections to pass quickly, and increases exposure to cigarette smoke and loud noises, while the poverty limits nutrition.

On average, non-Aboriginal kids experience middle ear disease for three months of their childhood while indigenous children can get fluctuating hearing loss for more than two years.

This can result in a permanent condition, which Dr Howard says is a “smoking gun” leading to over-representation in the criminal justice system.

Make FASD History

Fetal Alcohol Spectrum Disorders (FASD) are 100% preventable. If a woman doesn’t drink alcohol while she is pregnant, her child cannot have FASD.

There is a humanitarian crisis in the Fitzroy Valley region of remote North Western Australia, which has one of the highest Fetal Alcohol Spectrum Disorders (FASD) in the world.

The effects of alcohol on the fetal brain are a common cause of intellectual impairment in developed countries. Problems that may occur in babies exposed to alcohol before birth include low birth weight, distinctive facial features, heart defects, behavioural problems and intellectual disability.

Most infants with FASD are irritable, have trouble eating and sleeping, are sensitive to sensory stimulation, and have a strong startle reflex. They may hyperextend their heads or limbs with hypertonia (too much muscle tone) or hypotonia (too little muscle tone) or both. Some infants may have heart defects or suffer anomalies of the ears, eyes, liver, or joints.

Adults with FASD have difficulty maintaining successful independence. They have trouble staying in school, keeping jobs, or sustaining healthy relationships. They require long-term support and some degree of supervision in order to succeed.

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Bright Blue is very proud to partner with Nindilingarri Cultural Health Services to support the development and implementation of a comprehensive, evidence-based prevention and community capacity building programme, which aims to make FASD history.

The outcomes of this programme will work to:

  • Improve the health, quality of life and social and economic potential for the next generation of Fitzroy Valley children, and thus the fabric of the community itself;
  • Identify practical strategies that can be implemented elsewhere in Aboriginal and non-Aboriginal communities to reduce and eliminate FASD;
  • Make WA a leader in FASD prevention;
  • Decrease costs associated with service provision, productivity, welfare and justice.

stacks_image_6848Led by Aboriginal community leaders Maureen Carter and June Oscar; and Paediatrician Dr James Fitzpatrick, it is important that the leadership of the Marulu strategy reflects the community ownership of the process.

Bright Blue needs your support to assist in prevention and capacity building, to develop an effective community – level support for women to abstain from drinking during pregnancy and child bearing years, so that all babies born in this community and across Australia have a full potential for a long and productive life.

Become a part of history. Together, let’s make FASD history.

The inquiry led by co-commissioners Margaret White and Mick Gooda continues.

NACCHO Aboriginal health : #AIHW #AustraliasHealth2016 : What are the health experts saying about the report ?

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” The report has also pointed out ongoing areas of health inequality in Australia, driven by socioeconomic factors and social determinants.

Communities suffering socioeconomic disadvantage continued to have systematically poorer health including lower life expectancy, higher rates of chronic disease and higher smoking rates.

Aboriginal and Torres Strait Islander peoples recorded improved health indicators in some areas, including lower rates for smoking and infant mortality.

However, the report found life expectancy was shorter by 10 years than for non-Indigenous Australians, and Aboriginal and Torres Strait Islander peoples continued to suffer higher rates of diseases such as diabetes, coronary heart disease and end-stage kidney disease.

The impact of risk factors such as smoking, physical inactivity, poor nutrition and harmful alcohol use have been emphasised as significant contributors to Australia’s rising rates of chronic disease.

This is an opportunity for health leaders and the Commonwealth Government to heed the report’s message that lifestyle factors and social determinants are significant contributors to ill-health, and to address the issues of health inequality and the importance of reform across all of our care systems “

AHHA Chief Executive Alison Verhoeven

Download the report here australias-health-2016

 #AIHW and Minister Sussan Ley press releases from launch #AustraliasHealth2016 report

Life expectancy gap between Indigenous and non-Indigenous Australians remains about one decade

The life expectancy gap between Indigenous and non-Indigenous Australians remains about one decade, according to new statistics.

The latest report from the Australian Institute of Health and Welfare (AIHW) said that while health outcomes had improved for Aboriginal and Torres Strait Islander people, they still remain below those of non-Indigenous Australians.

The biennial report, published today, shows Indigenous males born between 2010 and 2012 have a life expectancy of 69.1 years, a decade less than their non-Indigenous counterparts.

The gap for women was slightly lower at 9.5 years.

Between 2009 and 2013, 81 per cent of all Indigenous deaths were of people under 75. This is more than twice the rate of non-Indigenous Australians, which stands at 34 per cent.

The latest statistics come 10 years after the establishment of the Closing the Gap campaign, which aims to end the disparity on life expectancies.

Earlier this year, Prime Minister Malcolm Turnbull pledged that the Government would better engage with Indigenous people in “hope and optimism rather than entrenched despair”.

