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

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

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

Federal Government Press Release 17 October 2017

Read 23 NACCHO Aboriginal Health and Disability Articles

Read 18 NACCHO Aboriginal Health and NDIS Articles

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

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

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

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

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

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

The plan identifies five key priority areas for action:

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

See Detail Below or in the Plan

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

Extract- Executive Summary

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

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

The Plan acknowledges that disability is everyone’s responsibility:

• Australian Government

• state/territory government

• local government

• business and industry sectors

• not–for–profit and community organisations

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

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

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

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

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

• be free from racism and discrimination

• have their rights promoted

• a disability inclusive justice system.

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

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

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

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

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

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

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

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

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

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

Why is it important?

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

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

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

Summary of press release

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

 

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

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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

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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 and Disability support : Ombudsman publishes report on Accessibility of Disability Support Pension for remote Indigenous Australians

damian-griffis-first-peoples-disability-network-overcoming-barriers-to-meaningful-participation-for-aboriginal-and-torres-strait-islander-people-with-disab

 ” This report focuses on the experiences of one particular vulnerable group—Indigenous people living in remote areas. Remote Indigenous Australians face significant disadvantage and unique cultural barriers in accessing a range of government services, including DSP.

The qualification criteria for DSP set a high bar and the claim process is rigorous. Even those applicants who are familiar with the income support and health systems say they find the DSP claim process complex, lengthy and confusing.

Complaints made to our office, along with the anecdotal feedback provided by peak bodies, advocates and community organisations, show that Indigenous people living in rural and remote Australia experience particular difficulty in preparing applications for DSP and meeting the high standard of evidence. “

Download the report here :

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 ” FPDN’s vision is a just and inclusive society, in which First Peoples living with disability are respected and valued for their culture, history and contribution to contemporary life, and in which their human rights are recognised, respected, protected and fulfilled.

First Peoples Disability Network is governed by Aboriginal and Torres Strait Islander people living with disability. FPDN is a member of the Disabled People’s Organisations Australia (DPO) alliance.”

Check out FPDN website

Press Release

Commonwealth Ombudsman, Colin Neave AM, released his report today into the accessibility of Disability Support Pension (DSP) for remote Indigenous Australians.

The Ombudsman’s inquiry responded to complaints from Indigenous Australians living in remote areas who were experiencing issues claiming DSP and with the assessment processes used by the Department of Human Services (DHS).

“We found remote Indigenous Australians face several barriers when claiming DSP. It is harder to access medical services, get appropriate medical evidence to support their claims and engage with DHS’s job capacity and medical assessment processes,” Mr Neave said.

The Ombudsman has made a number of recommendations which seek to address these issues.

From Page 31

5.1 Indigenous Australians living in remote areas face significant barriers in accessing DSP, including:

  •  difficulties in accessing appropriate health care
  •  problems obtaining medical evidence from treating doctors and specialists to support their claims
  •  being disadvantaged by not having face-to-face JCAs and DMAs
  •  a differing concept of ‘disability’
  •  difficulties discussing conditions and their functional impact with health professionals in a meaningful way, due to language and cultural barriers.

5.2 The recommendations made in this report are intended to address some of the most significant challenges we consider remote Indigenous Australians face in:

  •  collecting evidence
  •  preparing applications
  •  accessing, and participating in, JCAs and DMAs
  •  anticipating the need for and accessing a program of support where required

“We have recommended ways to improve administration and reduce accessibility barriers facing remote Indigenous DSP claimants. These include recommendations about the way assessments are carried out, the information sought from and given to treating health professionals and better information about DSP eligibility requirements.”

Overall, DHS and the Department of Social Services (DSS), which is responsible for the relevant legislation and policy, responded positively to the investigation, agreeing to all recommendations.

“DHS is taking steps to improve its DSP assessment processes for remote Indigenous Australians, but more needs to be done,” Mr Neave said.

The assistance received from DHS throughout the investigation and report drafting process was also acknowledged by the Ombudsman.

Mr Neave said the Ombudsman’s office would continue to work closely with DHS to monitor the implementation of the recommendations in this report

Executive summary

Over the past twelve months the Ombudsman’s office has investigated a number of cases in which Indigenous people and their advocates have complained about decisions to refuse Disability Support Pension (DSP) claims. We do not usually investigate where, as in most of those cases, a complainant has a right of review. However, the focus of these complaints was the Department of Human Services’ (DHS) assessment process.

The complainants argued that their medical impairments were not properly or appropriately assessed. We decided to investigate their circumstances and examine DHS’s approach.

Over recent years the qualification criteria for the DSP has been significantly revised and tightened. While it is not the role of the Ombudsman’s office to comment on the merits of government policy, it is appropriate that we are alert to situations where the practical application of a policy has unintended consequences.

This includes the potential to create inequitable access or outcomes that are inconsistent with legislative intent and do not reflect the principles of good administrative decision making.

We acknowledge that DHS assesses over 100,000 DSP claims per year. The majority of these are processed without significant cause for complaint by claimants.

However, the experience of the majority should not necessarily be taken as an indication that the process is working for the most vulnerable in the community.

This report focuses on the experiences of one particular vulnerable group—Indigenous people living in remote areas. Remote Indigenous Australians face significant disadvantage and unique cultural barriers in accessing a range of government services, including DSP.

The qualification criteria for DSP set a high bar and the claim process is rigorous. Even those applicants who are familiar with the income support and health systems say they find the DSP claim process complex, lengthy and confusing.

Complaints made to our office, along with the anecdotal feedback provided by peak bodies, advocates and community organisations, show that Indigenous people living in rural and remote Australia experience particular difficulty in preparing applications for DSP and meeting the high standard of evidence required by social security law.

