The employment in the community. The NDIS will

 

The
National Disability Insurance Scheme (NDIS) has been put in place to deliver
ongoing support for individuals with a disability along with their families and
carers. The NDIS have introduced an insurance scheme to help promote
occupational participation for individuals with a disability and help enable
each individual to increase skills and capability to increase participation and
employment in the community. The NDIS will outline the reasons for occupational
injustice to allow those with disability and their families the chance to live
an 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 in
Australia

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Over
the years, the perspectives of people with a disability within Australia have
changed shown through the statement “The key is trying to achieve the same good
standard of life for people with developmental disabilities as we want for
people who live in the general society” (Bengt Nirje, 2016). In the past “People with
disability have been ignored, hidden, cursed and treated as unwanted.”
(Margaret Verick, 2015, pg. 1). Up until the late 1970’s people with a
disability were dealt with by being put into intuitions or prisons (PWDA,
2010). In the 20th century the theory of Social Darwinism evolved
being referred to as the ‘Survival of the Fittest’ believing that those with disabilities
were unfit and would hinder the process of natural selection. It was believed that
persons with a disability were outbreeding others which was leading to a ‘dilution
of the gene pool’ (Kielhofner, 2005)

During the 1980’s – 1990’s perceptions of
disability began to change with introduction of equality legislations and a
shift in negative attitudes and beliefs within society.

In 1981, the International Year of Disabled persons
was created to emphasize equalization of opportunities, rehabilitation and
prevention of disabilities by the United Nation (UN Enable, 2016). In 1992, the
Disability Discrimination Act was put in place to prevent discrimination of
those with a disability and promote acceptance within the community. In 2008, the
Convention on the Rights of persons with disabilities was signed by Australia along
with 80 other countries at the UN in New York to outline human rights for
people with a disability and allowing them to be recognized and acknowledged
within the community supported by the Australian Government. (Australian Human
Rights Commission, 2017)

To ensure the correct attitudes within today’s
society it is important people are better educated about disability, more opportunities
are made, positive attitudes are shaped from an early age and the media
positively portray views of people with a disability within society.

 

 

2.    The theoretical framework underpinning the
NDIS and how this differs in relation to previous theoretical understandings of
disability in Australian society

 

The NDIS is
an insurance scheme that will help to provide persons under the age of 65 with
a disability ongoing support to live an ordinary life. The NDIS will fund
supports and services chosen by the individual to help increase occupational
performance and enable the person to achieve their goals and live their lives
to the fullest of their ability. The NDIS uses different frameworks to close
the gap and gain equality for those that suffer from occupational injustices
within society and change the views around the negative stigma associated with
people with a disability.

 

A frame
work 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 maximising
economic and social benefits of the resources used. (Upadhyay, 2013). Choice
and Control which gives the individual freedom to choose how much control they
want over the management of their own funds and support and Community and
Mainstream which focuses on participation of the individual within the
community allowing interaction between mainstream and supports within the
community.

 

Overlapping
the 3 pillars the NDIS uses the 3 tiers as a scheme to categorise people into 3
different groups, Tier 1 targets everyone in Australia who may acquire a disability
which promotes inclusion and opportunities with all costs for care and support
covered. Tier 2 targets people with a disability plus their primary carers, the
NDIS will provide connections to the right supports and community and
mainstream services to ensure they receive the correct care. Tier 3 targets
those with an ongoing permanent disability with significant care needs, this
provides individuals with funding packages for the supports they need for functional
impairment from their disability including equipment, transport, home
modification and personal care (Yooralla, 2016).

 

Another framework
used by the NDIS to measure goal attainment for each individual is the NDIS
Outcomes Framework. This consists of 8 domains which are used to record overall
performance and assess the benefits of the NDIS for participants. The 8 domains
included in the framework are “1. Daily Living 2. Home 3. Health and Well-being
4. Lifelong Learning 5. Work 6. Social and Community Participation 7.

Relationships 8. Choice and Control” (Ability Options, 2017). The domains help
to address goals within different areas of an individual’s life and assist in
planning supports at a more individual, client centred level.

 

The World
Health Organisation (WHO) International Classification of Functioning,
disability and Health (ICF) has directly influenced the design of the NDIS which
was developed in alignment with the ICF (RACP, 2016) The ICF helped to align the
NDIS to increase occupational participation for individuals with a disability.

As a framework,
the biomedical model focuses purely on biological factors rather than covering
a holistic approach of an individual’s disability however the current model of
disability being used ‘The Biopsychosocial Model’ approaches a combination of
factors including biological, psychological and social factors. The elements of
body, mind and environment are considered to affect each other with the
relationship between the 3 elements creating the results of a particular outcome.

