NDIA Accountability Project

Submission 74 — Tasmanian Government — Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability

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Tasmanian

Government

Submission

Royal Commission into Violence, Abuse, Neglect and

Exploitation of People with Disability

Tasmanian

Government

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Acronyms

Accessible Island -Accessible Island: Tasmania’s Disability framework for Action

DSA - Disability Services Act 20 I I

DAP - Disability Action Plan

DECYP - Department for Education, Children and Young People

DoH - Department of Health

DoJ - Department of Justice

JLO - Justice Liaison Officer

MDC - Multi-disciplinary Centres

MDCG - Ministers Disability Consultative Group

PDAC - Premier’s Disability Advisory Council

SDAC - Survey of Disability, Ageing and Carers

SFCU - Safe Families Coordination Unit

THS - Tasmanian Health Service

UNCRPD - United Nations Convention on the Rights of Persons with Disabilities

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Contents

  1. Prevention and protections - Tasmania’s disability policy, legislative and
  1. Improving inclusion, equality, and independence for people with disability in

3.2 Education …………………………………………………………………………………………………………………… I I

  • 3.3 Justice
  1. Safeguarding people with disability from violence, abuse, neglect, exploitation …………………………………………………………………………………………….. I 3

4.2 Restrictive practices and the role of the Senior Practitioner………………………………….. I5

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I. Introduction The Tasmanian Government welcomes the opportunity to provide a submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability.

The Tasmanian Government is committed to making Tasmania a safe place for all to live, and a place where everyone can participate equally in economic, social, political and community life. Supporting Tasmanians with disability to live independently and free from violence, abuse, neglect and exploitation is key to this vision, along with working with Tasmanians with disability, the people who support and advocate for them, and the wider community, to deliver better results for people with disability and to build an inclusive and accessible State.

This submission is informed by the Royal Commission’s Terms of Reference but does not seek to outline a response to all matters. Part I provides an introduction to Tasmania’s profile and disability service system. Part 2 of the submission outlines the legal and policy context in which the Tasmanian Government provides funding and services for people with disability, and the work underway in Tasmania to review and strengthen disability policy and legislation to improve inclusion, equality and independence of Tasmanians with disability. Further detail on policy responses in the key sectors of justice, education and health is outlined in Part 3. Part 4 of the submission considers specific responses that the Tasmanian Government and its agencies are taking to prevent and better protect people with disability from experiencing violence, abuse, neglect and exploitation.

1.1 Tasmania’s profile and disability service system

When using the term ‘disability’, the Tasmanian Government refers to people who have long-term physical, mental, intellectual or sensory impairments, which in interaction with various barriers may hinder their full and effective participation in society on an equitable basis.

The 2018 Survey of Disability, Ageing and Carers (SDAC) estimated that there are more than one quarter of the population (26.8 per cent, or 140,000 people) with disability in Tasmania. This is the highest percentage in any state or territory in Australia. Table I: Proportion ofdisability status and age for all persons living in households, 20 I8, Tasmania

        • ­ - - - - - ­ - - - - ­ - - - - - ­ - - - ­ - - - ­ - - - ­ Profound or Moderate or Allw1th

      Tasmania, severe core mild core Schooling or specific Allw1th No

      years of act1v1ty act1v1ty employment l1mitat1ons or reported reported

      age l1mitat1on l1mitat1on restriction restrictions d1sabil1ty d1sabil1ty Total

      0-64 years 5.7% 7.2% 14.8% 16.4% 17.8% 82.2% 100.0%

      65 years & 13.6% 38.1% 11.6% 51.9% 60.0% 40.0% 100.0% over

Source: Survey of Disability, Ageing and Carers, ABS, 2018

For people living in households, Table I shows that 60 per cent of people aged 65 and over report disability, compared to 17.8 per cent of people between 0-64 years of age. A much higher percentage of people with disability aged 65 years and over have a moderate or mild core activity limitation (38.1 per cent) compared to those aged 0-64 years (7.2 per cent).

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In addition to the SDAC, the Australian Bureau of Statistics 2021 Census found 6.8 per cent of the population (38,023 people) in Tasmania identified a need for assistance with core activities in one or more of three core activity areas’. The Census also reported 9.4 per cent of the Aboriginal and Torres Strait Iskander population in Tasmania identified a need for assistance.

There are several reasons to account for the rates of disability in Tasmania compared to other states and territories. The main factor is the ageing population. Tasmania has the highest median age of 42

years and a population ageing at a faster rate than other states and territories (Census of Population

and Housing, 2021).

Tasmania is also characterised by a population dispersed across the state within low density population areas. Of all the states and territories, Tasmania has the highest proportion of its population residing outside of the greater capital city (Census of Population and Housing, ABS, 2021). These factors are an ongoing consideration in planning the delivery of services, including services for Tasmanians with disability.

Since 2019, all direct service delivery to Tasmanians under 65 years of age with permanent and significant disability has transitioned to the National Disability Insurance Scheme (NDIS). Significant positive changes have taken place for Tasmanians living with disability and the services sector since the transition. The number of Tasmanian participants in the NDIS has increased consistently over time. In the first quarter of the scheme there were 6,980 active participants. As at 30 June 2022, there were 12,104 people with disability who had become participants and an additional 191 children active in the NDIS Early Childhood Approach.

