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Empower people with disability, older people and carers


Empower people with disability, older people and carers

People with disability have the right to participate fully and equally in the community, but are often excluded by systemic disadvantage. This disadvantage is not created by their impairments, but by the physical and social environment around them. Barriers can pervade all aspects of people’s lives, including access to health and disability services, education, employment, the built environment, housing, transport, information and community participation.[1] As many as 45 per cent of people with disability live in or near poverty.[2]

Barriers can pervade all aspects of people’s lives, including access to health and disability services, education, employment, the built environment, housing, transport, information and community participation.

The NDIS represents profound change, empowering people to exercise choice and self-determination. The NDIS must be accessible to every eligible person, adequately cover the state, and be accompanied by access to independent advocacy.

The NDIS does not tackle every barrier faced by people with disability. The Victorian government can work with people to shift community attitudes and remove the social, physical and legal hurdles preventing people with disability having the same opportunities as everyone else.

Carers provide invaluable support to people with disability and older people. This support is often provided at the expense of the carers’ own health and wellbeing, and compromises their ability to participate in education, work or community activities.[3] The government can improve carers’ lives, and help them continue caring, by maintaining their access to carer-specific support services, and adequately recognising their contribution.

Older people face higher risks of poverty compared with other age groups, with 14.8 per cent of people over the age of 65 living below the poverty line.[4] With an ageing population and aged care reforms, Victoria faces challenges in maintaining older people’s standard of living and adequately supporting them in retirement. This includes maintaining access to affordable and secure housing, high quality healthcare and aged care, transport and community services.

Budget investments

Empower people with disability through independent advocacy services

The Victorian government can empower people with disability and their carers to protect their rights and control their lives by increasing independent disability advocacy services. While the recent investments in disability advocacy funding following the Victorian parliamentary inquiry into abuse and neglect is welcome, one-off funding needs to be backed up by a long-term financial commitment.

Strong, independent advocacy helps people with disability, and their families and carers, to exercise their human rights, be involved in decisions, and meet their needs. It promotes wider awareness of disability rights and safeguards against abuse and neglect. It supports people’s rights to access services, the built environment, public transport, housing, education, employment, justice, legal services, and information and communication systems.

Disability advocacy includes self-advocacy, individual advocacy, family advocacy, citizen advocacy, systemic advocacy, legal advocacy, group advocacy and carer advocacy. These all complement one another, have different purposes and are suitable in different circumstances.

But there are not enough disability advocacy services. The Victorian government funds only one out of every 600 Victorians with disability to visit an advocate each year.[5] Disability advocacy funding is not matched with any meaningful demand measure, and demand will likely rise during the NDIS rollout. The Victorian Ombudsman’s 2015 report into abuse in disability services confirmed advocacy remains underfunded and underutilised. It recommended increasing funding and conducting a comprehensive needs assessment.[6]

Independent advocacy can help people navigate the NDIS rollout, understand their rights and entitlements, assist in preparing for NDIS planning, and help access internal and external review processes. VCOSS members report people using disability advocacy services during the NDIS planning process are more likely to have their needs met.

Carers may face disadvantage, social isolation and discrimination if their caring is unsupported or unrecognised.

People ineligible for individual NDIS funding packages use advocacy to access mainstream systems. Disability advocacy also helps people with inclusion and human rights violations not remedied by the NDIS.

Carers may face disadvantage, social isolation and discrimination if their caring is unsupported or unrecognised. Independent advocacy helps carers navigate complex systems, and address the cumulative disadvantage they face.[7] Advocacy helps carers secure the Carer Payment or Carer Allowance, respite and health services, employment, education and secure housing.

Through investing in advocacy, the Victorian government can support the needs of groups with specific diagnoses, such as people with an acquired brain injury, intellectual disability, autism or complex communication difficulties. It can recognise different advocacy needs of specific population groups, including women, children and young people, Aboriginal people and people from culturally and linguistically diverse communities. Specialist advocacy services can be ‘expert advisors’, and share their knowledge of inclusive practice with other services.

Investment can expand disability advocacy coverage in rural and remote areas, and reach out to underserviced people and communities.

 

Ensure people with disability receive continued support

The Victorian government can provide service continuity for people with disability by ensuring they continue to receive the same or better service quality during and after the NDIS transition.

Of the 1.1 million Victorians with disability,[8] only about 105,000 are eligible for the NDIS.[9] VCOSS members fear many people with disability will ‘fall through the cracks’ in the transition to the NDIS. They are particularly concerned for people with mental health conditions, people aged over 65, and people with disability who are ineligible for the NDIS.

The Victorian government can help maintain health and disability service delivery for people ineligible for the NDIS. It can act as a systems steward to better coordinate health and disability services.

