{\rtf1\adeflang1025\ansi\ansicpg1252\uc1\adeff0\deff0\stshfdbch0\stshfloch31506\stshfhich31506\stshfbi31506\deflang2057\deflangfe2057\themelang3081\themelangfe0\themelangcs0{\fonttbl{\f0\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman{\*\falt Times New Roman};}
{\f1\fbidi \fswiss\fcharset0\fprq2{\*\panose 020b0604020202020204}Arial;}{\f2\fbidi \fmodern\fcharset0\fprq1{\*\panose 02070309020205020404}Courier New;}{\f3\fbidi \fdecor\fcharset2\fprq2{\*\panose 05050102010706020507}Symbol;}
{\f10\fbidi \fdecor\fcharset2\fprq2{\*\panose 05000000000000000000}Wingdings;}{\f34\fbidi \froman\fcharset0\fprq2{\*\panose 02040503050406030204}Cambria Math;}{\f37\fbidi \fswiss\fcharset0\fprq2{\*\panose 020f0502020204030204}Calibri;}
{\f42\fbidi \fswiss\fcharset0\fprq2{\*\panose 020b0204020104020204}Abadi Extra Light;}{\f45\fbidi \fnil\fcharset77\fprq0{\*\panose 020b0604020202020204}Rubik-Light{\*\falt Calibri};}
{\f46\fbidi \fswiss\fcharset77\fprq2{\*\panose 00000000000000000000}Abadi MT Condensed Light;}{\f47\fbidi \fswiss\fcharset77\fprq0{\*\panose 020b0604020202020204}FS Me Pro{\*\falt Calibri};}
{\f48\fbidi \fswiss\fcharset77\fprq0{\*\panose 020b0604020202020204}FS Me Pro Heavy{\*\falt Calibri};}{\flomajor\f31500\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman{\*\falt Times New Roman};}
{\fdbmajor\f31501\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman{\*\falt Times New Roman};}{\fhimajor\f31502\fbidi \fswiss\fcharset0\fprq2{\*\panose 020f0302020204030204}Calibri Light;}
{\fbimajor\f31503\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman{\*\falt Times New Roman};}{\flominor\f31504\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman{\*\falt Times New Roman};}
{\fdbminor\f31505\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman{\*\falt Times New Roman};}{\fhiminor\f31506\fbidi \fswiss\fcharset0\fprq2{\*\panose 020f0502020204030204}Calibri;}
{\fbiminor\f31507\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman{\*\falt Times New Roman};}{\f788\fbidi \froman\fcharset238\fprq2 Times New Roman CE{\*\falt Times New Roman};}
{\f789\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr{\*\falt Times New Roman};}{\f791\fbidi \froman\fcharset161\fprq2 Times New Roman Greek{\*\falt Times New Roman};}
{\f792\fbidi \froman\fcharset162\fprq2 Times New Roman Tur{\*\falt Times New Roman};}{\f793\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew){\*\falt Times New Roman};}
{\f794\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic){\*\falt Times New Roman};}{\f795\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic{\*\falt Times New Roman};}
{\f796\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese){\*\falt Times New Roman};}{\f798\fbidi \fswiss\fcharset238\fprq2 Arial CE;}{\f799\fbidi \fswiss\fcharset204\fprq2 Arial Cyr;}{\f801\fbidi \fswiss\fcharset161\fprq2 Arial Greek;}
{\f802\fbidi \fswiss\fcharset162\fprq2 Arial Tur;}{\f803\fbidi \fswiss\fcharset177\fprq2 Arial (Hebrew);}{\f804\fbidi \fswiss\fcharset178\fprq2 Arial (Arabic);}{\f805\fbidi \fswiss\fcharset186\fprq2 Arial Baltic;}
{\f806\fbidi \fswiss\fcharset163\fprq2 Arial (Vietnamese);}{\f808\fbidi \fmodern\fcharset238\fprq1 Courier New CE;}{\f809\fbidi \fmodern\fcharset204\fprq1 Courier New Cyr;}{\f811\fbidi \fmodern\fcharset161\fprq1 Courier New Greek;}
{\f812\fbidi \fmodern\fcharset162\fprq1 Courier New Tur;}{\f813\fbidi \fmodern\fcharset177\fprq1 Courier New (Hebrew);}{\f814\fbidi \fmodern\fcharset178\fprq1 Courier New (Arabic);}{\f815\fbidi \fmodern\fcharset186\fprq1 Courier New Baltic;}
{\f816\fbidi \fmodern\fcharset163\fprq1 Courier New (Vietnamese);}{\f820\fbidi \fdecor\fcharset0\fprq2 Symbol;}{\f890\fbidi \fdecor\fcharset0\fprq2 Wingdings;}{\f1128\fbidi \froman\fcharset238\fprq2 Cambria Math CE;}
{\f1129\fbidi \froman\fcharset204\fprq2 Cambria Math Cyr;}{\f1131\fbidi \froman\fcharset161\fprq2 Cambria Math Greek;}{\f1132\fbidi \froman\fcharset162\fprq2 Cambria Math Tur;}{\f1135\fbidi \froman\fcharset186\fprq2 Cambria Math Baltic;}
{\f1136\fbidi \froman\fcharset163\fprq2 Cambria Math (Vietnamese);}{\f1158\fbidi \fswiss\fcharset238\fprq2 Calibri CE;}{\f1159\fbidi \fswiss\fcharset204\fprq2 Calibri Cyr;}{\f1161\fbidi \fswiss\fcharset161\fprq2 Calibri Greek;}
{\f1162\fbidi \fswiss\fcharset162\fprq2 Calibri Tur;}{\f1163\fbidi \fswiss\fcharset177\fprq2 Calibri (Hebrew);}{\f1164\fbidi \fswiss\fcharset178\fprq2 Calibri (Arabic);}{\f1165\fbidi \fswiss\fcharset186\fprq2 Calibri Baltic;}
{\f1166\fbidi \fswiss\fcharset163\fprq2 Calibri (Vietnamese);}{\flomajor\f31508\fbidi \froman\fcharset238\fprq2 Times New Roman CE{\*\falt Times New Roman};}{\flomajor\f31509\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr{\*\falt Times New Roman};}
{\flomajor\f31511\fbidi \froman\fcharset161\fprq2 Times New Roman Greek{\*\falt Times New Roman};}{\flomajor\f31512\fbidi \froman\fcharset162\fprq2 Times New Roman Tur{\*\falt Times New Roman};}
{\flomajor\f31513\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew){\*\falt Times New Roman};}{\flomajor\f31514\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic){\*\falt Times New Roman};}
{\flomajor\f31515\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic{\*\falt Times New Roman};}{\flomajor\f31516\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese){\*\falt Times New Roman};}
{\fdbmajor\f31518\fbidi \froman\fcharset238\fprq2 Times New Roman CE{\*\falt Times New Roman};}{\fdbmajor\f31519\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr{\*\falt Times New Roman};}
{\fdbmajor\f31521\fbidi \froman\fcharset161\fprq2 Times New Roman Greek{\*\falt Times New Roman};}{\fdbmajor\f31522\fbidi \froman\fcharset162\fprq2 Times New Roman Tur{\*\falt Times New Roman};}
{\fdbmajor\f31523\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew){\*\falt Times New Roman};}{\fdbmajor\f31524\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic){\*\falt Times New Roman};}
{\fdbmajor\f31525\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic{\*\falt Times New Roman};}{\fdbmajor\f31526\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese){\*\falt Times New Roman};}
{\fhimajor\f31528\fbidi \fswiss\fcharset238\fprq2 Calibri Light CE;}{\fhimajor\f31529\fbidi \fswiss\fcharset204\fprq2 Calibri Light Cyr;}{\fhimajor\f31531\fbidi \fswiss\fcharset161\fprq2 Calibri Light Greek;}
{\fhimajor\f31532\fbidi \fswiss\fcharset162\fprq2 Calibri Light Tur;}{\fhimajor\f31533\fbidi \fswiss\fcharset177\fprq2 Calibri Light (Hebrew);}{\fhimajor\f31534\fbidi \fswiss\fcharset178\fprq2 Calibri Light (Arabic);}
{\fhimajor\f31535\fbidi \fswiss\fcharset186\fprq2 Calibri Light Baltic;}{\fhimajor\f31536\fbidi \fswiss\fcharset163\fprq2 Calibri Light (Vietnamese);}{\fbimajor\f31538\fbidi \froman\fcharset238\fprq2 Times New Roman CE{\*\falt Times New Roman};}
{\fbimajor\f31539\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr{\*\falt Times New Roman};}{\fbimajor\f31541\fbidi \froman\fcharset161\fprq2 Times New Roman Greek{\*\falt Times New Roman};}
{\fbimajor\f31542\fbidi \froman\fcharset162\fprq2 Times New Roman Tur{\*\falt Times New Roman};}{\fbimajor\f31543\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew){\*\falt Times New Roman};}
{\fbimajor\f31544\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic){\*\falt Times New Roman};}{\fbimajor\f31545\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic{\*\falt Times New Roman};}
{\fbimajor\f31546\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese){\*\falt Times New Roman};}{\flominor\f31548\fbidi \froman\fcharset238\fprq2 Times New Roman CE{\*\falt Times New Roman};}
{\flominor\f31549\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr{\*\falt Times New Roman};}{\flominor\f31551\fbidi \froman\fcharset161\fprq2 Times New Roman Greek{\*\falt Times New Roman};}
{\flominor\f31552\fbidi \froman\fcharset162\fprq2 Times New Roman Tur{\*\falt Times New Roman};}{\flominor\f31553\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew){\*\falt Times New Roman};}
{\flominor\f31554\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic){\*\falt Times New Roman};}{\flominor\f31555\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic{\*\falt Times New Roman};}
{\flominor\f31556\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese){\*\falt Times New Roman};}{\fdbminor\f31558\fbidi \froman\fcharset238\fprq2 Times New Roman CE{\*\falt Times New Roman};}
{\fdbminor\f31559\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr{\*\falt Times New Roman};}{\fdbminor\f31561\fbidi \froman\fcharset161\fprq2 Times New Roman Greek{\*\falt Times New Roman};}
{\fdbminor\f31562\fbidi \froman\fcharset162\fprq2 Times New Roman Tur{\*\falt Times New Roman};}{\fdbminor\f31563\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew){\*\falt Times New Roman};}
{\fdbminor\f31564\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic){\*\falt Times New Roman};}{\fdbminor\f31565\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic{\*\falt Times New Roman};}
{\fdbminor\f31566\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese){\*\falt Times New Roman};}{\fhiminor\f31568\fbidi \fswiss\fcharset238\fprq2 Calibri CE;}{\fhiminor\f31569\fbidi \fswiss\fcharset204\fprq2 Calibri Cyr;}
{\fhiminor\f31571\fbidi \fswiss\fcharset161\fprq2 Calibri Greek;}{\fhiminor\f31572\fbidi \fswiss\fcharset162\fprq2 Calibri Tur;}{\fhiminor\f31573\fbidi \fswiss\fcharset177\fprq2 Calibri (Hebrew);}
{\fhiminor\f31574\fbidi \fswiss\fcharset178\fprq2 Calibri (Arabic);}{\fhiminor\f31575\fbidi \fswiss\fcharset186\fprq2 Calibri Baltic;}{\fhiminor\f31576\fbidi \fswiss\fcharset163\fprq2 Calibri (Vietnamese);}
{\fbiminor\f31578\fbidi \froman\fcharset238\fprq2 Times New Roman CE{\*\falt Times New Roman};}{\fbiminor\f31579\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr{\*\falt Times New Roman};}
{\fbiminor\f31581\fbidi \froman\fcharset161\fprq2 Times New Roman Greek{\*\falt Times New Roman};}{\fbiminor\f31582\fbidi \froman\fcharset162\fprq2 Times New Roman Tur{\*\falt Times New Roman};}
{\fbiminor\f31583\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew){\*\falt Times New Roman};}{\fbiminor\f31584\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic){\*\falt Times New Roman};}
{\fbiminor\f31585\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic{\*\falt Times New Roman};}{\fbiminor\f31586\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese){\*\falt Times New Roman};}}{\colortbl;\red0\green0\blue0;
\red0\green0\blue255;\red0\green255\blue255;\red0\green255\blue0;\red255\green0\blue255;\red255\green0\blue0;\red255\green255\blue0;\red255\green255\blue255;\red0\green0\blue128;\red0\green128\blue128;\red0\green128\blue0;\red128\green0\blue128;
\red128\green0\blue0;\red128\green128\blue0;\red128\green128\blue128;\red192\green192\blue192;\red0\green0\blue0;\red0\green0\blue0;\ctextone\ctint166\cshade255\red89\green89\blue89;\red255\green192\blue0;
\caccentone\ctint255\cshade191\red47\green84\blue150;\caccentfour\ctint255\cshade191\red191\green143\blue0;\red34\green30\blue31;\red0\green96\blue104;\ctextone\ctint255\cshade255\red0\green0\blue0;\chyperlink\ctint255\cshade255\red5\green99\blue193;
\red96\green94\blue92;\red225\green223\blue221;\ctextone\ctint191\cshade255\red64\green64\blue64;}{\*\defchp \f31506\fs24\lang3081\langfe1033\langfenp1033 }{\*\defpap \ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 }
\noqfpromote {\stylesheet{\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f42\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057
\snext0 \sqformat \spriority0 \styrsid4290160 Normal;}{\s1\ql \li0\ri0\sb240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs32\alang1025 \ltrch\fcs0
\b\fs24\ul\cf19\lang3081\langfe2057\loch\f46\hich\af46\dbch\af31501\cgrid\langnp3081\langfenp2057\ulc20 \sbasedon0 \snext0 \slink15 \sqformat \spriority9 \styrsid3897135 heading 1,Heading_02;}{
\s2\ql \li0\ri0\sb40\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\fs26\cf21\lang3081\langfe2057\loch\f31502\hich\af31502\dbch\af31501\cgrid\langnp3081\langfenp2057 \sbasedon0 \snext0 \slink16 \sunhideused \sqformat \spriority9 \styrsid15226110 heading 2;}{
\s3\ql \li0\ri0\sb40\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel2\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0
\fs36\cf22\lang3081\langfe2057\loch\f46\hich\af46\dbch\af31501\cgrid\langnp3081\langfenp2057 \sbasedon0 \snext0 \slink17 \sunhideused \sqformat \spriority9 \styrsid3897135 heading 3;}{\*\cs10 \additive \sunhideused \spriority1 Default Paragraph Font;}{\*
\ts11\tsrowd\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind0\tblindtype3\tsvertalt\tsbrdrt\tsbrdrl\tsbrdrb\tsbrdrr\tsbrdrdgl\tsbrdrdgr\tsbrdrh\tsbrdrv
\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af31506\afs24\alang1025 \ltrch\fcs0 \f31506\fs24\lang3081\langfe1033\cgrid\langnp3081\langfenp1033 \snext11 \ssemihidden \sunhideused Normal Table;}{\*
\cs15 \additive \rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \b\fs32\ul\cf19\loch\f46\hich\af46\dbch\af31501\ulc20 \sbasedon10 \slink1 \slocked \spriority9 \styrsid3897135 Heading 1 Char,Heading_02 Char;}{\*\cs16 \additive \rtlch\fcs1 \af0\afs26 \ltrch\fcs0
\fs26\cf21\lang0\langfe2057\loch\f31502\hich\af31502\dbch\af31501\langnp0\langfenp2057 \sbasedon10 \slink2 \slocked \spriority9 \styrsid15226110 Heading 2 Char;}{\*\cs17 \additive \rtlch\fcs1 \af0 \ltrch\fcs0 \fs36\cf22\loch\f46\hich\af46\dbch\af31501
\sbasedon10 \slink3 \slocked \spriority9 \styrsid3897135 Heading 3 Char;}{\s18\ql \fi-360\li720\ri0\sa283\widctlpar\tx680\wrapdefault\hyphpar0\facenter\ls1\rin0\lin720\itap0 \rtlch\fcs1 \af45\afs24\alang1025 \ltrch\fcs0
\f46\fs24\cf1\lang2057\langfe2057\cgrid\langnp2057\langfenp2057 \sbasedon0 \snext0 \styrsid3897135 Bullut_Body_LAST;}{\s19\ql \fi-360\li720\ri0\sa113\widctlpar\tx680\wrapdefault\aspalpha\aspnum\faauto\ls2\adjustright\rin0\lin720\itap0 \rtlch\fcs1
\af0\afs24\alang1025 \ltrch\fcs0 \f46\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 \sbasedon0 \snext19 \styrsid3897135 Bullets_Body;}{\s20\ql \fi-360\li720\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\ls4\adjustright\rin0\lin720\itap0
\rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f42\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 \sbasedon0 \snext20 \sqformat \spriority0 \styrsid3897135 Bullets;}{\s21\ql \li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0 \rtlch\fcs1
\af47\afs24\alang1025 \ltrch\fcs0 \f47\fs24\cf1\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 \snext21 \spriority0 \styrsid15887444 Default;}{\s22\ql \li0\ri0\sl221\slmult0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025
\ltrch\fcs0 \f47\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 \sbasedon21 \snext21 \styrsid15887444 Pa0;}{\*\cs23 \additive \fs32\cf23 \styrsid15887444 A0;}{\*\cs24 \additive \b\fs42\cf24 \styrsid15887444 A1;}{\s25\ql \li0\ri0\sl221\slmult0
\widctlpar\wrapdefault\faauto\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f47\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 \sbasedon21 \snext21 \styrsid15887444 Pa2;}{
\s26\ql \li0\ri0\sa180\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs32\alang1025 \ltrch\fcs0 \fs72\cf19\lang3081\langfe2057\loch\f1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057\ulc20
\snext26 \sqformat \spriority0 \styrsid15887444 Heading TITLE;}{\s27\ql \li0\ri0\sa180\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs32\alang1025 \ltrch\fcs0
\b\fs32\cf25\lang3081\langfe2057\loch\f1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057\ulc20 \sbasedon26 \snext27 \sqformat \spriority0 \styrsid15887444 Heading Title Small;}{\*\cs28 \additive \rtlch\fcs1 \af0 \ltrch\fcs0 \ul\cf26
\sbasedon10 \sunhideused \styrsid4610474 Hyperlink;}{\*\cs29 \additive \rtlch\fcs1 \af0 \ltrch\fcs0 \cf27\chshdng0\chcfpat0\chcbpat28 \sbasedon10 \ssemihidden \sunhideused \styrsid4610474 Unresolved Mention;}{\s30\ql \li0\ri0\sa120\sl360\slmult1
\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 \sbasedon60 \snext30 \sqformat \spriority0 \styrsid4141132
BODY - Royal Commission;}{\s31\ql \li0\ri0\sl301\slmult0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f47\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 \sbasedon21 \snext21 \styrsid4610474 Pa3;}{
\s32\ql \li0\ri0\sb360\sa240\sl301\slmult0\widctlpar\wrapdefault\faauto\outlinelevel0\rin0\lin0\itap0 \rtlch\fcs1 \ab\af47\afs30\alang1025 \ltrch\fcs0 \f1\fs48\cf29\lang2057\langfe1033\cgrid\langnp2057\langfenp1033
\snext30 \sqformat \spriority0 \styrsid4158171 Heading 1 - Royal Commission;}{\*\cs33 \additive \fs12\cf23 \styrsid5003121 A6;}{\s34\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025
\ltrch\fcs0 \f42\fs20\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 \sbasedon0 \snext34 \slink35 \ssemihidden \sunhideused \styrsid5003121 footnote text;}{\*\cs35 \additive \rtlch\fcs1 \af0\afs20 \ltrch\fcs0
\f42\fs20\lang0\langfe2057\langnp0\langfenp2057 \sbasedon10 \slink34 \slocked \ssemihidden \styrsid5003121 Footnote Text Char;}{\*\cs36 \additive \rtlch\fcs1 \af0 \ltrch\fcs0 \super \sbasedon10 \ssemihidden \sunhideused \styrsid5003121
footnote reference;}{\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057
\sbasedon34 \snext37 \sqformat \spriority0 \styrsid3477284 END NOTE - Royal Commission;}{\s38\ql \li0\ri0\sl221\slmult0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0
\f47\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 \sbasedon21 \snext21 \styrsid4140516 Pa8;}{\s39\ql \fi-360\li360\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\ls5\adjustright\rin0\lin360\itap0 \rtlch\fcs1
\ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 \sbasedon30 \snext39 \sqformat \spriority0 \styrsid4140516 BODY LIST - Royal Commission;}{\s40\ql \li0\ri0\sl261\slmult0
\widctlpar\wrapdefault\faauto\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f47\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 \sbasedon21 \snext21 \styrsid7157006 Pa9;}{
\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\f1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 \sbasedon2 \snext30 \sqformat \spriority0 \styrsid7095095 Heading 2 - Royal Commission;}{\s42\ql \li0\ri0\sl231\slmult0
\widctlpar\wrapdefault\faauto\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f48\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 \sbasedon21 \snext21 \styrsid2381068 Pa11;}{\*\cs43 \additive \b\fs26\cf23 \styrsid5768343 A7;}{
\s44\ql \li0\ri0\sl221\slmult0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0 \rtlch\fcs1 \af37\afs24\alang1025 \ltrch\fcs0 \f47\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 \sbasedon21 \snext21 \styrsid8587315 Pa10;}{
\s45\ql \li0\ri0\sl161\slmult0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0 \rtlch\fcs1 \af37\afs24\alang1025 \ltrch\fcs0 \f48\fs24\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 \sbasedon21 \snext21 \styrsid8587315 Pa6;}{\*\cs46 \additive \rtlch\fcs1
\af0 \ltrch\fcs0 \super \sbasedon36 \sqformat \spriority1 \styrsid8587315 EndNote_number;}{\s47\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0
\f42\fs20\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 \sbasedon0 \snext47 \slink48 \ssemihidden \sunhideused \styrsid161113 endnote text;}{\*\cs48 \additive \rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \f42\fs20\lang0\langfe2057\langnp0\langfenp2057
\sbasedon10 \slink47 \slocked \ssemihidden \styrsid161113 Endnote Text Char;}{\*\cs49 \additive \rtlch\fcs1 \af0 \ltrch\fcs0 \super \sbasedon10 \ssemihidden \sunhideused \styrsid161113 endnote reference;}{\s50\ql \li0\ri0\sb480\sl276\slmult1
\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af0\afs28\alang1025 \ltrch\fcs0 \b\fs28\cf21\lang1033\langfe1033\loch\f31502\hich\af31502\dbch\af31501\cgrid\langnp1033\langfenp1033
\sbasedon1 \snext0 \sunhideused \sqformat \spriority39 \styrsid882434 TOC Heading;}{\s51\ql \li0\ri0\sb120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\ai\af31506\afs24\alang1025 \ltrch\fcs0
\b\i\f31506\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 \sbasedon0 \snext0 \sautoupd \sunhideused \spriority39 \styrsid882434 toc 1;}{\s52\ql \li240\ri0\sb120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin240\itap0
\rtlch\fcs1 \ab\af31506\afs22\alang1025 \ltrch\fcs0 \b\f31506\fs22\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 \sbasedon0 \snext0 \sautoupd \sunhideused \spriority39 \styrsid882434 toc 2;}{
\s53\ql \li480\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin480\itap0 \rtlch\fcs1 \af31506\afs20\alang1025 \ltrch\fcs0 \f31506\fs20\lang3081\langfe2057\cgrid\langnp3081\langfenp2057
\sbasedon0 \snext0 \sautoupd \sunhideused \spriority39 \styrsid882434 toc 3;}{\s54\ql \li720\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0 \rtlch\fcs1 \af31506\afs20\alang1025 \ltrch\fcs0
\f31506\fs20\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 \sbasedon0 \snext0 \sautoupd \sunhideused \spriority39 \styrsid882434 toc 4;}{\s55\ql \li960\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin960\itap0 \rtlch\fcs1
\af31506\afs20\alang1025 \ltrch\fcs0 \f31506\fs20\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 \sbasedon0 \snext0 \sautoupd \sunhideused \spriority39 \styrsid882434 toc 5;}{
\s56\ql \li1200\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin1200\itap0 \rtlch\fcs1 \af31506\afs20\alang1025 \ltrch\fcs0 \f31506\fs20\lang3081\langfe2057\cgrid\langnp3081\langfenp2057
\sbasedon0 \snext0 \sautoupd \sunhideused \spriority39 \styrsid882434 toc 6;}{\s57\ql \li1440\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin1440\itap0 \rtlch\fcs1 \af31506\afs20\alang1025 \ltrch\fcs0
\f31506\fs20\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 \sbasedon0 \snext0 \sautoupd \sunhideused \spriority39 \styrsid882434 toc 7;}{\s58\ql \li1680\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin1680\itap0 \rtlch\fcs1
