Objective 6	Objective 10
Foster an aware and responsive public service	Collect and use relevant information about disabled people and disability issues
Objective 7
Create long-term support systems centred on the individual

Context: issues, activities and trends

The objectives covered by this chapter acknowledge the key role government plays in achieving an inclusive society and the need for it to be well-equipped for this role.

Historically, government policy and programmes often failed to consider disability perspectives and issues. This resulted in policy which either created or ignored serious barriers to participation in society and the loss of opportunities for disabled people. The assumption behind the first two objectives of this chapter is that, if government policy and service development is informed by more aware public servants and relevant, high quality information and research, it will be more able to reflect the realities of disabled peoples’ lives. Consequently it will have the capacity to ensure processes, policies and services are at least consistent with the Disability Strategy and, even better, progress some aspect of it.

The third objective in this chapter is focused on interagency issues and the overarching systems government uses for funding and providing disability supports. Changes in our understanding and approach to disability have led to the concept of ‘disability supports’ as a particular set of services with the common goals of participation and independence. However, there has not been a common set of principles guiding the development of support services as a whole. Rather, our support service systems reflect diverse and historic approaches to disability. Supports are funded out of more than seven government Votes and the ACC Account, each with its own goals, priorities, funding mechanisms and logic for providing them.

Currently we know that, from a client point of view, disability support services are often experienced as complicated to access and inequitable. From the government point of view there are overlaps, gaps and administrative inefficiencies. Moreover, many aspects of support services are not consistent with the vision articulated in the Disability Strategy. Some services fail to allow the personal autonomy and flexibility necessary to design the most sensible supports for an individual and there is a lack of responsiveness to cultural, gender or impairment-specific issues.

The assumption is the adoption of the Strategy as a common framework across all agencies that provide support, along with the systematic implementation of its objectives, should lead to a more coherent, equitable and easy-to-access system for providing supports. It is also assumed this improved coherency will allow for more consistent information collection across agencies about disability issues, thereby further improving the government’s capacity to implement the Strategy.

Key activities

1. When the Office for Disability Issues was established` two years ago, it was tasked with building the capacity of government agencies to deal with disability issues. This includes developing general initiatives to improve the awareness, responsiveness and information gathering of agencies as well as leading some cross-government policy work to improve the overall systems for providing services to disabled people. The Office’s work programme aims to ensure there is a systematic approach to increasing the awareness of and solutions to disability issues across government.
2. Over the last year, the Office for Disability Issues has scoped a cross-sector project to promote coherence across government with the New Zealand Disability Strategy and equity of access across government-funded disability supports. In June 2004, the government agreed to a review of long-term disability supports. The objectives of the review include: advice to government on how to achieve durable improvements to the systems for providing disability support services, consistent with the Strategy; and structures and processes which allow people with similar impairments and associated needs to have improved and more equitable access to long-term support services. The review will report on options for improvement in 2005.
3. There are three main levers used to ensure government agencies consider disability issues and the Disability Strategy in their policy and service development work:
   • government requires all Cabinet papers to consider the need for a disability perspective
   • all government departments are required to develop work plans outlining how they will implement the Strategy, and to report progress on these plans annually (as included in this report)

   • government is required by statute (the Bill of Rights Act 1990 and the Human Rights Act 1993) to ensure legislation, policy and services do not directly or inadvertently discriminate against disabled people through a failure to consider the unique life experiences and needs of disabled people.

     An individual can make a complaint about the activities of a government agency to the Human Rights Commission. This has sometimes led to significant policy development activity.

4. Statistics New Zealand’s post-census disability surveys of 1996 and 2001 are the first significant surveys in New Zealand to focus on disabled people as a population group. It is important to make good use of this data. An extensive report based on the 2001 Disability Survey will be published by the Ministry of Health in 2004. Also, the Ministry of Social Development conducted a more focused analysis of the 2001 Disability Survey data, looking specifically at disability and work participation.

   These reports are valuable for policy development and can be used as a baseline for measuring progress across many government programmes. Data from the post-census disability surveys informs much of the status trends described in chapters three and four of this report. Therefore, it is particularly pleasing that funding has been approved for a post-census disability survey in 2006, which will allow useful comparisons to be made in the future.

