advocacy
for inclusion I a f.
Response to the Joint Standing
Committee Inquiry into the NDIS Committee
Quality and Safeguards Commission Quality
Advocacy for Inclusion
August 2020
About Advocacy for Inclusion
Advocacy for Inclusion acknowledges the Ngunnawal people as the traditional owners of the Australian land on which we work. Advocacynationalfor Inclusion provides national advocacysystemic independentadvocacy and independent individual, selfadvocacyself and advocacydisabilitiesfor people with disabilities in the Australian Capital Territory. We are a DisabledOrganisationDisabled Peoples Organisation which means most of our board, members and staff are peoplepeople with disabilities. We represent all people with disabilities and recognise diversity. Webehalfact with and on behalf of individuals to act on their own behalf, to obtain a fair and just outcome.outcome.
Advocacy for Inclusion works within a human rights framework and acknowledges the andUnited Nations Convention on the Rights of Persons with Disabilities andtheis signed onto the ACT2004Human Rights Act 2004.
Contact details:
2.02 Griffin Centre
20 Genge Street
Canberra City ACT 2601
Phone: 6257 4005 Email: info@advocacyforinclusion.orgABN:90 90 670 934 099
Prepared and written by Bonnie Millen, Senior Human Rights Policy AdvisorPreparedPolicy
ApprovedApprovedby Nicolas Lawler, Chief Executive Officer
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Executive Summary
Advocacy for Inclusion (AFI) is a national systemic body representing people with disabilities in the ACT. AFI undertakes systemic advocacy and provides expert policy advice on issuesy affectingaffecting people with disabilities in the ACT. In addition, we provide individual advocacy for people with disabilities in a solutions-orientated approach to tackling complex barriers our-orientated clientsclients face. JointThis submission draws the andingJoint Standing Committee’s attention to the disconnection of safeguarding oversight over the disability systems under the NDIS Quality and Safeguardssafeguarding Commission (‘the Commission’), also recognising that the Commission is separate from thenceNOIA. This is with reference to Australia’s obligations under the Optional Protocol to the
Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment orConvention
Punishment (OPCAT), and the Convention on the Rights of Persons with Disabilities (CRPD).
The existing legislative and policy frameworks that are underpinned by the NDIS and the Commission’s purpose do not meet Australia’s obligation under the CRPD. Under Australia’saddressobligation to the CRPD, the primary policies that are designed specifically to address
violence against people with disabilities in closed institutional settings are open to
interpretation. The role of the Commission the regulatory body that has been established forcludingthe NDIS was envisioned to play a wide range of oversight roles, including taking
responsibility from the states and standardising these across jurisdictions.1responsibility1
The role of the Commission was envisioned in the original design of the NDIS but emerged in response to demand for greater regulation of the disability service sector and create ase for sector nationallynationally consistent oversight approach. It is noted that how the Commission has been structured, its role and how they will be shared or demarcated regarding the NOIA is stillplementationunclear. The Commission was proposed in response to the implementation issues of the NDIS and their perceived solutions.NDIS
The purpose of the Commission was to be an establishment of a regulatory body for oversight of the NDIS to explore the ways in which structural solutions are sought tothincomplex issues faced within the disability service provisions and the overall purpose of the
NDIS.NDIS. The lack of meaningful indicators for measurement of achievement against
enforcement mechanisms is highlighted as it limits the practical application of the
1frameworkframework.NationalCommonwealthCanberra Canberra:Department:Commonwealth.Commonwealthof FamiliesGovernmentand Communityof Australia.Services (2017) National quality and safeguarding
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rposedisability.disability.Commission’sIt is overallnot an appropriatepurpose in mechanismproviding a ’complaintsif people withmechanism’disabilities forare peoplerequiredwithto
contact the Commission, only for the provider to become involved in a mediation fashion.Commission, WeforWe criticise it anfor being an ineffective measure of understanding, monitoring, and protecting people with disabilities in closed institution settings by the Commission.people aThere remains a concern that the role of the Commission is ambiguous and does not solve the underlying barriers and issues of service provider culture. Acknowledging that this willthebarriers taketake time in developing, it remains figurative that the Commission now plays a role in further complicating governance arrangements and policy challenges.issionAFI believes the Commission should be focused on increasing meaningful and tangible
support for people with disabilities to exercise self-determination, tied with vigoroussupport-determination,
accountability, transparency, and monitoring systems when making complaints that areaccountability,w omplaints
often traumatic and scary in taking a first step to do so. In the original design of theoftenic scary.
Commission, this had been promised. This submission also keeps in mind that theCommission,
Commission is still in an early phase, with rollout into the ACT has only been in action since mid-2019. Australia’sandAustralia’s Obligations to the UNCRPD Implementationand the Implementation of OPCAT
Australia has been a longstanding party to the UN Convention on the Rights of Persons withAustralia
Disabilities (UNCRPD) and has implemented obligations domestically, including by
enacting legislation 'prohibiting disability discrimination and ensuring services andd
2facilities are available for, and accessible to, people with disabilities’.2 theWhileand toAustraliahave accesshas providedto supports,opportunitiesthey otherwiseto peoplemaywithhavedisabilitiesnever had livingpreviouslyin groupunderhomesthe -discriminationcommunityNDIS, the rightsshouldof notpeoplebe viewedwith disabilitiesthrough atolensliveofindependentlynon-discriminationand beasincludedit currentlyin theis. WhatomeWhat is abundantly clear is that the Australian Government refuses to become legally bindingbinding to the provisions of the UNCRPD, instead opting to take a more interpretative and flexible responsibility in the belief that obligations suggested and set by the UN CRPD
2thethetheSubmissionAustralianConventionGovernmenton the Rights(2017)of5SubmissionPersons withofDisabilities:the AustralianLivingGovernment,independentlyDraftandGeneralbeingCommentincluded inNo.,the5 oncommunity,Article 191ofp.1
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fulfilwith3iswithshouldthebeobligationin recommendationitself’3 is appliableonly. Theto consistencythe role of theof Commission.’measures to fulfil the obligations
The UN Concluding Observations in 2019 contradicted the Australian Government'sThe
supportedwhimsical notion of policy involving Australia’s obligation under the CRPD and supported the issues in which civil society, including AFI, continue to see as systemic barriers. The
Committee responded in their report in reference to Article 19 and the AustralianncernGovernment's approach and responses during delegation discussions in concern to closed
settings becoming a product of the NDIS and encouraged the establishment of residentialsettingsd institutionsinstitutions and will result in people with disabilities having to live in specific arrangements in order to access NDIS supports-which can be applied to the oversight of the Commission.4– to4
alsoofAFIof theis alsoOptional5toa supporterProtocolandto contributor5the Conventionto theAgainstnationalTorturework (OPCAT)surroundingin Australia.the implementationAFI holds a stronginstitutionalstronginstitutional-runpositionfacilities,that closedshouldsettings,be inspected,such as providermonitored,and Government-runand regulated bygroupan independenthomes and body. Under OPCAT, all ‘places of detention’ must be inspected. Places of detention includeention any place under a state’s jurisdiction and control where persons are or may be deprived ofany their liberty. This involves joining the dots from past complaints records, profiling the institutions and places where people are vulnerable, and relying on third-party tip-offs. Forlying- NDISNDIS service providers, the NDIS Quality and Safeguards Commission would be expected to also comply with OPCAT obligations.