This report centres on complaints about the DSP claim process and uses them to illustrate some of the common challenges Indigenous people living in remote areas of Australia face when making DSP claims. The report provides a snapshot of areas where the DSP assessment process has fallen short.

Although the number of complaints we receive about DSP is small compared to the total number of DSP claims, the challenges faced by remote Indigenous Australians in navigating the DSP claim process are real and the impact of these challenges can be disproportionately large, given the claimants’ particular vulnerabilities.

We acknowledge the initiatives DHS has implemented to improve access to DSP for remote Indigenous Australians. Despite these efforts, we continue to receive similar complaints at the time of publishing this report. The complaints suggest there remains a gap between DHS’s service delivery commitments and the reality experienced by Indigenous people in remote areas.

The report makes recommendations about the job capacity and medical assessment processes, including the way the assessments are carried out and the information given to Commonwealth Ombudsman—Department of Human Services: Accessibility of Disability Support Pension for remote Indigenous Australians and sought from medical professionals providing reports for DSP claims.

We have recommended steps to increase awareness of the eligibility requirements for DSP, including the need for some applicants to have participated in a ‘program of support’. Given the recent changes to the DSP claim process and the programs of continuous improvement which DHS has outlined in response to our investigation, we have also recommended that the department establishes an implementation, monitoring and evaluation framework to assess the effectiveness of those changes.

Our office will continue to work closely with DHS to monitor the implementation of the recommendations in this report

NACCHO press release: NACCHO praises release of FPDN 10 point plan for Aboriginal people with a disability.

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Access to DisabilityCare critical for Aboriginal people Measures to increase awareness of the benefits of DisabilityCare Australia within Aboriginal communities and establish targets to improve access to disability services are both welcome given thehigh numbers of Aboriginal people living with disabilities.

FACTS

  • 50% of Aboriginal people have some form of disability or long term health condition (ABS 2011 Disability and Carers Survey)
  • This prevalence of disability is more than twice that of the non-indigenous Australians.

The National Aboriginal Community Controlled Health Organisation (NACCHO) Chair Justin Mohamed (pictured below) today praised the 10 point plan developed by the First People’s Disability Network (FPDN pictured above) ) which would use peer to peer methods to get the message to communities about how DisabilityCare can improve their lives.

Justin

For more info about the FPDN click here

Mr Mohamed also welcomed the announcement by Minister Jenny Macklin that NACCHO will form part of the working group to help the Federal Government set new targets aimed specifically at increasing access to services for Aboriginal people with a disability.

“The fact is that around twice as many Aboriginal people have a disability than non-Aboriginal people,” Mr Mohamed said.

“The introduction of DisabilityCare Australia has the potential to turn around the lives of these people by providing them with quality care and support to help them reach their full potential.

“However it is often the case that as Aboriginal people we don’t always recognise disability or seek the appropriate levels of help.

“This is often highlighted in remote communities where service provision is low and there is less acceptance of help from outside.”

Mr Mohamed said Aboriginal Community Controlled Health Services can play a key role in helping to spread the word about DisabilityCare Australia.

“For DisabilityCare to have the impact it needs in Aboriginal communities, it’s critical Aboriginal Community Controlled Health services play a central role

“We are already a trusted source of comprehensive primary health care within our Communities in urban, regional and remote areas and we can help in educating and bringing awareness to our communities about the changes to the system and ensure they are not left out.

“We look forward to being key players in developing targets and mapping out the means through which to deliver quality access to disability services for Aboriginal and Torres Strait Islander people.

For more info about the FPDN click here

Ten Point Plan

  1. 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 language there was no comparable word for disability. Also that many Aboriginal people with disability are reluctant to take on the label of disability particularly if they may already experience discrimination based on their Aboriginality. In many ways disability is a new conversation in many communities therefore with regard the NDIS we are starting from an absolute baseline position. And as a consequence change in this area may evolve on a different timeline to that of the main part of the NDIS.
  2. Awareness raising via a concerted outreach approach informing Aboriginal people with disabilities, their families and communities about their rights and entitlements. And as well informing Aboriginal and Torres Strait communities about the NDIS itself and how to work this new system effectively. There is simply no other way to raise awareness then by direct face-to-face consultation. Brochures and pamphlets will not do the job in this instance as this will be as stated earlier a new conversation in many communities.
  3. Establish 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 disabilities the FPDN views it not only as critical but logical that a new Expert Working Group be established focused upon Aboriginal and Torres Strait Islander people with disabilities. The new working group would operate in the same way the 4 current working groups do, that is it would be chaired by 2 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 leadership 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.
  4. 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.
  5. Research including into the prevalence of disability and into a range other relevant matters. Critically this work must be undertaken in partnership with Aboriginal and Torres Strait Islander people with disabilities to ensure a culturally appropriate methodology. There remains very little reference material about disability in Aboriginal and Torres Strait Islander communities this needs to rectified to ensure that we are getting a true picture of the lived experience of Aboriginal and Torres Strait Islander people with disabilities.
  6. Recognise that there already exists a workforce in many Aboriginal communities that continues to do important work often informally. This work needs to valued and recognized with the potential being the creation of employment opportunities in some communities.
  7. 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.
  8. Recruitment of more Aboriginal people into the disability service sector.
  9. Build the capacity of the social movement of Aboriginal and Torres Strait Islanders with disabilities by supporting existing networks and building new ones in addition to fostering Aboriginal leaders with disabilities. 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.
  10. Aboriginal ‘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 the FPDN can readily identify key communities that would be appropriate as trial sites.