Activating Citizenship

A Social Inclusion Approach for Disability in South Australia

Discussion Paper ~ July 2010

 

Table of Contents

 

A Message from the Commissioner for Social Inclusion. 1

A Social Inclusion Approach for Disability in South Australia  7

How this paper is structured. 8

1. Purpose of this Discussion Paper 9

How to read this Discussion Paper: 13

2. Applying the Social Inclusion Approach to Disability in SA  15

The Social Inclusion Method. 16

Our approach to the concept of disability. 20

The current context 22

3. What do we want to achieve?. 25

3.1 Strengthening Dignity, Rights and Protection. 28

3.1.1 Building  South Australia’s  understanding of rights and responsibilities. 31

3.1.2 Making legislation meaningful 33

3.1.3 Building protections in the delivery of services. 37

1. Restrictive practices. 39

2. Monitoring services. 40

3. Minimising reliance. 41

3.2   Enabling communities. 44

3.2.1 Good health and wellbeing. 46

3.2.2 Positive personal and family relationships. 49

3.2.3 Decent and secure work. 53

3.2.4 Innovative and accessible education. 57

3.2.5 Enhanced social, civic and cultural participation  63

3.2.6 Accessible, open and friendly space, infrastructure and technology. 68

3.3 Shifting the focus from bureaucracies to citizens. 73

3.3.1 Understanding and addressing the needs of those with complex and additional needs. 77

3.3.2 Raising awareness: promoting independence and aspiration across all agencies. 84

3.3.3  Personalising the approach to service delivery. 87

3.3.4  Integrated Services and Joined-Up systems: ensuring ease, efficiency and equity. 95

Section 4: Next Steps. 100

Online Survey. 101

Email or Postal Submissions. 102

Community Meetings. 103

Phone Submissions. 103

Community Meetings. 105

 

A Message from the Commissioner for Social Inclusion

 

The Premier of South Australia, the Hon Mike Rann MP, has asked the Social Inclusion Board to develop a reform plan – a ‘Blueprint’ - to set a future direction for the way people with disability, their families and carers are supported in South Australia.

 

This is a tremendous opportunity for us all.  It is our chance to deliver a reform plan that is about choice, dignity and the rights of citizens.

 

South Australia is more enriched from the contributions of people with disability. It is from this basic premise that our Blueprint for reform will develop. 

 

We recognise that South Australians with disability today are too often shut out from participating and sharing the opportunities of our community. Barriers  such as discrimination, exclusion and ignorance mean that if you are a South Australian with disability you are more likely to live in poverty, be unemployed, not complete high school, not own your own home and be denied other opportunities to achieve and participate in the community.

 

Our communities need to become inclusive - shaped by the experiences, aspirations, needs and preferences of people with disability. This means delivering the entitlements for people with disability that should be a part of basic citizenship.  Simply put, it means Activating Citizenship for people with disability.

 

Just as important to our work are the needs of families and carers - many of whom are currently experiencing desperation, stress and fear about the future security of those they care for, as well as themselves.

 

Our work will review current legislation, programs, policies and services.  It will also identify and explore best practices locally, nationally and around the world. We will listen to the voices of people with disability, families, carers and those who work or volunteer in the sector to seek a better way forward. Drawing from all of this, the Social Inclusion Board will then make a series of recommendations to the Government.

 

But our work will not end there. We will closely monitor the implementation of our recommendations to the Government, ensuring they achieve a better quality of life for people with disability, their families and carers. 

 

A key focus in our work will be the transformation of service delivery. The Social Inclusion Board acknowledges that many people in our community today are in need of urgent and critical support. While many people are receiving valuable services and supports, we know that these are not always adequate, affordable or timely.

 

We know that currently, there are many valuable services being provided by community organisations. However, these important services are also under stress given increasing demands, limited resources, workforce pressures and unnecessary red tape.

 

The service system is increasingly broken and in crisis.  Too often, the system is placed ahead of the person, despite the best efforts of staff working within the system and increased funding from government. There are often not enough appropriate services being delivered leaving some families in desperate need. The result is that for many South Australians with disability – as well as their families – dealing with the disability system can make everyday tasks of ordinary life even more difficult. 

 

It is clear that our current approach is not sustainable – particularly considering the growing pressures of an ageing population. But lasting change requires more than just injecting additional funding into the system - which may provide temporary relief, but does not fix what is broken. Instead, our vision encompasses long-term reform that will support a better joined-up approach across government, as well as promote parallel shifts in community practice and attitudes. In essence, it will strengthen the rights of people with disability, make communities more enabling, and shift the focus away from bureaucracies towards citizens.

 

This Paper marks the beginning of a period of ‘actively listening’ to South Australians to help us develop our Blueprint for reform.  The Social Inclusion Board acknowledges that over the past few years there have been ongoing consultations with South Australians on the issue of disability reform at both state and national levels. The Board itself conducted consultations with South Australians in 2006 on ways to better connect young people with disability with post school pathways. We will not be repeating these important processes – we will build on them.

 

We encourage ideas, innovation and solutions.  We want to hear about the issues faced by people living with disability. We also want to hear the community’s vision for the future. Most importantly, we want to hear directly from people with disability, their families and carers.

 

The timing is right and we now have the opportunity to improve inclusion, participation and independence of South Australians with disability. I encourage all South Australians to provide feedback to the Board and build a consensus on future actions that will provide a more inclusive community for people with disability.

 

Monsignor David Cappo AO

Commissioner for Social Inclusion SA

Chair, Social Inclusion Board

 

 

 

Activating Citizenship

A Social Inclusion Approach for Disability in South Australia

 

 

How this paper is structured

 

Section 1 outlines the purpose and structure of this Discussion Paper.

 

Section 2 provides a short description of our approach to engagement and how we understand the term ‘disability’ within the context of our work. It also briefly describes the context in which we are seeking reform.

 

Section 3 outlines our broad vision for reform, discusses the key pathways on what this might mean in practice and poses a series of questions for your consideration and feedback.

 

Section 4 describes the further ways in which you can help inform the Social Inclusion Board’s work in developing the Blueprint for Disability Reform.

 

1. Purpose of this Discussion Paper

 

This paper outlines the Social Inclusion Board’s broad vision of how reform for people with disability might look. It is intended to provide South Australians with an opportunity to contribute their knowledge, experiences and expertise. It is a way for people with disability, their families and other carers, as well as stakeholders in community organisations, to put forward their own ideas on ways in which we can support transformational change in our community’s inclusion of people with disability.  This input will inform the Social Inclusion Blueprint for Disability Reform – to be delivered mid-2011.

 

Key areas of inquiry for this reform will be:

 

1.    Strengthening the dignity, independence, participation and rights of people with disability.

2.    Accelerating the development of integrated and joined-up services where the focus is on the personal and long-term needs of people with disability.

3.    Ensuring the role of carers and families is more effectively recognised and supported.

 

 

In essence the Blueprint will:

 

      Develop recommendations to the government on future policy commitments that support all people with disability;

 

      Identify the actions required by government to implement, monitor and measure progress in meeting these commitments to ensure the Blueprint remains an active and living document;

 

      Identify new and existing measures to address issues around unmet need and pressures on systems of care and support. These must consider the needs of people with disability before those of the system and acknowledge the crucial support role played by their families and community organisations;

 

      Identify ways to improve the level of control people with disability have in the purchase, delivery and design of services and support;

 

      Support recommendations based on new and existing best practice service delivery and community participation practices.  Such initiatives should enable people with disability to have choice over the services and support they receive and to remove barriers to independent living and community participation; and

 

      Identify ways to ensure that the diversity of people with disability is recognised and that the needs of our most vulnerable populations are understood and acted on, including Aboriginal and culturally and linguistically diverse communities, as well as those living in rural and remote regions.

