1. FACULTY OF HEALTH SCIENCES CENTRE FOR DISABILITY RESEARCH AND POLICY Rehabilitation and Disability Service Spectrum and NDIS Professor Gwynnyth Llewellyn 26 th June 2014 1

2. Australia 2

3. Australian desert 3

4. 4 All people with disabilityDisability support servicesRehabilitation

5. 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

6. 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

7. 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 2010-2020 (2011)  National Disability Research and Development Agenda (2011)  Productivity Commission Inquiry into Disability Care and Support (2012)  National Disability Insurance Scheme (2013) 7

8. National Disability Strategy 2010-2020  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 http://www.dss.gov.au/our-responsibilities/disability-and- carers/program-services/government-international/national-disability-strategyhttp://www.dss.gov.au/our-responsibilities/disability-and- carers/program-services/government-international/national-disability-strategy 8

9. 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

10. 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

11. 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

12. 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

13. 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 http://ahsri.uow.edu.au/aroc/index.html 13 Brief overview

14. Rehabilitation Model of Care 14

15. Enablers and care settings for effective rehabilitation systems and services 15

16. 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 http://www.enable.health.nsw.gov.au/

17. Centre for Disability Research and Policy www.sydney.edu.au/health_sciences/cdrp/ Email: disabilitypolicy.centre@sydney.edu.au gwynnyth.llewellyn@sydney.edu.au www.sydney.edu.au/health_sciences/cdrp/disabilitypolicy.centre@sydney.edu.au