Submission 94 — Remote Aboriginal and Torres Strait Island Childcare Advisory — Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability | External submission

SUB.001.03297_01_0001

Submission to the Royal Commission into Violence, Abuse Neglect

and Exploitation of People with a Disability by First Nation people with disability residing in the remote communities of Aurukun,

Napranum, Mapoon and Kowanyama in North Queensland

Yarning Circles and meetings with individuals were held in Gulf Communities by workers from the

Gulf and Cape York Rural and Remote Aboriginal and Torres Strait Island Childcare Advisory

(RAATSICC) and Lotus Support Services, Micah Projects Ltd.

Micah Projects has the contract in Queensland for the Disability Royal Commission Counselling and Support Services and subcontracts RAATSICC for the provision of counselling and support in the remote Aboriginal and Torres Strait Island Communities in the Gulf and Cape York.

Mapoon

16th November 2022

New Mapoon is a community near the tip of Cape York, 1000 kilometres northwest of Cairns, and 88 Km north of Weipa. The dirt road can be inoperable in the wet season.

Traditional Owners: Gudang people

Languages: The predominant language spoken in New Mapoon is Torres Strait Creole, although English and Kriole are also spoken.

A Brief History

Mapoon Mission was established under the name Batavia River Mission at Cullin Point in 1891 by the Presbyterian Church of Australia on the traditional lands of the Tjungundji people[4l- Its residents included the Tjungundji, descendants of other local language groups whose lands were incorporated into the Mapoon reserve over time, people forcibly removed to the mission from the Gulf area and descendants of South Sea Islanders bought to the mission by Presbyterian missionaries [sJ.

In 1954, the Presbyterian Church and Department of Native Affairs attended a conference at Mapoon to discuss the mission’s future. Director of Native Affairs, Cornelius O’Leary, rejected the Presbyterian Church’s proposal to maintain the mission and a policy decision was made to close the mission.

Residents of Mapoon were not consulted about the closure of Mapoon and most protested strongly against the initial plan to relocate residents to other Presbyterian missions or to ‘assimilate those ready for exemption [from the Protection Acts] into the Australian way of life elsewhere’[7l_

At the time the community became aware of the closure plan in 1954, around 285 people lived at Mapoon[3l_ The church administration did not commit to the government’s closure policy until 1960, after experiencing persistent pressure caused by under-funding and uncertainty after the discovery of bauxite deposits in the Mapoon-Weipa area in 1955[9l_

Between 1961 and 1962, the Presbyterian Church began deliberately reducing services to mission residents. The government had begun to build houses at New Mapoon. By July 1963, the last Presbyterian staff member had resigned, the Department of Native Affairs had appointed one of its staff as Superintendent of Mapoon and around 100 Mapoon residents had relocated to New

llP a g e

SUB.001.03297_01_0002

Mapoon. At the end of 1962, around 162 people still remained at Mapoon continuing their campaign against the closure and setting up alternative schooling, food supplies and transport[10l _

The Queensland Government reported in May 1963 that the ‘balance of the inhabitants of Mapoon of their own volition moved to New Mapoon’[11l _ However, the official records indicate that this was not the case. On 14 November 1963, the Director of Native Affairs, Patrick Killoran, instructed the Thursday Island police to remove 23 people from Mapoon to Bamaga and ‘commence demolition of the vacated shanties on the reserve’. The next night, 2 Queensland police officers arrived at Mapoon on the MVGelam, together with several Saibai Island Community Police officers. A police report of the event has never been located, however oral accounts and removal records confirm that all residents were removed and that some of the buildings and houses were burned at Mapoon at this time.

The bulk of the demolition of the Mapoon mission occurred in mid-1954[13l _ Presbyterian Church records indicate that the remaining 70 residents at Mapoon were transported to Weipa and New Mapoon aboard the MVGelam between January and May 1954[14l _

Participants at the Yarning Circle on the 16th of November, 2022

Elders

RAATSICC and Lotus Support

Services facilitated the circle.