 

The Blueprint will be developed in partnership with people with disability and their families to ensure it reflects their aspirations, knowledge and life experiences. This Discussion Paper provides an important platform to incorporate the community’s input. Further ways in which the public can inform this process are outlined in Section 4.

 

How to read this Discussion Paper:

 

This paper outlines the Social Inclusion Board’s vision for reform. It is intended to assist you to prepare a submission on this vision.

 

Throughout the paper, there are a range of questions which ask you to respond based on your own experiences, knowledge and opinions. This may be as a person with disability, a family member, a carer or  a worker within a community organisation delivering services.

 

The space beneath the questions is for you to take your own notes (as you work through the paper). We do not expect you to return the paper as your submission.

 

Important note: If you wish for your submission to be confidential, please indicate this clearly on your submission.

 

You do not need to respond to all of the questions, just those which interest you. These questions simply serve as a guide for you to write your submission. You may answer the questions as briefly or extensively as you wish, using your own experiences to give examples of where change might be needed, as well as where things are already being done well.

 

We are interested in your views and ideas on what long-term changes could look like and what the Government needs to consider in order to sustainably and successfully respond to the needs of people with disability, their families and carers.

 

In reading this Discussion Paper, you may identify others whom you believe would also benefit from preparing a submission. You are encouraged to share and distribute copies of this Paper, which can be downloaded from the Social Inclusion website: www.socialinclusion.sa.gov.au

 

There is further information about making your submission in Section 4.

 

2. Applying the Social Inclusion Approach to Disability in SA

 

South Australia is recognised around the world for its social innovation and, in particular, its history and tradition of championing citizenship rights and entitlements.  We see this in the fact that South Australia was the first place in the world to allow women to stand as a member of parliament and one of the first to allow women to vote. We also see this in the delivery of land rights for Aboriginal people.

 

In the area of disability, we see this tradition continuing with the enactment of South Australia’s Carer’s Recognition Act (2005), which, for the first time, enshrined the rights and roles of people who care for people with disability.

 

The Social Inclusion Board believes that the time is right for South Australia to strengthen its reputation as a national and international leader by furthering rights, opportunities, inclusion and dignity for our citizens living with disability.

 

The Social Inclusion Method

 

Since 2002, the South Australia’s Social Inclusion Initiative has delivered better outcomes to the most marginalised people through a range of innovative policy and joined-up government responses. The Initiative has a direct reporting relationship to the Premier as the Minister for Social Inclusion and operates with his mandate.

 

The Social Inclusion Board, led by the Commissioner for Social Inclusion, Monsignor David Cappo AO, has responsibility for developing independent policy advice on a range of complex social issues. South Australia’s approach to social inclusion has so far been effective on issues such as reducing homelessness; delivering mental health reform; increasing school retention rates, and; improving Aboriginal health and wellbeing through sports, recreation and the arts.

 

The Social Inclusion Initiative has developed and honed a distinct method of applying its approach to complex social problems. The Social Inclusion Method takes the usual steps of policy development, but applies them in a way that is more relevant to the task of delivering immediate benefit for people, especially the most vulnerable people in our community. This is a five-phase process:

 

In the first half of 2010, significant and extensive research of policy frameworks, academic literature and best practice has informed the Scoping phase of the Blueprint. This initial work has identified a number of key themes and ideas which are presented in this Discussion Paper.

 

The formal Active Listening phase begins with the release of this Discussion Paper and will conclude late 2010. This phase will feature state-wide engagement with South Australians to inform the final Blueprint for Disability reform. The Board will engage with South Australians through a series of mechanisms including:

 

      An online survey based on the themes and questions highlighted in this paper

      A state-wide phone in

      Community meetings

      Focus groups targeted at specific sections of the community

 

The information gained from the Scoping and Active Listening phases will then be analysed, cross–referenced and tested to determine the overall direction for the reform. This represents the Advice Development stage and will conclude when the Social Inclusion Board delivers its final recommendations to government.

 

The Blueprint will be used to inform an Action Plan. This promotes agencies across government sharing ownership of implementing recommendations in a joined-up approach. In order to bring about results quickly, clear targets and timeframes will be monitored carefully and regularly.

 

As Implementation of the Action Plan progresses, the Commissioner for Social Inclusion will continue to ensure government agencies remain on track in implementing the disability reforms to ensure the changes are effective and sustainable.

 

Our approach to the concept of disability

 

As Australians have become more informed and connected to the experiences of people living with disability, the way disability is defined and understood has changed.

 

The definition of ‘disability’ in the South Australian Disability Services Act (1993) relies on medical definitions where the “expert voice” predominates. These definitions see disability foremost as a limitation or barrier to activity and participation. There is now increasing recognition that attitudinal and environmental barriers impact on the lives of individuals with disability.

 

In 2008, Australia ratified the United Nations (UN) Convention on the Rights of Persons with a Disability. The Convention emphasises that environmental and attitudinal barriers are just as important in defining disability as an individual’s physical or intellectual impairment.

 

The principles of the Convention enforce the rights and entitlements of people with disability.  By signing the Convention and its Optional Protocol, Australia is committed to ensuring these entitlements are being received by Australians living with disability.

 

Article 1 of the  UN Convention on the Rights of Persons with a Disability:

Persons with disabilities include those 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 equal basis with others.

 

The Social Inclusion Board adopts a broad and holistic understanding of disability. It recognises disability is the product of impairment, functionality or potential and, significantly, environment. The community places social, economic and cultural barriers limiting a person with disability’s capacity to participate and be included. These barriers compound and further define the experience of disability and the problems which need to be overcome. 

 

The Board also recognises that people with disability differ, not only in relation to the degree and nature of their impairment, but more importantly in relation to their individual circumstances, capacities and skills. People with disability are not an homogenous group and do not have the same needs. Treating them as such only adds additional barriers and contributes to exclusion.

 

The current context 

 

A number of key disability reforms and developments are occurring at the state and national level. The Social Inclusion Board is factoring in these reforms and aligning its work where relevant.  

 

At the national level these include:

 

      A National Disability Agreement (NDA), signed by all jurisdictions in 2009, which aims to improve the delivery of specialist disability services in Australia.

 

      A National Disability Strategy (NDS), due for release in 2010, focusing on: rights protection; accessible communities; improving economic security; development of whole of life skills; improving health and well being; and  furthering independence.

 

      The Commonwealth Government has asked the Productivity Commission to undertake a feasibility study into a National Disability Insurance Scheme. This would transform the way governments fund services and supports for people with disability and their families and carers.

 

      New disability standards for access to buildings will come into effect from May 2011. These new standards ensure that all newly designed or constructed buildings will be accessible for people with disability and comply with anti-discrimination legislation. Consultation and information sessions on these new standards will be occurring in South Australia soon. 

 

      The Australian Government recently completed the South Australian consultation regarding the development of new Quality Service Standards for organisations delivering services to people with disability. It is anticipated that the new standards will address gaps and improve the overall quality of services.

 

At the state level these include:

 

The Department for Families and Communities is undertaking  consultation on service and structural improvements across its disability and ageing services known as the Ageing Disability Service Improvement Project.

 

The Department of Education and Children’s Services have convened a taskforce to inform the development of a 10 year plan for education reform in government preschools and schools for children with disability.

 

The Minister’s Disability Advisory Council has been asked to provide advice on appropriate options for ensuring the safety of vulnerable people.