Indigenous sobriety rate higher than non-Indigenous Australians

While smoking rates have been falling nationally, they remain high among Indigenous Australians, with 44 per cent of Aboriginal and Torres Strait Islander people aged 15 and over describing themselves as a current smoker.

The report states that 42 per cent smoke daily, 2.6 times the rate of their non-Indigenous counterparts.

However, Indigenous Australians drink less alcohol than non-Indigenous counterparts — 26 per cent of Aboriginal and Torres Strait Islander people aged 15 and over had not consumed alcohol in past 12 months.

This equates to a sobriety rate 1.6 times that of non-Indigenous Australians.

Potentially avoidable deaths — categorised as deaths that could have been avoided given timely and effective health care — accounted for 61 per cent of deaths of Indigenous Australians aged up to 74 years between 2009 to 2013.

This was 10 per cent more than their non-Indigenous counterparts.

Australians are living longer than ever but with higher rates of chronic disease, the latest national report card shows.

Reports below from the Conversation

According to the Australian Institute of Health and Welfare’s Australia’s Health 2016 report, released today, Australian boys can now expect to live into their 80s (80.3), while the life expectancy for girls has reached the mid-80s (84.4).

A boy born and girl born in 1890 could only expect to live to 47.2 and 50.8 years respectively. AIHW

The single leading cause of death in Australia is coronary heart disease, followed by:

Grouped together, cancer has overtaken cardiovascular disease (heart disease and stroke) as Australia’s biggest killer. Cancer is also the largest cause of illness, followed by cardiovascular disease:

Burden of disease, by disease group, Australia, 2011 AIHW

Chronic diseases are becoming more common, due to population growth and ageing. Half of Australians (more than 11 million) have at least one chronic disease. One quarter have two or more.

The most common combination of chronic diseases is arthritis with cardiovascular disease (heart disease and stroke):

AIHW

Australians have high rates of the biomedical risk factors that increase the risk of heart disease and stroke. Almost a quarter (23%) of Australian adults have high blood pressure and 63% have abnormal levels of cholesterol.


Lifestyle choices

Fron Jackson-Webb, Health + Medicine Editor, The Conversation

The good news is Australians are less likely to smoke and drink at risky levels than in the past.

Australia now has the fourth-lowest smoking rate among 34 OECD countries, at 13% in 2013. This is almost half that of 1991 (24%).

AIHW

The volume of alcohol Australians consume fell from 10.8 litres per person in 2007–08 to 9.7 litres in 2013–14. This is the lowest level since 1962–63. But 16% of Australians are still drinking to very risky levels: consuming 11 or more standard drinks on one occasion in the past 12 months.

AIHW

Around eight million Australians have tried illicit drugs in their lifetime, including 2.9 million in the last 12 months. The most commonly used illicit drugs are cannabis (10%), ecstasy (2.5%), methamphetamine (2.1%) and cocaine (2.1%).

Use of methamphetamine has remained stable in recent years. However, more methamphetamine users are opting for crystal (ice) rather than powder (speed).

The bad news is Australians are still struggling with their weight. Around 63% are overweight or obese, up from 56% in 1995. This equates to an average increase of 4.4kg for men and women. One in four children are overweight or obese.

Junk foods high in salt, fat and sugar account for around 35% of adults’ energy intake and around 39% of the energy intake for children and young people.

Most Australians (93%) don’t consume the recommended five serves of vegetables a day and only half eat the recommended two serves of fruit. Just 3% of children eat enough vegetables, though 70% consume the recommended amount of fruit.

Almost half (45%) of adults aged 18 to 64 and 23% of children aren’t meeting the national physical activity recommendations. These are for adults to accumulative 150 to 300 minutes of moderate intensity physical activity or 75 to 150 minutes of vigorous intensity physical activity each week. Children are advised to accumulate at least 60 minutes of moderate to vigorous physical activity every day.

Lifestyle choices have a huge impact on the risk of chronic disease; an estimated 31% of the burden of disease in Australia could have been prevented by reducing risk factors such as smoking, excess weight, risky drinking, physical inactivity and high blood pressure.

Proportion of the burden attributable to the top five risk factors

AIHW

Preventing chronic disease

Rob Moodie, Professor of Public Health, University of Melbourne

This report outlines a number of positives in Australia’s health – our life expectancy, the health services at our beck and call, major declines in tobacco and road deaths. We’re doing well, it says, but we could do better.

If we took prevention and health promotion far more seriously, we could do a lot better.

The report nominates tobacco use, alcohol, high body mass and physical inactivity as the chief causes of preventable illness and the chief causes of our increasing level of chronic illnesses. Yet national investment in prevention is declining.


Further reading: Focus on prevention to control the growing health budget


Tobacco use is rapidly declining because of really effective measures (plain packaging, advertising bans and increasing price through taxes) that save lives and enormous amounts of money over a lifetime for people who used to smoke.