All participants were aged and identified as people with disabilities, or family members of people with disabilities.

Issues and recommendations

Funding Models: The issue of the difference between funding for people with a disability funded under the Nation Disability Insurance Scheme and those funded under Aged Care, specifically Home and Community Care funding models, was discussed. The systems are mutually exclusive and there is a lack of model coherence in the amount and type of funds available and no account of the difference in the provision of services in remote areas given consideration.

Recommendation: That the NDIS upper age limit be removed for People with Disability who are aging

Pension: The cost of living in remote communities is high with police, teachers, health workers all receiving Remote Area Allowances, however for those on Centrelink payments there is no remote area allowance.

Recommendation: That a remote area allowance be paid to those receiving Centrelink benefits to address the higher cost of basic necessities in remote areas where choice is very limited if not nonexistent.

Staffing: Staffing is a major issue in the provision of services to people with disabilities in Mapoon.

Home and Community Care: The Mapoon HACC Service is run by the Mapoon Shire Council and the service is unable to attract and retain suitably Qualified and experienced staff to meet the need of HACC participants. The current staff are young and inexperienced, and more attention needs to be given to their training, support, and supervision.

21P a g e

SUB.001.03297_01_0003

Meals on Wheels: Meals on Wheels are only able to provide one meal a day, Monday- Friday with a small breakfast pack for weekends. The ability to find and retain staff is an issue as is the quality of food provided with support staff assisting with meal preparation.

In home care: In home care is an assessed need for participants, however due to the inability to attract workers, vacant positions have resulted in this service being unavailable. There is no house cleaning, meal preparation, yard maintenance, nor personal care available. (One example given about impact was a person using a manual wheelchair having to take the wheelie bin 400 yards to the road) Once again, the ability to find and retain staff is the main driver for the lack of service provision.

All of these staffing issues are impacted by the unavailability of housing stock for workers.

Recommendation: That housing be provided and subsidised in remote communities for aged care and disability support staff. Housing is supplied and subsidized for police, teachers, health workers. Disability and aged care sectors should be considered essential services and therefore receive the same subsidies.

Choice and control: There is no choice about service provision in Mapoon. HACC services are provided by the Council and NDIS services are provided by••• ■People state that in both services it is unclear what services are available to them in their funding packages, although as stated lack of staff results in no service provision even when the service is part of their package. Clear handbooks are not provided. NDIS staffing structures are too complex and fragmented, which causes confusion about the roles of Local Area Co-coordinators, Planners, Plan Managers, and Service Providers.

The location of NOIA Staff at Centrelink is an issue for participants due to negative interaction with Centrelink.

Recommendations:

One key premise of NDIS is the notion of choice and control. Data collection of both unmet need, and consumer satisfaction need to be collected and publicly reported by region to make clear the lack of on-the-ground support to individuals.

A review of the interface between N DIA and individuals to make the system comprehendible.

Respite Care The HACC Centre has a small block of respite units that are unable to be accessed due to the inability to find staff. These units do not have cooking facilities as it was presumed the HACC Centre Kitchen would provide meals.

Recommendation: HACC and NDIS review plans and fund travel and associated respite related costs so individuals and families can access respite elsewhere.

Equipment The provision of equipment for individuals with disability requires a complex system of

3IP a g e

SUB.001.03297_01_0004

assessment, home modification and supply. A major issue in Mapoon has been the wait times for assessment. One participant has been waiting for 2.5 years for grab rails and bathroom modifications. Appointments have been cancelled numerous times and staff resignations have meant no assessments done. This amputee is still not able to independently access her toilet. Once approval is given there are huge delays in the home modifications being undertaken in a timely and cost-effective manner. She has also been waiting for a new wheelchair for an inordinate amount of time with a temporary form seat that appeared to be a permanent inadequate solution with no information available on a timeline for her chair. Participants spoke of the gravy train for quotes if NOIA or HACC are paying for home modifications. It appears no-one feels responsible for, or cares about the impact of lack of equipment and home modifications causing ongoing hardship and emotional and physical distress to individuals.

