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
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
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
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:-
- 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.
- 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?"
- Broadly, "What are the "other specific conditions and guidelines (the obligations)" which make registered different from unregistered service providers?"
- Given the obligations, "What are the benefits of being a registered, against an unregistered service provider?"
Saturday, August 18 2012
The Department of Human Services, Disability Services, Victoria, blocked the release of the independent accreditation of all government funded services for people with intellectual and multiple disabilities in Victoria. Now they are blocking the release of a review by KPMG of its staff workpractices!
Our FOI request was:- We request, under FOI, a copy of the latest (final) KPMG Report on the “Workload Review” of DHS Services.
It is my decision that the document you have requested is fully exempt from release under sections 30(1), 33(1) and 35(1)(b) of the Act. Material not released to you is exempt on the basis of the following provisions of the Act.
Internal working documents
Section 30(1) of the Act exempts from disclosure documents that are internal working documents. For section 30(1) to apply, the documents must:
- disclose an opinion, advice or recommendation prepared by an officer, or relate to a consultation or deliberation that has taken place between officer(s) and/or Minister;
- have been prepared in the course of, or for the purpose of, deliberative processes involved in the functions of an agency; and
- release must be contrary to the public interest.
In this instance the Review of Workload for House Supervisors and Operational Managers (Final Report) report by KPMG was commissioned by the department, and its content forms part of the deliberative processes involved in the ongoing review of roles and responsibilities of direct care staff. As the material considered in the report has been superseded by events subsequent to its finalisation I have determined that the potential for its release to create confusion and ill-informed debate outweighs any benefit in providing access. Therefore, its release would be contrary to the public interest.
Personal affairs information
Section 33(1) of the Act exempts from disclosure any document (or any part thereof) that would unreasonably disclose information relating to the personal affairs of another person (including a deceased person).
For this exemption to apply, the information must:
- relate to the personal affairs of a person, and
- be unreasonable to release.
Section 33(9) of the Act defines 'personal affairs' to include information that identifies any person or discloses their address or location or from which any person's identity, address or location can reasonably be determined.
In this instance the documents concerns the personal affairs information of individuals other than yourself as the applicant, and it is my decision that the release of this information in this instance would be unreasonable.
Information obtained in confidence
Section 35(1)(b) provides that a document is exempt if its release would divulge information communicated in confidence to the department and the disclosure would be contrary to the public interest on the basis that it would be reasonably likely to impair an agency's (or Minister's) ability to obtain similar information in the future. Below, are the two components that must be met before the exemption can apply to documents.
- The documents must be communicated in confidence by or on behalf of a person to an agency; and
- Disclosure would be reasonably likely to impair the ability of the agency to obtain similar information in the future.
Further, were such information and the source of such information revealed, it is reasonably likely that the department's ability to obtain such information in the future would be impaired.
The report contains information provided to the consultants by department staff on the understanding that the material would be treated in confidence. It is my decision that to release information of this nature to the world at large would be likely to lead to a reluctance by staff to participate in similar reviews in the future, and impair the department's ability to obtain similar information on which to base workload or other reforms in the future.
LISA Comment: We see little chance of an 'Action Plan' being produced or made available as a result of this report. We expect the report to do little more than, like others, be a costly dust collector.
Friday, July 20 2012
Information on government departments and government funded organisations can often be accessed through the FOI process.
In Victoria, a simple written request and a small fee is all that is required. And, as can been seen through the following link, this aspect of DHS Victoria is often very helpful to applicants.
Wednesday, July 18 2012
The Policy and Funding Plan is an integral part of the Service Agreement which is negotiated by the department with funded organisations every three years for the delivery of services to Victorians.
The Plan describes the department’s policy framework, objectives, budget and funding initiatives as well as information in regard to the service activities.
The Plan contains detailed information regarding service activities, service standards and guidelines, targets, performance measures and data collection requirements.