However, we can’t seem to make any major dent in the commercial, industrial and lifestyle diseases related to junk food and drinks, harmful consumption of alcohol and car dependency.

We’ve known what will work for many years but the power of some of these unhealthy industries is still overwhelming – a situation in which our politicians fear these industries and their associations more than they fear the voters.

Our collective health would have been much better if we’d been able to follow the guidance of our own national task forces and learnt from other countries. The report card should read, “Doing well, but could have done a lot better”.


Inequities

Fran Baum, Matthew Flinders Distinguished Professor and Foundation Director at the Southgate Institute for Health, Society & Equity, Flinders University

Australia’s Health 2016 shows many Australians are not getting a fair go at health. There is a gradient across society whereby the richer the area you live in, the longer you can expect to live. The difference between the highest and lowest is four years.

Deaths by socioeconomic group: 1 = lowest; 5 = highest

AIHW

The gradient is evident from early life. Children most at risk of exclusion – those from poor areas who experience problems with education, housing and connectedness – are most likely to die before they reach 15 years from potentially preventable or treatable causes.


Further reading: Want to improve the nation’s health? Start by reducing inequalities and improving living conditions


Our most glaring inequity is the ten-year life gap between Aboriginal and Torres Strait Islander Australians and others. Indigenous life expectancy is 69.1 years for males and 73.7 years for females.

Compared with the non-Indigenous population, Indigenous Australians are:

  • 3.5 times as likely to have diabetes and four times as likely to be hospitalised with it or to die from it
  • five times as likely to have end-stage kidney disease
  • twice as likely to die from an injury
  • twice as likely to have heart disease.

Australians living outside major cities have higher rates of disease and injury. They also live in environments that make healthy lifestyles choices harder (such as more difficulties buying fresh fruit and vegetables) and so their risk of chronic diseases is increased.

AIHW

The data on who has private health insurance coverage points to the emergence of a two-tiered health system, where those who can afford to pay receive better access and quality of care. Just 26% of those in the lowest socioeconomic group have cover compared to about 80% of the top group.

Coverage with private health insurance and government health-care cards

AIHW

Cost of care

Professor Stephen Duckett, Director of the Health Program at Grattan Institute

Over the last decade, health expenditure grew about 5% each year, above the 2.8% average growth in Gross Domestic Product (GDP). As a result, health took up an increasing share of GDP.

Spending more on health means Australia spent less on other things. This is not necessarily bad, as long as the benefits from that increased expenditure – such as increasing life expectancy or increased quality of life – are worth the increased costs.

But spending above GDP growth cannot continue indefinitely. And the last few years saw an increase in rhetoric about health spending increases being “unsustainable” from so-called “futurists” and politicians.

Informed commentators have generally rejected the unsustainability claim, some labelling it a “myth”, while others take a more nuanced view.

Australia’s Health 2016 shows a slowing of the real growth rate in the most recent two years to about half that of the previous decade – 1.1% from 2011-12 to 2012-13 and 3.1% from 2012–13 to 2013–14.

Annual growth rates in health expenditure AIHW

This suggests the “unsustainability” rhetoric is at least overblown and potentially prompting budget decisions which are counter-productive, such as introducing a co-payment for general practice.

Commonwealth government expenditure was more or less stable over these most recent two years, declining 2.5% initially then increasing 2.4% in the last year.

Health expenditure by area (adjusted for inflation)

AIHW

Savings to the government came from shifting costs to consumers, by slowing the growth in government subsidies to private health insurers, and also by slowing spending on pharmaceuticals.

This latter slowdown was achieved through tighter controls on payments to drug manufacturers and because some big-selling drugs came off patent, resulting in falls in prices.

NACCHO Aboriginal Health Newspaper Next AGM Edition

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NACCHO Welcomes Advertising and Articles

NACCHO #NDIS NEWS: Understanding the NDIS: the scheme does not yet address all the needs of Indigenous people with disabilities

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” Life on a remote Indigenous settlement in central Australia, surrounded by red dust and scorched country may be tough. But it’s even tougher if you’re sick, old or living with a disability.

“Some people with disabilities who are in a wheelchair are pretty much living under their carport because they don’t even have enough support to put in a ramp [out the front of their house.

“Or, they may be stuck sitting around all day because no there is no access to an appropriate wheelchair to get up a bush track. So they can’t get to where they need to go and sometimes can’t leave the house.”

I believes a cultural barrier between Indigenous communities and government systems is preventing people with disabilities living in remote Australia from getting the basic services they need. That’s because there’s no actual word for disability in most Indigenous languages so the notion of ‘disability’ and ‘disability services’ gets lost in translation.

 Tracy Barrell, former Paralympian and spokesperson of the First Peoples Disability Network.