Equipment repairs are also an area of major concern and frustration. There is no ability for the maintenance and repairs of equipment including wheelchairs and mobility scooters. The cost of repairs and maintenance appears to relate to funding packages, yet it is not included in those funding packages. For a mobility scooter to be repaired would require shipment from Mapoon to Weipa and then on to Cairns. The freight costs are not affordable on a pension in a high-cost environment so there is a lot of equipment unused and unusable due to lack of repair. There is no public transport in Mapoon.

Recommendations:

That a Rural and Remote Supply, Repairs and Maintenance Commissioning Office be

established for the provision of equipment, maintenance, and repair of equipment through the provision of a mobile repair service. This should NOT be done on a fee-for-service basis as the repair costs for equipment are outside the affordability of pensioners.

Plans for NDIS and HACC must include actual maintenance and repair costs.

Local area infrastructure The public toilets in Mapoon are not wheelchair accessible.

Recommendation: Local councils review infrastructure on an annual basis

The HACC bus The HACC bus is unsafe for wheelchair users and needs modification as it is the only option for transporting individuals to WEIPA (88kms) for shopping and appointments. Service user feedback appears to be ignored.

Recommendation: Independent equipment audits need to occur in response to complaints about safety

Patient Travel Scheme: The use of the Patient Transport Scheme is problematic for individuals with disability traveling for hospital or specialists’ appointments. Queensland Health continue to book rooms that are not wheelchair accessible and/or rooms that do not have accessible facilities resulting in stress and distress for people with disabilities and family members.

Recommendation: Better training for the staff who are responsible for bookings and an on call number when accommodation is not suitable.

41P a g e

SUB.001.03297_01_0005

Aurukun

17th November 2022

The community of Aurukun is located on the north-west coast of the Cape York Peninsula, 178km (2hrs 30mins) by road south of the mining town of Weipa and 811km (11hrs) from Cairns. Nearly the entire population (99.6%) lives within the township.

The Accessibility/Remoteness Index of Australia (ARIA) rates Aurukun in the highest category of remoteness. Aurukun is rated as :5 Very Remote (ARIA score >9.08 — 12) — very little accessibility of goods, services, and opportunities for social interaction.

The ARIA rating is based on road distance. It does not recognise: the low rate of vehicle ownership in the community; the half year annual road closures due to flooding, and the cultural barriers limiting residents’ access to goods, services and opportunities for social interaction.

The alternative to road access, air travel, is expensive. Aurukun is one of the larger communities in the Cape with a population of approximately 1200.

Most residents are Traditional owners of the shire and surrounding lands. There are 5S spiritual clan

groups: Apalech; Winchanam; Wanam; Chara and Puutch

The predominant language is Wik Mungkan with remains of other dialects still spoken. English is taught in the school.

Based on the 2006 Census, 93.7% of the population is Indigenous (3.5% of the Queensland population is Indigenous). Furthermore, Aurukun is deeply linked to its traditional culture — 86.7% of the population speaks a traditional Indigenous language at home. This is rare in the Queensland Aboriginal population — only 5.3% of the total Queensland Indigenous population speaks a traditional Indigenous language at home.

Meetings were held in Aurukun with staff from the Home and Community Care Service, O Hub Community Centre, and the Aurukun Women’s Shelter.

ISSUES

Staffing Staffing is a major issue in Aurukun for the HACC Service which is funded to provide day respite, in home care and meals on wheels to both those who are aging, and those with a disability. The HACC Service currently has 6 vacancies and has had no success in filling these.

There are 5 clan groups within Aurukun and culturally and historically there are avoidance relationships between these groups which results in many not able to work with those in other clan groups for cultural reasons or because of conflict.

A major impediment to employment is the inability of many individuals to obtain a Blue Card or Positive Notice Card due to previous criminal justice involvement resulting in failing Criminal History Screening.

