Australia is moving to a nationally consistent system of support for people with disability following many reform initiatives on the state level. Even though the National Disability Insurance Scheme (NDIS) shifts policy focus on disability to the national level, there is still much which can only be achieved by the state. Enis Jusufspahic takes a look at the disability landscape in NSW and the challenges facing the NSW Government after the election.
Disability in NSW
One in five people in NSW have a disability, which is equal to the national rate (Disability, New South Wales, 2001, ABS). In 2012-13 NSW Government expenditure on disability services was $1.25 billion (Disability support services provided under the National Disability Agreement 2012–13, AIHW). Around half (54%) of service users lived with family (Disability support services provided under the National Disability Agreement 2012–13, AIHW) Half the people with a disability who used accommodation services used services provided by the state government (Disability, New South Wales, 2001, ABS).
In order to address these issues Ageing, Disability & Home Care, Family and Community Services (ADHC) of the NSW Government introduced a number of initiatives, the first of which was Stronger Together: A New Direction for Disability Services in NSW 2006–2016. Stronger Together marked a major step in addressing the needs of people with disability. It included a significant expansion of the disability service system, developed a person- centred approach that enables people with disability to plan their life, determine how and who delivers their support services, as well as building long-term pathways throughout the service system. Stronger Together: The second phase 2011?–?16 places greater emphasis on the closure of large residential centres and building a service system with the right capacity.
In the last three years, ADHC has introduced a number of innovative projects on a state-wide level in order to better position NSW residents in being able to take full advantage of the NDIS, such as:
- My Choice Matters (the Consumer Development Fund), which educates people with disability in life planning;
- the Industry Development Fund, which works with service providers in developing their service to continue under the individualised funding model;
- individualising support packages for current disability services recipients;
- the Supported Living Fund, which provides people living in congregate care the ability to live independently; and
- AbilityLinks, which works with individuals to achieve the person’s goals outside the disability service system – be it education, health or social inclusion.
Ready Together: a better future for people with disability in NSW introduced a marked shift in state government policy on disability support services. The National Disability Insurance Scheme (NSW Enabling) Act 2013 (the Enabling Act) provides for the transfer of the NSW state government’s disability assets and service delivery to the non?government sector, including the transfer of the Home Care Service of NSW (Home Care). This is apparently to remove government as the largest player from the disability services ‘market’ in order to create a more equitable playing field.
However, disability services are not a traditional ‘market’, as people have a need for services which is not consistent with price. There is significant undersupply of services with high demand, and most services are publicly funded in the first place as disability supports are a human right and not simply a consumable service.
NSW Government operated Home Care’s revenue amounts to $234.4 million in funding through the Home and Community Care (HACC) program. (Family and Community Services Annual Report 2013–14, FACS) According to the Australian Productivity Commission, the Australian Government spent $1,063.7 million on Community Care in NSW excluding information and assessment (Report on Government Services 2015, Aged Services, and Productivity Commission). The state’s Home Care then amounts to 22 per cent of total expenditure on Community Care in NSW. This means that Home Care is indeed a significant service provider, but not as large as many in the sector believe it to be.
In many regional and outlying areas, Home Care is the only provider of community care services and is the “service of last resort” for people “residing in places which lack basic services essential to the proper functioning of those persons“, which is defined in the Community Welfare Act 1987. There is concern that the transfer of management to another provider could impact on continued access to essential services currently available through the forty-five state-wide branches.
This structure has been very successful for the last 26 years and it is vital that this structure be maintained, to ensure equitable access to ageing and disability services across NSW, in addition to safeguarding the quality of care provided by Home Care staff that is renowned for their experience and skills. Over the years, ADHC has worked hard to train and develop a loyal and committed workforce; it would be a significant loss for clients, and their local communities, if this asset was lost.
The role of government
In NSW, disability policy and actual service delivery has been the State Government’s responsibility but it is now transitioning to a national system under NDIS. The State Government is in the process of transferring direct service delivery to the non-government sector in preparation of the full roll out of the NDIS by 2018. 2014 saw the introduction of the Disability Inclusion Act 2014 (DIA). DIA replaces the NSW Disability Services Act regulating support services for people with disability and, significantly, commits government into creating more inclusive and accessible communities for people with disability through a State Disability Inclusion Plan.
National priorities are quite different from state priorities, with the overwhelming focus at the national level being placed on direct supports, employment, income support and housing as opposed to state-type issues such as criminal justice, education and health. Even though we are transitioning to the NDIS, it’s important to remember that the NSW state government has legislative and morale responsibility for people with disability, and continuation of a well-resourced Disability Department (or ADHC) is vital to maintain state-based initiatives and obligations, including:
- To transition to the NDIS and to continue to monitor its implementation in NSW, including individualising funding packages ahead of the NDIS launch.
- To implement initiatives under the DIA which meet key performance measures and the principles of the UN Convention on the Rights of Persons with Disabilities.
- To develop and drive the implementation of the State Disability Inclusion Plan, which guides how all of government works to improve access and outcomes to government services and facilities, including health, education, criminal justice, transport and housing.
Within this context, NSW voters should reasonably expect the state government to develop specific programs/initiatives complementary to the NDIS which would assist NSW residents.
Some of the initiatives / programs needing to be looked at by the NSW Government are:
- To ensure adequate support services for people with disability who are not eligible for the NDIS through an overflow program similar to Community Care Supports Program.
- To develop sustainable models of social housing for people with disability through government investment, a funding scheme to develop social housing stock to encourage social housing providers to build accessible housing and low/no-interest home loans for people with disability.
- To ensure accessibility of public transport, including expanding the Taxi Transport Subsidy Scheme.
- To ensure people with disability have access to a range of appropriate local, state-based services for supports and information, including on specific disabilities such as vision impairment and acquired brain injury.
- To ensure access to expert advice and advocacy for both service providers and people with disability through continued support for local, state-based disability peak bodies.
- To enable research, innovation and community development, in order to increase the quality of supports offered to the sector.
- To ensure ongoing funding for My Choice Matters, so that NSW residents know their rights and are prepared to make the most of the NDIS.
- To progress plans for closure of congregate care and residential institutions for people with disability; many which are owned and administered by the state government. (In 2011 there were 20 large and 10 small residential institutions for people with disability, Disability Support Services 2011–12, AIHW)
- Consider broadening the scope of the Industry Development fund to include other peak bodies and research institutions as partners.
There may be a tendency with the NDIS introduction for the NSW Government to step away from the disability area, arguing it is being handled by the NDIS. The challenge for the state government is to ensure people do not slip through the state – federal cracks and that the kinds of initiatives outlined above are put in place.
Enis Jusufspahic is the Home and Community Care (HACC) Development Officer (Eastern Sydney)