The Royal Commission into Aged Care has suggested that the UN oversight measures of theProtocolOptional 6toProtocol to the Convention Against Torture (OPCAT)6 to prevent abuse, neglect, and exploitation in a closed environment that the government is about to apply to ’places ofexploitationa detention’detention’77should should be rolled out in aged care facilities. AFI has been long calling for OPCAT to be considered for disability institutional settings also as a protective measure. It was, into
3 SubmissionAustralian Government (2017) ofSubmission of the Australian Government, Draft General Comment No. 5 on Article 19 of ,4the Convention on the Rights of Persons with Disabilities: Living independently and being included in the community, p.4 ofa:ofConcludingCommitteeAustralia:-CRPD/C/AUS/CP/2-3,on the Rights of Persons, Junewith2019,Disabilities,p.10 Concluding observations on the combined second and third reports5 AustraliaAustralia,TheAFI contributedreport releasedto the nationalJanuaryOPCAT2020 asNetworkwell as reportpushingforforthetheUNACTvisitingmechanism.bodies, The Implementation of OPCAT in6–The OPCAT was adopted by the UN General Assembly in 2002. Australia signed it in 2009, it wasn’t until December 2017 –following the Don Dale revelations - entthat the federal governmentbyratified it and agreed to roll it out .by 2020/21. 7butntalbuthasIn acceptingall places theof detention.terms of theThistreaty,includesthe governmentimmigrationrandomhasdetentionagreed tocentres,randomsecureindependentmentalinspectionshealth facilitiesof not onlyand juvenileprisons,detentionThesedetention centres. These inspections will be carried out by local bodies called National Preventive Mechanisms (NPMs).ThepectionsThe office of the Commonwealth Ombudsman is the authority appointed as NPM coordinator. And OPCAT inspections differfromThefrom traditional forms of monitoring as they have a preventative focus. The United Nations Subcommittee on thePrevention–whichPrevention of Torture -which–willis comprised of 25 independent experts -will also inspect these closed environments andreportirreport their.findings back to the federal government.
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andfact, the original impression that the Commission would undertake inspections and inquiries against ‘complaints’, rather than a removed, mediative approach and leaving to the Statesagainst and Territories. We also believe that the Commission has the means to apply more pronounced oversight measures to disability settings than it is currently.tly.
AFI has been active in our advocacy for OPCAT and the need for its implementation to be applied to closed disability, mental health facilities, and aged care settings in Australia. For the work of the Commission, applying OPCAT inspections to the disability sector providesability benefits and preventive, rather than compliance focus. The monitoring, investigation, andbenefits enforcement powers available to the Commission cannot be conducive to the free flow of complaints and information if people with disabilities, their advocates and family supportstheir feel they will be reprised for speaking out against their provider. There is ill-confidence infeel-confidence the ‘tell us’ model that is implemented by the Commission.the
The implementation of OPCAT is a preventative measure. It can be applied to the monitoring,.canapplied investigation, and enforcement powers of the Commission if the approach is consumer-investigation, dbeyondcentred beyond the inspection of compliance with standards and regulations to identify issues that are not easily quantifiable, matching the obligation of the UNCRPD to protectissues,thePDotect vulnerablenerablewithpeople withuse,disability from abuse,.violence and neglect.ective,From AFl’s perspective, ofa ‘tick box’ mediative approach missionof the Commission does not actively reveal anything about the atmosphere and culture within closed environments or how people are really treated.the
The Commonwealth Attorney-General’s Department is responsible for the implementation-General’s of OPCAT in Australia with the Commonwealth Ombudsman undertaking the nationalofwithsmannational OPCAToversight role of the .TheOPCAT National Preventative Mechanism (NPM). The design of OPCAT to create an open dialogue of closed settings, in our case, closed settings including grouptoclosedluding
homes run by service providers, closed mental health facilities and prison or policehomes, orolice
watchhousesettisettingsherewherenedpeople with disabilities are detained.
The purpose of the NPM to have an educative and promotional agenda that will find smartTheNPM tive ways to influence ‘fence-sitters’ (people with concerns but who are unsure how to react) toways-sitters’
speak up - essentially similar of how the Commission performs its role. This meansspeak– sentially ofsionrole
penetrating the circle of tacit peer-backing that often sits at the heart of abuse. This is thepenetrating-backingThis extent to which torture, abuse, cruelty, and other forms of degradation are normal in certainextent contexts. Whether we like to admit it or not, there are settings in which these harms persistt precisely because no-one raises an eyebrow. The ‘blind-eye’ syndrome means that outragesprecisely-one-eye’ are justified and normalised.are
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Screening Checks
In the care sector, the risks remain high where potential providers enter the market with thes intention to seek profit at the expense of participants/consumers. Whereas the disabilityintention sector is more regulated and controlled with the NDIS structure in place, it is vastly different to the experience of the aged care sector where breaches of human rights and death havewhere occurredoccurred due to severe malpractice and unregulated providers. -MarieThe Ann-Marie Smith case in South Australia has highlighted the importance of oversight of worker screening checks as well as regulation checks on the organisations that employworkerthe them,them, and the importance of choice, control and a potential oversight mechanism that goes
beyond a 'complaints process'. The Commission role should extend from individual
employees through to whole organisations to remove the opportunity for individuals to bopopportunity fromfrom provider to provider in a casualised workforce, covering abuse and violence.