Tuesday, July 03 2012
Most families with an adult member in a supported accommodation group home and/or a day centre, have major concerns as to just what is happening to their vulnerable family member behind the closed-doors of these facilities - given many have few meaningful checks and balances, and little transparency.
Those group homes funded by the Department of Human Services, are subjected to visits by members of the community visitor program, under the Disability Act 2006, managed by the Office of the Public Advocate (OPA).
At present there is no independent evaluation of day services, where the outcome reports are available to families/the public.
Community visitor reports are not available from the OPA, as the OPA is not subject to FOI (Freedom of Information), CV reports are, however, available for all group homes funded by the DHS, under FOI from DHS Head Office in Melbourne - at a charge of $24.40 per FOI request.
Just make a simple written request to:
DHS, FOI: Manager, FOI Department, Department of Human Services,
50 Lonsdale Street, MELBOURNE 3000
Dear Sir, I request under FOI, copies of all the Community Visitor Reports for SSA, group home, at ……………………………, for the period, ………. to-date.
And, include the fee. Response time can be anything up to two months. But it’s worth the wait to see the CV view of the service
Friday, June 29 2012
There has always been a question as to what happens to vulnerable people behind closed-doors - whether this be children at kinder, the elderly in nursing homes, or those with limited capacity living in supported accommodation and attending day centres.
Mum worries about her regular three year old at kinder, but he or she can tell mum... Mum, therefore, worries far more about her 33 year old with limited intellectual capacity and little or no meaningful communications, and living in a supported accommodation group home.
The ‘Community Visitor Program’, under the ‘Disability Act’ in Victoria, helps to weed-out some of the questionable activities behind those closed doors, but families were still concerned that many services still lacked the level and quality of service they considered necessary to provide their vulnerable family member with consistent quality of life care. And, the ‘Community Visitor Program’ does not check ‘Day Centres (ATSS)’.
In the early 2000s, it was considered there was a need to evaluate all service provision, day services and group homes, independent of government or pseudo government - through independent accreditation by external accreditation agencies.
This was flagged by DHS Victoria in their publication entitled, ‘The Quality Framework for Disability Services’ as starting in 2009. Those families complaining about services were encouraged to look forward to 2009, when services would be scrutinized by people independent of service providers and government and the outcome results made widely available.
Well, 2009 came, and went and little happened, as the DHS was then under pressure from non government service providers (CSOs), that they would not take part in the independent accreditation program if outcome results were released to families.
So DHS, Victoria, went to water. They made a deal with CSOs that they would not sanction the release of outcome results, if the CSOs would agree to join the program and be independently accredited to help them justify their funding to these CSOs.
This action shows very clearly, that people with a disability and their families are far from the centre of service provision. Rather than at the centre of service provision, as is suggested in most department care policies, standards and values, and is directly proposed by NDS ( National Disability Services) in their ’Disability Services Transition Plan, 2012 – 2016’
This plan says, ‘The central recommendation of this report is for a major capability uplift of the entire Victorian disability system, in order to better position the service system to realise three objectives that are thought to encapsulate NDIS readiness:
- People with disabilities, their caring families and supporters at the centre of service delivery.
- Achieving a sustainable, integrated and equally regulated disability service system.
- High performing organisations achieving real outcomes for people with disability.
And, DHS Victoria says in its publication, Understanding the Quality Framework for Disability Services in Victoria (2007)’:-
3. Elements of the Quality Framework for Disability Services in Victoria (2007), page 7.
3.3 Independent quality monitoring Central to all robust quality frameworks is a mechanism to independently monitor and verify the quality of the product or service.
Independent quality monitoring is a process independent of the organisation that will require service providers to demonstrate how their systems and processes meet each of the standards.
As part of a staged approach to the implementation of the quality framework, independent quality monitoring will commence from July 2009.
An independent mechanism for monitoring the quality of support to people with a disability will:
- focus on outcomes
- involve support users, their families and carers in the process
- be cyclical
- be consistent with or complement existing quality systems
- be applied consistently to department-managed and community service organisations
- be applied across Disability Services Division funding models and activity types
- be aligned with divisional, departmental and government policy objectives
- promote continuous quality improvement.
