Disability Support and Services

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Disability Support and Services in Australia

Introduction

For most people with a disability, support and assistance comes mainly from family and friends. However, governments provide a range of services both directly and indirectly to help those with disabilities and the private and community sectors also provide significant resources in this regard. As well as disability specific services and support, the government, private and community sectors also provide a range of mainstream services (for example, health services) that people with a disability have access to. Because there is a mix of mainstream and disability-specific programs and services it is difficult to get an accurate picture of the extent of funding and support to the disability population.

The major aim of this electronic brief is to overview disability support and services in Australia and to briefly describe the role of the Commonwealth in this regard. The role of the States and the voluntary/community sectors is briefly mentioned and additional information on these areas can be obtained by following the various links that are contained either in the main part of this brief or in the section headed Links. There are a number of links to overseas web sites.

Defining Disability

It is difficult to easily define what is meant by a 'disability', but in general terms it can be considered as a condition that in some way hampers or hinders a person in terms of their ability to carry out day to day activities. The extent to which a condition hinders a person will vary from individual to individual and the general range of disabilities varies from conditions that are mild (for example, the need to wear reading glasses) to severe (for example, some forms of brain injury). In recent times various definitions or classifications of disability have been agreed to.

In the Productivity Commission's Report on Government Services 2002 disability is given the following definition:

The first international classification relating to disability was provided by the International Classification of Impairments, Disabilities and Handicaps, initially published in 1980 by the World Health Organisation (WHO). The 1980 classification was a framework for disability described in three dimensions: impairment, disability and handicap. The Australian Bureau of Statistics (ABS) Survey of Disability, Ageing and Carers in 1981, 1988 and 1993 was based on this classification. A revised classification— the International Classification of Functioning, Disability and Health (ICF)—was adopted by the World Health Assembly in May 2001, after several years of international revision.

Disability is conceptualised as being a multidimensional experience for the person involved. There may be effects on organs or body parts and there may be effects on a person's participation in areas of life. Correspondingly, three dimensions of disability are recognised in ICF: body structure and function (and impairment thereof), activity (and activity restrictions) and participation (and participation restrictions). The classification also recognises the role of physical and social environmental factors in affecting disability outcomes.

The ABS 1998 Survey of Disability, Ageing and Carers defined disability as any person with a limitation, restriction or impairment which has lasted, or is likely to last, for at least six months and restricts everyday activities.

Self care, mobility and communication are defined as core activities. The ABS defines levels of core activity restriction as follows:

mild — where a person has no difficulty with self care, mobility or communication,
but uses aids or equipment;

moderate — where a person does not need assistance, but has difficulty with self
care, mobility or communication;

severe — where a person sometimes needs assistance with self care, mobility or
communication; and

profound — where a person is unable to perform self care, mobility and/or
communication tasks, or always needs assistance.

Sources: ABS (1999) and WHO (1999), (2001).

The Extent of Disability

Every five years the Australian Bureau of Statistics carries out an extensive survey (ABS Survey of Disability, Ageing and Carers) that gives detailed statistics on the prevalence of disabilities in the Australian community. The last (1998) Survey found that, of the total population aged between 5 and 64 years, 19 per cent (some 3.6 million people) had some form of disability. The Survey also found that an additional 3.1 million people had some sort of impairment but it was not bad enough to restrict them in their daily activities. Of the total of those who had some form of disability (i.e. the 3.6 million group) approximately 3.2 million people experienced some sort of restriction with respect to daily activities, employment or schooling.

General Resources on Disability

Two excellent sources of information and data on disability support and services in Australia are:

Productivity Commission, Report on Government Services 2002
Australian Institute of Health and Welfare, Australia's Welfare 2001

Brief Historical Overview of Main Disability Milestones

Early Involvement

The Commonwealth first became directly involved with providing support for people with disabilities via the introduction of the Invalid Pension in 1908. The current version of this benefit is the Disability Support Pension and, to a lesser extent, the Sickness Allowance. During the 1940s the number of people with disabilities increased rapidly essentially due to injuries suffered during the Second World War. In response to this, the Commonwealth established the Commonwealth Rehabilitation Service (CRS) and at the same time there was an expansion of the number of sheltered workshops and accommodation services run by volunteer organisations. Through the 1960s and 1970s the Commonwealth increasingly provided funding to help these organisations provide accommodation, employment and other support services.