At a local, clinical level, while the working arrangements between the NDIS and the health service system are well developed, the interface between mainstream health service and NDIS has presented ongoing challenges. Having an effective interface where funding and delivery responsibilities are clear is crucial for supporting NDIS participants to receive the right level of care at the right time, delivered through the most appropriate service system. Having clear and responsive service processes and funding responsibilities between the NDIS and public health system will also contribute to reducing demand on the acute health system.

Issues with the interface between the mainstream health service and the NDIS can manifest at various points within a person’s service joumey and can include, for example, NDIS participants not receiving the right types of services and supports whilst they are in hospital and issues with NDIS participants (or prospective participants) transitioning in a timely manner back into the community once they are ready for discharge.

The Tasmanian Government continues to engage closely with the Australian Government, the National Disability Insurance Agency, state and territory governments and interjurisdictional officials’ groups to consider and implement activities to clarify funding responsibilities and address critical service gaps.

In recognition of the changes that have taken place since the transition to the NDIS for Tasmanians with disability and the services sector, and on 27 October 2020 the Tasmanian Legislative Council’s Parliamentary Committee resolved to commence an Inquiry into Disability Services in Tasmania. The

leeding assistance with self-care, mobility, and communication because of a long-term health conditi s or more), a disability (lasting six months or more) or older age.

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Committee made 18 recommendations in the final report delivered in May 20222 and the Tasmanian Government has indicated support, or support in principle for 14 recommendations.

The NDIS  is just one element of the service system available to  all Tasmanians. The

Tasmanian Government continues to support accessible and sustainable services for people who are not eligible for the NDIS.

  1. Prevention and protections - Tasmania’s disability policy, legislative and engagement context

The Tasmanian Government is committed to supporting the rights of people with disability in alignment with national disability strategies and the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). The following section outlines the overarching frameworks under which the Tasmanian Government works to promote inclusion in Tasmanian settings and outlines the considerable work underway in Tasmania to review and strengthen disability policy and legislation to improve inclusion, equality and independence of Tasmanians with disability.

2.1 Disability Services Act and Disability Services Regulations

Tasmania’s Disability Services Act 20 I I (DSA) provides the foundation for the provision of quality disability services and the safeguarding of people accessing those services in Tasmania. The DSA covers specialist disability services that are:

  • funded by the Tasmanian Government or the National Disability Insurance Scheme (NDIS)
  • provided directly by the Tasmanian Government and
  • registered with the NDIS in Tasmania. The DSA is supported by the Disability Services Regulations 2015 (the DSRs). The DSRs and policies require providers of disability services in Tasmania to have strategies and systems in place to ensure that all staff and volunteers understand their role in identifying and preventing the abuse and neglect of people with disability, and to develop a culture that promotes and encourages the open disclosure of suspected or alleged incidents of abuse and neglect

The DSA has provided a strong foundation for the provision of quality disability services and the safeguarding of people accessing those services in Tasmania. To create legislation that provides a contemporary vision for a safe and inclusive Tasmania for people with disability, in 2021 the Tasmanian Government commenced a review of the Act The review of the DSA aims to achieve better results for people with disability through high-quality and safe services and by supporting national and international commitments.

Expert assistance was sought to ensure consultation for the review was appropriately designed and inclusive. Feedback has been received from a wide range of stakeholders including people with disability, their families and carers.

It is envisaged that amended or new legislation will be introduced to the Parliament in 2023.

2 Parli ament of Tasmania - Disability Servi ces in Tasmania Committee

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2.2 Accessible Island

Tasmania’s whole-of-government approach is realised through Accessible Island: Tasmania’s Disability Framework for Action 2018-2021 (Accessible Island), which outlines a framework for ensuring that all government departments implement socially just policies and practices for Tasmanians with disability.

Accessible Island  is founded on a rights-based, social model of disability.  It acknowledges that many

challenges faced by people with disability are not due to the functional limitations of individuals but rather, by the failure of society to meet their needs.

Three principles underpin the implementation of Accessible Island:

  • ensuring access to and inclusion for government services, infrastructure and communications;

  • collaboration and consultation - agencies will share expertise and collaborate in the planning and development of services, infrastructure and communications; and

  • improving employment outcomes in the State Service.

Under Accessible Island, each Tasmanian Government department develops a Disability Action Plan

(OAP), placing a disability policy lens over the services they provide, or plan to provide, with a focus on access and inclusion, consultation and collaboration, and improving employment outcomes in the Tasmanian State Service for people with disability.

Once a year, Government departments submit a progress report to the Premier’s Disability Advisory Council (PDAC). To ensure transparency and accountability, DAPs are made publicly available on the Department of Premier and Cabinet website3.

Planning for the next iteration of Accessible Island is currently underway and will be developed within the context of aligning with Australia’s Disability Strategy 2021-203 I (ADS) and the associated Targeted Action Plans (TAPs), as well as the further initiatives outlined below.