 

The Government of South Australia has begun a process of reviewing its Promoting Independence Strategy so that it reflects the new National Disability Agreement and the future National Disability Strategy.

 

3. What do we want to achieve?

 

The Social Inclusion Initiative recognises the goal of Activating Citizenship as central to disability reform in South Australia. Activating Citizenship means that we move forward from exclusion and discrimination of people with disability to a fully inclusive and mutually supportive community that recognises individual talents, knowledge and skills. Activating Citizenship mean that people with disability can fully participate in community life on their own terms. Finally, Activating Citizenship means human rights are protected as a fundamental cornerstone of government disability policy and practice.

 

At a practical level, the Social Inclusion Board believes Activating Citizenship can be achieved through three independent but interrelated pathways:

 

Strengthening Dignity, Rights and Protection:   This requires that stigma, discrimination and exclusion have no place in our community. It means that South Australians with disability are treated with care and respect and are protected from abuse and neglect. It means the wider South Australian community must be well informed about the rights of people with disability and understand their responsibility to promote participation and inclusion. It means that legislation is strong and meaningful. Finally, it means that services for people with disability contain protections that are independent and effective.

 

Creating Enabling Communities:  This requires that our communities enable people with disability, their families and carers to achieve positive outcomes across all spheres of their life over a lifetime. It means that communities must be accessible in design, welcoming in attitude and enabling in approach. We must do better in promoting and supporting the inclusion of people with disability in our community.

 

Shifting the focus from Bureaucracy to Citizen: This requires that disability services put people at the centre of the system and that this system promotes choice, control and supported independence for people with disability. It means developing a service system that moves away from providing welfare and dependence, towards a care and support model that allows people to live autonomously with the supports they require.

 

Each of these areas aligns with national and international best practice and supports a framework to promote the goal of Activating Citizenship.

 

Across each of these areas, the issue of funding needs to be considered. It is essential that South Australia develop mechanisms to identify where new funding is required, in addition to focusing on how we can better utilise existing funding to improve the existence, efficiency and effectiveness of services for people with disability and their families.

 

3.1 Strengthening Dignity, Rights and Protection

 

People with disability experience stigma, discrimination and exclusion on a daily basis. It is the role of the community to build safeguards to ensure that these sorts of experiences do not occur, but if they do, they are addressed in a timely and effective way.

 

Strengthening the dignity, rights and protection of people with disability is of particular importance because of the vulnerability that disability imposes. Many people with disability are reliant on others to support their day to day living and goals. Many people with disability also need support and advocacy to address breaches of their individual freedoms, choices and rights. This reliance on others makes it critical that our community has effective laws and a range of safeguards in place to protect the dignity and rights of people with disability.

 

A strong legislative foundation is important. Legislation reflects the values, views, expectations and standards of the community. South Australia recognises that people with disability have human rights through the Disability Services Act (1993) and the Equal Opportunity Act (1984) and in Commonwealth legislation including the Disability Services Act (1986) and the Disability Discrimination Act (1992). More recently, this has been evident through Australia’s ratification of the United Nations Convention of the Rights of People with Disability.

 

Activating Citizenship means that people with disability have access to the rights described in legislation and conventions, but just as importantly that these rights are upheld. It is only then that they will become meaningful.

 

Safeguards serve as the checks and balances within our community to protect the rights of people with disability. It is in all our interests to ensure that protective mechanisms are working and meeting the needs of people with disability. The Board’s task is to ensure that the safeguards we have are of high quality, transparent, effective and accountable to people with disability.

 

3.1.1 Building  South Australia’s  understanding of rights and responsibilities

 

Strengthening dignity, rights and protections for people with disability means that citizens have responsibilities to ensure people with disability are respected, valued and supported. Communities have a role in ensuring that people with disability are being treated with care and respect. Communities also have the responsibility to act on concerns if a person with disability is placed at risk. For this to work, information about enforcing rights should be available.

 

Strengthening dignity, rights and protections for people with disability also requires that people with disability have access and recourse to advocacy. Disability advocacy enables and supports people with disability to safeguard their rights and overcome barriers that impact on their ability to participate in the community. It also allows them to actively participate in the decision-making processes that safeguard and advance their human rights, wellbeing and interests.

 

Under legislation, advocacy support services must be provided by both Commonwealth and South Australian governments. However, we know that people with disability and their families are often required to volunteer their own time to provide these services.

 

Possible approaches include:

 

      Promoting greater understanding across the community about the rights of people with disability;

 

      Building the community’s capacity to monitor the safety of people with disability;

 

      Providing information about advocacy services to people with disability and the wider community;

 

      Developing new and improving existing strategies to ensure people with disability are safe and protected from violence, exploitation and neglect.

 

Questions to consider:

 

What do you think the government should do to ensure the rights of people with disability are enforced?

 

How can the community play a role in protecting the rights of people with disability?

 

You do not have to answer all of these questions - just those that interest you.

 

3.1.2 Making legislation meaningful

 

Legislation is important because it reflects the values of the community. Strong laws can provide a foundation to enable people with disability to be supported to live independently in the community.

 

Current South Australian legislation recognises that people with disability have rights that are equal with the rest of the community and are entitled to the same services, dignity and respect as everyone else. It is important however, that this is enforced in all areas of life.

 

The new Victorian Disability Act (2006) provides an example of how a whole-of-government framework for laws can be strengthened. It includes a monitoring, review and accountability role for government, and has been crucial in ensuring that information is available to the community about enforcing and protecting the rights of people with disability. The Act has introduced the Office of the Senior Practitioner which is responsible for enforcing the rights of people with disability relating to the delivery of their care and support. It also reinforces what is and isn’t appropriate in relation to human rights for people with disability when being cared for and supported.

 

South Australia does not currently have a single entity that assumes responsibility for enforcing the rights of people with disability. Many different agencies including the Department for Families and Communities, the Public Advocate, the South Australian Equal Opportunity Commission and Commonwealth Human Rights and Equal Opportunity Commission, all play a role in performing this function. Even with the efforts of all of these agencies, there remain gaps in enforcement of protection for many people with disability.

 

We must strengthen the ways in which our community and government can deliver the outcomes articulated in our legislation. As such, we must ensure that the current legislation is reviewed so that it is better able to enforce the rights of people with disability.

 

Possible approaches include:

 

      Reviewing current legislation in order to identify strengths and gaps in relation to protection and rights enforcement for people with disability;

 

      Investigating a simple “one-stop” option for ensuring that the rights of people with disability are enforced;

 

      Providing clearer understanding for communities of what is acceptable and what is not in relation to the rights of people with disability.

 

Questions to consider:

 

In what areas should laws be strengthened to improve the protections for people with disability?

 

3.1.3 Building protections in the delivery of services

 

Independent bodies such as the Office of the Public Advocate and the Health and Community Services Complaints Commission have highlighted that South Australia could strengthen protections for people with disability. It has also been observed that the government can better manage serious complaints in the system. The Social Inclusion Board views building stronger and more transparent protections in the delivery of services to people with disability as a critical area of focus.

 

Building protections within all services is important in order to keep people with disability safe from possible harm within service environments. It promotes safer and more secure institutional and community based accommodation environments.

 

 

In order to build protections that are independent, effective and accountable, several mechanisms must be in place. These include:

 

      a way of addressing issues of restrictive practices;

      independent mechanisms to monitor and respond to complaints; and

      ways to minimise the reliance of people with disability on any one organisation.

