3Rd Enabling Masterplan (2017 – 2021)

3RD ENABLING MASTERPLAN 2017-2021

Caring Nation, Inclusive Society 3RD ENABLING MASTERPLAN 2017-2021

“As the Republic’s Golden Jubilee year draws Caring Nation, Inclusive Society to a close, Singaporeans should reflect on the kind of society they want, and continue to build a more inclusive society.”

— Prime Minister Lee Hsien Loong, 2 December 2015, Official Opening of the Enabling Village

Published in December 2016

ISBN: 978-981-11-1960-6 FOREWORD BY The prevalence rate of persons with disabilities in Singapore is as follows: CHAIRPERSON Population Group Approximate prevalence rate

Student population 2.1% of student population1 The 3rd Enabling Masterplan (2017– 2021) represents another significant 18 – 49 years 3.4% of resident population2 step towards empowering persons 50 years and above 13.3% of resident population3 with disabilities to achieve their fullest potential as integral and contributing The 3rd Enabling Masterplan sets The Steering Committee was of It is therefore the Committee’s members of society, as Singapore forth a multi-faceted plan to improve the view that a detailed profiling of hope that the adoption of the grows to be more inclusive. the quality of life of persons with persons with disabilities in the country recommendations and implementation disabilities, support their caregivers, along with the collection of relevant of the strategies and action plan The recommendations and proposed and build a community that is more and internationally comparable data proposed in the 3rd strategies have been endorsed by caring and inclusive. As one goes Enabling on disability, and information from a 22-member Steering Committee through this report, it will be evident Masterplan will better enable persons research on disability and related comprising persons with disabilities, that the person with disabilities with disabilities in Singapore to fulfil services was necessary for the caregivers, leaders and professionals is at the centre of all that is being their aspirations in all aspects of life. effective planning and delivery of in the disability field, voluntary welfare planned. As the Committee worked needed services in the disability sector organisations (VWOs) and government through the recommendations, we today and in the future. agencies.This Committee has were mindful of the need to enable identified broad areas which will help persons with disabilities to transition direct efforts in the disability sector through the various life stages over the next five years. with the appropriate support and guidance. The appreciation of the role of technology and assistive devices in enhancing their quality of life and Anita Fam independence was certainly not Chairman, lost on the Committee, and neither 3rd Enabling Masterplan Steering Committee was the value of access to support, 1 Source: Ministry of Education. This is based on the number of reported cases of students with sensory impairment, physical impairment, community-based rehabilitation and autism spectrum disorder and intellectual disability. The total student population is put at approximately 460,000. integration services. 2 Source: National Council of Social Service. Based on a random sampling of 2,000 Singapore residents and permanent residents aged 18 and above done by NCSS in 2015, the self-reported disability prevalence rate was 3.4% for those aged 18 – 49 years old. This includes those who acquired disabilities due to accidents and illness.

3 Source: National Council of Social Service. Based on a random sampling of 2,000 Singapore residents and permanent residents aged 18 and above done by NCSS in 2015, the self-reported disability prevalence rate was 13.3% for those aged 50 years and above. This includes those who acquired disabilities due to accidents, illness and older age. 3 RD ENABLING MASTERPLAN STEERING COMMITTEE Ms Anita Fam Mr Ardi S Hardjoe Chairperson Member Vice President, Chief Executive Officer, National Council of Social Service Thye Hua Kwan Nursing Home

Mr Ang Wei Tech Ms Chia Yong Yong Member Member Associate Chair (Research), President, School of Mechanical and SPD Aerospace Engineering, Nanyang Technological University

Mr Andrew Buay Member Vice President, Group Corporate Social Responsibility, Singtel

Prof Chong Siow Ann Member Vice Chairman, Medical Board (Research)/ Senior Consultant, Mr Abdul Majeed Bin Institute of Mental Health Abdul Khader Mr Ang Wei Neng Mr Chong Kwek Bin Mr Daniel Tan Tai Leng Member Member Member Member Director, Senior Vice President, IT Programme Executive, Board Member, Senior Consultant Psychologist, SBS Transit Singapore Association of the Movement for the Intellectually Singapore Police Force Visually Handicapped Disabled of Singapore Ms Denise Phua Mr J R Karthikeyan Mr Raja Singh Member Member Member President, Director, Founder and Owner, Autism Resource Centre Disability Support, DNR Wheels Education and Development, Ms Margaret Heng Ms Tan Ping Ling Family and Caregiver Support, Mr Eric Tseng Member Member AWWA Member Chief Executive, Deputy Director, Programme Manager Singapore Hotel and Tourism Human Resource, Digital & Technology Strategy Education Centre NTUC Fairprice

Ms Ku Geok Boon Dr Lee Tung Jean Member Member Ms Tina Hung Chief Executive Officer, Deputy Secretary, Member SG Enable Ministry of Social and Family Deputy Chief Executive Officer, Development National Council of Social Service Mr Lam Yi Young Ms Teoh Zsin Woon Dr Winnie Goh Member Member Member Deputy Secretary (Policy), Deputy Secretary (Development), Senior Consultant, Ministry of Education Ministry of Health Department of Paediatrics, Neurology Service, KK Women’s and Children’s Hospital Sunday, April 3, 2016 | The Sunday Times Topof theNews | A9 TABLE OF New roadmap for people with disabilities

CONTENTS Minister for Committee to develop 5-year plan to focus on Social and SUPPORTING Family more employment help, caregivers’ support Development Tan Chuan-Jin Seow Bei Yi For example, under SkillsFuture with Ms Anita – a movement to boost skill levels Fam, who chairs CAREGIVERS and promote lifelong learning – the 22-member Greater inclusiveness for people new modules will be developed for committee for with disabilities and more support people with disabilities. the third for their caregivers. “Some of the employers have spe- Enabling These will be part of the focus of cific needs, therefore we develop Masterplan. the third Enabling Masterplan – a specific training modules so that PHOTO: LIANHE blueprint to guide the development those with disabilities are trained ZAOBAO Recognition that caregivers play a critical role in 71 of policies, programmes, services and can move in quite seamlessly to and other support for those with dis- their jobs as well,” Mr Tan said. caring for persons with disabilities abilities. A 22-member committee The masterplan will build on the to develop the five-year plan was progress made by previous plans. announced yesterday by Minister This includes making more com- for Social and Family Develop- munity facilities and public trans- ment Tan Chuan-Jin at the Ena- port services more friendly for bling Village in Lengkok Bahru. those with disabilities, and improv- Chaired by Ms Anita Fam, a board ing their career prospects. member of the National Council of Social Service, it comprises people [email protected] from the public and private sectors, including people with disabilities and caregivers. They include Ms Chia Yong Yong, president of voluntary welfare organisation SPD, which supports people with disabilities, and Ms Denise Phua, president 02 ofthe AutismResource Centre. FOREWORD BY CHAIRPERSON The thirdmasterplan will look into a more seamless transition through stages in life – within the education system and towards employment – RD for people with disabilities. It will 3 ENABLING MASTERPLAN 04 alsolookinto supportfor caregivers. “Even if you help with employment, that makes a lot of difference (to families),” said Mr Tan. Individu- STEERING COMMITTEE als may be left without a job after completing school, leaving families “stretched”, he added. Ms Fam believes more can be done to ensure caregivers know of EXECUTIVE SUMMARY 10 the avenues of help available, by having resources that are more easi- “We have made significant progress ly obtainable. There is also a need to alleviate their worry that no one will be around to care for their loved ones INTRODUCTION 14 if they are no longer around. over the last few years under the current Mr Keh Eng Song, chief executive officer of the Movement for the In- BUILDING THE tellectually Disabled Singapore, said: “Caregiver support will be in- Enabling Masterplan. We should build on creasingly important because we want them to be empowered, and not be dependent on service provid- COMMUNITY ers all the time.” this momentum and develop a new Mr Tan also reiterated the need to incorporate national policies and schemes, such as SkillsFuture and Smart Nation, into the new plan. and bolder roadmap. Capacity and capability building of the 95 disability sector Panel members The goal is to build a more inclusive Ms Anita Fam (chairman), Technology is made a priority to improve the 104 board member, National Council of Social Service; Mr quality of life of persons with disabilities Abdul Majeed Abdul Khader, director, senior consultant Singapore where more persons with psychologist, Singapore Police Force; Mr Andrew Buay, vice- president, group corporate social responsibility, Singtel; disabilities can realise their potential and Mr Ang Wei Neng, senior vice-president, SBS Transit; Mr Ang Wei Tech, associate chair (research), School of become integral members of our society. All Mechanical and Aerospace IMPROVING THE Engineering, Nanyang Technological University; Mr Ardi S. Hardjoe, chief executive officer, Thye Hua Singaporeans have a role to play. Kwan Nursing Home; Ms Chia QUALITY OF LIFE Yong Yong, president, SPD; Mr Chong Kwek Bin, IT programme executive, I am confident that the committee, with its Singapore Association for the Visually Handicapped; Professor Chong Siow Ann, OF PERSONS WITH vice-chairman, medical board diverse expertise and experience, will come (research), senior consultant, Institute of Mental Health; Mr Daniel Tan, board member, Movement for the DISABILITIES Intellectually Disabled of up with exciting ideas.” Singapore; Ms Denise Phua, president, Autism Resource Centre; Mr Hao Chun T, programme manager; Mr Lam Yi Young, deputy BUILDING AN secretary, Ministry of Responsive and adaptable services throughout the 32 Education; Dr Lee Tung Jean, deputy secretary, Ministry of different life stages, to support and care for persons Social and Family Development; Mr — Minister for Social and Family Development, Mr Tan Chuan-Jin, April 2016, with disabilities INCLUSIVE Karthikeyan J.R., director, disability support, education st rd and development, family and 1 Public Consultation for 3 Enabling Masterplan at the Enabling Village caregiver support, AWWA; Timely and effective detection of disabilities 43 Ms Ku Geok Boon, CEO, SOCIETY SG Enable; Ms Margaret Heng, CEO, Shatec; Mr Raja Singh, founder and owner, Access to opportunities for development and 46 DNR Wheels; Ms Tan Ping Ling, deputy director, human quality education resource, NTUC FairPrice; Ms Teoh Zsin Woon, deputy secretary, Ministry of Health; Support and empower persons with 111 Ms Tina Hung, deputy CEO, Improved access to enhanced pathways for 52 National Council of Social disabilities to live within and participate Service; Dr Winnie Goh, employment and lifelong learning opportunities senior consultant, department actively in the community of paediatrics, neurology service, KK Women’s and Holistic and quality support across services 64 Children’s Hospital. 10 EXECUTIVE SUMMARY EXECUTIVE SUMMARY 11

EXECUTIVE SUMMARY

In April 2016, Minister for Social and Family Development, Mr Tan Chuan- Jin, announced the setting up of a Steering Committee to develop the 3rd The Steering Committee has drawn Enabling Masterplan. The Committee, up 20 recommendations based on led by Ms Anita Fam, comprised 22 nine strategic directions that support members from the people, public and efforts along the lines of these four private sectors, including persons with key thrusts: disabilities and caregivers. Key Thrust 1: The Enabling Masterplan is a roadmap Enabling Masterplan (2017– 2021) Improving the quality of life of for Singapore to build a more inclusive will build on the efforts of the past two persons with disabilities society where persons with disabilities Enabling Masterplans4. Its strategies The Steering Committee calls for the Key Thrust 2: are empowered and enabled to complement Singapore’s efforts to support and action of the community Supporting caregivers realise their true potential. The 3rd progressively realise her obligations at large, employers, the public under the United Nations Convention Key Thrust 3: sector, VWOs as well as persons with on the Rights of Persons with Building the community disabilities and their caregivers in Disabilities (UNCRPD) which Singapore enabling the realisation of the vision Key Thrust 4: ratified in 20135. for building a caring and truly inclusive Building an inclusive society society where persons with disabilities The Committee envisions Singapore to are able to realise their full potential be “a caring and inclusive society and participate fully as integral and where persons with disabilities are contributing members of our society. empowered to achieve their fullest potential and participate fully as integral and contributing members of society.“

4 First Enabling Masterplan (2007–2011); Second Enabling Masterplan (2012-2016)

5 https://app.msf.gov.sg/Press-Room/Singapore-Ratifies-UNCRPD 12 EXECUTIVE SUMMARY EXECUTIVE SUMMARY 13

Key Key Key Key Strategic Directions & Recommendations (R) Strategic Directions & Recommendations (R) Strategic Directions & Recommendations (R) Strategic Directions & Recommendations (R) Thrust Thrust Thrust Thrust Responsive and adaptable Responsive and adaptable 1 services throughout the different Timely and effective 1 services throughout the different Timely and effective 6 Recognition that caregivers play a critical role in 6 Recognition that caregivers play a critical role in life stages, to support and care 2 detection of disabilities life stages, to support and care 2 detection of disabilities caring for persons with disabilities caring for persons with disabilities for persons with disabilities for persons with disabilities

To improve caregivers’ To improve caregivers’ To develop ﬂexible service models To develop ﬂexible service models R R To support caregivers in their R R To support caregivers in their R R well-being and enhance their well-being and enhance their for persons with disabilities for persons with disabilities future care planning future care planning CAREGIVERS CAREGIVERS 1 1 SUPPORTING 13 caregiving capabilities 14 SUPPORTING 13 caregiving capabilities 14

R To meaningfully engage and support To ensure timely and effective R To meaningfully engage and support To ensure timely and effective persons with disabilities requiring R detection of developmental needs in persons with disabilities requiring R detection of developmental needs in 2 care to be as independent as possible children by enhancing the existing 2 care to be as independent as possible children by enhancing the existing 7 Capacity and capability building of the disability sector 7 Capacity and capability building of the disability sector 4 network of touchpoints 4 network of touchpoints R R To improve transition management To improve transition management 3 3 To build the capacity and To build the capacity and R capability of disability R capability of disability 15 service providers to To improve data 15 service providers to To improve data Access to opportunities Improved access to enhanced Access to opportunities Improved access to enhanced enhance service quality collection and analytics to enhance service quality collection and analytics to 3 for development and 4 pathways for employment and 3 for development and 4 pathways for employment and R enable better navigation, R enable better navigation, quality education lifelong learning opportunities quality education lifelong learning opportunities 17 coordination and 17 coordination and To mobilise volunteers to planning of services for To mobilise volunteers to planning of services for persons with disabilities persons with disabilities To develop and enhance vocational To develop and enhance vocational R support and promote R support and promote To ensure access to R preparation pathways to better cater To ensure access to R preparation pathways to better cater 16 inclusiveness of persons with 16 inclusiveness of persons with quality education in to persons with disabilities with quality education in to persons with disabilities with disabilities in the community disabilities in the community COMMUNITY COMMUNITY mainstream or 7 mainstream or 7 BUILDING THE BUILDING THE R diverse support needs R diverse support needs government-funded government-funded 5 SPED schools through 5 SPED schools through To develop a spectrum of open, To develop a spectrum of open, the Compulsory the Compulsory Technology is made a priority to improve Technology is made a priority to improve Education Act R supported and customised Education Act R supported and customised 8 8 employment models to provide more employment models to provide more the quality of life of persons with disabilities the quality of life of persons with disabilities 8 pathways to employment 8 pathways to employment

To enhance To strengthen efforts to provide To enhance To strengthen efforts to provide R R R R To include persons with disabilities in the Smart Nation initiative To include persons with disabilities in the Smart Nation initiative integration and lifelong learning opportunities for integration and lifelong learning opportunities for 18 18 R inclusion of children 9 persons with disabilities R inclusion of children 9 persons with disabilities 6 with special needs 6 with special needs within the context of To scale up efforts to build employers’ within the context of To scale up efforts to build employers’ R R Support and empower persons with disabilities to Support and empower persons with disabilities to our education system capabilities in hiring and managing our education system capabilities in hiring and managing 9 9 10 employees with disabilities 10 employees with disabilities live within and participate actively in the community live within and participate actively in the community

Holistic and quality support across services Holistic and quality support across services IMPROVING THE QUALITY OF LIFE PERSONS WITH DISABILITIES THE QUALITY IMPROVING 5 OF LIFE PERSONS WITH DISABILITIES THE QUALITY IMPROVING 5 To build positive attitudes To build positive attitudes towards persons with towards persons with To synergise partnerships within To synergise partnerships within R R To include persons with disabilities R R To include persons with disabilities disabilities and improve disabilities and improve and across health, education To study the need for the and across health, education To study the need for the in all settings in all settings

R R R R BUILDING AN BUILDING AN and social service to better establishment of a and social service to better establishment of a 19 knowledge on how to 20 19 knowledge on how to 20 11 support persons with disabilities 12 disability ofﬁce 11 support persons with disabilities 12 disability ofﬁce interact with them interact with them and their caregivers and their caregivers INCLUSIVE SOCIETY INCLUSIVE SOCIETY 14 INTRODUCTION INTRODUCTION 15

B. Growing number of persons with autism INTRODUCTION While the actual cause of autism is unknown, there is better awareness and DISABILITY TODAY detection. With a growing number of persons diagnosed with autism, our strategies must address the spectrum of needs (i.e. mild to severe). Three key identified trends affecting disability today are:

A. Increasing longevity of Singaporeans,Life Expectancy including persons at Birth with disabilities With medical advancements,Age (Years) many persons with disabilities will outlive their parents. Considerations100 have to be made to enable them to live independently.

90 Increase in Number of Children Diagnosed with Number of Working-Age Citizens Has Peaked Life Expectancy at Birth Developmental Issues 80 Age (Years) 100 Citizens Citizens 70 aged aged 65 90 Increase2010 in Number of Children Diagnosed with 2050 Number of Working-Age20-64 Citizens Has Peaked and older 60 Developmental Issues 80 50 Male 2014 +76% 4400 2010 : Female Citizens Citizens 70 aged aged 65 40 2010 2050 20-64 and 1.9Molder 220K 60 ASD Incidence amongst Children 30 Male 2015 : 50 2014 +76% 4400 2010 : 20 Female 40 in160 2.2M 440K 10 1.9M 220K ASD Incidence Worldamongst Health Children Organisation 30 2030 : 0 2015 : 1957 1970 1980 1990 2012 2013 2014 2015 20 1.9M 900K Data from 1980 onwards refer to the resident population. in160in 2.2M 440K 10 Data for 2015 are preliminary. 150 World Health OrganisationSingapore Number of Singapore’s working-age citizens has peaked. 2030 : 0 1957 1970 1980 1990 2012 2013 2014 2015 Modes of Consultation 1.9M 900K Data from 1980 onwards refer to the resident population. Sources: KK Women’s and Children’s Hospital, National University Hospital Data for 2015 are preliminary. in150 Singapore Source: Singapore Department of Statistics Number of Singapore’s working-age citizens has peaked.