2.3 Stakeholder and community engagement

An inclusive society recognises people with disability as equal citizens and that their voice is at the forefront of government decision-making. The Tasmanian Government recognises the importance of engaging people with disability to ensure a strong understanding of issues facing the community. There are two consultative groups at the whole-of-government level that advise the Tasmanian Government about ways to improve support for Tasmanians with disability. Engagement initiatives are also embedded in the work of the Tasmanian Department of Health (DoH) and Department for Education, Children and Young People (DECYP).

2.3. I Premier’s Disability Advisory Council

The Premier’s Disability Advisory Council (PDAC) was established in 2007 and meets four times a year. PDAC is chaired by the Premier and includes the Minister for Disability Services as a permanent member. There are currently IOcommunity members who bring their lived experience as people with disability, or as family members and carers of people with disability. Community members

3 Department of Premier and Cabinet - Accessible Island: Tasmania’s Disability Framework for Action 2018-20

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provide advice on the practical implications of policy and legislative changes and the ways in which the built environment can be made accessible.

The primary role of PDAC is to assist the Premier and Government to implement Accessible Island. As noted above, Government departments are required to provide an annual progress report on implementation of their DAP to the PDAC. This reporting informs PDAC’s annual report on the implementation of Accessible Island, including recommendations for future work, PDAC annual reports are available on the Department of Premier and Cabinet website.’

2.3.2 Minister’s Disability Consultative Group

The Minister’s Disability Consultative Group (MDCG) was established in early 2020 with the goal of looking at ways the Government can continue to improve support for Tasmanians with disability and encourage members to share their experiences and ensure their voices are heard and represented. The MDCG provides an opportunity for the Minister for Disability Services to consult with a range of stakeholders in relation to the development and delivery of disability services related policy and programs in Tasmania.

2.4 Tasmanian Disability Commissioner

In 2021 the Tasmanian Government made an election commitment to establish a Tasmanian Disability Commissioner (Disability Commissioner) to provide a strong voice for Tasmanians with disability. The newly created role will be central to the Tasmanian Government’s commitment to ensuring Tasmanians with disability have equitable access to services and give effect to obligations under the UNCRPD and the Australian Disability Strategy.

Establishing a Disability Commissioner was one of several focus topics consulted on as part of the DSA review. It is envisaged that the Tasmanian Disability Commissioner will provide a safe place for people with disability to report abuse, neglect or exploitation and will offer a ‘no wrong door’ approach, working with other safeguarding offices (such as the NDIS Commission for example) to ensure appropnate investigation and safeguarding occurs.

The Commissioner will:

e deliver continuous improvement in delivery of supports and services for people with disability; ° act as an independent boay;

® provide a free and confidential complaints resolution process, and

a help ensure people with disability, and their families, receive the inclusive and accessible support and services they need, including those supported through mainstream services.

Ahead of the legislation to give an independent Disability Commissioner power, an Interim Disability Commissioner role has been created to lead and drive the establishment of the Disability Commissioner role, including consultation and engagement with stakeholders and undertake other leadership and advocacy functions, pending the appointment of the Commissioner.

artment of Premier and Cabinet - PDAC Annual Report

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2.5 Advocacy and engagement

Advocacy services and community engagement practices are critical safeguard tools for governments to ensure people with disability are heard and can access the same freedoms, rights, choices and quality of life available to others. The Royal Commission Interim Report identified that increased advocacy would lead to a more inclusive society and is a key measure to address violence, abuse, neglect and exploitation.

Tasmania currently has funding agreements in place until June 2023 across three independent Advocacy organisations - Speakout Advocacy, Advocacy T as (Your Say) and the Association for Children with Disability (ACD). Citizen Advocacy Launceston is funded by the Australian Government’s Department of Social Services. Work has been progressing with funded advocacy services to identify service system gaps, quantify demand and assess the full range of advocacy, decision-making and capacity building supports that are required in a NDIS environment to avoid duplication. This work will inform a future model based on need within the Tasmanian context. 2.6 Quality and Safety in Community Sector Organisations

Community Sector Organisations that deliver disability services are required to meet the Quality and Safety Framework for Tasmania’s DHHS Funded Community Sector. A new set of principles have been drafted that articulate the expectations and requirements of the funded community sector. These include taking reasonable steps to provide services that are free from abuse, exploitation, harassment and neglect, and ensuring the workforce is appropriately qualified, competent and supported to deliver services safely.

A quality and safeguarding framework is being developed to reflect and expand on these principles. Public and internal consultation on the new approach to quality and safeguarding will continue in 2023.

  1. Improving inclusion, equality, and independence for people with disability in key sectors

Across the life course, people with disability access a variety of services through multiple systems for care and support (such as for health and housing) and through social and economic participation (such as through the education systems and the labour force). The Tasmanian Government acknowledges that the Royal Commission has highlighted the multiple settings and contexts where violence, abuse, neglect or exploitation may occur; and that there may be settings and contexts where violence may occur that are specific to people with disability.

The following section outlines recent and future developments to promote accessibility and inclusion in the key sectors of health, education and justice. 3.1 Health

Clear healthcare rights are the starting point for equitable access and describe what people can expect when receiving health care. As a requirement for accreditation under the National Safety and Quality Health Service (NSQHS) Standards, DoH is bound by a charter of healthcare rights for all

patients accessing services. This charter is available on the DoH website, and made rea   ·  available

across service delivery touchpoints across the Tasmanian Health Service (THS).

