The increase skills and capability to increase
TheNational Disability Insurance Scheme (NDIS) has been put in place to deliverongoing support for individuals with a disability along with their families andcarers. The NDIS have introduced an insurance scheme to help promoteoccupational participation for individuals with a disability and help enableeach individual to increase skills and capability to increase participation andemployment in the community.
The NDIS will outline the reasons for occupationalinjustice to allow those with disability and their families the chance to livean ordinary life and the opportunity to achieve their goals. 1. The past and present impacts of culture,attitudes, values and beliefs on the life chances of people with disability inAustralia Overthe years, the perspectives of people with a disability within Australia havechanged shown through the statement “The key is trying to achieve the same goodstandard of life for people with developmental disabilities as we want forpeople who live in the general society” (Bengt Nirje, 2016). In the past “People withdisability have been ignored, hidden, cursed and treated as unwanted.”(Margaret Verick, 2015, pg. 1).
Up until the late 1970’s people with adisability were dealt with by being put into intuitions or prisons (PWDA,2010). In the 20th century the theory of Social Darwinism evolvedbeing referred to as the ‘Survival of the Fittest’ believing that those with disabilitieswere unfit and would hinder the process of natural selection. It was believed thatpersons with a disability were outbreeding others which was leading to a ‘dilutionof the gene pool’ (Kielhofner, 2005)During the 1980’s – 1990’s perceptions ofdisability began to change with introduction of equality legislations and ashift in negative attitudes and beliefs within society. In 1981, the International Year of Disabled personswas created to emphasize equalization of opportunities, rehabilitation andprevention of disabilities by the United Nation (UN Enable, 2016). In 1992, theDisability Discrimination Act was put in place to prevent discrimination ofthose with a disability and promote acceptance within the community. In 2008, theConvention on the Rights of persons with disabilities was signed by Australia alongwith 80 other countries at the UN in New York to outline human rights forpeople with a disability and allowing them to be recognized and acknowledgedwithin the community supported by the Australian Government. (Australian HumanRights Commission, 2017) To ensure the correct attitudes within today’ssociety it is important people are better educated about disability, more opportunitiesare made, positive attitudes are shaped from an early age and the mediapositively portray views of people with a disability within society.
2. The theoretical framework underpinning theNDIS and how this differs in relation to previous theoretical understandings ofdisability in Australian society The NDIS isan insurance scheme that will help to provide persons under the age of 65 witha disability ongoing support to live an ordinary life. The NDIS will fundsupports and services chosen by the individual to help increase occupationalperformance and enable the person to achieve their goals and live their livesto the fullest of their ability. The NDIS uses different frameworks to closethe gap and gain equality for those that suffer from occupational injusticeswithin society and change the views around the negative stigma associated withpeople with a disability.
A framework used by NDIS is the 3 pillars, this includes having an Insurance Based Approach,this shares the cost of services and supports within the community by maximisingeconomic and social benefits of the resources used. (Upadhyay, 2013). Choiceand Control which gives the individual freedom to choose how much control theywant over the management of their own funds and support and Community andMainstream which focuses on participation of the individual within thecommunity allowing interaction between mainstream and supports within thecommunity. Overlappingthe 3 pillars the NDIS uses the 3 tiers as a scheme to categorise people into 3different groups, Tier 1 targets everyone in Australia who may acquire a disabilitywhich promotes inclusion and opportunities with all costs for care and supportcovered. Tier 2 targets people with a disability plus their primary carers, theNDIS will provide connections to the right supports and community andmainstream services to ensure they receive the correct care. Tier 3 targetsthose with an ongoing permanent disability with significant care needs, thisprovides individuals with funding packages for the supports they need for functionalimpairment from their disability including equipment, transport, homemodification and personal care (Yooralla, 2016). Another frameworkused by the NDIS to measure goal attainment for each individual is the NDISOutcomes Framework.
This consists of 8 domains which are used to record overallperformance and assess the benefits of the NDIS for participants. The 8 domainsincluded in the framework are “1. Daily Living 2. Home 3. Health and Well-being4. Lifelong Learning 5. Work 6.
Social and Community Participation 7.Relationships 8. Choice and Control” (Ability Options, 2017).
The domains helpto address goals within different areas of an individual’s life and assist inplanning supports at a more individual, client centred level. The WorldHealth Organisation (WHO) International Classification of Functioning,disability and Health (ICF) has directly influenced the design of the NDIS whichwas developed in alignment with the ICF (RACP, 2016) The ICF helped to align theNDIS to increase occupational participation for individuals with a disability. As a framework,the biomedical model focuses purely on biological factors rather than coveringa holistic approach of an individual’s disability however the current model ofdisability being used ‘The Biopsychosocial Model’ approaches a combination offactors including biological, psychological and social factors. The elements ofbody, mind and environment are considered to affect each other with therelationship between the 3 elements creating the results of a particular outcome.