Modes of Consultation Consultations Focus Group Ecosystem for Persons with Disabilities • Financial resources • Freedom, physical safety and security with Relevant Discussions • Health and social care: accessibility and quality Agencies (FGDs) • Home environment • Opportunities for acquiring new information and skills aregivers • Participation in and opportunities for Consultations Focus Group Ecosystem for Persons withC Disabilities • Financial resources recreation/leisure P • Freedom, physical safety and security s u • Physical environment with Relevant Discussions O b • Health and social care:(pollution/noise/tra c/climate) accessibility Environment and quality • Transport li Agencies (FGDs) W c • Home environment V • Opportunities for acquiring new Environment Personal Physical information and skills Public beliefs health • Energy and fatigue giv • Personal beliefs Persons • Participation in and opportunities for are er • Pain and discomfort C s recreation/leisure Consultations Personal P Physical with • Sleep and rest s beliefs u health Disabilities • Physical environment (Apr-Jul 2016) O b Level of (pollution/noise/tra c/climate)Psychological Persons l Environmentindependence • Transport W ic V with Environment Personal Physical

Disabilities beliefs health Public • Personal beliefs Social • Energy and fatigue Level of Persons relationships • Pain and discomfort independence Psychological Consultations Personal Physical with • Sleep and rest beliefs health Disabilities (Apr-Jul 2016) Level of Psychological Persons independence Social • Body image and appearance with s • Mobility G relationships r • Activities of daily living • Negative feelings Disabilities e VWO - Public o • Dependence on Social • Positive feelings y • Self-esteem Level of v medicinal substancesrelationships • Personal relationships organised Email Psychological o • Thinking, learning, memory independencee l and medical aids • Social support rn p • Work capacity and concentration FGDs Account m m • Sexual activity e E Socialn • Body image and appearance t s • Mobility G relationships r • Activities of daily living • Negative feelings VWO - Public o e • Dependence on • Positive feelings y • Self-esteem v medicinal substances • Personal relationships organised Email o • Thinking, learning, memory e l and medical aids • Social support rn p • Work capacity and concentration FGDs Account Enablersm Systems Inclusivem Mindsets Technology • Sexual activity e E nt

Enablers Systems Inclusive Mindsets Technology

Life Course Strategic Directions Impacting Quality of Life Early detection network

Early Intervention (0 - 6 yrs) Timely and effective detection Family/ Primary Community of disabilities caregivers Care Agencies Partners

Life Course Strategic Directions Impacting Environment Quality of Life Early detection network Education (7 - 18 yrs) Early Intervention (0Access - 6 yrs) to opportunities Personal Physical Holistic Timely and effective fordetection development and beliefs health quality education and Family/ Primary Community of disabilities Persons quality caregivers Care Agencies Partners with support Environment Disabilities Employment (+18 yrs) across Education (7 - 18 yrs) Level of Improved access to enhanced services Psychological Access to opportunities independence Ecosystem for pathways for employment and Personal Physical for development and Holistic Persons with Disabilities lifelong learning opportunities beliefs health quality education and Social Persons Persons with quality relationships Adult Care (+18 yrs) with disabilities are support No. of persons with disabilities served in 2012 and 2015 supported and Employment (+18 yrs)Responsive and adaptable Disabilities across Level of empowered to live Improved access to enhancedservices throughout the different Psychological aregiver Inclusive services independence Ecosystem for C s within and participate pathways for employmentlife stages, and to support and care P Mindset actively in the Early Intervention s u lifelong learning opportunitiesfor persons with disabilities Persons withO Disabilities Programme for b community Social li Infants and Children W c Persons with relationships V Adult Care (+18 yrs) Environment disabilities are

No. of persons with disabilitiesDevelopment served in 2012 and 2015 supported and Responsive and adaptable Support services throughout the different empowered to live Programme aregPersonaliver PhysicalInclusive C s within and participate life stages, to support and care beliefs P health actively in the Early Intervention s Personsu Mindset for persons with disabilities Adult Disability O b Programme for with community Homes li Infants and Children W Disabilities c V EnvironmentLevel of Development independence Psychological Day Activity Support Centres Programme Personal PhysicalSocial beliefs health s G Persons relationships r e Adult Disability o with y v Homes Disabilitiese lo Level of rn p m Psychological m independence e E Day Activity nt Centres 2500 Social s G relationships r e Family/ o y v Caregivers e lo rn p m m e E nt 2500

Family/ Caregivers Early 1900 1200 Detection Network

Community Primary Care 200 Early 1900 1200 850 PartnersDetection Agencies Network 700

Community Primary Care 200 850 1200 Partners Agencies 950 700

2012 2015 1200 950

2012 2015 Key Achievements under the past Masterplans

Early Intervention

0 - 6 yrs EIPIC DSP 1200 Desired Ecosystem for Key Achievements• Medishield under the Life past offers Masterplans better protection and Persons with Disabilities higher payouts to all, including to those with 200 The introduction of foreign domestic worker levy concessions pre-existing conditions 2500 1900 and grants, and caregiver training grant Early Intervention• Higher subsidies for the Early Intervention Strategic 0 - 6 yrs Programme for Infants and Children (EIPIC) Direction egi EIPIC 2012 2015 8 Car vers 1200 • Subsidies extended to cover more familiesDSP Building the capacity Desired Ecosystems for P • Medishield Life offers better protection and O u and capability of the b Persons withW Disabilities l higher payouts to all, including to those with 200 disability sector i V Environment c pre-existing conditions 2500 The introduction of foreign domestic worker levy concessions Systems 1900 and grants, and caregiver training grant • Higher subsidies for the Early Intervention Home-Based Care Services and Drop-in Disability Programme Strategic Personal Physical Programme for Infants and Children (EIPIC) Direction giBeliefs Health 2012 2015 for more ﬂexible care services and respite care options 8 Care vers Person • Subsidies extended to cover more families Building the capacity s P O withu Education and capability of the disabilitiesb W l disability sector Level of i 7 - 18 yrs V Environment c independence Psychological

Systems • Inclusion of children with special needs into the Compulsory Home-Based Care Services and Drop-in Disability Programme Personal Physical Education Act from 2019 Strategic Social s Beliefs G Health r for more flexible care services and respite care options Direction relationships e The establishment of the Special Needs Trust Company 9 o Person • Better support for children with special needs in mainstream schools v y ewith lo designated to assist caregivers in providing financial security Using technology to r Education • Improved quality of education in SPED schools by building teacher disabilitiesn p for persons with disabilities improve the quality Level of m m 7 - 18 yrs capability and a quality curriculum E of life of persons independence enPsychological with disabilities t • Inclusion of children with special needs into the Compulsory Education Act from 2019 Strategic Social s Direction G r The establishment of the Special Needs Trust Company 9 o relationships e • Better support for children with special needs in mainstream schools v y o designated to assist caregivers in providing financial security Using technology to e l • Improved quality of education in SPED schools by building teacher The streamlining of admission and screening processes for rn p for persons with disabilities improve the quality m m capability andEmployment a quality curriculum 7600 EIPIC and SPED schools for more efficient placement of of life of persons e E n + 18 yrs children and to reduce anxiety of caregivers with disabilities t 4800 • Increased accessibility to employment services • More support, training The streamlining of admission and screening processes for 650 opportunities 7600 140 EIPIC and SPED schools for more efficient placement of Employment + 18 yrs • Increased employability WORKFARE SPECIAL JOB OPEN DOOR children and toImproving reduce anxiety access of to caregivers information and services for persons with ** and employment 4800 INCOME EMPLOYMENT PLACEMENT PROGRAMME disabilities and caregivers through SG Enable • Increased accessibility SUPPLEMENT* CREDIT* AND options SUPPORT** to employment services Persons with Employers * Since 2012 disabilities ** Since 2014 Training Hub Practice Hub • More support, training 650 Provides Training Promotes the transfer of opportunities 140

Improving access to information and services for persons with Programmes Learning to Practice via • Increased employability WORKFARE SPECIAL JOB OPEN DOOR The establishment of the Tote Board-Enabling Lives Initiative and employment INCOME EMPLOYMENT PLACEMENT PROGRAMME** disabilities and caregivers through SG Enable Communities of Practice SUPPLEMENT* CREDIT* AND Grant which encourages ground-up initiatives by funding new options NEWSUPPORT** NEW

service models or scaling up successful pilots, including those Persons with EmployersDrop-In Disability Day * ActivitySince 2012 Home-Based Care Adult Care disabilities ** Since 2014 supporting caregivers Training Hub Practice Hub + 18 yrs Programme Centre Services Pilot Provides Training Promotes the transfer of Programmes Learning to Practice via • More care options Community-Based Facilities Residential Facilities The establishment of the Tote Board-Enabling Lives Initiative Career Centre CommunitiesResource of Practice Hub for adults with Grant which encourages ground-up initiatives by funding new disabilities Community Adult Disability Adult Disability Provides career and Encourages the sharing and NEW Group Home HostelsNEW Homes service models or scaling up successful pilots, including those Adult Care Drop-In Disability Day Activity Home-Based Care supporting caregivers skills upgrading dissemination of knowledge + 18 yrs Programme Centre Services Pilot advisory services and best practices for the sector • More care options Community-Based Facilities Residential Facilities for adults with Career Centre Resource Hub disabilities Community Adult Disability Adult Disability Provides career and Encourages the sharing and Group Home Hostels Homes skills upgrading dissemination of knowledge advisory services and best practices for the sector

Colour schemes for :

Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Colour schemes for :

Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 16 INTRODUCTION INTRODUCTION 17

C. An ageing population The current disability landscape will Parents who are caregivers are ageing and find it difficult to care for their own need to prepare itself for changes children with disabilities. With a declining natural population, families are getting that arise from growing trends. smaller and there will be less familial support for persons with disabilities. First, persons with disabilities are living longer and it is critical for us to enable them to live independently as they age. Secondly, the number Life Expectancy at Birth Age (Years) of persons diagnosed with autism 100 is growing and services to support this group need to be enhanced. ATTITUDES OF SINGAPOREANS 90 Increase in Number of Children Diagnosed with Number of Working-Age Citizens Has Peaked Thirdly, as the population ages and TOWARDS PERSONS WITH Developmental Issues 80 family size shrinks, ageing caregivers DISABILITIES Citizens Citizens will find it harder to take care of their 70 aged aged 65 grown-up children and themselves. Findings from studies conducted by 2010 2050 20-64 and older Our support for older persons in the National Council of Social Service 60 caregiving roles has to expand. Our (NCSS)6 and Lien Foundation7 on the Male support and strategies must also attitudes of Singaporeans towards 50 2014 +76% 4400 2010 : Female evolve to meet the needs of persons persons with disabilities revealed 40 1.9M 220K across a spectrum of disabilities. that Singaporeans were still unsure ASD Incidence amongst Children about interaction etiquette. It was cited 30 2015 : that many employers were unwilling to employ persons with disabilities. 20 in160 2.2M 440K Societal attitudes have to evolve too. 10 World Health Organisation Persons with disabilities and their 2030 : families felt that more support can 0 1957 1970 1980 1990 2012 2013 2014 2015 be provided to help persons with disabilities integrate into society and Data from 1980 onwards refer to the resident population. 1.9M 900K Data for 2015 are preliminary. in150 participate in social activities. Singapore Number of Singapore’s working-age citizens has peaked. Source: National Population and Talent Division

Modes of Consultation 6 In 2015, NCSS conducted a study of close to 1,000 persons with disabilities and 1,400 members of the general public on their attitudes towards disability.

7 In May 2016, Lien Foundation released findings from its Inclusive Attitudes Survey, which examined the views and attitudes of Singaporeans towards children with special needs. It had surveyed over 1,000 members of the public and 835 parents of children with special needs. Please visit: http://www.todayonline.com/singapore/survey-finds-conflicting-attitudes-towards-children-special-needs

Consultations Focus Group Ecosystem for Persons with Disabilities • Financial resources • Freedom, physical safety and security with Relevant Discussions • Health and social care: accessibility and quality Agencies (FGDs) • Home environment • Opportunities for acquiring new information and skills regive • Participation in and opportunities for Ca rs P recreation/leisure s u • Physical environment O b (pollution/noise/tra c/climate) l Environment • Transport W ic V Environment Personal Physical

Public beliefs health • Energy and fatigue • Personal beliefs Persons • Pain and discomfort Consultations Personal Physical with • Sleep and rest beliefs health Disabilities (Apr-Jul 2016) Level of Psychological Persons independence with Disabilities Social Level of relationships independence Psychological

Social • Body image and appearance s • Mobility G relationships r • Activities of daily living • Negative feelings VWO - Public o e • Dependence on • Positive feelings y • Self-esteem v medicinal substances • Personal relationships organised Email o • Thinking, learning, memory e l and medical aids • Social support rn p • Work capacity and concentration FGDs Account m m • Sexual activity e E nt

Enablers Systems Inclusive Mindsets Technology

Life Course Strategic Directions Impacting Quality of Life Early detection network

Early Intervention (0 - 6 yrs) Timely and effective detection Family/ Primary Community of disabilities caregivers Care Agencies Partners

Environment Education (7 - 18 yrs) Access to opportunities Personal Physical Holistic for development and beliefs health quality education and Persons quality with support Employment (+18 yrs) Disabilities across Level of Improved access to enhanced Psychological services independence Ecosystem for pathways for employment and Persons with Disabilities lifelong learning opportunities Social Persons with relationships Adult Care (+18 yrs) disabilities are No. of persons with disabilities served in 2012 and 2015 supported and Responsive and adaptable empowered to live services throughout the different aregiver Inclusive C s within and participate life stages, to support and care P Early Intervention s u Mindset actively in the for persons with disabilities O b community Programme for l W ic Infants and Children V Environment

Development Support Programme Personal Physical beliefs health Persons Adult Disability with Homes Disabilities Level of independence Psychological Day Activity Centres Social s G relationships r e o y v e lo rn p m m e E nt 2500

Family/ Caregivers

Early 1900 1200 Detection Network

Community Primary Care 200 Partners Agencies 850 700

1200 950

2012 2015

Key Achievements under the past Masterplans

Early Intervention

0 - 6 yrs EIPIC DSP 1200 Desired Ecosystem for • Medishield Life offers better protection and Persons with Disabilities higher payouts to all, including to those with 200 The introduction of foreign domestic worker levy concessions pre-existing conditions 2500 1900 and grants, and caregiver training grant • Higher subsidies for the Early Intervention Strategic Programme for Infants and Children (EIPIC) Direction gi 2012 2015 8 Care vers • Subsidies extended to cover more families Building the capacity s P O u and capability of the b W l disability sector i V Environment c

Systems

Home-Based Care Services and Drop-in Disability Programme Personal Physical for more ﬂexible care services and respite care options Beliefs Health Person with Education disabilities Level of 7 - 18 yrs independence Psychological • Inclusion of children with special needs into the Compulsory Education Act from 2019 Strategic Social s Direction G r The establishment of the Special Needs Trust Company 9 o relationships e • Better support for children with special needs in mainstream schools v y o designated to assist caregivers in providing ﬁnancial security Using technology to e l • Improved quality of education in SPED schools by building teacher rn p for persons with disabilities improve the quality m m capability and a quality curriculum of life of persons e E with disabilities nt

The streamlining of admission and screening processes for 7600 EIPIC and SPED schools for more efﬁcient placement of Employment + 18 yrs children and to reduce anxiety of caregivers 4800 • Increased accessibility to employment services

• More support, training 650 opportunities 140

Improving access to information and services for persons with • Increased employability WORKFARE SPECIAL JOB OPEN DOOR and employment INCOME EMPLOYMENT PLACEMENT PROGRAMME** disabilities and caregivers through SG Enable SUPPLEMENT* CREDIT* AND options SUPPORT** Persons with Employers * Since 2012 Training Hub Practice Hub disabilities ** Since 2014 Provides Training Promotes the transfer of Programmes Learning to Practice via The establishment of the Tote Board-Enabling Lives Initiative Communities of Practice Grant which encourages ground-up initiatives by funding new NEW NEW service models or scaling up successful pilots, including those Adult Care Drop-In Disability Day Activity Home-Based Care supporting caregivers + 18 yrs Programme Centre Services Pilot

• More care options Community-Based Facilities Residential Facilities for adults with Career Centre Resource Hub disabilities Community Adult Disability Adult Disability Provides career and Encourages the sharing and Group Home Hostels Homes skills upgrading dissemination of knowledge advisory services and best practices for the sector

Colour schemes for :

Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Life Expectancy at Birth Age (Years) 100

90 Increase in Number of Children Diagnosed with Number of Working-Age Citizens Has Peaked Developmental Issues Life Expectancy at Birth 80 Age (Years) 100 Citizens Citizens 70 aged aged 65 90 Increase in Number of Children Diagnosed with Number of Working-Age Citizens Has Peaked 2010 2050 20-64 and older Developmental Issues 60 80 Citizens Citizens 70 aged aged 65 50 Male 2014 +76% 4400 2010 : 2010 2050 20-64 and older Female 60 40 1.9M 220K 50 Male 2014 +76% 4400 2010 : ASD Incidence amongst Children Female 30 40 2015 : 1.9M 220K ASD Incidence amongst Children 20 30 2015 : in160 2.2M 440K 20 10 18 19 World Health Organisation INTRODUCTION INTRODUCTION in160 2.2M 440K 2030 : 10 World Health Organisation 0 2030 : 1957 1970 1980 1990 2012 2013 2014 2015 0 1957 1970 1980 1990 2012 2013 2014 2015 1.9M 900K Data from 1980 onwards refer to the resident population. Data from 1980 onwards refer to the resident population. 1.9M 900K Data for 2015 are preliminary. in150 Data for 2015 are preliminary. in150 WORLD HEALTH ORGANISATION QUALITY OF LIFE (WHOQOL) PEOPLE WE SPOKE TO Singapore Number of Singapore’s working-age citizens has peaked. Singapore Number of Singapore’s working-age citizens has peaked. FRAMEWORK

Modes of Consultation Modes of Consultation The WHOQOL is a quality of life assessment developed by the World Health Organisation (WHO). The study examines the quality of life of a person Consultations Focus Group Ecosystem for Persons with Disabilities • Financial resources across six domains. • Freedom, physical safety and security with Relevant Discussions • Health and social care: accessibility and quality Consultations Focus Group Ecosystem for Persons with Disabilities • Financial resources Agencies (FGDs) • Home environment • Freedom, physical safety and security • Opportunities for acquiring new • Health and social care: accessibility information and skills with Relevant Discussions gi • Participation in and opportunities for and quality are vers C recreation/leisure • Home environment P Agencies (FGDs) s u • Physical environment • Opportunities for acquiring new O b (pollution/noise/tra c/climate) Environment information and skills l • Transport W ic giv • Participation in and opportunities for V re e Environment Personal Physical a rs C recreation/leisure beliefs health Public • Personal beliefs • Energy and fatigue P Persons s u • Physical environment • Pain and discomfort (pollution/noise/tra c/climate) Consultations Personal Physical with • Sleep and rest O b beliefs health Environment • Transport Disabilities W li (Apr-Jul 2016) Level of Psychological c Persons independence V Environment Personal Physical with

Public beliefs health • Energy and fatigue Disabilities • Personal beliefs Persons Social • Pain and discomfort Level of relationships independence Psychological Consultations Personal Physical with • Sleep and rest beliefs health Disabilities (Apr-Jul 2016) Level of Psychological Persons independence Social • Body image and appearance s • Mobility with G relationships r • Activities of daily living • Negative feelings VWO - Public o e • Dependence on • Positive feelings y • Self-esteem Disabilities v medicinal substances • Personal relationships Social organised Email e lo • Thinking, learning, memory Level of and medical aids • Social support relationships rn p • Work capacity and concentration independence Psychological FGDs Account m m • Sexual activity e E nt

Social • Body image and appearance s • Mobility G relationships r • Activities of daily living • Negative feelings VWO - Public o e • Dependence on • Positive feelings Enablers Systems Inclusive Mindsets Technology y • Self-esteem v medicinal substances • Personal relationships organised Email o • Thinking, learning, memory e l and medical aids • Social support rn p • Work capacity and concentration FGDs Account m • Sexual activity m E “It was great sharing our ideas and inputs. The focus was very en t much on the reality of life and the challenges for a person with In 2015, the NCSS conducted a Quality of Life Study using the WHOQOL special needs.” assessment to better understand the needs of vulnerable adults, including Enablers Systems Inclusive Mindsets Technology persons with disabilities. 1,000 persons with disabilities aged 18 and above were — Participant of Focus Group Discussion, Life Course Strategic Directions Impacting surveyed. Findings of the study revealed that persons with disabilities want to be 3 April 2016 Quality of Life Early detection network

enabled to live independently, access information and relevant services easily, Early Intervention (0 - 6 yrs) receive social support and have the confidence to participate in society. Timely and effective detection Family/ Primary Community of disabilities caregivers Care Agencies Partners

Environment Education (7 - 18 yrs) Access to opportunities Personal Physical Holistic for development and beliefs health quality education and Persons quality with support Employment (+18 yrs) Disabilities across Level of Improved access to enhanced Psychological Life Course Strategic Directions Impacting services independence Ecosystem for pathways for employment and Quality of Life Early detection network Persons with Disabilities lifelong learning opportunities Social Early Intervention (0 - 6 yrs) Persons with relationships disabilities are Adult Care (+18 yrs) Timely and effective detection No. of persons with disabilities served in 2012 and 2015 Family/ Primary Community supported and Responsive and adaptable of disabilities empowered to live services throughout the different caregivers Care Agencies Partners aregiver Inclusive C s within and participate life stages, to support and care P Early Intervention s u Mindset actively in the for persons with disabilities Environment O b community Programme for l W ic Infants and Children Education (7 - 18 yrs) V Environment

Access to opportunities Development Personal Physical Support Holistic for development and beliefs health Programme quality education and Personal Physical Persons beliefs health quality Persons Adult Disability with with Homes support Disabilities Disabilities Employment (+18 yrs) across Level of Level of independence Psychological Day Activity Improved access to enhanced Psychological services independence Centres Ecosystem for pathways for employment and Social s lifelong learning opportunities G relationships r Persons with Disabilities e Social o y v o Persons with relationships e l Adult Care (+18 yrs) rn p disabilities are m m Responsive and adaptable No. of persons with disabilities served in 2012 and 2015 e E supported and nt 2500 empowered to live services throughout the different aregiver Inclusive C s within and participate life stages, to support and care Family/ P Early Intervention s u Mindset actively in the for persons with disabilities Caregivers O b community Programme for l W ic Infants and Children V Environment

Development Support Programme Personal Physical beliefs health Early Persons Adult Disability 1900 1200 with Homes Detection Disabilities Network Level of independence Psychological Day Activity Centres Community Primary Care 200 Social Partners Agencies 850 s G relationships r e 700 o y v e lo rn p m m E en 1200 t 2500 950

Family/ Caregivers 2012 2015

Key Achievements under the past Masterplans

Early 1900 1200 Detection Early Intervention 0 - 6 yrs EIPIC Network DSP 1200 Desired Ecosystem for • Medishield Life offers better protection and Persons with Disabilities higher payouts to all, including to those with 200 The introduction of foreign domestic worker levy concessions pre-existing conditions 2500 1900 and grants, and caregiver training grant • Higher subsidies for the Early Intervention Community Primary Care 200 Strategic Programme for Infants and Children (EIPIC) 850 Direction gi 2012 2015 Partners Agencies 8 Care vers • Subsidies extended to cover more families Building the capacity s P O u and capability of the b 700 W l disability sector i V Environment c

