Chapter 7 - Shared areas of responsibility
7.1
This chapter will cover shared areas of responsibility under the CSTDA
and other issues which were raised by submissions and during hearings including
consultation with the disability community and occupational health and safety
issues.
Information services
7.2
The complexity of the set of programs and services provided under the
current CSTDA arrangements has been noted in Chapter 3. In such an arrangement
information services become a crucial guide for people with disabilities and
their carers on how to access appropriate disability services. A number of
submissions and witnesses to the inquiry commented on the difficulties in
obtaining information about which disability services were available. For
example Brightwater Care Group commented:
Families are often challenged by the responsiveness of the
Disability system, not so much because of what might be available, but more
because of their inability to understand the system and the easiest way to
manoeuvre through it. While options for accommodation support may be available
for people with disabilities, their carers lack clear and consistent
information on how to access such support. This often leads to people giving
up, or not applying for support they may be entitled to. This issue is often
stronger for people with acquired disability who have not had natural entry
into the system in childhood.[1]
7.3
The difficulties with navigating the current system raised the issue of
the need for a single point of information - a 'one stop shop' for people with
disability and their carers to obtain information regarding available services.[2]
Ms Teresa Hinton of Anglicare Tasmania commented:
There is no one point of information for people to go to. They
may go to one agency and get a bit of the picture, and they go to another
agency and get another bit of the picture. But there is no one point of
information that can give them a picture of all the services they might be
entitled to. A very common experience in the research was for people to tell
us, "Well, it took us 14 years to find out that we could get assistance
with shoes", for instance.[3]
7.4
The Committee also found there was a reliance on print and internet
based solutions for disability information services that would be inappropriate
for many people with disabilities such as the vision impaired and people
without internet access.[4]
The Committee was also concerned at the low proportion of people from
non-English speaking backgrounds who access CSTDA services as well as have access
to interpreters. Ms Diana Qian of the National Ethnic Disability Alliance
commented:
One of the causes of the inequity, we believe to be a lack of
information that is accessible in community languages. Information is the first
step one can take to making informed choices, and if you cannot get accessible
information about essential services—about what is available so you know where
to go—you are basically stuck.[5]
Research and development
7.5
Under the current CSTDA the States and Territory governments jointly
contribute, on a pro-rata basis in proportion to their respective populations
at the time of contribution, $200,000 per annum to the national research and development
fund which the Commonwealth matches.
7.6
A work plan linked to the CSTDA implementation plan is developed by the National
Disability Administrators (NDA) and endorsed by Ministers to address key
national and strategic research, development and innovation priorities. The
CSTDA provides:
10 (5) The work plan will include the investigation of the need
for new services, or enhancement of existing services, as well as innovations
in planning and service delivery and the measurement of outcomes for people
with disabilities using these services.[6]
7.7
The amount of CSTDA funding devoted to research and development was criticised
as not sufficient to reflect the importance of the subject matters. Dr Ken Baker
commented:
It is really symptomatic of the weakness of the CSTDA that it
allocates only about—on my calculation—0.012 per cent of total expenditure
toward research. There is just no emphasis at all put on research which could
help inform budgetary planning and which could drive innovation and continuous
improvement.[7]
7.8
The ANAO audit of the administration of the CSTDA also dealt with
research and development:
The ANAO encourages FaCS to advise the NDA to have a greater
level of consultation with relevant non-government stakeholders when developing
and implementing the R&D Programme. The ANAO also considers that it is important
that stakeholders have access to the results of the research.[8]
7.9
At the request of the Committee the AIHW also suggested a number of
priority areas of research and analysis that could inform the CSTDA and related
policies. The AIHW noted that its role as the CSTDA Data Agency is funded from
the research and development budget (at approximately $150,000 per annum) and
that during 2002-2007 no funds have been directed to data quality improvement.
The AIHW recommended that the policy relevance of the CSTDA NMDS could be
improved by adding new data items (on funding, outputs and outcomes) and
improving the quality of data already available. The AIHW identified a number
of priority areas for research and analysis including:
- improving the availability of information about met and unmet
demand for disability services;
- ensuring that future work on met and unmet demand for disability
services extends to analysis of community support services;
- conducting analysis of multiple data sources, both administrative
data and population survey data, to research the interfaces between disability,
aged care, mental health and other health and community services programs;
- increasing research efforts into the health of people with
disabilities; and
- a systematic review of national equipment services, focusing on
the improvement of nationally comparable information available on these
services.[9]
Recommendation 26
7.10
That additional funding for research and development should be committed
under the next CSTDA within agreed policy priorities.
Advocacy
7.11
Advocacy services are designed to enable people with a disability to
increase the control they have over their lives through the representation of
their interests and views in the community. Advocacy services can include
individual advocacy, citizen advocacy, group advocacy and systemic advocacy. Under
the CSTDA, advocacy is an area of joint responsibility for the Commonwealth, State
and Territory governments.