The NDIS use the current Biopsychosocial Model to understand the unique needsof an individual looking at body function, activities, participation and environmentalfactors used for effective planning. 3. How services, systems and governmentpolicies have responded to the needs of people with disability in Australia andtheir families in the past, and associated issues of occupational injustice Servicesystems and government policies have significantly changed over time in responseto the needs of people with a disability. Government policies have helped tochange negative attitudes beliefs and values towards people with a disabilityshift to a more positive view within society. Statedby Kirsten Deane (2009) “support systems in Australiahave been described as underfunded, unfair, fragmented and inefficient”. It wasseen that rather than those with a disability having access to services andsupport as a basic human right, this was not provided due to lack of availabilityof funding and negative political influence.
(Department of Families, Housing,Community Services and Indigenous Affairs, 2009). Accordingto the Productivity Commission (2011) there was a lack of choice and no accessto much needed supports for people with a disability, this shaped the views ofhealth systems for those with a disability within Australia. In 2011, the ‘ProductivityCommission’ proposed the ‘Individual Choice Model’ to allow people with adisability and their families or carers to decide how much control and choice theywant to exercise surrounding support and participation in the community tocreate a more client cantered based system and increase self-management.A key event by the World HealthOrganisation was changing the definition of health to a more holistic viewchanging health to “a state of completephysical, mental and social well-being and not merely the absence of disease orinfirmity” (WHO 1946).
This definitionchanged the public view of health showing the different factors that caninfluence a person’s health. The Carer Recognition Act 2010 wascreated to increase public awareness, rights and support of the role of a careerin looking after a person with a disability. This Act enabled the government tofund carers in order to meet the needs of their responsibilities. (dss.gov.
au,2017)The Australian Government developedthe ‘National Disability Strategy’ a ten-year plan between (2010-2020) to helpclose the gap of injustice for those with a disability as equal members ofsociety. The stratgey ensures people with a disability have the right support toparticipate in the community (dss.gov.
au, 2012)The government initiating the NDISis a step forward for freedom, it has provided great increase of support andservices along with access to services for all people with a disability, theirfamily and carers. 4. Strategies adopted by the NationalDisability Insurance Agency to improve occupational participation Toimprove participation and occupational justice for people with a disability theNational Disability Insurance Agency (NDIA) as an independant agencyimplemented the National Disability Insurance Scheme (NDIS) within Australia.
The NDIA has an aim to increase access toemployment and increase skills of those with a disability, this is beingimplemented through their ‘Accessibility Action Plan 2013-2017’ where the NDIAis working along with the state and commonwealth government to increase supportfor people with a disability (NDIA, 2014).Aspart of the ‘Accessibility Action Plan’ the NDIA plan to increase employmentfor those with a disability by employing people for their own agency forsuitable roles. The plan will allow people with a disability access to trainingto increase skills needed in the workplace, ensure accessible and supportiveenvironments within the workplace and develop a culture which will influenceother companies within Australia to employ people with a disability.
(NDIA,2014).Astrategy created to increase occupational participation of people with adisability was the Assistive Technology (AT) Strategy which was created inOctober 2015 to increase participation of people with a disability through the developmentof individualised technology. (NDIS annual report 2015-2016). By listening tothe demands of participants involved they are able to better understand anddesign universal AT for people with a disability. TheNDIS are working to decrease occupational injustice by making the scheme availableto everyone, they currently assist diverse communities within Australia andhave developed a ‘Rural and Remote Strategy’ for those in rural and remoteareas with a disability to feel they can participate in the community and havethe resources they need equally available to them. Anotherstrategy created is the ‘Aboriginal and Torres Strait Islander Engagement Strategy’implemented to establish trust across all communities and deliver the NDIS to aboriginaland Torre strait Islander communities (NDIS, 2017) along with releasing a ‘MentalHealth Strategy’ to improve opportunities for people living with a psychosocialdisability by increasing supports and developing individual packages for thosewith a psychosocial disability.TheNDIS launched a ‘Delivery Strategy’ with 3 mains goals including beingfinancially sustainable and governed using insurance principals including beingfinancially sustainable including payments for supports to individuals,distribution of packages to individuals and basing all operations on stronginsurance principals and reliable data.
The second goal is allowing the peoplewith a disability to be the ones in control of their choices decreasing theoccupational injustice this came from the UN convention on the rights of a personwith a disability, this Is done by an increase of supports, service providers,increase of opportunities and promoting independence. The third goal of theDelivery Strategy which aims at community satisfaction is allowing thecommunity to have pride in the NDIS by working with the government, raisingcommunity awareness and seeking the views of those with a disability. In conclusion,the NDIA implementing the NDIS has provided a new way of giving support topeople with a disability allowing them to be in control of their decisions andsupporting people with a disability to achieve their goals.
By putting in placeseveral strategies and using different frameworks it has allowed a significantincrease of occupational participation and decrease of occupational injusticefor people with a disability all over Australia.