Systems

Home-Based Care Services and Drop-in Disability Programme Personal Physical for more ﬂexible care services and respite care options Beliefs Health Person 1200 with Education disabilities 950 Level of 7 - 18 yrs independence Psychological • Inclusion of children with special needs into the Compulsory Education Act from 2019 Strategic Social s Direction G r The establishment of the Special Needs Trust Company 9 o relationships e • Better support for children with special needs in mainstream schools v y 2012 2015 o designated to assist caregivers in providing ﬁnancial security Using technology to e l • Improved quality of education in SPED schools by building teacher rn p for persons with disabilities improve the quality m m capability and a quality curriculum of life of persons e E with disabilities nt

The streamlining of admission and screening processes for 7600 EIPIC and SPED schools for more efﬁcient placement of Employment Key Achievements under the past Masterplans + 18 yrs children and to reduce anxiety of caregivers 4800 • Increased accessibility to employment services

Early Intervention • More support, training 650 0 - 6 yrs EIPIC opportunities 140 DSP 1200 Improving access to information and services for persons with • Increased employability WORKFARE SPECIAL JOB OPEN DOOR Desired Ecosystem for • Medishield Life offers better protection and and employment INCOME EMPLOYMENT PLACEMENT PROGRAMME** disabilities and caregivers through SG Enable SUPPLEMENT* CREDIT* AND Persons with Disabilities higher payouts to all, including to those with 200 options SUPPORT** Persons with Employers * Since 2012 pre-existing conditions The introduction of foreign domestic worker levy concessions 2500 Training Hub Practice Hub disabilities ** Since 2014 1900 and grants, and caregiver training grant • Higher subsidies for the Early Intervention Provides Training Promotes the transfer of Strategic Programme for Infants and Children (EIPIC) Programmes Learning to Practice via Direction gi 2012 2015 The establishment of the Tote Board-Enabling Lives Initiative 8 Care vers Communities of Practice • Subsidies extended to cover more families Grant which encourages ground-up initiatives by funding new Building the capacity s P NEW NEW O u service models or scaling up successful pilots, including those and capability of the b Adult Care Drop-In Disability Day Activity Home-Based Care W l supporting caregivers Programme Centre Services Pilot disability sector i + 18 yrs V Environment c

Systems • More care options Community-Based Facilities Residential Facilities for adults with Home-Based Care Services and Drop-in Disability Programme Personal Physical Career Centre Resource Hub disabilities Community Adult Disability Adult Disability for more ﬂexible care services and respite care options Beliefs Health Provides career and Encourages the sharing and Group Home Hostels Homes Person skills upgrading dissemination of knowledge with Education disabilities advisory services and best practices for the sector Level of 7 - 18 yrs independence Psychological • Inclusion of children with special needs into the Compulsory Education Act from 2019 Strategic Social s Direction G r The establishment of the Special Needs Trust Company 9 o relationships e • Better support for children with special needs in mainstream schools v y o designated to assist caregivers in providing ﬁnancial security Using technology to e l • Improved quality of education in SPED schools by building teacher rn p for persons with disabilities improve the quality m m capability and a quality curriculum of life of persons e E with disabilities nt

• More support, training 650 opportunities 140 Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Improving access to information and services for persons with • Increased employability WORKFARE SPECIAL JOB OPEN DOOR and employment INCOME EMPLOYMENT PLACEMENT PROGRAMME** disabilities and caregivers through SG Enable SUPPLEMENT* CREDIT* AND options SUPPORT** Persons with Employers * Since 2012 Training Hub Practice Hub disabilities ** Since 2014 Provides Training Promotes the transfer of Programmes Learning to Practice via The establishment of the Tote Board-Enabling Lives Initiative Communities of Practice Grant which encourages ground-up initiatives by funding new NEW NEW service models or scaling up successful pilots, including those Adult Care Drop-In Disability Day Activity Home-Based Care supporting caregivers + 18 yrs Programme Centre Services Pilot

Colour schemes for :

Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Life Expectancy at Birth Age (Years) 100

90 Increase in Number of Children Diagnosed with Number of Working-Age Citizens Has Peaked Developmental Issues 80 Citizens Citizens 70 aged aged 65 2010 2050 20-64 and older 60

50 Male 2014 +76% 4400 2010 : Female 40 1.9M 220K ASD Incidence amongst Children 30 2015 : 20 in160 2.2M 440K 10 World Health Organisation 2030 : 0 20 1957 1970INTRODUCTION1980 1990 2012 2013 2014 2015 INTRODUCTION 21 Data from 1980 onwards refer to the resident population. 1.9M 900K Data for 2015 are preliminary. in150 Singapore Number of Singapore’s working-age citizens has peaked.

A series of consultation sessions and was also made available to members The feedback and ideas gathered at the FGD sessions provided useful insights focus group discussions (FGDs) wereModes of of the Consultation public to allow them to provide for the Committee members and were fed into the recommendations and organised for persons with disabilities, feedback at any time, outside strategies of the 3rd Enabling Masterplan. caregivers, VWOs and employers to of the FGDs. share their aspirations, feedback and ideas for the 3rd Enabling Masterplan. More than 400 participants gave their views and feedback through the various VWOs and disability-relatedConsultations Focus Group Ecosystem for Persons with Disabilities • Financial resources channels. The sessions were organised • Freedom, physical safety and security organisations were also encouragedwith Relevant Discussions • Health and social care: accessibility to conduct their own FGDs and as part of the SGfuture8 consultation and quality Agencies (FGDs) • Home environment consultation sessions to share their exercise, to help Singaporeans envision • Opportunities for acquiring new information and skills thoughts with the Steering Committee. a more caring and inclusive society. regive • Participation in and opportunities for Ca rs P recreation/leisure An email feedback channel s u • Physical environment O b (pollution/noise/tra c/climate) ([email protected]) l Environment • Transport W ic V Environment Personal Physical

Enablers Systems Inclusive Mindsets Technology

Source: Facebook, Tan Chuan-Jin

8 SGfuture is a series of public engagement sessions aimed at encouraging Singaporeans to share their views about the future and turn them into reality. Please visit: https://www.sg/sgfuture

Life Course Strategic Directions Impacting Quality of Life Early detection network

Early Intervention (0 - 6 yrs) Timely and effective detection Family/ Primary Community of disabilities caregivers Care Agencies Partners

Family/ Caregivers

Early 1900 1200 Detection Network

Community Primary Care 200 Partners Agencies 850 700

1200 950

2012 2015

Key Achievements under the past Masterplans

Early Intervention

Systems

• More support, training 650 opportunities 140

Colour schemes for :

Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 22 INTRODUCTION INTRODUCTION 23

Based on the key trends, concerns, feedback and opportunities identified within the ecosystem of persons with disabilities, the Steering Committee was of the view KEY THRUST 1: IMPROVING that efforts should focus around four key thrusts: THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES Vision: The first thrust focuses on improving the quality of life of persons with A caring and inclusive society where persons with disabilities are disabilities as they journey through the different life stages. The key strategic empowered to achieve their fullest potential and participate fully as directions and recommendations are as follows: integral and contributing members of society

Key Thrust 1: Key Thrust 2: Strategic RESPONSIVE AND ADAPTABLE SERVICES THROUGHOUT THE DIFFERENT LIFE STAGES, TO SUPPORT AND CARE Improving the quality of life of Supporting caregivers Direction 1 FOR PERSONS WITH DISABILITIES persons with disabilities

Each person’s needs are unique and their needs will evolve as they journey Key Thrust 3: Key Thrust 4: through their life. The Committee views that the key step towards improving Building the community Building an inclusive society the quality of life of persons with disabilities is to design services that are capable of meeting the varying needs across the spectrum of users in a holistic manner. Persons with disabilities and their caregivers will also benefit from improved transition management as they move across services. The Committee also drew up nine strategic directions and formulated 20 The recommendations are: recommendations to meet the outcomes envisaged in the 3rd Enabling Masterplan. Recommendation 1: To develop flexible service models for persons with disabilities.

FORMULATION OF RECOMMENDATIONS Recommendation 2: To meaningfully engage and support persons with disabilities requiring care to be as independent as possible. The recommendations made by the trends, concerns highlighted through Steering Committee in this report are ground feedback, and the interactions Recommendation 3: To improve transition management. intended to improve the quality of life with persons with disabilities and the (QOL) of persons with disabilities by sector. Evidence-based practices, impacting the QOL domains, and to coupled with international research focus on creating an ecosystem of and literature, provided guidance in support for persons with disabilities. formulating these recommendations. The process was guided by key 24 INTRODUCTION INTRODUCTION 25

Strategic TIMELY AND EFFECTIVE Strategic IMPROVED ACCESS TO ENHANCED DETECTION OF PATHWAYS FOR EMPLOYMENT AND Direction 2 DISABILITIES Direction 4 LIFELONG LEARNING OPPORTUNITIES

The Committee is of the view that the ability to identify children with Research has shown that persons with disabilities who are employed lead disabilities early is a key priority. Earlier detection of a child’s needs more fulfilling and enriching lives. The Committee is of the view that there is a coupled with appropriate timely intervention can help the child to develop need to expand employment opportunities and job support programmes, and competencies to maximise the child’s potential. provide better support to employers of persons with disabilities. In enabling persons with disabilities to remain employable and participate actively in the The recommendation is: workforce, there is also a need to look into efforts to support lifelong learning.

Recommendation 4: To ensure timely and effective detection of The recommendations are: developmental needs in children by enhancing the existing network of touchpoints. Recommendation 7: To develop and enhance vocational preparation pathways to better cater to persons with disabilities with diverse support needs. Strategic ACCESS TO OPPORTUNITIES FOR DEVELOPMENT AND Recommendation 8: To develop a spectrum of open, supported and Direction 3 QUALITY EDUCATION customised employment models to provide more pathways to employment.

Recommendation 9: To strengthen efforts to provide lifelong learning Education plays a significant role in helping persons with disabilities fulfil opportunities for persons with disabilities. their aspirations and potential by developing their abilities and strengths. Besides providing holistic educational support, the learning environment Recommendation 10: To scale up efforts to build employers’ should facilitate interaction and better understanding between persons with capabilities in hiring and managing employees with disabilities. disabilities and their peers to promote inclusiveness.

The recommendations are:

Recommendation 5: To ensure access to quality education in mainstream or government-funded SPED schools through the Compulsory Education Act.

Recommendation 6: To enhance integration and inclusion of children with special needs within the context of our education system. 26 INTRODUCTION INTRODUCTION 27

Strategic HOLISTIC AND with disabilities will experience better care, when we help caregivers to be QUALITY SUPPORT more effective in their caregiving and care planning roles. Direction 5 ACROSS SERVICES The recommendations are:

Recommendation 13: To improve caregivers’ well-being and enhance Steps should be taken to improve service coordination across the sectors, so their caregiving capabilities. that persons with disabilities can experience smoother and more seamless support for the services offered in the different sectors. Collaborations and Recommendation 14: To support caregivers in their future partnerships between adult disability and eldercare services should be care planning. promoted to reap economies of scale. This can be in the areas such as home care services and manpower training. The recommendations are: KEY THRUST 3: BUILDING THE Recommendation 11: To synergise partnerships within and across COMMUNITY health, education and social service to better support persons with disabilities and their caregivers. Strategic CAPACITY AND CAPABILITY BUILDING OF THE Recommendation 12: To study the need for the establishment of a Direction 7 DISABILITY SECTOR disability office.

An integrated system and structure to enable and empower the community to KEY THRUST 2: SUPPORTING better support persons with disabilities is key to building an inclusive society. It is crucial to invest in developing the capabilities of the disability sector so CAREGIVERS that services delivered to persons with disabilities are effective and of good The second thrust seeks to provide support to caregivers as they journey quality. The Committee is of the view that more can be done in building the through life caring for persons with disabilities. sector’s capacity and capability in supporting persons with disabilities and their caregivers. Data analytics and research should be adopted to support Strategic RECOGNITION THAT CAREGIVERS service planning and innovation in meeting the needs of persons PLAY A CRITICAL ROLE IN CARING with disabilities. Direction 6 FOR PERSONS WITH DISABILITIES

Caregivers are recognised as the main care coordinators for the persons with disabilities whom they are caring for, and are a crucial link between persons with disabilities and the community. The Committee is of the view that persons 28 INTRODUCTION INTRODUCTION 29

The recommendations are: KEY THRUST 4: BUILDING AN Recommendation 15: To build the capacity and capability of disability service providers to enhance service quality. INCLUSIVE SOCIETY Beyond persons with disabilities and caregivers, community involvement is the Recommendation 16: To mobilise volunteers to support and promote cornerstone for building an inclusive society. inclusiveness of persons with disabilities in the community.

Recommendation 17: To improve data collection and analytics to Strategic SUPPORT AND EMPOWER PERSONS enable better navigation, coordination and planning of services for WITH DISABILITIES TO LIVE WITHIN AND persons with disabilities. Direction 9 PARTICIPATE ACTIVELY IN THE COMMUNITY

Strategic TECHNOLOGY IS MADE A PRIORITY It is important for persons with disabilities to feel that they are part of society as TO IMPROVE THE QUALITY OF LIFE this builds their confidence and encourages them to step out to participate in Direction 8 OF PERSONS WITH DISABILITIES the community. The Committee hopes to see persons with disabilities participate actively in social and cultural activities, and for the needs of persons with disabilities to be taken into consideration whenever national Technology is recognised as an enabler that can help lower barriers faced by initiatives are being planned. persons with disabilities in their daily living, education, employment and communications. More resources should be channelled towards training on the The recommendations are: use of technological support for persons with disabilities. This will increase the Recommendation 19: To build positive attitudes towards persons with use of Assistive Technology (AT) and Information Technology (IT) by persons disabilities and improve knowledge on how to interact with them. with disabilities so that they can maximise their full potential and have a better quality of life. Recommendation 20: To include persons with disabilities in all settings. The recommendation is:

Recommendation 18: To include persons with disabilities in the Smart Nation initiative. Through the recommendations that have been drawn up for the 3rd Enabling Masterplan, the Committee hopes to enable persons with disabilities and their loved ones to lead more fulfilled lives and feel a greater sense of belonging in Singapore. Life Expectancy at Birth Age (Years) 100

90 Increase in Number of Children Diagnosed with Number of Working-Age Citizens Has Peaked Developmental Issues 80 Citizens Citizens 70 aged aged 65 2010 2050 20-64 and older 60

50 Male 2014 +76% 4400 2010 : Female 40 1.9M 220K ASD Incidence amongst Children 30 2015 : 20 in160 2.2M 440K 10 World Health Organisation 2030 : 0 1957 1970 1980 1990 2012 2013 2014 2015 Data from 1980 onwards refer to the resident population. 1.9M 900K Data for 2015 are preliminary. in150 Singapore Number of Singapore’s working-age citizens has peaked.

Modes of Consultation

Enablers Systems Inclusive Mindsets Technology Under the past two Enabling The 3rd Enabling Masterplan takes a Masterplans, significant progress has holistic and person-centred approach been made in identifying service gaps, to improve the quality of life for improving services, and making them persons with disabilities. It builds on accessible and affordable to persons the foundations laid by the previous with disabilities and their families. two Enabling Masterplans to address emerging needs and gaps.

Life Course Strategic Directions Impacting Quality of Life Early detection network

Early Intervention (0 - 6 yrs) Timely and effective detection Family/ Primary Community of disabilities caregivers Care Agencies Partners

Environment IMPROVING THE Education (7 - 18 yrs) Access to opportunities Personal Physical Holistic for development and beliefs health QUALITY OF LIFE quality education and Persons quality with support Employment (+18 yrs) Disabilities across Level of OF PERSONS WITH Improved access to enhanced Psychological services independence Ecosystem for pathways for employment and Persons with Disabilities lifelong learning opportunities DISABILITIES Social Persons with relationships Adult Care (+18 yrs) disabilities are No. of persons with disabilities served in 2012 and 2015 supported and Responsive and adaptable empowered to live services throughout the different aregiver Inclusive C s within and participate life stages, to support and care P Early Intervention s u Mindset actively in the for persons with disabilities O b community Programme for l W ic Infants and Children V Environment

Development A person-centred approach places Support Programme Personal Physical the person with disability at the centre beliefs health Persons of decision-making and services; and Adult Disability with Homes Disabilities examines the needs of that person in a Level of holistic manner. independence Psychological Day Activity Centres Social s G relationships r e o y v e lo rn p m m e E nt 2500

Family/ Caregivers

Early 1900 1200 Detection Network

Community Primary Care 200 Partners Agencies 850 700

1200 950

2012 2015

Key Achievements under the past Masterplans

Early Intervention

Systems

• More support, training 650 opportunities 140

Colour schemes for :

Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Life Expectancy at Birth Age (Years) 100

90 Increase in Number of Children Diagnosed with Number of Working-Age Citizens Has Peaked Developmental Issues 80 Citizens Citizens 70 aged aged 65 2010 2050 20-64 and older 60

Modes of Consultation

Enablers Systems Inclusive Mindsets Technology

Life Course Strategic Directions Impacting Quality of Life Early detection network

Early Intervention (0 - 6 yrs) Timely and effective detection Family/ Primary Community of disabilities caregivers Care Agencies Partners

Family/ Caregivers

Early 1900 1200 Detection Network

Community Primary Care 200 Partners Agencies 850 700

1200 950

32 33 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING2012 THE QUALITY OF LIFE OF PERSONS2015 WITH DISABILITIES

Strategic RESPONSIVE AND ADAPTABLE SERVICES THROUGHOUT Key Achievements under the past Masterplans THE DIFFERENT LIFE STAGES, TO SUPPORT AND CARE Direction 1 FOR PERSONS WITH DISABILITIES Early Intervention 0 - 6 yrs EIPIC DSP 1200 Desired Ecosystem for • Medishield Life offers better protection and Persons with Disabilities higher payouts to all, including to those with 200 The introduction of foreign domestic worker levy concessions pre-existing conditions 2500 1900 and grants, and caregiver training grant Each person’s needs are unique and • Higher subsidies for the Early Intervention Strategic Programme for Infants and Children (EIPIC) different. AsDirection a child grows and ages, his gi 2012 2015 8 Care vers • Subsidies extended to cover more families Building the capacity s P needs too will evolve. Services needO u and capability of the b W l disability sector i to be holistic, flexible and relevantV to Environment c

cater to the varying needsSystems of a person Home-Based Care Services and Drop-in Disability Programme Personal Physical for more flexible care services and respite care options with disability across his life course, Beliefs Health Person with Education so that a person with disability will disabilities Level of 7 - 18 yrs be appropriately supported as he independence Psychological • Inclusion of children with special needs into the Compulsory moves from one life stage to the next. Education Act from 2019 Strategic Social s Direction G r The establishment of the Special Needs Trust Company 9 o relationships e • Better support for children with special needs in mainstream schools In the past five years, improvementsv y o designated to assist caregivers in providing financial security Using technology to e l • Improved quality of education in SPED schools by building teacher have been made to the accessibility,rn p for persons with disabilities improve the quality m m capability and a quality curriculum of life of persons en E affordabilitywith disabilitiesand quality of services t The Enabling Village is an inclusive in the areas of early intervention, community space which is also education, employment and adult care. home to several social businesses and community services. It has The streamlining of admission and screening processes for 7600 EIPIC and SPED schools for more efficient placement of Employment a special focus on training and + 18 yrs children and to reduce anxiety of caregivers employment of persons with 4800 • Increased accessibility disabilities and provides a to employment services

first-stop information centre on • More support, training 650 disability services. opportunities 140 Improving access to information and services for persons with • Increased employability WORKFARE SPECIAL JOB OPEN DOOR and employment INCOME EMPLOYMENT PLACEMENT PROGRAMME** disabilities and caregivers through SG Enable SUPPLEMENT* CREDIT* AND (Photo: Information and Career options SUPPORT** Persons with Employers * Since 2012 Training Hub CentrePractice at Enabling Hub Village) disabilities ** Since 2014 Provides Training Promotes the transfer of Programmes Learning to Practice via The establishment of the Tote Board-Enabling Lives Initiative Communities of Practice Grant which encourages ground-up initiatives by funding new NEW NEW service models or scaling up successful pilots, including those Adult Care Drop-In Disability Day Activity Home-Based Care supporting caregivers + 18 yrs Programme Centre Services Pilot

• More care options Community-Based Facilities Residential Facilities for adults with Career Centre Resource Hub disabilities Community Adult Disability Adult Disability Provides career and Encourages the sharing and Group Home Hostels Homes skills upgrading disseminationSource: SG Enable of knowledge advisory services and best practices for the sector

Colour schemes for :

Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 34 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 35

Recommendation 1

Although much progress has been To develop flexible service models for persons with disabilities made, regular reviews of services and (QOL Domains: Level of Independence and Environment) the disability sector should continue to ensure that services remain relevant and responsive to the changing needs ENSURE A SPECTRUM OF SERVICES of persons with disabilities. Not all the IS AVAILABLE FOR PERSONS WITH needs of persons with disabilities may DISABILITIES AT EACH LIFE STAGE be fully met by existing programmes. Unlinked and isolated service delivery may make it difficult for persons with disabilities to easily access and fully There is also room to improve benefit from these programmes. existing care services for adults with Current funding support and service disabilities. Today, most programmes models can be enhanced to provide focus on improving their clients’ level service providers sufficient flexibility of independence by developing and needed resources to try out new skills that will help them with their ideas to meet the varying needs of the Activities of Daily Living (ADL). Service spectrum of users. models of care services should be reviewed with a view to taking a more holistic approach towards improving the quality of life of persons with disabilities. Adults with moderate to severe disabilities also have other needs beyond their ADL that are often neglected. More targeted support and care options should also be put in Willis, 20, has autism spectrum disorder. He lives with his parents and a brother, place for adults with higher needs. and attends the Day Activity Centre at St. Andrew’s Autism Centre. Willis enjoys using the iPad. His parents want him to learn more self-help skills and live independently.