7.12
As in several other areas of the CSTDA, the coordination of services
between the jurisdictions also seems to be problematic. The NSW Government
indicated advocacy was an area where there could be better clarity of roles and
responsibilities and considered that having two quite separate streams of
funding and directions for advocacy was probably not the most appropriate way
to support the sector.[10]
The Victorian Disability Advocacy Network also noted that there was no
framework for shared planning or development for advocacy services between the
jurisdictions.
7.13
A number of submissions and witnesses raised proposed changes to the
National Disability Advocacy Program (NDAP) with the Committee. The NDAP funds
71 advocacy organisations to provide advocacy services on issues affecting the
daily lives of people with disability. The Commonwealth invested $12 million in
2005-2006 into the program, which assisted over 17,000 people.
7.14
In 2006 FaCSIA initiated a review of the NDAP which involved analysis of
data and other information held on the program by the department as well as
engaging consultant Social Options Australia to assess how the program was
operating against its stated goals and objectives. The final report Evaluation
of the National Disability Advocacy Program found:
- The objectives of the program need to be measurable and
realistic. The performance data currently collected does not allow a good
assessment to be made.
- Funding of advocacy agencies is variable, and funding for many
smaller agencies is not enough to meet the full costs of running the service,
which compromises their ability to provide effective services. It is apparent
that funding from the Australian government and state and territory governments
does not match the population distribution of people with disabilities.
- The current quality assurance system of annual self-assessment by
services and 5-yearly audits by FaCSIA does not guarantee that advocacy
services are providing an appropriate level of service. The current Disability
Services Standards could be improved by replacing the 101 supporting standards
with a smaller number of Key Performance Indicators.
- Six types of advocacy are now funded – individual, self, citizen,
systemic, parent and family - but the different types are not available
everywhere and it is hard to compare outcomes.
- Geographic coverage is uneven and advocacy services are not available
in many regional areas.
- Coordination between NDAP advocacy services and other bodies
providing advocacy needs to be improved.
- Many people with disability are unaware of the disability
advocacy programme or other available advocacy support, such as the Human
Rights and Equal Opportunity Commission. They also lack knowledge about rights
and responsibilities. All services have unique names and some do not mention
disability or advocacy in their title.[11]
7.15
In September 2006 FaCSIA released a consultation paper Enhancing the
National Disability Advocacy Program.[12]
The paper proposed:
-
introducing measurable programme goals and objectives;
- introducing standard operating policies and procedures across all
funded services as a condition of funding;
- introducing a ‘priority table’ as a condition of funding setting
out which cases advocates will give priority to, to make sure advocacy services
are directed at those most in need of assistance;
-
requesting services to meet benchmarks for service to people with
particular types of disability, indigenous people with disability and those
from culturally diverse backgrounds;
- focusing disability advocacy services on individual and
family/parent advocacy, with smaller effort directed to systemic and citizen
advocacy;
- re-balancing funding across States and Territories to better
reflect the distribution of the disability population;
- ensuring people with disability know more about their rights and
responsibilities by promoting services and introducing a centralised referral
service with a single free-call telephone number; and
- improving the quality assurance system, including the
introduction of Key Performance Indicators and external auditing that services
meet the quality standards. Require minimum qualifications for paid advocates.
7.16
The consultation paper provided that organisations funded through the
National Disability Advocacy Program (NDAP) would be offered new funding
contracts extending for the period 1 January 2007 to 30 June 2008. The new contracts would require increased reporting of outcomes from advocacy services.
Another key proposed change was that in September 2007, a competitive funding
round would be scheduled and would also be open to organisations that are not
currently providing services under the NDAP.
7.17
On 16 November 2006 the Minister for Community Services, John Cobb,
announced an additional $600,000 funding over the next 18 months to increase
the availability of and increase access to advocacy to people with disability
and their families.
7.18
Advocacy groups were critical of the processes involved in the review of
the NDAP and the consultation paper as well as the reduction in emphasis on citizen
and systemic advocacy. For example Ms Su-Hsien Lee from the Development
Disability Council of WA commented:
In particular, there has been a push against systemic advocates.
There are little bits of funding here and there for individual advocacy but
nothing for systemic advocacy. You have to be cynical and ask why. Individual
advocacy, as much as it is valued and it is necessary, only deals with one
issue at a time. It does not focus on the system as a whole...[13]
Ms Barbara Page-Hanify commented:
The whole process has been incredibly flawed and rushed. There
has been NO opportunity to discuss the planned service, no chance to discuss
any short or long term benefits for those who need advocacy, but more
importantly, no discussion at all on likely short and long term detrimental and
potentially life-threatening outcomes from the planned service.[14]
7.19
Other advocacy groups had concerns regarding the timing of funding
contracts following the review and the implications for their organisations.
