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Friday, July 2, 2010

Flying the Standard Part One: being a citizen


As you may know, there is currently a review of the National Standards for Disability Services. The current Standards are: 1) service access, 2) individual needs, 3) decision making and choice, 4) privacy, dignity and confidentiality, 5) participation and integration, 6) valued status, 7) complaints and disputes, and 8) service management.

The Standards ( click here to read more about them) were implemented in 1993 with the goal of ensuring Commonwealth and State funded disability services have a positive impact in people’s lives. The Standards provide the framework for disability service provision expectations and apparently the Standards focus on ensuring services are addressing the principles and objectives of Commonwealth and State/Territory legislation, including assisting people to integrate into community, assisting people to achieve positive outcomes, such as Independence, and promoting in the community a positive image of people and enhancing their self-esteem (taken from the Commonwealth Disability Services Act 1986, which you can access by clicking here).

Well, if that’s true then the Standards have failed. Failed, failed, failed. Just reading the Shut Out report (click here to read it) is more than enough evidence of that. Seventeen years on from the introduction of the Standards, there are many, many Australians living with disability who have not been assisted to integrate into community, who have not been supported to achieve positive outcomes such as independence, and where there are not sufficient positive images within community of people living with disability as valued citizens.

If the whole point of the Standards is to shape disability support services, it begs the question why billions of dollars of public funds have continued to be handed out to service agencies if they are not meeting the standards. And if that remark invokes outrage among service providers who believe they are meeting the Standards, how come this wasn’t reflected in Shut Out, and how come there are still many thousands of Australians living with disability whose service arrangements mean they remain separated from community life, are not achieving ordinary life outcomes, and are still regularly encountering discrimination?

So it’s about time the Standards were reviewed.

Let’s start from the beginning. A standard is a basis for comparison, a reference point against which activities can be evaluated. It follows that a standard should somehow encapsulate the driving values of the enterprise. It is therefore important that disability service standards are based on a strong value base and associated vision.

The main reason why we set aside public funds for people living with disability (and people who are ageing, and people living with mental health issues, and people who are homeless, etc) is to provide a response to the increased vulnerability of their circumstances, so that they can get on with their lives on a similar basis to other people.

In its essence this is about being a citizen.

Therefore, the updated Standards must be based on the driving value that people living with disability are citizens first and foremost, and therefore belong at the core of our communities.  This means that the Standards must have proper regard for the rights of people living with disability to live active, inclusive lives in community, and to promote and uphold this 'citizenhood' in the design and commissioning of disability supports.

Further, this means that those disability support arrangements must ensure that people living with disability have genuine opportunity to access, and maintain, presence within a welcoming local community, and to enjoy active participation in mainstream community life alongside non-disabled people.

To provide for anything less would mean that our disability service settings are undermining the right of people living with disability to live a decent, valued life.

And if we wish to uphold the notion of people as citizens, then we need to be clear about what it means to be a citizen, and how we might support people to take up that role. Achieving this degree of clarity will make it easier to then set meaningful, compelling and accountable standards for the support that people seek.

In pursuit of such clarity, the Julia Farr Association (the organisation behind Purple Orange) recently published its Model of Citizenhood Support, which has five domains that we think are critical for people to move into citizenhood roles (if you’re interested in knowing more about our Model of Citizenhood Support, get in touch). 

We found our model useful when thinking about the current standards, because it helped us spot certain problems. For example, the current Standards are not explicit about fellowship and connection with other people (one of the domains in our Model of Citizenhood Support). Some might argue that the current disability service Standard 5 (participation and integration) delivers that, but I disagree. Undertaking an activity in the community does not automatically bring a person into rich association with other citizens. In fact, a lot of so-called community-based services actually result in people living with disability spending their time primarily alongside other people living with disability, and where the nature of their connection into community life is as though they are moving through community in a hermetically-sealed opaque bubble. Such opaque bubbles include disability-specific transport, sheltered workshops, group outings, unnecessary substitute decision-making and one-sided relationships with paid support workers, all of which serve to insulate the person from more natural, organic community connections.

If we are to replace such sham experiences with more authentic connections, this must be reflected in the Standards.  So let us hope that the review of the Standards brings forth a more compelling accountable framework for supporting people into ordinary valued lives.  Otherwise, as a society we are in danger of failing people living with disability well into the future.

The second installment on this topic looks at the language within the Standards, and how the words we choose can critically misshape entire service systems.


In the meantime, you have until Sunday 18 July 2010 to make a submission to the national consultation on the National Standards for Disability Services, so now is the time to give your views.  You can click here to find out how.

3 comments:

  1. Robbi
    here's a pretty good model than now seems to work well and gets support from the professional carers in the system. It does encourage Self Audit...
    http://accreditation.amplify.com.au/accreditation/accreditationoverview/

    all the best Chris Howells
    Sunnyfield Auxiliary

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  2. I think a huge part of the problem with disability services is not the services themselves but the difficulty of getting access - let alone sufficient access - to any services at all.

    Standards and such are important, but they don't mean much without access!

    Ricky Buchanan,
    Melbourne, Victoria

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  3. Hi Robbi

    The problem with the current standards at the Commonwealth level is that no matter what the orininal intention was in the end the Commonwealth bureaucrats and politicians set the bar at rock bottom to ensure all services would comply. We ended up with a set of minimum standards that do not make sense! As you point out the integration standard is passed by all services- the test being do they have any contact with non-disabled people (service staff count!) not whether the Avon lady calls.

    I remember the talk of quality and continuous improvement and our enthusiastic response; I also remember our dismay when the only major effort that had to be made (after thousands of additional dollars being given to service providers) was to have a complete set of policies and procedures. These are easily audited (ticked off) apparently.

    What will change with this review - nothing. The same people who will have to bring about change, ie, put effort and $ into it, bureaucrats and service providers will still have the final say.

    Also, what is being talked about is a standards framework, which will sound nice, but I am sure that all states and territories and the Commonwealth will say their current standards comply with it.

    Mark

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