\af31506\afs20\alang1025 \ltrch\fcs0 \f31506\fs20\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 \sbasedon0 \snext0 \sautoupd \sunhideused \spriority39 \styrsid882434 toc 8;}{
\s59\ql \li1920\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin1920\itap0 \rtlch\fcs1 \af31506\afs20\alang1025 \ltrch\fcs0 \f31506\fs20\lang3081\langfe2057\cgrid\langnp3081\langfenp2057
\sbasedon0 \snext0 \sautoupd \sunhideused \spriority39 \styrsid882434 toc 9;}{\s60\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0
\f42\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 \sbasedon0 \snext60 \slink61 \ssemihidden \sunhideused \styrsid4141132 Body Text;}{\*\cs61 \additive \rtlch\fcs1 \af0 \ltrch\fcs0 \f42\lang0\langfe2057\langnp0\langfenp2057
\sbasedon10 \slink60 \slocked \ssemihidden \styrsid4141132 Body Text Char;}}{\*\listtable{\list\listtemplateid875586354\listsimple{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext
\'02\'00.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li1492\jclisttab\tx1492\lin1492 }{\listname ;}\listid-132}{\list\listtemplateid-345711432\listsimple{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0
\levelstartat1\levelspace0\levelindent0{\leveltext\'02\'00.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li1209\jclisttab\tx1209\lin1209 }{\listname ;}\listid-131}{\list\listtemplateid284720376\listsimple{\listlevel\levelnfc0
\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\'02\'00.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li926\jclisttab\tx926\lin926 }{\listname ;}\listid-130}
{\list\listtemplateid-694370988\listsimple{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\'02\'00.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li643
\jclisttab\tx643\lin643 }{\listname ;}\listid-129}{\list\listtemplateid1043634882\listsimple{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\'01\u-3913 _;}{\levelnumbers;}
\f3\fbias0\hres0\chhres0 \fi-360\li1492\jclisttab\tx1492\lin1492 }{\listname ;}\listid-128}{\list\listtemplateid2065836186\listsimple{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext
\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0 \fi-360\li1209\jclisttab\tx1209\lin1209 }{\listname ;}\listid-127}{\list\listtemplateid-377836382\listsimple{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1
\levelspace0\levelindent0{\leveltext\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0 \fi-360\li926\jclisttab\tx926\lin926 }{\listname ;}\listid-126}{\list\listtemplateid867967930\listsimple{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0
\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0 \fi-360\li643\jclisttab\tx643\lin643 }{\listname ;}\listid-125}{\list\listtemplateid-257818272\listsimple{\listlevel\levelnfc0
\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\'02\'00.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li360\jclisttab\tx360\lin360 }{\listname ;}\listid-120}
{\list\listtemplateid312616022\listsimple{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0 \fi-360\li360\jclisttab\tx360\lin360 }
{\listname ;}\listid-119}{\list\listtemplateid-1874822354\listhybrid{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid-951927120\'01\u-3913 _;}{\levelnumbers;}
\f3\fbias0\hres0\chhres0 \s20\fi-360\li720\lin720 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807555\'01o;}{\levelnumbers;}\f2\fbias0\hres0\chhres0
\fi-360\li1440\lin1440 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807557\'01\u-3929 _;}{\levelnumbers;}\f10\fbias0\hres0\chhres0
\fi-360\li2160\lin2160 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807553\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0
\fi-360\li2880\lin2880 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807555\'01o;}{\levelnumbers;}\f2\fbias0\hres0\chhres0 \fi-360\li3600\lin3600 }
{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807557\'01\u-3929 _;}{\levelnumbers;}\f10\fbias0\hres0\chhres0 \fi-360\li4320\lin4320 }{\listlevel
\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807553\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0 \fi-360\li5040\lin5040 }{\listlevel\levelnfc23
\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807555\'01o;}{\levelnumbers;}\f2\fbias0\hres0\chhres0 \fi-360\li5760\lin5760 }{\listlevel\levelnfc23\levelnfcn23\leveljc0
\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807557\'01\u-3929 _;}{\levelnumbers;}\f10\fbias0\hres0\chhres0 \fi-360\li6480\lin6480 }{\listname ;}\listid98188056}{\list\listtemplateid-1072646508
\listhybrid{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid-1729445492\'02\'00.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \fbias0\hres0\chhres0
\fi-720\li1080\lin1080 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'01.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0
\fi-360\li1440\lin1440 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'02.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0
\fi-180\li2160\lin2160 }{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807567\'02\'03.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0
\fi-360\li2880\lin2880 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'04.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0
\fi-360\li3600\lin3600 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'05.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0
\fi-180\li4320\lin4320 }{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807567\'02\'06.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0
\fi-360\li5040\lin5040 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'07.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0
\fi-360\li5760\lin5760 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'08.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0
\fi-180\li6480\lin6480 }{\listname ;}\listid236479956}{\list\listtemplateid-383716750\listhybrid{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid134807567
\'02\'00.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \fbias0\hres0\chhres0 \fi-360\li360\lin360 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807577\'02\'01.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li1080\lin1080 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807579\'02\'02.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li1800\lin1800 }{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807567\'02\'03.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li2520\lin2520 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807577\'02\'04.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li3240\lin3240 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807579\'02\'05.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li3960\lin3960 }{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807567\'02\'06.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li4680\lin4680 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807577\'02\'07.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li5400\lin5400 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807579\'02\'08.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li6120\lin6120 }{\listname ;}\listid374739520}{\list\listtemplateid164298676\listhybrid{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0
\levelfollow0\levelstartat3\levelspace0\levelindent0{\leveltext\leveltemplateid-1047656076\'02\'00.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \fbias0\hres0\chhres0 \fi-720\li1080\lin1080 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0
\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'01.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li1440\lin1440 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2
\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'02.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li2160\lin2160 }{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0
\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807567\'02\'03.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li2880\lin2880 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0
\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'04.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li3600\lin3600 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2
\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'05.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li4320\lin4320 }{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0
\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807567\'02\'06.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li5040\lin5040 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0
\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'07.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li5760\lin5760 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2
\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'08.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li6480\lin6480 }{\listname ;}\listid497355177}
{\list\listtemplateid1196060014\listhybrid{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace360\levelindent0{\leveltext\leveltemplateid-1545821130\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0 \s39
\fi-360\li360\lin360 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace360\levelindent0{\leveltext\leveltemplateid134807555\'01o;}{\levelnumbers;}\f2\fbias0\hres0\chhres0 \fi-360\li1080\lin1080 }
{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace360\levelindent0{\leveltext\leveltemplateid134807557\'01\u-3929 _;}{\levelnumbers;}\f10\fbias0\hres0\chhres0 \fi-360\li1800\lin1800 }{\listlevel
\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace360\levelindent0{\leveltext\leveltemplateid134807553\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0 \fi-360\li2520\lin2520 }{\listlevel\levelnfc23
\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace360\levelindent0{\leveltext\leveltemplateid134807555\'01o;}{\levelnumbers;}\f2\fbias0\hres0\chhres0 \fi-360\li3240\lin3240 }{\listlevel\levelnfc23\levelnfcn23\leveljc0
\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace360\levelindent0{\leveltext\leveltemplateid134807557\'01\u-3929 _;}{\levelnumbers;}\f10\fbias0\hres0\chhres0 \fi-360\li3960\lin3960 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0
\levelfollow0\levelstartat1\lvltentative\levelspace360\levelindent0{\leveltext\leveltemplateid134807553\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0 \fi-360\li4680\lin4680 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0
\levelstartat1\lvltentative\levelspace360\levelindent0{\leveltext\leveltemplateid134807555\'01o;}{\levelnumbers;}\f2\fbias0\hres0\chhres0 \fi-360\li5400\lin5400 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative
\levelspace360\levelindent0{\leveltext\leveltemplateid134807557\'01\u-3929 _;}{\levelnumbers;}\f10\fbias0\hres0\chhres0 \fi-360\li6120\lin6120 }{\listname ;}\listid725757134}{\list\listtemplateid1219557740\listhybrid{\listlevel\levelnfc0\levelnfcn0
\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid-1507567998\'02\'00.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \fbias0\hres0\chhres0 \fi-440\li440\lin440 }{\listlevel\levelnfc4\levelnfcn4\leveljc0
\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'01.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li1080\lin1080 }{\listlevel\levelnfc2\levelnfcn2\leveljc2
\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'02.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li1800\lin1800 }{\listlevel\levelnfc0\levelnfcn0\leveljc0
\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807567\'02\'03.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li2520\lin2520 }{\listlevel\levelnfc4\levelnfcn4\leveljc0
\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'04.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li3240\lin3240 }{\listlevel\levelnfc2\levelnfcn2\leveljc2
\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'05.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li3960\lin3960 }{\listlevel\levelnfc0\levelnfcn0\leveljc0
\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807567\'02\'06.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li4680\lin4680 }{\listlevel\levelnfc4\levelnfcn4\leveljc0
\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'07.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li5400\lin5400 }{\listlevel\levelnfc2\levelnfcn2\leveljc2
\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'08.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li6120\lin6120 }{\listname ;}\listid733160764}
{\list\listtemplateid-2030935654\listhybrid{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat3\levelspace0\levelindent0{\leveltext\leveltemplateid1291880658\'02\'00.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0
\fbias0\hres0\chhres0 \fi-720\li1080\lin1080 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'01.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0
\ltrch\fcs0 \hres0\chhres0 \fi-360\li1440\lin1440 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'02.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0
\ltrch\fcs0 \hres0\chhres0 \fi-180\li2160\lin2160 }{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807567\'02\'03.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0
\ltrch\fcs0 \hres0\chhres0 \fi-360\li2880\lin2880 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'04.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0
\ltrch\fcs0 \hres0\chhres0 \fi-360\li3600\lin3600 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'05.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0
\ltrch\fcs0 \hres0\chhres0 \fi-180\li4320\lin4320 }{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807567\'02\'06.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0
\ltrch\fcs0 \hres0\chhres0 \fi-360\li5040\lin5040 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'07.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0
\ltrch\fcs0 \hres0\chhres0 \fi-360\li5760\lin5760 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'08.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0
\ltrch\fcs0 \hres0\chhres0 \fi-180\li6480\lin6480 }{\listname ;}\listid940382982}{\list\listtemplateid-2023988934\listhybrid{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext
\leveltemplateid1209071554\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0 \s19\fi-360\li720\lin720 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807555\'01o;}{\levelnumbers;}\f2\fbias0\hres0\chhres0 \fi-360\li1440\lin1440 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807557
\'01\u-3929 _;}{\levelnumbers;}\f10\fbias0\hres0\chhres0 \fi-360\li2160\lin2160 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807553
\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0 \fi-360\li2880\lin2880 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807555\'01o;}{\levelnumbers
;}\f2\fbias0\hres0\chhres0 \fi-360\li3600\lin3600 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807557\'01\u-3929 _;}{\levelnumbers;}
\f10\fbias0\hres0\chhres0 \fi-360\li4320\lin4320 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807553\'01\u-3913 _;}{\levelnumbers;}
\f3\fbias0\hres0\chhres0 \fi-360\li5040\lin5040 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807555\'01o;}{\levelnumbers;}\f2\fbias0\hres0\chhres0
\fi-360\li5760\lin5760 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807557\'01\u-3929 _;}{\levelnumbers;}\f10\fbias0\hres0\chhres0
\fi-360\li6480\lin6480 }{\listname ;}\listid1118568822}{\list\listtemplateid-1501635446\listhybrid{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid-368429272
\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0 \s18\fi-360\li720\lin720 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807555
\'01o;}{\levelnumbers;}\f2\fbias0\hres0\chhres0 \fi-360\li1440\lin1440 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807557\'01\u-3929 _;}{\levelnumbers
;}\f10\fbias0\hres0\chhres0 \fi-360\li2160\lin2160 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807553\'01\u-3913 _;}{\levelnumbers;}
\f3\fbias0\hres0\chhres0 \fi-360\li2880\lin2880 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807555\'01o;}{\levelnumbers;}\f2\fbias0\hres0\chhres0
\fi-360\li3600\lin3600 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807557\'01\u-3929 _;}{\levelnumbers;}\f10\fbias0\hres0\chhres0
\fi-360\li4320\lin4320 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807553\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0
\fi-360\li5040\lin5040 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807555\'01o;}{\levelnumbers;}\f2\fbias0\hres0\chhres0 \fi-360\li5760\lin5760 }
{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807557\'01\u-3929 _;}{\levelnumbers;}\f10\fbias0\hres0\chhres0 \fi-360\li6480\lin6480 }{\listname
;}\listid1120297091}{\list\listtemplateid1661363080\listhybrid{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat3\levelspace0\levelindent0{\leveltext\leveltemplateid1452443864\'02\'00.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0
\ltrch\fcs0 \fbias0\hres0\chhres0 \fi-720\li720\lin720 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'01.;}{\levelnumbers\'01;}\rtlch\fcs1
\af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li1080\lin1080 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'02.;}{\levelnumbers\'01;}\rtlch\fcs1
\af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li1800\lin1800 }{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807567\'02\'03.;}{\levelnumbers\'01;}\rtlch\fcs1
\af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li2520\lin2520 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'04.;}{\levelnumbers\'01;}\rtlch\fcs1
\af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li3240\lin3240 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'05.;}{\levelnumbers\'01;}\rtlch\fcs1
\af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li3960\lin3960 }{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807567\'02\'06.;}{\levelnumbers\'01;}\rtlch\fcs1
\af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li4680\lin4680 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807577\'02\'07.;}{\levelnumbers\'01;}\rtlch\fcs1
\af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li5400\lin5400 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807579\'02\'08.;}{\levelnumbers\'01;}\rtlch\fcs1
\af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li6120\lin6120 }{\listname ;}\listid1472554844}{\list\listtemplateid-1672547544\listhybrid{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext
\leveltemplateid2071086658\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0 \fi-360\li1080\lin1080 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807555\'01o;}{\levelnumbers;}\f2\fbias0\hres0\chhres0 \fi-360\li1800\lin1800 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807557
\'01\u-3929 _;}{\levelnumbers;}\f10\fbias0\hres0\chhres0 \fi-360\li2520\lin2520 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807553
\'01\u-3913 _;}{\levelnumbers;}\f3\fbias0\hres0\chhres0 \fi-360\li3240\lin3240 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807555\'01o;}{\levelnumbers
;}\f2\fbias0\hres0\chhres0 \fi-360\li3960\lin3960 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807557\'01\u-3929 _;}{\levelnumbers;}
\f10\fbias0\hres0\chhres0 \fi-360\li4680\lin4680 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807553\'01\u-3913 _;}{\levelnumbers;}
\f3\fbias0\hres0\chhres0 \fi-360\li5400\lin5400 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807555\'01o;}{\levelnumbers;}\f2\fbias0\hres0\chhres0
\fi-360\li6120\lin6120 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext\leveltemplateid134807557\'01\u-3929 _;}{\levelnumbers;}\f10\fbias0\hres0\chhres0
\fi-360\li6840\lin6840 }{\listname ;}\listid1676495868}{\list\listtemplateid796815608\listhybrid{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat3\levelspace0\levelindent0{\leveltext\leveltemplateid-424630282
\'02\'00.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \fbias0\hres0\chhres0 \fi-720\li1080\lin1080 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807577\'02\'01.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li1440\lin1440 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807579\'02\'02.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li2160\lin2160 }{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807567\'02\'03.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li2880\lin2880 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807577\'02\'04.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li3600\lin3600 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807579\'02\'05.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li4320\lin4320 }{\listlevel\levelnfc0\levelnfcn0\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807567\'02\'06.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li5040\lin5040 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807577\'02\'07.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-360\li5760\lin5760 }{\listlevel\levelnfc2\levelnfcn2\leveljc2\leveljcn2\levelfollow0\levelstartat1\lvltentative\levelspace0\levelindent0{\leveltext
\leveltemplateid134807579\'02\'08.;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 \fi-180\li6480\lin6480 }{\listname ;}\listid1756513625}}{\*\listoverridetable{\listoverride\listid1120297091\listoverridecount0\ls1}
{\listoverride\listid1118568822\listoverridecount0\ls2}{\listoverride\listid1676495868\listoverridecount0\ls3}{\listoverride\listid98188056\listoverridecount0\ls4}{\listoverride\listid725757134\listoverridecount0\ls5}{\listoverride\listid733160764
\listoverridecount0\ls6}{\listoverride\listid374739520\listoverridecount0\ls7}{\listoverride\listid-132\listoverridecount0\ls8}{\listoverride\listid-131\listoverridecount0\ls9}{\listoverride\listid-130\listoverridecount0\ls10}{\listoverride\listid-129