Clockwise from top: Carol Gilligan, Sandra Windy, Annette Wilyuka and Cora Meruntji from Waltja. (Photo supplied by Waltja Tjutangku Palyapayi Aboriginal Corporation) See second article below

” As my research has shown, the factors that impact on Indigenous people’s access to disability specific services are not just geographical. They also include the ways in which disability is conceptualised in Indigenous communities as well as lack of trust for mainstream services and lack of community connections.

Many Indigenous people don’t engage with disability support programs because of the stigma associated with the mainstream definition of disability adopted by government and non-government agencies.

My research has also highlighted the fact that Indigenous people often focus on a person’s strengths, which is contrary to the clinical deficit model of disability adopted by the current service system. “

John Gilroy  ARC Research Fellow in Indigenous Health, Disability and Community Development, University of Sydney Full Article here

On July 1 2016, the National Disability Insurance Scheme (NDIS) moved from a trial phase to a full national roll-out. In this series on Understanding the NDIS, we explore how the scheme works, why Australia needs it, and the issues to be addressed before eligible Australians can receive the benefits they are entitled to.


The National Disability Insurance Scheme (NDIS) allows Australians with a disability to choose which agencies or people they wish to collaborate with to help achieve their goals.

For Indigenous people, there are many positives to this scheme. It provides the opportunity to address the identified shortfalls of the former institutionalised service system, some of which uniquely impact Indigenous people.

For instance, if an NDIS participant is not satisfied with a support worker or an agency, they can recruit a different person or withdraw their funding and transfer to another agency. This will enable Indigenous people to access those supports that are culturally appropriate for them and their needs.

The growing Indigenous disability rights movement has fostered more involvement in the planning and development of the NDIS. But there is still a need to acknowledge those who feel their voices are not being heard by the government.

I have previously expressed my frustration with the National Disability Insurance Agency (NDIA) – the agency responsible for overseeing the NDIS – for its lack of transparency on the NDIS rollout, with limited evidence that it is meeting the needs of Indigenous people.

Unrepresentative participation

As of March 2016, nearly 30,000 people with disabilities were participating in NDIS trial sites, around 5% of them Indigenous. The latest National Aboriginal and Torres Strait Islander Social Survey reported that 45% of Indigenous Australians aged 15 years and over said they had experienced a disability, and nearly 8% needed assistance with core activities (such as self-care or mobility) some or all of the time.

Added to this is the high rate of chronic health conditions that lead to physical impairments and disability, such as renal disease, middle ear diseases and glaucoma; as well as issues of low cognitive ability among many Indigenous children.

While adequately estimating the NDIS eligibility rate in the Indigenous population is problematic, the 5% does not seem to be representative of the rates of disability in Indigenous communities.

While the reasons for a lack of participation are many and complex, the underlying problem is access. A 2008 report showed that nearly half of Indigenous people with severe core activity limitations identified problems in accessing generic and specialist services.

As my research has shown, the factors that impact on Indigenous people’s access to disability specific services are not just geographical. They also include the ways in which disability is conceptualised in Indigenous communities as well as lack of trust for mainstream services and lack of community connections.

Many Indigenous people don’t engage with disability support programs because of the stigma associated with the mainstream definition of disability adopted by government and non-government agencies.

My research has also highlighted the fact that Indigenous people often focus on a person’s strengths, which is contrary to the clinical deficit model of disability adopted by the current service system.

Challenges of remote Australia

The state of disadvantage in Indigenous communities presents a range of problems that exist outside of the NDIS’s scope and objectives.

There are many Indigenous communities where basic housing and utilities are either limited or absent. As such, many Indigenous people with disability have their energies focused on addressing the basics of day-to-day living.

In remote regions, staff often have to travel hundreds of kilometres to deliver services to people. shutterstock.com

The NDIA has been promoting the NDIS model as one that expands personal choice when it comes to the services and support people with disabilities can access. Yet individual choice requires service and support opportunities to exist in local communities. Limited opportunities, especially in remote communities, equates to limited choice for those on NDIS plans.

The costs to deliver supports and services to remote and very remote communities can be astronomical when compared with metropolitan regions. Research into remote service delivery conducted by the National Disability Services identified workforce shortages further inhibited service growth and development.

In remote regions, staff often have to travel hundreds of kilometres to deliver services to people. The distance between the regional centre of Alice Springs to another town in Central Australia, Tennant Creek, is 500km.

There is limited evidence to assess whether the NDIS can effectively and efficiently provide equitable opportunities for those living so far away from regional centres.

Research shows more than 13% of Indigenous adults have provided unpaid assistance to people with a disability, such as relatives; the highest number of these are in very remote communities. Establishing a system that enables people to recruit family members needs more discussion throughout the scheme’s rollout.

Self-managed funds

According to the First People’s Disability Network, the peak body representing Indigenous Australians with a disability, many Indigenous people need accessible support and training to self-manage their NDIS plans.

If we consider the language diversity among Indigenous communities, options for training in managing personalised NDIS plans may be limited for those with English as a second or third language.

