Adequacy of Existing Residential Care Arrangements Available for Young People with Severe Physical, Mental Or Intellectual Disabilities in Australia
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The Senate Community Affairs References Committee Adequacy of existing residential care arrangements available for young people with severe physical, mental or intellectual disabilities in Australia June 2015 Commonwealth of Australia 2015 ISBN 978-1-76010-247-0 Secretariat Ms Jeanette Radcliffe (Committee Secretary) Ms Monika Sheppard (Senior Research Officer) Mr Tasman Larnach (Acting Senior Research Officer) Ms Megan Jones (Research Officer) Ms Carol Stewart (Administrative Officer) PO Box 6100 Parliament House Canberra ACT 2600 Phone: 02 6277 3515 Fax: 02 6277 5829 E-mail: [email protected] Internet: www.aph.gov.au/senate_ca This document was produced by the Senate Community Affairs Committee Secretariat and printed by the Senate Printing Unit, Parliament House, Canberra. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Australia License. The details of this licence are available on the Creative Commons website: http://creativecommons.org/licenses/by-nc-nd/3.0/au/ ii MEMBERSHIP OF THE COMMITTEE 44th Parliament Members Senator Rachel Siewert, Chair Western Australia, AG Senator Zed Seselja, Deputy Chair Australian Capital Territory, LP Senator Catryna Bilyk Tasmania, ALP Senator Carol Brown Tasmania, ALP Senator Jo Lindgren (from 15 June 2015) Queensland, LP Senator Nova Peris OAM Northern Territory, ALP Senator Linda Reynolds (to 15 June 2015) Western Australia, LP Participating members for this inquiry Senator Claire Moore Queensland, ALP Senator Helen Polley Tasmania, ALP Senator Dean Smith Western Australia, LP iii iv TABLE OF CONTENTS Membership of the Committee ........................................................................ iii Abbreviations ..................................................................................................... ix List of Recommendations ............................................................................... xiii Chapter 1 Introduction .............................................................................................................. 1 Terms of Reference ................................................................................................ 1 Conduct of the inquiry ............................................................................................ 2 Acknowledgements ................................................................................................ 3 Structure of the report ............................................................................................. 3 Chapter 2 Young people in residential care and unmet need—trends and statistics .......... 5 Introduction ............................................................................................................ 5 Young people living in the residential aged care system and other cared accommodation ....................................................................................................... 5 Table 2.1: Number of young people (<65 years of age) in residential aged care facilities by state and age group in 2013–14 .................................................. 7 Table 2.2: Number and per cent of young people in permanent residential aged care by age group in 2013–14 ........................................................................ 7 Trends for young people ......................................................................................... 9 Recent initiatives and inquiries for young people with disability in RACF ........ 10 Figure 2.1: Number of people (aged 0–49 years) admitted to permanent residential aged care ............................................................................................. 11 Unmet need ........................................................................................................... 13 Chapter 3 Residential aged care facilities as an accommodation option for severely disabled young people ............................................................................................ 15 Introduction .......................................................................................................... 15 International obligations ....................................................................................... 16 The right to choose a home .................................................................................. 16 Suitability of Residential Aged Care Facilities and other types of accommodation ..................................................................................................... 17 Supporting families and individuals to stay at home or in the community .......... 29 Committee view .................................................................................................... 34 Chapter 4 Current systems of care for young people living with severe disability ............ 37 Introduction .......................................................................................................... 37 Service delivery and transition ............................................................................. 37 Table 4.1: Estimated costs of delayed transitions through the rehabilitation continuum ............................................................................................................. 44 Figure 4.1: Model of continuous care .................................................................. 55 Table 4.2: Summary of accommodation options for young people living with disability ....................................................................................................... 58 Regional, rural and remote communities ............................................................. 65 Assisted decision making and advocacy .............................................................. 69 Training the workforce ......................................................................................... 75 Chapter 5 The Younger People with Disability in Residential Aged Care Initiative, the National Disability Agreement and the National Disability Insurance Scheme ..................................................................................................................... 79 Introduction .......................................................................................................... 79 Younger People with Disability in Residential Aged Care Initiative .................. 79 Figure 5.1: Extract from the Mid-term YPIRAC scheme report .......................... 81 National Disability Agreement ............................................................................. 82 National Disability Insurance Scheme ................................................................. 84 Subsequent developments and current support options for young people with a disability .................................................................................................... 92 Figure 5.2: Process for support assessment options for young people with a disability who are known to the DSC ................................................................ 94 vi Figure 5.3: Process for support assessment for young people with a disability not known to the DSC .......................................................................... 95 Committee view .................................................................................................... 98 Chapter 6 Conclusion and Recommendations ....................................................................... 99 Introduction .......................................................................................................... 99 Recommendations to the Australian Government .............................................. 100 Recommendations to the Joint Standing Committee on the National Disability Insurance Scheme .............................................................................. 102 Recommendations to the Council of Australian Governments (COAG) ........... 102 Appendix 1 Submissions and additional information received by the Committee ............. 107 Appendix 2 Public hearings ...................................................................................................... 117 vii viii ABBREVIATIONS AA Alzheimer's Australia ABI Acquired Brain Injury ACAT Aged Care Assessment Team ACT Australian Capital Territory ADACAS Australian Capital Territory Disability, Aged and Carer Advocacy Service Inc AHAC Anyinginyi Health Aboriginal Corporation AHCS Australian Home Care Services AIHW Australian Institute of Health and Welfare BCG Brightwater Care Group CAP Combined Application Process COAG Council of Australian Governments DANA Disability Advocacy Network Australia DDWA Developmental Disability Western Australia DRC Disability Reform Council (COAG) DSC Disability Services Commission (Western Australia) DSS Department of Social Services (Australian Government) FASD Foetal Alcohol Spectrum Disorder HACC Home and Community Care HCS Home Care Service HOF Housing Options Facilitator ILC Information, Linkages and Capacity Building ISP Individualised Support Package LAC Local Area Coordinators LASA Leading Age Services LWB Life Without Barriers MJD Machado Joseph Disease NACAP National Aged Care Advocacy Program NADA National Disability Advocacy Program NDA National Disability Agreement NDIA National Disability Insurance Agency NDIS National Disability Insurance Scheme NDS National Disability Strategy ND SPP National Disability Specific Purpose Payment NIIS National Injury Insurance Scheme NRHA National Rural Health Alliance NSW New