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DoH wants people with disability to be empowered to engage in their health, wellbeing and health care needs, including by making reasonable adjustments as required by federal and state legislation.

DoH and THS health care professionals regulary work with consumers who may find health services less accessible, for reasons such as culture, language, age, mobility, disability and other barriers. To support these consumers, DoH strives to provide responsive, inclusive and sensitive services and deliver additional support where specific needs are identified. For example, screening for cognitive impairment (which includes cognitive disability) is undertaken where cognitive disability or further decline is suspected upon admission to Tasmanian public hospitals to ensure patients with additional support needs are quickly identified, and communication with patients and their families and/or carers aligns with patient needs.

DoH and the THS have a range of policies, frameworks and similar guidance material in place for ensuring consent in the delivery of healthcare for individuals. DoH’s Clinical Consent Policy outlines the minimum mandatory requirements for healthcare professions in obtaining a person’s valid, informed consent to treatment and assists healthcare professions to be aware of their ethical, legal and practical obligations in terms of seeking and obtaining that consent. The Policy also outlines consent requirements for specific circumstances, including, for example, supported decision-making and considerations under the Mental Health Act 2013 (Tas), Guardianship and Administration Act 1995 (Tas) and the Aged Care Act 1997 (Cth).

At a service level, DoH is supporting the healthcare needs of people with disability in a variety of ways, including delivering staff training and strengthening our health care service provision and planning approaches, Key activities under these themes are:

e Specialist assessments and pathways to support people who are experiencing cognitive difficulties, such as changes in memory or problems with language, attention, personality and behaviour via the Cognitive Assessment and Pathways Service (CAPS) °.

° Complex Care Coordinators work out of the major hospitals in the South (Royal Hobart

Hospital) and North (Launceston General Hospital). They are Allied Health Professionals or

Registered Nurses who advocate for patients at risk of long stay to enable seamless navigation through the health network, and support the involvement and education of patients, families/carers to ensure optimal patient flow.

® Improving services through training of clinical and departmental staff to increase awareness of disability, such as training on autism in dentistry services and mental health first aid.

e Working in partnership with Primary Health Tasmania to improve the health outcomes for people with intellectual disability, including when they come to hospital.

3.1.1 Mental health policy

Rethink 2020, Tasmania’s strategic mental health plan, has several initiatives aimed to improve mental health care for people with disability. The plan aims to integrate mental health services, improve accessibility to mental health care and nurture social inclusion for Tasmanians with mental healthcare needs.

PS operates across north-west Tasmania and can be accessed via self-referral, or via referral from friends, families or care! nsent from the patient: Clinical assessments are provided by nurses who are specifically trained.

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A priority focus area for Rethink 2020 is improving coordination of services for people with severe and complex mental illness. DoH is developing a new model of care which provides evidence-based care and treatment for people with dual disability. 6 A specialist team will be established on a statewide basis (with outreach to the north and north-west regions) to integrate with other statewide mental health services and improve capacity to support people living with complex needs.

DoH is also in the process of implementing a Mental Health Integration Hub that will include a partnership with the Local Area Coordinators to support access to the NDIS; and a Mental Health and Intellectual Disability Service for individuals aged between 16 and 64 years with a confirmed or suspected diagnosis of intellectual disability and mental health issues.

3.2 Education

Over recent years, DECYP has given high priority to a continuous improvement model of supports for students with disability. DECYP aims to provide high quality, inclusive education for students with disability and to support all schools to become increasingly prepared and responsive to meet the needs of all students. DECYP’s Strategic Plan 2022-2024 vision is Learners First: Connected, Resilient,

Creative and Curious Thinkers. The Strategic Plan explicitly incorporates the United Nation’s

Convention on the Rights of the Child, which provides the overarching framework to ensure the child’s best interest are the first priority, particularly their right to safety, their right to an education, and their right to a voice on things that affect them.

The continuous improvement model of supports for students with disability has taken place through the development and implementation of:

  • A needs-based funding model - Educational Adjustments Disability Funding - for students with disability in Tasmanian Government Schools.

    • Planning for Improvement - Inclusive Practice an online tool linked to school improvement to

build inclusive school cultures.

•   A support school model ensuring there  is one specialist school setting within each region of the

State where parents can request full or dual enrolment for their child.

  • An ongoing commitment to building the expertise and capacity of all staff. 3.2. I Educational adjustments disability funding

In 2020 DECYP implemented a new needs-based funding model, Educational Adjustments, to deliver funding to schools in support of students with disability. The model has been informed by research, co-constructed with schools and key stakeholders and a through a collaborative consultancy with KPMG7 for some components of the work.

The model has moved the DECYP system away from a medical, categorial and deficit approach, to one where the supports funded are based on the educational adjustments each student requires to participate in teaching and learning. The implementation of the Educational Adjustments model was supported by Government and resulted in approximately 2,000 more students receiving Educational

6 Dual disability means people who have disability additional to their mental illness, have complex post-traumatic stress disorders, and people who are homeless or at risk of homelessness.