Further, operating in a market-based system requires adequate access to information and skills in budgeting and book-keeping. Indigenous people who are socially isolated and don’t have either this information, or the skills or resources with which to seek help, may find these tasks difficult.

The NDIA will need to further explore these challenges as they plan and implement culturally responsive training and support programs for those who wish to self-manage their packages.

The principles of the World Health Organisation’s twin-track approach should be adopted in the roll-out of the NDIS. Broadly speaking, this approach aims to build specialist, targeted disability programs and supports for Indigenous people (such as Indigenous community controlled organisations) while simultaneously considering their needs in all generic policies, initiatives and programs.

The NDIS provides us an opportunity to address the gaps between Indigenous and non-Indigenous people with disabilities. But this should run parallel to government spending on specialist services and community controlled organisations.


You can read previous stories on groups likely to miss out under the NDIS, and the risk to support services for parents with newly diagnosed children with disability.

What would your life be like if you lived in a remote community in central Australia? How would you fare if you developed a disability or chronic disease?

Life on a remote Indigenous settlement in central Australia, surrounded by red dust and scorched country may be tough. But it’s even tougher if you’re sick, old or living with a disability.

“Some people with disabilities who are in a wheelchair are pretty much living under their carport because they don’t even have enough support to put in a ramp [out the front of their house],” says Tracy Barrell, former Paralympian and spokesperson of the First Peoples Disability Network.

“Or, they may be stuck sitting around all day because no there is no access to an appropriate wheelchair to get up a bush track. So they can’t get to where they need to go and sometimes can’t leave the house.”

Barrell believes a cultural barrier between Indigenous communities and government systems is preventing people with disabilities living in remote Australia from getting the basic services they need. That’s because there’s no actual word for disability in most Indigenous languages so the notion of ‘disability’ and ‘disability services’ gets lost in translation.

“There are so many different types of disabilities and [many people in remote Indigenous communities] can’t differentiate between a brain injury or a mental illness because ‘that’s just Mary’. They don’t see disability and everyone helps to look after that person.

“But that also means they can’t access support. They don’t understand that they have to say ‘this person has cerebral palsy or mental health issues’ to access government help.”

Barrell is hopeful that the situation will change once the National Disability Insurance Scheme (NDIS) rolls out from this month and people start to get the services they request and need.

“For our mob, the conversation about the NDIS has only just started in the last year and is filtering down. So when people who have never received any services or transport, find out about the NDIS and when I tell them to start writing their wish-lists of the things they could have in their life to improve their standard of living, they think they have won the lotto.”

“They don’t understand that they have to say ‘this person has cerebral palsy or mental health issues’ to access government help.”

Executive director of Waltja Tjutangku Palyapayi Aboriginal Corporation, Irene Nangala tells me that accessing seniors’ services in her home town of Kintore, situated around 530 kilometres west of Alice Springs, isn’t quite as desperate.

The remote location of Kintore (Walungurru) has its own health clinic and aged care workers help relatives to care for the elderly at home, in the community.

“The families make the bed, cook supper for them, and make breakfast,” says Nangala. “Sometimes if the old people want to sleep outside, they sleep outside because they all help to make a fire for them.”

But one real problem is that many of the aged care staff are ‘work for the dole’ volunteers: No pay means no income and the continuation of poverty, poor housing conditions and bad diets for many.

It’s also important to recognise that ageing means something different in this community. The Australian Institute of Health and Welfare, ‘older’ Indigenous Australians are considered to be those aged 50 and over, not 65-plus, because of the life expectancy gap between Indigenous and non-Indigenous Australians.

Kate Lawrence, Waltja Management Support Worker, explains that although some elders are aged well over 70 – who grew up on bush tucker – are fighting fit, many others aged around 50 are not in such good helath.

“A lot of the older people are getting heart problems and they can’t do exercise and can’t stay healthy,” says Lawrence. “It’s really hard for people to afford to eat healthy food and no one’s got much money.

“People need to go out to hunt to keep feeding people but they need a car and petrol. The conditions of housing are really hard for people. I think people here deal really well with a tough situation.”

“A lot of the older people are getting heart problems and they can’t do exercise and can’t stay healthy.”

Kidney disease is also quite common throughout the community of 400 Indigenous residents. Kidney Health Australia states that the incidence of end stage kidney disease (ESKD) for Aboriginal and Torres Strait Islander people is 20 times higher for those living in remote and very remote areas of Australia, compared with non-Indigenous peoples. According to a report on the health of people from Kintore, the prevalence of ESKD in the town’s Pintupi Aboriginal group is 40 times higher than in the average Australian population.

But with only four dialysis chairs available at the local health clinic, most renal patients have to live the majority of the year in Alice Springs in order to access life saving dialysis services.

“The chairs aren’t only for people at Kintore but for the mob all over community,” says Lawrence. “It’s really hard for renal patients to come in and stay in a hostel in Alice. They can’t bring family to live with them when they are here so they are usually here by themselves. They are lonely and it’s really disruptive to family.”

