NDIA Accountability Project

Submission 50 — South Australian West Coast ACCHO Network (SAWCAN) Aboriginal Organisation — Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability

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SUBMISSION OF THE SOUTH AUSTRALIAN WEST COAST ACCHO (ABORIGINAL

COMMUNITY CONTROLLED HEALTH ORGANISATIONS) NETWORK

NOTE

This submission has been prepared by Jo Battersby, Senior Advocate, Advocacy for Disability

Access and Inclusion Inc. for the South Australian West Coast ACCHO Network (SAWCAN). It

is based on information provided during meetings with and a discussion paper provided by Polly Paerata from SAWCAN, which include insights into the issues and challenges faced by Aboriginal people in Port Lincoln, Whyalla, Ceduna, Oak Valley and Yalata.

For any further details please contact Polly Paerata (SAWCAN).

ISSUES

Systemic neglect

  • insufficient services

  • lack of culturally appropriate services

  • lack of information and/or supports for potential participants to apply for NDIS funding

  • little interest from the NOIA to work with Aboriginal people and communities.

DISCUSSION

Impact of the NDIS

The implementation and roll out of the NDIS has resulted in a range of unintended consequences for Aboriginal people and Aboriginal communities generally on Eyre Peninsula. Whilst the aims of improving services, access, choice and control may have been achieved in urban settings, it has resulted in the opposite outcomes for Aboriginal people with disability on Eyre Peninsula.

People with disability in these communities are becoming less engaged with services and as a result, are experiencing poorer life outcomes. Due to this situation, whilst it is not their core role, ACCHOs, have been left with no choice but to step into the disability space and change their business and ways of working to try to provide services to the Aboriginal people who need them.

Overall there are several challenges for Aboriginal people with disability, and organisations like PLAHS, who are helping them where possible:

  • There are insufficient or no services available in the region.

  • People with disability don’t apply for NDIS funding.

  • People with disability who experience violence, abuse, neglect or exploitation often don’t recognise that what is happening to them isn’t right.

  • People expect very little and don’t complain. 1

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Example

Many people living with intellectual disability don’t recognise that it’s not okay that they haven’t received any services for 18 months. They may be homeless and vulnerable, having left supported independent living and gone back to community. No one checks to see that they are receiving services and they are not aware of their right to services or how to get them.

There are Aboriginal people with disability who would be eligible for the NDIS but there is no culturally appropriate help for them to apply for access. Everything takes a long time, there is no one to guide them and they disengage with the process.

Within communities people don’t want to be associated with the complexity of the NDIS and dealing with the NOIA. It only takes a few people to have a bad experience and the whole community will be unwilling to engage with the NOIA. It is almost impossible to get anywhere because the NOIA, as gate keeper, puts up so many hurdles and there is a complete lack of trust within Aboriginal communities to be part of the process. Then there is no funding support to help people through this journey. The more challenging it gets, the less likely Aboriginal people are to engage with the process. This means that people are going without services and equipment that they would be entitled to. For example someone might not get a wheelchair that they need because it’s too hard to apply for funding, they don’t understand it and there is no one to help them with it. The NOIA has completely missed an opportunity to engage with the sector.

Aboriginal organisations feel that they have to beg the NOIA to do their job with them. Aboriginal organisations want to form a partnerships to help roll the NDIS out to communities but their experience is that they get ‘spoon fed a bunch of words and there is no real action’.

There is no willingness to commit long term funding to enable Aboriginal people to be able to connect with the system.

Five ACCHOs located along the Eyre and Far West Coast region have recently partnered and created a consortia to develop a regional model to increase access to the NDIS and build a suite of culturally appropriate disability services using a multi-pronged approach. This program is funded through the Department of Social Services. The model focuses on how people see the NDIS and NOIA to see what can be done to encourage people to be more willing to engage in the first place. Then it develops community supports to community members who can help others within their community to engage with the system. This is achieved by providing communities and service providers with education.

To date PLAHS is the only ACCHO on Eyre Peninsula to obtain funding to support the local Aboriginal community to engage with the NDIS. Since 2017 PLAHS received two Information, Linkages and Capacity Building grants from the NOIA. This funding has supported PLAHS to employ an NDIS coordinator. The main focus of the role has been to:

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  • identify and link Aboriginal people with disabilities in the Port Lincoln and surrounding areas to NOIS planning and supports

  • run educational workshops for the local community to build awareness of the supports available through the NOIS

  • provide one-to-one support to Aboriginal people with disability and their families in the Port Lincoln area.