Source: DesignSingapore Council 36 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 37

Appropriate research and studies should also be conducted to study Recommendation 2 the needs of the different groups of persons with disabilities at each life Where necessary, standardised To meaningfully engage and support persons with disabilities stage, as well as the level and type of assessment tools should also be requiring care to be as independent as possible support required to adequately meet developed to enable persons with (QOL Domains: Level of Independence, Social Relationships, the needs of different disability groups disabilities to be matched to the Environment and Psychological) and profiles. These studies will help appropriate services and as an identify service gaps and inform the indicator of the kind of support that Government and service providers may be required by the individual. ENHANCE SUPPORT FOR ADULT PERSONS WITH DISABILITIES IN on the types of services and support DIFFERENT FACETS OF LIFE required by persons with disabilities in Singapore.

ENSURE AFFORDABILITY AND QUALITY OF SERVICES IN MEETING THE NEEDS OF USERS

It is commendable to note that through the last Enabling Masterplan, early intervention, employment and care services have been expanded and new programmes have been introduced. As quality improvements are made While these have been done, there to enhance efficacy, services should should be clear and measurable continue to remain affordable. The client and family outcomes for funded funding structures should also reflect services to ensure the efficacy and the level of support needed based on impact of service in meeting clients’ the severity of needs of persons with Huiqun, 32, was born with an intellectual disability and suffers from speech needs. These outcomes will also disabilities in the services. impairment. When Huiqun was first referred to TOUCH Centre for Independent reflect the effectiveness of the use of Living (TCIL) in 2012, she was afraid and would throw tantrums. Gradually, with resources in realising the intended constant encouragement from the coaches at TCIL, including TOUCH social objectives of the services worker, Ms Chloe Liew, she soon opened up and became receptive to learning and programmes. new skills, which included how to manage her time and money, personal hygiene, proper decorum and cooking simple meals. It was a significant breakthrough for Huiqun as she started to enjoy attending classes at TCIL.

Source: TOUCH Community Services 38 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 39

Care services should ensure that the programming has breadth to support Recommendation 3 the different facets of life, and improve the overall quality of life of persons Likewise, programmes will need to To improve transition management with disabilities. The needs of persons evolve with greater emphasis on (QOL Domain: Environment) with disabilities will grow beyond daily social participation, recreation, living aspects in the course of their as well as community living skills, lifetime as they mature from childhood especially for higher functioning EXPLORE THE INTRODUCTION OF A STANDARDISED CASE into adulthood. persons with disabilities. MANAGEMENT, CARE PLANNING AND COORDINATION SYSTEM WITH A VIEW TO IMPLEMENTATION

ENSURE ADULT DISABILITY SERVICES ARE Persons with disabilities and their ACCESSIBLE AND AVAILABLE, IN PARTICULAR TO families face greater levels of stress THOSE WITH HIGHER CARE NEEDS whenever they move across different should be better supported with life stages or when transitioning from Some adults with disabilities, better signposting and case one service to another. For example, especially those with higher care management as they transition from persons with disabilities and their needs, face difficulties in accessing one service to another across their life families are often not aware of the care services. Barriers to access such stages. They also need care planning community support services that are as transportation, proximity of services Service planning by the various advice as their caregivers and available to them and do not know and availability of services should authorities such as the Ministry of themselves age. where to go in times of crisis. Stressors be lowered. Persons with severe Social and Family Development are also felt by persons with disabilities The Committee proposes that a disabilities may require dedicated (MSF) and Ministry of Health (MOH) and their families when they transition standardised case management, transport services. Such dedicated must ensure sufficient spaces in from early intervention services to care planning and coordination transport options must be sufficient their services and also locate them schools, graduate from schools into system be explored with a view and affordable to enable access to centrally for ease of access by employment or other care services to implementation. This system community services. persons with disabilities. Persons with as they age. Persons with disabilities should ensure continued access severe disabilities will require better and smooth transition to appropriate access to home-based services to services and care planning advice meet their needs. for persons with disabilities and their caregivers as required. 40 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 41

Clear guidelines to ensure smooth As we empower persons with transition from one service to disabilities to make choices on another across life stages should services, a case coordinator of the be established with service providers. primary agency from which the person This model envisions persons with The Committee recognises that there with disability is receiving services may disabilities receiving services from their are two broad groups of persons with be assigned to help families navigate primary agency to be supported during disabilities where a more targeted the system at different milestones. the transition phase. In adopting a approach needs to be adopted as The case coordinator’s role will be person-centric approach, it is important reflected in the table below: to advise the person with disability that the primary agency and other and his family of the service choices service providers use a standardised and options, as well as the means case management tool in ensuring Target Group Suggested Approach of support available based on the that the person with disability receives needs of that family. Similarly for those holistic support at each phase of his Persons with disabilities known ‘Hub-and-Spoke’ Model who are not receiving any services life. These efforts will also provide to and receiving services from a A primary agency can carry out: currently, they may be assisted by a greater reassurance to persons with primary agency 1) In-house services central referral and advisory agency congenital or acquired disabilities to to ensure that they are referred be able to weather changes to their 2) Case coordination to appropriate services based on condition and environment. 3) Transition management and their needs. Stronger partnerships proper handover to another amongst agencies must therefore agency when clients need be established to ensure that there is to access another service proper and smooth handover. beyond the primary agency

Newly diagnosed persons Central, Single Touchpoint with disabilities who are not An agency to oversee persons accessing any services, or have with disabilities who are not been discharged from disability under the care of a primary services for some time agency, to provide case referral, care planning and advisory services 42 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 43

ENHANCE PARTNERSHIPS AMONGST SERVICE PROVIDERS Strategic TIMELY AND EFFECTIVE TO SUPPORT TRANSITION BETWEEN SERVICES DETECTION OF Direction 2 DISABILITIES As part of effective transition management, it is also important for service providers to collaborate Parents and caregivers are likely and coordinate services closely with George and Lynn’s three-year-old to be the first to notice their child’s child, Ken, was diagnosed with Global developmental progress or delays. each other. It may not be possible Developmental Delay at age one. His The second Enabling Masterplan’s for service providers to be able to speech and motor skills lag behind efforts focused on helping parents provide all the needed services that of his peers. monitor their child’s growth and to the users due to capability development. The health booklet, and capacity constraints. In such “We were actually very which is presented to all parents instances, collaboration between when a child is born in Singapore, service providers to provide the relieved when we received provides information on their required services in a holistic the diagnosis for Ken; child’s developmental milestones. manner will benefit both clients and we knew exactly what Complementary resource kits from the Health Promotion Board (HPB) on service providers. This will also enable service providers the issue with him was. child development are also available to build on their core competencies. It gave us hope that for parents, healthcare professionals When the time comes for persons and early childhood educators to with disabilities to transition to another something could be done to monitor a child’s development. phase of life, this collaboration will help him with regard to enable smoother transition and his condition.” Besides parents, caregivers and support as clients move from one healthcare professionals, other key service to the next. To encourage first touchpoints such as pre-school and accelerate this practice amongst teachers can also be equipped to service providers, service standards identify developmental needs and and funding agreements should also ensure that the child is assisted be reviewed to ensure adequate through timely support. resourcing and capability to better support clients during transition Early detection of a child’s needs, between services. coupled with appropriate timely intervention, will help the child to maximise his or her potential. Life Expectancy at Birth Age (Years) 100

90 Increase in Number of Children Diagnosed with Number of Working-Age Citizens Has Peaked Developmental Issues 80 Citizens Citizens 70 aged aged 65 2010 2050 20-64 and older 60

Modes of Consultation

Enablers Systems Inclusive Mindsets Technology

Life Course Strategic Directions Impacting Quality of Life Early detection network

44 EarlyIMPROVING Intervention THE (0 QUALITY - 6 yrs) OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 45 Timely and effective detection Family/ Primary Community of disabilities caregivers Care Agencies Partners

Environment Education (7 - 18 yrs) Access to opportunities Personal Physical Holistic for development and beliefs health Recommendationquality education 4 and Persons quality with support Employment (+18 yrs) Disabilities To ensure timely and effective detectionacross of developmental Level of needs MAKE INFORMATION ON KEY DEVELOPMENTAL Improved access to enhanced Psychological services independence Ecosystem for in children by enhancingpathways for employment the existing and network of touchpoints MILESTONES MORE EASILY ACCESSIBLE TO Persons with Disabilities lifelong learning opportunities PARENTS AND CAREGIVERS (QOL Domains: Physical and Environment) Social Persons with relationships Adult Care (+18 yrs) disabilities are No. of persons with disabilities served in 2012 and 2015 supported and Responsive and adaptable To complement the existing early empowered to live services throughout the different detection network, information on aregiver Inclusive C s within and participate ENHANCE EXISTINGlife stages, to support NETWORK and care OF TOUCHPOINTS P Early Intervention s u Mindset actively in the for persons with disabilities developmental milestones should be O b community FOR EARLY DETECTION AND SUPPORT Programme for l made more accessible for parents to W ic Infants and Children V Environment play a proactive role in monitoring their There is an existing network of such as pre-schools and family service Development Support child’s development andProgramme growth. For Personal Physical touchpoints for early detection centres. To improve early detection, beliefs health example, the information can be made Persons comprising the family, healthcare relevant information and training Adult Disability with available through electronicHomes platforms Disabilities agencies as well as other community should be made more widely available Level of for parents. independence Psychological partners. These include hospitals, to these touchpoints to better support Day Activity polyclinics, family medicine them in the care of children with Centres Social s G relationships r practitioners and community partners, developmental issues. e ENHANCE TRAINING OF PRIMARY o y v e lo CARE DOCTORS IN AREAS SUCH AS rn p m m DEVELOPMENTAL SCREENINGS FOR e E nt CHILDREN WITH DISABILITIES 2500

Family/ Caregivers Training of primary care practitioners should be enhanced to assist them in identifying developmental delays early in young children.

Early 1900 1200 Detection Network

Community Primary Care 200 Partners Agencies 850 700

1200 950

2012 2015

Key Achievements under the past Masterplans

Early Intervention

Systems

• More support, training 650 opportunities 140

Colour schemes for :

Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 46 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 47

Strategic ACCESS TO OPPORTUNITIES Schools support the holistic FOR DEVELOPMENT AND development of children during their Direction 3 QUALITY EDUCATION formative years in preparation for adult life. This support is all the more crucial for children with special needs. Aaron was diagnosed with autism at In the last five years, more support has four years old. He attended an EIPIC been introduced in Special Education Centre for three years before entering (SPED) and mainstream schools for Pathlight School. He was transformed students with Special Educational from a lost and shy boy into a chatty Needs (SEN). The curriculum in SPED and confident child, one who enjoys sharing his adventures and secrets with schools has been reviewed and Learning should not stop when his family, teachers and friends. He is updated so that students in SPED persons with disabilities leave school. now an extremely sociable and active schools can benefit from skills and It should continue so that they can boy, always greeting someone with his knowledge that are more relevant to continue to upgrade their skills and cheeky grin. He loves football and his them after graduation from school. knowledge beyond the school favourite football club is Arsenal! setting. This is in line with our nation’s Given the importance of education, push towards promoting lifelong children with SEN who are able learning through initiatives such as the to participate in formal education SkillsFuture movement. Since 2015, settings should be given access to SG Enable, through the SG Enable (Photo: Aaron with his sister) a school setting that can best meet Training Grant for Training Providers, Source: Mr & Mrs Oh their learning needs. The educational has encouraged training providers support for children with SEN should to develop and run accessible and be reviewed regularly to ensure that affordable work-related courses for the needs of these children are being persons with disabilities. In addition, Education plays a big part in the met and their strengths and abilities are SkillsFuture Credit funding support development of young persons and further developed. is now available for training courses prepares them for life as an adult. catering to persons with disabilities. Education is key to helping persons This has greatly helped to reduce the with disabilities fulfil their aspirations out-of-pocket portion of the course and potential by developing their fees that trainees would have to pay abilities and strengths. and thus helps keep training affordable for persons with disabilities. 48 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 49

PLACE GREATER FOCUS ON LIFE SKILLS Recommendation 5 THAT WILL BETTER PREPARE PERSONS WITH DISABILITIES FOR ADULT LIFE To ensure access to quality education in mainstream or government-funded SPED schools through the Compulsory While many young people with and adult life. This curriculum should Education Act disabilities receive an academic place greater emphasis on life skills (QOL Domain: Environment) education and vocational preparation, such as social skills, employment and they also need to be better prepared independent living, as they will help for adulthood with life and work skills. them function safely and effectively PROVIDE STUDENTS WITH SPECIAL EDUCATIONAL NEEDS AT These skills are necessary, especially and allow them to be better engaged THE SCHOOL-GOING AGE WITH APPROPRIATE SUPPORT IN for young people with more in the community. Some persons with MAINSTREAM OR GOVERNMENT-FUNDED SPED SCHOOLS severe disabilities. disabilities may be more vulnerable and will need to be educated and The Ministry of Education (MOE) has are able to access quality education The SPED curriculum should therefore supported so that they can have safe recently announced the inclusion in an appropriate school setting have a greater focus on imparting skills and healthy social relationships. of children with SEN under its that can best serve their needs. This and knowledge that will better prepare compulsory education framework, could either be in a mainstream or students for transition to post-school starting with the 2019 Primary One government-funded SPED school. cohort. Compulsory primary education School fees across SPED schools THE SPED CURRICULUM FRAMEWORK—LIVING, for children with SEN is necessary to should also be kept affordable for LEARNING AND WORKING IN THE 21ST CENTURY ensure that all children with SEN who children with SEN and their families. are able to benefit from education The SPED Curriculum Framework, launched in 2012, is key to raising the quality of education in SPED schools. It BUILD UP CAPABILITY OF MAINSTREAM sets a common direction for excellence SCHOOL SYSTEM TO APPROPRIATELY SUPPORT in teaching and learning across the STUDENTS WITH SPECIAL EDUCATIONAL NEEDS 20 SPED schools, and guides schools in delivering a quality and holistic The capability of the professional staff AT and resources that can help children education. At the same time, the within the mainstream school system with SEN to acquire knowledge and Framework provides the flexibility and should be further enhanced so benefit from the mainstream settings space for SPED schools to customise that they will be able to appropriately should be put in place and used. their curriculum to the unique needs of their student profiles. support children and students with SEN. Source: Ministry of Education 50 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 51

Recommendation 6

To enhance integration and inclusion of children with special needs 40% of parents of children with special within the context of our education system needs surveyed felt that their children (QOL Domains: Social Relationships, Environment and Psychological) with special needs spent too little time in public spaces. The study also found that almost half of the parents of children with special needs indicated STRENGTHEN AND ENHANCE OPPORTUNITIES that their children did not have typically FOR PURPOSEFUL AND APPROPRIATE developing friends, due to the lack of a INTERACTION BETWEEN STUDENTS IN conducive environment. MAINSTREAM AND SPED SCHOOLS The values of inclusion are best NCSS pioneered Children in Action to inculcated from a young age. Such The Committee therefore promote interaction between children early exposure benefits both children recommends that current with and without special needs with and without disabilities. Children opportunities for interaction through play. Through this initiative, without disabilities can benefit from between students in mainstream VWOs, including SPED schools, close friendships through activities positive developmental, social and schools and SPED schools as organise play trips and activities such as camps, experiences from attitudinal outcomes through such well as between mainstream suitable and appropriate to the volunteering and excursions. Through experiences. They will be able to preschools and EIPIC9 Centres children’s needs and interests. this programme, the SPED students demonstrate greater compassion, be strengthened and enhanced, have been observed to improve in empathy, and better understanding with new opportunities to be NCSS piloted Buddy’IN in 2014 to initiating conversations and social on how to interact with peers with explored and implemented. This provide opportunities for graduating responsiveness, while their IHL peers disabilities, and accept diversity. should include studying approaches students from SPED schools to interact have gained awareness, knowledge that work towards a balance between with their peers from Institutes of and understanding of disability. meaningful integration and having Higher Learning (IHLs) and develop specialised services to meet the While progress has been made in needs of students with moderate to this area, Lien Foundation’s Inclusive severe disabilities, within the context of Attitudes Study in 2016 reported that Singapore’s education system.

9 The Early Intervention Programme for Infants and Children (EIPIC) provides developmental and therapy services for children with moderate to severe disabilities. 52 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 53

Riding on the success of satellite Employment contributes to one’s partnerships10 between mainstream physical, mental and personal and SPED schools, the Committee well-being as well as a sense of suggests that MOE looks into identity. Income from employment The first Enabling Masterplan built a studying models that provide enhances financial independence and value-chain employment framework more opportunities for interaction raises living standards. in industries such as cleaning, between students from mainstream food and beverage, hospitality and and SPED schools. For persons with disabilities, landscape. It also supported persons employment is valued for many with disabilities by introducing reasons—social inclusion, physical, dedicated job placement, support Strategic IMPROVED ACCESS TO ENHANCED mental and psychological well-being, systems and the Open Door Fund to PATHWAYS FOR EMPLOYMENT AND personal development and application encourage employers to hire more Direction LIFELONG LEARNING OPPORTUNITIES 4 of learned skills, and financial well- persons with disabilities. The second being are but some of the reasons. Enabling Masterplan developed more Research has shown that persons with employment and training opportunities Azizah, 42, works in the canteen at a disabilities who are employed lead and built on the initiatives started in sheltered workshop in Woodlands more fulfilling and enriching lives. the first. and lives in a hostel for persons with intellectual disability. She has moderate Persons with disabilities face Significant progress has been made intellectual disability. greater challenges when it comes in enabling persons with disabilities Azizah dreams of being employed in to employment, job retention and to secure employment. With better open employment market as a cook to career development than able-bodied training and job support services, earn more money. The supervisor at the persons. For some, these barriers can the number of persons with disabilities canteen said that it only took one year be lowered in part through adequate placed in open employment by to train Azizah to be adept in her tasks preparation for employment and government-funded job placement around the canteen. the adoption of appropriate AT that is and job support agencies and compatible from training through SG Enable rose from about 200 persons to employment. prior to 2014 to 500 in 2015.