7 KPMG’s final report on their component ofthe consultancy can be found at Develo ment of a Needs-Based Fundin

-  Final Report. All information on the model  is publicly available on the DECYP website at Educational Adjustments

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Adjustments funding than were eligible to be supported through the previous deficit-based model. The Educational Adjustment model is based on a simple, structured approach to funding and resourcing which takes into consideration the additional and variable needs of students with disability, where students requiring more intensive levels of support and adjustment attract greater levels of additional resources, compared with those requiring lower levels of adjustment.

In 2022, there are 7,064 students with disability in Tasmanian Government schools. Of these students, 5,377 are receiving additional funding into their School Resource Package to contribute to the educational adjustment in place aligned to the student Learning Plans.

3.2.2 Supporting inclusive practice

DECYP has a policy of inclusion, which means that the vast majority of children with disability attend mainstream schools. Tasmania has three segregated specialist support schools, with one school in each region of the State designated as a Support School for students with disability. The total number of students enrolled across the three schools in 2022 is 309 FTE (head count). Students who are eligible to enrol can do so on a full-time or part-time basis. Those with a part-time enrolment are dual enrolled in their neighbourhood mainstream school and Support School.

Enrolments at the Support Schools currently make up 6.1 per cent of the total number of students with disability supported within all DECYP schools from Supplementary to Extensive levels of educational adjustment. There are currently more students with disability with highly complex educational and personal care needs supported in DECYP neighbourhood schools than there are in the Support Schools.

Each school is required to establish and maintain School Support and Wellbeing T earns who play an important role in planning and implementing school strategies and processes that support the well being of all students, with a particular focus on those students with diverse and complex needs requiring coordinated support. 3.3 Justice

As a universal service provider, the Department ofJustice (DoJ) is committed to ensuring all Tasmanians, including those with disability, receive high quality and inclusive access to services provided by the justice system.

In 2017 DoJ released a whole-of-government DisabilityJustice Plan for Tasmania 2017-2020. The Plan brought together many existing commitments across the justice system to ensure that all Tasmanians have access to an efficient and effective justice system, including protection from violence, abuse or neglect and improving understanding and access to formal legal and court procedures. Key elements of the Plan are outlined below.

3.3. I Improved data collection

Improved arrangements have been implemented for the collection of information about the disability status of people in the justice system and to promote increased information sharing. Improved arrangements include:

  • improved and more detailed intake processes and data capture across key services such as Tasmania Legal Aid, Community Corrections, the Tasmania Prison Service and t l-,e…Ea ii Violence Management System to identify the presence of disability and any support n

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° improved data sharing arrangements on support needs between the Supreme Court and the Magistrates Court;

® the inclusion in the new Justice Connect Program Astria of improved data collection across the

Courts, Tasmania Prison Service, Community Corrections, Crown Law, and the Victims Support

Service, including the number of people with disability receiving support and/or accessing the NDIS; and

° the development of a new Digital Policy Framework to improve compliance with web accessibility protocols across the Department of Justice.

3.3.2 Prison and youth detention services

Implementation of the Disability Justice Plan for prison and youth detention services has included building staff capacity to identify and support people with disability in custodial settings. For early intervention purposes, Correctional Primary Health Services has implemented a disability screening tool taken upon entry to the adult prison system and the Ashley Youth Detention Centre. This assessment includes screening for disability (physical and intellectual/cognitive) to ensure that appropriate support services are in place to assist with the person’s health, within detention and planning for release.

The Department of Justice also works with the NDIS Justice Liaison Officers (JLO) to implement an integrated case management framework, with a particular focus on supporting those transitioning from custody to community-based orders. The JLO works with staff to ensure potential and existing NDIS participants who are approaching release have appropriate NDIS supports in place when they transition back to the community. JLOs also provide assistance in forensic facilities, youth justice facilities and remand centres.

3.3.3 Improving accessibility to police and court facilities

Upgraded and more accessible facilities for people with disability have been put in place as part of the establishment of the new Tasmanian Civil and Administrative Tribunal. Accessibility appraisal reports have been commissioned and implemented to ensure compliance of existing Court buildings and facilities with relevant national standards.

Work has commenced to scope significant upgrades to Magistrates Court video-conferencing capabilities in all Registry locations. Upgrades will include the Protected Witness Room in Launceston and increased capacity to support the witness intermediary scheme through video-conferencing appearances.

  1. Safeguarding people with disability from violence, abuse, neglect, exploitation

Safeguards for people with disability is of the highest importance. People with disability have the same rights as all members of the Tasmanian community. People with disability have the right to feel safe and to live and receive services which do not expose them to abuse or neglect. They are also entitled to privacy, dignity and confidentiality in all aspects of their lives.

There is limited data on the prevalence and experience of violence, abuse, neglect and exploitation of

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prevalence and experience of violence for people with disability. The Tasmanian Govemment supports exploring national reforms to improve data collection and reporting, including the National Disability Data Asset (NDDA).

The Tasmanian Government acknowledges the challenge highlighted broadly in current research, of achieving appropnate and effective safeguarding which needs to balance protection, support the rights of individuals and maximise choice and control.

The following section outlines specific actions the Tasmanian Government is taking to better protect Tasmanians with disability from experiencing violence, abuse, neglect and exploitation, including actions to encourage and remove impediments to reporting, investigating and responding to such conduct.

