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Francene McCartin, A/Director, Community and Individual Support Francene McCartin, A/Director, Community and Individual Support

Disability Services Division Disability Services Division

Disability and Ageing Forum

Transforming Disability Support Overview

• The move to self-directed support

• New approaches to protecting the rights of people with a disability

• A new quality framework for Victoria's Disability Support Services

• Making a difference with a focus on outcomes

The context for transformation

• UN Convention on Rights of Persons with Disabilities

• Victorian State Disability Plan 2002-2012

• Disability Act 2006

• Victorian Charter of Human Rights and Responsibilities 2006

• Victorian Context: Support Your Way

• National and international trends

It’s about improving outcomes for people It’s about improving outcomes for people with a disability and their familieswith a disability and their families

• Achieve economic participation and social inclusion

• Enjoy choice, wellbeing and the opportunity to live as independently as possible

• Well supported and resilient families/carers

A self-directed approach

Disability Services Current Outcome Disability Services Current Outcome DomainsDomains

• Increased individual capacity, choice and independence

• A more sustainable and responsive service system

• More inclusive communities and improved human rights

Demographics - Residents with a Disability

Age of People Receiving Accommodation Support

0

1,000

2,000

3,000

4,000

0-9

10

to

19

20

-29

30

-39

40

-49

50

-64

65

+

Age

CSTDA - SupportedAccommodation

CSTDA - People w ithIntellectual Disability inSupportedAccommodation

Demographics - VictoriaAge of Victorians

0%

10%

20%

30%

0-9

10 t

o 1

9

20-2

9

30-3

9

40-4

9

50-6

4

65+

All Victorians %

CSTDA - Vic %

CSTDA - SupportedAccommodation

CSTDA - People w ith Intellectualdisability in SupportedAccommodation

National Study

National project – Aging with a Disability (2006)

• National survey – 42% of people in residential services over 50 years– 27% of residents under 50 years had increased age-related support needs

• Aging-in-Place– Strategies include:

» Staffing and skills» Modifications to the physical environment and Aids & Equipment» Service design eg. program operation» Organisational changes

– Barriers» Organisational willingness and capacity for adaption» Choices and preferences of person/family

• Resident's of CSTDA services less likely to move to RAC than people with a disability in the community.

• Complex interaction of Disability, Health and Aged Care sectors.

Some Challenges

• Increasing health related needs and access to good health services and advice

• Earlier “ageing” including risk dementia

• Goal to retire from fulltime day activity and participate in more age appropriate activities

• Disability workforce having knowledge and skills in working with people who are

ageing

Disability Health Interface1. Discharge planning - Coordination of Disability, Health and Aged Care sectors

• A hospital admission is a common pathway to RAC.• Aim is to guide and improve communication, planning and processes between health

services and disability services to improve the person’s experience and outcomes.

2. Parkinson’s Nurse Practitioner pilot – Western Health

• Appropriate health care support is essential for people with progressive neurological conditions

• Joint Department of Health and Department of Human Services funded pilot. • Western Health have successful bid for a movement disorders clinic using the pilot.

3. Medicare item – Intellectual Disability

• Medicare rebate introduced for people with intellectual disability due to having additional support needs.

• Enable general practitioners to better manage health care and age-related needs.

Disability Supported Accommodation

1. Disability Hospital guide (draft)

• Describes the agreed roles of disability and hospital staff related to the admission

2. CHAP – Comprehensive Health Assessment Program

• Schedule of health checks for a person with a disability • Ill health can be misinterpreted as early onset ageing• Implemented in disability managed accommodation & negotiations underway for use in

CSO sector

3. Care Coordination pilots

• Care coordinators review health care needs of residents and supports residential services staff.

• Resulted in identification of health conditions and improved access to health services.

4. Disability Palliative Care Guide

• Describes key issues regarding end-of-life care and the existing resources available.• Describes the role of palliative care providers in supporting residents and staff.

Changed Approach to Day Supports

• 1 January 2010 – Day program funding client attached

• Increases choice and control for day program users

• Capacity to change the activities they are undertaking to be more age appropriate

Aged Care - Support Proposal

• Commonwealth Aged Care Proposal

• 200 Community Aged Care packages for trial by States and Territories

• Target group – people with a disability living in supported accommodation

• Additional funds to purchase age-related needs

In summary – continuing to move forward

• Enabling choice and control based on a self-directed approach

• Shifting the power to the service user

• Supporting an agile and sustainable industry

• Quality improvement based on outcomes