Introduction
As representatives of the
28 disability sector organisations
signing the letter of 6th
May 2002 to Hon
Mrs Faye Lo Po' regarding 'personal support
services for people with physical disability in
NSW', we welcome the opportunity to meet with
the Minister.
We thank Mrs Lo Po' for
meeting us on 4th July 2002.
Our concerns were
summarised in the letter of 6th May as
follows:
- There is a need for
a thorough re-examination of the full range
of personal assistance support systems to
lead to a new strategic direction; and
- There is a real
crisis in the current service system placing
people with disability at risk of not being
able to continue to live at home
independently.
We hope to find common
ground with the Minister and identify immediate
and long-term strategies for addressing unmet
need. We recognise that the context of debate
around these matters has not been made easier by
the reluctance of the Commonwealth Government to
speedily and satisfactorily reach agreement on
the CSTDA. We feel, however, that there is scope
and time (in this final period of the current
Government's term of office) to fund and
implement solutions to current and long-term
problems.
Recent
Progress
As representatives of a
broader constituency of interest we are pleased
to acknowledge recent developments and
Government decisions that have addressed some of
the issues of concern to us.
Specifically:
- We welcome the
decision to fund the supplementation of hours
for 65 existing recipients of support through
the Attendant Care Programme.
- We welcome the
decision to offer one-off and recurrent
funding to service providers of the Attendant
Care Programme to raise the hourly rate
payable by DADHC to $30 from 1st July
2002.
- We welcome the
commitment to review the new hourly rate for
Attendant Care Programme and to enhance that
rate from 1st July 2003.
- We welcome
confirmation in this year's Budget
Announcement that funds will be provided to
meet the Government's commitment to reduce
the Attendant Care Programme waiting list by
100 people over four years.
It is our hope that we can
work with Government and DADHC to identify and
implement further financial and non-financial
strategies for making further progress possible
in the future.
Unresolved Issues &
Unmet Need
Despite the progress
acknowledged above, it is clear to us that
significant and substantial unmet need continues
to exist with regard to personal assistance and
support services in NSW. Some of that unmet need
can only be described (for those living with its
consequences) as a crisis, requiring immediate
intervention. Some of that unmet need requires a
partnership involving all stakeholders to
identify and implement reform strategies for
modernisation of personal support systems for
the long-term benefit of residents and taxpayers
in New South Wales.
- At least 300
people are currently on the waiting list
for support through the High Needs Support
Pool (Virtual Pool) of the Home Care Service
of NSW.
- In some HCS areas
(Inner West, Lismore, Newcastle and
Shoalhaven are among the examples known to
us) people with high levels of support
requirements have been told not to bother
with applications for support because no
funds are available.
- Despite the resolution
of issues around the Attendant Care Programme
hourly rate and confirmation of previously
announced funds to reduce the waiting list,
more than 100 people with disability remain
on the waiting list.
- The findings of the
ADD Review of the Attendant Care Programme
have not been implemented.
- As we illustrate in
our "Case
Studies" appendix,
people with disability continue to live
inappropriately in hospital rehabilitation
units and/or are being discharged from Sydney
units to regional rehabilitation units.
- As our "Case Studies"
illustrate, people with disability experience
difficulties with inadequate service
provision (in terms of hours available,
quality and flexibility) from the State's
largest provider, the Home Care Service of
NSW.
- Inconsistency of
service provision is a flawed characteristic
of local implementation of Home Care Service
policies. Variation of service standards and
implementation exists between HCS branches
and, within branches, between service
coordinators.
We wish to use the meeting
with Minister, held on 4th July 2002, as a
springboard for seeking, planning, funding and
implementing solutions to the problems which led
us to write to Mrs Lo Po' in the first
instance.
Strategies for addressing
current unmet need and initiating longer-term
reform
In our
letter of 6th May 2002
we proposed to the Minister a number of
strategies and actions. They would, in our
judgement, take us a considerable way towards
solving immediate and longer-term
problems.
Our principle aim in
meeting with the Minister on 4th July 2002 is to
find common ground around which the respective
stakeholders can take action to build and
sustain a partnership that solves problems and
delivers high quality services at the same time
as providing value for taxpayer's money. Some of
what we propose will require Government to
allocate new money to personal support services.
Some of what we propose requires re-allocation
of existing funds within the context of a whole
of government approach to unmet need. Some of
what we propose involves no money at all but
does require commitment to transforming current
best practices into State-wide
practice.
Specifically we seek
the support of the Minister in these
areas
- New funds totaling
$5.25 Million on a recurrent basis are
required to eliminate the current waiting
list for support through the High Needs
Support Pool (Virtual Pool).
Based on assumptions of
average levels of need (as described in HCS
documentation) the whole of government cost
of the current waiting list would be $13.25
Million. The Government, however, is already
spending some of this money, on people on the
waiting list. Some are in hospital units;
some are receiving support from Home Care
Service branches at levels below their actual
need. In estimating the funds we believe to
be required to eliminate the High Needs
Support Pool (Virtual Pool) waiting list we
have made two assumptions:
- i. Most of the
people on the waiting list will be
currently receiving Government funded
support through one programme or another
that equates roughly to the upper limit of
HCS hours before High Needs Support Pool
(Virtual Pool) funding would 'kick-in'
(i.e. 60 hours per month).
ii. Some people on
the waiting list are currently funded
inappropriately to live in rehabilitation
nursing home or hospital beds at costs,
which greatly exceed those of supporting
people to live at home.
Using these assumptions
we estimate that somewhere in the region of
$5.25 Million is required to eliminate the
High Needs Support Pool (Virtual Pool)
waiting list.
- New funds totaling $5
Million on a recurrent basis are required to
eliminate the current waiting list for the
Attendant Care Programme.
In November 2001 48
people on the Attendant Care Programme
waiting list were allocated funds at a cost
of approximately $2 Million. The average cost
per person was almost $42,000 per year.
Assuming that everyone currently on the
waiting list was to be deemed eligible at the
new hourly rate, we estimate that
approximately $5 Million is
required.
- The establishment of a
State-wide Review (based on the draft Terms
Of Reference attached as an appendix) to
report to the Minister on reform and
modernisation of the personal assistance and
support services in NSW.
We feel strongly that a
new strategic framework, based upon
well-established principles, is required to
ensure that people with physical disability can
be supported to live as valued, participating
citizens in the communities of NSW. We believe
that the development of such a framework
requires the establishment of a Review Panel or
Advisory Committee (led by DADHC) similar to the
State-wide PADP Advisory Committee led by NSW
Health. Its objective would be to reform,
re-structure and modernise personal assistance
and support services in NSW, reporting to you as
the Minster responsible for these
matters.
The review would consider
the entire range of needs and services provided
by Government and non-government agencies and
could incorporate existing review data such as
that already conducted into the Home Care
Service, the High Needs Support Pool (Virtual
Pool) and the Attendant Care
Programme.
Participants from the
Disability Sector
Mr John Moxon,
President, Physical Disability Council of
NSW
Ms Wendy Potter,
President, People With Disabilities
NSW
Ms Kim Rowles, Service
User & Committee Member, PDCN
Ms Amanda Ellison,
Manager, Community Living Service
The Northcott
Society
And, staff member
support:
Mr Dougie Herd,
Executive Officer, Physical Disability
Council of NSW
Thursday, 4th July
2002