4.1 Improving approaches to restrictive practices and decision-making practices

The Tasmanian Government is in the process of reforming how decision-making abilities are safeguarded. Tasmania’s Guardianship and Administration Act 1995 (the Guardianship Act)® was the subject of substantial review by the Tasmanian Law Reform Institute (TLRI) in 2018. The TLRI’s Final Report: Review of the Guardianship and Administration Act 1995 (the TLRI Report) recommended a shift away from the ‘best interests’ model of decision-making contained in the Act to one in which a represented person is put at the centre of the decision-making process and representatives are required to understand the wishes and preferences of the represented person when making decisions on their behalf.

In July 2020 the Tasmanian Government agreed to reform the Guardianship Act, commencing with the introduction of a legislative framework governing the making and implementation of advance care directives. The Guardianship and Administration Amendment (Advance Care Directives) Act 202] (Advance Care Directives Act) passed both Houses of the Tasmanian Parliament in September 2021.

In preparing the Advance Care Directives Act, the Government agreed that key reform principles be included and reflected in further tranches of reform of the Guardianship Act. These included:

8 a revised approach to decision-making ability, including recognition of the common law position that adults possess decision-making capacity unless demonstrated otherwise;

e enhanced requirements to take into account the wishes and preferences of an individual in giving effect to future health care decisions.

In October 2022, the Department of Justice (Do]) released a draft Bill for public consultation to provide further significant changes to Tasmania’s guardianship and administration system, such as:

° establishing rights-based principles as a framework for the way in which decisions under the Guardianship Act are to be made;

° moving away from a ‘best interests’ approach toward a ‘will and preference’ approach

® The Guardianship Act provides for the appointment of a guardian or administrator for people with disability wh isions in relation to personal or financial matters; and arrangements for consent to medica! and dental treatm ility who are unable to provide that consent.

unable to make

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  • requiring the provision of supports to people with impaired decision-making ability to enable them to make and participate in decisions affecting them and to promote their decision-making ability to the extent reasonably practicable; and

  • strengthening the criteria for circumstances in which an emergency order can be made and requiring a hearing to be held in relation to applications for an emergency order.

    It is expected that the Attorney-General will introduce the Bill into the Tasmanian Parliament in early

4.2 Restrictive practices and the role of the Senior Practitioner

In Tasmania the DSA (which, as noted above, is currently under review) provides the legislative basis and sets out the process for authorisation of restrictive practices. Currently the DSA describes two categories of restrictive intervention in relation to a person with disability:

  • Environmental restriction - this means a restrictive intervention in relation to the person that consists of the modification of an object, or the environment of the person, so as to enable the behavioural control of the person, but does not include personal restriction.

  • Personal restriction - this means a restrictive intervention in relation to the person that consists wholly or partially of: o Physical contact with the person to enable the behavioural control of the person: or o The taking of an action that restricts the liberty of movement of the person. The type of restrictive practice determines the authorisation pathway. Currently the Secretary of Department of Premier and Cabinet can approve environmental restrictions, whereas the Tasmanian Civil and Administrative Tribunal (TASCAT) Guardianship Stream (previously the Guardianship and Administration Board) can approve personal restrictions and environmental restrictions.

The DSA also describes the functions and powers of the Senior Practitioner. The main role of the Senior Practitioner is to protect the rights of people with disability who have restrictions placed upon them. The Senior Practitioner also works with providers to ensure safe and quality services are provided to people with disability by providing advice and education consistent with contemporary evidence. The Senior Practitioner is appointed by the Secretary of the Department of Premier and Cabinet and the DSA requires the appointee to be a State Service officer and have appropriate qualifications and experience to fulfil the role.

Since the transition to full scheme NDIS and the commencement of the NDIS Commission, there has been an increase in reporting and authorisations. The increased reporting and authorisations are an additional protection for people with disability where restrictive practices are in place. These requirements ensure ongoing monitoring and oversight of the practices by the Senior Practitioner.

The Tasmanian Government acknowledges findings stated in the Royal Commission’s Restrictive Practice Issues Paper, that research is now highlighting strategies for how restrictive practices can be prevented or avoided.

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4.3 Safety of children and young people in health and education

Safeguarding the rights of all children and young people to have an education, to be heard, and to be kept safe from harm is a priority for DECYP. Safeguarding describes a culture in which every person understands their responsibility to uphold the rights of all children and to have the child at the centre of every decision that affects them. This culture of continuous improvement has prevention as its overriding objective while it strengthens awareness, sensitivity and responsiveness to the signs and effects of abuse and trauma.

In Tasmania, mandatory reporting requirements are outlined under the Children, Young Persons and Their Families Act 1997 (Tas) (currently under review). All staff in DoH and DECYP are bound by mandatory reporting requirements to report any concerns about the safety and well being of all young people. Internal DoH procedures outline a process to trigger a formal referral for appropriate escalation, including notifying the Child Safety Service Advice and Referral Line and Tasmania Police. To build on existing patient quality and safety approaches, in 2021 the DoH Child Safe Organisation Project was launched. DoH has since released a Safety and Well being Framework outlining the approach to safeguarding children and young people accessing DoH services.