5. The National Advisory Committee on Health and Disability reported to the Minister of Health and the Minister for Disability Issues its findings from a two and a half year research project which built a detailed picture of the lives of adults with an intellectual disability. Much of the information for the project was collected through talking directly to adults with an intellectual disability. The report, To have an ‘Ordinary’ Life: Community Membership for Adults with an Intellectual Disability, provides a good model for disability research. The Committee has also published on their website nine literature reviews prepared by the Donald Beasley Institute and other background papers developed during the project.

Gaps in activity

Research into the costs of disability would fill a major knowledge gap about the impact of disability on society and the economy.

 

Trends

The achievement of the objectives in this chapter will particularly affect the government’s capacity to achieve the objectives in chapters three and four that relate to government-funded services to support participation in all areas of life. Therefore the outcome trends in these later chapters will give the best indication of the effectiveness of activity under the objectives of this chapter. However, there is some information that can be usefully noted here and possibly used as a baseline for comparison at a future date.

Over the last 30 years, the main shift in disability support services has been from an institutional approach to community-based services. The majority of disability support services are now provided by not-for-profit agencies contracted by a wide range of government agencies. There has been considerable movement, including restructuring and reform, in the management and funding of these contracts, and in which government agency is responsible for them.

Currently, some government agencies provide services on a demand-driven basis according to a legally defined entitlement (ACC) and/or an income test (Social Development). Other services are provided out of a capped budget rationed on the basis of clinical, educational and/or vocational need. The underlying goals for providing support also differ: Education provides support to enhance education goals; Social Development is concerned with providing security and helping people into work; Health has health and independence goals; and the ACC is required to return people to their previous condition or to compensate them.

There has been no single agency responsible for developing policy for disability support, and the diverse mix of policy drivers across the agencies with a role contributes to a lack of co-ordination between policy-makers, purchasers and providers. Currently, there is a lack of consistent and co-ordinated criteria for support across agencies and regions, and a wide range of eligibility mechanisms.

There is a current trend across all government agencies to focus on a more co-ordinated and ‘whole of government’ approach to service development. This should have a positive impact on the future development of disability support.

Reported activity between July 2003 and June 2004

Objective 6: Foster an aware and responsive public service

6.1 Develop mechanisms to ensure that all government policy and legislation are consistent with the objectives of the New Zealand Disability Strategy

The Ministry of Social Development reports work on better integration of Disability Strategy objectives in their planning processes, including a clearer link with the Ministry’s Statement of Intent.

Land Information New Zealand reports incorporating the Disability Strategy into their own capability strategy as a way of making sure disability issues are part of their mainstream approach.

The ACC reports the appointment of a Rehabilitation Advisor who provides support in the development of operational and strategic policy relating to claimant rehabilitation and, where appropriate, includes a disability perspective.

6.2 Adapt public sector training to ensure that service development and service delivery are consistent with the New Zealand Disability Strategy

All government agencies report some activity to make management and staff, particularly front-line staff, more aware of and responsive to disabled people. Most agencies report including information about the Strategy in their staff induction and training programmes.

The New Zealand Police report a national awareness initiative organised by their Disability Network. This included encouraging staff in police stations to attempt a number of tasks while using a wheelchair, crutches or darkened glasses, as well providing articles in internal newsletters about how employees with disabilities have overcome work-related barriers.

The Department of Conservation reports New Zealand Sign Language classes for interested staff, at no cost.

The Ministry of Housing reports the development of training for front-line staff to better equip them to provide services to people with mental illness. The Ministry will work together with the Ministry of Social Development, the Housing New Zealand Corporation and the Christchurch City Council to pilot this training programme.

The Ministry of Health reports the introduction of a service excellence pilot. This is a change-management process in which over 50 providers are participating. Consultation tools have been developed for employment practices and induction processes for senior and middle managers. Disabled people are being trained to introduce the tools and help with the implementation of the pilot.

6.3 Ensure that all government agencies treat disabled people with dignity and respect

The New Zealand Police report consultation with consumer groups to produce a comprehensive reference module on how to manage incidents with people with a mental illness.

The Ministry of Health reports a process for making sure district health boards and other health providers are aware of and responsive to disabled people, including accessibility, signage and access to New Zealand Sign Language interpreters. These requirements are specified in accountability documents.