1980s

Increasing awareness of the difficulties faced by people with disabilities was enhanced by the International Year of Disabled Persons in 1981. One of the main aims of the International Year was to lower the barriers that had tended to prevent disabled people achieving equality with able bodied people.

Following the International Year of Disabled Persons there were a range of initiatives/trends that had implications for the provision of support and services for people with disabilities. The most important of these initiatives/trends were:

a general move away from institutional type services towards a more community orientated type of service provision

the Disability Services Act 1986 which provided for a comprehensive framework for the funding and provision of support services for people with disabilities

For full details of disability policy and developments from the early 1980s to the mid 1990s see the Parliamentary Library publication by Mary Lindsay, Commonwealth Disability Policy 1983–1995.

1990s

the 1991 Disability Reform Package which reformed Commonwealth income support payments for people with disabilities with a view to encouraging their integration into the workforce to the maximum extent possible

the 1991 Commonwealth-State Disability Agreement (CSDA) which aimed to clarify the roles and responsibilities of the respective governments. In essence, the Commonwealth was given responsibility for employment services and the States and Territories were given responsibility for accommodation and other support services. A major aim of the CSDA was to reduce the amount of duplication and administrative complexity that existed in the funding and service arrangements for disabled people

the Disability Discrimination Act 1992 which is primarily aimed at eliminating discrimination against people with disabilities as well ensuring equality before the law and promoting acceptance within the community of the fundamental rights of people with disabilities

the National Mental Health Strategy 1992

the 1994 Commonwealth Disability Strategy which is a ten year framework designed to ensure that people with disabilities have equal opportunity to access all Commonwealth programs, facilities and services

the 1998 Commonwealth-State Disability Agreement (CSDA) which was due to continue until the end of June 2002 but has now been extended until the end of October 2002

2002: Negotiations for a New CSDA

the new Commonwealth State Territory Disability Agreement (CSTDA) has yet to be signed and the old CSDA, which was due to expire on 30 June 2002, has been extended for four months i.e. until the end of October this year. The 'sticking point' on the new Agreement is the level of funding - the Commonwealth arguing that the States should provide more and the States saying the Commonwealth should provide more.

Data from the Report on Government Services 2002 on CSDA expenditure by Commonwealth and States/Territories for the main CSDA categories (accommodation, employment etc.) in recent years shows that in terms of the total expenditure on disability services there has been a steady rise in funding in real terms over recent years.

The data shows that the total expenditure on services has risen from $2 206 990 in 1998–99, to $2 357 173 in 1999–2000 and to $2 481 480 in 2000–01. This equates to percentage increases in total real expenditure on services by the Commonwealth and the States/Territories of 6.8 per cent in 1999–2000 (over the previous year) and 5.3 per cent in 2000–01.

The Family and Community Services Portfolio Budget Statement 2002–03 and a media release by the Minister, Senator Vanstone (28 June 2002) provide some data on just what the Commonwealth is offering to provide under the auspices of the new CSTDA.

The Portfolio Budget Statement (p. 179) indicates that additional funding is being offered by the Commonwealth to the States and Territories of the order of $547.5 million over the five years of the new CSTDA (2002–03 to 2006–07). It states that 'provision for funding of $2.1 billion over five years from 2002–03 to renew the Commonwealth State Territory Disability Agreement had already been included in the budget estimates'.

The additional funding of $547.5 million would take the total Commonwealth commitment to $2.7 billion over the life of the new CSTDA. According to the Statement an additional $105.2 million will be provided in 2002–03; an additional $107.2 million in 2003–04; an additional $109.4 million in 2004–05 and an additional $111.6 million is to be provided in 2005–06. No figure for 2006–07 is given.