The bad thing happens. They drop the person, some terrible assault,Thehappens.
whatever it is. Who's accountable? So, if they're employed by [an whatever
organisation] or whatever, then the government goes to [that
organisation], and it goes, what the hell? Was the person supervised properly? Were they trained properly? What were your assurances around rly?
that? What went wrong? Was this just a completely random rogue that?
individual? Dr is something systemic happening with your organisation? … And we’ll hold the firm to the greater extent somehow accountable for accountable what .whatcase orhappenednot.8 … The job of a regulator is to check whether that’s the More–More regulation (not policing) over the disability service sector is inherently a good thing ofworkforceworkforcefor AFI, we thatbelievefreelythatmovesmorebetweenregulationorganisationsover the movementsto take on ofshifts,employeeswill circumventof a casualisedissues
emerging where abuse, violence and neglect is prevalent from individual harms to
organisational functioning.hasThe role of the Commission has been envisaged to take control of the worker screening and qualificationsqualifications to protect against poor practices in the disability service sector. AFI continues to share concern over the responsibility and accountability surrounding the workers within
8ParticipantusPolicyusGemmaParticipantabout policyin (2018)Gemmaimplementation?Carey & Eleanor,Policy MalbonDesign and(2018)Practice,Strange1:3,vol.1:3,magic:p.173what can the emergence of ‘magic concepts’ tell
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the NDIS and the provision of workers moving between service providers in an increasingly casualised workforce.
Whilst it is welcomed that the state-based such as Working with Vulnerable Peoples’ checks will remain the responsibility of the states and territories,9 the oversight and monitoring of registered workers and the providers they are employed by should be the responsibility of the Commission. While the Commission may solve some issues regarding the complexity of worker screening, greater complexity will persist in the coordination of state, territory, and Commonwealth practices.
The issues of violence, neglect and abuse in service provider settings is a cultural and
structural issue where there is no oversight over a casualised, fast-moving disability
industry. Disability support staff have been able to move fluidly between organisations to pick up casual shifts where full-time and permanent roles are becoming harder to access. It is known to AFI that individuals seek out workplaces where they will be placed in a position that might allow the opportunity to misuse power and harm people. Thorough screening
processes to prevent such people from entering the disability sector are, therefore,
incredibly important.
The following case studies are examples of the seriousness that has occurred for clients who have faced abuse, violence and neglect in group home settings run by providers. In both case studies, both disability support workers were swiftly removed from the provider setting and placed elsewhere, essentially allowed to remain working with vulnerable people without oversight. Both disability support workers were reported to police with support of an AFI advocate but both were considered to be ‘unreliable witnesses’ due to their difficulty in communication and considered incapable in providing evidence to support their claims. Both case studies occurred before the implementation of the Commission, but remain relevant to experiences that are currently faced by others who require the Commission to provide oversight over worker screening checks as well as casualisation of shifts that allow them to move between disability service providers.
9 From 1 July 2019, all disability service providers in the ACT registered to deliver supports under the NDIS will be overseen by the NDIS Quality and Safeguards Commission. Quality and safeguards matters that occurred prior to 1st July 2019 remain under the jurisdiction of the ACT government. The ACT government and the Commission will continue to liaise and process outcomes of these matters. Safeguards and quality assurance frameworks that currently exist to protect people in the ACT sit under the ACT Disability Services Act 1991 and related instruments. This Act applies to all specialist disability service providers in the ACT.
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1Case Study 110 oursneededZafirneededattendedsupporta dayto centredo mostfor a thingsfew hoursthroughoutthree daysthea weekday. andZafirliveddoesin a notgroupusehomemuchsetting.verbalHe communication, but he can express himself using vocal sounds and hand gestures, and occasionally some words.-psychoticZafir has been a client of AFI for many years on and off. He was given anti-psychotic medications to address-harm,address challenging behaviour, including self-harm, which is prescribed by his psychiatrist on a low basis.atbasis. In 2013, the advocate became aware that staff -at the day centre had been giving Zafir anti psychotic medication more frequently, and that his challenging behaviour was becoming more of a problem in that setting. edThis continued for about 9 months, until in early 2014 the CEO of the day centre contacted our advocateadvocate to inform her that day centre staff had reported a serious incident of physical violence against Zafir by the senior support worker at the day centre. The senior support worker had been andemployee at the day centre for 17 years. The CEO had already contacted the police, who advised her toto contact Zafir’s legal guardian or advocate to support him to make a police report.
Deidentified day centre staff incident reportbyToday Zafir was verbally and physically abused by my team leader, Paul. Zafir had finished eating his carrotscarrots and was banging the container on the table. Paul yelled “stop banging that fucking container” and grabbed Zafir and pulled him out of his chair and pushed him across the room. Then Paul yelled at him again “get in the fucking corner you fvfuslim fuck.” Zafir immediately went to the corner and looked at Paul over his shoulder. Then Paul yelled “don’t look at me”. Then he went and placed hiswall.hand on the back of Zafir’s head and banged it into the wall. It was hard enough that I saw the gyprock wallwall break free from the corner.
There have been other instances involving Zafir:
-
offtheZafirthe knucklesgot droppedand said,off to“how[day arecentre]you goingand Paulmate?“wasLaterquite thatpolitesameanddaygaveZafirZafircamea friendlyup to Paultouchandof“noheld out his fist for a friendly touch again and Paul threw his hand and said, “no don’t fuckingtouchtouch me”. 10studySenatestudye,All detailsAFI usedincludedin its submissionare actual todetailsthe Senatefrom Zafir’sInquirycase,into includingviolence, abuseincidentandreportsneglectandagainstexcerpts.peopleIt waswitha notabledisabilitycaseininstitutionalininstitutional and residential settings agencyin 2015. All individual and agency names (including Zafir’s) have been changed toprotectprotect Zafir’s privacy. This story has been shared with permission from Zafir and his legal guardian.
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-
We were at Macdonald’s for a morning snack and Paul threw Zafir’s pancakes in front of him. As Zafir was putting the butter on them and he gave a cough in Paul’s general direction. “Don’t cough me”on me” Paul said, then he went around to Zafir and gave a large cough in his face and then again onon his pancakes.
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irPaulwas someoneand I werewalkinggoing fortwoa largewalk withdogs.ZafirKnowingwith oneZafirofwashis scaredpeers whenof dogsI sawI suggestedup aheadwethatchangetherethethe plan of the walk. Paul disagreed and said, “nah fuck him”. When we were getting closer Paul told Zafir to stay close.
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ggestedWe went for a walk it was winter and quite cold. Zafir had no jumper and jacket and I suggested we should not go, fearing Zafir might get a cold. Paul said not to worry about Zafir, “fuck him”. I took my jacket off and gave it to Zafir and Paul said I was too kind.
-
egs.annoyingannoyingWe were atPaulMacdonald’sand he madeandZafirwe getwereup havingand standlunch.facingZafirthewaswall.tapping both his legs. This was
-
G“black/\1any times,boy shutZafirup,is stopvery yourverbal/\1uslimin the fuckingcar. Paulwailing,alwaysZAFIRgets verySHUTmadTHEatFUCKINGthis and saysHELLthingsUP”. like
-
We were at the park for lunch and Zafir was taking his time with his lunch. Paul got impatient and threw his lunch on the ground. This happened a couple of times.