\listoverridecount0\ls11}{\listoverride\listid-120\listoverridecount0\ls12}{\listoverride\listid-128\listoverridecount0\ls13}{\listoverride\listid-127\listoverridecount0\ls14}{\listoverride\listid-126\listoverridecount0\ls15}{\listoverride\listid-125
\listoverridecount0\ls16}{\listoverride\listid-119\listoverridecount0\ls17}{\listoverride\listid940382982\listoverridecount0\ls18}{\listoverride\listid1472554844\listoverridecount0\ls19}{\listoverride\listid236479956\listoverridecount0\ls20}
{\listoverride\listid1756513625\listoverridecount0\ls21}{\listoverride\listid497355177\listoverridecount0\ls22}}{\*\rsidtbl \rsid161113\rsid678699\rsid788264\rsid882434\rsid1381092\rsid1525393\rsid1771450\rsid1997998\rsid2118636\rsid2169741\rsid2381068
\rsid2562873\rsid2625213\rsid2848743\rsid2849289\rsid3084610\rsid3308888\rsid3346980\rsid3477284\rsid3550661\rsid3567488\rsid3739375\rsid3897135\rsid4140516\rsid4141132\rsid4158171\rsid4290160\rsid4358134\rsid4539194\rsid4547339\rsid4599876\rsid4610474
\rsid4666648\rsid4935206\rsid5001872\rsid5003121\rsid5267025\rsid5518317\rsid5526123\rsid5652905\rsid5767301\rsid5768343\rsid6032543\rsid6445344\rsid6512553\rsid7095095\rsid7157006\rsid7425148\rsid7425658\rsid7890839\rsid7951150\rsid8064884\rsid8258069
\rsid8462528\rsid8475683\rsid8587315\rsid8604794\rsid9187727\rsid9191374\rsid9387869\rsid9457135\rsid9583102\rsid9583334\rsid10176576\rsid10577270\rsid10627663\rsid11151371\rsid11358995\rsid11755138\rsid11938584\rsid12006923\rsid12058958\rsid12152404
\rsid12198289\rsid12601830\rsid12615622\rsid12804631\rsid13124370\rsid13238462\rsid13251227\rsid13320433\rsid13638150\rsid13782692\rsid14026192\rsid14837795\rsid14974780\rsid15226110\rsid15349042\rsid15401483\rsid15427077\rsid15602616\rsid15679996
\rsid15730590\rsid15887444\rsid16014488\rsid16471590\rsid16474993}{\mmathPr\mmathFont34\mbrkBin0\mbrkBinSub0\msmallFrac0\mdispDef1\mlMargin0\mrMargin0\mdefJc1\mwrapIndent1440\mintLim0\mnaryLim1}{\info{\author Dina Theodoropoulos}
{\operator Dina Theodoropoulos}{\creatim\yr2020\mo7\dy1\hr14\min34}{\revtim\yr2020\mo7\dy20\hr9\min13}{\version43}{\edmins499}{\nofpages66}{\nofwords18910}{\nofchars107793}{\nofcharsws126451}{\vern5007}}{\*\xmlnstbl {\xmlns1 http://schemas.microsoft.com/o
ffice/word/2003/wordml}}\paperw11900\paperh16840\margl1440\margr1440\margt1440\margb1440\gutter0\ltrsect
\widowctrl\ftnbj\aenddoc\trackmoves0\trackformatting1\donotembedsysfont1\relyonvml0\donotembedlingdata0\grfdocevents0\validatexml1\showplaceholdtext0\ignoremixedcontent0\saveinvalidxml0\showxmlerrors1\noxlattoyen
\expshrtn\noultrlspc\dntblnsbdb\nospaceforul\formshade\horzdoc\dgmargin\dghspace180\dgvspace180\dghorigin1440\dgvorigin1440\dghshow1\dgvshow1
\jexpand\viewkind1\viewscale109\pgbrdrhead\pgbrdrfoot\splytwnine\ftnlytwnine\htmautsp\nolnhtadjtbl\useltbaln\alntblind\lytcalctblwd\lyttblrtgr\lnbrkrule\nobrkwrptbl\snaptogridincell\allowfieldendsel\wrppunct
\asianbrkrule\rsidroot15887444\newtblstyruls\nogrowautofit\usenormstyforlist\noindnmbrts\felnbrelev\nocxsptable\indrlsweleven\noafcnsttbl\afelev\utinl\hwelev\spltpgpar\notcvasp\notbrkcnstfrctbl\notvatxbx\krnprsnet\cachedcolbal \nouicompat \fet0
{\*\wgrffmtfilter 081f}\nofeaturethrottle1\ilfomacatclnup0{\*\ftnsep \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5003121 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0
\f42\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4547339 \chftnsep
\par }}{\*\ftnsepc \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5003121 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f42\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4547339 \chftnsepc
\par }}{\*\aftnsep \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5003121 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f42\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4547339 \chftnsep
\par }}{\*\aftnsepc \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5003121 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \f42\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4547339 \chftnsepc
\par }}\ltrpar \sectd \ltrsect\linex0\headery708\footery708\colsx708\endnhere\sectlinegrid360\sectdefaultcl\sectrsid10577270\sftnbj {\*\pnseclvl1\pnucrm\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl2\pnucltr\pnstart1\pnindent720\pnhang {\pntxta .}}
{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl4\pnlcltr\pnstart1\pnindent720\pnhang {\pntxta )}}{\*\pnseclvl5\pndec\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl6\pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}
{\pntxta )}}{\*\pnseclvl7\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl8\pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl9\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}\pard\plain \ltrpar
\s21\ql \li0\ri0\widctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid15887444 \rtlch\fcs1 \af47\afs24\alang1025 \ltrch\fcs0 \f47\fs24\cf1\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15887444
\par }\pard\plain \ltrpar\s27\ql \li0\ri0\sa180\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0\pararsid12615622 \rtlch\fcs1 \af0\afs32\alang1025 \ltrch\fcs0
\b\fs32\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057\ulc20 {\rtlch\fcs1 \af0 \ltrch\fcs0 \cs23\insrsid15887444\charrsid15887444 \hich\af1\dbch\af31501\loch\f1 Submission to the}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs23\fs72\cf19\insrsid15887444
\par }\pard\plain \ltrpar\s26\ql \li0\ri0\sa180\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0\pararsid12615622 \rtlch\fcs1 \af0\afs32\alang1025 \ltrch\fcs0
\fs72\cf19\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057\ulc20 {\rtlch\fcs1 \af0 \ltrch\fcs0 \cs24\insrsid4610474
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs24\insrsid15887444\charrsid15887444 \hich\af1\dbch\af31501\loch\f1 Royal Commission into Violence, Abuse, Neglect \hich\af1\dbch\af31501\loch\f1 and Exploitation of People with Disability}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid15887444\charrsid15887444
\par }\pard\plain \ltrpar\s27\ql \li0\ri0\sa180\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16471590 \rtlch\fcs1 \af0\afs32\alang1025 \ltrch\fcs0
\b\fs32\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057\ulc20 {\rtlch\fcs1 \af0 \ltrch\fcs0 \cs23\insrsid4610474
\par }\pard \ltrpar\s27\ql \li0\ri0\sa180\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0\pararsid12615622 {\rtlch\fcs1 \af0 \ltrch\fcs0 \cs23\insrsid15887444\charrsid15887444 \hich\af1\dbch\af31501\loch\f1
by the Victorian Disability Services Commissioner}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15887444\charrsid15887444
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15887444 \hich\af1\dbch\af31501\loch\f1 June 2020
\par }\pard \ltrpar\s27\ql \li0\ri0\sa180\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid15887444 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15887444\charrsid15887444
\par \hich\af1\dbch\af31501\loch\f1 Authorised by:}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15887444
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15887444\charrsid15887444
\par }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b0\insrsid15887444\charrsid15887444 \hich\af1\dbch\af31501\loch\f1 Arthur Rogers
\par \hich\af1\dbch\af31501\loch\f1 Disability Services Commissioner
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15887444
\par }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b0\insrsid15887444\charrsid15887444 \hich\af1\dbch\af31501\loch\f1 Samantha Dooley
\par \hich\af1\dbch\af31501\loch\f1 Acting Deputy Commissioner
\par \hich\af1\dbch\af31501\loch\f1 03 8608 5761
\par }{\field{\*\fldinst {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b0\insrsid4610474 \hich\af1\dbch\af31501\loch\f1 HYPERLINK "mailto:}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b0\insrsid4610474\charrsid15887444 \hich\af1\dbch\af31501\loch\f1 samantha.dooley@odsc.vic.gov.au}
{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b0\insrsid4610474 \hich\af1\dbch\af31501\loch\f1 " }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b0\insrsid7425148 {\*\datafield
00d0c9ea79f9bace118c8200aa004ba90b0200000003000000e0c9ea79f9bace118c8200aa004ba90b660000006d00610069006c0074006f003a00730061006d0061006e007400680061002e0064006f006f006c006500790040006f006400730063002e007600690063002e0067006f0076002e00610075000000795881f4
3b1d7f48af2c825dc48527630000000085ab00000000000000}}}{\fldrslt {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \cs28\b0\ul\cf26\insrsid4610474\charrsid12601830 \hich\af1\dbch\af31501\loch\f1 samantha.dooley@odsc.vic.gov.au}}}\sectd \ltrsect
\linex0\headery708\footery708\colsx708\endnhere\sectlinegrid360\sectdefaultcl\sectrsid10577270\sftnbj {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b0\insrsid15887444
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4610474 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4610474\charrsid4610474
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4610474
\par
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4610474\charrsid4610474
We acknowledge the Traditional Owners of country throughout Australia and recognise their continuing connection to land, waters, and culture. We pay our respects to their Elders past, present and emerging.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15427077
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4610474
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7095095 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4610474\charrsid4610474 {\*\bkmkstart _Toc45903169}\hich\af1\dbch\af31501\loch\f1 About the Disability Services Commiss
\hich\af1\dbch\af31501\loch\f1 ioner{\*\bkmkend _Toc45903169}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7095095 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4610474\charrsid4610474
The Disability Services Commissioner (DSC) is a Victorian independent oversight body resolving complaints and promoting the right of people with disability to be free from abuse. We work under the Disability Act 2006 (the Act).
\par Our compla
ints service is free, confidential and accessible. Most complaints are finalised through resolution, but the Commissioner can also conciliate or investigate a complaint. Disability service providers are also compelled to report annually to our office on t
he number and types of complaints that they receive and how these complaints are resolved.
\par Through a Ministerial Referral made under s 128I(2) the Act, we also investigate matters relating to the provision of disability services identified in incident repor
ts received from the Department of Health and Human Services (DHHS). This includes deaths, and major impact incidents of assault, injury and poor quality of care. The State Coroner and the Community Visitors Board also refer matters to us.
\par The purpose of o
ur inquiries and investigations is to identify issues in disability services and develop service improvements in response to those issues. Following an investigation, we can provide a Notice to Take Action to a service provider, or a Notice of Advice to a
l
l service providers and to funding bodies and regulators, to help improve the safety and quality of disability services. We report on the outcomes of our investigations to the Minister, the Secretary of DHHS, and in some cases the State Coroner and the ND
IS Quality and Safety Commission (the NDIS Commission).
\par The Commissioner\rquote s oversight jurisdiction of service providers is predicated on service providers being registered under the Act. The Commissioner does not have jurisdiction over unregistered providers
. Many formerly registered providers are becoming unregistered. This is because they have transitioned to funding under the National Disability Insurance Scheme (the NDIS) and are subject to the oversight of the NDIS Commission. While our oversight role w
ill gradually decrease over 2020/2021, we will continue to ensure quality, safeguarding and oversight mechanisms are in place for people outside the NDIS who are provided residual disability services by the Victorian Government.}{\rtlch\fcs1 \af0
\ltrch\fcs0 \insrsid15226110
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1381092\charrsid15226110
\par }\pard\plain \ltrpar\s32\ql \li0\ri0\sb360\sa240\sl301\slmult0\widctlpar\wrapdefault\faauto\outlinelevel0\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af47\afs30\alang1025 \ltrch\fcs0 \f1\fs48\cf29\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {
\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid5003121\charrsid4158171 {\*\bkmkstart _Toc45903170}Introduction}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid5003121\charrsid5003121 {\*\bkmkend _Toc45903170}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5003121 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5003121\charrsid5003121
All forms of violence, abuse, neglect and exploitation against people with disability, in all settings, is abhorrent and cannot be tolerated. Governments, organisations and community have a critical role to play in preventing and better responding
to violence, abuse, neglect and exploitation of people with disability.
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7425658 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5003121\charrsid5003121
There have been a number of public enquiries into the violence, abuse, neglect and exploitation of people with disability in disability services.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid5003121 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7425658 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid882434 \chftn Enquiries include the Australian Government\rquote s National Disability Strategy Consultation Report Shut Out: The experience of people with disabilities and their families in Australia (2010) (the \lquote
Shut Out Report\rquote ); the Parliament of Australia\rquote s Senate Standing Committee on Community Affairs (2
015) Report on the inquiry into abuse and neglect against people with disability in institutional and residential settings, including the gender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people with
disability, and culturally and linguistically diverse people with disability; the Victorian Ombudsman\rquote s (2015) Reporting and Investigations of Allegations of Abuse in the Disability Sector: Phase 1 \endash
The Effectiveness of Statutory Oversight; and the Parliament of Victoria\rquote s (2015) Inquiry into Abuse in Disability Services.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5003121\charrsid5003121
These inquiries have identified negative social attitudes and daily instances of people with disability being segregated, excluded, marginalised and }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5003121\charrsid7425658 ignored.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid7425658\charrsid7425658 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7425658 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid16471590 \chftn T}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 he Shut Out Report 3}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid7425658 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5003121\charrsid5003121 Of c
oncern is that people with disability themselves considered disability services as a barrier to, rather than an enabler of, their participation in society. For example, they considered that supports were under-resourced, unavailable, unaffordable, or of p
oor quality and little }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5003121\charrsid7425658 benefit.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid7425658\charrsid7425658 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7425658 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid16471590 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 Ibid 4}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5003121\charrsid5003121
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5003121 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5003121\charrsid5003121 The D
isability Services Commissioner (DSC) has reviewed and investigated too many cases where people with disability have been abused, assaulted, neglected, and otherwise badly treated. People with disability and their families and representative organisations
have also highlighted the problematic aspects of the environments in which they live. We therefore welcome the establishment of the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (the Royal Commission).
\par Our participation to date with this Royal Commission has included our broad support for the draft Terms of Reference, production of data and documents in compliance with the Notice to Produce issued to our office, the Commissioner\rquote
s witness statement and appearance at the Homes and Living hearing in Melbourne (201}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5003121\charrsid4140516 9),}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid4140516\charrsid4140516 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4140516 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \insrsid15730590\charrsid16471590 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Arthur Rogers (21 November 2019) }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 Witness Statement to the Royal Commission into Violence
, Abuse, Neglect and Exploitation of People with Disability.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5003121\charrsid5003121 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5003121\charrsid4140516 and the Commissioner\rquote
s Plain English summary of his statement, published following that hearing.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid4140516\charrsid4140516 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4140516 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid16471590 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid4140516 Disability Services Commissioner (12 February 2020)}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid4140516 Summary of the witness statement of Arthur Rogers to the Royal Commission \endash Plain English (Web Page) < https://www.odsc.vic.gov.au/2020/02/12/royal-commission-statement-plain-english- summary-available-now/>.}}}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid4140516 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5003121\charrsid5003121
\par Our office has identified overarching themes that have shaped our recommendations in th
is submission. First, it is our experience that decisions made for and about people with disability can reflect attitudes and practices that are disabling. Therefore, cultural change in relation to how disability is perceived is urgently needed. We consid
er a whole of community approach is necessary to effect change in laws, policy and education to cultivate a culture of human rights and inclusion of people with disability.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5003121
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4140516 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid4140516
Second, disability service providers have increasingly moved away from institutional
and segregated approaches to service provision, yet many demonstrate a lack of capacity to offer high quality supports and safe environments to people with disability. We recommend a strong focus on workforce training and education, and consideration of
more diverse and culturally appropriate housing models. Such action is essential to prevent violence, abuse, neglect and exploitation of people with disability before it starts.
\par Third, our office considers that regulation and oversight of the disability sec
tor is critical to activating sector-wide responses to violence, abuse, neglect and exploitation of people with disability. While the NDIS Commission offers a nationally consistent approach to quality and safeguarding, there is further need to give primac
y
to the voices, experiences and knowledge of people with disability. This should occur not only via complaints processes, but also in relation to incident review and investigation procedures, and through enhanced access to Community Visitors and independe
nt advocacy.
\par Fourth, it is imperative to look beyond the disability sector and ensure disability inclusive policy alignment across areas of housing, health, justice, education, employment, and so on. Rather than focus on disability from a siloed perspective
, we have included cross-cutting recommendations for governments and civil society to ensure that mainstream services are also accountable for promoting the equal and active participation of people with disability in the community.
\par The structure of this su
bmission, including the ordering of recommendations, is organised according to the terms of reference set forth by the Royal Commission. Based on knowledge drawn from our years in the disability sector and our understanding of issues relating to abuse and
neglect of people with disability, we have a number of recommendations for the Royal Commission about what should be done to:
\par {\listtext\pard\plain\ltrpar \s39 \rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f3\lang3081\langfe2057\langnp3081\langfenp2057\insrsid4140516\charrsid4140516 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard\plain \ltrpar\s39\ql \fi-360\li360\ri0\sa120\sl360\slmult1
\widctlpar\wrapdefault\aspalpha\aspnum\faauto\ls5\adjustright\rin0\lin360\itap0\pararsid4140516 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid4140516\charrsid4140516 prevent, and better protect, people with disability from experiencing violence, abuse, neglect and exploitation \emdash term of reference (a) as covered in section 2.