 

While there are many existing practices in South Australia that are delivering good protections, the Board invites the community to think about new and innovative ways to strengthen protections for people with disability within service settings. It also welcomes feedback on the three areas noted above and described below.

 

 

1. Restrictive practices

 

Where an individual may cause harm to themselves or others, service delivery staff may need to resort to “restrictive practices” with the intention of protection. These, according to the Victorian Officer of the Senior Practitioner, can include chemical restraint, mechanical restraint or seclusion. Given the impact on people’s rights, freedoms, and mental and physical health, these should be seen as an option of last resort.

 

The South Australian branch of the Australasian Society for the Study for People with Intellectual Disability (ASSID) has noted that there is limited regulation to identify or monitor restrictive practices in this state. While many organisations have procedures to minimise the use of these practices, as a community there are no formal agreed uniform standards regarding when, or how, this practice is used.

 

One possible response is to build more transparency into services to ensure there is information as to when, why and how service providers use restrictive practices.  A system of services and supports with strong accountability mechanisms contains opportunities for people with disability to have greater decision making and control in the delivery of the care they receive. It also provides clear frameworks and guidelines for service providers to perform their work safely and effectively.

 

2. Monitoring services

 

South Australia needs to strengthen and standardise monitoring mechanisms so that they are consistent across government and non government sectors.  A strong protective system should contain opportunities for people with disability to have access to people outside of organisations with whom they can discuss their concerns and who can act as advocates.

 

For example, “circles of support” could be used to assist people with disability to build relationships with others in their day to day lives and provide opportunities to share problems.  In addition, schemes such as the Victorian Community Visitors Scheme for people with disability gives volunteers the power to inspect community based residential facilities in relation to the quality of care being provided. In South Australia, a community visitor scheme is in place for people who are receiving treatment in psychiatric wards (under the Mental Health Act 2009). This does not exist for people with physical or intellectual disability.

 

3. Minimising reliance

 

It is important that people with disability are not solely reliant on any or only one organisation to meet their basic needs. Put simply, if a person is unhappy with the service they are receiving, they should have the choice to go elsewhere.

 

For example, in South Australia we have begun a process of separating the delivery of tenancy and support functions in our supported accommodation. This means that one organisation does not take on the role of landlord and support provider; it does not control all decisions. These kinds of processes could be applied to people living in supported accommodation facilities and group homes. 

 

Possible approaches include:

 

      Building greater choice and decision-making control for people with disability about the services they are receiving;

 

      Providing more training and development opportunities for staff and volunteers around the rights and protection of people with disability;

 

      Ensuring complaints mechanisms are standardised, easy to use and effective;

 

      Developing common standards around the definition and use of restrictive practices;

 

      Promoting the reporting of serious complaint by people with disability;

 

      Introducing options such as circles of support and visitor schemes to monitor services.

 

Questions to consider:

 

How can we build better protections into services for people with disability?

 

What sort of information should be made available about service providers’ use of restrictive practices?

 

How can we monitor service providers to ensure that they are delivering a high quality of care?

 

How can better protections be built into government and community organisations?

 

How can we ensure that people with disability are not solely reliant on any one organisation in meeting all of their needs?

 

3.2   Enabling communities

 

“The people who participated (in the Shut Out Consultations) are just like…. all other Australian citizens…. the consistent message….is the desire to have the same opportunities as everyone else for a fulfilling and productive life. Many said ….they do not want special treatment – they just want the barriers removed so they can get on with living.”  Australian Government (2009) “Shut Out – The Experience of People with Disabilities and their Families in Australia, National People with Disabilities and Carers Council” p. iv.

 

Accessible and enabling communities allow us all to contribute and achieve our individual potential with minimal restrictions. They allow anonymity - to be “ordinary” as we go about our day to day tasks.

 

People with disability are entitled to the same things as everyone else. Activating Citizenship means as children, people with disability are entitled to enjoy stress free family environments and the chance to play, learn and thrive. Young people with disability are entitled to get a job, leave home and develop friendships and intimate relationships with others. As adults, people with disability are entitled to seek satisfying and sustainable work opportunities, innovative educational opportunities, secure and affordable housing and accommodation, successful personal relationships, family life and a healthy and leisurely retirement.

 

Across all stages of life, people with disability - just like all South Australians - are entitled to the supports and opportunities to make the most of life. An enabling community actively promotes better outcomes for people with disability and their families across a range of areas through emphasising the principles of access, ease and equity.

 

3.2.1 Good health and wellbeing

 

People with disability are more likely than others to have poor physical and mental health, and higher rates of smoking and obesity.

 

An enabling community should ensure that people with disability have choice and control over their health needs and can independently manage their own long-term conditions with the right supports in place. An enabling community should promote better links between organisations that deliver disability services and hospitals, general practitioners, medical specialists, allied health professionals and other health bodies.

 

An enabling community should acknowledge that Aboriginal people are restricted in their access to mainstream health services and culturally and linguistically diverse communities can experience similar barriers.  An enabling community should support a health workforce that understands the needs specific to people with disability, with a focus on addressing barriers specific to more vulnerable groups. 

 

It should focus on ensuring that public awareness campaigns around issues such as obesity, smoking, mental health and vaccinations are relevant and accessible to all people with disability. It should also support the development of accessible and innovative early intervention options, particularly for children with disability, that empower families to manage their lives and make choices that support positive outcomes.

 

Possible approaches include:

 

      Training our health workforce to incorporate issues and needs specific to people with disability;

 

      Designing new health services (mental health, drug and alcohol, primary health care) and refining existing ones to promote linkages and collaboration with the disability sector;

 

      Redesign existing health services to ensure that they are accessible to more vulnerable populations with disability; This may entail strategies such as cultural training for staff and development or increasing outreach facilities;

 

      Placing a greater emphasis across health issues on early intervention and prevention initiatives for people with disability.

 

 Questions to consider:

 

What could health services do differently to better support people with disability?

 

What new services or programs could be made available to achieve better health outcomes for people with disability?

 

How can our broader community enable people with disability to be healthy, active and strong?

 

3.2.2 Positive personal and family relationships

 

Social isolation is an daily reality for many people with disability. The Australian Bureau of Statistics estimates that of people aged 15 to 59, 15 per cent of people with disabilities live alone, compared with 6.8 per cent of people without disability.

 

An enabling community designs its services and supports in a way that recognises that people with disability – like all South Australians - have lifestyle choices about relationships, sexuality and reproductive potential. An enabling community ensures that policy and practice designed to tackle social challenges such as child poverty, drug and alcohol abuse and domestic violence, also acknowledges and addresses the personal needs and circumstances of families affected by disability.

 

An enabling community promotes initiatives aimed at eliminating the barriers that lead to social isolation, low self esteem and family breakdown. It encourages initiatives that help people with disability enjoy positive personal and family relationships. An enabling community recognises that families and carers of people with disability are also impacted by disability through the unpaid care and assistance they provide.  Accordingly, an enabling community provides supports and respite for family members and other carers to enjoy life outside of their caring responsibilities.

 

Possible approaches include:

 

      Ensuring that information around lifestyle choices is accessible to people with disability;

 

      Establishing better links between disability services and relationship counselling, parenting and peer support;

 

      Promoting initiatives targeted at people with disability that also recognise the needs of their families and carers;

 

      Establishing respite services for families and carers that are tailored to meet an individual’s needs and circumstances;

 

      Promoting positive family relationships amongst people with disability.

 

Questions to consider:

 

Are you aware of any best practice programs or services that support people with disability and their families to enjoy active and positive social lives?

 

What barriers do people with disability face in meeting people who share similar personal interests? What can be done to provide greater opportunities?