More help was also given to employers Source: DesignSingapore Council to better support their employees with disabilities through initiatives such as the Open Door Programme, Workfare Income Supplement (WIS) and the 10 Satellite partnerships between mainstream and SPED schools aim to increase opportunities for interaction between children with and without special needs. Please visit: https://www.moe.gov.sg/media/press/2007/pr20070307b.htm Special Employment Credit (SEC). 54 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 55

Recommendation 7

Students with disabilities who are To develop and enhance vocational preparation pathways to better in mainstream schools may also cater to persons with disabilities with diverse support needs require assistance in areas ranging (QOL Domains: Level of Independence and Environment) from internship programmes to gain work experience to enhancing their Even though more support has been resumes to better their chances for a put in place to help persons with EXPAND OPPORTUNITIES FOR VOCATIONAL job interview. TRAINING PATHWAYS AND JOB PLACEMENT disabilities secure jobs and remain in FOR WORK-CAPABLE SPED STUDENTS IN AND employment, the employment rate of Employers too need to be ready BEYOND SPED SCHOOLS persons with disabilities remains low. and willing to hire, develop and Persons with disabilities only form 0.1% manage employees with disabilities. While SPED schools generally have of the private sector workforce. Those Employers often voice concerns some form of vocational preparation with complex or more severe needs about the lack of knowledge and in place, the level of vocational skill still struggle to sustain or even skills in managing employees training across these schools is and receive the needed training for find employment. with disabilities in the workplace, uneven. Studies also show that the them to acquire the necessary skills. and the impact of their hiring on participation in job development To provide SPED students with a Recognising that not all persons work processes, productivity and activities by students with disabilities real taste of vocational training and with disabilities will be able to workplace dynamics. A change in during their school-going years work experience, SG Enable, MSF participate in or secure employment mindset through public education increases their chances and MOE should also work with the opportunities in the open market, 11 and equipping employers with the for employment post-graduation . community to strengthen and expand alternative employment models should requisite knowledge and skills is opportunities for vocational training be explored and created for those To enhance work readiness, MOE key to building a more inclusive and job placement for persons with who are work capable. Some may should work with SPED schools workforce in future. disabilities who are work capable, in require a longer runway to prepare for to further strengthen vocational and beyond SPED schools. employment so vocational preparation preparation for SPED students, programmes should be made more including those with more complex flexible to take into account their or severe needs to help them better varying abilities. understand the world of work, discover their capabilities and career interests,

11 Karpur, A., Brewer, D. and Golden, T. (2014). Critical Program Elements in Transition to Adulthood: Comparative Analysis of New York State and the NLTS2. Career Development and Transition for Exceptional Individuals. 56 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 57

SCALE UP TRANSITION-TO-WORK PROGRAMMES TO BENEFIT MORE SPED STUDENTS OF DIVERSE Recommendation 8 DISABILITY PROFILES To develop a spectrum of open, supported and customised In 2014, SG Enable, MOE and MSF employment models to provide more pathways to employment prototyped the School-to-Work (QOL Domains: Level of Independence and Environment) (S2W) transition programme for SPED students. The programme aimed by leveraging peer student support to offer more customised training or career programmes as well as EXPLORE NEW SERVICE MODELS FOR JOB pathways for students with diverse VWO-run vocational preparation PLACEMENT AND SUPPORT FOR THE DIFFERENT disability profiles who may not benefit services. With a successful DISABILITY GROUPS, ESPECIALLY THOSE WITH from the vocational certification internship experience, students with MORE COMPLEX NEEDS programmes, but who are work disabilities will be better prepared for Current employment models fall capable, so as to successfully bridge employment. Tie-ups with employers’ largely into open employment and the transition from school to work. network are possible opportunities supported employment models. Both Moving forward, this programme which create more internship and are characterised by competitive should be scaled so that more SPED mentoring opportunities for special work undertaken in integrated work schools will be able to prepare their needs students. settings, but differ in the level of students through the S2W programme. Another group of individuals that face accommodation and job support Students with disabilities who significant barriers to being employed received by the employee with progress to IHLs may also require are persons with acquired disabilities, disability. The intent is to enable a support to allow them to transition for example, victims of serious motor or person with disability to perform There have been many initiatives smoothly from school to employment. industrial accidents. Currently, return- as near on par as possible to other such as the Open Door Programme, For example, IHLs can explore ways to-work vocational support is limited. colleagues without disabilities in the Workfare Training Support and to support these students in sourcing Given that these individuals may have same job. Workfare Income Supplement that and preparing for their internships been economically active prior to have enabled open employment acquiring a disability and still able to for persons with disabilities. This work in some capacity, more resources arrangement works for some should be put into developing and/or persons with disabilities, but scaling up return-to-work programmes others—in particular those with such as the iEnable pilot run by more complex or severe needs— SG Enable and the Transition struggle to sustain or even Programme to Employment (TPE) find employment. by SPD. 58 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 59

There is a need to explore employment options for this group as they may not Recommendation 9 be suited for open employment. More ‘controlled’ setting with the support of To strengthen efforts to provide lifelong learning job coaches and training officers will opportunities for persons with disabilities enable the productive engagement (QOL Domains: Level of Independence and Environment) of those that are work capable in a structured environment tailored for persons with disabilities. PROMOTE THE PROVISION OF ACCESSIBLE AND AFFORDABLE CONTINUED EDUCATION AND TRAINING Differentiated post-school employment (CET) OPTIONS TO FACILITATE LIFELONG LEARNING models and options should be FOR PERSONS WITH DISABILITIES developed to cater to the different Post-graduation, persons with abilities and needs of persons Eng Chwee, 43, has moderate intellectual disabilities need to have access to with disabilities. Some VWOs and disability. He lives with his parents and continuing professional education employers are already exploring three siblings, and works in a sheltered and skills training to keep themselves different ways to design and workshop. His siblings have intellectual disabilities as well. current with developments in their organise work. These efforts include fields of work and changing job customising jobs by redesigning a He has a keen interest and patience demands. They should therefore piece of work into smaller processes or for going into the stock room and continue to have access to affordable tasks, and setting up supported work systematically comparing and picking lifelong learning and training options Currently, the SkillFuture Credit is settings where persons with disabilities out products. He wants to make more to enable them to remain current and extended to individuals who are undertake paid competitive work, with money to help out his family. relevant to the job market. 25 years or older. To keep courses job coaches on hand to provide Source: DesignSingapore Council affordable for younger persons with on-going supervision and support. The range of training options as well disabilities, it is proposed that the use as the number of inclusive training of the Post-Secondary Edusave Such efforts should be encouraged With the increasing diversity in providers should be increased through Account be expanded to cover and adequately resourced, with employment options for persons with initiatives such as the SG Enable more training courses that improve successful pilots replicated and disabilities, the current models of job Training Grant. employability of persons with disabilities. scaled-up to create diverse placement and job support should employment options for persons also be strengthened to provide more with disabilities. differentiated support for persons with disabilities, especially those with complex needs but are work capable. 60 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 61

Recommendation 10

To scale up efforts to build employers’ capabilities in hiring WORK WITH AGENCIES LIKE WORKFORCE and managing employees with disabilities SINGAPORE (WSG) AND TAFEP TO INCREASE (QOL Domains: Level of Independence and Environment) AWARENESS ON INCLUSIVE HIRING

The employment of persons with disabilities is but one facet of the larger DEVELOP MORE TRAINING AND EDUCATIONAL RESOURCES ON DISABILITY-INCLUSIVE issue of inclusive employment and EMPLOYMENT PRACTICES AND SKILLS workplace diversity. A more conscious effort should be made to include Employers have cited the lack of skills persons with disabilities as part of and knowledge to effectively manage our nation’s movement to promote employees with disabilities as well fair employment practices under the as the lack of awareness regarding There is a need to increase awareness Tripartite Alliance for Fair & Progressive their capabilities. There are also amongst employers on the Employment Practices (TAFEP). concerns and misconceptions about employment of persons with disabilities the possible impact of an employee so that a more inclusive workforce can with disability on work process and be built. Additional initiatives should ENABLE PUBLIC SECTOR TO TAKE THE LEAD IN BECOMING AN INCLUSIVE EMPLOYER productivity, and on their co-workers, include professional education and and that the company would need networking opportunities for Human The public sector should take the lead to make extensive adjustments to Resource (HR) personnel, as well as the in being an inclusive employer and set accommodate an employee creation of HR toolkits on workplace the example for businesses in adopting with disabilities. accessibility and inclusive practices. inclusive hiring practices. In doing so, the public sector will also be able to Misconceptions on the impact of share with other employers on disability employing persons with disabilities inclusive practices that have enabled should also be addressed. One way persons with disabilities to be included of doing so is in sharing exemplary as integral members of the public success stories by way of public sector workforce. education which will focus positive attention on the possibilities and value of disability-inclusive hiring practices. 62 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 63

Mr Norrizwan Rasip, 35, uses a wheelchair after sustaining a spinal cord injury 15 Ms Koh Huimin, 31, is currently an Assistant Public Prosecutor (APP), years ago. He is currently a manager for Knowledge Management at the Ministry of with the Criminal Justice Division of the Attorney-Generals’ Chambers (AGC) since National Development (MND). 2011. Ms Koh has a congenital mild hearing disability.

The selection panel initially had some doubts about possible challenges Rizwan As a legal advisor, Ms Koh gives legal advice primarily to enforcement agencies such might face in the work environment. However, after speaking to him at the job as the Singapore Police Force (SPF) and the Central Narcotics Bureau (CNB). In interview, they were confident in his abilities and found him suitable. His supervisor addition, as an advocate, Ms Koh also engages in court work, primarily in the State has described Rizwan to be an independent and resourceful person, and has not Courts, by conducting pre-trial conferences, court mentions, coroner’s inquiries and excluded him from any duties in the past two years. His condition has not been a trials. Ms Koh was initially employed as a legal research assistant and later promoted barrier for him to take on new assignments. to her current role in 2012.

All it took for MND to welcome Rizwan was to make small adjustments to the office Whilst her disability has less impact in her advisory role, her superiors initially had space to ensure that it was wheelchair-friendly, and the belief that persons with some doubts of the possible challenges that she would have to overcome in her role physical challenges are no different from the rest. as an advocate, which places her in a hearing intensive environment. However, with the assistance of hearing aids used in the course of her court work, Ms Koh was not (Photo: Mr Norrizwan Rasip (right) and his supervisor, Mr Lam Kwok Leong, excluded from any court-related duties in the course of her employment as a result at MND’s office) of her condition.

Source: Ministry of National Development Source: Attorney-General’s Chambers Life Expectancy at Birth Age (Years) 100

90 Increase in Number of Children Diagnosed with Number of Working-Age Citizens Has Peaked Developmental Issues 80 Citizens Citizens 70 aged aged 65 2010 2050 20-64 and older 60

Modes of Consultation

Enablers Systems Inclusive Mindsets Technology

Life Course Strategic Directions Impacting Quality of Life Early detection network

Early Intervention (0 - 6 yrs) Timely and effective detection Family/ Primary Community of disabilities caregivers Care Agencies Partners

Environment Education (7 - 18 yrs) Access to opportunities Personal Physical Holistic for development and beliefs health quality education and Persons quality with 64 IMPROVING THE QUALITYsupport OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 65 Employment (+18 yrs) Disabilities across Level of Improved access to enhanced Psychological services independence Ecosystem for pathways for employment and Persons with Disabilities lifelong learning opportunities Social Persons with relationships Adult Care (+18 yrs) disabilities are CREATE OPPORTUNITIES FOR HIRING No. of persons with disabilities served in 2012 and 2015 supported and Responsive and adaptable empowered to live ORGANISATIONSservices throughout TO the different BE INVOLVED EARLIER IN THE aregiver Inclusive C s within and participate TRAININGlife stages, AND to support TRANSITIONING and care OF POTENTIAL P Mindset actively in the Early Intervention s u EMPLOYEESfor persons INTOwith disabilities THE WORKPLACE O b community Programme for l W ic Infants and Children V Environment

Today, the training for persons Development Support with disabilities is done by training Programme Personal Physical beliefs health providers and employers are generally Persons Adult Disability with only involved when the employee Homes Disabilities Level of is job-matched. In the adoption of independence Psychological Day Activity “train-place-train”, there is potential Centres Social for greater involvement of employers s G relationships r e to co-develop the training curriculum o y v e lo and delivery to ease the transition A’zimiee, 26, has moderate intellectual rn p m disability. She is employed in the open m E of persons with disabilities into en t the workplace and allow for better market and continues to be supported 2500 by her job support officer. adjustment to its organisational Family/ Caregivers culture. For the person with disability, Her mother says that she is quite smart it also reduces the need to ‘relearn’ or and is capable of doing many things. ‘retool’ over again based on what is adopted by the hiring company. Source: DesignSingapore Council

Early 1900 1200 Strategic HOLISTICDetection AND QUALITYNetwork SUPPORT Direction 5 ACROSS SERVICES Community Primary Care 200 850 In the past fivePartners years, the capacity of of servicesAgencies should not be affected. services has been expanded to serve Our service providers sometimes find 700 more persons with disabilities and new themselves with insufficient resources programmes have been introduced to and manpower to provide timely and better meet their needs. quality services that are effective. 1200 950 There is therefore a need to develop As more persons with disabilities are innovative and sustainable manpower supported, the quality and timeliness and resourcing models. 2012 2015

Key Achievements under the past Masterplans

Early Intervention

Systems

• More support, training 650 opportunities 140

Colour schemes for :

Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 66 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 67

In 2013, MSF piloted the Drop-in Disability scheme for adults with mild Recommendation 11 to moderate disabilities to access social and recreational activities To synergise partnerships within and across health, education regularly for a few hours each day at and social service to better support persons with disabilities and selected Senior Activity Centres. This their caregivers is an example of how services can be (QOL Domain: Environment) synergised to optimise resources and capabilities while retaining the flexibility of meeting the needs of persons PROMOTE COLLABORATION AMONG THE with disabilities. The programme has HEALTH, SOCIAL AND EDUCATION SECTORS TO been able to support the inclusion DEVELOP CAPABILITY, SHARE RESOURCES AND of persons with disabilities in the There is scope to further synergise COORDINATE SERVICES community through activities taking the adult disability and eldercare place beyond the centre and in the services to benefit from economies There is potential to cross-tap on neighbourhood. The programme of scale, such as in the area of home services across the health, education is currently available in four Senior care services and manpower training. and disability sectors, especially Activity Centres. Partnerships between service where the needs of users are similar. providers within and across the health, For example, home care service education and social service sectors providers can provide home-based should be strengthened so that clients care to both the elderly and persons can enjoy services that meet their with disabilities based on location needs holistically, as well as a smooth rather than clientele group (i.e. elderly, professionals in these sectors should and seamless transition between disabled) as is the current situation. be aligned to build up the capability of services when required. Professional competency framework the professionals to provide services and practice standards for allied health across the health, education and social service sectors. This will position these sectors as attractive career choices with ample development opportunities and in turn enable better retention of personnel. 68 IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES IMPROVING THE QUALITY OF LIFE OF PERSONS WITH DISABILITIES 69

SUPPORT AND ENABLE COLLABORATION AMONG VWOS FOR INNOVATIVE/NEW PROJECTS Recommendation 12 AND GROUND-UP INITIATIVES To study the need for the establishment of a disability office Community agencies and social (QOL Domain: Environment) service providers (i.e VWOs) delivering services and support to persons with disabilities and their caregivers are able to identify the needs of their EXPLORE THE SETTING UP OF A DEDICATED clients and community through their OFFICE TO STRENGTHEN COORDINATION services. Service providers should be ACROSS GOVERNMENT AGENCIES encouraged and supported to share ideas and best practices, as well as Matters pertaining to persons with collaborate in new and innovative pilot Collaborative efforts among VWOs to disabilities cut across the health, projects to bridge service gaps for transform services or address service education and social service sectors. persons with disabilities. gaps are currently supported with seed To address the concerns of persons funding through the VWO Capability with disabilities holistically, the Fund (VCF) and the Tote Board- Standing Committee on Disability TOTE BOARD-ENABLING LIVES INITIATIVE GRANT Enabling Lives Initiative Grant made (SCD) was set up to coordinate While there is increasing coordination available to service providers in the disability-related policy issues at among agencies, there are still Tote Board-Enabling Lives Initiative sector. These funds should continue the government level. It also serves issues that persist. The Committee Grant aims to improve the well-being to build on the momentum of the spirit as the national mechanism for recommends that MSF study the of persons with disabilities and of innovation and in addition promote coordinating policies and monitoring efficacy of establishing a disability their caregivers. collaboration in innovation for the the implementation of the office comprising relevant government next phase. United Nations Convention for the agencies to coordinate and address The grant supports new, innovative Rights of Persons with Disabilities the responsibility and accountability of and evidence-based projects in the cross-cutting disability areas of Data Pilot programmes that are (UNCRPD). disability initiatives and cross-cutting and Technology, Caregiver and Natural implemented successfully can be issues. Besides enhancing coordination Support and Transition Management. scaled and mainstreamed if proven with service provision, there are many successful in making a difference to cross-agency strategies that can be There will be persons with disabilities and encouraged by having a dedicated a total of eight their families. disability office. Existing platforms such uniquely themed as the SCD should also be reviewed grant calls from 2015 till 2018. and enhanced accordingly if required. SUPPORTING CAREGIVERS 71

Strategic RECOGNITION THAT CAREGIVERS PLAY A CRITICAL ROLE IN CARING Direction 6 FOR PERSONS WITH DISABILITIES

Caregivers are persons who provide care12 to a person requiring support due to age, disability, illness or special needs. While caregivers are usually family members, some persons with SUPPORTING disabilities also receive care from others, such as friends or foreign CAREGIVERS domestic workers. As the first line of support for persons with disabilities, caregivers play many important roles— as family, friend, confidante, teacher, Dear Caregivers nurturer, supporter, and advocate. We know you. We’ve talked to you Caregivers are a crucial link between We’ve listened to you persons with disabilities and the community. They are often the main We’ve followed you. care coordinator for the person with Thank you for giving us your care. disability, the ‘red thread’ that ties Caregivers, the red thread for persons You care for someone else. together the different touchpoints and with disabilities Do remember to care for yourself too. access to services. Caregivers are a key focus under this Enabling Masterplan Source: “Who Cares? Transforming the Caregiving Experience so that their needs can be addressed — Extracted from “Who Cares? Transforming the Caregiving Experience in Singapore”, in Singapore”, design more holistically. A publication by National Council of Social Service & fuelfor ethnography by NCSS & fuelfor.

12 Caregiving is defined as the process of helping in a holistic (physically, mentally, emotionally and socially) manner for another person who is unable to do those things for himself. Caregiving is facilitated by certain character traits, emotions, skills, knowledge, time spent and an emotional connection with the care recipient. Source: Caregiving, A Qualitative Concept Analysis, Melinda Hermanns and Beth Mastel-Smith, The University of Texas, in ‘The Qualitative Report 2012 Volume 17, Article 75 I-18’. Please visit: http://files.eric.ed.gov/fulltext/ EJ989821.pdfEJ989821.pdf Life Expectancy at Birth Age (Years) 100

90 Increase in Number of Children Diagnosed with Number of Working-Age Citizens Has Peaked Developmental Issues 80 Citizens Citizens 70 aged aged 65 2010 2050 20-64 and older 60

Modes of Consultation

Enablers Systems Inclusive Mindsets Technology

Life Course Strategic Directions Impacting Quality of Life Early detection network

Early Intervention (0 - 6 yrs) Timely and effective detection Family/ Primary Community of disabilities caregivers Care Agencies Partners

Family/ Caregivers

Early 1900 1200 Detection Network

Community Primary Care 200 Partners Agencies 850 700

1200 950

2012 2015 72 SUPPORTING CAREGIVERS SUPPORTING CAREGIVERS 73

Key Achievements under the past Masterplans Some of the key initiatives introduced to support caregivers include:

Early Intervention

0 - 6 yrs EIPIC DSP 1200 However, there are areas that continue TheyDesired were: Ecosystem for • Medishield Life offers better protection and higher payouts to all, including to those with to pose challenges for caregivers Persons with Disabilities 200 The introduction of foreign domestic worker levy concessions pre-existing conditions 2500 1900 and grants, and caregiver training grant of persons with disabilities. During • Preparing for the future when they • Higher subsidies for the Early Intervention Strategic were no longer able to care for the Programme for Infants and Children (EIPIC) the focus groupDirection discussions gi 2012 2015 8 Care vers • Subsidies extended to cover more families Building the capacity s person with disabilityP conducted to gather feedback for O u and capability of the b W l disability sector i this Masterplan, caregivers V Environment c

expressed three key concerns.Systems • Being able to perform their Home-Based Care Services and Drop-in Disability Programme Personalcaregiving rolePhysical well for more flexible care services and respite care options Beliefs Health Person with Education • A needdisabilities for self-care and respite Level of 7 - 18 yrs independence Psychological • Inclusion of children with special needs into the Compulsory Education Act from 2019 Strategic Social s Direction G r The establishment of the Special Needs Trust Company 9 o relationships e • Better support for children with special needs in mainstream schools v y o designated to assist caregivers in providing financial security PREPARINGUsing FOR technology THE to FUTURE e l • Improved quality of education in SPED schools by building teacher rn p for persons with disabilities improve the quality m m capability and a quality curriculum of life of persons en E The greatest withworry disabilities voiced by t caregivers was about what would happen to the person with disability The streamlining of admission and screening processes for when they were no longer able to care security of persons with disabilities, 7600 EIPIC and SPED schools for more efficient placement of Employment + 18 yrs children and to reduce anxiety of caregivers for them. This concern was particularly they expressed deep concern about 4800 heightened for caregivers of persons the lack of options for the provision of • Increased accessibility to employment services with disabilities who required a higher support for the future care needs of • More support, training 650 level of support. While caregivers the persons with disabilities, as well as opportunities 140 Improving access to information and services for persons with acknowledged that the Special Needs the lack of support for the future care • Increased employability WORKFARE SPECIAL JOB OPEN DOOR and employment INCOME EMPLOYMENT PLACEMENT PROGRAMME** disabilities and caregivers through SG Enable 13 SUPPLEMENT* CREDIT* AND Trust Company (SNTC) was a good planning of their loved ones. Some options SUPPORT** Persons with Employers * Since 2012 start to helpTraining ensure Hub the financial caregiversPractice felt that the Hub only option disabilities ** Since 2014 Provides Training was to place Promotes their loved the ones transfer in adult of Programmes disability homes. Learning to Practice via The establishment of the Tote Board-Enabling Lives Initiative Communities of Practice Grant which encourages ground-up initiatives by funding new NEW NEW service models or scaling up successful pilots, including those Adult Care Drop-In Disability Day Activity Home-Based Care supporting caregivers + 18 yrs Programme Centre Services Pilot

13 SNTC case managers work with caregivers to develop a care plan to care for the person with disability when the caregiver is no longer • More care options Community-Based Facilities Residential Facilities around. SNTC will review the care plan with the caregivers. Case Managers will make home visits to review the feasibility and relevance of for adults with the care plan based on the condition of the person with disability during the period of review. For more information on SNTC, please visit Career Centre Resource Hub disabilities Community Adult Disability Adult Disability https://www.sntc.org.sg/Pages/Home.aspxProvides career and Encourages the sharing and Group Home Hostels Homes skills upgrading dissemination of knowledge advisory services and best practices for the sector

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Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 74 SUPPORTING CAREGIVERS SUPPORTING CAREGIVERS 75