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theupZafirup tippingwas sittingZafir offonthethecouchcouchandbeingtheverycouchverbal.landedPaulongottopmadof him.and picked the side of the couch
-
–theWe wereback off- myoncountrY,a programmy andrules“.Zafir went to sit in the front seat and Paul said, “no fuck you get in
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topointingpointingWe were atbowlingit. I didn’tandunderstandZafir went whatto pickwasupwronga bowlingwith ballZafirandchoosingPaul saidhis own“no pickupball. Paulthathasn’tball” done the same with [other clients]. clients].AnotherverAnother day centre worker’s incident report outlines that over the course of many months (the exact timetime frame is not clear) they observed “several instances of inappropriate behaviour toward clients”
by Paul. It reads “Paul uses racial abuse and taunting, particularly towards Zafir who is from aItMuslim family”. It outlines that the reporting staff member and two other staff decided to confront
PaulPaul and tell him they did not agree with the way he treated clients, especially Zafir. Zafir.ThebehaviourThe incident report also outlines the way the staff member tried to address Paul’s behaviour directly byby “pointing out to him the behaviours of concern as they happened … but the result is often unsatisfactory due to Paul’s highly agitated state at the time of the incident. Therefore, I woulddown”.sometimes prefer to wait until Paul had calmed down”.
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Over the next 6 months leading up to the assault that prompted the CEO to phone the police, incidents continued to occur, and Paul sometimes apologised and refrained from abusive behaviour for a while.
Response by direct support workers Zafir experienced an intersection of race based and disability-based violence, for example by Paul withholding appropriate supports, applying force and physical violence while undertaking his support responsibilities, intimidating him because of his communication style, at the same time as using racial slurs. The violence was emotional, psychological and physical and occurred at least over the course of around 9 months. It is apparent that Zafir’s increased “challenging behaviours” were in response to the abuse targeted at him by Paul. However, support workers did not take serious action until the final assault by Paul against Zafir when Paul slammed Zafir’s head into the wall. Even staff members who did report to Paul felt intimidated by his behaviour and did not know how to respond in an effective and appropriate manner, for example by contacting the police in response to criminal offenses, including racial vilification and physical assault.
Response by senior manager The advocate at Advocacy for Inclusion informed Zafir’s psychiatrist of the details of the assault and the patterns of violence against him by Paul, given the significance of this to his mental health and the increased use of medications to restrain him. The psychiatrist wrote a report which included
documentation of the assault and preceding violent behaviour and made reference to Zafir's
“worsening” behaviour for some months. The day centre CEO subsequently wrote a reply letter, which reads:
Deidentified excerpt of day centre CEO letter to psychiatrist: I was shocked that confidential and private information had been mentioned in a required objective report, particularly the disclosing of the names of two [day centre] staff members and that such emotive language as “having his head slammed against a wall” was used which was incorrect - the participant’s head was pushed into a wall, not slammed. There was no sign of physical injury to fvlr [Zafir] and no mark on the wall. fvfr [Zafir] had not been physically abused prior to this incident - he had been racially abused. There were misleading comments made in your report and fvlr [Zafir’s] behaviour at [day centre] has not deteriorated since the incident nor indeed before.
I find your comments in the report unnecessarily inflammatory and possibly in breach of privacy and confidentiality.
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The CEO took appropriate action by contacting the police and dismissing Paul immediately. However, the defensiveness in response to outside scrutiny is very clear and reflects how organisations
typically respond to allegations of violence, in Advocacy for Inclusion's experience. The CEO
expresses a clear concern with saving face, particularly in the way they speculated that Zafir’s head was “pushed” not “slammed”, as though this makes a significant difference to the seriousness of the assault and misuse of power. The CEO’s denial of previous physical assaults is also striking, given that the CEO is not typically present during direct support activities, and at least two staff members had documented clear, long term patterns of physical violence. The CEO seems to express a sense of entitlement to conceal some of the details of the violence, as though this information belongs to the organisation, and not to Zafir as the service user and victim.
Police investigation The advocate at Advocacy for Inclusion worked closely with Zafir and his mother, who is his legal guardian, throughout the police investigation. Zafir became visibly distressed at the police station when his mother was being interviewed, indicating he had some understanding that they were discussing Paul’s violence against him. Although Zafir could not explicitly articulate his personal wishes in terms of pursuing the case at that time, Zafir’s mother was determined to follow this through for him and for other people with disabilities who might be supported by Paul in the future.
Despite the two support workers willing to come forward as witnesses, the police decided not to charge Paul and instead give him a warning. The police said that the reason they would not charge Paul was because there was not enough evidence; Zafir was not a reliable witness because of his cognitive and communication impairments, and he could not make a statement in conventional formats. They noted that Paul expressed significant remorse and suggested that the process would be too stressful for Zafir and his family.
Case Study 2
Michelle experienced gender based as well as disability-based violence. She refers to some of the staff who are “horrible” and call her names, and she also refers to the long-term impacts of trauma and facing constant reminders in her living environment where the assault happened several years earlier.
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“I live in a group house and sometimes it’s ok. Some of the staff are nice. But some of them are horrible. They call me names. I’m sick of living there and I want to move out.
I was sexually assaulted by a worker in my bedroom. I reported it to the police and it went to court. One of the workers told the court that it didn’t happen. They didn’t believe me and the man who abused me got let off.
I never got any closure. I saw him one day in public. It made me cry. Why did he get let off? He got fired but I wonder if he’s working with other disabled people now. I worry for their safety.
My house brings up painful memories. It hurts a lot. It makes me quite upset. I moved into a different bedroom so that I don’t have to remember it so much. I can make my own decisions about where I live, but for now I am stuck there.
Sometimes I get frustrated. But I amok now. I am a very strong woman and I know I can do it.“
The support worker was simply moved to another provider and continued to work with vulnerable people with disabilities at the time this case study was recorded.
With a highly casualised workplace, clients have expressed that high staff turnover is a major concern for them as well as the lack of preparedness of new disability staff to work safely with them. The education delivery of Certificate Ill and Certificate IV as the baseline of care qualifications remains a great concern to AFI, particularly the length of time that it takes to obtain qualifications that enable staff to be fully qualified and vetted to work with vulnerable people with disability. AFI clients have felt safer with staff that have become familiar with their individual support needs and have established a rapport and trust with them. The NDIS has enabled this to be a cemented aspect for people to choose and pay for qualified support workers through their NDIS plans, however, in group home and provider settings where a casualised workforce is more apparent, it is harder to manage.
In the past, clients of AFI have been hurt by unfamiliar support workers in the past, on purpose as well as accidentally when the support worker has not understood how to meet their basic needs because of a lack of familiarity.