 

What do families – where one or more members have disability - need to sustain positive and strong relationships?

 

What should ideal respite look like? Who should enjoy respite? Who should provide respite?

 

3.2.3 Decent and secure work

 

People with disability have some of the poorest economic outcomes in Australia. In June 2008, over 64,700 South Australians were on the Disability Support Pension (DSP). According to the Pension Review Report (2009), the DSP does not provide financial security or adequately cover costs incurred by people living alone.

 

In South Australia, it is critical that people with disability and their families are able to access the opportunities and share in the benefits arising from our State’s economic growth. An enabling community must create new and innovative employment opportunities arising from high growth sectors - for example, mining and defence.

 

Participation in the labour force and employment is critical to reducing economic disadvantage amongst people with disability and their families.  Employment is also important for overall wellbeing as it provides opportunities for self development, community participation, financial independence, increased self esteem and building relationships. 

 

An enabling community acknowledges that people with disability are often uncertain about how employment may affect their support payments and sometimes unsure about whether they can meet the demands and pressures of the workplace. In this context, an enabling community ensures that people with disability are helped into employment and are supported so that employment is suitable and sustainable. 

 

An enabling community promotes avenues for people with disability to acquire education and training opportunities that will increase their skills and move into employment. Such opportunities must be flexible and tailored to individual needs and goals. They must also be controlled by people with disability. Information about education, training and career options must be easy to access. Put simply, an enabling community provides the incentives, mechanisms and policies that allow people with disability to find, access and sustain good jobs, if that is their choice. 

 

An enabling community is one where stigma and discrimination have no place in the workforce.  It recognises that employers sometimes require additional information, ideas and resources about how to open their workplaces to people with disability. An enabling community must support flexible employment arrangements both for people with disability and carers.

 

Possible approaches include:

 

      Providing supports within the workplace – such as the presence of a carer or support worker, flexible working times, assistive technologies and extra payments for additional costs such as clothing and transport that will enable people with disability to do their job;

 

      Developing targeted campaigns aimed at raising awareness amongst employers about the potential and capabilities of people with disability;

      Developing public awareness campaigns designed to promote the benefits of employing people with disability;

 

      Encourage innovative approaches to employment of people with disability in areas of economic growth in South Australia;

 

      Promoting the appointment of people with disability in leadership positions in the workforce.

 

Questions to consider:

 

What are some of the barriers that currently prevent people with disability from finding a good job? What barriers prevent people from keeping their jobs?

 

What is needed to ensure that employees with disability are doing their job effectively and enjoying the workplace ?

 

How can we promote access and equity in the workplace for people with disability? Do you know of any best practice employers who are doing this?

 

What do employers need to employ people with disability?

 

3.2.4 Innovative and accessible education

 

Some children are still being denied access to schools – mainstream or specialist - because of their disability.  Educational settings – schools, TAFEs and universities - are not always accessible or inclusive for people with disability. For many young people, the transition from school to employment or post-school education is problematic. A disproportionate number of people with disability are not completing higher-level qualifications. 

 

An enabling community values and respects students and teachers with disability at all levels, ranging from pre-school to tertiary education. An enabling community promotes initiatives and supports good teaching practices that maximise the learning potential of students with disability and encourage high standards in learning outcomes.

 

An enabling community ensures that buildings, playgrounds, canteens, libraries and all other features of the structural learning environment are not just accessible, but easy to navigate and user-friendly. An enabling community promotes the use of technology, aids and equipment to support student’s independence within the classroom, and requires that educational material is accessible in a range of formats for both students and teachers with disability. 

 

At a pre-school level, an enabling community provides opportunities for young children to explore their learning potential and be provided with early intervention responses to support future independence.

 

At primary school and high school levels, an enabling community promotes educational practices and learning programs that are flexible and tailored to meet individual learning needs and styles. It facilitates learning cultures that accept and support diversity.  It supports a teaching workforce that has the knowledge, skills and resources to meet students’ needs and support their aspirations. 

 

In the post-school environment, an enabling community encourages mechanisms that allow students with disability and their families to develop plans and pathways to meet their future learning needs and promote their future aspirations.  An enabling community also acknowledges that financial support to study is essential if we are to improve educational opportunities. 

 

Possible approaches include:

 

      Improving availability of information for people with disability about vocational training and further education;

 

      Ensuring that all learning institutions are accessible for people with disability;

 

      Training education providers to cater for people with disability to participate in educational programs from early childhood and through adulthood;

      Promoting and resourcing innovative learning strategies and supports for students with disability;

 

      Promoting an education workforce that understands the complexities associated with disability and caring;

 

      Providing better assistance and protection for students with disability who have complex needs;

 

      Strengthening the focus and support for work experience placements for students with disability;

 

      Encouraging government partnerships with universities and TAFEs to promote improved access and opportunity for students with disability.

 

 

Questions to consider:

 

How can the current education system better help a student with disability or carer to achieve their study/education goals?

 

Can you provide examples of where a school or other learning institution has been successful in helping students with disability achieve positive outcomes? What made it successful?

 

What factors need to be considered when designing curriculum that is relevant for people with disability and their carers?

 

 

Questions to consider:

 

What can be done to make buildings, playgrounds and other facilities within educational settings more accessible?

 

What do our teachers and education staff need to work more successfully with students with disability and carers?

 

How can we improve the education environment for teachers with disability?

 

3.2.5 Enhanced social, civic and cultural participation

 

56% of submissions to the Commonwealth Government’s National Disability Strategy cited “social inclusion and community participation as the main barriers experienced by people with disability”. The Shut Out Report (2009) observed that “Where once they were physically segregated, many Australians with disabilities now find themselves socially, culturally and politically isolated.”

 

An enabling community ensures that people with disability are included in community life on their own terms, equal opportunities are guaranteed and choices are available. In an enabling community, it should not be unusual to see people with disability as players or spectators on sporting fields, as volunteers in homeless shelters or nature reserves, as travellers or tourists, or as actors or the audience in a theatre performance.

 

An enabling community provides support to social, arts and cultural initiatives run by and for people with disability. It provides opportunities for people with disability to create, perform and develop their own art and access the thriving South Australian arts community. It fosters participation and leadership by people with disability in political and civic spheres. It guarantees that people with disability have access and support to participate independently in electoral processes at all levels of government and provides opportunities to be actively involved in the conduct of public affairs through boards, committees, governments and other organisations.

 

An enabling community must be supported by state and local government, community organisations, businesses and the wider community to ensure that discrimination is eliminated and barriers – both physical and attitudinal - are removed.

 

 

Possible approaches include:

 

      Developing state-based anti-discrimination programmes that focus on the participation of everyone;

 

      Designing campaigns that recognise and honour the achievements of people with disability;

 

      Promoting the community benefits of having people with disability participating as active community members;

 

      Ensuring churches, mosques, temples, theatres, airports, bus stations, courts, libraries and other public spaces include ramps, lift access, hearing loops and other accessibility features;

 

      Ensuring local governments become more actively involved in providing access and  supports to people with disability to participate in all areas of the local community;

 

 

      Promoting stronger partnerships between the disability sector and arts and cultural organisations ;

 

      Supporting initiatives that develop and celebrate the creative and artistic aspirations of people with disability in South Australia;

 

      Ensuring that South Australia is a key collaborator in the development of the National Framework for Inclusive Sport and Active Recreation which aims at increasing opportunities for all Australians with disability in sport and active recreation.

 

Questions to consider:

 

What do people with disability need to enjoy more leisure and entertainment opportunities, including sports and arts?