The NDIS use the current Biopsychosocial Model to understand the unique needs
of an individual looking at body function, activities, participation and environmental
factors used for effective planning.

 

3.    How services, systems and government
policies have responded to the needs of people with disability in Australia and
their families in the past, and associated issues of occupational injustice

 

Service
systems and government policies have significantly changed over time in response
to the needs of people with a disability. Government policies have helped to
change negative attitudes beliefs and values towards people with a disability
shift to a more positive view within society.

Stated
by Kirsten Deane (2009) “support systems in Australia
have been described as underfunded, unfair, fragmented and inefficient”. It was
seen that rather than those with a disability having access to services and
support as a basic human right, this was not provided due to lack of availability
of funding and negative political influence. (Department of Families, Housing,
Community Services and Indigenous Affairs, 2009).

According
to the Productivity Commission (2011) there was a lack of choice and no access
to much needed supports for people with a disability, this shaped the views of
health systems for those with a disability within Australia. In 2011, the ‘Productivity
Commission’ proposed the ‘Individual Choice Model’ to allow people with a
disability and their families or carers to decide how much control and choice they
want to exercise surrounding support and participation in the community to
create a more client cantered based system and increase self-management.

A key event by the World Health
Organisation was changing the definition of health to a more holistic view
changing health to “a state of complete
physical, mental and social well-being and not merely the absence of disease or
infirmity” (WHO 1946).  This definition
changed the public view of health showing the different factors that can
influence a person’s health.

 

The Carer Recognition Act 2010 was
created to increase public awareness, rights and support of the role of a career
in looking after a person with a disability. This Act enabled the government to
fund carers in order to meet the needs of their responsibilities. (dss.gov.au,
2017)

The Australian Government developed
the ‘National Disability Strategy’ a ten-year plan between (2010-2020) to help
close the gap of injustice for those with a disability as equal members of
society. The stratgey ensures people with a disability have the right support to
participate in the community (dss.gov.au, 2012)

The government initiating the NDIS
is a step forward for freedom, it has provided great increase of support and
services along with access to services for all people with a disability, their
family and carers.

 

4.    Strategies adopted by the National
Disability Insurance Agency to improve occupational participation

 

To
improve participation and occupational justice for people with a disability the
National Disability Insurance Agency (NDIA) as an independant agency
implemented the National Disability Insurance Scheme (NDIS) within Australia.  The NDIA has an aim to increase access to
employment and increase skills of those with a disability, this is being
implemented through their ‘Accessibility Action Plan 2013-2017’ where the NDIA
is working along with the state and commonwealth government to increase support
for people with a disability (NDIA, 2014).

As
part of the ‘Accessibility Action Plan’ the NDIA plan to increase employment
for those with a disability by employing people for their own agency for
suitable roles. The plan will allow people with a disability access to training
to increase skills needed in the workplace, ensure accessible and supportive
environments within the workplace and develop a culture which will influence
other companies within Australia to employ people with a disability. (NDIA,
2014).

A
strategy created to increase occupational participation of people with a
disability was the Assistive Technology (AT) Strategy which was created in
October 2015 to increase participation of people with a disability through the development
of individualised technology. (NDIS annual report 2015-2016). By listening to
the demands of participants involved they are able to better understand and
design universal AT for people with a disability.

The
NDIS are working to decrease occupational injustice by making the scheme available
to everyone, they currently assist diverse communities within Australia and
have developed a ‘Rural and Remote Strategy’ for those in rural and remote
areas with a disability to feel they can participate in the community and have
the resources they need equally available to them.

Another
strategy created is the ‘Aboriginal and Torres Strait Islander Engagement Strategy’
implemented to establish trust across all communities and deliver the NDIS to aboriginal
and Torre strait Islander communities (NDIS, 2017) along with releasing a ‘Mental
Health Strategy’ to improve opportunities for people living with a psychosocial
disability by increasing supports and developing individual packages for those
with a psychosocial disability.

The
NDIS launched a ‘Delivery Strategy’ with 3 mains goals including being
financially sustainable and governed using insurance principals including being
financially sustainable including payments for supports to individuals,
distribution of packages to individuals and basing all operations on strong
insurance principals and reliable data. The second goal is allowing the people
with a disability to be the ones in control of their choices decreasing the
occupational injustice this came from the UN convention on the rights of a person
with a disability, this Is done by an increase of supports, service providers,
increase of opportunities and promoting independence. The third goal of the
Delivery Strategy which aims at community satisfaction is allowing the
community to have pride in the NDIS by working with the government, raising
community 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 to
people with a disability allowing them to be in control of their decisions and
supporting people with a disability to achieve their goals. By putting in place
several strategies and using different frameworks it has allowed a significant
increase of occupational participation and decrease of occupational injustice
for people with a disability all over Australia.

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