Tuesday, December 5, 2017

NDIS Have we Learnt Lessons From The Past


Surely o journey forward we need to take with us lessons from our past.

As our knowledge and understanding of disability grew we decided that perhaps the history of disability could take a new path and people with disabilities didn't need state care or protection form society. History tells us regardless of the size and nature of the institution the structure almost always leads to abuse. In our determination to protect our most vulnerable people had left them dis-empowered and without a voice.

The ndis or National Disability Insurance Scheme was launched in Australia last year, as on going measures to ensure the humane rights of all Australians with disabilities.  Specifically to give people a greater choice in the was they are supported to achieve their hopes and dreams. 

Supporters of people with disabilities and later people with disabilities began to demand that people with disabilities be treated like every other Australian. This movement became known as the 'Every Australian Counts campaign. 




  Every Australian should have a voice in our democratic process. 


Because some people in the industry cared enough we began to realise that some people with disabilities may be capable of living in the community given the correct assistance and care.  As individuals moved into the community we saw more potential for these individuals. Their faces told us. just like us they yearned to learn and explore. 

So began the transit from being in 'Care of The State' to being 'care for in the community'.  However this stopped short of seeing people with a disability as being part of that community.  Things like education, employment, access to legal representation and a voice in our democracy.  We also discovered that people with disabilities has some types of disabilities could learn and potentially be employed at some level and thus integration to he community may be possible for some if not all.



But have we learnt from the mistakes of the past.

So someone, somewhere decided institutional care as we had know it was actually detrimental  to human growth and development and so our era of 'sate care was closed down and we opted to 'caring for people with disability' with in the community itself.  These individual were still the primary responsible of a state and new provisions for their care needed to be established. 

Most but not all residents of large scale institutions move into smaller more 'house like' institutions or 'group homes'  their reality was they continued to be 'cared for by the state. The only change for these individuals was the size of the building in which they were housed had changed.  The continued to have no rights and thus no voices are members of society.



Emergence of grated communities.

As the era of deinstitutionalisation and a end to 'state care' was ushered in the state government scrabbled to pass laws to protect these individuals and a new system where by they could 'be cared for in the community'; These individuals became the primary responsibly of what would become known as the Department Disability Services. This department was specifically founded to 'care' for individuals once under 'state care'. 

With many residents having loss family contact or abandoned by family altogether, there needed to be award to 'protect' these unskilled people and thus the responsibility was given to the Public Trust to represent them legally manage their money. No one had give through to the care and the needs of children born with a disability born post state run institutions. 

At almost the same period of time, medical advances meet than more children were surviving pre-birth defects and difficult births.  Coupled with an increased survival rates of common childhood illness and injuries later in life the number of people with disabilities needing assistance significantly.  It was accepted that these people to should be also be supported by the Department of Disabilities, introduction of community care and allied health support services commenced to care for those living in the community.    




This gave birth to the NGO's and the disability sector as we know it today.  The organisations provided respite care to family members; in-home care, community outings, life skills, day respite centres, social groups and activities and support groups for siblings. 


As mentioned in a previous post many people including the disability sector itself still see the state as being part of the participants care.  This language gives rise to the belief that integration has taken place not the social inclusion of those living with disabilities.  Three decades after the role shifted from providing care to only providing care and assistance where needed, individuals and organisations still referred to carers as being paid employees.   

As we move from state less responsibility for a caring role and families become directly responsible for in the lives of people with disabilities, we needed to find another name for care workers.  Carers were now unpaid family members who took responsibly for the care for individuals with disabilities.  The role of a paid employee in now to empower the participant to achieve their personal goals.

Until the development of the ndis, disability policy was then being writing in order to keep paces with the expanding role of the Department of Disabilities Services.  From the beginning writing policies and changes to the way the funding was provided were desperate attempts to plug holes in a system that was failing many.  

Eventually the Queensland State Government admitted they was and would never be any more funding.  Funding was only reallocated when a person passed away or moved out of the region which the funding was attached too. Pre ndis moving address could mean potentially losing or support. Though out its short history, disability policy and thus Disability Services in Queensland could only apply band aids to needs the required major surgery.  


These were the condition that gave birth to the human rights movement known as the Everybody Counts campaign that would give birth to the introduction of the National Disability Insurance Scheme. However, the legislation that gave life to the ndis was about much more that providing basic care for survival. 

Support under the ndis ceased to be known as 'care' and became assistance for people with disabilities and their families to live a life style they themselves would determine. When we look at support under the ndis we are not just looking at respite care, in home and community support, we are looking at a whole range of services the can enable a participant to become more independent and thus engaged and be included in their local community.  Thus the ndis broadens the range of assistance being include, things such as home modifications, allied services for adults, equipment and medical needs have been added.  

The ndis was never meant to be the next funding model for disability care.  The term 'care' does not sit well with a generation of individuals and families who were failed under the medical model that Disability Service oversaw.  History tells us that governments no longer need to protect and care for people with disabilities that role in now handed to the legal unpaid carer of the individuals with disability. 



The need to move from a medical model to a social model of disability assistance and support was highlight by the fact a person needed a medical diagnoses to even apply for assistance. By moving away from the medical model a diagnoses in not longer required.  The social model of disability respects it is not the impairment or impairments that disable people.  People with disabilities are impaired by the structures we have created as a modern society. 

The ndis believed to revolutionised the disability support system we needed redefine the term disability .  Further to that funding should not be about what the person can't do (ie what their disability is), funding should be about the persons aspirations. The ndis became a scheme that all Australians could access it it ever became necessary. The role of the scheme was to increased social and economic participation of individuals and families over time the scheme should pay for itself.  

Given the speed of the roll out and magnitude of a shift in thinking required to make these historical and legal changes, is it not surprising we needed to fall back on what we have always known to meet government timelines and targets. The old OT assessments were pulled out to speed up the process of determining the 'needs' of the individuals.  Most providers don't even look at your goals their only concern is do you have the money pay us. 


It has quick emerges that services are currently operating in survival mode.  The very same survival mode the been operating under the watch dog of the Department of Communities. The way we fund support and assistance has not changed, because mistakes from the past have not been recognised.  We needed a lot more time to adjust to the changes.  Pass a baton requires more than relabelling a system.  

Now we see the same mistakes being repeated,  The roll out in Ipswich is to be completed by December 31st.  The state government will no longer fund supports of people with disabilities in this region after January 1. At conception it was agree that the medical model should not be involved at the assessment processes. Rather individual supports would be decided by the participants goals  and the way the nominated to achieve the goals.

It was a shock when an OT assessment was used during my planning meeting.  In the zealousness to transfer existing clients and intake new participants, my planning meetings took place over the phone, without the person with a disability being involved.  From the out set the promises the ndis upheld were broken.  Is now recognised that planning meetings over the phone were a mistake.    
What participants wanted and services needed was more time to process a new way of thinking.  To grasp what a social model of disability was and how to implement new polices to assist staff to empower participants make choices. Instead participants were told what a service was offering and they choose to take part or look else where.

An offer and take it or leave it for most people with disabilities second best is better than no service at all.  Society continues to remind us we are less and thus less is what we are still being offered. Once gain we need to stand up and be counted.  We need to remind people what we fraught for.  We must asked to be counted as equals to deliver, and remind others,  anything else means we failed. 


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