 

What should a disability friendly church, theatre, sporting ground or swimming pool look like?

 

How can natural environments – parks, beaches, camping spots and nature reserves – promote better access to people with disability?

 

Are you aware of any good examples of where people with disability have been able to fully enjoy social and cultural experiences?

 

3.2.6 Accessible, open and friendly space, infrastructure and technology

 

Our society is built in a way that assumes we can all see signs, read directions, hear announcements, reach buttons, have the strength to open heavy doors, walk up steps, catch the train and so on. While South Australia has standards and legislative requirements for accessibility, facilities such as schools, workplaces, supermarkets and houses are, for the most part, designed and built by people without a disability for people without a disability.

 

Simply changing attitudes towards disability is not enough to promote a community that is inclusive of all.  This must be accompanied by buildings and transport that are accessible, as well as telecommunications that are designed to increase the contribution of people with disability to the economy as customers and users of technology.

 

An enabling community is designed for people with disability to live as independently as they can within the setting of their choice. It consults with, and thinks about the needs of, people with disability when designing all community spaces and facilities. It is geared towards enhancing personal mobility, independence and enjoyment, taking into consideration the specific barriers that people with disability face.

 

An enabling community must contain a choice of settings to live; accessible and affordable public transport; buildings that take on principles of universal design; outdoor spaces that are easy to navigate; and up to date infrastructure – including road signage and lighting. Urban and regional planning must incorporate the development of accessible routes to connect buildings, public spaces and transport systems. 

 

Transport systems must be accessible and reliable in order to support people with disability to get to work, to visit friends and family, to play sport.  This may entail improving the regulation and supply of accessible taxis; increasing transport options for people living in non-metropolitan areas and enhancing consistency in transportation design.

 

In rural and remote areas, particular attention must be focused on the barriers that people with disability face on a daily basis.  Initiatives that facilitate the use of technology – i.e. banking, telecommunications and e-health services, all have a role in addressing issues of distance.  Such technologies also play a key role in enabling all people with disability to live independently in their own community setting.

 

Possible approaches include:

 

      Promoting the adoption of minimum accessibility standards for all public transport and incorporating universal design principles for all buildings and indoor facilities including housing, shopping centres and sporting arenas;

 

      Promoting representation from the disability sector on government and community steering committees around design, building and space;

 

      Supporting  access for people with disability and their families to the National Broadband Network as a way of facilitating access to a range of government services  and broader life-enhancing opportunities in areas such as health, employment and education;

 

      Providing appropriate assistive technology in the areas of core communication, mobility, respiratory function and self-care;

 

      Establishing initiatives which provide people with a permanent or long-term disability with subsidised assistive technology and home and vehicle modifications;

 

      Ensuring that people with disability are provided with essential equipment and technology to support their independent functioning at home.

 

 

 

 

Questions to consider:

 

What should architects and designers consider when thinking about disability?

 

How can we better represent the views and expertise of people with disability in the planning stages of development?

 

What should a good bus, train or taxi service deliver for people with disability?

 

How can we promote greater mobility for people with disability? 

 

How can we ensure people with disability and their families have access to technologies that help them live independently?

 

Can you identify some examples of existing places that are friendly to people with disability?  What features make them easy to use?

 

 

3.3 Shifting the focus from bureaucracies to citizens 

 

We are increasingly hearing the experiences of people in relation to their specific needs not being met and of a system that is struggling to meet demands and is complex to navigate. These are issues being experienced by people with disability in all states and territories.

 

In South Australia, unmet need for people eligible for specialist services, as reported by the Department for Families and Communities, has increased from 2,189 individuals in December 2008 to 2,698 in March 2010, an increase of 23.3%. The number of individuals in Category 1 - i.e. those who are highly vulnerable and at extreme risk - has increased by 63% over the same period.  In reality, these statistics translate into fear, desperation and (increasingly) crisis for individuals and families who are not getting what they need from the system.

 

The Department for Families and Communities has also acted to improve flexibility and responsiveness through trialling a self managed funding approach; person-centred active support model; centralised access to accommodation allocation and; prioritising need for respite and support. Despite these efforts and increased funding to address these challenges, funding alone will not improve the overall responsiveness and flexibility of services.

 

Activating Citizenship will require transformation in our approach so that people with disability, families and carers have a voice in determining what services are needed and how they should be provided. Giving people with disability greater choice and control over the support they need is critical, not just in relation to specialist services, but also across mainstream services such as housing, transport, health, employment, education and training.

 

Shifting the focus back to the individual means ensuring all our services are resourced, not just adequately, but effectively. In order to understand what people with disability and families need, we must have an understanding, not just of where funding is insufficient, but also how it could be spent in ways that will better benefit service users, rather than the service system.

 

Activating Citizenship requires a shift from a complex and rigid system to the provision of flexible and accessible services. Our service system is currently difficult to navigate, fragmented and driven by outcomes that are often not about the needs or aspirations of the people that they intend to serve.

 

Activating Citizenship requires a shift in focus from bureaucracies to placing citizens at the centre of the system. There must be more emphasis on service integration and simplification. Activating Citizenship also demands that our disability services must strive to be economically sustainable and geared towards continuous improvement. The objectives identified by the Social inclusion Board are threefold. They are to ensure that people with disability:

 

      have their individual needs acknowledged and addressed when receiving services related to housing, transport, health, employment and education and training opportunities;

      have choice and control over the specialist support, assistance, aids and equipment they need to go about daily life;

      are treated within the service system as equal citizens with care and respect.

 

It is only when these objectives are achieved that we will have a system that is geared towards achieving greater inclusion and participation for people with disability in all aspects of community.

 

3.3.1 Understanding and addressing the needs of those with complex and additional needs

 

Disability impacts on some people more than others. Nationally, across all age groups in 2006, Aboriginal people were 1.8 times as likely to need assistance with core activities than non-Aboriginal people. In 2003, South Australian carers represented 15.2% of all South Australians who earned a wage compared to 84.8% of the population who did not have caring responsibilities. In metropolitan Adelaide, people living in the most disadvantaged geographic locations were 2.6 times as likely to have severe disability (4.0%) than people living in the least disadvantaged areas (1.5%). 

 

The Social Inclusion approach recognises that not all people with disability are alike. As well as having particular needs, priorities and perspectives, they experience different personal circumstances relating to sex, age, sexuality, ethnic or cultural background, Aboriginality, level of education and locational disadvantage. These factors are interrelated and some compound the barriers that people with disability face.

 

For Aboriginal people, a disability is an added layer of disadvantage. It creates barriers that compounds other problems including stigma and discrimination, acute poverty, increased incidence of poor mental health and chronic health problems and higher levels of unemployment and incarceration.

 

In South Australia, many of the most disadvantaged households are in South Australia’s remote Aboriginal communities. Access to supporting aids and equipment for people with disability is more difficult or non-existent in remote and rural areas. This can be compounded for Aboriginal and Torres Strait Islander people in remote communities as service provision is often not culturally appropriate and access to services is limited.

 

People with disability from culturally and linguistically diverse backgrounds can also experience acute poverty and exclusion.  For example, to qualify for the Disability Support Pension, an individual must be an Australian citizen or must meet the 10-year permanent residence requirement (unless specific circumstances apply, e.g. they arrived as a refugee). 

 

Migrants with disability often face additional barriers to entering the labour force, difficulty obtaining support services and additional discrimination related to their race, ethnicity or religion. They are also more likely to experience a lack of culturally sensitive mainstream and specialist services, a shortage of interpreters to communicate their needs and prevalence of myths, misconceptions and negative stereotypes about disability and ethnicity.  