The market-driven nature of the NDIS can leave gaps in service delivery, particularly in rural and regional areas. VCOSS members advise some rural areas are already underserviced, and shifting from the block funding model may make this worse.

Members advise the NDIS is not consistently being delivered as intended in rollout areas. Some families are being rushed to develop their child’s care plans, to meet NDIS participant intake targets. This can lead to children, young people or adults with disability missing out on support they are entitled to. The Victorian government can work with the Commonwealth government to ensure people with disability receive high quality services and full service coverage in Victoria, particularly in rural areas.

The NDIS shifts state and Commonwealth responsibilities, creating uncertainty about the continuity of Information Linkages and Capacity Building (ILC) type services and highly specialised programs supporting people with disability and mental illness, such as RuralAccess, MetroAccess and Deafaccess services, the ‘Slow to Recover’ program, and the ‘Disability and Family Violence Crisis Response Initiative’. Effective Victorian-based initiatives should be retained.

 

Improve public transport accessibility

The Victorian government can help more people reach employment, education, and health and community services by investing in applying universal design to public transport. This supports people with disability, older people, parents travelling with young children, and people with shopping trolleys and luggage.

Victoria suffers a significant legacy of inaccessible public transport infrastructure and vehicles due to underinvestment over many decades. Progress on achieving milestones under the Disability Standards for Accessible Public Transport has stalled, with the state’s public transport system unlikely to achieve 90 per cent compliance by the legally required date of 31 December 2017. Our public transport system is not adapting to our changing population, with more older people requiring public transport options as they age, and more people with disability likely to require greater transport options once their basic needs are met by the NDIS.

Victoria suffers a significant legacy of inaccessible public transport infrastructure and vehicles due to underinvestment over many decades.

Universal design principles should be built into public transport procurement. Disability advocates report consultation on design of infrastructure and vehicles is being undertaken after procurement has already been decided. This often ‘locks in’ inaccessible features and limits the ability to make changes or develop ‘work-arounds’ for inaccessible designs.

VCOSS members also report increasing congestion on public transport is compromising people’s ability to use it, especially older people and those with mobility impairments.

 

Invest in community transport

The Victorian government can improve transport for people with mobility difficulties by expanding community transport services. This supports a range of people, including those with disability and older Victorians.

Community transport is the ‘missing link’ in Victoria’s transport system. It can be more cost-effective than taxis, ride-sourcing or local bus travel, especially in rural and regional Victoria. Because it is delivered by mission-driven, not-for-profit organisations, it can be more sensitive to customers’ diverse needs.

Victoria lags behind other states and territories in developing community transport services. Community transport in NSW and Queensland, for example, delivers millions of customer journeys and even manages local public transport bus contracts. With changes to Home and Community Care services and the introduction of the NDIS, Victoria’s community transport is under threat, potentially resulting in people being forced to use high-cost, poor quality alternatives, or have no transport options at all.

Further strategies

Make the NDIS accessible to all eligible people

The Victorian government can help all eligible people access the NDIS by ensuring information and services are welcoming, culturally safe, gender responsive and engaging for underserviced or hard to reach communities. This will help engage people with disability from Aboriginal communities, CALD communities, those in rural areas and those experiencing disadvantage such as homelessness.

Strategies include undertaking outreach activities to engage isolated people or communities, and supporting people on low incomes to obtain relevant disability assessments required for NDIS applications. Increasing the number of Aboriginal and CALD employees in disability services, building the cultural competency of all staff, and adopting inclusive practices improves services’ cultural safety. NDIS information can be made more accessible to fully include everyone with disability. Online communication does not reach everyone, particularly those most marginalised. The Victorian government can also work with the Commonwealth and other states to change NDIS eligibility so asylum seekers can access it.

Empower children with disability and developmental delay through high quality early childhood intervention

The Victorian government can empower children with disability or developmental delay to optimise their learning, development and wellbeing by investing in high quality early childhood intervention (ECI) services. The NDIA has endorsed the National Guidelines for Best Practice in Early Childhood Intervention,[10] but funding can help the entire early childhood intervention sector translate and embed these principles.

Developing resources and tools can help maintain high quality, consistent services for children and families. For example, provider self-assessment tools and factsheets can help inform families when selecting providers, and training professionals can improve their practice delivery. This can be supported by developing formalised, accredited ECI training for all ECI professionals.

The government can assist families and children receiving ECI services to make a smooth transition to the NDIS through continued support for the Victorian ECI sector to prepare for the changes. NDIS readiness funding[11] is only available to June 2017, but the sector requires continued support during the NDIS rollout period, to be ready to operate.

Support carers’ health and wellbeing

The Victorian government can support carers’ health and wellbeing and help them continue caring by providing carer-specific service continuity and developing a whole-of-government, statewide carer strategy.