As with Mapoon the housing crisis in Aurukun has resulted in staff shortages as there is no available accommodation. Police and Teachers live in a fenced compound in subsidised housing. Aged Care and Disability Care Workers are not deemed essential services and therefore no provision for housing is available, resulting in reduced or no service capability.

Due to the inability to find and retain staff, there is no in home support for personal care, meal preparation, shopping cleaning etc. being provided for this community. The staff pick

5|Page

SUB.001.03297_01_0006

up some individuals to come to the centre for breakfast and activities (which are limited due to lack of staff) and have some capacity for personal care at the centre.

Meals are provided Monday to Friday and are delivered by Centre staff if participants are unable to attend (when it is both physically and culturally safe to do so). Weekend meal packs are provided however due to staff shortages all staff work outside their work scope to ensure people have access to food, resulting in the inability to provide other programs.

Staff report concerns of abuse and neglect of people with disability with high care needs but there appears to be no solutions to service provision other than police intervention.

Equipment repairs: The HACC Centre has 8 Mobility Scooters at the centre which require repairs. There is no ability for the maintenance and repairs of equipment including wheelchairs and mobility scooters. The cost of repairs and maintenance appears to relate to funding packages, and it is not included in them. To repair a mobility scooter requires shipment from Aurukun to Weipa and then on to Cairns. The freight costs are not affordable on a pension in a high-cost environment so there is a lot of equipment unused and unusable due to lack of repair.

Recommendation: That a Rural and Remote Supply, Repairs and Maintenance

Commissioning Office be established for the provision of equipment, maintenance, and repair of equipment through the provision of a mobile repair service. This should NOT be done on a fee-for-service basis as the repair costs for equipment are outside the affordability of pensioners.

Plans for NDIS and HACC must include actual maintenance and repair costs.

Pension: The cost of living in remote communities is high with police, teachers, health workers all receiving Remote Area Allowances however for those on Centrelink payments there is no remote area allowance.

Recommendation: That a remote area allowance be paid to those receiving Centrelink benefits to address the higher costs of basic necessities in remote areas where choice is very limited if not nonexistent.

6IP a g e

SUB.001.03297_01_0007

Napranum

29th November 2022

Napranum is located 819 kilometres Northwest of Cairns and 12 kilometres south of Weipa on the western side of the Cape York Peninsula.

Napranum is home to approximately 1000 Indigenous people who are descended from as many as 40 different groups from around Cape York Peninsula.

Staffing: Disability and Aged Care staffing is a major issue at Napranum.

Although Napranum is approximately 12 kilometres from Weipa, Weipa is a predominantly a mining town with the majority of people being employed in the mines. The mining company subsidise housing for workers. The combination of high wages and subsidised housing in the mining sector, make the community services sectors of disability and aged care an unattractive option for locals. There is little ability to attract workers to the area as most housing is owned by the mines, privately owned houses are expensive, and rentals are both limited and expensive. This results in a contracted workforce.

Health, mental health and allied health staff typically fly in on a Monday and out on a Thursday to provide services. The staff turnover is high, resulting in lack of consistency resulting from staff being unfamiliar with clients. This results in poor quality care.

Recommendation:

That housing be provided and subsidised in remote communities for aged care and disability support staff. Housing is supplied and subsidized for police, teachers, and health workers. Disability and aged care sectors should also be considered essential services.

Equipment repairs: There is no ability for the maintenance and repairs of equipment including wheelchairs and mobility scooters. The cost of repairs and maintenance appears to relate to funding packages, yet it is not included in them. Repair of a mobility scooter would require shipment from Napranum to Cairns. The freight costs are not affordable on a pension in a high-cost environment so there is a lot of equipment unused and unusable due to lack of repair.