Additionally, the Statement makes clear that the 'increase in funding depends upon the States and Territories making the same percentage increase themselves as the Commonwealth has made to all Commonwealth State Territory Agreement services, including employment services'. In her media release of 28 June this year Minister Vanstone offered an additional $125 million over the life of the new CSTDA to help meet the unmet need for accommodation for the disabled. This $125 million is over and above the extra funding outlined in the Portfolio Budget Statement. As is clear in the media release the Commonwealth is also expecting the States and Territories to match this additional funding. Senator Vanstone says that if the Commonwealth offer is matched an additional $625 million ($125 million from the Commonwealth and $500 million from the States and Territories) will be available in the area of accommodation over the life of the new CSTDA.

Overview of Current Commonwealth Support and Assistance

Summary

The main forms of support provided by the Commonwealth for people with disabilities include:

income support (for example, the Disability Support Pension, Carer Payment, Carer Allowance (adult and child), Sickness Allowance, Mobility Allowance and Wife Pension)

funding to organisations to provide employment services as well as the direct provision of employment and training programs

the provision of services and support through the Commonwealth Rehabilitation Service

the provision of funding to the States and Territories for accommodation support, respite, independent living and recreation services

joint funding with the States for the Home and Community Care (HACC) Program

funding to the States for administering aids and appliances schemes

funding of organisations to provide advocacy, information and print disability services

funding of organisations under the Continence Aids Assistance Scheme

funding to sponsor industry projects

funding for research and development projects

providing services for Veterans. A major source of income support for veterans is the Veteran's Disability Pension.

the provision of pharmaceutical and other medical benefits.

Overview of Current Commonwealth Funding for Disability Support and Services

Income Support

The Commonwealth currently outlays in excess of $6 billion per annum to provide income support for people with disabilities and the people who care for them. The main types of income support provided by the Commonwealth for people with disabilities and their carers are given in the following table.

Income Support Payment	Funding 2000–01
Disability Support Pension	$5 849m
Wife Pension	$446m
Carer Payment	$481m
Carer Allowance (adult and child)	$533m
Sickness Allowance	$95m
Mobility Allowance	$59m

Source: Department of Family and Community Services, Annual Report, 2000–01.

Main Support Services

The main Commonwealth commitment for support services comes via the CSDA - the 2000–01 Federal Budget allocated $426 million to the CSDA. As well, a further $279 million was provided for employment assistance and other services.

In addition, the Commonwealth Rehabilitation Service outlaid $101 million in 2000–01 to assist in excess of 29 000 people with an injury or disability receive work related rehabilitation programs.

The Commonwealth also provides approximately $7 million per annum to provide various incentives to employers to employ people with disabilities.

The Problem of Unmet Need

There is general acceptance in government circles and the wider community that there is a significant problem of unmet need with respect to the provision of support and assistance for people with disabilities. The 1998 ABS Survey of Disability, Ageing and Carers found some 24 000 people with a profound or severe disability who received no assistance at all. Further, more than 41 000 primary carers were found to be also receiving no support or assistance. For background and further details on the unmet need issue see the Parliamentary Library publication by Jackie Ohlin, Unmet need in disability services: shortfall or systemic failure, Current Issues Brief no. 6, 1999–2000.

The Australian Institute of Health and Welfare has recently completed a major study into the unmet need issue (Unmet Need for Disability Services) and it found that, despite some additional funding being added via the CSDA (for example, the Commonwealth and the States allocated approximately $500 million over the 2000–02 period for unmet need) there were, in 2001, over 12 000 people still in need of accommodation and respite services and over 5000 people needing employment support.

Disability Legislation, Rights and Advocacy

The main Commonwealth legislation covering the rights of people with a disability is the Disability Discrimination Act 1992 and the main Commonwealth body that is charged with protecting the rights of disabled people and advocating on their behalf is the Human Rights and Equal Opportunity Commission (HREOC). For more background on HREOC and disability rights and advocacy see the HREOC disability rights page. Another source of information on legislation, rights and advocacy can be found at the Disability Information and Resource Centre.