NDIA Accountability Project

Disability case management and respite services

‹ PrevPage 1 of 7 · Source p. 1Next ›

Submission to the Senate

Standing Committee on Community Affairs

Inquiry into the NDIS Bill

ANGLICARE Diocese of Sydney

January 2013

1

Introduction

ANGLICARE Sydney thanks the Federal Parliament House Standing Committee on Community Affairs for the opportunity to make a submission to the Inquiry into the National Disability Insurance Scheme (NDIS). We look forward to the deliberations of this Inquiry and sincerely hope it will lead to outcomes which are beneficial for all Australians with disabilities, across all aspects of their lives.

Who we are

ANGLICARE Sydney

ANGLICARE Sydney is the community care arm of the Anglican Church in the Diocese of Sydney and is one of the largest Christian community service organisations in Australia. It embodies the Christian commitment to care for all people in need. ANGLICARE Sydney has been providing a wide range of professional services to the community since 1856, and serves many thousands of people every year. Overall, ANGLICARE Sydney services include:

  • counselling;
  • community education for families;
  • family support services;
  • youth services;
  • emergency relief for people in crisis;
  • foster care and adoption for children including those with special needs;
  • migrant services including humanitarian entrants and new emerging communities;
  • English as a second language classes;
  • aged care both through nursing homes and community services;
  • opportunity shops providing low-cost clothing;
  • emergency management services in times of disaster;
  • disability case management and respite and chaplains in hospitals, prisons, mental health facilities and juvenile justice institutions.

Specifically in relation to persons with a disability ANGLICARE Sydney provides the following services:

  • Commonwealth Carelink and Carer Respite Centres: ANGLICARE operates both Commonwealth Carer Respite Centre and the Commonwealth Carelink Centres.
  • Community Options This is a case management and brokerage service to assist people of all ages with a functional disability, who are at risk of premature admission to residential care, to remain living in their own home.
  • Support Co-ordination for Older Parent Carers provides case management for carers over the age of 65 still supporting a son or daughter with a disability at home.
  • Respite Options provides flexible respite packages to carers who have a child with a disability.
  • Westlink Host Family Program offering family-based respite care provided by volunteer families of individuals in the community.
  • Culturally and Linguistically Diverse Social Support for persons who have a disability or are frail aged.
  • Brokerage Options: short term case management for persons with a disability.
  • W.H.I.R.L.S. - Head Injury and Recreational and Leisure Service- this is an out of hours respite service for people aged 18 years and over with an acquired brain injury and their carers/families.
  • PHaMS programs: recovery model of support for people experiencing mental health issues
  • The Haven Project – a mental health capacity building program operating in Camden.

The Social Policy and Research Unit (SPRU) of Anglicare Sydney

The Social Policy and Research Unit (SPRU) of Anglicare Sydney has conducted research in a number of areas pertinent to the services for persons with a disability which are provided by the organisation.

In 2013, the SPRU plans to release research reports based in the following areas:

  • The Support Coordination Program
  • The Lived Experiences of Families of Persons with Severe Intellectual Disabilities accompanied by Challenging Behaviours

Given the experience of the organisation in serving and working closely with persons with a disability in the diverse ways listed above, in addition to the research carried out in the disability services sector, Anglicare Sydney is well placed to provide comments on the NDIS.

3. Anglicare Sydney Comments about the NDIS Bill

3.1 Carers and their rights

3.1.1

Anglicare Sydney is concerned that the rights of carers be addressed in the Bill. The role and rights of carers should be acknowledged in the Bill, along with the rights of the person with a disability. The aim of the Bill is to better support persons with a disability; acknowledgement of the role of carers serves to protect persons with a disability. As the Bill stands funding sources specifically for carers is not addressed.

3.2 Community Awareness and Community Inclusion

3.2.1

Anglicare Sydney believes that the statement “raise community awareness of the issues that affect the social and economic participation of people with disability, and facilitate greater community inclusion of people with disability” should also take into account the multicultural nature of Australian society and the diversity of levels of both awareness and inclusion, which will be influenced by cultural background, beliefs, values, traditions etc.

3.2.2

In addition, it should be noted that the concept of inclusion is far more difficult for the severely physically disabled, the moderately to severely intellectually disabled (especially those with challenging behaviours), and people with severe mental health issues (who may also have challenging behaviours).

3.3 Support Coordination

3.3.1

Anglicare Sydney is concerned that the stated requirement for “locally provided coordination, strategic or referral service or activity” implies the existence of a large workforce of coordination workers. Anglicare Sydney believes clarification is required in order to outline where the financial provision for development of this workforce is to be found, and from whence a cohort of highly trained and experienced workers is to be provided in order to implement the stated services and/or activities.

3.4 Definition of Disability requirements

3.4.1 ANGLICARE Sydney believes the Bill would be better served by inclusion of a reference for the

definition of disability requirements outlined in this section of the Bill. For example, the World Health Organization definition:

“Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations.

Disability is thus not just a health problem. It is a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in which he or she lives. Overcoming the difficulties faced by people with disabilities requires interventions to remove environmental and social barriers.

