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L.I.S.A Inc
 
LISA... is a parent support and lobby group, for parents and families with a family member having an intellectual or multiple disability, and living in a supported accommodation group home in the State of Victoria, Australia.
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Sunday, December 30 2012

More than one billion people in the world live with some form of disability, of whom nearly 200 million experience considerable difficulties in functioning. In the years ahead, disability will be an even greater concern because its prevalence is on the rise. This is due to ageing populations and the higher risk of disability in older people as well as the global increase in chronic health conditions such as diabetes, cardiovascular disease, cancer and mental health disorders.

Disability is part of the human condition – almost everyone will be temporarily or permanently impaired at some point in life, and those who survive to old age will experience increasing difficulties in functioning. Disability is complex, and the interventions to overcome the disadvantages associated with disability are multiple and systemic – varying with the context.

Problems with service delivery:

Poor coordination of services, inadequate staffing, and weak staff competencies can affect the quality, accessibility, and adequacy of services for persons with disabilities.

People with disabilities were more than twice as likely to report finding health care provider skills inadequate to meet their needs, four times more likely to be treated badly and nearly three times more likely to be denied needed health care.

Many personal support workers are poorly paid and have inadequate training.

A study in the United States of America found that 80% of social care workers had no formal qualifications or training

Inadequate funding:

Resources allocated to implementing policies and plans are often inadequate. The lack of effective financing is a major obstacle to sustainable services across all income settings. In high-income countries, between 20% and 40% of people with disabilities generally do not have their needs met for assistance with everyday activities

Inadequate policies and standards:

Policy design does not always take into account the needs of people with disabilities, or existing policies and standards are not enforced

Negative attitudes:

Beliefs and prejudices constitute barriers to education, employment, health care, and social participation. For example, the attitudes of teachers, school administrators, other children, and even family members affect the inclusion of children with disabilities in mainstream schools. Misconceptions by employers that people with disabilities are less productive than their non-disabled counterparts, and ignorance about available adjustments to work arrangements limits employment opportunities.

Lack of provision of services:

People with disabilities are particularly vulnerable to deficiencies in services such as health care, rehabilitation, and support and assistance

Poorer health outcomes:

Increasing evidence suggests that people with disabilities experience poorer levels of health than the general population. Depending on the group and setting, persons with disabilities may experience greater vulnerability to preventable secondary conditions, co-morbidities, and age-related conditions. Some studies have also indicated that people with disabilities have higher rates of risky behaviours such as smoking, poor diet and physical inactivity. People with disabilities also have a higher risk of being exposed to violence.

Full Report - 300 pages - 3.9MB LINK

Report Summary - 24 pages - 1.2MB LINK

Posted by: Hatton AT 04:56 pm   |  Permalink   |  0 Comments  |  Email
Friday, December 28 2012

Most traditional block funded services for people with disabilities, like group homes and day services, have developed a captive market, charity hand-out culture towards consumers.

As demand for services has always exceeded supply, service providers (especially government direct services) can, and mostly do take the attitude of, “Take it or leave it, be forever grateful and never, ever, complain!”

Many of these traditional services provide little more than ‘basic minder care’, despite recognised care policies, standards and values say care should be quality of life care. Where demand exceeds supply, there is little motivation to meet service standards.

ISPs, money in the consumer’s pocket, will not drive service quality where demand exceeds supply. The ‘futures funding’ for day services is a failure in its intention, as the exercise was too small and restricted to motivate an increase in places and new providers.

National Disability Services is very actively motivating their CSO members to change from a traditional block funded, captive market culture, to a marketplace driven culture to accommodate NDIS ISP finding. This is fine in theory, but the concern of the traditional CSOs will be, “Will the ISP ‘passing-trade’ be sufficient to maintain their infrastructure?”

Businesses in the marketplace fail where they have insufficient ‘passing-trade’. The major supermarkets consistently do all in their power to attract customers - and they have a large audience in comparison with service providers in the disability field.

Equally, people do not start businesses without first ascertaining the potential demand for their service. Newly registered service provision in the disability field, and those with the infrastructure to provide quality support services, will be restrained by a number of factors which include:-

  1. the difficulty for, and the reluctance of many people with disabilities to change service providers,
  2. the potential for consumers use almost anyone in the community, including family members and,
  3. the potential for registered service providers to be held to account against service standards.

Whereas there is little real potential of unregistered service provision to be similarly held to account.

In conclusion: “Will the ISP process be little more than, more of the same in respect to the traditional culture of block funded service providers towards onsumers”? Whereas what is needed, is service providers who,

  1. always consider the consumer as at the centre of service provision,
  2. treat consumer as always right,
  3. treat the consumer as respected and valued and,
  4. provide meaningful evidence services are being consistently and meaningfully provided within recognised care policies, standards and values, not expect the consumer to prove beyond reasonable doubt that they are not.