PERFORMING THE ROLE OF A CAREGIVER WELL

As the main care providers, caregivers were keen to improve their skills and knowledge to manage the biological, cognitive and psychological needs of the person with disability under their care across the different life stages. Though there are existing Caregivers of family members with training courses for caregivers, some disabilities may face challenges in caregivers wanted to acquire a carrying out their caregiving functions deeper knowledge to what is currently alongside full-time employment. provided. In some instances, the If caregivers do not have additional courses that caregivers were interested support to provide care or are Akhbar, 46, and Ashraf, 43, are brothers who have Muscular Dystrophy. They live with their parents, and are cared for full-time by their ageing mother. As grown men, in attending were only open to social unable to switch to part-time jobs or Akhbar and Ashraf feel that they should be the ones caring for their mother, not the service professionals. Caregivers flexi-work hours, they are likely to give other way round. were also concerned with the cost of up their employment to focus on their such training. caregiving role. The family may be When their mother is not able to care for them any more, the plan is to send them to an reliant on the caregiver’s income to Adult Disability Home. Their mother feels it is her obligation to care for them as long as Caregivers also shared that they meet the household’s financial needs she can, but she is getting old and her body aches. were stressed by having to care for and this will pose a strain on the family multiple care recipients, such as elderly Source: DesignSingapore Council finances. In some cases, the person family members or young children, in with disability whom they look after addition to the person with disability may require a higher level of support Some caregivers were not aware of the Caregivers who participated in the in their care. Moreover, caregivers of (for example, assistance with daily resources and information available for focus group discussions were divided persons who were recently diagnosed living activities, medical conditions) care planning and did not know who on the issue of deciding on whom with disabilities often struggled and this will place an even greater to approach for help. Those who had they could pass the caregiving role with accepting the condition and economic strain on the caregiver. gone through the process of making to. Some believed that other family their expanded caregiving role. future care arrangements found the members such as siblings should be Such diagnosis could also affect experience to be tedious, complicated the primary source of support for the relationships within the family and and costly. person with disability while others were weaken the support network for both apprehensive about how other family the caregiver and the person members would view the caregiving with disability. role, and whether this would affect their personal aspirations. 76 SUPPORTING CAREGIVERS SUPPORTING CAREGIVERS 77

SELF-CARE & RESPITE

For some, coming to terms with being have anyone else take their place as Caregivers need to have a high level care recipients for as long as they are the primary caregiver of a person with caregiver even if it was for a very short of well-being; physically healthy, able to. The Committee sees a need disability is the first psychological time due to either a limited support psychologically strong, socially and to ensure that caregivers are well barrier to their caregiving journey. network or a lack of trust in others to emotionally supported, and financially supported so that they can be effective Caregivers shared that the initial care for the person with disability well. secure to perform their caregiving and resilient as they continue to care reaction to the diagnosis was often role effectively. Many caregivers for persons with disabilities. shock, self-blame and denial. This It has been noted that the stress desire to continue to care for their could result in them delaying seeking faced by caregivers of persons with support and intervention for the person disabilities affects their personal with disability in a timely manner. Fear health in multiple ways—physical, and social stigma also contributed to mental, and emotional. This is due to Recommendation 13 these delays. the increased time spent on caring for the person with disability, possible To improve caregivers’ well-being and enhance Another observation was that increase in household duties, sleep their caregiving capabilities caregivers had varied perceptions disruption, emotional impact, isolation (QOL Domain: Social Relationships, Environment and Psychological) of their caregiving responsibilities. and loneliness. Some caregivers believed that their time and resources should be used It is important to acknowledge that EXPAND SUPPORT OPTIONS FOR to care for the person with disability the needs of caregivers do not solely CAREGIVERS TO MANAGE CAREGIVING NEEDS AND THEIR OWN WELL-BEING and that their own personal pursuits revolve around the needs of the person should be secondary while others with disability whom they are caring A study conducted by NCSS on expressed a strong need for personal for as they too have their own needs, caregivers of persons with disabilities time. Caregivers found it difficult to aspirations, interest, and feelings. found that these caregivers had poor mental health14. There is a need to support caregivers to balance “A balance must be found, so that each person [the caregiver their caregiving role and caring and the person with disability they are providing care for] has for themselves. independence, dignity, and quality of life.”

— WHO World Disability Report, 2011

14 NCSS Respite Care Study (2014). The study also looked into the factors which caregivers considered important in respite care services, their receptiveness to different modes of respite care, preferred profiles of respite caregivers, and situations in which these caregivers needed respite. 78 SUPPORTING CAREGIVERS SUPPORTING CAREGIVERS 79

A greater continuum of support and There were also calls to expand respite options should be developed the existing criteria for the Foreign such as access to trained foreign Domestic Worker Grant to better domestic workers, caregiving leave caregivers in their Respite Care study, cater to persons with disabilities who and formal respite services. NCSS one of which is availability of trusted may be physically able to perform could also work with service providers respite options for caregivers. Formal daily living routines, but may not to address the concerns raised by respite services are needed to provide have the cognitive ability to perform sufficient assurance to caregivers that these functions on their own or have the safety and well-being of the person behavioural challenges that require with disability will not be compromised. additional support to manage.

PROVIDE RESOURCES TO CAREGIVERS TO INCREASE THEIR KNOWLEDGE AND COMPETENCY TO MANAGE THE NEEDS OF PERSONS WITH DISABILITIES IN THEIR CARE

Information empowers families to better care for persons with disabilities. At present, there is a myriad of resource materials available for caregivers of The Committee suggests that persons with disabilities. However, steps should be taken to improve these resource materials tend to access to information on reside with their author agencies and disability-related social support cover different areas of information and services. This can be in the separately. There is a need for these form of a one-stop information resources to be collected and portal for caregivers designed to curated such that caregivers can meet their needs for information on access the needed information freely service, caregiving, self-care, AT and online at all times with expediency. well-being. Resource materials should also be developed to meet Source: “Who Cares? Transforming the caregiving experience in Singapore”, information gaps, such as educating design ethnography by NCSS & fuelfor caregivers on the changes that persons with disabilities experience as they transition through life stages. 80 SUPPORTING CAREGIVERS SUPPORTING CAREGIVERS 81

Ideas on howP A caregiversR T 2P -A RCTA REG2 - CI AV IREGN canG ITVOMI N GObe RTROMO WresourcedO R R O W and supported through the use of IT P A R TP 2A-R CT A2REG- C AIREGV I N GI V ITNOMG OT OMR R OOWR R O W

AfterAfter the diagnosisthe diagnosis of her of mum,her mum, the hospitalthe hospital put Yiwenput Yiwen in contact in contact with witha a FamilyFamily Manager. Manager. Their Their assigned assigned Family Family Manager Manager visits visits them them to assess to assess their their care care needsneeds and helpand helpthem them to agree to agree on the on primarythe primary caregiver caregiver role. role.

The CareThe CareCope Copedigital digital platform platform facilitates facilitates YiwenYiwen to plan to plantasks, tasks, overview overview appointments, appointments, All membersAll members of the of familythe family gather gather including including Yiwen’s Yiwen’s brother brother via Skype. via Skype. connectconnect to the to carethe carecommunity, community, share share and saveand save They Theyuse theuse CAREthe CAREROLE ROLEPLAY PLAYtool totool find to findout theout bestthe bestcaregiving caregiving plan planfor mum. for mum. importantimportant moments moments and careand careabout about her ownher wellbeing.own wellbeing.

SO, HOWSO, HOWCAN ICAN SEE I SEE IT ISIT EASY! IS EASY! YOU YOU THE APPOINTMENTSTHE APPOINTMENTS CAN VIEWCAN VIEW AND ANDTHE MEDICATIONTHE MEDICATION THEMTHEM HERE... HERE... LIST?LIST?

AfterAfter the familythe family assessment assessment meeting meeting it becameit became clear clear that thatYiwen Yiwen is the is onlythe only ..and ..andhe introduces he introduces her toher the to Carethe CareCope Copeplatform platform one whoone canwho takecan takethe primarythe primary caregiver caregiver role. role. whichwhich she canshe usecan foruse coordinating for coordinating family family communications, communications, AfterAfter one yearone yearof caring of caring for herfor mom,her mom, Yiwen Yiwen is about is about to leave to leave abroad abroad to continue to continue her studies.her studies. She receivesShe receives a Starter a Starter Pack Packand aand Caregiver a Caregiver appointments,appointments, accessing accessing self-care self-care services services etc. etc. She needsShe needs to pass to passthe caregivingthe caregiving role roleto her to youngerher younger brother. brother. This Thisis made is made easy easywith withthe sharethe share Card Cardfrom fromthe Familythe Family Manager... Manager... and transferand transfer caregiving caregiving functionality functionality of the of Carethe CareCope Copeapp. app.

Source: “Who Cares? Transforming the caregiving experience in Singapore”, design ethnography by NCSS & fuelfor 82 SUPPORTING CAREGIVERS SUPPORTING CAREGIVERS 83

As the main provider of care to persons support persons with disabilities to Many service providers currently with disabilities, it is imperative that live more independently within the run their own caregiver training caregivers are equipped with the right community and have the confidence independently. NCSS and MSF should skills and knowledge to perform their to be able to improve the quality of work together with relevant agencies role effectively. With a higher level of life of the person with disability in and organisations to study how the and competencies to better support competency, caregivers can better their care. provision of such training options for the person with disability in their caregivers can be enhanced through care. Service providers can also better coordination and outreach. reach out to caregivers so that they Jason, 37, has severe cerebral The Social Service Institute (SSI)15 can be made aware of the training palsy. Jason currently spends can facilitate partnerships between options available to them. Effective most of his time on the floor at training providers and disability service in-house training programmes should home, as he might slide down providers to understand caregivers’ be expanded and made available to on the floor when seated on a training needs. SSI can also develop caregivers in other agencies so that chair. Jason’s family lacks the more caregivers are able to benefit. knowledge to take care of him a training framework to support properly. His family can be better caregivers with appropriate knowledge These training programmes and supported in ways to cope with courses should be affordable Jason’s condition and challenges to caregivers. faced with physiological changes.

STRENGTHEN CAREGIVERS’ RESILIENCE THROUGH SUPPORT NETWORKS

Source: DesignSingapore Council From the focus group discussions and other studies involving caregivers, it was noted that caregivers value the The Committee suggests providing caregivers who may wish to pursue presence of socio-emotional support a greater variety of courses higher level training beyond what is throughout their caregiving journey. and mode of training options to available currently. Caregivers with Caregivers feel assured knowing that caregivers of persons with disabilities. enriched knowledge will not only be there is a source of support they can As it is difficult for some caregivers to able to use their expertise to meet turn to even if they did not require it at be away from the person with disability their needs but can also be resource that point in time. to attend training, these training persons to train or support other options must be provided creatively caregivers, or may even be able to and flexibly so that caregivers are provide direct services. able to access them. There are some 15 The Social Service Institute (SSI) is part of the NCSS, and is appointed by SkillsFuture Singapore as the Continuing Education and Training (CET) centre for social services. 84 SUPPORTING CAREGIVERS SUPPORTING CAREGIVERS 85

Provide Caregivers Access Informal Support—Caregiver to Counselling Support Support and Resource Networks

The Committee recommends helping Research has shown that informal The Committee recommends caregivers improve their coping skills, networks function as a source creating more opportunities for especially at points of transition or of emotional support or respite caregivers to meet and appointing decision making, by providing them for caregivers, and foster social experienced caregivers as ease of access to counselling relationships. However, these befrienders or mentors. Existing services, to talk through their networks may be difficult to form due caregiver support networks can be concerns. This can be delivered by a to the lack of opportunities to meet leveraged to reach out to and impact counsellor, social worker or volunteer, such services, they may still need other caregivers. a larger spectrum of caregivers with such as an experienced caregiver who socio-emotional support, especially different profiles. Caregivers can can empathise with the new caregiver. if they are coming to terms with the also share resources, tips and advice For example, at the point of diagnosis, diagnosis or they may be worried through inspiring examples of the hospital or service provider about finding an appropriate service for success stories. should have a person trained in basic the person with disability. Appropriate counselling to attend to the caregiver support should therefore be made Strengthening Family Relationships and the person with disability who may available to them and their families. have difficulty in coming to terms with The Committee also recognises the for caregivers as well as disability the diagnosis. Caregivers and their families may also require support in other areas beyond importance of building up strong service providers should take into Although not all persons with those that pertain to the person with family relationships for caregivers of consideration the needs of the other disabilities and their caregivers may disability in their care. They may require persons with disabilities. family members in the planning of need to access direct services, or assistance with job placement, social programmes. Services and activities Having a person with disability in they may be on a wait list to enrol into assistance, and marriage counselling designed for the person with disability the family can affect the family’s among others. Social service agencies should be designed more holistically dynamics16. There may be rejection must have an understanding of various to encourage family involvement and of the person with disability, strain community resources available for strengthen the family support for both on marriage, or sibling rivalry. Thus appropriate advisory and referrals the caregiver and the family member agencies involved in service planning to be made so that they can assist with disability. the caregiver and their family more holistically.

16 Nealy, O’Hare, Pwers, & Swick. (2012). The Impact of Autism Spectrum Disorders on the Family: A Qualitative Study of Mothers’ Perspectives. 86 SUPPORTING CAREGIVERS SUPPORTING CAREGIVERS 87

PILOT A HUB-AND-SPOKE MODEL FOR MORE EFFECTIVE CAREGIVER SUPPORT

While there are caregivers who are currently being supported through the services accessed by the person with disability, others such as new caregivers, or caregivers of persons with disabilities who are not accessing services may not have an entry point to support services.

For caregivers in this situation, it services (the spoke) to render is recommended that they have a assistance. To serve the needs of centralised platform that can assist caregivers who otherwise may not them with various concerns pertaining have access to tangible support and to the care of their person with valued initiatives, NCSS can pilot the disability. This platform can mirror ‘hub-and-spoke’ model together with a ‘hub-and-spoke’ model, where other social service providers. This the platform (the hub) connects the will complement existing caregiver caregiver to a network of caregiver services and allow the different Me Too! Club is a programme that arranges regular leisure activities and outings needs of caregivers to be met more for adults with moderate to severe disabilities to enhance their well-being. Family members and caregivers are welcome to join in the outings for family bonding and effectively. In addition, the approach to form informal support networks. The programme also has volunteer befrienders to will lend support to piloting new visit persons with disabilities who are socially isolated. caregiver support initiatives and provide a springboard to share and replicate good practices across Source: National Council of Social Service and Movement for the Intellectually the sector. Disabled of Singapore 88 SUPPORTING CAREGIVERS SUPPORTING CAREGIVERS 89

P A R T 2 - C A REGI V I N G T OMO R R O W

Ideas on how a support network of caregivers might look like in future Recommendation 14

To support caregivers in their future care planning Care Hub is running Care Cloud (QOL Domain: Social Relationships and Environment)

CARECLOUD SUPPORT CAREGIVERS IN THEIR FINANCIAL AND CARE PLANNING FOR THEIR CARE RECIPIENT FOR WHEN THEY ARE NO LONGER ABLE TO PROVIDE CARE AND SUPPORT

PROGRAMMING

Family Managers “The more we want to take care of our child’s

APPOINTMENTS FAMI CONNECT /CONNECT NAVIGATE future, the more we are penalised.”

— Focus Group Discussion participant, on bearing more costs for trying to depend on others less

Caregiver Care receiver Many caregivers are deeply concerned about how the person with disability in their care will continue to be supported Greater awareness of such financial Family when they are no longer around or and care planning services is required able to be the primary caregiver. It is to help caregivers plan for the future critical to ensure the continued of persons with disabilities. Caregivers Volunteer well-being and smooth transition of perceived the setting up of trust persons with disabilities beyond the accounts to be tedious, costly and Fellow Caregiver lifetime of their primary caregivers. having limitations. Caregivers also Currently, the SNTC provides services wanted assurance on how the funds to help caregivers with financial would be used. and care planning for persons with disabilities in their care.

Source: “Who Cares? Transforming the caregiving experience in Singapore”, design ethnography by NCSS & fuelfor 90 SUPPORTING CAREGIVERS SUPPORTING CAREGIVERS 91

The Committee acknowledges the need to raise awareness on the importance of financial and care planning and the availability of such services to prepare for when the caregiver passes on or is no longer able to provide care. SNTC should continue expanding its outreach to processes to apply for deputyship caregivers to educate them on the and Lasting Power of Attorney to financial mechanisms available for be complicated, costly and may not future financial and care planning. take into account disability-related They should also consider partnering issues. The Committee therefore agencies providing direct services recommends simplifying the to persons with disabilities for a deputyship and Lasting Power of more integrated and holistic support Attorney processes for caregivers package for caregivers in this aspect. of persons with disabilities. This may include assessing the effectiveness of Disability service providers working the existing pilot at the Movement for with persons with disabilities aged the Intellectually Disabled in Singapore The Committee recommends to For those who require support in 16 years and above, as well as (MINDS), which has simplified the support caregivers in their care transitioning their caregiving role, agencies such as the Office of the process for deputyship applications planning journey by creating a this would include assistance with Public Guardian and the Law Society, for caregivers of graduating SPED system of support at the natural documenting and passing on should also educate caregivers on students, and expanding the initiative touchpoints for caregivers. The caregiving-related knowledge and the importance of ensuring that to more caregivers. system of support will help them skills18 to the next caregiver. The legal and financial matters are in in their care planning journey, process should be iterative and requires order—such as in the case of applying While the general objective of disability including the identification of the clear communication to the next for deputyship. This is especially services and intervention is to support next caregiver and the transitioning caregiver (for example, a family member critical if the person with disability persons with disabilities to live as of the caregiving role17 when the or formal services) on their roles and the lacks the capacity to make decisions independently as possible, especially time comes. needs of the person with disability. when he/she reaches 21 years of in their adult years, some persons with age. Caregivers also perceive current disabilities may still require support in their daily routines throughout their

lives. It is therefore of vital importance 17 This also includes understanding the needs of the care recipient and how it is likely to change over time, assessing the suitability of potential caregivers, deciding on an appropriate care arrangement for the person with disability, and preparing for the person with that proper care planning is in place for disability’s transition to a new care arrangement. the handover of that caregiving role. 18 E.g. information on the condition, needs, habits and behaviour of persons with disabilities, hands-on learning to interact with and care for the persons with disabilities. BUILDING THE COMMUNITY 93

In the earlier chapters, we put forward BUILDING THE recommendations to improve the quality of life of persons with disabilities and to better support their The community requires good COMMUNITY caregivers. This will enable persons information and understanding of with disabilities to live and participate the various profiles of persons with actively amongst us. In tandem with disabilities in the country. This will “We want to catalyse and enable the these efforts, we need to enhance greatly help in understanding rising community and the partners to come forward the capabilities of the community, trends, gaps in our services and in to look for sustainable solutions and most comprising members of the public, being pro-active in designing future employers, social service providers services that will be required by importantly, develop local solutions for local and the Government, so that they persons with disabilities. There are data community challenges.” can better support persons with gaps currently within the landscape disabilities and their caregivers. of persons with disabilities that require — Extracted from Minister Chan Chun Sing’s speech at the Social further detailed study in piecing Service Partner Conference, May 2014 together a more complete picture of “what” is required, “who” should be involved and the “how“ to best serve the needs of persons of disabilities. 94 BUILDING THE COMMUNITY BUILDING THE COMMUNITY 95

Strategic CAPACITY AND CAPABILITY BUILDING OF THE Direction 7 DISABILITY SECTOR

As Singapore moves towards the To enhance capacity and capability next lap of realising its vision of being in the sector, schemes and resources a Smart Nation, technology and its have been made available to help supporting infrastructure should be VWOs and professionals in the social used to empower and enable persons service sector to this end. Examples with disabilities to lead meaningful and include the VWOs-Charities Capability independent lives. Fund (VCF) which provides resource support for building professional professionals with the Enablers such as technology and expertise and the expansion of potential to lead organisations or research are vital in supporting the professional hubs such as therapy professional practice. ecosystem of persons with disabilities The Committee has therefore identified hubs and the setting up of a and to realise the vision of the two strategic directions that will help Community Psychology Hub. The Social Service Institute (SSI) aims Enabling Masterplan. enable the community be an effective to provide an ecosystem for sector partner in this area: The recently introduced Sun Ray professionals and social service scheme aims to attract and retain talent organisations to convene, collaborate 1. Build capacity and capability and expertise in the social service and share best practices in the area of the disability sector to support sector by developing the experience of human capital development. persons with disabilities and of a core group of social service This is done by providing capability their caregivers. development initiatives, sharing of local and international expertise, 2. Use technology to improve the research and evaluation, and adopting quality of life and independence blended learning. of persons with disabilities. 96 BUILDING THE COMMUNITY BUILDING THE COMMUNITY 97

DEVELOP EVIDENCE-BASED PRACTICES Recommendation 15 AND RESEARCH

To build the capacity and capability of disability service providers to Beyond building the professional methodology, potential gaps in enhance service quality capability and capacity of the sector, services as well as client impact (QOL Domain: Environment) the Committee recommends that studies will ensure that resources the sector moves towards more are better channelled to benefit evidence-based practices in persons with disabilities and their DEVELOP STRATEGIES TO ATTRACT ensuring the quality and efficacy of supporting organisations. AND RETAIN SKILLED MANPOWER services. Research on intervention

Noting the various efforts under the previous Enabling Masterplans, the BUILD CAPABILITY OF VOLUNTARY WELFARE Committee recognises the importance professionals (AHPs) in both the social ORGANISATIONS IN THE USE OF INFORMATION of continuing to build capability service and healthcare sectors, the TECHNOLOGY AND MAINSTREAM and expertise of disability service Committee recommends that AHPs, TECHNOLOGICAL PRODUCTS providers to deliver better service especially therapists, be treated as It is important that the use of VWOs should be aware of and adopt and care. This includes the ability to a national talent pool to be cross- technology is encouraged and relevant new technologies that attract, recognise and retain skilled deployed between the government- assimilated into our delivery of services improve processes and services, manpower with the right training funded organisations in social service to persons with disabilities. reap productive gains and address and qualifications, especially and healthcare sectors so as to better manpower shortages. Assistance on expertise that is required to support attract and reduce competing needs the adoption of relevant technologies persons with moderate to severe and attrition in both sectors. can be sought from the People Sector disabilities which is currently lacking in Infocomm Resource Centre (PSIRC)19. the sector. Such cross-sector manpower deployment will benefit the staff in With a national shortage of skilled terms of professional development and manpower such as allied health career advancement. VWOs in both sectors will also benefit from the cross- learning expertise that results.