Inland Revenue reports research to help focus on the needs of disabled clients.

The Department of Internal Affairs reports a review of all their services to find out whether they are accessible to people with disabilities and if there are any specific ways service delivery could be improved.

6.4 Improve the quality of information available, including where to go for more information, the services available and how to access them
&

6.5 Make all information and communication methods offered to the general public available in formats appropriate to the different needs of disabled people

The internet has proven a great door-opener for many disabled people. The State Services Commission has used an external reference group to make sure the e-government portal is accessible, and manages government website guidelines to continue to increase accessibility.

A large proportion of departments report how they have made publications and information, including their websites, more accessible to disabled people.

The National Library reports its Print Disabilities Unit issued about 32,000 items to local authority libraries, educational organisations and disability services to support their services to print-disabled clients. A review of the Print Disabilities Unit’s future position and strategic direction was also completed. As a result, there will be an assessment of future formats for audio books and of the use of digital books.

6.6 Ensure the locations and buildings of all government agencies and public services are accessible

The majority of government departments report on physical access. In the few buildings where access does not comply with the access standard, the relevant departments report plans to remedy the situation. All new refurbishment projects incorporate access for disabled people. A number of departments also report they ensure their cars are able to accommodate the needs of disabled staff, and they provide accessible car parks for disabled staff and clients.

6.7 Work with territorial authorities to develop ways they can support the New Zealand Disability Strategy

In June 2004, the Office for Disability Issues met with three metro-authorities, Auckland, Manukau and Wellington, to brainstorm how the Office and other central government agencies can work with Local Government New Zealand and territorial local authorities to support the Strategy.

Objective 10: Collect and use relevant information about disabled people and disability issues

10.1 Ensure that guidelines for research funding take into account the need for research on disability issues, include disabled people in the development and monitoring of the disability research agenda, and enable disabled people to put forward their own experiences in the context of the research

The Health Research Council uses relevance to the Disability Strategy as a criterion for prioritising research in the assessment process for its annual funding round. However, it reports very few applications that address the Strategy. In the 2002–2003 funding round, no proposals relevant to the Strategy were submitted. The Council is currently considering whether the assessment process should be changed to allow the special consideration of proposals classified as disability research. The Council is also planning specific capacity-building initiatives for the disability research workforce.

The Ministry of Research, Science and Technology reports activity to ensure the government’s investment in research supports the knowledge requirements for implementing the Disability Strategy.

The Department of Labour has published a report that sets out the framework, assesses the quality of data available, and indicates priorities for addressing the gaps in information available for measuring the costs of injury.

10.2 Collect relevant and useful information about disability through all relevant surveys to inform the research programme

Statistics New Zealand is currently leading work on the development of a co-ordinated social statistics programme across government to develop more coherent and integrated statistics. As part of that work, options will be examined for improving the range and quality of official statistics on disabled people.

The Ministry of Health reports work on a national population health survey that includes the collection of disability data. The Ministry also reports work on a national mental health epidemiology study, which will help to describe patterns of mental health service use and how mental health problems and substance abuse limit people’s activities. The final report is expected be published in June 2006.

The Department of Corrections reports that information on disability was included in the November 2003 Prison Census. The Department is currently considering a more in-depth approach for the next prison census.

The new Centre for Housing Research New Zealand focuses on the information needs of the wider housing sector. It has commissioned a scoping report on housing issues for disabled people.

The Ministry of Health produced two reports that include disability data: Health and Independence and the New Zealand Health Survey.

10.3 Use disability research, and analyse disability data, including that from the 1996 and 2001 Disability Surveys, to contribute to policy work, service development and monitoring

The ACC produces quarterly serious injury reports to inform future improvement work, especially for injury prevention, case management practice and service delivery. The information also helps inform the development of lifetime rehabilitation planning.

The Ministry of Social Development makes information available, via its website, on working age Sickness and Invalids Benefit recipients. The objective is to provide data that may help other agencies improve their provision of services to disabled people.

10.4 Undertake research focusing on disability issues for Māori and Pacific peoples
See 11.3.

10.5 Make disability research information available to disabled people in culturally appropriate and accessible formats
&

10.6 Adopt ethical and procedural standards for disability research projects

The Department of Statistics identified barriers for disabled people participating in all their surveys, and provided training and guidelines to field interviewers.