For example Ms Lyndell Grimshaw of Brain Injury Australia commented:
With the current review and the fact that all disability
advocacy providers were in receipt of a letter saying their funding is ceasing
at the end of December, you can imagine small organisations trying to run their
businesses and support individuals with whom they may be midstream while also
having responsibilities to employees...
There seems to be little understanding that organisations are
run and operated by committees of management, or boards of management, who have
responsibilities. They have responsibilities to staff; they have responsibilities
to the people they meet with. They cannot wait until the eleventh hour to make decisions
about their future.[15]
Carers Advocacy
7.20
Carers Australia noted that the current CSTDA definition of advocacy
services excludes families and carers of people with disabilities. It also
highlighted that in 2005 the ANAO audit of the administration of the CSTDA
suggested that FaCSIA (then FaCS) in consultation with the National Disability
Administrators consider extending access to advocacy services to the families
and carers of people with disabilities in any future CSTDA. Carers Australia
argued that carers also need advocacy services as they are service users in
their own right, they access health, social and financial benefits, they as a
population group with distinct needs and often act on behalf of those for whom
they provide care.[16]
The National Carers Coalition highlighted the important contribution of unpaid
family carers and also urged 'that any government reform of disability services
under the CSTDA is inclusive of the urgent need for funding of disability
family advocacy at the national, state and regional level'.[17]
Recommendation 27
7.21
That the Commonwealth defer the implementation of its restructure of the
national disability advocacy program and incorporate planning for advocacy services,
including carers advocacy, in the negotiation of the next CSTDA.
Consultation with the disability community
7.22
In the CSTDA the Commonwealth and the States/Territories acknowledge the
role of the Disability Advisory Bodies to ensure that the government hears the
views of people with disabilities and carers on disability-related issues. Under
the CSTDA the Commonwealth makes up to $314,000 available in funding
contributions per annum to State and Territory Disability Advisory Bodies.
7.23
The Disability Advisory Bodies allow people with disabilities, carers,
families and others to: provide advice regarding the planning, delivery and
evaluation of services; advise their respective Ministers on progress against
meeting the CSTDA objectives and priorities; provide advice on directions for
research and development; and consult with the National Disability Advisory
Council (NDAC) on matters of broader national significance that impact on
people with disabilities, their families and carers.[18]
7.24
However, Committeed About Securing Accommodation for People with
Disabilities (CASA) raised concerns that the NDAC had been closed down in
August 2005 and the new National Disability and Carers Council had not at that
stage been announced:
The families once again feel that their voices have been
silenced, or not deemed important. Family carers are often confused, exhausted,
frustrated and disempowered. They feel that because of the demands of their
caring role, and their low profile that their work has in the community, and at
the government level, that they don’t have a voice in the decision making.[19]
7.25
In October 2006 the Minister for Families, Community Services and
Indigenous Affairs, the Hon Mal Brough, announced the appointment of the
executive and members of the new National Disability and Carer Ministerial
Advisory Council. This Council brings together the previously separate advisory
councils for people with disabilities and carers.[20]
Recommendation 28
7.26
That the next CSTDA continue to incorporate a prominent role for
disability and carer advisory bodies as well as the new National Disability and
Carer Ministerial Advisory Council. These bodies should be able to provide
advice to government on service delivery, progress made in meeting objectives
and priorities and directions for research and development.
Occupational health and safety and paid carers
7.27
Carers' groups raised the problem of the home becoming a workplace as a
consequence of an increased emphasis on home-based care for people with a
disability.[21]
Emerging issues included occupational health and safety requirements and the
home owner's liability when care workers visit a person's home. The National
Carers Coalition commented:
What is becoming more and more apparent is that this industry of
'paid help in the home' is not only an ever increasing encroachment upon the
privacy of the family home, but it has now declared the family home to be a "workplace".
This declared workplace is now a place in which families are
being sued as "third party liable" under workcover regulations in
some if not all states. Laws which protect paid care workers but give "NO
PROTECTION" to the caring family are an abomination that will see more and
more families think twice before having any in-home help for which they can be
potentially sued.[22]
7.28
This is a difficult area as the homes of service clients are workplaces
for the paid carers and health professionals providing support. The Committee
understands many service providers conduct off-site checks including
assessments of health and safety issues before an initial home visit. People
with a disability and the family also have a responsibility to cooperate to
ensure the health and safety of paid carers is protected.
Recommendation 29
7.29
That Commonwealth, State and Territory governments ensure that people
with disabilities and their families are not discouraged from accessing care services
in their homes because of potential occupational health and safety liability.
Senator Gary
Humphries
Chairman
February 2007
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