Northern NSW Regional 2015 National Respite 19 February 2015

Agenda 1.Welcome14:00 2.Policy Landscape Update14:15 3.Discussion of Policy Issues14:45 4.National Respite Activity15:00 5.Open Forum Discussion15:30 6.Close16:00

1.1 National respite Communities of strong relationships that support the lives people choose Support interconnected wellbeing between people with disability, frailty from age, mental illness and their chosen carers, families, and informal supports

Last meeting issues 1.Transport in NDIS plans 2.Industrial reforms to match aims of NDIS 3.CALD clients under NDIS 4.Flexible respite support 5.Disconnect: – ADHCs flexible respite packages growth – NDIS ‘reasonable and necessary’ support 6.Interface of NDIS with mental health services 7.Accurate unit costing and managing cash flow in rural/regional areas 8.Non-respite carer support 9.Future of NRCP clients 10.Emergency respite and crisis care

Carer Care recipient Respite Care Carer support ? 37 NDISCHSP Integrated Carer Support Programme (DSS) 3.1 Respite and carer support in 3 systems Mental Health

Policy Landscape Update – Respite Disability (NDIS) Significant changes for carers and respite services: 1.Outcomes framework for NDIA 5 strategic outcomes for carers and families: Families/carers 1.have the support they need to care 2.know their rights and advocate effectively for the person they are caring for 3.are able to gain access to desired services, programs and activities in their communities 4.have succession plans 5.enjoy health and well-being 2.Respite language to be restored: – currently not listed but respite outcomes are – Recognise ‘the service type that cannot be named.’ 3.Flexible bundling of supports? Further consultation this year on respite in NDIS

Policy Landscape Update – Tier 2 “NDIS stands and falls on strong Tier 2 support for those just outside funded plans” Bruce Bonyhady Tier 2 :now Linkages, Information and Capacity building. NDIA paper released yesterday: where are – volunteer model – flexible supports Exact role of Ability Links and LACs – – NSW contribution to Tier 2?

Policy Landscape Update – Tier 2 NDIA paper – five streams 1.Information, linkages and referrals 2.Capacity building for mainstream services 3.Community awareness and capacity building 4.Individual capacity building 5.Local area co-ordination Available to all people with disability, including those also receiving Tier 3 HOWEVER: “a significant proportion is likely to receive most, if not all, the supports they need through mainstream systems”

Policy Landscape Update – Tier 2  Linkages, information, and referrals: references CALD specific and other advocacy groups, possibility in this stream for case management?  Individual Capacity Building stream: supports which are ‘one-off, low level or episodic’ 1.Programmes for carers and counselling for people who are caring (disability &/or mental illness) 2.Parent breaks and programmes to provide parents with skills and information about disability 3.Professional development (including for parents) 4.Diagnosis specific peer support groups 5.Disability specific support providers can be funded here  Other streams for mainstream community or LAC role

Policy Landscape Update – Tier 2 DSS seeking feedback by 15 March on: 1.What are the most important elements of ILC? 2.What is missing? 3.How will we know the ILC streams are meeting their objectives/vision? 4.What would be the implementation challenges? 5.Which aspects of a person’s life do you think ILC could have the greatest impact on? 6.What are some of the principles that should guide investment across ILC streams? 7.How do you see the interface between ILC functions and activities and the interaction with the mainstream service system? (housing, education, employment, health, family, accessibility and transport)

NDIS – Quality and Safeguarding NDIA paper proposes three domains: 1.Developmental: – Advocacy – building natural safeguards – consumer led initiatives, including through social media 2.Preventative: – Formal individual safeguards eg risk assessments in plan – service level safeguards eg policy and procedures, feedback mechanisms – system level quality measures eg registering with NDIA 3.Corrective: – Universal measures eg ombudsman – Complaints handling – Serious incident reporting BUT Limited discussion of self management and micro businesses

NDIS – Quality and Safeguarding NDS paper proposes: co-regulatory model comprised of an industry regulator and an independent consumer complaints body We propose a framework that: 1.Acknowledges that people with disability can be supported in strong relationships and meaningful community involvement through: - a quality and safeguarding framework that measures success of supports through met outcomes that have been set and assessed by the individual - supporting natural safeguards such as family and friends 2.Empowers people with disabilities through a regulatory and legal quality and safeguarding system that meaningfully puts people first. 3. Caters to a changing disability supports market with attention to the unique needs of those self managing employment of staff and funds and micro businesses Feedback to DSS until 30 April 2015

Policy Landscape Update - CHSP Respite issues Outcome 6 Care relationships 3 types: cottage, emergency, flexible Grow flexible respite? Trial cashing out ? Issues Carers and carer support? Carer/care recipient goal conflict Inflexibility of non-residential respite – hours, continuity of staff, training, rural remote Gaps in secure residential respite? Dementia and younger onset dementia Possible approaches Supporting challenging behaviours Learning from CDRC & disability: – Drawing in informal supports – Out of pockets Pilots, training, best practice Flexible Respite project

Policy Landscape Update - CHSP Respite issues Recent developments Accelerating consumer choice and control: – HCP+CHSP? Transition processes Future approaches Inclusive community & CDC markets Within CHSP: Innovation, flexibility & choice – low value supports? Flexible respite? Emergency respite? Small and micro organisations?

Next steps CHSP Aged Care Information sessions Sydney session 1 3-Mar-15 Sydney session 2 4-Mar-15 Port Macquarie 5-Mar-15 CHSP contracts 1.Small extension to 31 October, then new contract Nov 2015 – Jun NRCP incorporated, & <65 grandfathered Sector Support & Dev 1.Non-output services 1Q16 extension 2.Review of CSIA and non- output services 3.Competitive tender

Mental health Systemic issues  Recovery vs. permanent disability  Underfunding of respite  Different emergency respite needs Recent developments  NHMC report with government  MHR-CS – NDIS different agreements  Minister Fifield announced 12 month extension for:  MHR-CS  PHaMs  NDIS funding Mental Health Australia to support capacity building

Carer Support Issues  Service systems moving in different directions for carers NDIS vs CHSP  Need for single point – especially for 11% caring across service systems  CHSP – NRCP absorption  Concerns  particular client groups – young carers, rural & remote, CALD, Indigenous  loss of expertise, referral pathways Recently…  CRCC contracts will be extended to 2017  Government developing integrated carer support model  Co-design with carers and service providers  Minister Fifield – carer supports outside NDIS & single carer assessment  Minister Morrison – importance of carers  But issue of different state funding ‘base level of community support’

Policy Landscape Update – Carer Support DSS Karen Wilson in charge of carer support policy Designing ‘Integrated Carer Support Programme’ to roll out nationally across all service sectors Consultations this year on what carer support should look like. Young Carer Program and other carer peer support programs most discussed by services

Top 2 Policy Issues? What are the two most pressing respite policy issues for Northern NSW???

National Respite Activity Trial site update: i.Emergency Respite (Forums and submission) ii.Coordination of supports iii.Accommodation and pricing iv.Transport and travel (Submission)

Preparing Families for an NDIS Plan National Respite resource created with CarersNSW, ARAFMI, two trial site services and other providers Steps with linked resources Mental Health Australia and Carers Australia capacity building project Individual or shared workshops through providers

Research Update Transitioning Respite Volunteer/Flexible family project CMS Project Marketing Project Flexible respite for people with dementia

Open Discussion customers? Areas for more intelligence? NDIA ecommerce site for consumers and providers? Information, linkages and capacity building Quality and Safeguarding Sector Development DSS Emergency/Crisis Care Supporting CALD communities through reform