19 The People Sector Infocomm Resource Centre (PSIRC) was set up in 2012 to build capability of VWOs, grassroots organisations and community groups to enhance their public outreach efforts as well as raise organisational productivity through the use of infocomm technologies. Please visit: https://www.imda.gov.sg/about/newsroom/archived/ida/media-releases/2012/infocomm-resource-centre-set- up-to-help-people-sector-organisations-enhance-public-outreach-and-raise-productivity 98 BUILDING THE COMMUNITY BUILDING THE COMMUNITY 99

P A R T P2A-R TC A2REG- C IAVREGI N GI VTIOMN GO TROMR O WO R R O W P A R TP A2R- TC 2A-REG C A REGI V I NIGV I NT OMG TOOMR RO RWR O W Ideas on how technology can enhance caregiver’s experience and capability

AnotherAnother unpredictable unpredictable day startsday starts for Madamfor Madam Wong. Wong. The Thecrisis crisis is under is under control. control. Her husband’sHer husband’s illness illness causes causes her aher lot a of lot anxiety... of anxiety... SECONDSECOND LEVEL LEVEL OF ALERT: OF ALERT: She cannotShe cannot control control the the situationsituation anymore, anymore, and and Her FamilyHer Family Manager Manager suggests suggests asks asksfor helpfor helpvia the via the I AMI AMSCARED, SCARED, she useshe theuse Parachutethe Parachute App App application...application... to facilitateto facilitate help helpduring during HE CANHE CAN ACT ACT crisiscrisis situations... situations... UP ANYTIMEUP ANYTIME EVERYTHINGEVERYTHING WILL WILL BE BE DOWNLOADDOWNLOAD PARACHUTE PARACHUTE APP APP ALL RIGHT,ALL RIGHT, I'LL I'LL COMECOME TO YOUR TO YOUR HOME HOME RIGHTRIGHT NOW! NOW!

FAMILYFAMILY MANAGER MANAGER

She canShe triggercan trigger pre-set pre-set help helpto different to different channels: channels: FamilyFamily member, member, Family Family Manager,Manager, Ambulance, Ambulance, Police.Police. The TheFamily Family Manager Manager assesses assesses the the The TheFamily Family Manager Manager receives receives caregivercaregiver dashboard dashboard and decidesand decides a messagea message so he so becomes he becomes upon uponan action... an action... WhenWhen a crisis a crisis situation situation is about is about to happen... to happen... awareaware of the of situation.the situation. The Thenext next day heday calls he callsMadam Madam Wong Wong and invitesand invites her toher meet to meet and discuss.and discuss.IT WASIT WASYOUR YOUR I AMI SO AM SO EIGHTHEIGHTH ALERT ALERT EXHAUSTED. EXHAUSTED. IN THEIN THELAST LAST WHATWHAT CAN CAN TWO TWOWEEKS. WEEKS. I I I DO?I DO? THINKTHINK WE CAN WE CAN HELPHELP YOU... YOU...

AfterAfter assessing assessing her crisisher crisis history,history, he searches he searches for afor a She Sohpe nos ptehnes the suitablesuitable support support service. service. appliacaptpiliocna. tion. He advisesHe advises her toher attend to attend FIRSTFIRST LEVEL LEVEL OF ALERT: OF ALERT: reACT,reACT, a personalised a personalised WhenWhen activated, activated, the appthe functionsapp functions like like crisiscrisis management management training training a blacka black box recorder.box recorder. organisedorganised by the by Carethe CareHub Hub

She enrollsShe enrolls in reACT in reACT MeanwhileMeanwhile she she trainingtraining to build to build crisis crisis BECOMESBECOMES A A attemptsattempts to calm to calm managementmanagement skills skills for for her husbandher husband down. down. futurefuture crises. crises. TRAINERTRAINER HERSELFHERSELF

Source: “Who Cares? Transforming the caregiving experience in Singapore”, design- 68 -ethnography - 68 - by NCSS & fuelfor - 69- - 69 - 100 BUILDING THE COMMUNITY BUILDING THE COMMUNITY 101

The Committee recognises that those in need to specially trained The 2012 President’s Challenge technology and mobile information teams who will provide assistance. The Volunteer drive was started with the and communications technology (ICT) Committee encourages commercial aim of building Singapore to be a more can be leveraged to support service players and various stakeholders to compassionate and caring society. As delivery of VWOs and independence work on and create solutions and more Singaporeans become keen to of persons with disabilities by accommodations that will make volunteer, VWOs need to understand The development of a service- encouraging them to participate in a difference in the lives of persons how to be prepared and equipped to based volunteering framework to the community. One such example is with disabilities and others who face tap on this valuable resource. encourage regular volunteerism JeeNee Mobile from Australia, which challenges in their activities of daily among individuals, including corporate provides a 24/7 help service through living such as the elderly. The Committee is of the view employees, should therefore be a mobile application that connects that individual and corporate encouraged and supported to sustain volunteerism engagement efforts volunteering efforts. This should should be enhanced beyond the also be actively driven through the Recommendation 16 current approach of corporate social SG Cares20 movement as part of the responsibility. Volunteers are also national initiative to build a caring and To mobilise volunteers to support and promote natural advocates for persons with inclusive society. inclusiveness of persons with disabilities in the community disabilities. Having a more flexible (QOL Domain: Social Relationships) training approach may encourage Corporate volunteers can be a rich more volunteers to build capability and resource of support for VWOs. Beyond be able to contribute more effectively. sponsorship of resources at events ENHANCE INDIVIDUAL AND CORPORATE NCSS could work with National and fundraising, corporates can VOLUNTEERISM ENGAGEMENT EFFORTS IN Volunteer and Philanthropy Centre also pave the way to ease access to THE SECTOR (NVPC) to develop different modes of products and services, help spread learning for volunteers including online awareness and educate, contribute Manpower and resources are platforms through technology. to skills building of persons with necessary for service quality and disabilities, and promote inclusiveness delivery to improve. Recognising that Volunteers are also important at corporate and public events. Some there may be labour constraints and stakeholders in encouraging the corporations even have an internal limited resources, volunteers are a community spirit and promoting team dedicated to work with the valuable resource to supplement and inclusion. Volunteerism helps shape community to support persons support service provision. our society into one that is more caring with disabilities. and inclusive.

20 SG Cares is a movement dedicated to involving and inspiring more Singaporeans to help one another, so as to grow a strong volunteering culture in the nation. It is coordinated and co-led by NVPC and NCSS. 102 BUILDING THE COMMUNITY BUILDING THE COMMUNITY 103

VWOs should therefore be better management process. For example, The Committee is also of the view that and better service delivery. Consent equipped and have their capability support for VWOs through the hiring of more data should be aggregated and data privacy issues will have to be built so that they can develop, dedicated volunteer managers could across the government agencies addressed with users of the system. deploy and manage volunteers to be a strategy to develop capabilities for and the social service sector for These strategies will facilitate service augment21 service delivery. VWOs more efficient and effective volunteer more effective planning of services, planning, coordination and transition should be supported in developing their management and deployment. managing service transitions management in the sector. Investment own dedicated and robust volunteer and monitoring trends to identify in better analytics and data capturing potential service gaps. The Social tools that enable the measurement of Service Net (SSNet) that is available efficiency and efficacy of our services for social support management could should be added features in systems Recommendation 17 potentially be a rich source of data to such as SSNet. facilitate planning for persons with To improve data collection and analytics to enable better navigation, disabilities and to facilitate transition coordination and planning of services for persons with disabilities (QOL Domain: Environment) CONDUCT STUDIES TO UNDERSTAND THE NEEDS OF PERSONS WITH DISABILITIES AND IDENTIFY SERVICE GAPS DEVELOP A CENTRAL DATABASE OF PERSONS WITH DISABILITIES TO FACILITATE SERVICE While most of the data currently This will continue to provide insights to PLANNING AND TRANSITION collected has been administrative in whether current services are meeting nature, research studies such as the needs or should be redesigned, or Statistical data and information are enabled to deliver their services— NCSS Quality of Life Study (2015), whether new services are required critical to helping stakeholders plan and ranging from information, referral Attitude Study (2015) and Respite to address emerging needs. Such provide better support to persons with services, case management, Care Study (2014) have contributed profile studies can be extended to disabilities and their caregivers. The service provision, social assistance insights into the needs of persons the support systems for persons with Committee therefore recommends and application to schemes and with disabilities and their caregivers. disabilities, such as their caregivers in data collection be improved. subsidy support—can be used to The Committee suggests that more establishing their needs, as well as the A shared portal for service providers capture valuable information to targeted research studies on the quality community in determining their level of providing services for persons with understand the needs of persons of life of children, youth and adults with acceptance of persons with disabilities. disabilities or a shared network with disabilities and plan services. disabilities should be conducted to A central repository for research in which service providers are continue efforts in gaining more in- studies and data collected on persons depth understanding of persons with with disabilities would further facilitate disabilities and analysing the trend of and encourage researchers to conduct 21 MINDS MYG is a volunteer arm of MINDS (www.myg.org.sg). MYG is completely volunteer-run whose span of activities include holding disability incidence rates in Singapore. studies on issues faced by persons weekly programs for clients, organising activities that help to promote inclusion, organises training sessions for the volunteers and recruit volunteers directly. with disabilities. 104 BUILDING THE COMMUNITY BUILDING THE COMMUNITY 105

Strategic TECHNOLOGY IS MADE A PRIORITY Technology can be an enabler to TO IMPROVE THE QUALITY OF LIFE help lower barriers that persons with Direction 8 OF PERSONS WITH DISABILITIES disabilities face in their daily lives and help them become more independent. This will benefit them in the area of “We want to transform our lives for the better, daily living, education, employment, and we have what it takes to achieve this vision— security and communications. It can also be used to help VWOs better serve the capabilities and the daring to pull it all their clients as well as further support To encourage ground-up initiatives together and make a quantum leap forward…” caregivers in providing care to their in improving the lives of persons with care recipients. disabilities, resources such as the Tote — Extracted from Prime Minister Lee Hsien Loong’s speech at the Board-Enabling Lives Initiative Grant launch of Smart Nation in November 2014 Tech Able (an assistive technology and funds VWOs and other organisations innovation centre) was set up to help to innovate or scale successful pilots drive the awareness and adoption of in transition management, caregiver AT by persons with disabilities. Persons and natural support and AT. The with disabilities are enabled to adopt Committee recommends that more AT with assistance from the Assistive resources be put into technology Technology Fund. and the promotion of technology adoption so that technology can be This fund enables more persons with used more pervasively by persons disabilities to use AT by defraying with disabilities to allow them to reach the costs of acquiring such devices. their full potential. Persons with disabilities who are eligible to tap on this fund are entitled As Singapore is a relatively up to $40,000 of subsidies over their small market for AT and IT and lifetime to pay for AT devices. as such costs could be high, it is recommended that global partnerships or alliances for AT are explored for the sourcing of a wider range of AT and at a lower cost. 106 BUILDING THE COMMUNITY BUILDING THE COMMUNITY 107

FIT HOMES WITH TECHNOLOGY TO ENABLE Recommendation 18 INDEPENDENT LIVING FOR PERSONS WITH DISABILITIES IN THE COMMUNITY To include persons with disabilities in the Smart Nation initiative (QOL Domains: Level of Independence, Social Relationships, Environment and Psychological) Technology can help improve the lives of persons with disabilities and provide more opportunities for active and PROMOTE THE USE OF ASSISTIVE TECHNOLOGY/ independent living. The Committee INFORMATION TECHNOLOGY AS ENABLERS believes that there is much potential FOR EMPLOYMENT for technology to be harnessed in this area. Smart Homes can enable AT can be enablers to improve equipment that helps employees with independent living for persons with the employability of persons with disabilities to perform better at work. disabilities in the community. For disabilities. The technology can The Committee recommends raising example, the use of one touch control, be simple, for example modified the awareness of AT for employment robotic homes, tracking of food, keyboards, or involve specialised and the available support. artificial intelligent personal assistants, adaptations or software, to enable and automated replenishment of home video monitoring can be useful to access and use of computers. These VWOs providing training for employment essentials through online orders, home help persons with disabilities live can be funded under the Assistive should also understand what AT and monitoring and sensors enabling independently in the community. Technology Fund to defray the costs of IT are potentially used by employers To achieve this vision, it is important procuring AT devices. so that the training they provide on that Singapore builds an ecosystem these technologies remain consistent and infrastructure that encourage The Open Door Programme subsidises and relevant where possible to what is the development and adoption of job redesign, including the purchase of being used by potential employers. technology for independent daily living by persons with disabilities, the elderly and others who are challenged Yazid, 46, has cerebral palsy. He can in other ways. Technology product walk, but not for long distances. Yazid developers should be encouraged works in a sheltered workshop. He uses a motorised wheelchair and to work with the disability sector and takes the public bus to travel from his persons with disabilities, to develop workplace to his home. products that meet the needs of persons with disabilities.

Source: DesignSingapore Council 108 BUILDING THE COMMUNITY BUILDING THE COMMUNITY 109

STRENGTHEN THE USE OF ASSISTIVE TECHNOLOGY/INFORMATION TECHNOLOGY Tech Able is an integrated AT space that TO ENHANCE LEARNING OUTCOMES aims to help persons with disabilities live and work independently through the Education plays an important listening, reading, and writing, can use of AT. Specialists are on site to assess role in moulding the future of our benefit from the use of AT for enabling users’ needs, recommend and facilitate the trying out of suitable assistive devices, nation, and technology can enable development and acquiring education. as well as provide advice on subsidies students, especially those with and purchase of equipment. Users are disabilities, to learn more effectively. With the pervasiveness of the also able to loan from the AT library which Both mainstream schools and SPED Internet and in view of the additional currently houses over 100 different types schools can strengthen their vulnerabilities of persons with of AT devices. use of ICT and AT/IT to enhance disabilities, schools should promote learning outcomes. Students with the safe and responsible use Source: SG Enable disabilities, who face challenges in of technology.

ENSURE SUFFICIENT SUPPORT FOR ADOPTION OF ASSISTIVE TECHNOLOGY AND TECHNOLOGICAL ACCOMMODATIONS FOR PERSONS WITH DISABILITIES

There should be sufficient Financial assistance schemes such as resourcing to facilitate the learning, the Assistive Technology Fund should training and adoption of AT and be continually reviewed to ensure that technological accommodations, they support new technologies that and their deployment at social benefit persons with disabilities. service agencies serving persons with disabilities. For persons with disabilities, technology is life-changing, in VWOs should also include the use particular accessible technology. of technology in their programmes, It is therefore an imperative that the for example monitoring health data, adoption and affordability of AT for wearables, tele-rehabilitation and persons with disabilities are virtual care delivery. This will help facilitated so that their quality of life increase the reception and awareness can be enhanced. Source: SPD of technology for use by persons with disabilities. Life Expectancy at Birth Age (Years) 100

90 Increase in Number of Children Diagnosed with Number of Working-Age Citizens Has Peaked Developmental Issues 80 Citizens Citizens 70 aged aged 65 2010 2050 20-64 and older 60

Modes of Consultation

BUILDING AN INCLUSIVE SOCIETY 111 Enablers Systems Inclusive Mindsets Technology

Strategic SUPPORT AND EMPOWER PERSONS WITH DISABILITIES TO LIVE WITHIN AND Direction 9 PARTICIPATE ACTIVELY IN THE COMMUNITY

In building an inclusive society that is will allow one and all, including accepting of persons with disabilities, persons with disabilities such as Nazar, Life Course Strategic Directions Impacting Quality of Life Early detection network BUILDING AN the community and society play to live independently and be included an important role—whether they in the community. Only when this Early Intervention (0 - 6 yrs) Timely and effective detection Family/ Primary Community INCLUSIVE SOCIETY are neighbours, service providers, happens will persons with disabilities of disabilities caregivers Care Agencies Partners employers, the general public find greater confidence in interacting Environment including persons with disabilities with others and impactful inclusion Education (7 - 18 yrs) Access to opportunities themselves—in understanding and possibilities be realised. Personal Physical for development and Holistic Nazar, 48, works in a supermarket, acknowledging that they form the beliefs health quality education and keeping the space around the garbage Persons quality ecosystem of mutual support which with containers clean. He was assigned support Employment (+18 yrs) Disabilities to take care of the areas outside the across Level of Improved access to enhanced Psychological services independence supermarket to avoid being seen by Ecosystem for pathways for employment and customers, because children were afraid Persons with Disabilities lifelong learning opportunities of his appearance. He has an intellectual Social Persons with relationships disability and also a syndrome which disabilities are Adult Care (+18 yrs) Responsive and adaptable No. of persons with disabilities served in 2012 and 2015 affects his gums, hands and feet. Nazar is supported and empowered to live services throughout the different conscious of his looks and often receives aregiver Inclusive C s within and participate life stages, to support and care P Early Intervention nasty remarks about his appearance. s u Mindset actively in the for persons with disabilities O b community Programme for l W ic Infants and Children V Environment He shares a 1-room rental flat with a Development friend whom he met at work. It takes a Support Programme long time for Nazar to make new friends Personal Physical beliefs health and he often gives up as he deems it too Persons Adult Disability difficult. He wants an operation on his with Homes Disabilities hands and mouth to make him feel less Level of independence Psychological Day Activity afraid of going out in public. Centres Social s Source: DesignSingapore Council G relationships r e o y v e lo rn p m m e E nt 2500

Family/ Caregivers

Early 1900 1200 Detection Network

Community Primary Care 200 Partners Agencies 850 700

1200 950

2012 2015

Key Achievements under the past Masterplans

Early Intervention

Systems

• More support, training 650 opportunities 140

Colour schemes for :

Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 112 BUILDING AN INCLUSIVE SOCIETY BUILDING AN INCLUSIVE SOCIETY 113

P A R T 2 - C A REGI V I N G T OMO R R O W P A R T 2 - C A REGI V I N G T OMO R R O W Ideas of how a community network can support caregivers and persons with disabilities in the future P A R T 2 - C A REGI V I N G T OMO R R O W P A R T 2 - C A REGI V I N G T OMO R R O W

Kind Eyes is a service that helps to spot people in the community who need support. Local shops are encouraged to use their direct social links to channel caregivers to social services. Kind Eyes is a service that helps to spot people in the community who need support. Local shops are encouraged to use their direct social links to channel caregivers to social services.