Examples:

Waiting 18 months to have a lift recliner fixed.
Waiting over 18 months for appropriate footwear recommended by a podiatrist.
Aged Care or NDIS equipment assessments are not occurring, or not occurring within a timely manner, due to staff shortages.
No bathroom or accessibility home modification occurring, including slippery floors in bathroom with Occupational Therapist saying nonslip surfaces cannot be supplied

Recommendation:

That a Rural and Remote Supply, Repairs and Maintenance Commissioning Office be established for the provision of equipment, maintenance, and repair of equipment through the provision of

71P a g e

SUB.001.03297_01_0008

a mobile repair service. This should NOT be done on a fee-for-service basis as the repair costs for equipment are outside the affordability of pensioners.

Plans for NDIS and HACC must include actual maintenance and repair costs.

Transport: Home and Community Care funded transport is only available to HACC eligible participants. People with Disability who are funded by NDIS are ineligible to be transported as are family members of those with disability requiring transport.

Those participants in Napranum who have NDIS Packages which include transport typically are funded $899/year. One-way taxi fare from Napranum to Weipa costs $50.00. This means that people accessing support in Weipa have about 8 trips per year.

Recommendation:

That the HACC / NDIS guidelines be relaxed in remote communities to ensure the limited transport resources can be shared for the benefit of people with disability living in remote communities.

That the amount of money allocated in HACC/ NDIS Packages should reflect the real costs related to transport in Remote Communities.

Health: No regular doctor who knows the client’s history. New doctors regularly change medication with negative health impacts.

While the Medical Clinic dispenses medication, they do not deliver it. People with disabilities or elderly people with mobility issues are unable to pick up medication. One worker from a Disability Support Service dispenses medication in her own time, as this is outside her role.

There is no home nursing service for people with disabilities to access.

Persons with high needs are unable to receive support from NDIS provider due to lack of staff and staff skill. HACC only provides support on a limited basis.

Abuse of People with Disability: Staff of Aged Care and Disability Service report that elder abuse and abuse of people with disability do occur. Napranum experiences high levels of domestic and family violence. Financial abuse is a key driver of exploitation. With no options for care, outside of care by family, most abuse goes unreported.

Recommendation:

Increase funding to ensure that family wellbeing is supported by the provision of respite services.

Increase Domestic and Family Violence funding to allow an appropriate response to people with disabilities.

SI P a g e

SUB.001.03297_01_0009

Pension: The cost of living in remote communities is high with Police, Teachers, Health Workers all receiving Remote Area Allowances however for those in Centrelink payments there is no remote area allowance.

9IP a g e

SUB.001.03297 _01_0010

Kowanyama

29th November 2022

Kowanyama lies on the west coast of Cape York, 600 kilometres northwest of Cairns. Kowanyama. Kowanyama has a population or approximately 1,000 people. Kowanyama is accessed by an all weather airstrip, as well as unsealed roads in the dry season. Kowanyama to Cairns is 605 kilometres and a 7.6-hour drive.

Traditional Owners are the Kokoberra, Yir Yoront (or Kokomnjen) and Kunjen clans. Languages

spoken include Yir Yoront, Yirrk Thangalkl, Koko Bera, Uw Oykangand, and Olkola. English is also

spoken.

Home and Community Care supports approximately 65 people in Kowanyama, with 4 living permanently in the HACC Centre, the remainder are community clients. NDIS supports approximately 23 participants. Many older participants who are aged live with disabilities.

Management turnover has been an ongoing issue as has staff recruitment and retention with burnout resulting. HACC currently employ about 24 local staff who receive on the job training in aged care.

Assessment: NDIS assessment is particularly hard due to the complexity of the system. Individuals often lack what is considered basic information like a birth certificate and proof of address. Privacy is used by agencies to not allow enquiries over the phone. People are told to call in in person even though the office is 600 km away.

Accessing assessment is a major issue with both occupational therapists and aged care assessors flying into the community (the last OT visit was over 6 weeks ago). Visiting services have no permanent accommodation and there are limited options available for the many fly-in fly-out workers resulting in frequent changes in plans by agencies.

