The Australian Government is in the process of developing a National Disability Insurance Scheme (NDIS) for Australia. The NDIS will help to cover the costs of support for people with significant and permanent disabilities. The NDIS commenced in mid 2013 in a limited number of launch sites in order to test the operation of the scheme and to allow for its design to be informed by feedback from people with a disability, their families and carers, service providers and community organisations.¹ As this monograph was written before the initial launch of NDIS, it contains no discussion of the launch sites...

It is well established that the prevalence of disability among Indigenous Australians is significantly higher than that of the general population (AIHW 2009a). Indigenous Australians are at greater risk of disability, in part because they are more frequently subject to predictive factors including low birth weight, chronic disease and infectious diseases (e.g. ear infections such as otitis media, especially in young children). In addition, the Indigenous population has an increased risk of acquiring disability through accidents and violence, mental health problems and substance abuse. There is greater prevalence of these factors in communities where there are higher rates of unemployment,...

Individuals with disability, both Indigenous and non-Indigenous, have general needs which can be met by accessing mainstream services. However, people with severe or profound disability often have unique needs that can more appropriately be met by specialist disability services. The purpose of such services is to support and enhance the participation of individuals with disability in their communities in ways that are most effective for the individual. In particular, the purpose of specialist disability services funded under the National Disability Agreement (NDA) is that ‘people with disability and their carers have an enhanced quality of life and participate as valued...

As has been seen in analysis thus far, a range of different data sets have had to be drawn upon to try to identify the level and incidence of disability amongst Indigenous people, and their level of access to support services. In discussion a number of weaknesses have been identified in the data. These are considered in more detail in this chapter.

There are a number of gaps and limitations in current data collections on disability including:

under-identification of Indigenous Australians in administrative data and population surveys

gaps in coverage in survey data e.g. age groups, remoteness status

limitations on...

Although the majority of Indigenous Australians live in major cities and inner regional areas, a much higher proportion of the Indigenous population resides in outer regional, remote and very remote areas than is the case for the non-Indigenous population. While a number of the issues that need to be considered when delivering disability services to Indigenous Australians apply in all geographic areas, there is a set of specific issues that relates to providing services in regional, remote and very remote areas. This chapter discusses key issues involved in delivering disability services to Indigenous people and possible delivery models. Several possible...

There is very little Australian research on the pros and cons of different models of disability service provision in terms of their impact on Indigenous people. There is, however, some research which provides insights into Indigenous experiences of disability and related service usage, as well as the extent to which this differs to that of other Australians. Much of this has already been touched on in this monograph. This chapter expands upon these issues.

A relatively comprehensive review of Australian research was undertaken for this monograph. While selected international research was reviewed, a more comprehensive assessment of international research was...

Irrespective of the service delivery model used, the increased demand for disability services resulting from the increased funding will require a substantial increase in the disability care workforce. The move towards a greater level of consumer control is likely to also result in changes in the particular services provided and hence in the skill composition of the disability workforce. While the NDIS will mostly expand employment of existing job types, one new role that will be created as part of the NDIS is that of local area coordinator. This person will act as the main contact point between the system...

The data and evidence provided and discussed in the earlier chapters have significant implications for the design of a disability service delivery model. Effective screening and assessment of disability will be paramount, and specific approaches are likely to be needed to address the nature of Indigenous disability. In terms of provision of disability services, issues include the training needs of a disability workforce, the extent to which disability support services should be built upon the health system, the implications of significantly higher rates of disability in the Indigenous population, and barriers to accessing services. These issues need to be considered...