The funding for this program will cease on 30 June 2023.

PLAHS has also obtained funding through the National Aboriginal Community Controlled Health Organisation to employ a O.SFTE Community Connector who supports the work of the NOIS Coordinator.

Through the work of the staff in these positions, Aboriginal people are lining up at PLAHS to get help accessing disability services. The numbers continue to increase which, in itself, shows the benefit of having Aboriginal workers on the ground to give people information and support them to access services.

NDIS challenges for ACCHOs

Whilst PLAHS has become a registered NOIS provider there are numerous challenges to ACCHOs, becoming NOIS providers:

  • lack of consultation with Aboriginal communities and organisations from the beginning to the present. If it does exist it is tokenistic and no real change in the way policy is implemented has been experienced

  • unwillingness from government or other providers to truly partner with the Aboriginal community

  • lack of understanding and drive from all levels of government about culture and delivering services to Aboriginal people

  • no accessible, accurate data available for organisations to undertake planning or building business models

  • few Aboriginal people employed within government to direct/input into policy

  • information from the NOIA and the Quality and Safeguards Commission is complex and lengthy

  • lack of information within regions about those delivering services

  • too many layers/departments within the NOIA, making it hard to navigate

  • limited local, dedicated resources to support Aboriginal organisations to implement new ways of working to support NOIS participants

  • piecemeal funding, given out sporadically, with limited ongoing practical support from the NOIA to embed sustainable practices

  • limited Aboriginal specific resources developed to educate communities

  • limited local (if any) staff employed by the NOIA to support organisations/communities

  • unwillingness to invest in Aboriginal organisations to build capacity if the NOIA cannot find staff to do this role

  • no investment to support Aboriginal organisations to become providers 3

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  • no appropriate training available in communities
  • no targeted approach to increase interest in NDIS roles
  • lack of job security in NDIS roles. Ideas for improvement
  1. Partnerships and consultation from government SAWCAN is a partnership consortium consisting of five ACCHOs on the Eyre Peninsula and Far West Coast:

  • Port Lincoln Aboriginal Health Service

  • Nunyara Aboriginal Health Service in Whyalla

  • Vadu Health Aboriginal Corporation in Ceduna

  • Tullawon Health Service in Valata

  • Oak Valley Health Service SAWCAN’s purpose is to:

  • build capacity within the region to achieve improved health and wellness outcomes for Aboriginal people

  • demonstrate a strengths-based approach to achieving large scale solutions

  • Share and co-operate with each other to utilise each other’s skills, experience and specialist knowledge

  • leverage opportunities by advocating as one voice

  • become a central point of contact that provides advice and direction to external parties on issues affecting Aboriginal people in the region

  • act as a point of truth telling and supporting each other.

  1. Better, more accessible information Information about the NDIS needs to be specifically developed for Aboriginal people with disability, local communities and the organisations that support them. There is a general need for a community awareness campaign targeted and relevant to individual communities.

Organisations need to be provided with information about how different systems and services interact with each other e.g. the NDIS, health services, education services, and who is responsible for providing what services.

Regional directories to advise organisations and Aboriginal people with disability about the services that are available in their region would be useful. This would help organisations and service providers to have accurate information on their websites.

  1. Capacity building 4

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There is a need for training and resources for Aboriginal organisations and people working in the disability sector. Training should include:

  • the NDIS generally and use of relevant forms and guides e.g. the price guide

  • billing and record keeping under the NDIS framework

  • patient journey mapping and the integration of disability services into the ACCHO model, given that most Aboriginal health services are filling the gap where disability services are not available

  • safety and quality safeguards, including NDIS requirements and the role of the

Quality and Safeguards Commission

  • an interpretive guide for organisations that provides real life examples of how standards can be met

  • formal training to obtain disability qualifications

  • a disability module in the Aboriginal Health Worker and Aboriginal Health Professional qualification

  • webinars and sector workshops. Training should be delivered by an Aboriginal Registered Training Organisation.

Other helpful capacity building resources would be:

  • investment in local organisations to provide culturally appropriate LAC services to Aboriginal communities in regional and remote communities

  • support for ACCHOs to transition to the NDIS

  • a support person to provide support to health workers and other staff delivering disability services to Aboriginal communities.

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