Many children with Foetal Alcohol Syndrome, Attention Deficit and Hyperactivity Disorder,

Autism/ Asperger’s, and mental health issues are undiagnosed. Paediatric services are unavailable and require an appointment in Cairns. Appointment wait times are high and the transport issues are complex for people to access. Children with behavioural difficulties are either expelled, or have their hours cut, and then have no educational options available to them.

Recommendation:

Service navigation needs to occur away from Centrelink officers and done in a culturally appropriate way with respect to language and culture.

Assessment of children needs to be prioritized with Education Queensland taking more responsibility for keeping children engaged in the classroom, rather than suspension, expulsion being used. When there is no other alternative to removal from the school alternative engagement strategies must be enacted.

Equipment and Home Modifications There is no ability for the maintenance and repair of equipment including wheelchairs and mobility scooters. The cost of repairs and maintenance appears to relate to funding packages, yet it is not included in them. For a mobility scooter to be repaired requires shipment from

lOIP a g e

SUB.001.03297 _01_0011

Kowanyama to Cairns. The freight costs are not affordable on a pension in a high-cost environment so there is a lot of equipment unused and unusable due to lack of repair.

Example:

Occupation Therapist sent request to Housing Department for home modifications, however still waiting for an acknowledgement of the referral and a timeline for the modifications to occur.

Recommendation: That a Rural and Remote Supply, Repairs and Maintenance Commissioning

Office be established for the provision of equipment, maintenance, and repair of equipment through the provision of a mobile repair service. This should NOT be done on a fee-for-service basis as the repair costs for equipment are outside the affordability of pensioners.

Plans for NDIS and HACC must include actual maintenance and repair costs.

Health: There is a high turnover in medical staff at the hospital with visiting special services infrequent, there has been no visiting doctor regarding deafness/hard of hearing for over 2 years. There has been no eye doctor visiting recently either. As stated, paediatric visits are Cairns based as are many specialties.

Participants reported that the clinic will not allow elders and others to sit inside the clinic, but insists on them remaining outside under the veranda where they are exposed to extreme heat.

Queensland Health have banned an elder with disability and Apunipima Health Service state they mainly see women and children. One visiting Doctor stated they will see anyone in the community who requires medical attention. A doctor visits every 3 weeks.

Medication: The HACC Centre is unable to store or administer medication as there is no Director of Nursing and staff are untrained to administer medication. Neither Apunipima, who run the Health Clinic nor Queensland Health deliver medication for clients in the community. Staff at Apunipima fly in on a Monday and out on a Friday so in effect the clinic runs 3.5 days /week

Queensland Health have stated that they do not employ drivers to pick up Clients for appointments or to drop medication off.

Recommendation:

Given the high rates of morbidity and premature deaths with the indigenous population more attention needs to be paid to addressing disadvantage.

Clinics need to open more than half time.

The high rates of staff turnover in fly-in fly-out staff need addressing.

Medication delivery needs to be funded to ensure access to medication in a timely way as does transport to and from medical appointments. Incorporating travel in a plan when there is no viable transport option currently available is inadequate. Not all responses to community needs should be individualised.

The community, in response to community anger, has been calling for a change in staff and policy regarding physical access to the clinic.

Domestic and Family Violence 11 I P a g e

SUB.001.03297_01_0012

Staff of Aged Care and Disability Service report that elder abuse and abuse of people with disability do occur. Kowanyama experiences high levels of domestic and family violence. Financial abuse is a key driver of exploitation. With no options for care outside of care by family most abuse is unreported.

Recommendation:

Increase funding to ensure that family wellbeing is supported by the provision of respite services.

Increase Domestic and Family Violence funding to allow an appropriate response to people with disabilities.

Pension: The cost of living in remote communities is high with police, teachers, health workers all receiving Remote Area Allowances however for those on Centrelink payments there is no remote area allowance.

For further information or clarification on this submission please contact:

June Kellermeier

Mob: 0417 35114 4 Email: drc1@raatsicc.org.au

Constance Sailor

Mob: 0419 55 0 620 Email: drc2@raatsicc.org.au

12 I Pa g e