The original intention of the NDIS was,

  1. to reduce the overall waiting list for services and,
  2. ensure all services were rights based, entitlement services where consumers are respected and valued.

Note: The word ‘consumer’ encompasses the person with disabilities, their family and other stakeholders.

Posted by: Hatton AT 05:02 pm   |  Permalink   |  0 Comments  |  Email
Friday, December 21 2012

DHS Victoria will not, at present, make registered service provision from ISP funding mandatory. They say that family members, for example, may provide a service from ISP funds, providing they don’t live at the same venue as the person with the ISP.

Anyone paid for their services from an ISP is defined as a ‘Service Provider’, and is required to provide these services within DHS Standards.

The DHS ‘Standards Evidence Guide’, page 3, says, "Any services working directly with clients will need to comply with the Department of Human Services Standards".

DHS Standards Evidence Guide - LINK

LISA Inc is questioning the following:-

  1. If the person with the ISP were to use a relation living at a different location, that relation would be required, by the DHS, to provide support within departmental care policies, standards and values. Therefore, the said person would be required to know, understand and abide by the department's extensive and comprehensive care policies, standards and values, similar to registered service providers - in a similar way that we are all obligated to 'know the law (common law)'. Ignorance of the law, is not an excuse for breaking it.
  2. Therefore, both registered and unregistered service providers, paid from DHS funded ISPs, must know, understand and abide by the department's care policies, standards and values. "How does the department regulate, or propose to regulate unregistered service providers with equal opportunity to registered service providers in this regard?"
  3. Broadly, "What are the "other specific conditions and guidelines (the obligations)" which make registered different from unregistered service providers?"
  4. Given the obligations, "What are the benefits of being a registered, against an unregistered service provider?"
Posted by: Hatton AT 05:13 pm   |  Permalink   |  0 Comments  |  Email
Monday, December 10 2012
  1. The change from ‘BLOCK’ to ‘ISP’ funding,
  2. The level of regulation will affect the degree of competition and costs

The ‘Statement’ considers four options for market place regulation

  • Service provision limited to government-funded service providers;
  • Service provision limited to providers (including new providers) who meet regulatory standards;
  • Service provision is unrestricted, except for higher risk circumstances;
  • No limits to consumer choice.

RIS LINK

NDIS Bill - Draft Legislation LINK

Posted by: Hatton AT 05:24 pm   |  Permalink   |  0 Comments  |  Email
Friday, December 07 2012

“Judgment Failure” or a need for “maximum political brownie points NOW”?? They are the only two possible interpretations of the announcements made about NDIS funding yesterday.

Julia Gillard appears to have learnt little from history. The 1990’s Commonwealth State Disability Agreement (CSTDA) was the major precursor to the proposed NDIS. CSTDA shared funding responsibility between the state and federal governments on agreed responsibilities with the states assuming major responsibility for funding of accommodation, respite and in-home support and the federal government managing supported employment underpinned CSTDA.

CSTDA, undermined by states that habitually and systematically underfunded the increasing demand for disability services, has led to the national disability crisis that exists today. Eight states and territories, changing Premiers and leaders regularly, while making short term decisions on priority funding decisions for their jurisdictions, largely focused on getting themselves re-elected has decimated disability services nationwide. CSTDA funding being split largely 75/25% with the states funding the majority does not sound very different to yesterdays announcement of a 50/50 split. The Federal/ NSW joint venture does little to change the long term funding future funding certainty that is so desperately needed for the NDIS to succeed.

Read mone LINK

Posted by: Hatton AT 05:27 pm   |  Permalink   |  0 Comments  |  Email
Wednesday, December 05 2012

Individualised funding continues to be the buzz word of this disability decade. It is truly a sign of how low things are in the disability community that new era solutions includes hyping new case management models that for many the benefits are problematic.

For 80-90 % of disability service clients will not be better off under individualised funding and Disability Speaks would caution consumers to proceed carefully and not be consumed by hype alone.

Can you imagine the furore that would erupt if the government announced that instead of improving Education systems to modern and acceptable levels they would simply move to package funding and shift management responsibility onto the parents of children to source and control their own education services.

Such an analogy is appropriate to today’s disability service world.

Service management is complex and complicated and comes with inherent risks and costs

Individualised funding is a service management approach and should be recognised only as such

It is not a solution to the chronic underfunding woes that dog the disability sector

Consumers need to be very careful about the future choices they are now being asked to make.

There is no doubt for some individualised funding and by extension self managed funding will be a major windfall.

For people with the acumen or the expertise to negotiate better service options may come out well in front

For others complexity, confusion and additional costs are guaranteed.

Read More LINK

Posted by: Hatton AT 05:31 pm   |  Permalink   |  0 Comments  |  Email
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LISA Inc   ~   Phone: 03 9434 3810   ~   Email: vk3qq@optusnet.com.au   ~   Address: 73 Nepean Street Watsonia VIC 3087

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