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“Sometimes I say to the staff ‘who’s on in the afternoon or who’s on in the morning?’ and they say ‘why do you want to know?’ And I say ’cause I just want to know who’s say on so I’m not nervous if we’ve got strange people or if I don’t know them. 11111 on11
Support workers also need on the job supervision and instruction from staff who are already familiar with the supported person. Our self-advocates told us that while their service-advocates providers have policies instructing staff to read files and have a handover, they feel thatprovidersthey staff are not often afforded the time to do so in practice and are required to undertakestaffpracticeare practical duties immediately when they begin their shifts. Self-advocates also identifiedpractical-advocates that when support workers are afforded the time to prepare for their shift, they have notthatr necessarily used it for its purpose.necessarily
Brendan: When I have new carers, I feel a bit unsafe for a while but after that it'sBrendan:carers,
alright.
Facilitator: And is that because you don’t know them, or they don’t know you? alright.Facilitator:
Brendan: Yes. Both. Like this bloke it was his first time supporting me I almost fell th. out the hoist… things like that are frightening. out
Facilitator: Dk. So, what might help when you’re feeling a bit unsure when you’ve got new support people? Is there something that the service providers could do to make vice that better? that
Brendan: Tell the new workers how to support me.
Facilitator: Give them a good hand over?
Brendan: Yep that’s what I mean.– caFacilitator:can find outHowhowaboutbest toyousupportKim, whenyou? there’s new staff on - is there a way that they you?Kim:Kim: Yeah there is if they read the book but they often don’t. But anyway, I’d prefer it if they read but then also talk to me.
Facilitator: Yeah. So, it’s a bit about you not having to explain absolutely everything and they get some background knowledge- they
11 Advocacy for Inclusion. (2013). Ask me. I make my own decisions: Choice and Control Study, Individual
Participant
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Kim: Yeah but then if they’ve got an indication you can tell more stuff. And explain it a bit better or-
-Yeah,Brendan: -Yeah, I might ask [supported accommodation agency] about that.
Facilitator: Would a new staff member whether they’re a casual relief person or a Facilitator:member new staff member do they get some hand over time? So maybe half an hour of time new to read information and talk to you, talk to the other staff before they start working? Or when they walk in the door are they expected to start straight away?ey
Tim: Start work straight away. Tim:
Kim: It depends on what people [support workers] prefer. Some people will
automatically read. But others will use the time to do-you know if there’s time. -you People make their own decisions about how they use it. Peopleout
Brendan: I think it depends on how busy they are. They might have a bit of a handover Brendan: but everybody’s busy in the morning because all the people [residents] are going out.12 .
In our experience working with clients of high and complex needs, the lack of progress toIneeds, address gaps where scarce services are available or exist has been highlighted continuouslyaddress that requires oversight by the Commission. We also note NDIA’s reluctance to consider any service delivery model that is not based on the individualised and broadly-rolling-out of fee-the- - -servicefor-service models. It is also a gap when continuity of supports lessens, and the participants lose their chosen provider and are required to redevelop a rapport or support system with alose portnew provider or support staff who may be less experienced in working with high complex
needs.needs. This is apparent where allied health workforce is thin within the NDIS: OTs,
psychologists, speech and language therapy and behavioural therapists are all in demandingas part of tackling thin markets. CaseCase studies highlight a significant gap where disability support workers are low in numbers and reliant on casual contracts due to low support staff available. We regularly receivepeoplerequests for advocacy for mpeople being put to bed at 8 pm and not provided choice and controlcontrol in their own group home accommodation due to lack of support staff available to monitor and support during the night. Equally, people have been left in bed until 11 am to be
12 Advocacy for Inclusion. (2013). Ask me. I make my own decisions: Choice and Control Study, Individual
Participant
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releasedunable13providedunable to breakfast,commit to showered,early morningand availabilities.13dressed or released into the community due to staff –alreadyWealreadyarguewellthatknown,there isacknowledged,currently an immatureand possiblymarketburntframeworkto a crispunderwherethe NDISawareness- that isis concerned. The NOIA also appears to be working in isolation and not building on existingng service delivery models, which in turn, falls back into the disability advocacy organisations where capacity is overflowing, and the availability individual advocacy is narrow and based14on the severity of individual cases.14 ifferentA thin market, except in a different context. This is not surprising where the Joint Standing Committee on the NDIS in 2018 has pointed out “there issurprising currently no clear national strategy to grow the workforce despite the need for an additional 70 000 disability workers by 2020”.15 This is where the role of the Commission could be15 This beneficialbeneficial in terms of oversight, monitoring and observation of thin markets.
In addition, there is also a need to begin addressing the potential growth in a growing agedypopulation of people with disability over 55 where the NDIS age cap and participants are then reliant on the aged care system for service provisions. Effectively and realistically, boththen sectors and service provisions are requiring growth in support and specialised staff. This is going to place additional strain on the current thin/weak market structure where NDISace fundingfunding for the participant is supplied, but the aged care sector and those ineligible for the NDIS may potentially require just as frequently and urgently. The Commission will also planplan and consider the growing older population of people with disabilities to ensure compliance is also in working conjunction to aged care oversight and compliance models.
The Commission needs to provide a separate entity within to track and monitor a screen-creen checkedchecked disability support worker to increase safety when they are moving across disability
service organsiations fluidly. This does not mean policing - but instead, allows for–
complaintsanisations.complaints to be better tracked if an individual works across several organisations.
itsOfficialEach StateVisitorsand Territory manages its own approach to oversight mechanisms through a
varietyvariety of closed settings. The current ACT Quality and Safeguarding mechanism is
13 Also refer to Advocacy for Inclusion (2014) I Make My Own Decisions paper.
14 Productivity Commission 2017, National Disability Insurance Scheme (NDIS) Costs, Position Paper, Canberra,
p.34 15 Joint Standing Committee on the National Disability Insurance Scheme (2018) Market readiness for provision of services under the NDIS
Commission 13/08/2020 16
ServicesDisabilityoverseenDisability Servicesby the HumanScheme.implementedServicesAt full Registrarscheme rolloutand implementedthe Commissionthroughthroughwill thedealOfficialwith mattersVisitor relating to the NDIS, participants, workers, and service providers in the Scheme. There is anotrisk that services provided to people who are not participants will have no standards oversight.oversight.
In the interim, the ACT Official Visitor Scheme in cooperation with the Human Rights Commission and the Office of the Public Advocate plays a key role in oversight of serviceain quality,tionquality, particularly in relation to accommodation. This allows them to enter spaces where disability advocates are unwelcome and considered ‘pesky’ in comparison, despite thedisability necessary need for people with disabilities requiring access to information to allow them to make complaints or raise concerns under the ACT Disability Services Act 1991.orDisability.