4.4 Reporting and responding to family and sexual violence in Tasmania

The Royal Commission’s inquiry to date has provided depth to what current research has told us, that people with disability experience violence and abuse at significantly higher rates than people without disability (Centre of Research Excellence in Disability and Health, 2021 ). This is compounded for women and girls who are twice as likely to experience violence than those without disability (Our Watch and Women with Disabilities Victoria, 2022), and most often perpetrated by someone known to the victim.

The Tasmanian Government has a strong record of prevention and response to family and sexual violence. Tasmania is a leader in providing an integrated response to family violence. The enactment of the Safe at Home service model, which is underpinned by the Family Violence Act 2004 (the Family Violence Act) paved the way for government including specialist services across multiple agencies, to implement an integrated criminal justice response to family violence.

The Family Violence Act does not differentiate between disability, gender or age but focuses on the prevention, detection and prosecution of family violence offenders and providing assistance to victims of family violence and their children. Family violence in Tasmania is recognised as more than physical violence and includes sexual assault; threats and coercion; economic abuse; emotional abuse or intimidation; breaching orders relating to family violence; and property damage. Violence perpetrated by someone other than a current or former spouse or intimate partner is not considered family violence under the Family Violence Act However, for those not covered under Family Violence Act (for instance, where a relationship has ended) they may be able to apply for a restraint order pursuant to the Justices Act I959.

Safe Homes, Families, Communities is Tasmania’s whole-of-government action plan. Each iteration of the plan enacts actions to enhance the integrated system and respond to learnings from community and stakeholder consultation, research and best practice service delivery 9 . The following section

9 For more detailed information about each action please refer to the action plan https://www.communities.tas.gov.au/children/safehomesfamiliescommunities

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describes the key elements of a service system response to family and sexual violence as maintained by Safe Homes, Families and Communities and the Criminal Justice response.

Tasmanians with disability who seek assistance with family violence are identified and supported in the emergency assistance and non-crisis response pathway. The crisis response is supported through Safe at Home, Tasmania’s integrated criminal justice response. Safe at Home responds to all reported incidents of family violence where a range of services work together to protect and support victim­ survivors of family violence (including children and young people).

All Tasmanians seeking emergency assistance for family violence can call 000. It is at this point in the pathway that support will be enacted if a person with disability is a party at the incident. When a family violence incident is reported to police it is recorded on the Family Violence Management System, which has a field where additional narrative, such as disability criteria, can be provided and an adapted service system response can be enacted.

Identification of victim support needs and risks are further captured by the Safe Families Coordination Unit (SFCU). Led by Tasmania Police, SFCU provides coordinated support for high-risk families, including those with disability, experiencing family violence. The Unit comprises employees from multiple government agencies who review all incidents. Agency-held information is shared to ensure families at risk are identified and supported as early as possible. This can include information on persons with disability, as a victim, child or a perpetrator of family violence.

Women with disability are supported through the Local Support Coordinator role in Safe Choices who offer post-crisis case coordination, integrated case management and flexible support to clients with disability and connect them to other services. Safe Choices is the statewide non-crisis service providing practical advice and referrals for people experiencing family violence and family and friends seeking information or support. Safe Choices is delivered through face-to-face services based out of Hobart, Burnie and Launceston; and through the statewide phoneline and website.

In June 2020, Safe Choices launched No Excuse for Abuse, an online training package to assist frontline workers who work with or support women with disability to recognise family violence, available on the Safe Choices website.

    1. I Sexual violence service support response Tasmanians seeking emergency assistance for sexual violence can call 000 and the statewide Sexual Assault Crisis Service which is available 24 hours. The service provides assistance for individuals to attend medical/forensic examinations and connect with counselling support.

The Tasmanian Government provides funding support to two community-based specialist sexual violence services: the Sexual Assault Support Service and Laurel House. Since the onset of the COVID-19 pandemic, the Tasmanian Government has provided additional funding to each service to provide additional service responses to meet demand. In June 2022, the Tasmanian Government committed to providing increased recurrent funding to each of the services to maintain increased operational capacity through five-year contracts, providing greater certainty and increased capacity to each of the organisations to respond to demand over the long term.

4.4.2  Development of new Multi-disciplinary Centres -  Crisis and ongoing support

To enhance the integrated nature of services, and with a new priority focus for sexual ““v”ro er.i e support system, the State Government recently announced a commitment to pilot two

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Multi-disciplinary Centres (MDCs) to provide victim-survivors of both sexual and family violence with immediate and integrated support in a safe place. The MDCs will integrate specialist police investigators, child safety service professionals and specialist support services for both sexual and family violence. The MDCs are focused on bringing services together to create a holistic approach to meet the needs of individuals.

4.4.3 Support in court - Witness Assistance and Witness Intermediary Scheme

A Witness Assistance Scheme has been established to assist persons with disability with complex needs who are required to give evidence in court proceedings. The scheme supports witnesses and victims through witness assistance officers who can give information about court procedures and legal processes, provide crisis counselling or debriefing, and help prepare the victim impact statement.

In addition, a three-year Witness Intermediary Scheme Pilot commenced in March 2021 which enables victims and witnesses to use witness intermediaries to help ensure better participation in the criminal justice system. The scheme is open for all children under the age of I8 and adults with communication needs participating in the criminal justice system in sexual offence and homicide matters.

