FACULTY OF HEALTH SCIENCES CENTRE FOR DISABILITY RESEARCH AND POLICY Rehabilitation and Disability Service Spectrum and NDIS Professor Gwynnyth Llewellyn 26 th June

Australia 2

Australian desert 3

4 All people with disabilityDisability support servicesRehabilitation

Federal and state organisation of rehabilitation and disability 5 Federal Health funding to States - National Health Performance Agreements – Department of Health Disability funding to States - National Disability Agreement – Department of Social Services State/ Territory State health funding + Federal health funding to Local Health Districts with performance targets State disability funding + Federal disability funding to Disability Support Services (mostly non-government organisations) Service level Local Health Districts distribute to hospitals, specialist rehabilitation centres and community services with performance targets by DRG and Casemix Disability services provide programs – e.g. community support, employment, recreation, behaviour support, personal living skills

National leadership with state engagement  UN Convention on Rights of Persons with Disabilities signed March 2007 and July 2008 ratified the Convention and the Optional Protocol  Strong push from DPO’s, NGO’s, parliamentarians for a coordinated federal and state response to disability  National People with Disabilities and Carer Council – representatives from all states and territories  Late 2008 Report Shut Out: The experience of people with disabilities and their families in Australia 6 Recent brief history – critical events in disability sector

National Disability Reform Agenda  National Disability Agreement (2009)  All Australian governments report to Council of Australian Governments on performance on the National Disability Agreement  Provides the framework for delivering government services to people with disability  Development of person-centred services as a key policy direction  National Disability Strategy (2011)  National Disability Research and Development Agenda (2011)  Productivity Commission Inquiry into Disability Care and Support (2012)  National Disability Insurance Scheme (2013) 7

National Disability Strategy  The Human Rights Imperative  Attitudes and practices are disabling  Reporting to the United Nations  Advocacy  The Social Imperative  Everyone is part of the solution  The Economic Imperative  Improving productivity  Looking to the long term Available at carers/program-services/government-international/national-disability-strategyhttp:// carers/program-services/government-international/national-disability-strategy 8

Areas of policy action  Inclusive and accessible communities  Rights protection, justice and legislation  Economic security  Personal and community support  Learning and skills  Health and wellbeing 9

Disability support services in transition  18.5% of Australians report a disability – 4 million people  Only around 25% use disability support services  Many use mainstream services  Services are unevenly distributed  Around 2,500 agencies in Australia providing disability support services  The National Disability Insurance Scheme Act 2013  Person-centred support to maximise social and economic participation 10 Block funded services personal plans and individual budgets

National Disability Insurance Scheme  Tier 1  Targets everyone in Australia  Creates general community awareness about the issues faced by people with disability and promotes inclusion and opportunities for people  Tier 2  Targets about 800,000 people with disability and their family and carers  Provides general information about the most effective care and support options within generic and community support groups and services.  Tier 3  Targets 400,000+ people who need specialised supports  Provides specific supports, aids and equipment from specialised and/or generic services and facilities in the community, according to an agreed plan and resource allocation for each person 11 NDIS is a three tiered scheme

Individualised supports  Individual support plans developed with NDIS planner  Outcome is a Participant Plan  Management of the plan options  Self managed by the participant  Registered plan management provider  The National Disability Insurance Agency  Combination of the above  Referral or linking in with mainstream services  Allocation of resources determined by Participant Plan 12 Tier 3 – planning and support process

Rehabilitation in Australia  Rehabilitation  Inpatient rehabilitation units in Australia (100 public/ 80 private)  Ambulatory and community rehabilitation services (attached to hospitals around the country)  AROC – Australasian Rehabilitation Outcome Centre  Conducts a national benchmarking system to improve clinical rehabilitation outcomes in both the public and private sectors  Produces information on the efficacy of interventions through the systematic collection of outcomes information in both the inpatient and ambulatory settings 13 Brief overview

Rehabilitation Model of Care 14

Enablers and care settings for effective rehabilitation systems and services 15

Aids and Equipment Program  Aids and Equipment Program Aids and Equipment Program  Continence Assistance Continence Assistance  Home Respiratory Program (HRP) Home Respiratory Program (HRP)  Prosthetic Limb Service  Specialised Equipment Essential for Discharge Specialised Equipment Essential for Discharge  Speech Generating Device Speech Generating Device 16

Centre for Disability Research and Policy