I need HOW ARE YOU ZORIADA? I Can somebody Ifetch need HAVEN'T SEEN Care Exchange is a programme initiated my son from school HOW ARE YOU CARE EXCHANGE next Friday? YOU IN A by social services to activate HDB I offer ZORIADA? I SEND WHILE communities. The Resident Community Shopping Can somebody fetch HAVEN'T SEEN leader,Care supported Exchange by isFSC a staff,programme initiated my son from school YOU IN A CARE EXCHANGE next Friday? introducesby social and managesservices tothe activate way HDB CookingI offer WHILE SEND The shop assistant residentscommunities. can exchange The services...Resident Community Shopping leader, supported by FSC staff, Cleaning is a voluntary Kind Cooking Eyes mediator introduces and manages the way Transportation The shop assistant residents can exchange services... Cleaning is a voluntary KindMY SON IS ILL SO I Eyes mediator HAVE TO STAY AT Transportation HOME WITH HIM FROMMY NOW SON ONIS ILL SO I HAVE TO STAY AT HOME WITH HIM The residents can offer and ask for help from one FROM NOW ON another by means of Exchange Cards. Each HDB building will have its own board to display and facilitate matching EASY of needsThe and residents offers. can offer and ask for help from one GUIDE another by means of Exchange Cards. Each HDB building The mediator offers him a will have its own board to display and facilitate matching copy of an EASY GUIDE which EASY of needs and offers. EXCHANGE CARD is published by the Care Hub GUIDE with theThe intention mediator to offers help him a I offer: caregiverscopy ofseek an helpEASY moreGUIDE which EXCHANGE CARDCare Exchange has a digital is effectively.published by the Care Hub platform as well. Help can be with the intention to help I offer: offered and searched via the caregivers seek help more caregiverCare application, Exchange hasthe aCare digital effectively. KIND EYES Cope App.platform as well. Help can be I need: offered and searched via the How to caregiver application, the Care ask the Cope App. rightKIND EYES I need: question?How to ask the I need someone right to help me shop My contact: Trainingquestion? I need someone Shop assistants can Feedback to to help me shop My contact: be trained to tips Family Manager better recognise Training familiesShop that assistants need can Feedback to special besupport trained to tips Family Manager better recognise families that need Source: “Whospecial Cares? support Transforming the caregiving experience in Singapore”,

design- 1 0 ethnography4 - by NCSS & fuelfor - 1 05 -

- 1 0 4 - - 1 05 - 114 BUILDING AN INCLUSIVE SOCIETY BUILDING AN INCLUSIVE SOCIETY 115

While many efforts such as the Participants at the focus group The factors which influence the level With these findings and concerns in ‘See the True Me’ campaign have discussions for 3rd Enabling Masterplan of independence and participation of mind, the Committee recommends heightened awareness of disability expressed five main barriers to greater persons with disabilities in mainstream that more efforts be made to build issues to date, much of the community inclusion in the community: community include the availability positive attitudes towards persons with still lacks understanding and is not of activities that cater to these disabilities, enhance knowledge on accepting of persons with disabilities. I. A general lack of effort by organisers individuals, physical accessibility, how to interact with them and include This discourages persons with in taking into consideration the needs accessibility to information and ease persons with disabilities in all settings. disabilities from participating and living of persons with disabilities in national of communication. These factors also independently in the community which and community initiatives influence a person with disability’s in turn may result in social isolation and perception level of feeling safe in the an erosion of the quality of life of II. Limited opportunities for inclusion at community and his ability to move these individuals. a young age for both children with about independently with confidence. and without disabilities The NCSS QOL study found that inclusion through active participation III. A lack of specific consideration Recommendation 19 in society contributed strongly to of accessibility and safety issues a good quality of life for persons pertaining to persons with To build positive attitudes towards persons with disabilities and with disabilities. However, surveys disabilities due to inadequate public improve knowledge on how to interact with them done with persons with disabilities understanding and awareness (QOL Domains: Social Relationships and Psychological) showed that they perceived having limited opportunities for leisure and IV. A lack of confidence in persons recreation. Some cited the lack of with disabilities to participate in the PROMOTE INCLUSION AND BETTER UNDERSTANDING accommodations for persons with community OF THE SPECTRUM OF ABILITIES AMONG PERSONS WITH AND WITHOUT DISABILITIES disabilities as a limiting factor to V. Barriers to accessing their participation in these activities. soft infrastructure22 Participants of the focus group being stereotyped with having less Improving opportunities for interaction discussions shared that while some ability, and is not representative of in the community between persons Caregivers may also be overly- members of the public have some the spectrum of abilities that persons with and without disabilities is therefore protective and unknowingly hold back knowledge of disability and related with disabilities have. The Lien crucial. the persons with disabilities whom they issues, they did not know how to Foundation study also revealed that are caring for from realising their full interact with persons with disabilities. many parents of children with special potential and participating in In addition, the frequent portrayal needs cited ‘pity’ as one of the most the community. of persons with disabilities needing common emotions observed as assistance has resulted in them adults interacted with their children 22 Soft infrastructure refers to the agencies and organisations which are required to maintain economic, health, cultural and social standards of Singapore. This includes Singapore’s financial, education and health care system, the system of government, law enforcement and emergency services. 116 BUILDING AN INCLUSIVE SOCIETY BUILDING AN INCLUSIVE SOCIETY 117

with special needs. Such perceptions community groups and associations to Platforms for interaction with the public reveal a lack of understanding and expand public outreach and facilitate can also serve to build confidence ask for help and when to turn down acceptance of persons with disabilities activities to encourage interaction among persons with disabilities and help when it is not necessary. This will which affects the desire and motivation between persons with and without the belief that they too can play a role complement public education efforts of persons with disabilities to disabilities. This will also help build a in building inclusion in the community. to raise awareness of persons with participate in the community. positive self-identity among persons For example, persons with disabilities disabilities and their abilities. with disabilities. For example, this can should be taught when and how to A more accurate and better be in the form of carefully curated understanding of persons with disability awareness activities to disabilities will go a long way enhance public understanding of to building an inclusive society. disability and persons with disabilities. EDUCATE THE PUBLIC TO RESPECT THE USE OF Members of the public tend to be less ACCESSIBLE FEATURES judgemental of any atypical behaviour The Committee is also of the view While Singapore has made much in public if and when they understand that the frontline staff in various progress in making our public spaces the nature of the disability. public service agencies, for example, accessible to persons with disabilities, shared that facilities meant for persons hospitals, police and community more can be done to raise awareness with disabilities, such as accessible The Committee therefore recommends centres, should be equipped with among the public that disability-friendly toilets, were sometimes used as that the current public awareness knowledge and trained so that they features are meant for persons with storerooms or locked, or ramps were efforts by NCSS be leveraged and can communicate with customers with disabilities who require additional blocked by bicycles, thus making it enhanced by partnering other disabilities more effectively. stakeholders such as public agencies, support for mobility and in other inconvenient or impossible for persons areas of daily living, and that such with disabilities to access community facilities should not be misused by settings. In 2015, NCSS ran a public INCREASE OPPORTUNITIES FOR INTERACTION BETWEEN members of the public. Participants education campaign23 to remind PERSON WITH DISABILITIES AND MEMBERS OF PUBLIC at the public consultation sessions drivers to be gracious by not parking in accessible parking lots. To reduce The Attitude Study conducted by so that understanding through positive the misuse of accessibility features, the the NCSS in 2015 found that a higher experiences can be built. This can Committee recommends that efforts frequency of contact with persons be done in the form of activities and continue to educate the public on with disabilities correlated with gatherings held at the community the use of accessible features. more favourable attitudes towards or neighbourhood level, organised these individuals. The Committee by grassroots organisations, interest therefore recommends increasing groups, associations and other the opportunities for the public to community partners. interact with persons with disabilities 23 The Let’s Be Gracious campaign was launched by NCSS with the support of MSF, MND, BCA, HDB, LTA, NParks, SG Enable and URA. It consisted of radio advertisements and island-wide publicity banners and posters. 118 BUILDING AN INCLUSIVE SOCIETY BUILDING AN INCLUSIVE SOCIETY 119

Recommendation 20

To include persons with disabilities in all settings (QOL Domains: Level of Independence, Social Relationships, Environment and Psychological)

To encourage the inclusion of persons The Committee recommends that the with disabilities in all settings, policies, Government should always include the programmes and solutions should be needs of persons with disabilities when designed with persons with disabilities shaping policies and when designing and their needs in mind. Feedback and and implementing national initiatives. suggestions gathered from the public By doing so, the Government will be consultations have highlighted that seen as taking the lead in society’s role there are existing national frameworks in accepting persons with disabilities in and resources such as the SkillsFuture the mainstream of life. and Smart Nation initiatives, that should be leveraged to better support persons with disabilities.

DEVELOP AN INCLUSION INDEX FOR PERSONS WITH DISABILITIES

Studies such as the QOL Study and inclusion index which serves as a tool Attitude Study conducted by NCSS for evaluating Singapore’s progress The Purple Parade is a ground-up movement that supports the inclusion and in 2015 provide baseline information in inclusion across a broad spectrum celebrates the abilities of persons with special needs. It covers a series of awareness- on the inclusion of persons with of attributes, for example, attitudes, building activities in October and November each year with a campaign, carnival, contingent march-past and concert. The Purple Parade began in 2013 with disabilities in Singapore. perceptions, accessibility and 4,500 participants and grew to 10,000 in 2016. At the recent Purple Parade, 135 employment, which gives a sense of organisations from the public, private and people sectors came together in the city The Committee recommends how both persons with and without district on 5 November 2016. developing or leveraging an existing disabilities perceive each other.

Source: The Purple Parade 120 BUILDING AN INCLUSIVE SOCIETY BUILDING AN INCLUSIVE SOCIETY 121

ADOPT THE PRINCIPLES OF UNIVERSAL DESIGN IN THE BUILT ENVIRONMENT TO IMPROVE ACCESSIBILITY

Under the second Enabling The Committee recommends that Masterplan, efforts were made to the Principles of Universal Design and improve accessibility and participation guidelines be incorporated when by persons with disabilities in designing products, buildings and community, sports and employment. exterior spaces which will ensure that these can be used by everyone. Building and Construction Authority (BCA)’s Code of Accessibility in the Built Environment24 which was revised in 2013 has helped to create more accessible and inclusive buildings for persons with disabilities, seniors and families with young children. Universal Design Guides25, including the Universal Design Guide for Public Places published in 2016, help designers create more inclusive public buildings and exterior spaces. The BCA Universal Design Award introduced in 2006, subsequently Universal Design makes buildings and places such as foodcourts and cafes replaced with the BCA Universal user-friendly and accessible for all ages 26 Design Mark in 2012, has further and abilities NDP 2016 featured a segment where over 150 participants with special needs from encouraged building owners to adopt across seven VWOs led the 55,000-strong audience in song-signing to favourite Universal Design principles for their Source: BCA National Day songs such as Home and Count on Me, Singapore. This performance was buildings. also accompanied by 420 participants from the Singapore Soka Association to create a mass display of images adapted from hand-painted artwork of students with special needs. The specially curated performance portrayed inclusiveness and the importance of building a kind and gracious society in the future by embracing people from all walks

of life. 24 See BCA’s website: http://www.bca.gov.sg/friendlybuilding/contents/Contents.aspx?ContId=439

25 See BCA’s website: http://www.bca.gov.sg/friendlybuilding/Contents/Contents.aspx?Id=66

Source: MINDEF 26 See BCA’s website: http://www.bca.gov.sg/friendlybuilding/contents/Contents.aspx?Id=118 122 BUILDING AN INCLUSIVE SOCIETY BUILDING AN INCLUSIVE SOCIETY 123

With infrastructure and facilities The Committee therefore recommends However, feedback gathered from constantly being upgraded and that when renovations or changes are the focus group discussions revealed renovated, persons with disabilities are made to a physical environment, the that there are still many physical, affected when the temporary physical parties involved in these renovations information and communication features or routes do not take into or changes (i.e. developers, resident barriers for persons with disabilities. account their needs. A person with committees, vendors engaged in For example, lack of signage visual impairment may have to public works, and other relevant and inaccessible technology. re-orientate himself to an alternative agencies) should ensure that These barriers not only affect their route, or a person with physical alternative accessible routes for independence and ability to tap impairment may no longer be able to persons with disabilities are considered on community resources, activities use the same path due to the lack and made. and facilities, but also have safety of ramps. implications. For instance, the lack of Removing barriers to soft accessible evacuation routes or visual infrastructure IMPROVE PHYSICAL, INFORMATION AND COMMUNICATION or aural information in place to help ACCESS FOR PERSONS WITH DISABILITIES persons with disabilities during times of There are various processes and emergency such as train breakdowns. legislation available to protect Enhancing accessibility Communication access is also persons who lack mental capacity important to enable persons with and are vulnerable. These include Enhancements to the public affordable for persons with disabilities. disabilities to obtain help. For example, persons making a Lasting Power of 28 transport system have made it Dedicated transport services were a person with hearing impairment will Attorney under the Mental Capacity possible for persons with disabilities also introduced for persons with more not be able to use the intercom when Act to voluntarily appoint one or more to move around more conveniently severe disabilities. The transportation trapped in a lift. persons to act or make decisions on and independently. system, which has become more their behalf when they lose mental accessible and affordable for persons capacity; and appointing through 27 More than 80% of our bus stops with disability with the support of the Court a Deputy who is given and public buses have been made transport subsidy, demonstrates a authority to make decisions on behalf wheelchair-accessible, with the well-designed and integrated model of a person who lacks capacity in target for all public buses to be with persons with disabilities at the relation to his personal welfare and/or wheelchair-accessible by 2020. heart of it. This allows persons with property and affairs under the Mental The Public Transport Concession disabilities to be better integrated into Capacity Act. scheme was also introduced in the community. July 2014 to make travelling more

27 https://www.lta.gov.sg/content/ltaweb/en/public-transport/system-design/enhancing-physical-accessibility-for-all.html

28 https://app.msf.gov.sg/Press-Room/Dedicated-Transport-Services-for-Persons-with-Disabilities 124 BUILDING AN INCLUSIVE SOCIETY BUILDING AN INCLUSIVE SOCIETY 125

However, these processes are perceived by the persons with disabilities or their caregivers as complicated, costly and time consuming. Caregivers of adults with The Committee therefore recommends intellectual disabilities shared that they simplifying the current processes faced challenges in opening bank for Lasting Power of Attorney and accounts for the persons under their Deputyship and guidelines as well care (including accessing the SNTC as making more schemes available Trust and Special Needs Savings to persons with disabilities and Scheme) or in giving consent for caregivers of persons with disabilities non-emergency medical procedures. who have diminished mental capacity For persons with disabilities and their for the provision of services such as caregivers, the navigation through financial and healthcare services. such processes has also proven to be Photo: Sport Singapore challenging. Through the Disability Sports Master Plan, we want to further harness the potential of sport by making it easier for those with disabilities to lead an active lifestyle.

PROMOTE SOCIAL INTERACTION AND One of the recommendations in the Master Plan is to set up Centres of Expertise for INCLUSION IN PHYSICAL SETTINGS AND Disability Sports. These Centres will provide sports facilities and programmes for ACTIVITIES, INCLUDING SPORTS AND persons with disabilities, making it easier for them to learn a sport. CULTURAL ACTIVITIES Sport Singapore introduced the “Yes! I Can” Swim Programme at the ActiveSG Sengkang Swimming Complex. The programme is tailored for persons with As part of its efforts to improve and opportunities for persons with disabilities (see above). community participation, sports and disabilities in sports participation a healthy lifestyle amongst persons amongst its objectives. As part of this Source: Ministry of Culture, Community and Youth with disabilities, the Ministry of Culture, Disability Sports Master Plan, the first Community and Youth (MCCY) Centre of Expertise for Disability Sports launched the Disability Sports Master was launched on 31 May 2016 at Plan which includes improving access ActiveSG Sengkang Sports Centre. 126 BUILDING AN INCLUSIVE SOCIETY BUILDING AN INCLUSIVE SOCIETY 127

NCSS has been working with the National Parks Board and Town Councils to build inclusive playgrounds island-wide, with three already built. More inclusive playgrounds will be built across Singapore.

“Sport has been a big part of my life and has shaped me into who I am today. It is my hope that sport can also impact the lives of many others with or without a disability. The Disability Sports Master Plan will go a long way in shaping the mindset of Singaporeans towards persons with disabilities. It will also help more people with disabilities lead a more holistic life.”

— Yip Pin Xiu

Yip Pin Xiu, three-time gold medallist at the Paralympic Games and world record holder for 100m backstroke S2 event Photo: NCSS Mr Abhimanyau Pal, Executive Director of SPD, said: “Inclusive playgrounds like this will Source: Sport Singapore enable children with special needs to have fun alongside their able-bodied peers. This is a positive step towards helping them integrate into the society early in their lives and encourage them to be ‘out there’ participating actively with their peers rather than be an observer from the outside. This also creates opportunities for interaction between able- bodied children and those with disabilities which will result in greater understanding and acceptance among the next generation of Singaporeans.”

Source: SPD 128 BUILDING AN INCLUSIVE SOCIETY BUILDING AN INCLUSIVE SOCIETY 129

In tandem with Singapore hosting the with disabilities. In recognition of 8th ASEAN Para Games for the first these efforts, the National Museum The ‘Quiet time in 2015, the ‘Be Socially Enabled’ of Singapore was awarded the BCA Mondays’ campaign was launched by NCSS to Universal Design Mark Award for programme has been in place increase the public’s awareness and wheelchair users. since 2013 at knowledge on how to interact with Asian Civilisation persons with disabilities. ‘We Are Able!’ Beyond physical infrastructure, National Museum and events were also launched in January Gallery Singapore, National Museum of the Peranakan 2014 and February 2016 to engage Singapore, Asian Civilisations Museum Museum, where persons with disabilities and celebrate and the Peranakan Museum have also special needs their abilities and contributions. initiated programmes for those with and elderly disabilities. National Gallery Singapore groups enjoy priority bookings and tailored programmes. The above photo is from the pilot programme for elderly in long-term care. This programme, a collaboration To increase accessibility to arts offers Singapore Sign Language with the Agency for Integrated Care and Ling Kwang Home for Senior Citizens, was and heritage offerings, MCCY Interpretation tours, while the other internationally recognised as one of the top 20 best practices in the International extended concessions to persons museums have launched a ‘Quiet Council of Museums—Committee for Education and Cultural Action (ICOM-CECA) with disabilities from 1 June 2016 Mondays’ programme to encourage Best Practice Book 2016. at all National Heritage Board (NHB) persons with disabilities to visit the museums and heritage institutions museums on Monday mornings. Source: Peranakan Museum, 2016 as well as the Singapore Art Museum and National Gallery Singapore. In 2015, the National Arts Council (NAC) Superhero Me Persons with disabilities enjoy the organised the inaugural Arts & Disability is an inclusive lowest concession price for permanent Forum as an annual platform to bring ground-up and special exhibitions, and an artists and the disability sector together community arts movement accompanying caregiver is also given to explore how the arts can play a part inspiring special- in engaging people with disabilities. In complementary entry. Singaporeans needs children and Permanent Residents are also able 2016, NAC partnered British Council and those from to enjoy free entry to all exhibitions Singapore and Singapore International low-income at NHB museums and heritage Foundation to co-organise the Forum, communities to institutions all year round. together with support from National build resilience Gallery Singapore. It was a three-day and a stronger sense of self. Superhero Me 2016: The Special Edition was supported Museums such as the National Forum with the theme “Shaping by Lien Foundation and the NAC. It involved over 80 children, young artists and youth volunteers from all walks of life who put together a month-long art show and Museum of Singapore and National Perspectives, Enabling Opportunities” inclusive tours for the public. Gallery Singapore are also access- which aimed to raise awareness on friendly, with designated parking how the arts and culture could shape Source: Superhero Me and accessible restrooms for visitors an inclusive society. 130 BUILDING AN INCLUSIVE SOCIETY BUILDING AN INCLUSIVE SOCIETY 131

“I want the public to know “A life spent making arts is that I have passion for music not only more honourable, but and I am not writing and more useful than a life spent singing just to raise funds doing nothing and wallowing for my condition. This also in self-pity” means that I can share my — Eugene Soh Yew Lin experience and life with the public and express my views on friendship and life.”

— Adelyn Koh

Unseen: Constellations is a two-year long project initiated by artist Alecia Neo and Very Special Arts (VSA) Singapore Ltd supported by the NAC which provided seven youths who live with visual impairment The mission of VSA is to provide access and opportunities for persons with disabilities to explore their self-identities and dreams through art. to the arts for enjoyment and integration into society.

Source: Very Special Arts Singapore Ltd Adelyn dreams of being a professional singer-songwriter. Under the guidance of her mentor Sarah Ismail, Adelyn wrote three original songs focusing on the challenges of integration she faces in school, and how she turns to her close friends and family for While much has been done to persons with disabilities in sport and support. Her positive and child-like lyrics reveal an inspiration from relationships in her encourage the participation of cultural activities to help them lead daily life: incidents of misunderstandings; isolation; and possible reconciliatory actions. persons with disabilities in sport, active and balanced lifestyles, and Source: Alecia Neo, Unseen: Constellations, 2016 cultural and social activities, only to encourage their inclusion into the a small percentage participate in community. More attention should be these activities. The Committee given to encourage and improve the recognises the importance of participation of persons with disabilities increasing the participation of in these activities. Organisations ACKNOWLEDGEMENTS Association for Persons with Special Needs National Council of Social Service Attorney-General’s Chambers People’s Association The Steering Committee would like to accord its heartfelt appreciation to Autism Resource Centre The Purple Parade the organisations and individuals that have worked with us to produce the AWWA Saint Andrew’s Autism Centre 3rd Enabling Masterplan report and have given their valuable time to share Cerebral Palsy Alliance Singapore SG Enable ideas, thoughts and feedback on making Singapore a more caring and Lien Foundation Singapore Association of the Visually inclusive society. Movement for the Intellectually Disabled Handicapped of Singapore Singapore Disability Sports Council Special thanks to the National Council of Social Service (NCSS) for its Ministry of Culture, Community and Youth Singapore Red Cross Society involvement in this Masterplan. NCSS, together with DesignSingapore Ministry of Defence SPD Council and fuelfor, also provided insights generated from design research Ministry of Education Sport Singapore projects, including illustrations and photographs from the “Who Cares? Ministry of Health The Singapore Association for the Deaf Transforming the Caregiving Experience in Singapore” publication. Ministry of National Development Thye Hua Kwan Moral Charities Ministry of Social and Family Development TOUCH Community Services Muscular Dystrophy Association Singapore Very Special Arts Singapore Ltd National Arts Council

Individuals Nur A’zimiee Ansar Binte Md Ayoob, Aaron Oh and his family, Abhimanyau Pal, Adelyn Koh, Alecia Neo, Azizah, Eng Chwee, Eric Yao, Eugene Soh, Chloe Liew, Jason Ong Eng Kiat, Jeric Yang and his parents, Koh Huimin, Lam Kwok Leong, Md Akhbar Bin Md Yusof, Md Ashraf Bin Md Yusof, Minah Binti Mohd, Mohd Yazid Bin Mohd Sani, Nazar, Norrizwan Rasip, Saravanan, Tan Huiqun, Tan Kian Song, Willis, Yang Zhenbin, Tan Mui Mui, Yip Pin Xiu

29 NCSS had commissioned fuelfor to carry out a strategic design project to design a better caregiving future for Singapore. For more information on the project, please visit http://www.fuelfor.net/ncss