LISA Inc. was provided with a very good legal team through PILCH, Victoria, to challenge the DHS, Victoria, decision (agreement with CSOs) not to release independent accreditation results for any service, including its own direct care services.
As is the general situation, the all-powerful DHS won the day!
Monday, June 11 2012
Supported residential services (SRS) are currently regulated under the Health Services Act 1988, and the Health Services (Supported Residential Services) Regulations 2001. The current model of regulation is based on a broad definition of SRS and a set of principles guiding how those services are provided, coupled with more detailed minimum requirements for those services.
In 2008 the Department of Health commenced a review of the current Act and Regulations. Consultation was a critical element of the review process. A discussion paper was used to highlight key issues with the current SRS regulatory scheme and to seek input from stakeholders. Residents of SRS, their families, SRS staff and proprietors provided feedback to the department. The department also ran a number of public consultation forums across Victoria.
The information gathered through the review process led to the new regulatory regime set out in the Supported Residential Services (Private Proprietors) Act 2010. The SRS Act streamlines the administration and regulation of SRS, strengthens occupancy rights, strengthens financial protections, promotes staff capability, introduces outcome-based standards, strengthens reporting of serious incidents and introduces new enforcement mechanisms.
The purpose of the proposed Regulations is to provide for effective administration of the new Act, which is planned to commence from 1 July 2012.
Regulatory Impact Statement
Statement of Reasons
Friday, October 28 2011
The Gillard Government’s controversial changes to the Social Security Act – which includes changes to the Impairment Tables used to determine eligibility for the Disability Support Pension - have passed through Parliament.
With the legislation passing through the Senate with coalition backing, people who apply for the Disability Support Pension (DSP) from the 1st January 2012 will be assessed under the new Impairment Tables.
The Impairment Tables are used in Disability Support Pension assessments to measure how a person's impairment affects their ability to work, and were last reviewed in 1993.
The government unveiled its plan to get people off the Disability Support Pension and into the workforce in July, revealing that the number of people receiving the DSP had reached 800,000, growing by 100,000 over the last 2 years alone. The changes to the Impairment Tables are estimated to save the government $35 million a year.
The Gillard Government said the legislation will ensure the Impairment tables “are able to be updated regularly and enable the introduction of new Tables that are consistent with modern medical and rehabilitation practice.” The Gillard government said the new tables “focus on what people are able to do, rather than what they can’t do”, however this has not stopped criticism of the changes.
The Greens say the government and coalition have united in supporting changes to the Social Security Act that are likely to lead to deeply unjust outcomes for vulnerable people. Greens Senator Rachel Siewert said her party supports efforts to assist people into the workforce, however the changes will push large numbers of people with disabilities onto the Newstart allowance, a payment which is $131 a week below the DSP.
It has been estimated that as many as four out of every ten people who qualified for the Disability Support Pension earlier this year would not qualify under the new regime which is set to come into effect in 2012.
As well as less financial assistance, people will be forced to meet stricter activity requirements in a deeply inhospitable labour market
Tuesday, July 19 2011
This state government department provides a large percentage of direct care services throughout the state, funds most of the non government direct care services and controls almost all placements throughout the state, through the DSR (Disability Support Register) – The waiting list for all services funded by the DHS – which is almost all of them.
The department considers the relatively few complaints it receives, in comparison to the number of services it provides, shows it must be doing it right.
It does not consider that any complaint, demonstrates it is not getting it right. The level of complaints is low for the reasons detailed by the ODSC:-
- fear of being victimised for making a complaint
- fear of having the service withdrawn
- being branded as a trouble maker or appearing ungrateful to the service provider
- lack of confidence that any real or lasting change will eventuate from the complaints process
- costs that may be associated with pursuing a complaint.