\par {\listtext\pard\plain\ltrpar \s39 \rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f3\lang3081\langfe2057\langnp3081\langfenp2057\insrsid4140516\charrsid4140516 \loch\af3\dbch\af0\hich\f3 \'b7\tab}
achieve best practice in reporting and investigating of, and responding to violence, abuse, neglect and exploitation \emdash term of reference (b) as covered in section 3.
\par {\listtext\pard\plain\ltrpar \s39 \rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f3\lang3081\langfe2057\langnp3081\langfenp2057\insrsid4140516\charrsid4140516 \loch\af3\dbch\af0\hich\f3 \'b7\tab}promote a more inclusive society that supports the in
dependence of people with disability and their right to live free from violence, abuse, neglect and exploitation \emdash term of reference (c) as covered in section 4.
\par {\listtext\pard\plain\ltrpar \s39 \rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f3\lang3081\langfe2057\langnp3081\langfenp2057\insrsid4140516\charrsid4140516 \loch\af3\dbch\af0\hich\f3 \'b7\tab}
address intersectional issues and specific experiences of violence against, and abuse, neglect and exploitation of people with disability, including the particular situation of First Nations peoples \emdash term of reference (g) as covered in section 5.
\par {\listtext\pard\plain\ltrpar \s39 \rtlch\fcs1 \ab\af0 \ltrch\fcs0 \f3\lang3081\langfe2057\langnp3081\langfenp2057\insrsid4140516\charrsid4140516 \loch\af3\dbch\af0\hich\f3 \'b7\tab}
support families, carers, advocates, the workforce and others in providing care and support to people with disability \emdash term of reference (h) as covered in section 6.
\par }\pard\plain \ltrpar\s32\ql \li0\ri0\sb360\sa240\sl301\slmult0\widctlpar\wrapdefault\faauto\outlinelevel0\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af47\afs30\alang1025 \ltrch\fcs0 \f1\fs48\cf29\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {
\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid4140516\charrsid4140516 {\*\bkmkstart _Toc45903171}Recommendations{\*\bkmkend _Toc45903171}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7890839 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4140516\charrsid7890839 Recommendation 1:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid7890839 A national framework for the closure of disability-specific residential institutions, including group homes, that do not meet th
e requirements of the Convention on the Rights of Persons with Disabilities or that do not comply with all domestic laws that apply, including those in relation to the National Disability Insurance Scheme (NDIS) Act.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4140516\charrsid7890839 Recommendation 2:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid7890839 The full incorporation of the Convention on the Rights of Persons with Disabilities into domestic law, including through the development of a national Human Rights Act.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4140516\charrsid7890839 Recommendation 3:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid7890839 Strengthening of human rights legislation in relation to the responsibilities of public
authorities. In Victoria, this should include clarification and education around who is a public authority under the Victorian Charter of Human Rights and Responsibilities.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4140516\charrsid7890839 Recommendation 4:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid7890839 Develop and establish a new ten-year National Disability Strate
gy, directed by an Office of Disability within a central agency such as the Department of Prime Minister and Cabinet, to monitor progress and oversee implementation of the new Strategy.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4140516\charrsid7890839 Recommendation 5:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid7890839 That the new National Disability Strategy incorpor
ates clear, measurable goals and timelines for implementation of those goals; mandatory action plans for all levels of government and disability service providers; regular public reporting processes; and additional resources to achieve desired outcomes.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4140516\charrsid7890839 Recommendation 6:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid7890839 Establish permanent
consultation mechanisms for the active engagement of people with disability and their representative organisations in the development, implementation and review of the new National Disability Strategy and disability inclusive policies.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4140516\charrsid7890839 Recommendation 7:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid7890839 Person-centred practice \endash Education and training of disability staff in person-centred planning and the implementation of Active Support. The NDIS Commission should}{\rtlch\fcs1 \af0
\ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid4140516\charrsid4140516 consider the circumstances in which this training be mandated and the adequate provision of
education and training should be reflected in the NDIS pricing arrangements.
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4140516 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\lang2057\langfe1033\langnp2057\langfenp1033\insrsid4140516\charrsid4140516
Recommendation 8: }{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\lang2057\langfe1033\langnp2057\langfenp1033\insrsid4140516
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7095095 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid4140516\charrsid4140516
Communication supports \endash Education and training of disability staff to ensure people who require communication supports are assessed annually by a speech patho
logist and have a detailed communication plan implemented. The NDIS Commission should consider the circumstances in which this training be mandated and the adequate provision of education and training should be reflected in the NDIS pricing }{\rtlch\fcs1
\af0 \ltrch\fcs0 \insrsid4140516\charrsid3567488 arrangements.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4610474\charrsid3567488
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3567488 {\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4140516\charrsid3567488 Recommendation 9: }{\rtlch\fcs1 \ab0\af0
\ltrch\fcs0 \b\insrsid3567488\charrsid3567488
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid3567488 All governments should provide all information in accessible formats, including plain-English formatting, captioning, Australian Sign Language (Auslan) and Braille.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4140516\charrsid3567488 Recommendation 10: }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid3567488\charrsid3567488
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7095095 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid3567488 Positive behaviour supports \endash
Education and training
of disability staff in how to deliver positive behaviour supports which are responsive to the individual and that minimise the use of restrictive practices. The NDIS Commission should consider the circumstances in which this training be mandated and the
adequate provision of education and training should be reflected in the NDIS pricing arrangements.
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4140516 {\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4140516\charrsid4140516 Recommendation 11:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid4140516 Implement a nationally consistent supported decision-making framework, as recommended by the Australian Law Reform Commission in their re
port, Equality, Capacity and Disability in Commonwealth Laws.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4140516\charrsid4140516 Recommendation 12:
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7095095 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid4140516 Supported decision-making \endash
Education and training of disability staff to ensure that people with disability enjoy legal capacity on an equal basis with others and receive t
he support they require in decision-making. The NDIS Commission should consider the circumstances in which this training be mandated and the adequate provision of education and training should be reflected in the NDIS pricing arrangements.
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4140516 {\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4140516\charrsid4140516 Recommendation 13:
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7095095 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid4140516 End of life care \endash
Education and training of disability staff in how to support people with disability to learn about death and dying, and to make choices about their participation in advance care planning. The NDIS Commission should consider the circ
umstances in which this training be mandated and the adequate provision of education and training should be reflected in the NDIS pricing arrangements.
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4140516 {\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4140516\charrsid4140516 Recommendation 14:
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7095095 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid4140516 Health promotion and prevention \endash
Education and training for disability staff in th
e prevention of key health risks to persons with disability, including reducing deaths related to respiratory issues and choking, epilepsy and inadequate bowel management. The NDIS Commission should consider the circumstances in which this training be man
dated and the adequate provision of education and training should be reflected in the NDIS pricing arrangements.
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4140516 {\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4140516\charrsid4140516 Recommendation 15:
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7157006 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid4140516
Build the capacity of people with disability to understand their human rights and encourage them to make complaints and act
ively contribute to the quality of supports they receive. A well-resourced outward facing capacity development team that promotes human rights and develops a positive complaints culture has been integral to building the knowledge and capacity of people wi
th disability in Victoria to engage with complaints mechanisms.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4140516\charrsid7157006
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 16:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Increase publicly available information and education for people with disability and their natural support networks about the operation of quality, safeguarding and oversigh
t mechanisms under the NDIS Quality and Safeguards Framework, including arrangements in place for registered and unregistered providers.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 17:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Strengthen working definitions of, and provide education about, the categories of reportable incide
nts in the NDIS Incident Management Rules, to reduce service provider discretion and under-reporting about the impact of violence, abuse, neglect and exploitation on an individual.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 18:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Develop a nationally consistent arrangement for review
ing and investigating the deaths of people with disability, not only including those who are NDIS participants but also those who are not receiving NDIS funding.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 19:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Consider how category and causes of death will be determined in cases not reported to state coroners, and the measures that can address under-reporting of deaths that are \lquote reportable
\rquote to state coroners; as recommended by Carmela Saloman and Julian Trollor in A scoping review of causes and contributors to deaths of people with disability in Australia.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 20:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006
Legislative reforms should bring into effect a nationally consistent framework in relation to Community Visitor Programs as a key component of the NDIS safeguarding arrangements as recommended by the Office of Public Advocate (Vic) in the report, "I
\rquote m too scared to come out of my room".
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 21:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006
Increase funding of independent advocacy to ensure that organisations responsible for independent advocacy for people with disability can adequately undertake their work in enhancing quality and safeguar
ding, including addressing intersectional discrimination.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 22:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Develop more diverse and culturally appropriate Specialist Disability Accommodation (SDA) options to be made available to people with disability, beyond the group home model, tha
t promote people\rquote s meaningful participation and inclusion in the community.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 23:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Increase the funding and supply of appropriate and accessible housing, including private rental and public and social housing, for all people with disability,
not only including those who are NDIS participants but also those who are not receiving NDIS funding.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3567488\charrsid7157006
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 24:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Enhance the capacity of people with disability to exercise their right to live independently in the community. Funding of individualis
ed supports should allow for the development of independent living skills and for environmental adjustments to be made to their home of choice.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 25:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Increase the Medicare Benefits Schedule to reflect the real cost of providing ongoing patien
t-centred care such as undertaking comprehensive assessments, regular follow-ups, and preventative measures; as recommended by the Royal Australian College of General Practitioners in their submission to this Royal Commission.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 26:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Increase
funding and development of education and training of health professionals in the human rights model of disability to enhance their capacity to provide quality health care and supports to people with disability. This training should be co-designed by peopl
e with disability and their representative organisations.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 27:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Increase funding and development of connected and integrated health and disability services. This should include a national network of disability health specialists to support peo
ple with disability who have complex health conditions and co-morbidities.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 28:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Enhance the capacity of police to respond to allegations of violence, abuse, neglect and exploitation impacting people with disability. This requires an increas
e in the availability of Disability Liaison Officers, and disability awareness training that focuses on ensuring reasonable adjustments for people with disability.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 29:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Develop and implement a national action plan for inclusive education, to
ensure a successful transition from parallel systems of education to one inclusive system of education, as recommended by Children and Young People with Disability Australia in their submission to this Royal Commission.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 30:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Increase suppo
rts to enable people with disability to transition from segregated forms of engagement, such as day services or sheltered employment, into open and accessible employment, ensuring individuals receive equal remuneration for work of equal value.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 31:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006
Allocate resources towards a nation-wide public education campaign, co-designed with people with disability and their representative organisations, that promotes human rights and a positive message of disability within the community. This should be
complemented by adequate funding of other disability-led conferences and initiatives.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 32:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Develop nationally consistent measures for the collection of government data that is disaggregated by groups such as First Nations people with disabi
lity, women and girls with disability, older people with disability and non-NDIS participants.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 33:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Public reporting of data about the incidence and prevalence of violence, abuse, neglect and exploitation occurring in NDIS funded services. N
DIA and NDIS Commission data should be linked with other key databases and made available for ethical research and intersectional}{\rtlch\fcs1 \af47\afs22 \ltrch\fcs0
\f47\fs22\cf23\lang2057\langfe1033\langnp2057\langfenp1033\insrsid7157006\charrsid7157006 analysis.
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\lang2057\langfe1033\langnp2057\langfenp1033\insrsid7157006\charrsid7157006 Recommendation 34: }{\rtlch\fcs1 \af0 \ltrch\fcs0 \b\lang2057\langfe1033\langnp2057\langfenp1033\insrsid7157006
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid7157006\charrsid7157006
Build the capacity of First Nations peoples and their community-controlled organisations to develop service models for the delivery of supports to First Nations people with disability, respecting that First Nations peoples be afforded their right to make
choices and self-}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 determine their own lives.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 35:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Culturally responsive services \endash
Education and training of disability staff in the provision of culturally responsive services for First Nations people with disability. This education should b
e designed and led by First Nations peoples. The NDIS Commission should consider the circumstances in which this training be mandated and the adequate provision of education and training should be reflected in the NDIS pricing arrangements.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 36:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Gendered disability violence \endash
Education and training of disability staff about forms of gendered disability violence, abuse, neglect and exploitation experienced by women and girls with disability. The NDIS Commission should consider the circumstanc
es in which this training be mandated and the adequate provision of education and training should be reflected in the NDIS pricing arrangements.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 37:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Contingency funding for practical supports and accommodation to be immediately accessible
to people with disability who experience crises as a result of their experience of violence, abuse, neglect and exploitation.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 38:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Older people with disability \endash Education and training of disability staff in how to support the complex healt
h needs of people with disability as they develop age-related health conditions. The NDIS Commission should consider the circumstances in which this training be and the adequate provision of education and training should be reflected in the NDIS pricing a
rrangements.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 39:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006
Funding to be directed to community organisations to implement Circles of Support and the Microboard model of support. This should allow for education and training of people with disability, supporters and service providers
about principles of supported decision-making.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 40:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Human rights approach \endash
Education and training of staff in the human rights model of disability. This training should be co-designed by people with disability and their representative organ
isations. The NDIS Commission should consider the circumstances in which this training be mandated and the adequate provision of education and training should be reflected in the NDIS pricing arrangements.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 41:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 That consideration be given t
o how NDIA pricing of supports can be improved to accommodate the additional administration and professional development costs incurred by disability service providers as a result of operating in an NDIS environment.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid7157006\charrsid7157006 Recommendation 42:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 That the NDIS Commi
ssion consider highlighting the report by our office, Building safe and respectful cultures as a community of practice approach and collaborative methodology that can be used to improve organisational culture within disability services, and to identify an
d address early indicators of violence, abuse, neglect and exploitation.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006
\par }\pard\plain \ltrpar\s32\ql \li0\ri0\sb360\sa240\sl301\slmult0\widctlpar\wrapdefault\faauto\outlinelevel0\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af47\afs30\alang1025 \ltrch\fcs0 \f1\fs48\cf29\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {
\rtlch\fcs1 \ab0\af47 \ltrch\fcs0 \insrsid4158171\charrsid4158171 {\*\bkmkstart _Toc45903172}1.}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid4158171 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid7157006\charrsid7157006 The }{\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid7157006\charrsid4158171 policy}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid7157006\charrsid7157006 context}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid7157006\charrsid10627663 {\*\bkmkend _Toc45903172}
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 {\*\bkmkstart _Toc45903173}\hich\af1\dbch\af31501\loch\f1 Segregated and }{\rtlch\fcs1 \af0
\ltrch\fcs0 \insrsid7157006\charrsid4158171 \hich\af1\dbch\af31501\loch\f1 institutional}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 \hich\af1\dbch\af31501\loch\f1 settings{\*\bkmkend _Toc45903173}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7157006 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 Historically, much of law, policy and practice relating to disability has adopted a medical approach}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid10627663
, which views people with disability as objects that need to be fixed}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10627663\charrsid10627663 .}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid10627663\charrsid10627663 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid10627663 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \cs36\super\insrsid15730590 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Anna Arstein-Kerslake, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590
Restoring Voice to People with Cognitive Disabilities: Realising the Right to Equal Recognition before the Law (Cambridge University Press, 2017) 70.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid10627663 In contrast, the}{\rtlch\fcs1 \af0
\ltrch\fcs0 \insrsid7157006\charrsid7157006 social approach recognises that disability is not merely the result of an individual\rquote
s impairment, rather disability may occur because of the way that society responds to the person in relation to an impairment, such as through discrimination }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid10627663 and exclusion}{\rtlch\fcs1 \af0
\ltrch\fcs0 \cs36\super\insrsid10627663\charrsid10627663 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14837795 \rtlch\fcs1 \af47\afs20\alang1025
\ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid14837795 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid14837795 Theresia Degener, \lquote
Disability in a Human Rights Context\rquote (2016) 5 Laws 1, 3.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid10627663 .}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006
\par The social approach to disability has advanced our understanding of how to achieve inclusion for people with disability by focusing on policies that seek to remove these societal }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid10627663 barriers}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid10627663\charrsid10627663 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14837795 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid14837795 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid14837795
Tom Shakespeare, Disability: The Basics (Routledge, 2018) 14.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid10627663 .}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006
This includes breaking down physical and non-physical structures that segregate and institutionalise people with disability. Such segregated settings include, though are not limited to, group homes, special developmental schools, sheltered workshops }{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid10627663 and day programs.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid10627663\charrsid10627663 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14837795 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid15730590\charrsid14837795 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid14837795 Anna Arstein-Kerslake, Restoring Voice to People with Cog
nitive Disabilities: Realising the Right to Equal Recognition before the Law (Cambridge University Press, 2017) 195.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10627663\charrsid10627663 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid10627663
Segregation}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006 removes people with disability from natural community environments and places them into relationships, generally with paid sta
ff and others in the same situation. Where there is a lack of natural family and social networks and supports, abusive cultures can develop.
\par Our office has observed the harmful effects of segregation, particularly in residential settings. Deinstitutionalis
ation in Victoria has seen a shift from housing people with disability in large institutions to shared supported accommodation that combines housing with 24-hour staff support, usually in the form of group homes. While the NDIS Specialist Disability Accom
modation Rules state that new builds are not to allow for more than five people, there are over 100 existing homes forming DHHS legacy stock that will }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid10627663 continue to accommodate more.}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid10627663\charrsid10627663 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14837795 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid14837795 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid14837795
Office of the Public Advocate, \'93I\rquote m too scared to come out of my room\'94: Preventing and responding to violence and abuse between co-residents in group homes (November 2019) 27.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006
\par There are a number of factors in supported accommodation that we observe have contributed to violence, abuse, neglect and exploitation of people with disability. A key problem is the group home model itself; the service type that has triggered the largest
number of in-scope enquiries and }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid10627663 complaints to our office.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid2381068 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3477284 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284 Disability Services Commissioner, 2018-19 Annual Report (2019) 12.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006\charrsid7157006
Group homes can often replicate institutional living arrangements. This is because rarely are people provided with opportunities to choose their service provider, which staff will be employed, and what }{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid7157006\charrsid2381068 supports will be prioritised.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid2381068\charrsid2381068 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3477284 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284 Sally Robinson and Lesley Chenoweth, \lquote Preventing abuse in accommodation services: From procedural response to protective cultures\rquote
(2011) 15(1) Journal of Intellectual Disabilities 63, 66.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7157006
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid2381068 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2381068\charrsid2381068
In group homes, people with disability commonly have their everyday routines and structures determined by managers and staff.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid2381068\charrsid2381068 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3477284 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284 Anna Arstein-Kerslake, Restoring Voice to People with Cognitive Disabilities: Realising
the Right to Equal Recognition before the Law (Cambridge University Press, 2017) 196.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2381068\charrsid2381068
Staff may make decisions about daily meal choices, for example what food is purchased and when it can be eaten; scheduling of activities of daily living such as bathing
and sleeping; social interactions, including who is allowed to enter a home or if there is a curfew; and the kinds of leisure activities and community outings available. In addition, these routines and structures are often designed for the group rather t
han the individual.