The Community Official Visitors Review observed that there are strong arguments that the protections offered by the Commission could be enhanced by the inclusion of official visitors to disability services as a function. The roles of the Official Visitors should play a roledisability in safeguarding vulnerable NDIS participants, working with the broad framing provided byin the NOIA and the specific guidance of the Commission.
The justification includes:Commission.Thedes:
-
Strong internal links with key areas of risk (such as restrictive practices) which could facilitate the dissemination of information and expertise.
• ldDirectNDIS flowsCommissionof informationshould fromtherelocalbe sitestrends/patternsto the NDIS Commissionof concernandthatfromneedthe
investigation.investigation.
-
The simplicity offered by a single national scheme for providers, NDIS participants and members of the public.
-
h.The ability to set a common philosophy of practice, standards and follow through. 16focusDrivingwhichnationalmayconsistencynot be achievedof approachesif commitmentto safeguardingis variable requiresacross jurisdictions.16investment and
notOne of the challenges for Official Visitors is that of maintaining clear boundaries and not acting outside their legislative responsibility, including as case managers, advocates, or auditors. The role of the Official Visitors to ensure that compliance is being met, informationneedsof ‘outside’ advocacy support is available and ensuring that the needs of individuals are not
WestwoDisability16DisabilityWestwoodReformCommunitySpiceCouncil,(2018) ,CommunityCouncil of AustralianVisitor SchemesGovernments,Review: DecemberFinal Report,2018Department of Social Services for the
Commission 13/08/2020 17
being overshadowed by the service provider. In addition, official visitors also play a role in assisting local resolution of issues. Skills in providing constructive feedback are highly valued and assist in improving service quality. By asking questions on site they are alreadyuality. helpinghelping staff or residents think through problems and solutions. They can also bring an independent and fresh pair of eyes to issues.functionThe Commission has been granted wide competences including an audit function that will be undertaken by independent auditors using NDIS Practice Standards at registration andbe
renewal. We believe, that in consideration and working with the States and Territory
Government that Official Visitors to be provided with more responsibilities alongside thensibilities CommissionCommission in a developmental role with information and other assistance to enable
providers to meet requirements. The Commission already undertakes own actioniteinvestigations and follow up complaints or reportable incidents with site visits, interviews,
andand other checks on compliance. JointIt is recommended that the Joint Standing Committee consider the Official Visitors role to increase presence alongside the Commission: creating a preventative visiting modelincrease ycompletes this approach by providing an independent mechanism separate from the regulator. The description of NPM visiting under the OPCAT highlights the potential forregulator.
-centred,person-centred, local problem solving offered by the Official Visitors in States and
Territories and highly valued by advocacy services.Territoriesd
The South Australian case of Ann-Marie Smith17 has proven why Official Visitors need to beThe- 17 entrustedentrusted with greater responsibility that is closer to the ground and more responsive. Increased national consistency could also be achieved with the development of a nationalwith corecore competency framework for Official Visitors beyond voluntary roles, supported by a national training curriculum and visiting protocols. Also given the powers that OfficialviceVisitors use for entry and inspection of service provisions, we do note there needs to be clear legislative authority under OPCAT as well as State and Territory legislation.18legislative18
–InProviderIn a growingof Lastand unstableResort - market,the Commissionthere remainsneedsconfusionto step upof what constitutes as a ‘Provider of Last Resort’ (POLR). As an advocacy organisation, we have faced confusion as to whether
17MAGAREY,REPORTMAGAREY, J (2020) CLIENTSREPORT URGED INDEPENDENT CHECKS ON VULNERABLE NDJS CLIENTS,NINDAILY (ONLINE), 22ND MAYHTTPS://INDAILY.COM.AU/NEWS/2020/05/22/REPORTMAY 2020, ACCESSED 11TH AUGUST 2020: HTTPS://INDAILY.COM.AU/NEWS/2020/05/22/REPORT-URGED-INDEPENDENT-URGED -INDEPENDENT
CHECKSCHECKS-ON-VULNERABLE-NDIS-CLIENTS/O -VULNERABLE NDIS CLIENTS/
18 Ibid
Commission 13/08/2020 18
alfbewebe suppliedare actingadequateas a sourcecare ofand’lastaccommodation.resort’ is urgently advocating on behalf of a consumer to
In submissions made to the Productivity Commission in 2017, the NOIA stated that:
[It] is prepared to act to reinforce thin markets where intervention is necessary to[It] ensure market supply and to act as a Provider of Last Resort where the market fails nd to provide this supply. to
19 highlights the presence of ’weak/thinThe19The NOIA’S current ‘market intervention framework’ markets’ as well as describing the authorisation of a POLR by the NOIA where “provision ofmarkets’provision goodsgoods and services in order to ensure supply” is commissioned. The confusion lies in the line that “even in a mature NOIS marketplace, insufficient local demand, limited-service delivery,-service workforce shortages, and lack of infrastructure will produce “weak” or “thin” markets“20 -workforceoduce20 providing no reassurance that even at a crisis intervention point, support and supply will beproviding provided under the NOIA.
At best, providing advocacy where crisis support is required, is difficult when the NOIA is seen as a giant boulder in the path of progress for an individual in need and no oversightaand mechanism in place. In our experience, we often have participants being denied services andmechanism. care due to funding disputes between the NOIA and other government services, including:care
-
ssupportsupportNOIS participants,their independentwith plansliving.providing for intensive supports including 24/7 care to
-
Trapped in a constant cycle of recidivism due to lack of supports to aid people with disability and mental health in the criminal justice system
-
mresidentialcannotresidentialget carebail supportsfrom the incourtplace.because they cannot safely return home without
-
-homecannotprovidersattractto coordinateservice theirprovidersin-hometo givesupportsthemasthetheynecessaryare deemedsupporttoo complexor attractand challenging.challenging. -definedThecomplexissueandof thethe interfaceroles of eachbetweenneed theto becomeNOIS andwell-definedmainstreamin servicesa policy frameworkhave becometo differmore
NDIA19 (NOIA (National Disability Insurance Agency) (2016),),NDIS,NDJS fvtarket Approach: Statement of Opportunity and Intent, Gee long. 20 NDIA (2016) NDIS Market Approach: Statement of Opportunity and Intent, p.15
Commission 13/08/2020 19
to avoid conflict of interest - this an area that the Commission will need to provide more oversight and guidance to the NOIA.
The confusion of whether Last-resort issues and if such issues equate as a thin market is confusing and needs to be addressed. People with a disability with complex needs or
unpredicted circumstances, ending up in public aged care facilities, hospitals, or
institutional care such a prison, mental health wards and group homes is concerning. The lack of resolution surrounding how jurisdictions, including the ACT, can settle for a framework that identifies key service providers or settings of last resort to maintain critical supports that are ongoing.