Informal carers make an enormous social contribution across Australia, caring for an estimated 1.9 billion hours each year. This care is valued at $60.3 billion,[12] and allows many people to remain living in their own homes and communities. Yet people often care at the expense of their own health and wellbeing, compromising their participation in education, work and community activities.[13]

Too often, carers have limited awareness of available services, experience difficulty navigating service systems, are not identified as carers, and do not receive referrals to services that would assist them.[14] Carers have higher rates of disability or long-term health conditions than others,[15] but are often not identified as people needing disability or health support.

To support carers’ wellbeing and allow them to keep caring, the Victorian government can provide carer-specific support, regardless of the age or diagnosis of the person they care for. This includes maintaining funding for the Victorian Support for Carers Program during and after the transition to the NDIS, and the Commonwealth Home Support Program.[16]

The upcoming statewide Carers Statement will consider how to best support people’s unique and specific needs as carers. To be most effective, the carer strategy will need to be appropriately resourced, co-designed with carers, and have a clear vision and targets, including progress towards a whole-of-government carer strategy. It can align with other relevant strategies including Victoria’s Mental Health Plan and State Disability Plan.[17] The statement should reflect the breadth of carers’ experiences, including young carers and those caring for people with mental illness.

Prevent violence, abuse and neglect of people with disability

VCOSS has welcomed the Victorian government’s announcement of a ‘zero tolerance approach’ to abuse of people with a disability, in response to the recommendations from the Victorian Parliamentary Inquiry into Abuse in Disability Services and the Victorian Ombudsman’s Investigation into Disability Abuse Reporting. Like every Victorian, people with disability have the right to be free from all forms of violence, abuse and neglect. Cases are significantly under-reported due to people’s fears of making complaints, and poor processes.[18]

Systemic change is required in disability services, and VCOSS looks forward to working with its member organisations and the government on making the announced measures a reality.

Including independent financial safeguards in the NDIS Quality and Safeguards Framework and strengthened independent advocacy will also help prevent people with disability from experiencing financial abuse.

Develop an older Victorians strategy

The Victorian government can support a productive and connected ageing community by developing an integrated whole-of-government strategy for older Victorians, building on the ‘Ageing is everyone’s business’ work by the Commissioner for Senior Victorians.

Victoria has no overarching strategy to meet the changing demands of an ageing population. With the proportion of the population over 65 expanding rapidly, the Victorian government can bring together different portfolios to accommodate an ageing society and enable people to lead happy, productive and dignified lives as they age.

 

[1]      National People with Disabilities and Carer Council, Shut Out: The experience of people with disabilities and their carers in Australia, 2009, Australian Government, p. 3.

[2]      Victorian Health Promotion Foundation, Disability and health inequalities in Australia: Research summary, 2012, p. 5.

[3]      Australian Bureau of Statistics, Disability, Ageing and Carers, Australia: Summary of Findings, Cat. No. 4430.0, 2012.

[4]      Australian Council of Social Service, Poverty in Australia 2014, 2014, p. 18.

[5]      Victoria funds 1700 people for individual advocacy (Victorian Government, Victorian Budget 16-17, Budget Paper No. 3: Service Delivery, p. 258) of the 1.1 million people with disability in Victoria.

[6]      Victorian Ombudsman, Reporting and investigation of allegations of abuse in the disability sector: Phase 1 – the effectiveness of statutory oversight, June 2015.

[7]      Carers Victoria, Discussion paper on Individual Advocacy and Caring Families, October 2011, p. 9.

[8]      Australian Bureau of Statistics, ‘Disability, Ageing and Carers, Australia: Victoria 2012’ Ageing and Carers, Australia: Summary of Findings, 2012, Cat. No. 4430.0, ABS, 2013.

[9]      Council of Australian Governments, Schedule A: Bilateral Agreement between the Commonwealth and Victoria for the transition to an NDIS, 2015, p. 4.

[10]    Early Childhood Intervention Australia, National Guidelines: Best Practice in Early Childhood Intervention, 2016.

[11]    Victorian Government, NDIS, accessed November 2016.

[12]    Deloitte Access Economics, The economic value of information care in Australia 2015, Carers Australia, June 2015, p. iii.

[13]    Australian Bureau of Statistics, Disability, Ageing and Carers, Australia: Summary of Findings, Cat. No. 4430.0, 2012.

[14]    Victorian Auditor-General’s Office, Carer Support Programs, Victoria, 2012.

[15]    Australian Bureau of Statistics, ‘carers- characteristics’, Disability, Ageing and Carers, Australia: Summary of Findings, 2012, Cat. No. 4430.0.

[16]    Carers Victoria, Take Action for Victorian Carers: Pre-Budget Submission 2016-2017, Carers Victoria, 2016.

[17]    Ibid.

[18]    Victorian Ombudsman, Reporting and investigation of allegations of abuse in the disability sector: Phase 2 – incident reporting, December 2015.