10.7 Appoint disabled people as members of ethics committees

No specific activity is reported on this action.

Objective 7: Create long-term support systems centred on the individual

7.1 Ensure that overarching processes, eligibility criteria and allocation of resources are nationally consistent, but that individual needs are treated flexibly
&

7.2 Ensure that government agencies, publicly funded services and publicly accountable bodies co-operate to ensure that the disabled person is at the centre of service delivery

The Ministry of Health reports the completion of a review of specialist health and disability services for older people. The aim of this project was to develop a service framework for specialist health services for older people that integrates services across physical and mental health, disability support services, primary care and other secondary services. A report will be published late in 2004.

The Ministry of Health has been the lead agency in a cross-sector project aimed at improving the co-ordination of intra-sectoral and inter-sectoral assessments and services. It reports the establishment of three pilot programmes in June 2004. It also reports work with local communities to develop networks of learning support, aimed at reducing the fragmentation of services and encouraging collaboration.

The Department of Child, Youth and Family Services reports an initiative focused on children and young people with high and complex needs. This spans two or more sectors and is designed to provide tailored services over and above what can be provided within sectors.

The Department of Corrections reports work with the Ministry of Health to develop an appropriate delivery model for providing health services to inmates, including disabled inmates. The focus is to deliver accessible support services, including needs assessment and service co-ordination, equal to the standards that generally exist in the community. It reports their living needs assessment process, which includes disability information, is intended to be progressively undertaken as part of the offender-management process, particularly for sentence planning.

The Housing New Zealand Corporation reports developing their Neighbourhood Units’ working relationships with local service providers, and inter-sectoral service delivery initiatives for their high and complex needs clients, including those with intellectual and psychiatric impairments.

7.3 Investigate the development of an holistic approach to assessment and service provision that applies across agencies and funding sources
&

7.4 Develop and maintain effective rehabilitation services

The ACC reports recruiting 12 lifetime rehabilitation planners who are responsible for making sure all claimants who have experienced a serious injury have a plan designed to increase their inclusion and participation in society. This holistic approach is based on assessment, the identification of support, and options that will help the claimant to achieve their rehabilitation goals.

The ACC has also produced a video for claimants who have suffered a serious injury. The video provides information for the claimants and their families and whānau, to help them to adjust to life following a serious injury.

The Ministry of Health reports the Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003 was passed by Parliament and came into effect in September 2004. The Act and related amendments provide courts with the power to order a person with an intellectual disability charged with or convicted of an imprisonable criminal offence to accept compulsory care and rehabilitation. It also allows the Family Court to order the transfer of people from prison or a mental health facility. The Ministry of Health reports the development of rehabilitation services for the intended client group and also for people with an intellectual disability who have high and complex behavioural support needs. As at June 2004, approximately 200 people were supported by these services.

7.5 Encourage equity of funding and service provision for people with similar needs, regardless of the cause of their impairment

In June 2004, the government agreed to a major review of long-term disability supports to be led by the Office for Disability Issues. One of the review’s objectives is to ensure more equitable access to long-term support services, regardless of whether a person’s impairment is the result of an accident, sickness or a congenital condition, where they live, their gender or their ethnicity.

7.6 Identify unmet need and develop affordable solutions to fill these gaps
&

7.7 Improve timeliness of service provision

There is no reported activity for these actions.

7.8 Develop a highly skilled workforce to support disabled people

The Ministry of Health reports working with the Tertiary Education Commission to complete an analysis of the health and disability education and training courses funded by the Tertiary Education Commission and the Clinical Training Agency. The second stage of this project aims to gain an understanding of the needs of the health and disability support sector. The project’s focus is on improving the workforce/training sector interface in the health and disability sectors.

The Ministry of Health reports a nation-wide provider survey collecting data on the support workforce and a national certificate for support workers lodged with the New Zealand Qualifications Authority. These two initiatives have been part of a quality and safety project for improving the support services for older people and disabled people.

7.9 Ensure that disability services do not perpetuate the myth that disabled people are ill, while recognising that disabled people do need access to health services without discrimination

This is no specific action reported.