These fears, combined with high levels of unmet need and a lack of alternative service options, are often a strong motivation for people with a disability and their families to put up with a poor service rather than complain. This is further complicated in regional Victoria, where there may be only one disability service provider in an area.
The following factors affecting frequency of complaints also need to be considered by providers when developing, putting into practice and assessing their complaints process and management:
- Complainants may not be aware of the process
- The complaints process may not be readily accessible
- If a complainant has had a negative experience in the past, they may fear unpleasant or unfavourable treatment by the service provider when lodging a current complaint.
Whilst disability service providers may believe that they have sound complaints management systems in place it is important to ascertain the views of service users in order to confirm that this is the case.
Although DHS policy state this should occur, it does not consider complaints as tools to service improvement.
Its management is reactive, not pro-active. Consumers with service level and quality concerns have to repeatedly raise their concerns against department opposition and denial.
Department management frequently state, ‘complaints are the complainants opinion’. Inferring, the complainant is wrong from the outset.
They never come to consumers who have concerns - like good business in the market place who want to enhance their customer relations
It does not consider that 90% of solving a problem, is admitting you have one. The department spends more resources supporting its in-denial strategies, than it would have fixing its strategic problems.
It has no reason to solve customer concerns, as it has a captive market, and consumers can go to no other service which takes funding from the DHS, unless the DHS agree, as the DHS controls the DSR state wide
It cannot solve customer concerns caused directly or indirectly by staff lore, as its management cannot man-manage staff lore.
Staff with secure, public service employment, can claim bullying, intimidation and interference under work cover legislation.
Thursday, June 30 2011
The Victorian Disability Act is a set of laws passed by the state government in 2006. Amongst other things this provided for the set up of a disability services commissioner (DSC)
One of the functions of the DSC’s office is to receive enquiries and complaints about disability services people receive or wish to access. The DSC has no real power to make providers do anything and can generally only conciliate. This means talking about the problem and trying to get a solution.
The commissioner is an ex-DHS employee and some consumers have expressed dissatisfaction with the amount of ex-DHS people in the DSC organization. Additionally they have had teething problems with communication and systems.
The DCS is required to produce an annual report and the 2009-10 report can be viewed on their web site www.odsc.vic.gov.au
. This sets out a very detailed analysis of the enquiries and complaints made to the Office of the Disability Services Commissioner (ODSC) as well as the statistics reported by service providers about complaints made directly to them - known as annual complaints reporting (ACR).
In summary the amount of enquiries and complaints reported as being made to the ODSC and to providers has increased by about one third each year and about one third of all complaints involved supported accommodation.
For 2009-10 the ODSC received 571 enquiries of which 157 resulted in a complaint and 63 of these were resolved. Service providers reported having received 1364 complaints.
The ODSC web site encourages complaints – “Its OK to complain” – and does some work in publicity and training to assist people speaking up. But many consumers do not have family or other support, do not know what service quality they should be receiving, do not know their rights, and may be intimidated by the support system that they are so reliant upon. Additionally issues of fear of retribution, language or cultural diversity, and frustration of trying to deal with seemingly huge government departments and service providers suggests that the level of reported complaints is probably only a fraction of the real level of justified dissatisfaction.
Do you have an experience with a complaint? Post a comment.
Monday, June 20 2011
The interim decision of Fair Work Australia in May, needs the Commonwealth and all other governments to commit to fully funding their share of the outcome of the case if we are to achieve national parity.
In Victoria, there are ‘Community Service Organisations’, non-government service providers, and government, Department of Human Services, direct care services for people with an intellectual or multiple disability living in supported accommodation group homes, or similar.
It has been traditional for many years that CSO workers are paid less than the DHS workers doing almost identical work. “Why is this so?”
We suggest this has occurred, not because of an initially strong union for DHS workers, but because they became strong as a direct result of captive market DHS management with government money to keep their staff content, whilst short funding the CSOs.
Fair Work Australia should ensure all direct care staff in supported accommodation group homes, government and non-government, are paid equally.