 

Families and carers of people with disability are also impacted by disability through the unpaid care and assistance they provide to people with disability.  Carers of people with disability experience poorer outcomes in a number of areas than people who don’t have significant caring responsibilities. It is imperative that services support them in their role as carers, but also help them fulfil other life roles and objectives.

 

When a person with disability comes into contact with the justice system, it is important that their needs are understood and addressed.

 

Supporting the inclusion of people with disability who have complex needs requires organisations to acknowledge their particular vulnerabilities. It requires that targeted specialist services are delivered in a way which reflects a competency to work with people with more complex needs or diverse cultural backgrounds.  It requires that disability support workers are provided with the resources, knowledge and training that enable them to develop skills to meet these demands.  

 

Possible approaches include:

 

      Conducting more accurate assessments of the prevalence and incidence of disability within disadvantaged communities and within particular institutions such as correctional settings;

 

      Promoting support and service delivery by locally owned, managed and staffed providers, in particular for Aboriginal and Torres Strait Islander communities;

 

      Fostering a specialist service workforce that delivers culturally sensitive services. This may include strategies such as increasing the number of Aboriginal and culturally and linguistically diverse people in the disability workforce;

 

      Developing integrated service models to support people with disability who have other complex needs (e.g. mental health; drug and alcohol abuse);

 

      Promoting service delivery initiatives that take an assertive outreach approach, that is encouraging the establishment of services that go to the community – rather than having individuals come to them;

 

      Providing targeted approaches for people with disability living in areas of disadvantage, especially in rural or remote areas.

 

Questions to consider:

 

What barriers do Aboriginal communities face in accessing specialist disability services?  What is needed to overcome these barriers?

 

How can we ensure that people with disability who experience other complex problems and circumstances are able to access specialist disability services?

 

What are some specific needs of migrant communities affected by disability? What barriers do these groups face in receiving the services they need?

 

Who should be delivering specialist disability services to populations with additional and complex needs?

 

Can you tell us about any initiatives – programs, services or activities – that are demonstrating positive outcomes for people with disability who have additional and complex needs?

 

3.3.2 Raising awareness: promoting independence and aspiration across all agencies

 

Australia’s Initial Report, under the Convention on the Rights of Persons with Disabilities notes that “Australia’s approach to addressing the needs of persons with disabilities in the provision of services aims to help persons with disabilities develop maximum independence in activities of daily living.” 

 

A Government funding model for community organisations must promote the best outcomes for the client. 

 

Reform of disability services can build a shared accountability in meeting the life long goals of people with disability. These goals can be reflected as outcomes in funding and service agreements between government and community organisations. Organisations and agencies delivering services across all areas – e.g. health, transport, employment and education - should work from the same basic premise that people with disability  require services and support to promote the goal of independence. Specialist services have critical roles in advocacy and linking broader community services and supports for people with disability.

 

On this basis, any reform should focus on ensuring that organisations delivering services to people with disability, across all sectors and at all levels of government, view and engage people with disability as partners in policy making - encouraging people with disability to take part in decision-making and to take on leadership roles.

 

 

Possible approaches include:

 

      Fostering an aware and responsive public service through mechanisms such as appropriate training courses, education and capacity building;

 

      Establishing leadership, development and mentoring programs for people with disability which include a focus on advocacy;

 

      Ensuring that positive outcomes for people with disability across the whole of their life are built into service delivery and design;

 

      Developing performance indicators for all services and programs relating to people’s aspirations and life-long goals as well as their needs;

 

      Assisting self-help initiatives, service provision and advocacy organisations run by people with disability for people with disability.

 

 

Questions to consider:

 

Are you aware of any organisations or agencies (government or non government) that do well in promoting a person’s long-term goals?

 

How can organisations that deliver specialist services be encouraged to acknowledge the aspirations and long-term goals of people with disability?

 

 

3.3.3        Personalising the approach to service delivery

 

Too often, additional needs for assistance or equipment have been addressed in ways which do not give people with disability choice and control. Instead, others decide on behalf of people with disability how assistance should be provided. Consequently, many services can and do encourage self-reliance but can lead towards dependency. Activating Citizenship requires that people with disability have greater choice and control about what services they receive, who provides these and how they are received.

 

While we must work towards a system where eligibility for and allocation of resources is consistent and equitable, it is also important to ensure that individual needs are treated flexibly. People with disability experience a diverse range of circumstances. Services must be flexible to respond appropriately to each individual, and deliver a level of control to the individual.

 

Shifting the focus from bureaucracies to citizens means delivering specialist services to promote supported independence, choice and inclusion for people with disability. A personalised approach to service delivery is based on the premise that services should not be highly regulated by professionals or dictated by ‘system experts’. Instead, services should be determined and delivered by people with disability and their families in partnership with service providers.  Put simply, services should foster independence, autonomy and control over one’s own life.

 

A personalised model of care is characterised by several features:

 

      It delivers care and support that reflects the individual’s unique needs, skills, capacities and opportunities;

 

      It promotes decision-making control by the individual and their family in determining what services and supports are provided and choice in who delivers those services;

 

      It promotes and encourages training, mentoring or other activities so that an individual can develop the skills, capacity and confidence to be more active in the decision-making processes related to their care and support;

 

      It enables flexibility and control to vary services and supports as needs change over time;

 

      It provides effective safeguard mechanisms to support people in identifying and managing risk and increasingly provides control to the individual around funding to purchase services.

 

A personalised approach to service delivery recognises and responds to the fact that people with disability are experts on their own experience and must be in control of their own decisions and life course.

 

Individual funding and direct payments are one example of personalising support. Individual funding can be defined as a package of funds allocated for a particular person that enables them to control how they purchase both specialist and mainstream services. It is based on the important premise that people with disability have the capacity to successfully choose and administer their own support arrangements, either by themselves or through a nominated organisation or individual.

 

Individualised funding models can come with risks, including: potential extra administrative burdens and responsibilities in managing the direct payments; lack of appropriate support for people with additional vulnerabilities or restricted capacity; and the requirement of accountability of spending.

 

Despite this, individualised funding models have delivered significant benefits to people with disability, enabling greater flexibility and choice in services. They have also been a means to ensure that the service system is more responsive to the outcomes for individuals and that people with disability are not excluded from services through cumbersome assessment processes and restrictive service criteria. An individualised funding model recognises that the best assessor of what a person with disability needs, is often the person themselves.

 

South Australia is also currently testing a form of individualised funding with a small group of consumers.  However, this approach is not well advanced in South Australia compared to some other states.

 

Personalised approaches to services is not new to South Australia. For example, the Community Living Project (established in 1985) and Community Support Incorporated (established in 1991) are two distinct models developed by people with disability and their families to maximise independent community living and participation for people with disability.

 

Possible approaches may include:

 

      Reviewing the role of government as funder, regulator and service provider;

 

      Expanding individualised funding to enable all people with disability greater choice in purchasing the services they need and want;

 

      Exploring individualised funding models that are premised on simplicity and ease;

 

      Simplifying eligibility and assessment processes so they are understood and accessible for people with disabilities and their families, as consumers of services rather than recipients; 

 

      Localising the coordination of services;

 

      Promoting a strategic shift towards investment in early intervention and preventative approaches;

 

      Fostering the establishment and growth of user-led organisations;

 

      Providing access to better information, advocacy and support so that people are able to navigate health and social care systems.

 

 

Questions to consider:

 

Who should deliver specialist services for people with disability?

 

How can personalised services be promoted for people with disability in South Australia? 