In our experience, when people with high and complex needs rely on support to eat and drink are admitted to hospital are often left unsupported as it becomes a health vs NDIS interface issue. Arguments seem to arise from Supported Independence Living (SIU providers that this support is not covered in their SIL quote if the participant is not present in the home and when the quote covers daily Living matters. Instead, such support seems to then appear from their social support funding. It then becomes left for an advocacy organisation to organise such independent Living support as it is overlooked in by the SIL provider.
We also see alarming cases of people being admitted to hospital, healthcare or aged care facilities and not being released (or placed under guardianship arrangements) due to lack of support staff available to assist daily. Within these practices, AFI can attest to handover processes lacking or unprovided, compromising the care and support of the individual. Despite participants being eligible and have access to NDIS, the question of what happens when sudden care changes occur, and they cannot be cared for in their own homes. Without the NDIS and Limited care options available in the community for family or providers, there has been no choice but to admit them to a hospital or an institutional setting arrangement.
The NOIS as a boulder analogy can well be applied to barriers faced by advocates trying to find a solution to crisis intervention and access to accommodation but note the friction between the NOIA and State and Territory health systems, and would benefit from support from the Commission as a compliance and oversight body. If the NOIA do not have the capacity nor the willingness to actively respond to crises in jurisdictions, including the ACT, that actively requires the health system to intervene and a thin market, how can they actively develop a ‘service response’ in time and with a Limited capacity of staff?
It is unfair to assume the individual should have funding to cover any critical incidents that may occur outside of that the NDIS would traditionally fund. The confusion of how last
Commission 13/08/2020 20
esandandresortshouldsupportnot willfall tobe theaddressed,person withwho adequateprovides supportsupport andmeasureshow quicklyput in place.falls toThisthe isNOISnot
the role of an advocate and nor should it be if the NOIA claims to be a PORL provider. Ityplaces extra strain on advocacy organisations to pick up the pieces for individuals in PORL
situations.situations.TheThe prioritisation of urgent and critical needs requires the NOIA to act faster to address gaps when they arise in a crisis. If services are not already in place, have ended or changed for theed individual,individual, the real consequences are that situations will worsen for people and advocacy
organisations will continue to be safety net. People with disability and psychosocialomdisability have been provided wrong supports as an option by staff whom-are ill-trained or
equipped to support them, be retained in a custodial environment, hospitals or institutionalequipped settings as there is nowhere for them to go and forced to remain in their homes withouthereadditional support for their families or carers. If there are no complex services to support individuals ’to attain and maintain maximum independence, full physical, mental, social andindividuals 21vocational ability, and full inclusion and participation in all aspects of life’21, then it enters a
thin market domain. This is evident where there is no market and no accessibility tothins
alternativealternative options.
The NOIS is currently dedicated to a funding model, with limited flexibility. There is also conflict where the NOIA is not only the funder but also holds a view of the appropriateopriate
-funding model that it expects from its jurisdictions. Moving to a fee-for-service-service and paid
from individual packages raises the question of whether it is appropriate to use thefrom
forindividual plan model that may work for some participants but may worsen for others who have limited funding or are ineligible for NOIS funding.have
Currently a partnership approach between the ACT Government providing the service and the NOIA funding, which is being implemented to support areas of the service delivery system under health that the ACT system any otherwise struggle to fund. From 1st July 2019,er thenowthe NOIA now fund public rehabilitation, aged and community services in the ACT under CanberraneedCanberra Health. From here, consumers payneed funds allocated in their NOIS plans to pay for these-kind’these services as the funding model switches from ‘in-kind’ to a ‘fee for service’ model. ConsumersConsumers rewere being told through a promotion that supports can be still supplied; however,-allocatedhowever, without funds pre-allocatedovernmentor approved in their NOIS plans. As a government entity under ACT Health, Canberra Health Services is now an NOIS Service Provider. Is this
21 ArticleUN CRPD –Article 26 - ,Rehabilitation and habilitation, s.18(a)
Commission 13/08/2020 21
interface a conflict of interest with a jurisdictional government entity becoming an NOIS service provider and will it plug gaps?
In addition, the severe lack of behavioural management support in the ACT has also been aack
highlighted-22highlighted issue for our clients. There is a Catch-22 within the ACT where (1) NOIS
participants cannot receive funding to support them to receive Behavioural Managementparticipants fficultySupport, creating difficulty to find services that fit their needs whilst also liaising with education and health outside of NDIS remit and, (2) there are extremely limited capacity ofeducation behavioural support specialists to sign and support further behavioural management support in line with the current and new Senior Practitioner Act 2018. In the ACT, this hasinSenior. createdcreated a stalling of supports as they toe the line with education and health.
In the ACT, there is a severe shortage of NOIS behavioural support planning available, and itt falls to the requirement of the provider who must be registered creating backlog and urgency where qualified behaviour specialists are available. This in turn must be provided to the Commission for quality assessment, monitoring and recording.
Existing state and territory government processes that arise in crisis and emergencies thattate will cease despite the absence of formal arrangements under the NOIS is a concern. 22will22 Without key services that can respond to emergency crises and have expertise in linking people with complex needs to providers and services, there will be consequences where people continue to be placed in environments in which they will be stuck. The NOIA has notA placed triaging systems in place to address urgent cases.placed
The NOIA, which has fundamentally changed previous state and territory previous funding and service structures, should be revisiting the way state and territory services used tonoperate in emergencies to ensure that the individual is well placed and not left in limbo. From an advocacy perspective, there appears to have been no process to ensure theFrom provision of adequate, equipped services that manage crisis intervention and emergency service as there is no direct market and the system ultimately relies on state and territoryce governments.governments.ThePrinciplesThe COAG document servicelacksservice systems Thelacks Principlesclarity andtoaredetermineopen to misinterpretation.the responsibilitiesackTheoflackthe ofNOISfunding,and otherroles andand responsibility between the NOIA and mainstream services has created an emerging gap of its own where the fault is not of the participant. The impact on access to services for both
22 Transitional arrangements for the NDIS and the Market readiness for provision of services under the NDIS reports
Commission 13/08/2020 22
eligible and non-eligible people with disabilities is great, particularly in the areas of justice, health, transport, and crisis accommodation.
The focus should be on addressing boundary issues with mainstream services, the health interface and supported living accommodation settings. The slow delivery and promise of the fvlaintaining Critical Supports pilot framework remain unignored by the advocacy sector
- as advocacy organisations are often called to address and hopefully plug the gaps involving participants with short-term solutions. We recognise and welcome the
introduction of the NDIS Complex Needs Pathway. However, crisis intervention is a priority.