LISA Inc has no reservations in respect to direct care staff being well paid and well trained. The reservation being, that of work valve expectation being set, monitored and maintained to ensure the residents of these group homes receive real quality of life care in their home - not minder care in a staff workplace.
Work value expectations fail to occur in government direct care services, as traditional public service culture seriously limits the ability of management to man-manage direct care staff lore to ensure services are with the direction, intention and spirit of recognised care policies, standards and values.
Friday, June 17 2011
In the days before FOI, getting information from a government department was a nightmare. Although FOI makes it relatively easy, delays and exempt material remain.
What these departments don’t make too well known, is that much material can be made available through “Administrative Release”. That is directly, without FOI formalities or fees.
Click on this LINK
to see the “Administrative Release Guidelines of the Department of Human Services, Victoria.
Friday, June 17 2011
(Confirm details and personal situation with Centrelink, these are general guidance notes)
Recipients of the Disability Support Pension, under the age of 35 years, who are assessed as having a partial work capacity of eight or more hours per week, and who are not working, will be required to attend Centrelink interviews on a quarterly basis for the first 18 months after first receiving a payment and then twice yearly thereafter at an estimated cost to government of $92.8m over four years.
From 3 September 2011, DSP claimants, with the exception of those who are clearly unable to work, will need to provide evidence that they have tested their future work capacity by participating in training or work related activities. In addition, job capacity assessments will be refined to focus on people's potential to work. This measure is expected to save $49.7m over 4 years.
A variety of changes to DSP entitlements and Carers payments affecting those people with disabilities and their carers travelling overseas are expected to save $19m over five years.
Subject to the income test, DSP recipients will now be permitted to work up to 30 hours per week and still retain eligibility for a part-pension for up to 2 years.
In 2012-13 $1m will be made available to up to ten disability employment broker projects, designed to help create job opportunities for people with disabilities and building relationships with employer and industry groups.
Beginning on 1 July 2012, employers will be provided with wage subsidies of $3000 to provide a 26 weeks minimum employment placement to approximately 1000 job seekers with disabilities who have been unemployed for more than 12 months. Up to $2000 will be also be made available to assist employers to provide appropriate training and supervision to employees employed under the Supported Wage Program. In total this measure is expected to cost $11.3m over 3 years.
Mandatory annual ongoing support assessments for Disability Employment Service recipients will cease for those who have had no change in their previous two assessments.
Tuesday, June 07 2011
Government departments, but not their ministers, can be scrutinised by the State Ombudsman.
If a government department wants a matter not to be subjected to scrutiny by the Ombudsman, they can get their Minister to approve or sign-off on the matter - and they are fire-proof.
Tuesday, June 07 2011
Community Visitors, under the Disability Act 2006, within the Office of the Public Advocate (OPA), visit government and non-government group homes throughout Victoria. Yet, their specific reports on group homes are not available to the residents and their families from the OPA, not even under “Freedom of Information (FOI)”.
As the OPA is not subject to FOI! So here we have a pseudo government department, the OPA, responsible for monitoring the care of vulnerable people, and they are not obligated to show their findings to the very residents of the house they are visiting.
As we (LISA) have said many times… The residents of group homes have few reasonable rights. In group homes where the Department of Human Services (DHS) is the direct care service provider, the residents are specifically denied residential tenancy rights by this all powerful government department, or individualised funding, so they can choose their service provider.
If the residents of DHS group homes had residential tenancy rights and individualised funding, they could choose their service provider, and have an agreed quality of life service contract, where they could change contractors if not satisfied.
Sunday, June 05 2011
There is enormous credence given to “Human Rights” these days. Although human rights is a great tool in the fight for quality of life care, it can become a direct care staff work avoidance tool in supported accommodation group homes and similar
It is easy to say, those with little or no understanding of consequences are indicating not wanting a bath, their teeth cleaned or to go out, etc, etc, as a valued choice when it suits staff who would rather not do these things.
Where is the balance between “Client’s Choice” and “Duty of Care”?