\par While any form of accommodation \endash from large institutions to small and large group homes, or private dwellings \endash may present as institutional in nature,}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid2381068\charrsid2381068 \chftn
{\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3477284 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284
Human Rights Council, Thematic study on the right of persons with disabilities to live independently and be included in the community: Report of the United Nations High Commissioner for Human Rights, UN Doc A/HRC/28/37 (12 December 2014) [21].}}}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2381068\charrsid2381068 we are concerned that Australia has relied upon the group home as the primary housing model
for people with disability. Splitting large institutions into smaller ones with the aim of reducing the number of persons living in a dwelling, only results in the replacement of one type of institution with another.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid2381068\charrsid2381068 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14837795 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284 15. Ibid [22].}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid2381068\charrsid2381068 We discuss issues pertaining to homes and living in further detail throughout this submission and specifically in section 4.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2381068
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid2381068\charrsid2381068 Recommendation 1:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2381068\charrsid2381068
A national framework for the closure of disability-specific residential institutions, including group homes, that do not meet the requirements of the Convention on the Rights of Persons with Disabilities or that do not comply with all domestic laws that a
pply, including those in relation to the National Disability Insurance Scheme (NDIS) Act.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2381068
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid7890839 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5768343\charrsid7425148 {\*\bkmkstart _Toc45903174}\hich\af1\dbch\af31501\loch\f1 A human rights-based approach
{\*\bkmkend _Toc45903174}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7890839 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7425148\charrsid7425148 The disability rights movement, and linked social movements away from institutional approaches, provided momentum
for the drafting of the Convention on the Rights of Persons with Disabilities (the Conventio}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7425148\charrsid8587315 n)}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid7425148\charrsid8587315 \chftn {\footnote
\ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3477284 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284
Convention on the Rights of Persons with Disabilities, opened for signature 30 March 2007, 2515 UNTS 3 (entered into force 3 May 2008).}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7425148\charrsid8587315 .}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid7425148\charrsid7425148 The Convention offers a human rights-based alternative for service provision, placing people with disability at the centre of their own lives, and as subjects of rights.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid7425148\charrsid7425148 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3477284 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284
Committee on the Rights of Persons with Disabilities, General Comment No 5 (2017) on living independently and being included in the community, UN Doc CRPD/C/GC/5 (27 October 2017) [5].}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7425148\charrsid7425148
The drafting of the Convention was ground-breaking in terms of the principal participation of people with disability and their representatives, in keeping with their slogan \lquote nothing about us without us\rquote .
\par While the Australian Government has signed and ratified the Convention and its Optional Protocol,}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid7425148 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3477284 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284 United Nations, Status of Treaties: Convention on the Rights of Persons with Disabilities (8 July 2019) United Nations Treaty
Collection https://treaties.un.org/Pages/ViewDetails.aspx?src=TREATY&mtdsgno=IV-15&chapter=4&clang=en; United Nations, Status of Treaties: Optional Protocol}{\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \cf23\insrsid15730590
to the Convention on the Rights of Persons with Disabilities (8 July 2019).}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7425148\charrsid7425148 and argues strongly f
or the advancement of human rights set forth in the Convention, it has demonstrated a disinclination to fully commit domestically. The Australian Government does not offer a constitutional guarantee for human rights or a written catalogue of human rights
protections.
\par This lack of domestic human rights law perpetuates inconsistencies and gaps across Australian states and territories, and it impacts substantially upon people with disability who historically have been marginalised within the community. Our off
ice is acutely aware of injustices and the indignities impacting upon people with disability, through the information we receive about their lived experience of violence, abuse, neglect and exploitation.
\par In Victoria, human rights are recognised and protect
ed in law through a dedicated charter of human rights. The Charter of Human Rights and Responsibilities Act 2006 (Vic) (the Charter) compels my office, as a public authority, to adopt a human rights framework when engaging in analysis of issues impacting
people with disability. This Charter is critical to the work of our office, given we encounter human rights subject matter in virtually all the office\rquote s activities and decision-making.
\par However, the full potential of the Charter has been limited because of t
he way in which section four of the Charter defines a public authority. The Charter applies to disability service providers within the sector that are or function as public authorities. We have found that a lack of clarity around this definition has led n
o
n-government disability service providers to assume they are not public authorities, when in fact they maintain a responsibility to uphold Charter rights when they are providing a service that is public in nature. In Victoria, it also remains unclear whet
her NDIS }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7425148\charrsid8587315 providers will be covered by the Charter}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs46\super\insrsid7425148\charrsid4539194 .\chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid12152404 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid12152404 \chftn Australian Human Rights Commission, A future without violence: Quality, safeguarding and oversight to prevent and address violence against people with disability in institutional settings (June 2018) 48.}}}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \cs46\super\insrsid4610474\charrsid4539194
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8587315\charrsid8587315
Further, where the Charter is accepted as applying to a provider, we do not always see it upheld in practice. For example, we regularly find that service providers develop policies and procedures that comply with the Charter, however we observe that those
policies and procedures are not being routinely followed or enforced. It is our view that governments should fully incorporate human rights legal protections into domestic law, and that the legal safeguards embedded in the Charter not be diminished with
the transition to the NDIS.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8587315
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4599876\charrsid8587315 Recommendation 2:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876\charrsid8587315 The full incorporation of the Convention on the Rights of Persons with Disabilities into domestic law, including through the development of a national Human Rights Act.}{\rtlch\fcs1 \af0
\ltrch\fcs0 \insrsid4599876
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4599876\charrsid8587315 Recommendation 3:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876\charrsid8587315
Strengthening of human rights legislation in relation to the responsibilities of public authorities. In Victoria, this should include clarification and education around who is a public authority under the Victorian Charter of Human Rights and Responsibili
ties.
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid7890839 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876\charrsid8587315 {\*\bkmkstart _Toc45903175}\hich\af1\dbch\af31501\loch\f1 Disability inclusive policy
{\*\bkmkend _Toc45903175}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7890839 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876\charrsid8587315 In Australia and elsewhere, people with disability experience marked inequalities and are more likely to experience poverty and other forms of social exclusion than the general population.}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid4599876 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4599876 \rtlch\fcs1 \af47\afs20\alang1025
\ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid12152404 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid12152404 Commonw
ealth of Australia, National Disability Strategy 2010-2020 (2001) 12.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876\charrsid8587315 People with disability are less likely to be employed, find suitable housing, receive an education, or access justice.}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid4599876 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4599876 \rtlch\fcs1 \af47\afs20\alang1025
\ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid12152404 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid12152404
Catalina Devandas Aguilar, Report of the Special Rapporteur on the rights of persons with disabilities, UN Doc A/HRC/71/314 (9 August 2016) [6].}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876\charrsid8587315
They may be restricted in their participation in political and cultural life, in sport and recreation, and in social connections and community groups.
\par The National Disability Strategy 2010-2020 (the \lquote Strategy\rquote )}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid4599876 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4599876 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid15730590\charrsid12152404 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid12152404 Commonwealth of Australia, National Disability Strategy 2010-2020 (2001).}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876\charrsid8587315
is Australia\rquote s overarching policy framework for disability reform and the key mechanism for driving disability inclusive policy and program de
sign in alignment with the principles of the Convention. While states and territories have their own disability strategies, this was the first time in Australia that all governments signed and committed to a national strategy with long-term goals.
\par The Strategy aims to overcome the siloing of disability policy within disability-specific areas within governments, by increasing the responsiveness of policies in areas of health, education, employment, housing and income support.}{\rtlch\fcs1 \af0
\ltrch\fcs0 \cs36\super\insrsid4599876 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4599876 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid4599876 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid4599876 Committee on the Rights of Per
sons with Disabilities, Combined second and third periodic reports submitted by Australia under article 35 of the Convention, UN Doc CRPD/C/AUS/2-3 (5 February 2019) [17, 33].}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876\charrsid8587315
While the principles and policy areas of the Strategy are a good response to Australia\rquote s obligations under the Convention, the Strategy has not been implemented through a systematic approach across Australia.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid4599876 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4599876 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid4599876 24. Social Policy Research Centre, Review of implementation of the National Disability Strategy 2010-2020: Final Report (2018)
1.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876\charrsid4599876
The Australian Government, at the time of writing, is engaged in the development of a new 10-year National Disability Strategy for beyond 2020. We endorse the revision of this Strategy, and view that its implementation should be strengthened through c
entral leadership, better coordination and the introduction of specific targets to raise the new Strategy\rquote
s profile across all government departments and agencies. This could be directed by an Office of Disability, within a central agency, such as the Department of Prime Minister and Cabinet.
\par Linked national disability plans across policy areas, including health, housing, education and justice, are also important if the new Strategy is to gain traction. The new Strategy should also mandate that government a
gencies and disability service providers that function as public authorities, complete action plans on the steps they plan to take in the key policy areas. It should also embed stronger accountability mechanisms through public reporting on the progress of
the new Strategy.
\par Critically, the Australian Government must consult and actively involve people with disability in all aspects of the new Strategy. This is because people with disability know best which barriers they face in the context of their everyday lives.}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid4599876 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4599876 \rtlch\fcs1 \af47\afs20\alang1025
\ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid4599876 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid4599876
Catalina Devandas Aguilar, Report of the Special Rapporteur on the rights of persons with disabilities, UN Doc A/HRC/71/314 (9 August 2016) [63].}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876 }{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid4599876\charrsid4599876 The effectiveness of a new Strategy will be shaped by the extent to which the government establishe
s permanent consultation mechanisms for the active engagement of people with disability and their representative organisations in its development, implementation and evaluation.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4599876\charrsid4599876 Recommendation 4:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876\charrsid4599876 Develop and establish a new ten-year National Disability St
rategy, directed by an Office of Disability within a central agency such as the Department of Prime Minister and Cabinet, to monitor progress and oversee implementation of the new Strategy.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4599876\charrsid4599876 Recommendation 5:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876\charrsid4599876 That the new National Disability Strategy inco
rporates clear, measurable goals and timelines for implementation of those goals; mandatory action plans for all levels of government and disability service providers; regular public reporting processes; and additional resources to achieve desired outcome
s.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4599876\charrsid4599876 Recommendation 6:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876\charrsid4599876
Establish permanent consultation mechanisms for the active engagement of people with disability and their representative organisations in the development, implementation and review of the new National Disability Strategy and disability
inclusive policies. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4599876
\par }\pard\plain \ltrpar\s32\ql \li0\ri0\sb360\sa240\sl301\slmult0\widctlpar\wrapdefault\faauto\outlinelevel0\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af47\afs30\alang1025 \ltrch\fcs0 \f1\fs48\cf29\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {
\rtlch\fcs1 \ab0\af47 \ltrch\fcs0 \insrsid16471590\charrsid16471590 {\*\bkmkstart _Toc45903176}2.}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid16471590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid4290160\charrsid4290160
Preventing and protecting people with disability from experiencing violence, abuse, neglect and exploitation}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15349042 {\*\bkmkend _Toc45903176}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4290160\charrsid4290160 Terms of reference (a)
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4290160\charrsid4290160 What governments
, institutions and the community should do to prevent, and better protect, people with disability from experiencing violence, abuse, neglect and exploitation, having regard to the extent of violence, abuse, neglect and exploitation experienced by people w
ith disability in all settings and contexts. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4290160
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4290160\charrsid4290160 {\*\bkmkstart _Toc45903177}\hich\af1\dbch\af31501\loch\f1 Person-centred practice
{\*\bkmkend _Toc45903177}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4290160\charrsid4290160 Person-centred planning is an individualised approach to organising support for people with disability, with the view to considering and developing an individual\rquote s
capabilities and strengths, rather than focusing on their deficiencies.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid4290160 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4290160 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid15730590\charrsid4290160 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid4290160 Victoria Ratti et al, \lquote
The effectiveness of person-centred planning for people with intellectual disabilities: A systematic review (2016) 57 Research in Developmental Disabilities 64, 64.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4290160\charrsid4290160
It is underpinned by the idea that activities and relationships are an important way in which quality of life is achieved.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid4290160 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4290160 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid15730590\charrsid4290160 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid4290160 Christine Bigby et al, \lquote
Quality of practice in supported accommodation services for people with intellectual disabilities: What matters at the organisational level\rquote (2020) Journal of Intellectual & Developmental Disability (advance) 1.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid4290160\charrsid4290160 Thus, it promotes and emphasises planning for supports that are flexible and adaptable to achieving the person\rquote s goals in these areas.
\par Aside from a recent improvement in person-centred planning undertaken for the purposes of NDIS planning, our office has observed significant shortcomings in the qu
ality of plans created for individuals by disability service providers. For example, individualised plans are commonly incomplete, planning meetings do not always involve the individual or their natural support network, and goals are not written in specif
ic measurable terms or reviewed within clearly defined timelines.
\par We have found that even when person-centred planning is of high quality, service providers fail to enact individualised plans in everyday practice. This implementation gap is evident in how d
isability support workers may prioritise doing household work over other activities that might be meaningful to the individual, such as spending time outdoors. Or staff might assist people with ordinary activities, such as eating meals and dressing, howev
er with low levels of engagement, for example, without asking what that person might want to eat or wear.
\par In research contracted by our office, we found it is attention to the \lquote little things\rquote and the relationships between staff and people with disability t
hat impacts significantly upon the quality of care and the sense of safety that people with disability experience. For example, when staff and people with disability chat warmly while setting the table together, or when encouragement is provided }{
\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid4290160\charrsid4290160 by a support worker to an individual while eating, it can positively affect quality of life.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid4290160 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5767301 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid5767301 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid5767301
Sally Robinson et al, Building safe and respectful cultures in disability services for people with disability (Report for the Disability Services Commissioner, June 2019) 94}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid4290160
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid14837795\charrsid14837795
An approach of Active Support can mitigate against disengagement, by tailoring support to ensure that people with disability are provided with just the right amount of assistance to experience success during participation.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid161113 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5767301 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid5767301 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid5767301
Christine Bigby, Emma Bould & Julie Beadle-Brown, \lquote Implementation of active support over time in Australia\rquote (2019) 44(2) Journal of Intellectual & Developmental Disability 161, 161.}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0
\fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid14837795\charrsid14837795 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid14837795\charrsid14837795 We are aware of an online learning resource \lquote
Every moment has potential\rquote , which was developed to assist disability staff to enact this approach.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid161113 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5767301 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid15730590\charrsid5767301 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid5767301 Department of Industry (Cth) (2015) Every moment has potential (Web Page) .}}}{\rtlch\fcs1 \af0\afs12
\ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid14837795\charrsid14837795
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid14837795\charrsid14837795 Disability support workers should also be provided with opportunities for practical
, hands-on training in Active Support. This is because research has shown that the implementation of Active Support is more effective if senior leaders of an organisation exercise practice leadership close to frontline service delivery, with coherence in
their enactment of person-centred values and actions.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid161113 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3477284 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid15730590\charrsid5767301 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid5767301 Christine Bigby et al, \lquote
Quality of practice in supported accommodation services for people with intellectual disabilities: What matters at the organisational level\rquote (2020) Journal of Intellectual & Developmental Disability (advance) 11.}}}{\rtlch\fcs1 \af0\afs12
\ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid161113 }{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid7890839
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid161113\charrsid161113 Recommendation 7:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid161113\charrsid161113 Person-centred practice \endash
Education and training of disability staff in person-centred planning and the implementation of Active Support. The NDIS Commission should consider the circumstances in which
this training be mandated and the adequate provision of education and training should be reflected in the NDIS pricing arrangements. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid161113
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid7890839 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid161113\charrsid12615622 {\*\bkmkstart _Toc45903178}\hich\af1\dbch\af31501\loch\f1 Communication supports
{\*\bkmkend _Toc45903178}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid161113\charrsid161113 Critically, the right to freedom of expression and opinion is considered t
o encompass both the right to communicate (to share ideas and information with others), and as is implied by this, the right to be able to communicate (to have a mode of communication).}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid161113 \chftn
{\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5767301 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid5767301 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid5767301 Jane McCormack, Elise Baker & Kathryn Crowe
\lquote The human right to communicate and our need to listen: Learning from people with a history of childhood communication disorder\rquote (2018) 20 International Journal of Speech-Language Pathology 142, 142.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid161113\charrsid161113 By enabling people with disability to communicate on an equal basis with others
and through a form of communication of their choice, human rights can be secured in other spheres of life, including in health, education and employment.
\par Regretfully, our office has observed how people with disability, who have high communication support
needs, are limited in their access to ongoing speech pathology. In 2018-2019, we found multiple instances when reviewing the death of a person with disability who had no verbal communication, that they had never had a communication assessment by a speech
p
athologist, despite having lived in group homes for most of their lives. It is fundamentally unacceptable that people could have received disability supports for so long without a formal communication assessment to facilitate their ability to communicate
with, and be understood by, their }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid161113\charrsid13782692 family and social network, support workers and other people in the community.
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13782692\charrsid13782692 Critically, the risk of poor health outcomes and premature death increases if a person with complex communication needs is not assessed and supported to express their needs effectively.}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid13782692 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13782692 \rtlch\fcs1 \af47\afs20\alang1025
\ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid13782692 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid13782692
Disability Services Commissioner, A review of disability service provision to people who have died 2018-2019 (2019) 10.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13782692\charrsid13782692
In these situations, support workers must be familiar and even more alert to the signs of illness or pain, indicators of which may include behavioural changes, such as refusing to eat or drink.
\par A failure to engage a speech pathologist means that people do not access the full benefits of individualised communication aids and technologies that they
may require, including augmentative and alternative communication. Significantly, it places people at increased risk of violence, abuse, neglect and exploitation. Women with cognitive disability or complex communication impairments are significantly more
at risk of sexual assault if they experience difficulties in communicating what has happened.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid13782692 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13782692 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid15730590\charrsid13782692 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid13782692 Jane Maree Maher, et al Women, disability and violence: Barriers to accessing justice \endash Final Report (Australia\rquote
s National Research Organisation for Women\rquote s Safety, April 2018)27.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13782692\charrsid13782692
\par Further, it is essential that all Australians, whatever their communication skills or type of disability, be supported to participate and be included in the community. This requires resourcing and mainstreaming of accessible formats o
f communication in government messaging, including plain-language formatting, captioning, sign language interpretation and Braille.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid13782692\charrsid13782692 Recommendation 8:
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7095095 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13782692\charrsid13782692 Communication supports \endash
Education and training of disability staff to ensure people who require communication supports are assessed annually by a speech pathologist and have a detailed communication plan implemented. The NDIS Commission should consider the circumstances in whic
h this training be mandated and the adequate provision of education and training should be reflected in the NDIS pricing arrangements. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid161113\charrsid13782692
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4158171 {\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid13782692\charrsid13782692 Recommendation 9:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13782692\charrsid13782692 All governments should provide all information in accessible formats, including plain-English formatting, captioning, Australian Sign Language (Auslan) and Braille.}{\rtlch\fcs1 \af0
\ltrch\fcs0 \insrsid13782692
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12804631\charrsid12804631 {\*\bkmkstart _Toc45903179}\hich\af1\dbch\af31501\loch\f1 Positive behaviour supports
{\*\bkmkend _Toc45903179}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12804631\charrsid12804631 Restrictive practices involve the use of interventions and practices that have the effect of restricting the rights or freedom of movement of a person with disability.}{\rtlch\fcs1 \af0
\ltrch\fcs0 \cs36\super\insrsid3346980 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3477284 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284 Jeffrey Chan \lquote
Challenges to realising the Convention on the Rights of Persons with Disabilities (CRPD) in Australia for people with intellectual disability and behaviours of concern\rquote (2016) 23(2) Psychiatry, Psychology and Law 207, 210.}}}{\rtlch\fcs1 \af0
\ltrch\fcs0 \insrsid12804631\charrsid12804631 Typically, these practices are used with people with disability who display \lquote challenging behaviours\rquote or experience behaviours of concern. These practices, when unauthorised, infringe upon people
\rquote s human rights, and can have a serious impact on an individual\rquote s health and wellbeing.
\par Our office has completed multiple investigations which found restraints were not being administered in accordance wi
th an approved Behaviour Support Plan, including a failure to apply least restrictive principles, or to consult with families. We have also uncovered unauthorised restrictive practices, such as mechanical restraint including restrictive clothing; chemical
restraint through the use of psychotropic medication; and isolation or seclusion, such as the locking of bedrooms.