Nangala, aged 54, is one of Kintore’s many seniors forced to leave home to receive treatment. Diagnosed with kidney disease around four years ago, she requires dialysis three times a week. So she lives most of the year in a hostel in Alice Springs, at a subsidised cost, so she can receive the treatment she needs to stay alive and travels to Kintore every few months whenever a chair becomes available.

“I am on a dialysis machine and I have to stay in Alice Springs,” Nangala says. “I dilate and after that, I feel a little sick. So I have to go straight to bed and have a rest.”

Nangala adds that although it’s nice to be in the city and have time off from the duties of being a grandparent, she longs for home and misses feeling connected to community.

“Sometimes I want to go back and see my family. The grandchildren, they worry for me when I am in Alice Springs. It’s lonely when family goes away.

“We need something better for old people.”

 .Women story telling and singing in Kintore, Northern Territory.

Women story telling and singing in Kintore, Northern Territory. (Photo supplied by Waltja Tjutangku Palyapayi Aboriginal Corporation)

The community needs connectingIt was this hunt for ‘something better’ and a greater sense of connectedness that lead Nangala and the other Waltja Tjutangku Palyapayi directors to create a temporary solution.

The Aboriginal organisation, governed by senior Aboriginal women from remote communities across central Australia, will run a four-day festival, for older people and those with disabilities this September, to reconnect Indigenous people who have been excluded from community because of poor health, age or disability.

The idea is that around 200 seniors and Indigenous people with disabilities from central Australia’s most remote communities will be brought into participate in The Waltja Aged and Disability Festival, at a bushland camp east of Alice Springs.

“There’ll be a lot of making fire and telling stories,” says Nangala. “There’ll be a lot of lot of laughing, crying, singing and dancing too.”

It’s the sixth time the corporation has held the festival since 1999, as it can only ever be run when the group has enough money to fund it.

“[In past festivals], we’ve had lots of old people sleeping there and making fire,” she adds. “It was so lovely to see the old people. They were so happy together.

“People come from many places, a long way away. We bring everyone in to have a celebration of those older people and people with disabilities. They normally don’t meet as they can’t travel across to community without help.

“There’ll be a lot of making fire and telling stories. There’ll be a lot of laughing, crying, singing and dancing too.”

There’ll also be pampering and information sessions about NDIS services available to Indigenous communities like Kintore.

Barrell, a proud Indigenous woman with a disability, says she’ll also be attending.

“The festival will bring like-minded people together to have yarn ups and make connections that they’ve never made before,” says Barrell. “The way it’s been organised, you’ve got time. You don’t have to worry about your transport, home care coming or going or any of your daily struggles.

“The event is all about being able to be yourself. We’ll be able to just sit back and actually be a person.”

NACCHO #HealthElection16 #TowardsRecovery Mental Health , NDIS , PHN’s and Aboriginal Community Controlled Health

PHNs-in-scope

Current Commonwealth programs migrating to PHN’s

Indigenous ?

The mental health sector is in the midst of “a perfect storm” of change, as one speaker put it during the recent VICSERV #TowardsRecovery conference in Melbourne. This comes as the sector grapples with how to offer people with mental illness not just choices but control over their lives.

Mental Health Australia CEO Frank Quinlan told delegates that the system was in a period of “quite unprecedented change”, with the rollout of the National Disability Insurance Scheme (NDIS), the new role in mental health of Primary Health Networks (PHNs) and other reforms planned or underway in response to the National Mental Health Commission’s Review of Mental Health Programmes and Services.”

A delegate from an Aboriginal community controlled health organisation (ACCHO) raised issues for her sector, where Aboriginal communities are estimated to have twice the incidence of disability as non-Aboriginal communities but much less access to services, and agencies that are not specialists for disability support.

“If you focus most of the effort on transitioning current supports (to the NDIS), that will continue to leave Aboriginal communities under-supported,” she told the NDIS panellists.

She was told the NDIA had identified it needed to do a lot more work around Aboriginal disability, and would step up that engagement and transition work. Other culturally and linguistically diverse (CALD) communities will also get a bigger focus.

Another ACCHO representative voiced fears that if Aboriginal people with disability transitioned to other services under the NDIS, only to find they were not culturally safe for them, that the ACCHO workforce might not still be there for them to return to.

Marie McInerney writes: Melissa Sweets edits in

Croakey New

While many of the major system changes underway, including the NDIS, are welcomed in the mental health sector, there is confusion over details and concern that many people with mental health issues could fall through new gaps in the system.

Some at the conference said the upheaval rivals the days of deinstitutionalisation, particularly in Victoria which has just emerged from much criticised recommissioning of mental health services and where there is also uncertainty about what of its mental health community support funds will be committed to the NDIS.