Protected witness facilities have also been introduced to allow vulnerable witnesses to give evidence via video conferencing facilities in a location outside the courtroom. Pre-recording continues to be utilised in Supreme Court proceedings to minimise the negative impact associated with giving evidence. Evidence is given from a remote room in the absence of a jury and aids are able to be used to assist It also enables vulnerable witnesses, such as those with disability, to give evidence at a much earlier stage, therefore reducing the trauma of delay and anxiety caused by participation in a trial. Further preparation for the court process is provided by a video series on the experience of coming to Court for people with disability or with low, or no, literacy. Problem solving or therapeutic justice programs have been adopted by the Magistrates Court to ensure individuals who are vulnerable or have disability are identified and dealt with by the Court in a more therapeutic and rights-based framework This includes the introduction of a separate Family Violence List to ensure vulnerable individuals are provided with appropriate support.

4.5 Commission of Inquiry into the Tasmanian Government’s Responses to Child Sexual Abuse in Institutional Settings (COi)

On 15 March 2021, by Order of the Governor of Tasmania, a Commission of Inquiry into the Tasmanian Government’s Responses to Child Sexual Abuse in Institutional Settings was established. Under its Terms of Reference, the Commission has been asked to inquire into what the Tasmanian Government should do to:

  • better protect children against child sexual abuse in institutional contexts in the future;

  • achieve best practice in the reporting of, and responding to reports or information about, allegations, incidents or risks of child sexual abuse in institutional contexts;

  • eliminate or reduce problems that currently prevent appropriate responses to child sexual abuse in institutional contexts, including addressing failures in, and barriers to, reporting, investigation and responding to allegations and incidents of abuse, and

    • address or alleviate the impact of past and future child sexual abuse in institution I contexts,

including, in particular, ensuring justice for victims through processes for referrals fo investigation and prosecution and support services.

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The Commission has heard evidence relating to the Tasmanian Government’s responses to allegations and incidents of child sexual abuse in government institutions and non-government institutions where they receive funding from the Tasmanian Government to provide services on its behalf ( eg out-of-home care). The Commission is expected to conclude its hearings by October 2022 and will submit its report and recommendations to the Governor of Tasmania by I May 2023.

In her opening statements, the President of the Commission asked the Government not to wait until

the outcomes of the Commission are known to take action which  it already knows  is necessary. In

response to the first few weeks of the Commission hearings, on 24 May 2022 the Premier gave a statement committing the Government to a number of actions that would be implemented ahead of the Commission recommendations. As part of this statement the Premier also announced Keeping Children Safer as a Premier’s priority. Thirty actions are currently underway ahead of the Commission’s report.

Conclusion

The Tasmanian Government supports the Royal Commission and the vision of achieving a more inclusive society that upholds the independence of people with disability, and their right to live free from violence, abuse, neglect and exploitation.

The Tasmanian Government is investing in the NDIS so people with disability can have increased choice and control over their own care; supporting accessible and sustainable services for people who are not eligible for the NDIS; and supporting the rights of people with disability with responsive policy, and in alignment with national disability strategies and the UNCRPD. Considerable work is underway in Tasmania to reform disability legislation and policy that will reflect these commitments and build a more equitable, inclusive and accessible state.

The valuable contributions of the Royal Commissions inquiry to date are acknowledged and the Tasmanian Government looks forward to the release of the final report.

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References

Australian Bureau of Statistics 202.1, Location: Census, ABS, viewed 28 October 2022,

<https://www.abs.gov.au/statistics/people/people-and-communhities/location-census/202 | >.

Australian Bureau of Statistics 2021, Population: Census, ABS, viewed 28 October 2022, https://www.abs.gov.au/statistics/people/population/population-census/latest-release.

Australian Bureau of Statistics 2018, Disability, Ageing and Carers, Australia: Summary of Findings, ABS, viewed 28 October 2022, <https://www.abs.gov.au/statistics/health/disability/disability-ageing-and carers-australia-summary-findings/latest-release>.

Centre of Research Excellence in Disability and Health, 2021 Nature and extent of violence, abuse, neglect and exploitation against people with disability in Australia, Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability.

Chesterman, J, 2019 The Future of Adult Safeguarding in Australia, Australian Journal of Social Issues, 54, 4,

NDIS Market Monitoring dashboard, accessed July 2022, <https://data.ndis.gov.au/reports-and analyses/market-monitoring/market-monitoring-tas-act-and-other-territories>.

Our Watch and Women with Disabilities Victoria (2022) Changing the Landscape, A national resource to prevent violence against women and girls with disabilities; Our Watch and Women with Disabilities Victoria (2022) Prevention of violence against women and girls with disabilities.

Royal Commission, Research Report, March 2021, Nature and extent of violence, abuse, neglect and exploitation against people with disability in Australia <www.royalcommission.gov.au>.

Tasmanian Law Reform Institute, 2017 Review of the Guardianship and Administration Act 1995 (Tas), Issues Paper 25, TLRI Tasmania.

Tasmanian Department of Health, 2019, The Patient Will See You Now, <www.dhhs.tas.gov.au>.

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Tasmanian

Government

www.dpac.tas.gov.au