\par In a 2018-2019 investigation, we found that staff at a group home used unauthorised restrictive practices with a man with intellectual disab
ility who was nonverbal in his communication, prior to his death from pneumonia. To reduce the impact of loud vocalisations, this person\rquote
s bedroom was sound-proofed, a second set of doors were installed in the corridor, and staff wore noise cancelling earm
uffs. It is not uncommon for such actions to be justified on the grounds of protecting the rights and safety of staff, without a deep consideration of less restrictive alternatives that respect the rights of people with disability.}{\rtlch\fcs1 \af0
\ltrch\fcs0 \cs36\super\insrsid11358995 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11358995 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid11358995 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid11358995 Ibid}{\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590 }}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12804631\charrsid12804631
\par Restrictive pra
ctices may be influenced by diagnostic overshadowing, for example, where behavioural problems are attributed to a disability at the outset, without any attempt to understand if there are other underlying causes of the behaviour. In another 2018-2019 inves
t
igation, support workers did not identify that severe constipation was a possible cause of distress to a person who was non-verbal in their communication but who was vocalising loudly. Rather than investigating further, the support workers wore noise canc
elling earmuffs to block this nonverbal expression of distress. Further, staff did not recognise that their actions constituted a dehumanising form of restrictive practice.
\par The Positive Behaviour Support Model is an evidence-based therapeutic approach for the support of a person presenting with behaviours of concern, which can help to reduce or eliminate the use of restrictive practices.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid11358995 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11358995 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid11358995 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid11358995 Ibid 211.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid12804631\charrsid12804631 Positive behaviour support should be provided through proactive measures that enhance quality of life generally, rather than applied in response to a crisis point.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid11358995 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3477284 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid11358995 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid11358995 }{\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid3477284 Office of the Public Advocate, \'93I\rquote m too scared to come out of my room\'94: Preventing and responding to violence and abuse between co-residents in group homes (November 2019) 42.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid12804631\charrsid11358995
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11358995\charrsid11358995 The NDIS Commission is involved in the development of a regulatory framework and nationally consistent minimum standards in relation to the use of restrictive practices.}{\rtlch\fcs1 \af0
\ltrch\fcs0 \cs36\super\insrsid11358995 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3477284 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284
Graeme Head (11 February 2020) Witness Statement to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability [155].}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11358995\charrsid11358995
It has also produced resources to educate specialist behaviour support practitioners and registered providers to adhere to the NDIS Restrictive Practices and Behaviour Support Rules.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid11358995 \chftn
{\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3477284 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284 NDIS (Restrictive Pract
ices and Behaviour Support) Rules 2018.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11358995\charrsid11358995
Our findings highlight that to combat poor practices that may be entrenched in an organisation, it is important that staff receive practical training in how to deliver quality positive behaviour supports.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11358995
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid11358995\charrsid11358995 Recommendation 10:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11358995\charrsid11358995
Positive behaviour supports - Education and training of disability staff in how to deliver positive behaviour supports which are responsive to the individual and that minimise the use of restrictive practices. The NDIS Commission should consider
the circumstances in which this training be mandated and the adequate provision of education and training should be reflected in the NDIS pricing arrangements.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11358995
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid11358995 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11358995\charrsid11358995 {\*\bkmkstart _Toc45903180}\hich\af1\dbch\af31501\loch\f1 Supported decision-making
{\*\bkmkend _Toc45903180}\hich\af1\dbch\af31501\loch\f1
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11358995 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11358995\charrsid11358995 People with disability may want or require support to make decisions. The supported decision-making model set out in the Australian Law Reform Commission\rquote
s report, Equality, Capacity and Disability in Commonwealth Laws seeks to ensure that people with disability receive the support necessary to make, communicate and participate in decisions that affect them.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid11358995 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid12058958 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284
Australian Law Reform Commission, Equality, Capacity and Disability in Commonwealth Laws (Commonwealth of Australia, August 2014) 67.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11358995\charrsid11358995
Further, under this model supporters have a duty to ensure the will and preferences of the individual direct decisions that are made; in contrast to substitute decision-making with its emphasis on outside judgments about what is in an individual\rquote
s best interests.\rquote }{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid3477284 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid12058958 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284 Ibid 116.}}}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11358995\charrsid11358995
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3477284 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11358995\charrsid11358995
When barriers to decision-making arise, people may be forced to exert their legal agency where they otherwise should not need to, for example, about their daily routine, personal relationships, clothing, nutrition, and so on.}{\rtlch\fcs1 \af0
\ltrch\fcs0 \cs36\super\insrsid3477284 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid12058958 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284 Anna
Arstein-Kerslake, Restoring Voice to People with Cognitive Disabilities: Realising the Right to Equal Recognition before the Law (Cambridge University Press, 2017) 153.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11358995\charrsid11358995
While some people with disability may feel confident to speak up, others who are consistently denied the opportunity to make decisions through participation in daily activities, may not develop or maintain the skills necessary to make those decisions.}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid3477284 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid12058958 \rtlch\fcs1 \af47\afs20\alang1025
\ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid3477284 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3477284 Ibid 196-197.}}}{\rtlch\fcs1 \af0
\ltrch\fcs0 \insrsid11358995
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid12058958 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958\charrsid12058958
In research contracted by our office, we found people with disability may
be nervous or hesitant to raise issues because support workers sometimes were too rushed to listen, or not perceived to be in a good mood and people were concerned about further upsetting them.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid12058958
\chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid12058958 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid12058958 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid12058958 Sally Robinson et al, }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid12058958 Building safe and respectful cultures
in disability services for people with disability }{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid12058958 (Report for the Disability Services Commissioner, June 2019) 77.
\par }}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958\charrsid12058958 In addition, on some occasions, when people with disability raise
d problems they had no recollection of receiving feedback about the outcome, or it was considered that no changes or no meaningful change occurred.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid12058958 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1771450 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid1771450 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid12058958 Roger Stancliffe et al \lquote
Knowing, planning for and fearing death: Do adults with intellectual disability and disability staff differ?\rquote (2016) 49-50 }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid12058958
Research in Developmental Disabilities }{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid12058958 47, 56.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958\charrsid12058958
\par Families too who believe in and encourage supported decision-making, can find it difficult to know how to support the decision-making of their family member. For exam
ple, we have found that families may be reticent to speak up about a problem, because they are aware that they do not have a full understanding of the situation or they are worried that by raising minor concerns or small indignities, their family member w
ill be impacted by a disproportionate response.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid12058958 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1771450 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid1771450 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid12058958 Sally Robinson et al, }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0
\i\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid12058958 Building safe and respectful cultures in disability services for people with disability }{\rtlch\fcs1 \af47 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid12058958 (Report for the Disability Services Commissioner, June 2019) 92}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958\charrsid12058958
\par While the shift to supported de
cision-making can empower people with disability, it may be less straightforward to implement in practice. It is not uncommon for families to occupy a position more in keeping with substitute decision-making, having more reliance on the service to take re
sponsibility for providing support to their family member when making decisions, as well as lower expectations of their family member\rquote s capabilities and agency in decision-making}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958 .}{\rtlch\fcs1 \af0
\ltrch\fcs0 \cs36\super\insrsid12058958 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1771450 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid1771450 \chftn Ibid}{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid12058958 61.}
}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958\charrsid12058958 .
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1771450 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958\charrsid12058958 The di
ffering values and approaches that can be taken in relation to supported decision-making may create tension or conflict among people with disability, their families, and support workers.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid12058958 \chftn
{\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1771450 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid1771450 \chftn Christine}{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid12058958
Bigby, Mary Whiteside & Jacinta Douglas \lquote Providing support for decision making to adults with intellectual disability: Perspectives of family members}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958\charrsid12058958
We consider that dedicated resources are required to embed supported decision-making in the everyday practices of the disability sector; training should assist pe
ople with disability, their families and disability support workers to understand core principles of supported decision-making, and how to engage in collaborative working practices. We discuss this issue further in Section 6 in relation to organisational
culture.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958\charrsid1771450
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid12058958\charrsid1771450 Recommendation 11:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958\charrsid1771450
Implement a nationally consistent supported decision-making framework, as recommended by the Australian Law Reform Commission in their report, Equality, Capacity and Disability in Commonwealth Laws.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid8587315\charrsid1771450
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid12058958\charrsid1771450 Recommendation 12:
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7095095 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958\charrsid1771450 Supported decision-making \endash
Education and training of disability staff to ensure that people with disability enjoy legal capacity on an equal basis with others and receive the support they require in decision-making. The NDIS Commission should consider the circumst
ances in which this training be mandated and the adequate provision of education and training should be reflected in the NDIS pricing arrangements.
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid7095095 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958\charrsid1771450 {\*\bkmkstart _Toc45903181}\hich\af1\dbch\af31501\loch\f1 End of life care{\*\bkmkend _Toc45903181
}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1771450 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958\charrsid1771450 At the core of supported decision-making is the idea that all pers
ons, except in very limited circumstances, have some level of decision-making ability, and that with appropriate support, they can be supported to make decisions}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid1771450 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1771450 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \insrsid15730590\charrsid1771450 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid12058958 Australian Law Reform Commission, }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0
\i\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid12058958 Equality, Capacity and Disability in Commonwealth Laws }{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid12058958 (Co
mmonwealth of Australia, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid1771450 August 2014)}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958\charrsid1771450
. People with disability may formally appoint their supporter, including a family member, friend or carer to assist them in a range of life decisions, including in relation to medical treatment and end of life care.
\par A
principal issue that we observe in our work, is that service providers are not always clear about how to implement supported decision-making in relation to end of life care. This is particularly the case for people with cognitive disability. In our inves
tigations, it is evident that support workers have implemented Advance Care Directives, completed and signed by family members, despite the directive not being a suitable legal document when an individual does not have capacity to complete it.
\par We have also observed that advance care planning for people with disability commonly does not occur, or it is implemented as a rushed response to a person\rquote
s rapidly deteriorating health. This lack of a timely and proactive approach contributes to a narrowed medical em
phasis, for example, the making of resuscitation orders and directives on life-sustaining treatments. It is a missed opportunity for people to consider and express their preferences, including about where they would like to die or their spiritual needs fo
r dying (such as wishes for visitation).}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs46\super\insrsid1771450\charrsid1771450 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1771450 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid15730590\charrsid1771450 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid1771450 Michele Wiese et al, \lquote
What is talked about? Community living staff experiences of talking with older people with intellectual disability about dying and death\rquote (2014) 58(7) Journal of Intellectual Disability Research 679, 686.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs46\super\insrsid12058958\charrsid1771450 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958\charrsid1771450
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1771450\charrsid1771450
We find that where there is an absence of formal arrangements, family members typically assume the role as supporter. However, this too can cause problems. In 2018-2019, we observed how some families were provided with the choice between act
ively treating or withholding treatment from an individual with cognitive disability, despite not having a close and continuing relationship with the individual. In such cases, service providers were aware of this tension, however, did not proactively req
uest the advice or intervention of the Office of Public Advocate (OPA).
\par Medical professionals do not always support people with cognitive disability to exercise their right to decision-making about their medical treatment. A common example is how attempts
are not always made to involve an individual in discussions about their medical treatment. We have also observed too often cases where the decision to withhold treatment or to refer to palliative care, has been made in relation to medical professional
\rquote s perception of the person\rquote s quality of life rather than to best practice procedures for the person\rquote s presenting conditions and treatment options.
\par It is not always evident that medical professionals consider other life-prolonging treatments for people with di
sability; rather they may make a value judgment about what the individual should want or what is in their best interests. This practice appears to be shaped by ableist assumptions that the quality of life of people with disability is very low, and that th
ey will never live happy and fulfilling lives. Ableism leads to discrimination, including the denial of treatment on the basis of disability.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid15679996 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid15679996 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid15679996 \chftn Catalina Devandas Aguilar, Report of the Special Rapporteur on the rights of persons with disabilities, UN Doc A/HRC/71/314 (9 August 2016) [31].}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1771450\charrsid1771450
\par Broadly speaking, people with disability encounter death without an understanding about what may be happening, and this situation can be compounded by a fear of death.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid15679996 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid15679996 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \insrsid15730590\charrsid15679996 \chftn Michele Wiese et al, \lquote What is talked about? Community living staff experiences of talking with older people with intellectual disability about dying and death\rquote
(2014) 58(7) Journal of Intellectual Disability Research 679, 688.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1771450\charrsid1771450 It is essential that disability staff have the skill and confidence to assist people with disability to learn over
their lifespan about death and dying.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid15679996 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11938584
\rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid11938584 \chftn Ibid}{\rtlch\fcs1 \af47 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid1771450 .}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1771450\charrsid1771450 \lquote Talking end of life with people with intellectual disability\rquote
is one online learning resource developed by stakeholders to assist disability support workers and managers to acquire the skills and confidence to have such conversations.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid11938584 \chftn {\footnote
\ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11938584 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid11938584 \chftn D}{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid1771450 epartment of Health (Cth), (2018) }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0
\i\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid1771450 Talking end of life with people with intellectual disability }{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid1771450
(Web Page) .}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1771450\charrsid1771450
\par We support the view of the OPA that funding should be provided to provide support to people who require support for decision-making about medical treatment, beyond the realm of NDIS planning.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid11938584
\chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11938584 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid11938584 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid1771450
Office of the Public Advocate (Vic), Submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability \endash Health care for people with cognitive disability (March 2020) 12.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid1771450\charrsid1771450 For example, we are aware of the ben
eficial impact of the Decision Support Pilot, which provides independent advocacy and decision-making support to NDIS participants who have limited decision-making capacity and a lack of either informal supporters or formal decision-making arrangements in
place.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid11938584 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11938584 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid11938584 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid1771450 Ibid}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12058958
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3550661 {\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid3550661\charrsid3550661 Recommendation 13:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3550661\charrsid3550661 End of life care \endash
Education and training of disability staff in how to support people with disability to learn about death and dying, and to make choices about their participation in advance care planning. The NDIS Commis
sion should consider the circumstances in which this training be mandated and the adequate provision of education and training should be reflected in the NDIS pricing arrangements. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1771450\charrsid3550661
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid3550661 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3550661\charrsid3550661 {\*\bkmkstart _Toc45903182}\hich\af1\dbch\af31501\loch\f1 Health promotion and prevention
{\*\bkmkend _Toc45903182}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3550661 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3550661\charrsid3550661 People with disabi
lity are at increased risk of ill-health due to the development of secondary conditions, chronic conditions associated with risk factors such as physical inactivity, unintentional injury and falls, or due to the early onset of the ageing process in their
40s and 50s.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid3550661 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3550661 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3550661 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid3550661 World Health Organisation, }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid3550661 World Report on Disability }{
\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid3550661 (2011) 59.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3550661\charrsid3550661
Health inequalities are significant for people with intellectual and psychosocial disability who on average die more than 15 years earlier than the general population, due to neglect, poor treatment and failure to undertake routine screening, health prom
otion and prevention activities.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid3550661 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3550661
\rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3550661 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47
\ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid3550661 Catalina Devandas Aguilar, }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid3550661
Report of the Special Rapporteur on the rights of persons with disabilities}{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid3550661 , UN Doc A/HRC/73/161 (16 July 2018) [22].
\par }}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3550661\charrsid3550661
\par A lack of access to preventative health is particularly evident in group h
omes, where we observe people with disability may not receive routine immunisations, screening for cancer and interventions for a range of mental health conditions. We see instances of poor oral and dental health, including where people who are missing so
me or all of their teeth do not see a dentist for years at a time; this compounds the risks associated with poor nutrition and swallowing issues.
\par It is evident that service providers do not always individualise preventative measures on offer to their reside
nts. For example, the same general practitioner may conveniently visit all residents in a group home. In 2015, we received a complaint about five women with intellectual disability in a group home who received near identical bulk tooth extraction \endash
one individual had 22 teeth removed. Our investigation found the service provider failed to: facilitate annual dental health care, obtain informed consent, and provide pain relief and post-operative care. This poor quality of care is unacceptable.
\par Low expectations
of people with disability reduce their participation in preventative health initiatives, and they do not always receive support to lead healthy lifestyles, such as through a balanced diet and physical exercise. Our office has observed how many people wit
h
disability in group homes may spend a lot of time in their own rooms engaging in sedentary activities such as watching television or listening to music. In some instances, this separation is used to minimise conflict among residents, yet it can compound
their social isolation.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs46\super\insrsid3550661\charrsid3550661 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11755138
\rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3550661 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47
\ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid3550661 Sally Robinson et al, Building safe and respectful cultures in disability services for people with disability (Report for the }{\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid11755138 Disability Services Commissioner, June 2019) 79.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3550661\charrsid3550661
\par The net effect of this lack of access to health prom
otion and disease prevention services, is that in Victoria, as has occurred in other states and territories, we have found that people with disability in receipt of disability services die approximately 25 to 30 years younger than the general population.}
{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid11755138 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11755138 \rtlch\fcs1 \af47\afs20\alang1025
\ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid11755138 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid11755138
Disability Services Commissioner, A review of disability service provision to people who have died 2018-2019 (2019) 7.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3550661\charrsid3550661
While people with disability may experience complex health conditions and co-morbidities that increase ill-health, it is also clear through our investigations that deaths are preventable.
\par Overall, the number of potentially avoidable deaths of people with disability represents a failure of disability services to manage the key health risks impacting people with disability in receipt of ser
vices. We have found specific health management plans are not consistently created, or up to date; staff may consider that this falls to the responsibility of others. This is despite known risks to an individual in areas such as choking and aspiration, ch
ronic constipation and epilepsy.
\par Indeed, many of the deaths reported to our office continue to be unexpected, for example, due to aspiration pneumonia and choking on food.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid11755138 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s34\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f42\fs20\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid15730590
\chftn }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \f47\fs16\cf23\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid11755138 Ibid 6.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid3550661\charrsid3550661 We are concerned that these deaths occur despite it being known that a per
son had difficulty swallowing and eating. It appears, in such cases, the person died because staff were either unaware of, or did not follow, their mealtime support plan. Further, staff do not always recognise when a person\rquote
s health is deteriorating, or they do not escalate action by calling for appropriate medical advice or emergency care.
\par We have found that partnership with stakeholders across the disability and health sectors to be most effective in addressing these barriers to preventative health. For e
xample, our office has convened a working group focused on ensuring people with disability receive appropriate mealtime supports. A range of cross-sector representatives, including the NDIS Commission, have participated to effect change, including through
the development of an educative poster for display in relevant disability services to alert staff to this risk.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3550661
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11755138 {\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid11755138\charrsid11755138 Recommendation 14:
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4158171 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11755138\charrsid11755138 Health promotion and prevention \endash
Education and training for disability staff in the prevention of key health risks to person
s with disability, including reducing deaths related to respiratory issues and choking, epilepsy and inadequate bowel management. The NDIS Commission should consider the circumstances in which this training be mandated and the adequate provision of educat
ion and training should be reflected in the NDIS pricing arrangements.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4158171 {\*\bkmkstart _Toc45903183}
\par }\pard\plain \ltrpar\s32\ql \li0\ri0\sb360\sa240\sl301\slmult0\widctlpar\wrapdefault\faauto\outlinelevel0\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af47\afs30\alang1025 \ltrch\fcs0 \f1\fs48\cf29\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {
\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid4158171 3. }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid11755138\charrsid11755138 Reporting, investigating and responding to violence, abuse, neglect and exploitation of people with disability}{\rtlch\fcs1 \af47
\ltrch\fcs0 \insrsid11755138 {\*\bkmkend _Toc45903183}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11755138 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid11755138\charrsid11755138 Term of Reference (b)
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11755138\charrsid11755138
What governments, institutions and the community should do to achieve best practice to encourage reporting of, and effective investigations of and responses to, violence against, and abuse, neglect and exploitation of, people with disability, including ad
dressing failures in, and impediments to, reporting, investigating and responding to such conduct.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11755138
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid11755138 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11755138\charrsid11755138 {\*\bkmkstart _Toc45903184}\hich\af1\dbch\af31501\loch\f1 Responding to complaints
{\*\bkmkend _Toc45903184}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11755138 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11755138\charrsid11755138 People with disability can face multiple barriers to making a complaint about their service provider. Our off
ice has learnt that there are a number of reasons why people with disability do not complain, including fear of retribution and withdrawal of service; not being aware of their rights; previous negative experience with making a complaint; lack of communica
tion support; and that they don\rquote t \lquote know\rquote of experiences better than the service they are receiving.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid16471590 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16471590 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid16471590 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid11755138 Disability Services Commissioner, }{\rtlch\fcs1 \af47 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid11755138 Disability services complaints data (2007-2015): What have we learnt so far? (2017) 20.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11755138\charrsid11755138
\par To address these barriers to com
plaints, people with disability should be provided with opportunities to develop their capabilities to raise issues and navigate complaints systems. Our office has undertaken preventative work, providing information to people with disability and their fam
ilies on speaking up about violence, abuse, neglect and exploitation. For example, in 2018-2019, we developed a plain English resource \lquote Living in a disability group home? You have rights.\rquote
\par Our \lquote It\rquote s OK to complain\rquote campaign has contributed to the increased
understanding within the Victorian disability sector about the development of a positive complaints culture and the beneficial role of effective complaint handling. Having an outward facing part of our office, our capacity development team, to promote th
is message has been integral to building the knowledge and capacity of people with disability in Victoria to engage with complaints mechanisms.
