Rehabilitation and Disability Service Spectrum and NDIS
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Transcript of Rehabilitation and Disability Service Spectrum and NDIS
FACULTY OF HEALTH SCIENCES
CENTRE FOR DISABILITY RESEARCH AND POLICY
Rehabilitation and Disability Service Spectrum and NDIS
Professor Gwynnyth Llewellyn
26th June 2014
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Australia
2
Australian desert
3
4
All people with disability
Disability support services
Rehabilitation
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Federal and state organisation of rehabilitation and disability
Federal
• Health funding to States - National Health Performance Agreements – Department of Health
• Disability funding to States - National Disability Agreement – Department of Social Services
State/
Territor
y
• 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
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
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Recent brief history – critical events in disability sector
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)
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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-strategy 8
Areas of policy action
Inclusive and accessible communities
Rights protection, justice and legislation
Economic security
Personal and community support
Learning and skills
Health and wellbeing9
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
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Block funded services personal plans and individual budgets
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
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NDIS is a three tiered scheme
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
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Tier 3 – planning and support process
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
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Brief overview
Rehabilitation Model of Care
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Figure 1: NSW Rehabilitation Model of Care
Principles – “statements of intent for rehabilitation s e rv ic e s”
1 L e a d e rship 2 Equitable a c c ess 3 Multidisciplinary care te a m s 4 Care c o o rd in a tion
5 Patient centred c a re 6 Evidence based c are 7 Appropriate care s e ttin g 8 Clinical process and outcome in d ic a tors
Patient journey – “across one or m u ltip le care s e ttin gs ”
Patient journey – “consistent p a tie n t
journey within a care s e ttin g ”
R e fe rra l D is c h a rge
Care setting
Care setting
Enablers and care settings for effective rehabilitation systems and services
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Enablers – “support im p le m e nta tion ”
• W ork fo rce • Data and performance im p ro v em ent • Care coordination and lin k a g es • Te c h n olog y • Appropriate in f ra s truc ture
Care settings – “six defined care s e ttin g s”setting 1: e in p a tie nt Care setting 1: Inreach to acute Care setting 2: Sub-acute inpatient
Care setting 3: Ambulatory care- day hospital
Care setting 4: Ambulatory care- Outpatients Care setting 5: Ambulatory care – Home based Care setting 6: Outreach
Aids and Equipment Program
Aids and Equipment Program
Continence Assistance
Home Respiratory Program (HRP)
Prosthetic Limb Service
Specialised Equipment Essential for Discharge
Speech Generating Device 16
http://www.enable.health.nsw.gov.au/
Centre for Disability Research and Policy
www.sydney.edu.au/health_sciences/cdrp/
Email: [email protected]