These concerns are only exacerbated by the uncertainty surrounding the policy outcomes likely to result from the July 2 federal election, and the marathon eight-week election campaign and caretaker period.

Despite all the planning for the NDIS, which on 1 July begins its full national rollout after three years of trials, the fate of some programs such as the Personal Helpers and Mentors (PHaMs) program is still not known.

(As a measure of ‘reform fatigue’, Victorian Alcohol and Drug Association CEO Sam Biondo told one session that when he started out in the 1970s, all he wanted was change; now all he wants is some stability).

“Some organisations don’t know what contracted services they’ll be offering on July 1,” Quinlan told Croakey in a follow-up interview yesterday. “That means uncertainty for their clients, people who rely on them, and also for their workforce who don’t know whether they will have employment in six weeks time.”

At the weekend Mental Health Australia released its election platform, saying the important reforms that are underway “cannot be forgotten during the current electoral cycle”. It is calling on political leaders for long-term commitment to:

  • reducing the national suicide rate
  • improving the physical health of people with a mental illness
  • increasing employment rates for people experiencing mental illness and their carers
  • increasing mental health consumer and carer participation and choice in national policy design and implementation
  • maintaining current overall levels of investment in mental health, with measures that support full reinvestment of cost efficiencies and savings.

Mental Health Australia will produce a ‘report card’ to be released prior to the election, outlining the major parties’ response on these issues.

Meanwhile, just a few days after the conference ended, one of its speakers, Professor Jane Burns, CEO of the Young and Well Cooperative Research Centre, joined other mental health leaders in releasing details on suicide across 28 Federal electorates, calling on party leaders and candidates to spell out what they intend to do to address the rising toll of suicide and self-harm across Australia.

NDIS concerns

The mental health sector has welcomed the NDIS, saying a well funded and well run scheme will meet many needs.

But the numbers provide the context for some of the concerns raised at the conference: it is estimated that each year in Australia, there are around 600,000 people who experience severe mental illness, and 300,000 who experience severe mental illness with “complex inter-agency needs”.

By comparison, there are around 60,000 places in the NDIS for people with mental health issues.

VICSERV CEO Kim Koop said the conference message was: “The NDIS is a welcome addition to a contemporary mental health system but is not sufficient replacement for the current offering.”

She said Victorian community managed mental health services were “desperate for more information” about the NDIS.

But the State Government has an equal role to play, she said, pointing out that the bilateral agreement makes clear that the introduction of the NDIS is a shared responsibility between the States and the Commonwealth. “Both need to step up and provide information,” she said.

VICSERV has played a lead role in documenting the Victorian trial of the NDIS in the Barwon area, but is waiting to hear back on how its concerns will be addressed.

Koop said:

The NDIS is not a bad thing (for mental health).

The trouble is that the funding for the existing services is being transferred to the NDIS and that it is still very uncertain if the NDIS will offer a similar range of services.

At the moment it’s just really unclear. We’re waiting to hear from the NDIA (National Disability Insurance Agency) around the review of supports for people with mental illness but until that comes out, we just don’t know what kind of supports, what price they will be at, what workforce (levels) there will be required.”

Delegates at one conference session peppered a panel that included senior managers in the National Disability Insurance Agency (NDIA) about many details of the NDIS’s likely operation.

A delegate told the panel it had been great to have different trials conducted across Australia over the past three years but their different reports on different experiences have created “confusion and misinterpretation…trying to compare apples with oranges”.

Others expressed continuing concern about how people with episodic mental health issues would be included in a Scheme designed around permanent disability.

On markets and mental health

The session followed a keynote by UK philosopher Dr Simon Duffy raising issues such as citizenship and the need to focus on community rather than institutional and organisational interests. By contrast, the language of the NDIS discussions was all around markets, market failures, entrants and competition.

In an aside to me, one delegate questioned whether there is a “market” in people with mental illness.

Asked at another session whether there really was a “fair dinkum market’” for organisations to start competing in, National Mental Health Commissioner Rob Knowles said there wasn’t yet.

But he warned that one would develop as it has in other countries, and he was not sure people in the sector understood the significance of the changes that will occur.

When the UK went down this road, about 80 per cent of existing services were provided by not for profit organisations, the remainder by private providers. That was soon reversed, he said.

A mistake many not-for-profits made was to think “people stick with us”. Knowles said: “People are much more fickle than that. I think there are significant challenges for those operating in this: how they make themselves be a service provider of choice”.

What will PHNs offer mental health?

Another panel session focused on the news, announced last year, that funds will be reallocated from Canberra to primary health networks (PHNs) to commission — but not deliver — mental health services.

Again, the sector has welcomed the move, particularly as a bridge between States and Commonwealth, but with concerns about how it all might work in practice.

Quinlan gaps

The aim of the PHNs, to make sure they get local services on the ground where they are needed, was very welcome, Quinlan said. The concern is how to maintain national standards.