\par The NDIS Commission\rquote s communication and engagement strategy similarly aims to inform people with disability about
their rights under the NDIS Code of Conduct and to encourage them to make complaints if they have concerns about the safety or quality of services they receive.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid16471590 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16471590 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \insrsid15730590\charrsid16471590 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid11755138
Graeme Head, Witness Statement to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (11 February 2020) [121].}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11755138\charrsid11755138
We note that the NDIS Commission has issued grants for the development of training and resources to support people with disability and service providers to engage}{\rtlch\fcs1 \af47\afs22 \ltrch\fcs0 \fs22\insrsid11755138 with NDIS complaints processes.
}{\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \cs36\fs22\super\insrsid16471590 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16471590 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid16471590 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid11755138 Ibid.}}}{\rtlch\fcs1 \af47\afs22 \ltrch\fcs0 \fs22\insrsid11755138
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid2625213 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213\charrsid2625213
We are further encouraged that the NDIS Commission as part of implementing the NDIS Complaints Management and Resolution Rules will require registered service providers to have an internal complaints management and resolution system,}{\rtlch\fcs1 \af0
\ltrch\fcs0 \cs36\super\insrsid2625213 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid2625213 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid2625213 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid2625213 NDIS }
{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid2625213 (Complaints Management and Reportable Incidents) Rules 2018 s 8.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213\charrsid2625213
and that they have incorporated into their guidelines for complaints handling our work on the \lquote Four As\rquote model.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid2625213 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid2625213 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid2625213 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid2625213
NDIS Quality and Safeguards Commission, Effective Complaint Handling Guidelines for NDIS Providers (2015) 14.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213\charrsid2625213
This best practice approach recognises that people who make a complaint are generally seeking one or more of four outcomes: acknowledgement, answers, actions and apology.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid2625213 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid2625213 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \insrsid15730590\charrsid2625213 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid2625213 Disability Services Commissioner, Everything you wanted to know about complaints \'85
Tips for service providers on successfully resolving complaints and seeing the opportunities for improvement (2017) 12.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213\charrsid2625213
\par The NDIS Commission has broad powers in relation to registered service providers, and it will be abl
e to take complaints about unregistered service providers where the complaint relates to a potential breach of the NDIS Code of Conduct. In doing so the NDIS Commission will have the option of enacting its various powers such as compliance notices, enforc
eable undertakings, injunctions, and banning providers from delivering services.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid2625213 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid2625213 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid2625213 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid2625213
NDIS Quality and Safeguards Commission, Compliance and Enforcement Policy (V2.0, June 2019) 4.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213\charrsid2625213 While these are all important safeguards, unregistered providers will not have
to undertake worker screening checks, report critical incidents, or undergo independent quality audits against relevant disability practice standards.
\par We support people\rquote s right to choose their disability service provider, including an unregistered provid
er. However, we are concerned about the level of regulatory oversight for unregistered providers under the NDIS, given the high number of enquiries and complaints our office has received that were about unregistered service providers, including allegation
s of assault. It is important that people with disability are provided with access to clear, concise information about the quality, safeguarding and oversight mechanisms embedded in the NDIS Quality and Safeguarding Framework.
\par In Victoria, the introduction
of the Victorian Disability Worker Commission (VDWC) is an attempt to promote consistency in worker conduct. The Disability Service Safeguards Code of Conduct applies to all disability workers in Victoria, regardless of whether they are funded through the
NDIS or other providers.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid2625213 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid2625213 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid2625213 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15730590\charrsid2625213 Disability Service Safeguards Act 2018 s 22.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213\charrsid2625213
This allows the VDWC to act upon concerns over the safety and quality of supports, for example, by issuing prohibition orders to ban unregistered disability workers.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid2625213\charrsid2625213 Recommendation 15:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213\charrsid2625213
Build the capacity of people with disability to understand their human rights and encourage them to make complaints and actively contribute to the quality of supports they receive. A well-resourced outward facing capacity development team that promotes h
uman rights and develops a positive complaints culture has been integral to building the knowledge and capacity of people with disability in Victoria to engage with complaints mechanisms.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid2625213\charrsid2625213 Recommendation 16:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213\charrsid2625213 Increase publicly available information and educa
tion for people with disability and their natural support networks about the operation of quality, safeguarding and oversight mechanisms under the NDIS Quality and Safeguards Framework, including arrangements in place for registered and unregistered provi
ders.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid2625213 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213\charrsid2625213 {\*\bkmkstart _Toc45903185}\hich\af1\dbch\af31501\loch\f1 Responding to serious incidents
{\*\bkmkend _Toc45903185}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid2625213 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213\charrsid2625213 Through successive Ministerial Referrals, DSC has provided increasing levels of oversight of reportable incidents}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid2625213 \chftn {\footnote
\ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid2625213 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid2625213 \chftn According}{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 to s14 of the }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\insrsid15730590
NDIS (Incident Management and Reportable Incidents) Rules 2018}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590
, reportable incidents are incidents that happen, or are alleged to have happened, in connection with the provision of supports or services by registered NDIS providers. These incidents include the death, serious injury, abuse or neglect of a person
with disability and the use of restrictive practices in particular circumstances.
\par }}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213\charrsid2625213
since 2012. From 2017 this has included the authority to enquire into and investigate any incidents relating to abuse or neglect in the provision of services, and the provision of disability services to people who have died.
\par Our office\rquote s experience of the
incident reporting mechanisms in Victoria is that the categorisation of reportable incidents has relied too greatly on a subjective decision by the service provider and staff about the degree to which the incident has impacted a person. For example, non-
government service providers have been required to classify incidents as either \lquote Major Impact\rquote or \lquote Non-Major Impact\rquote
. In this system non-major incidents were not reported to our office, and therefore not subject to effective oversight.
\par The NDIS Incident Man
agement Rules exclude some acts from the definition of reportable incidents, and it allows for service provider discretion about reporting. In particular, unlawful physical contact is not a reportable incident where the contact with, and impact on, the pe
rson with disability is deemed to be \lquote negligible,\rquote }{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid8258069 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8258069 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid8258069 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 NDIS (Incident Management and Reportable Incidents) Rules 2018, s 16 (2).}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213\charrsid2625213
for example, where the person had \lquote no reaction to the contact or only a minor reaction which was brief and barely noticeable.\rquote }{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid8258069 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8258069 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid8258069 \chftn N}{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 DIS Quality and Safeguards Commission, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590
Reportable Incidents: Detailed Guidance for Registered NDIS Providers (June 2019) 22.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2625213
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8258069 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8258069\charrsid8258069
An issue arising with this approach is that management and staff are not best placed to make what is a subjective decision about the impact of an incident. They may fail to appreciate or choose not to report, the impact of incidents on people with disabil
ity. This is particularly disadvantageous if the person impacted by the incident is not capable of communicating and raising how they feel, or if they do not react in ways that may typical of the broader community.
\par We have found that the subjective nature o
f incident reporting potentially minimises critical issues of concern in the disability sector. We have seen examples where incidents have not been reported because the impacted person did not or could not verbalise any distress. In one case, a person was
hit in the face by another resident but was then assessed by a staff member as not having been adversely affected as they continued with activities at their day service. It is concerning that the service provider did not consider this to constitute abuse.
\par In 2018-2019, our office found incidents of physical assault or abuse including staff forcibly administering medications and rough handling of people with disability. Poor quality of care encompassed individuals being left unsupervised in vehicles in extr
eme heat and staff on active night shift falling asleep.
\par This service provider discretion has contributed to under reporting and limited our office\rquote s ability to assess the quality of supports offered to people with disability after an incident. If an inci
dent is deemed not to be a reportable incident, it may fail to compel a service provider to implement secondary prevention measures that empower individuals to recognise and report abuse, as well as efforts to provide medical, psychological and social sup
ports for abuse victims, and counselling for perpetrators.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8258069
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid8258069\charrsid8258069 Recommendation 17:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8258069\charrsid8258069 Strengthen working definitions of, and provide education about, the categories of reportable incidents in the NDIS Incident Management Rules, to reduce service provider discretio
n and under-reporting about the impact of violence, abuse, neglect and exploitation on an individual. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8258069
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid5267025 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid5267025\charrsid5267025 {\*\bkmkstart _Toc45903186}
\hich\af1\dbch\af31501\loch\f1 Investigations and death reviews{\*\bkmkend _Toc45903186}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5267025 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5267025\charrsid5267025 One of the powers afforded to our office in August 2017 was the authority to undertake systemic
investigations, including Authorised Officer visits which are unannounced inspections of disability services. Authorised Officer visits allow us to visit people in their home to ascertain what might be occurring in that home, beyond the usual reporting me
chanisms. They send a visible message about the quality, safeguarding and oversight mechanisms in place across the sector and reinforce that staff need to ensure that they are providing high quality supports at all times.
\par Wherever possible, we endeavour to
take an educative, rather than punitive, approach in our investigations. We have seen encouraging results from this approach, with many service providers engaging positively throughout the investigation process and taking actions and improving services be
fore our investigation concludes. This means that improvements to services are happening in a timely manner, with more immediate benefits for the safety and well-being of people with disability.
\par The NDIS Commission has the power to investigate complaints an
d reports of non-compliance with the NDIS Practice Standards, NDIS Code of Conduct and other legislative requirements, as well as own-motion investigations into any other matter relating to compliance.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid5267025 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14974780 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3084610 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 NDIS Quality and Safeguards Commission, }{\rtlch\fcs1 \ai\af47
\ltrch\fcs0 \i\insrsid15730590 Compliance and Enforcement Policy }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 (V2.0, June 2019) 5.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5267025\charrsid5267025
However, it is our experience that the process of investigation is time and labour intensive and requires an appropriate allocation of resources.
\par The National Disability Insurance Scheme Act 2013 (Cth) (the NDIS
Act) mandates that all registered NDIS providers across Australia must notify the NDIS Commission of deaths of people that occurred, however the NDIS Commission has not yet committed to a national approach to reviewing all deaths of people with disabilit
y.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid5267025 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14974780 \rtlch\fcs1 \af47\afs20\alang1025
\ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid3084610 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590
NDIS Quality and Safeguards Commission, }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\insrsid15730590 Research: Causes and contributors to deaths of people with disability in Australia \endash NDIS Commission\rquote s response to recommendations }{\rtlch\fcs1
\af47 \ltrch\fcs0 \insrsid15730590 (Web Page). .}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5267025\charrsid5267025
They have commenced taking action to reduce the identified risks, based on existing knowledge generated by our office and comparable state reviews in other jurisdictions; and incorporated into key research report, A scoping review of cau
ses and contributors to deaths of people with disability in Australia.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid3084610 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14974780 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid3084610 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Ibid.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4935206\charrsid5267025
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5267025 While we agree that not all deaths need to be investigated by the NDIS Commission, we consider a robust approach is required if the sector is to identify and address the full r
ange of contributors to the deaths of people with disability. For example, most cases of unauthorised restrictive practices have been identified through our comprehensive death investigations; using this information we have required a service provider to
make service improvements to protect all residents. Such investigations provide insight into practice issues that are not raised through complaints or incident reporting, due to unequal power }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5267025\charrsid5267025
relations that typically characterise service provider relationships.
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14974780 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14974780\charrsid14974780
We have found that there is a significant gap in our knowledge on the cause of death of people with disability in Victoria. This is influenced in part by limitations of the definition of a \lquote reportable death\rquote
under the Coroners Act 2008, which does not
require deaths in group homes managed by non-government service providers to be reported to the State Coroner, unless they are unexpected. As DHHS continues to transition its supported accommodation services to the non-government sector, the number of de
aths in-scope for coronial investigation will reduce significantly.
\par In Victoria, the under-reporting of \lquote reportable\rquote deaths of people with disability in receipt of disability services to the State Coroner is also cause for concern. This may occur because ho
spital staff and disability service providers lack awareness of their reporting obligations in the event of an \lquote unexpected death\rquote .}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid14974780 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9457135 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid9457135 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid9457135 Carmela Salomon & Julian Trollor, \lquote A scoping review of causes and contributors t}{
\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 o }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid9457135 deaths o}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 f }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid9457135
people with disability in Australia \endash Findings\rquote (Department of Developmental Disability Neuropsychiatry UNSW, 19 August 2019) 3.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14974780\charrsid14974780
In 2018-2019 we identified that staff at a group home were confused about what to do when a resident died, and due to a delay in reporting, they failed to preserve evidence of relevance to a coronial investigation.
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid2118636 {\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid2118636\charrsid2118636 Recommendation 18:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2118636\charrsid2118636
Develop a nationally consistent arrangement for reviewing and investigating the deaths of people with disability, not only including those who are NDIS participants but also those who are not receiving NDIS funding.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid14974780\charrsid2118636
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid2118636\charrsid2118636 Recommendation 19:
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14026192 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2118636\charrsid2118636 Consider how categor
y and causes of death will be determined in cases not reported to state coroners, and the measures that can address under-reporting of deaths that are \lquote reportable\rquote
to state coroners; as recommended by Carmela Saloman and Julian Trollor in A scoping review of causes and contributors to deaths of people with }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2118636\charrsid14026192 disability in Australia.
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid14026192 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192\charrsid14026192 {\*\bkmkstart _Toc45903187}\hich\af1\dbch\af31501\loch\f1 Community Visitors
{\*\bkmkend _Toc45903187}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14026192 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192\charrsid14026192 Segregated settings, such as group homes, can be closed environments. By this we mean a place where people with disability live (for the
purpose of ensuring they receive care and services) that limits their autonomy and power to make decisions and choices regarding their day to day activities. It is our view that, whilst balancing the privacy of residents, it is necessary to shine a light
on the daily practices of disability service providers which may constrain or enable human rights.
\par In August 2017 amendments to the Act enhanced our capacity to engage in greater collaboration and information sharing with external stakeholders such as the
OPA and Community Visitors Board. Community Visitors play an important role visiting in-scope disability services to identify conditions or problems that may not have been reported elsewhere by people with disability, and their networks.}{\rtlch\fcs1
\af0 \ltrch\fcs0 \cs36\super\insrsid14026192 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14026192 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid14026192 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Department of S
ocial Services (Cth), }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\insrsid15730590 NDIS Quality and Safeguarding Framework }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 (9 December 2016) 53.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192\charrsid14026192
\par Community Visitor schemes continue to operate alongside the NDIS, in accordance with the jurisdictional arrangements of states and territories. This is important; however
, we consider that future reforms should seek to achieve national consistency and underscore the essential oversight role of Community Visitors to NDIS safeguarding arrangements. For example, we note that OPA recommends that in Victoria, independent monit
oring should extend to NDIS funded non-SDA settings, such as boarding houses.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid14026192 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14026192 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid14026192 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Office of the Public Advocate, }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\insrsid15730590 \'93I\rquote m too scared to come out of my room\'94
: Preventing and responding to violence and abuse between co-residents in group homes }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 (November 2019) 8.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192\charrsid14026192
\par In particular, we agree with the OPA that the NDIS Act should be amended to allow Community Visitors to cite key documents, such as NDIS plans, and to share information to the extent that it is necessary to advocate or raise concerns with relevant complai
nts bodies.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs46\super\insrsid14026192\charrsid14026192 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14026192
\rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid14026192 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47
\ltrch\fcs0 \cf1\insrsid15730590 Ibid 52.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192\charrsid14026192
We consider this additional frontline oversight would be helpful to hold service providers to account for ensuring safety and quality of services so that people with disability are able to lead an ordinary and fulfilling life.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid14026192\charrsid14026192 Recommendation 20:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192\charrsid14026192
Legislative reforms should bring into effect a nationally consistent framework in relation to Community Visitor Programs as a key component of the NDIS safeguarding arrangements as recommended by the Office of Public Advocate (Vic) in the report, "I
\rquote m too scared to come out of my room".}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid14026192 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192\charrsid14026192 {\*\bkmkstart _Toc45903188}\hich\af1\dbch\af31501\loch\f1 Independent advocacy
{\*\bkmkend _Toc45903188}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14026192 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192\charrsid14026192 In the section \lquote Responding to complaints\rquote , we raised the issue of how it can be difficult for people with disability to self-advocate about issues that impact their
safety and quality of life. This is particularly evident in group homes, when social isolation and a lack of natural support networks can create an environment where people with disability may not be able to identify that what they are experiencing is vio
lence, do not know their rights, and do not know how to report the violence or to seek help.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid14026192 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6445344 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid6445344 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Australian Human Rights Commission, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590
A future without violence: Quality, safeguarding and oversight to prevent and address violence against people with disability in institutional settings (June 2018) 15.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192\charrsid14026192
\par Individual advocates therefore play an important role in ensuring quality and safeguarding for people with disability, not only in relation to disability-specific services but also in mainstream systems.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid14026192 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6445344 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid6445344 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590
Australian Cross Disability Alliance, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 Submission: Department of Social Services (DSS) Review of the National Disability Advocacy Program (June 2016) 15.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid14026192\charrsid14026192 For example, there is limited access to skilled patient advocates to support people with disability in their access to the health system, despite the fact that having a patient advocate or a trained \lquote
service navigator\rquote who understands the needs, wants and priorities of the individual is often necessary.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid14026192 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6445344 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid6445344 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Royal Australian College of General Practitioners, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590
Submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability \endash Health care for people with cognitive disability (April 2020) 8.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192\charrsid14026192
\par The role of advocacy is acknowledged in the NDIS Complaints Management and Resolution Rules that stipulate how people with disability who want to make a complaint should have their access to an independent advocate facilitated.}{\rtlch\fcs1 \af0
\ltrch\fcs0 \cs36\super\insrsid6445344 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6445344 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid6445344 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590
NDIS (Complaints Management and Reportable Incidents) Rules 2018 s 15(4)(b).}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192\charrsid14026192 However, there may also be a confounding perception that the NDIS Commission\rquote
s grants program and the NDIA\rquote s Information, Linkages and Capacity Building (ILC) framework will build the capacity of people with disability to self-advocate, thereby reducing the need for funding of advocacy functions.}{\rtlch\fcs1 \af0
\ltrch\fcs0 \cs36\super\insrsid6445344 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6445344 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid6445344 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590
Australian Human Rights Commission, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 A future without violence: Quality, safeguarding and oversight to prevent and address violence against people with disability in institutional settings (June 2018) 53.}}}
{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192\charrsid14026192
\par Our office has not observed this reduction in the demand for advocacy, rather advoc
acy bodies appear to lack the resources to do their work. There is also increasing anecdotal evidence that suggests many advocacy organisations in Victoria have had to place people with disability on waiting lists and close their books due to growing dema
nd of their services. Not only has the transition to the NDIS increased demand for all forms of advocacy and required disability advocates to quickly acquire new knowledge and expertise,}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid6445344 \chftn
{\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6445344 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid6445344 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Australian Cross Disability Alliance, }{\rtlch\fcs1 \af47
\ltrch\fcs0 \insrsid15730590 Submission: Department of Social Services (DSS) Review of the National Disability Advocacy Program (June 2016) 12.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192\charrsid14026192
their resources have been increasingly tied to supporting people with disability for the review of NDIA decisions in the Administrative Appeals Tribunal.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid14026192
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6445344 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6445344\charrsid6445344 The Australian G
overnment funds a range of advocacy services through the National Disability Advocacy Program (NDAP), and some states and territories also fund complementary advocacy programs.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid6445344 \chftn {\footnote
\ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6445344 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid6445344 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Department of Social Services (Cth), }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0
\i\insrsid15730590 NDIS Quality and Safeguarding Framework }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 (9 December 2016) 34.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6445344\charrsid6445344
The NDAP was reviewed in 2016-2017, however identified reforms and a new NDAP have not been implemented. Organisations representing people with disability report the competition for limited funding through NDAP.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid6445344 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6445344 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid6445344 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590
Civil Society CRPD Shadow Report Working Group, }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\insrsid15730590
Disability Rights Now 2019: Australian Civil Society Shadow Report to the United Nations Committee on the Rights of Persons with Disabilities (2019) in response to the list of issues prior to the submission of the combined second and third periodic
reports of Australia [CRPD/C/AUS/QPR/2-3] }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 (July 2019) 12.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6445344\charrsid6445344
\par We are concerned that in addition to chronic under-funding, disability representative organisations across most state and territory jurisdictions are at risk of having their funding reduced, in tu
rn limiting people with disability from accessing an advocate who is independent from service providers.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid6445344 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6445344 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid6445344 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Australian Human Rights Commission, }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\insrsid15730590
A future without violence: Quality, safeguarding and oversight to prevent and address violence against people with disability in institutional settings }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 (June 2018) 54.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid6445344\charrsid6445344 We further note a need for funding of systemic advocacy to highlight issues related to intersectional discrimination impacting particular groups of people with disability, including First Nations peop
les, women and girls and people from culturally and linguistically diverse backgrounds (CALD).}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid6445344 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6445344 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid6445344 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Ibid.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6445344
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid6445344\charrsid6445344 Recommendation 21:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6445344\charrsid6445344
Increase funding of independent advocacy to ensure that organisations responsible for independent advocacy for people with disability can adequately undertake their work in enhancing quality and safeguarding, including addressing intersectional discrimina
tion.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6445344
\par }\pard\plain \ltrpar\s32\ql \li0\ri0\sb360\sa240\sl301\slmult0\widctlpar\wrapdefault\faauto\outlinelevel0\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af47\afs30\alang1025 \ltrch\fcs0 \f1\fs48\cf29\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {
\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid4666648\charrsid4666648 {\*\bkmkstart _Toc45903189}4. Promoting a more inclusive society for people with disability}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid4666648 {\*\bkmkend _Toc45903189}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid4666648\charrsid4666648 Terms of Reference (c)
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4666648\charrsid4666648 What should be done to promote a more inclusive society that supports the independence of people with disability and their right to live free from violence, abuse, neglect and exploitation}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid4666648 .