People with disabilities have the same health needs as non-disabled people for immunization, cancer screening etc. They also may experience a narrower margin of health, both because of poverty and social exclusion, and also because they may be vulnerable to secondary conditions, such as pressure sores or urinary tract infections. Evidence suggests that people with disabilities face barriers in accessing the health and rehabilitation services they need in many settings1.“

3.4.2 The United Nations Definition:

“The term persons with disabilities is used to apply to all persons with disabilities including those who have long-term physical, mental, intellectual or sensory impairments which, in interaction with various attitudinal and environmental barriers, hinders their full and effective participation in society on an equal basis with others. However, this minimum list of persons who may claim protection under the Convention does not exhaust the categories of the disabilities which fall within the it nor intend to undermine or stand in the way of wider definition of disabilities under national law (such as persons with short-term disabilities). It is also important to note that a person with disabilities may be regarded as a person with a disability in one society or setting, but not in another, depending on the role that the person is assumed to take in his or her community. The perception and reality of disability also depend on the technologies, assistance and services available, as well as on cultural considerations2.”,

Page 5

3.4 Disability Requirements

3.4.1 Alignment With International Definitions

ANGLICARE Sydney believes the Bill would be better served by aligning the definition of disability requirements as defined in the Bill with the definition of an international organization, whose definition has been ratified by Australia. In this way, Australian policy and legislation regarding persons with a disability would be aligned with that of other signatory nations. This provides a firm basis in international law to protect and clarify the rights of those with a disability.

3.4.2 Clarification on Definition Usage

ANGLICARE Sydney would also seek clarification on the degree of alignment between the definition used in the Bill, and definitions used by State government departments and other service providers.

3.5 Funding

3.5.1 Appropriate Funding Systems

The Bill states that “the support is most appropriately funded or provided through the National Disability Insurance Scheme, and is not more appropriately funded or provided through other general systems of service delivery or support services offered by a person, agency or body, or systems of service delivery or support services offered: (i) as part of a universal service obligation; or (ii) in accordance with reasonable adjustments required under a law dealing with discrimination on the basis of disability;”

3.5.2 Need for Clarity On Appropriateness Of Support Provisioning

ANGLICARE Sydney seeks clarification regarding the definition of “appropriate” and whose responsibility it is to provide the definition. The current wording is ambiguous and may be interpreted in a number of ways: - The services could be provided if “other general systems” had more money; - The services should be provided by other agencies but are not; - The services are able to be met by others.

ANGLICARE Sydney believes clarification of this point will assist in provision of the best possible services through all systems of service delivery or support services.

3.6 Rules Governing Service Providers

3.6.1 Consultation Concerns Regarding Provider Operating Rules

ANGLICARE Sydney is concerned that, the rules under which service providers will operate are not available for consultation and discussion at the current time. ANGLICARE Sydney looks forward to the release of these rules and the opportunity to make comments about them.

3.6.2 Single National Verification Process Preference

ANGLICARE Sydney believes that the rules should specify a single national verification process. Given that NSW is proceeding towards a state based verification process for service providers it is important to know if this will be sufficient for national verification or if alternative and duplicate processes will be required of service providers – which is both costly and time consuming.

3.7 Assessment System

3.7.1 Potential Problems Inherent To The Assessment Process As Outlined In The Bill

ANGLICARE Sydney believes that there are a number of potential problems intrinsic to the assessment process as outlined in the Bill. The main concern is the subjective nature of the process, and the need for consistency in order to provide fair and equitable treatment to all persons with a disability under the Bill. Some areas of discrepancy between assessors may include equality of access

Equality Considerations

Across Geographical Regions , Disability Types And Degrees Of Severity , Culturally And Linguistically Diverse Backgrounds And Aboriginal Participants

equality of access across geographical regions , equality of access across disability types and degrees of severity, and equality of access for those persons from culturally and linguistically diverse backgrounds and Aboriginal participants.

Individual Differences Between Assessors Have The Potential To Create Inequalities

Differing levels of experience within areas of disability and across multiple areas of disability may result in differing measures of assessment. The level of competence and experience across multiple fields of disability which is required to provide equal and fair assessment of all persons with a disability would seem to be beyond the reach of assessors.

An Anglicare Sydney Seeks Reassurance That The Assessment Tool To Be Used Has Been Shown To Be Valid

ANGLICARE Sydney believes the Bill should ensure provision of multidisciplinary assessment for all persons with a disability, in alignment with the United Nations Convention on Rights of Persons with Disabilities (Article 26), which states that:

“States Parties shall organize, strengthen and extend comprehensive habilitation and rehabilitation services and programmes, particularly in the areas of health, employment, education and social services, in such a way that these services and programmes:

a. Begin at the earliest possible stage, and are based on the multidisciplinary assessment of individual needs and strengths“3 (underlining added).

Advisory Council Composition

An Anglicare Sydney Believes That The Advisory Council Should Consist Of The Broadest Range Of Persons Possible , In Order To Ensure Adequate Representation Of All Stakeholders

ANGLICARE Sydney has noted that page 58 of the Explanatory Memorandum to the Bill states that “the Minister must have regard to the desirability that the membership of the Advisory Council reflects the diversity of people with disability”.

An Anglicare Sydney Would Encourage The Inclusion Of More Carers On The Council ; That The Carers Should Be Carers Of People With Severe Disabilities , And In Particular , A Cared Of A Person With An Intellectual Disability Should Be Included ( Since These People Are Not Able To Represent Themselves On The Council ) , And That One Of The People With A Disability On The Council Should Be Someone With A Lived Experience Of A Mental Health Issue .

Council Members Should Also Be Representative Of The Various Age Groups , Aboriginal And CALD Groups Within Australian Society

3 http://www.un.org/disabilities/convention/conventionfull.shtml

4. Concluding Statement

ANGLICARE Sydney appreciates the opportunity to provide feedback into this significant policy area and looks forward to the final implementation of the NDIS.

Susan King

Acting Chief Executive Officer

ANGLICARE Sydney

7