 

Do you think a personalisation approach activates citizenship for people with disability? Are there other approaches that should be considered?

 

How can people with disability and their families have greater input into  the design and delivery of services?

 

Do you support self-managed funding? What would be the benefits and risks? How could these risks be managed?

 

 

3.3.4        Integrated Services and Joined-Up systems: ensuring ease, efficiency and equity

 

Many people with disability, their families and carers find it frustrating to navigate the different services that government provides. Quite often, departments do not share information with each other and services become fragmented.

 

The Social Inclusion Board has identified that services can be poorly integrated and fragmented and that these pose consequences for people with disability and their families.  For example, the involvement of different government departments in the delivery of services often creates confusion amongst people with disability and their families about what services are available and how to access those services. Growing demand on services and limited resources have forced many agencies to prioritise their “core business” on an increasingly narrow range of activities. As a result, clients are often subject to numerous assessments in order to receive a service, or “get referred” to other services rather than receiving a continuous uninterrupted service.

 

Shifting the focus from bureaucracies to citizens requires a whole-of-life and joined-up approach to the coordination of services for people with disability. The integration of services and a whole-of-community approach has been a consistent focus of the Social Inclusion Initiative, simply because gaps and unnecessary complexities in the system equate to people missing out on getting a service or being provided with an inadequate or inappropriate service.

 

Integrated services must be geared towards enabling all people with disability to secure essential needs for their future and achieve their goals.  Services must be provided equitably and promote equality. Integrated services means that people have a high degree of certainty on what their entitlements to services are across all areas for the whole of their life. It requires coordinated and comprehensive planning across all portfolios and between all levels of government.

 

Across this long-term objective, it is critical that South Australian government departments and agencies establish mechanisms that ensure all policy and legislation is consistent with the objectives of the future National Disability Strategy. In conjunction with this, public sector training must be modified to ensure that service development and service delivery are also consistent with achieving the outcomes of the National Disability Strategy.

 

 

Possible approaches include:

 

      Promoting joined-up initiatives that provide people with disability choice and control over the support they receive and services they access;

 

      Promoting the concept of entitlement to service for people with disability as good practice across all government agencies;

      Reviewing the Government’s Promoting Independence Strategy to strengthen principles and outcomes related to integrated services for people with disability.

 

Questions to consider:

 

Where have government departments failed to communicate with each other, causing frustration for you?

 

What are the key services or areas of service which need to be integrated for people with disability?

 

 

 

What should the government do to ensure it communicates more effectively across departments and community organisations?

 

How can community organisations implement joined-up approaches?

 

Are you aware of any examples of joined-up and integrated approaches to service delivery that you believe have worked well?

 

Section 4: Next Steps

 

This Discussion Paper is a way for South Australians to contribute their opinions and ideas on a new system of support for South Australians with disability, their families and carers might look.  Your responses will be used to inform the Social Inclusion Blueprint for Disability Reform. The Social Inclusion Blueprint for Disability Reform is expected to be released in mid 2011.

 

To view the discussion paper online, please visit the Social Inclusion Unit website:

www.socialinclusion.sa.gov.au

 

There are several ways for you to contribute your opinions and ideas on the Discussion paper OR anything else about disability that we may not have raised:

 

Online Survey

Email or Postal Submissions

Community Meetings

Phone Submissions

 

The closing date for submissions is 5:00pm Monday 27 September 2010.

 

Online Survey

 

The online survey is based on the questions in this Discussion Paper. You can answer as many or as few questions as you wish.

 

Please visit www.socialinclusion.sa.gov.au to complete the survey.

 

It is not necessary to have read the Discussion paper before completing the online survey. If you have not read the discussion paper, you may wish to complete the easy-version survey which is also the website.

 

To request the survey in languages other than English, visit the Social Inclusion website.

 

 

Email or Postal Submissions

 

It is possible to provide your submission via email or post. This is a great way for you to provide us with any additional information that has not been covered in the discussions paper or online survey, but that you think is important.

 

For those who would prefer to make a written submission via email or post, please use the following:

 

Email: socialinclusion@saugov.sa.gov.au

Postal address: GPO Box 2343, Adelaide SA 5001

 

 

Community Meetings

 

There will be community meetings across South Australia for people to provide direct feedback, identify important issues, and generate ideas and possible strategies. A schedule of community meetings is available on page 50..

 

 

Phone Submissions

 

Please note that phone submissions are primarily available for those who cannot provide a written submission or attend a community meeting.  Phone submissions will be based on the questions in the Discussion Paper.

 

Calls can be taken by the Disability Information Resource Centre (DIRC) during; Monday to Friday 9.00 am to 5.00 pm. 

 

You can answer as many questions as you would like. If the lines are busy please leave your details and DIRC will call you back.  The numbers to call to make a submission over the phone are:

Metropolitan callers  (08) 8236 0555

Regional callers  1300 305 558

TTY users 133 677 - then ask for - 1300 305 558

Speak and Listen (speech-to-speech) 1300 555 727 - then ask for 1300 305 558

 

For languages other than English, Disability Information Resource Centre can arrange interpreter and translation services.

Phone (08) 8236 0555

Fax (08) 8236 0566 

 

To obtain copies of this Discussion Paper in Braille, contact the Disability Information Resource Centre on:

Phone (08) 8236 0555

Fax (08) 8236 0566 

 

If you have a hearing or speech-language impairment, contact us via the following:

TTY users 133 677 - then ask for - (08) 8226 0916

Speak and Listen 1300 555 727 - then ask for (08) 8226 0916

Internet relay users visit the National Relay Service website at

www.relayservice.com.au and ask for (08) 8226 0916

 

For any other queries please contact the Social Inclusion Unit at (08) 8226 1840

 

Community Meetings

 

To provide direct feedback to the Social Inclusion Board, community meetings will take place at the following locations and times.

 

Elizabeth

Playford Civic Centre

Tuesday 17 August

10:30am to 12:30pm

 

Wynn Vale

Jubilee Community Centre

Thursday 19 August

2:00pm to 4:00pm

 

Port Adelaide

Mansfield Park Community Hall

Monday 23 August

10:30am to 12:30pm

 

Victor Harbor

Recreation Centre Hall

Wednesday 25 August

10:30am to 12:30pm

 

Noarlunga

Seaford Moana Neighbourhood Centre, Beechwood Grove, Seaford

Thursday 26 August

2:30pm to 4:30pm

Mount Barker

Mount Barker Town Hall

Monday 30 August

10:30am to 12:30pm

 

Adelaide CBD

Pilgrim Centre, Flinders Street

Monday 30 August

7:00pm to 9:00pm

 

Ceduna

Ceduna TAFE

Thursday 2 September

10:30am to 12:30pm

 

Coober Pedy

Coober Pedy Council Chambers

Monday 6 September

2:30pm to 4:30pm

 

Mount Gambier

Mount Gambier TAFE

Thursday 9 September

11:00am to 1:00pm

 

Port Pirie

Port Pirie TAFE

Monday 13 September

1:00pm to 3:00pm

 

Port Augusta

Port Augusta TAFE

Tuesday 14 September

10:30am to 12:30pm

 

Port Lincoln

Civic Centre

Thursday 16 September

10:30am to 12:30pm

 

Berri

Senior Citizens Hall

Monday 20 September

10:30am to 12:30pm

 

Murray Bridge

Murray Bridge TAFE

Wednesday 22 September

11:00am to 1:00pm

 

 

 

 

RSVP is preferred. Contact the Social Inclusion Unit for further details;

(08) 8226 1840 or email socialinclusion@saugov.sa.gov.au