The lack of information and approach by the NOIA is troubling - particularly when it is
blatantly obvious that the issue is ignored and hidden behind a bureaucratic response.
The NOIA remains responsible for the PLOR arrangements, and it remains frustrating from an advocacy point of view as a policy and no oversight over ensuring critical care needs are met. For the Commission’s role, it is vital that an oversight mechanism is included. As far as thin markets are concerned, this is an area of critical need.23 The absence of crisis and emergency services remain critical where there is a market failure in this area, and the workforce is ill-equipped.
Lack of Support Coordination
At 31 December 2018, 40 per cent of NDIS participants had support coordination in their plans and many more require it due to the complexity of sourcing appropriate supports. 24 However, there is a confusing mythical misunderstanding of what support coordination is, who should receive it and why, and why people who would benefit from support coordination miss out.
In our experience, we continuously find people with complex support needs are falling through the gaps and are facing a significant risk of homelessness, reoffending and without continuous supports due to the lack of support coordination. We have questioned the previous 76 hours25 of support coordination in NDIS plans was considered as significant for those with core supports, it remains from enough for people with high complex support needs particularly when dual psychosocial and mental health is also a factor. Under the
23 Joint Standing Committee on the National Disability Insurance Scheme (2018) Market readiness for provision of services under the NDJS 24 Ibid. 25 Previous NDIS Price Guide 2018-2019.
Commission 13/08/2020 23
26andcurrentand supportmarkettheyeconomy,require.26Insupport27 thesupportmentalcoordinationhealth space,has anthereimpactis aonlackpeopleof servicegainingprovidersservices which offer support coordination for people who have a large core funding amount in theirort packages.packages. ervices,ourPeopleadvocacyhave requiredcapacity;assistancehowever, insupportsetting coordinatorsup for the righthavesupportsa tougherand jobserviceswhenoutsideservices,of -existingsupports and programs, needed, based on a participant’s goals, pre-existing supports
(informal, mainstream and/or community supports), within the plan period - are non-(informal,– -
inedprovidingexistentproviding andservicestheretoispeoplea risk withof serviceshigh and closingcomplexdownneeds.or are unequipped and trained in
AFI has experienced questions of confusion from participants as to what and how support coordination is supplied, regulated, and managed as an NDIS funded requirement. There is confusion of from participants of what constitutes support coordination and how it differsfrom the role of advocacy. Advocacy for Inclusion acknowledges that ‘advocacy’ is separatethe
support and cannot be meddled with the roles of support coordination or even case
management..
We have also experienced instances where people with disabilities are not been properly accommodated by support coordinators, who appear to operate on an ad-hoc basis in the-hoc community and with limited oversight of the NOIA itself. Despite the concept of supportcommunitysupport
coordination is a necessary component for people with high and complex needs,
participants have equally complained to AFI that support coordinators are not skilled orsupport fundedknowledgeablefunded adequately to deliver a holistic service for people with disabilities nor knowledgeable in finding the services they require, instead pocketing funding despite being required for a specific purpose.
Support coordinators should not be funded to service providers that also provide advocacysservices under Government funding. It is a high conflict of interest, blurs the understanding betweenbetween support coordination and advocacy, and is not an oversight and regulated by the 28 Organisations should28NOIA or DSS if both advocacy and support coordination is provided.
26Jointservices26servicesMarketJoint Standingunder theCommitteeNDJS. on the National Disability Insurance Scheme (2018) Market readiness for provision ofIbid,282827 Ibid,NDAPp. Code32. of Conduct for advocacy specifically state that:
-
- Disability Advocates are concerned with issues of social justice and equity for people with disabilities including access to quality services. 2.2. entAn advocacy service must remain independent of government and service provision so to ensure all conflicts of interestsinterests are minimised.
Commission 13/08/2020 24
anot receive funding for a free service (advocacy) and another bucket for providing a service (support coordination).(support
We argue that the high conflict of interest present can create bias from an advocate that may be present in both ‘services’, and clients may be referred indirectly to the services ofy support coordination offered by advocacy organisations that have a support coordinationsupport service attached. Organisations may insist that a free service (advocacy) and support coordination (funded via participant plans) are mutually separate. However, in a currentrate. debate of the difference between the roles, they are easily blurred. 29debate29
The premise of a service provision side of an NDAP funded individual advocacy (i.e. AFI)
remain completely independently operated by the advocacy organisation.30 Non-bias andon. Non bias
protection of privacy and confidentiality cannot be guaranteed under two models if they areprotection responsible for both a paid and unpaid provision, both similar in nature and approach to assisting the participant to access their NDIS packages successfully.successfully.
Conclusion
AFI has welcome and supported the rollout of the implementation of the Commission as an important role for independent oversight of at-risk adults to reduce violence, exploitation,-risk and neglect. However, it is argued that improvements are made to ensure the safeguardingandsafeguarding of vulnerable NDIS participants, working with the broad framing providing by the NOIA and the specific requirements of the Commission as a ‘watchdog’. However, the effectiveness of the Commission remains critical and untested. There is an urgent and important need toent maintainmaintain and enhance understanding of the experience of vulnerable NDIS participants within the evolving service system.
29Ibid.outofof29 Ibid.this "Arelationshipclient/Advocateto; relationship is unique. The advocates role carries with its specific responsibilities that arise out• Act independently.
•motingPromoting the autonomy and best interests of the person with a disability; •Respecting the privacy, dignity and confidentiality of the person with a disability; •neglect;Maximising the safeguards of the person with a disability from possible exploitation, abuse and/or neglect;
• with disabilities to make informed choices." Supporting people3030 Code of Conduct for advocacy specifically state that: "Disability“DisabilityNDAP•Minimise conflicts of interest; Advocates must:
-
Promote Decision making and choice free from bias •tionsSupport options are planned, developed, implemented and reviewed in a manner that is responsive to the decisions,decisions, choices, and aspirations of individuals.
-
Maintain Privacy, dignity and confidentiality“ Commission 13/08/2020 25
Under Australia’s obligations to the CRPD, it remains incredibly concerning that the Commission remains under-resourced, underfunded and under stressed when dealing with the burst of complaints and reportable incidents due to low staff and capacity. It is a serious concern for AFI to learn that the Commission are reluctant to take a stronger stance against disciplining non-compliant providers harshly. The implementation of the Royal Commission into Violence, Abuse, Neglect and Exploitation to People with Disabilities and role of the Commission has been carried out to meet calls that had been raised time and time for protection to be put in place. The Commission, with no excuses, needs to step up.
Commission 13/08/2020 26