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Harmful Use of Alcohol in Aboriginal and Torres Strait Islander Communities

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Harmful Use of Alcohol in Aboriginal and Torres Strait Islander Communities HOUSE OF REPRESENTATIVES STANDING COMMITTEE ON INDIGENOUS AFFAIRS: Harmful use of alcohol in Aboriginal and Torres Strait Islander communities Department of the Prime Minister and Cabinet response to questions on notice Hansard Proof Transcript page 6: Referring to income management: is there any evidence that you will be having regard to, an evaluation, that will guide the 'what comes next'? Response: Several evaluations of income management have been conducted and the following evaluations are underway: • Place-based Income Management in Greater Shepparton (Victoria), Logan and Rockhampton (Queensland), Playford (South Australia) and Bankstown (New South Wales); • Voluntary Income Management in the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands; and • New Income Management in the Northern Territory. More information about each evaluation can be found on the Department of Social Services website. It should be noted that due dates of reports are a guide only, and the public release of reports is a decision for Government. The Income Management Evaluation and Review fact sheet is at Attachment A. The Government will consider the longer-term direction for income management policy guided by the outcomes of the McClure report on Welfare Reform, the Forrest Review of Indigenous Training and Employment Programmes, the evaluations, as well as other relevant data. There are various measures of income management currently operating in a number of locations. In this year’s Budget the Government provided $101.1 million in 2014-15 to extend income management in existing locations for one year. This will continue income management in the Northern Territory, and in trial sites in Perth and the Kimberley region, Laverton, and Ngaanyatjarra Lands of Western Australia and APY Lands in South Australia. Income management was also expanded to Ceduna and the surrounding region in South Australia from 1 July 2014. Income management in Cape York is funded until 31 December 2015 and in Greater Shepparton, Logan, Rockhampton, Playford, and Bankstown until 30 June 2016. 1 Hansard Proof Transcript pages 6 and 9: Referring to alcohol taxation: On page 8 of your submission you talk about supply, demand and harming strategies, and then a few paras below that it says: 'the Australian Government does not support policies that increase alcohol prices' including excise and price regulation. Does that mean that the federal government is actively working against some of the policies that are in place, such as in the Northern Territory where there have been steps in terms of their supply, demand and harm strategies, and Alice Springs has taken a few steps to control? Response to alcohol taxation The statement — that harmful drinkers are generally less responsive than moderate drinkers to alcohol price changes — refers to a point made in the Australian National Preventative Health Agency report, ‘Exploring the Public Interest Case for a Minimum (Floor) Price for Alcohol’. Contrary to the statement in submission (second sentence, paragraph 5, page 8), the Government has not formed a position on how general alcohol pricing policies might reduce harm. 2 Hansard Proof Transcript page 8: Referring to FASD: Can you tell us whether in fact there are any children or adults who receive disability support pension as a consequence of being diagnosed with FAS or FASD or whether any children under 16 are getting an additional support or care benefit because of the condition? Response: Social Security Payments The number of people with FASD, or numbers of people caring for people with FASD, and receiving an income support payment, cannot be determined. There is no specific medical code in the payments system for FAS or FASD. Cases would be coded under other more general categories, depending on their particular disability, for example learning disability or congenital malformations, deformations and chromosomal abnormalities. Often a particular condition, such as intellectual disability or behavioural difficulty, is diagnosed well before a link to FASD has been confirmed in a particular case. The Disability Support Pension (DSP) is designed to give people an adequate means of support if they have a permanent physical, intellectual or psychiatric impairment which attracts at least 20 points under the Impairment Tables. The person must also be assessed as being unable to work for 15 or more hours per week, for at least the next two years, because of their impairment. The assessment for DSP eligibility involves examining the individual’s ability to function in a work- related environment. As FAS/FASD involves varying degrees of disability and a wide range of behaviours and social skills, these assessments will vary depending on the individual’s level of ability. This process ensures that the system is fair and equitable and is not based on specific disabilities or conditions. The Impairment Tables cover both intellectual and cognitive impairment. As explained above the Impairment Tables are not diagnosis based so there is no need to have one particular diagnosis to benefit from the application of the tables. Carers of children or adults with FAS/FASD, may apply to claim Carer Allowance and/or Carer Payment. Their qualification will be determined according to the eligibility criteria, including assessment against the Disability Care Load Assessment (DCLA) (for children) or the Adult Disability Assessment Tool (ADAT) (for adults). In general, access to the payments includes an assessment of the care required rather than focusing on diagnosis of a medical condition. For Carer Allowance (child), a limited list of medical conditions, which are known always to have a high care requirement, provides fast-track qualification. FAS and FASD are not on the list, but that does not preclude carers of people with these conditions from qualifying for payment if the level of care satisfies the criteria. Response: Carer Support The Government recognises the difficulties experienced by carers and is committed to assisting carers access the support they need. The National Respite for Carers Programme (NRCP) is targeted to assist carers of: • All frail older Australians (65 years or over, or 50 years and over if Aboriginal or Torres Strait Islander); • People with dementia; • People with dementia and challenging behaviour; 3 • Younger people (under 65 years or under 50 years if Aboriginal or Torres Strait Islander) with moderate, severe or profound disabilities who are living at home; and • People with a terminal illness in need of palliative care. The NRCP funds a range of programmes to assist all carers in their caring role. The programmes delivered under the NRCP are expected to ensure that services are responsive to the needs of people who have particular difficulties in accessing services, including carers of people from an Aboriginal or Torres Strait Islander background. The NRCP provides services to carers through the provision of respite, information, counselling and other support services through: • The National Carer Counselling Program which provides short term counselling, emotional and psychological support services for carers in need of support. • The Carer Information and Support Programme which provides information and support to carers to assist them to navigate the community care system. • The Commonwealth Respite and Carelink Centres (54 nationally) which provide information and support and assist carers in arranging respite services to meet emergency or short term carer needs; and • Funding for more than 500 respite services across Australia. From 1 July 2015, the Australian Government will launch the Commonwealth Home Support Programme (CHSP), which will combine the existing Commonwealth HACC Program, the NRCP, the Day Therapy Centres Program and potentially the Assistance with Care and Housing for the Aged Program, under a single streamlined programme to provide basic maintenance, care, support and respite services for older people living in the community, and their carers. Further information about the CHSP is available on the Department of Social Services website at: http://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care-reform/reforms-by- topic/commonwealth-home-support-programme 4 Hansard Proof Transcript page 8: Referring to FASD: Given that I have just identified, and it is commonly discussed, the problems of the current sets of impairments that do not match FAS-FASD as a disability—for example, it is cognitive not intellectual. A person forgetting to eat and having to be prompted to eat is different from somebody who has to be assisted physically to eat, yet they are both represented as a serious impairment, if you have this condition. Are you aware of anyone in PM&C or a related department actively working to correct these inadequacies of the current impairment criteria, if you like, to deal with the FAS-FASD issues? Response: NDIS To be eligible for the NDIS, the National Disability Insurance Scheme Act 2013 (NDIS Act) requires that a person has a permanent impairment which results in them having a substantially reduced capacity to undertake activities of daily living. A person can also access the scheme through a separate early intervention requirement that allows the scheme to provide support to people with a permanent impairment who would benefit from early intervention to reduce their future needs for support. This means that access to the NDIS is not based on a diagnosis, it is based on the permanence of the disability, the level of
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