He said: “For example with eating disorders and suicide prevention, you can quickly see you wouldn’t want 31 PHNs across the country all inventing their own way of doing things. Addressing how we tackle some national issues while ensuring local suitability is a big challenge.”

The PHN session involved panelists Jason Trethowan – Chief Executive, Western Victoria PHN, Lyn Morgain – Chief Executive, cohealth, and Christopher Carter – Chief Executive, North Western Melbourne PHN. They outlined what PHNs would cover, and what they wouldn’t.

The questions they sought to answer in their session demonstrated the issues of concern for many of the delegates there:

  • How will planning be undertaken that ensures the range of demographic, clinical, aged related, cultural, socio-economic and comorbidity of people is properly planned for?
  • How will the flexible funding pool work – be prioritised – is it flexible for service models of care?
  • How will PHNs work with the State system, and with each other to ensure continuity – especially given the transient nature of some consumers?
  • What does this mean for existing youth primary mental health services? Youth with severe mental health?
  • How will we ensure that services for Aboriginal and Torres Strait Islander people recognise the social determinants of health and cultural safety?
  • What are the potential approaches to reduce fragmentation (suicide prevention)?
  • What are the commissioning challenges and opportunities for rural communities?
  • There will likely be a gap with the move of specialist recovery based community mental health support services to the NDIS. Will PHN’s be able to fund recovery based CMH or will as suggested PHNs be limited to commissioning only “clinical primary MH” as has been suggested in some of the guidance documents?

PHNs not in scope

PHN perspectives

Croakey later asked panellist Chris Carter for his reflections on the session.

Q: What were the main messages you wanted to get across during the session on the role of PHNs within the context of national mental health reforms?

That the role of PHNs is developing – in the first phase this will be about development of a stepped care model that reflects regional needs, and is focussed around safe, quality mental health care.  There will be a number of stages and phases in the evolution of an integrated system given the high level of fragmentation in the healthcare system.

Q: What key concerns emerged from the session? What’s your response to them?

Not really concerns, but a genuine desire to participate in the conversation about reform – how PHNs will take into account the diversity of populations, families and individuals when considering future planning and investments in the mental health system.

Q: The Federal Opposition said recently: “The PHNs, as the critical commissioners under the new reform agenda, are stuck in an unenviable position, wedged between the enormous pressure to deliver the reforms with unreasonable demands and an information vacuum from the Department of Health and at the same time trying to manage an increasingly agitated mental health sector hungry for information and advice.” What’s your response to that?

Our role as PHNs is to help facilitate as much information sharing and participation in planning processes as is possible.  Some of the tension lies between acute and primary systems, as well as State and Commonwealth systems.  At a regional level, our job is to bring local intelligence / evidence and wisdom to try and meet the needs of consumers / citizens, whilst bringing along the sector – which we acknowledge is reform / change fatigued in Victoria.

Q: What do you want to see promised for mental health in the federal election? Has the campaign put major work on hold? What certainty is needed now?

I support Mental Health Australia’s call for a long-term strategy for mental health – and would add that we need to integrate State and Commonwealth responses at a regional level in order to target diverse populations and diverse needs.  The election campaign has not put our work on hold – we are on track to implement continuing and new arrangements ready for July 1 and beyond in partnership with stakeholders.

Some Twitter observations

PHNs twitterPHNs twitter2

Control, not choice

Another big theme at the conference was given a sharp focus by keynote speaker Simon Duffy – that the idea of ‘choice’ is not enough for people with disabilty.

Rather, he said, control is what’s vital. (See also Duffy’s views about the NDIS in this earlier Croakey story and in this interview on Radio National’s Life Matters).

In a similar vein, RMIT Associate Professor Paul Ramcharan told delegates about the It’s My Choice toolkit (DVD, discussion guide and booklets) developed with Inclusion Melbourne, a day service that supports people with intellectual disability. The project sought to inform people with disabilities, family, friends and others as well as service personnel about how to explore choices within complex lives and relationships. .

Ramcharan later told Croakey:

“Of the nine principles of choice (identified), one in particular challenges us to rethink the notion of choice. In this principle,  the important question is not whether people with disability have choice – given that no one really has a total choice in what happens in their lives and that choices are made within a complex of relationships, services and environments. The question should be whether the limitations placed on their choices are reasonable or not.

Organisations delivering services should be looking at discrimination and community norms and other barriers that get in the way of people expressing their choices not just about mundane matters like what to eat and wear (though important) but pervasive areas relating to health, education, work, family and intimacy.

Choice of services alone does not equate to personal choice. It’s the journey of life that counts, not formal academic indicators, but the rich fabric that enriches our lives day to day.”

(Note: this quote above was added to the original published story to give more context about the project).

See his slide below.

PRINCIPLE6
Conference perspectives

Quinlan view from front

Quinlan twitter

• Marie McInerney is covering the #TowardsRecovery conference for the Croakey Conference News Service. Bookmark this link to track the coverage.

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