Abstract:Australia is immersed in its largest reform of disability services in a generationthe staged rollout of the National Disability Insurance Scheme (NDIS). Enacted swiftly to capitalize on rare bipartisan political and public support, the $AU22billion scheme promises to design and deliver disability services differently, with emphasis on service user choice and control. However, the scheme's rollout is outpacing the readiness of service users, service providers and the agency charged with implementing it to achie… Show more
“…Some reported being discouraged by earlier experiences with the NDIS to the extent that they did not even try to make the changes they needed, which may have led to students with disability missing out on plan flexibility that would in fact have been possible. The administrative burden associated with the NDIS has been well documented, for both scheme participants and service providers (Carey, Dickinson, Malbon, Weier, & Duff, 2020; Foley, Attrill, McAllister, & Brebner, 2020; Mavromaras, Moskos, Mahuteau, & Iskerwood, 2018; Olney & Dickinson, 2019). Research has shown that individualized funding schemes, which rely on participant and carer self‐advocacy and ability to navigate complex administrative systems, are more accessible for well‐educated, native English‐speaking, and assertive individuals and families (Heneker, Zizzo, Awata, & Goodwin‐Smith, 2017; Mavromaras et al, 2018; Owens et al, 2017; Russo, Brownlow, & Machin, 2020).…”
Individualized funding schemes are designed to offer people with disability greater choice and control over the services they receive. In this research, we report on a survey of over 700 families to explore how Australia's National Disability Insurance Scheme (NDIS) supported children and young people and their families to learn remotely during COVID‐19. NDIS funding to support education during the first COVID‐19 lockdown period forms an important case study of the flexibility of individualized funding schemes. Our results suggest that participant experiences varied widely, with some people able to make the changes they required and others left with a significant service gap. This shows that individual funding schemes are not necessarily more flexible than traditional systems in an emergency situation—useful flexibility depends on many factors, such as clarity of information giving, all actors having a shared message, proactive support of flexibility initiatives, and participants' ability to quickly navigate a complicated system. This research also highlights problems with the interface between the NDIS and mainstream services such as education.
“…Some reported being discouraged by earlier experiences with the NDIS to the extent that they did not even try to make the changes they needed, which may have led to students with disability missing out on plan flexibility that would in fact have been possible. The administrative burden associated with the NDIS has been well documented, for both scheme participants and service providers (Carey, Dickinson, Malbon, Weier, & Duff, 2020; Foley, Attrill, McAllister, & Brebner, 2020; Mavromaras, Moskos, Mahuteau, & Iskerwood, 2018; Olney & Dickinson, 2019). Research has shown that individualized funding schemes, which rely on participant and carer self‐advocacy and ability to navigate complex administrative systems, are more accessible for well‐educated, native English‐speaking, and assertive individuals and families (Heneker, Zizzo, Awata, & Goodwin‐Smith, 2017; Mavromaras et al, 2018; Owens et al, 2017; Russo, Brownlow, & Machin, 2020).…”
Individualized funding schemes are designed to offer people with disability greater choice and control over the services they receive. In this research, we report on a survey of over 700 families to explore how Australia's National Disability Insurance Scheme (NDIS) supported children and young people and their families to learn remotely during COVID‐19. NDIS funding to support education during the first COVID‐19 lockdown period forms an important case study of the flexibility of individualized funding schemes. Our results suggest that participant experiences varied widely, with some people able to make the changes they required and others left with a significant service gap. This shows that individual funding schemes are not necessarily more flexible than traditional systems in an emergency situation—useful flexibility depends on many factors, such as clarity of information giving, all actors having a shared message, proactive support of flexibility initiatives, and participants' ability to quickly navigate a complicated system. This research also highlights problems with the interface between the NDIS and mainstream services such as education.
“…9 What is known about the health care experiences of people with disability Inadequate health care workforce capacity, including primary care 10 Accessible forms of communication and information not always available (e.g Auslan/BSL interpreters, 11 easy read material 12 ) Discriminatory practices that prevent access to health care on an equal basis to others 13 , including life-saving treatments Lack of effective, targeted health promotion programmes 14 Low levels of participation in preventative health programs (e.g. mammographic screening 15 ) Lack of coordination across sectors including health, education, and social care and across different levels of government 16 Alt-text: Box 1 …”
Section: Introductionmentioning
confidence: 99%
“…Lack of coordination across sectors including health, education, and social care and across different levels of government 16 …”
COVID-19 has exacerbated pre-existing difficulties children and adults with disability face accessing quality health care. Some people with disability are at greater risk of contracting COVID-19 because they require support for personal care and are unable to physically distance, e.g. those living in congregate settings. Additionally, some people with disability have health conditions that put them at higher risk of poor outcomes if they become infected. Despite this, governments have been slow to recognise, and respond to, the unique and diverse health care needs of people with disability during COVID-19. While some countries, including Australia, have improved access to high-quality health care for people with disability others, like England, have failed to support their citizens with disability. In this Commentary we describe the health care responses of England and Australia and make recommendations for rapidly improving health care for people with disability in the pandemic and beyond.
“…The trial's formal Process Evaluation component of the study will document the ongoing evolution of the ABIC role and barriers and facilitators involved in its implementation and sustainability. Changing contexts throughout the trial will provide many further insights and also see potential for alignment of the ABIC role with other initiatives such as the National Disability Insurance Scheme (Olney & Dickinson, 2019). The ABIC role may also serve as a model of support roles for Aboriginal people with other conditions.…”
Brain injury, resulting from stroke and traumatic brain injury, is a common occurrence in Australia, with Aboriginal people affected at a significant rate and impact felt by individuals, families and communities. Access to brain injury rehabilitation services for Aboriginal people is reported to be often limited, with very little support outside the hospital environment. Our research involving Aboriginal brain injury survivors and their families to date has revealed that people often manage ‘on their own’ following such events. Following recommendations from survivors and their families, the Healing Right Way clinical trial, currently underway in Western Australia, has created the role of Aboriginal Brain Injury Coordinator (ABIC) to assist in navigating information and services, particularly after discharge from hospital. Eight positions for this role have been instigated across metropolitan and rural regions in the state. Healing Right Way’s aim is to enhance rehabilitation services and improve quality of life for Aboriginal Australians after brain injury. The ABIC’s role is to provide education, support, liaison and advocacy services to participants and their families over a six-month period, commencing soon after the participant’s stroke or injury has occurred. This paper outlines the development of this role, the partnerships involved, experiences to date and identifies some facilitators and barriers encountered that may impact the role’s ongoing sustainability. Details of components of the planned full Process Evaluation of Healing Right Way related to the ABIC role and the partnerships surrounding it are also provided. In combination with the trial’s ultimate results, this detail will assist in future service planning and provide a model of culturally secure care for stroke and brain injury services that can also inform other sub-acute and primary care models.
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