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid4666648 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid4666648\charrsid4666648 {\*\bkmkstart _Toc45903190}
\hich\af1\dbch\af31501\loch\f1 Housing{\*\bkmkend _Toc45903190}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4666648 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid4666648\charrsid4666648 Typically, in the current group home model, people have not been able to make decisions about where or with whom they live \endash
rather they were offered accommodation with limi
ted or no real choice around accepting or rejecting that accommodation. This has been exacerbated over the years where demand has far outstripped supply and vacancies have been prioritised to people who are already in crisis.
\par Our office has seen a number
of issues, including frequent client to client assaults, that have arisen between people who are forced to live together or whom share a dependant relationship, but who are incompatible. This is a serious issue for safety in residential settings. A 2018-2
0
19 investigation into the death of a woman with an intellectual disability found that she was the subject of 91 incident reports over a ten-year period, 42 of which related to assaults perpetrated by a co-resident. Despite multiple complaints to the servi
ce provider by the family, no meaningful steps were taken to address the issue.
\par The separation of housing and support under the NDIS is part of a commitment to advancing choice and diversity for people with disability, in recognition that there could be a c
onstraint upon choice when one organisation provides both. However, there are limitations to how this can be practically achieved. In Victoria, government made the original decision about which non-government provider would be contracted for service provi
sion at each house, and if an individual residing in a group home wants to change service provider, they would need to persuade other residents to agree.
\par Where issues arise in service provision, people with disability typically need to move to another group
home, if they can find one, in order to change their service provider. In this regard, the Housing Hub is a useful website and knowledge platform that connects people with disability to suitable housing vacancies.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid4666648 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4666648 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid4666648 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0
\cf1\insrsid15730590 Summer Foundation, }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\insrsid15730590 The Housing Hub }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 (Web Page) .}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0
\fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid4666648 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid4666648\charrsid4666648
While the intent is to promote choice of co-residents, once a vacancy is located, Specialist Disability Accommodation (SDA) providers administer the process and existing residents are not always consulted on applications mad
e by incoming tenants or their compatibility considered}{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid4666648 .}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid4666648
\chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13638150 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid4666648 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590
Office of the Public Advocate, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 \'93I\rquote m too scared to come out of my room\'94: Preventing and responding to violence and abuse between co-residents in group homes (November 2019) 8.}}}{\rtlch\fcs1
\af0 \ltrch\fcs0 \insrsid4666648\charrsid4666648
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13238462 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13238462\charrsid13238462 We consider that grou
p home options should incorporate design elements that provide for privacy, such as ensuites, and safe spaces for all residents in the event of resident conflict or incompatibility. The group home model could also be improved if it better reflected a shar
e
house model. In this approach people choose to be housemates. Whilst they have individual support plans, they could still combine funding and share support provision. In this scenario, because people are choosing to share, they are likely to have more co
mmon interests and compatibility.
\par In addition to group home and shared housing models, more diverse and individualised SDA options should be made available. Home Share, Shared Lives and KeyRing are more contemporary housing options which can be effective in
the development of informal supports.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid678699 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13638150
\rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid13638150 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47
\ltrch\fcs0 \cf1\insrsid15730590 Independent Advisory Council to the NDIS, }{\rtlch\fcs1 \ai\af47\afs16 \ltrch\fcs0 \i\cf23\insrsid15730590 Pathway to contemporary options of housing and support }{\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \cf23\insrsid15730590
(May 2018) 11.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13238462\charrsid13238462 Models should also consider cultural issues, such as those relevant to First Nations people with disability.
\par It is important that all people with disability, including those not eligible for NDIS, build their capacity to live independently in their prefe
rred locality and accommodation. This may require an individual be supported to engage in goal-setting and skill development in areas such as personal care and household tasks.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid678699 \chftn {\footnote
\ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13638150 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid13638150 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Independent Advisory Council to the NDIS, }{\rtlch\fcs1 \ai\af47\afs16
\ltrch\fcs0 \i\cf23\insrsid15730590 Pathway to contemporary options of housing and support }{\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \cf23\insrsid15730590 (May 2018) 11.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13238462\charrsid13238462
It also requires their participation in holistic planning for the range of products and systems that can be used to enhance an individual\rquote s control over activities in their home, including suitable smart home technologie
s, telemonitoring, and home modifications.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid678699 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13638150 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid13638150 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Natasha Layton & Emily Steel, \lquote
The convergence and mainstreaming of integrated home technologies for people with }{\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \cf23\insrsid15730590 disability\rquote (2019) 9(4) }{\rtlch\fcs1 \ai\af47\afs16 \ltrch\fcs0 \i\cf23\insrsid15730590 Societies }{
\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \cf23\insrsid15730590 69, 72.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13238462\charrsid13238462
\par A lack of social housing contributes to homelessness,
especially for people with cognitive impairments or mental illness. The private rental system is a problem area due to affordability issues, because of the discrimination people with disability experience when trying to secure a rental property, and a lac
k of properties that are physically accessible. Such limitations of appropriate rental vacancies, and thin markets in particular localities, preclude people with disability from their right to live in a community of their choosing.
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid12006923 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13238462\charrsid13238462
While we have focused on issues in the group home model, other significant human rights issues include how young people with disability continue to reside in aged care settings due to a lack of appropriate housing, and the ongoing reliance on families to
provide housing and supports, in an unpaid capacity.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid13638150 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13638150 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid13638150 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 Zoe Aitken et al, \lquote Precariously Placed: Housing Affordability, Quality and Satisfaction of Australians with Disabilities\rquote (2019) }{\rtlch\fcs1
\af47\afs16 \ltrch\fcs0 \cf23\insrsid15730590 34(1) }{\rtlch\fcs1 \ai\af47\afs16 \ltrch\fcs0 \i\cf23\insrsid15730590 Disability and Society }{\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \cf23\insrsid15730590 121, 123.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid13238462\charrsid13238462 In addition, the closure of residential institutions may lead to the issue of \lquote transinstitutionalisation\rquote , where people with disability move from, but are similarly restricted in other institutions, such }{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13238462\charrsid12006923 as boarding houses and prisons.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13638150\charrsid12006923 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13638150 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid13638150 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 Ilan Wiesel & Christine Bigby, \lquote Movement on Shifting Sands: Deinstitutionalisation and People with Intellectual Disability }{\rtlch\fcs1 \af47\afs16
\ltrch\fcs0 \cf23\insrsid15730590 in Australia, 1974-2014\rquote (2015) 33(2) }{\rtlch\fcs1 \ai\af47\afs16 \ltrch\fcs0 \i\cf23\insrsid15730590 Urban Policy and Research }{\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \cf23\insrsid15730590 178, 182.}}}{\rtlch\fcs1
\af0 \ltrch\fcs0 \insrsid14026192\charrsid12006923
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid12006923\charrsid12006923 Recommendation 22:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12006923\charrsid12006923 Develop more diverse and culturally appropriate Specialist Disability}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15401483 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12006923\charrsid12006923
Accommodation (SDA) options to be made available to people with disability, beyond the group home model, that promote people\rquote s meaningful participation and inclusion in the community.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid12006923\charrsid12006923 Recommendation 23:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12006923\charrsid12006923 Increase the funding and supply of appropriate and accessible housing,
including private rental and public and social housing, for all people with disability, not only including those who are NDIS participants but also those who are not receiving NDIS funding.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid12006923\charrsid12006923 Recommendation 24:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12006923\charrsid12006923 Enhance the capacity of people with disabilit
y to exercise their right to live independently in the community. Funding of individualised supports should allow for the development of independent living skills and for environmental adjustments to be made to their home of choice.}{\rtlch\fcs1 \af0
\ltrch\fcs0 \insrsid12006923
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid15401483 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15401483\charrsid15401483 {\*\bkmkstart _Toc45903191}
\hich\af1\dbch\af31501\loch\f1 Health{\*\bkmkend _Toc45903191}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid15401483 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15401483\charrsid15401483
People with disability, throughout their life course, have unequal access to health care services and have greater unmet health care needs compared with the general population.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid15401483 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid15401483 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid15401483 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0
\cf1\insrsid15730590 World Health Organisation, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 WHO Global Disability Action Plan 2014-2021 (2015) 6.}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0
\fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid15401483\charrsid15401483 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15401483\charrsid15401483
This can be particularly pronounced for people residing in regional, rural and remote areas; travelling to tertiary hospitals and rehabilitation centres for consultation can be costly and time consumin
g and public transport may not be accessible or able to accommodate their needs.
\par People with disability do not always access specialist care, which limits the identification and management of emerging and known health conditions. They may be unable to aff
ord to see a specialist or only able to afford a bulk-billing general practitioner, who may not have the specific skills or expertise to focus on the full range of health and wellbeing concerns that require due attention. A reliance on bulk-billing and pu
blic health services can lead to lengthy wait times for people with disability.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid15401483 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid15401483 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid15401483 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Royal Australian College of General Practitioners, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590
Submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability \endash Health care for people with cognitive disability (April 2020) 8.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15401483
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16474993 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid16474993\charrsid16474993
General practitioners play an important role in coordinating the ongoing care of people with disability, yet we have identified concerning gaps. For example, we observe how the Comprehensive Health Assessment Program (CHAP)}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid16474993 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16474993 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid16474993 \chftn C}{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\insrsid15730590
omprehensive Health Assessment Program }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 available at .}}}{\rtlch\fcs1
\af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16474993\charrsid16474993 }{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16474993 }{\rtlch\fcs1 \af0 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16474993\charrsid16474993 tool that is prepared as part of an annual heal
th review, is typically incomplete or lacks sufficient explanatory information to have practical utility. There are financial disincentives for general practitioners to provide long consultations,}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs46\super\insrsid16474993\charrsid16474993 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16474993 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid16474993 \chftn R}{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 oyal Australian College of General Practitioners, }{\rtlch\fcs1
\ai\af47 \ltrch\fcs0 \i\insrsid15730590 Submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability \endash Health care for people with cognitive disability }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590
(April 2020) 9.}} }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid16474993\charrsid16474993 and short consultation times may limit the detection of issues early.
\par In our work, we have found that people with disability may be compelled to see a medical practitioner based on what is convenient for the service provider. In 2018-2019, we had one particularly concerning case where on multi
ple occasions, two residents were reviewed by the same psychiatrist during the one appointment, with each remaining in the consulting room while the other individual was attended to. It is unacceptable that both service provider and medical professional a
llowed this to occur; staff efficiencies should not be prioritised over a person\rquote s human rights.
\par People with cognitive disability are a high-risk group. In 2018-2019 more than half of the people whose death was reported to our office had an intellectual disability and multiple, chronic health conditions.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid16474993 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid15602616 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid16474993 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid16474993 Disability Services Commissioner, A review of disability service provision to people who have died 2018-19 (2019) 6.}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0
\fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16474993\charrsid16474993 }{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16474993 }{\rtlch\fcs1 \af0 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16474993\charrsid16474993 We are concerned that while it is known that multi-morbidity is a strong predictor of
deaths in people with intellectual disability, there remains a gap in terms of how medical professionals and disability staff are trained and therefore confident in models of complex support.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid16474993 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid15602616 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid16474993 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid16474993
Nathan Wilson et al, \lquote Complex support needs profile of an adult cohort with intellectual disability transitioning from state-based service provision to NDIS-funded residential support\rquote
(2020) Journal of Intellectual & Developmental Disability (advance) }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid15602616 2.}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0
\fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16474993\charrsid16474993
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid16474993\charrsid16474993 Due to their chronic health conditions, people with disabilit
y may be exposed to polypharmacy, where multiple medications are taken, thereby increasing health risks due to reactions and interactions of the medication. In 2018-2019, a woman with an intellectual disability who died due to choking had recently receive
d an increase in the dosage of her antipsychotic medication; no behaviour charts were provided to the general practitioner to evidence the need for this change, which likely exacerbated her pre-existing swallowing difficulties.
\par In hospital settings, health
and disability staff do not always work effectively together. Our investigations have identified that disability specific support is not consistently provided to people with disability in hospital, even when an individual lacks other existing natural soci
a
l networks or would benefit from a degree of staff familiarity. In 2018-2019, one individual who lacked existing natural supports was not visited by anyone over a ten-day period, despite hospital staff informing the service provider that the person had ex
pressed feeling isolated. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid16474993
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid16474993\charrsid16474993 Our investigations have found disability support workers do not consistently raise the specifics of an individual\rquote
s support needs or provide adequate written health summaries for hospital staff. On other occasions, disability supp
ort workers have been present, however they may not be listened to or have directly been asked by hospital staff to reduce their involvement. A positive development is how the information contained in Health Passports}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid15602616 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid15602616 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid15602616 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590
West Moreton Hospital and Health Service (2016), }{\rtlch\fcs1 \ai\af47\afs16 \ltrch\fcs0 \i\cf23\insrsid15730590 This is my Health Passport }{\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \cf23\insrsid15730590
.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid15602616 }{\rtlch\fcs1 \af0 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16474993\charrsid16474993 has been used in limited circumstances, to prompt discussion and cross-sector collaboration.
\par The lack of a defined pathway for people with disability in hospital is also evident in the lack of reasonable adjustments made for people with disability, such as
dedicated sensory spaces, additional mealtime supports, extended time for consultation or decision-making, single rooms, and accommodation for family to stay overnight. This is problematic in, for example, a hospital setting, given the fast-paced and cro
wded environment, which can already be over-stimulating or unfamiliar for some people with disability.
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9583334 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid16474993\charrsid16474993
A number of factors are problematic in the discharge planning of people with disability, including inappropriate and early discharge, a lack of discharge
information and education, and fewer options for multidisciplinary rehabilitation. Our investigations highlight that this may occur in part, because hospital staff incorrectly assume that group homes are staffed by nurses who are qualified to, for example
, provide post-operative care and administer medications. Disability staff and }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16474993\charrsid9583334 management may also fail to speak up about the high risks involved in a discharge.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid9583334\charrsid9583334 Recommendation 25:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9583334\charrsid9583334 Increase the Medicare Benefits Schedule to reflect the real cost of providi
ng ongoing patient-centred care such as undertaking comprehensive assessments, regular follow-ups, and preventative measures; as recommended by the Royal Australian College of General Practitioners in their submission to this Royal Commission.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid9583334\charrsid9583334 Recommendation 26:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9583334\charrsid9583334
Increase funding and development of education and training of health professionals in the human rights model of disability to enhance their capacity to provide quality health care and supports to people with disability. This training should be co-d
esigned by people with disability and their representative organisations.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid9583334\charrsid9583334 Recommendation 27:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9583334\charrsid9583334 Increase funding and development of connected and integrated health and disability services. This should include a national network of disability health specialis
ts to support people with disability who have complex health conditions and co-morbidities. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9583334
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid9583334 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid9583334\charrsid9583334 {\*\bkmkstart _Toc45903192}
\hich\af1\dbch\af31501\loch\f1 Justice{\*\bkmkend _Toc45903192}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9583334 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9583334\charrsid9583334 Our office has observed how people with disability, when reporting to police their experience as a victim of violence and abuse do
not enjoy equality before the law. On a number of occasions, people with disability have made disclosures to police, however, police may not proceed with an investigation for reasons that remain unclear to the individual. This failure to keep people with
disability informed about the progress of an investigation, may perpetuate fears that their reports to police are not being taken seriously.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9583334 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9583334 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid9583334 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Department of Health and Health and Human Services (Vic), }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590
Responding to allegations of abuse involving people with disabilities: Guidelines for disability service providers and Victoria Police (June 2018) 35.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9583334\charrsid9583334
\par Police decision-making to discontinue an investigation may stem from attitudes about how to regard evidence from people with disability. Police may incorrectly
assume that people with cognitive disability or communication impairments are not credible or not capable of giving evidence or making legal decisions.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9583334 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9583334 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid9583334 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Law Reform Committee, Parliament of Victoria, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590
Inquiry into Access to and Interaction with the Justice System by People with an Intellectual Disability and their Families and Carers (Parliamentary Paper No 216, March 2013) 6.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9583334\charrsid9583334
Our investigations have found that police may consult with families about whether or not to proceed with an investigation, rather than asking the individual about what they might choose to do.
\par We also have learnt how support, which should be tailored to the cognitive and communication needs of the individual, is not consistently offered by police to people with disability throughout t
he phases of investigation. For example, people with disability may be interviewed without a support person present or without access to an Independent Third Person, this may be because it is assumed that the individual has a greater understanding of thei
r situation than they actually do.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9583334 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9583334
\rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid9583334 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Ibid 104}}}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9583334\charrsid9583334
\par Therefore, it is important that police are trained and supported to make reasonable adjustments for people with disability including during the initial reporting, interviewing or taking of a statement, and in
communicating about the progress and outcomes of an investigation. In Victoria, the recent roll-out in each region of a police member as a \lquote disability liaison officer\rquote is an important initiative;}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid9583334 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9583334 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid9583334 \chftn O}{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 ffice of the Public Advocate, }{\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590 \'93I\rquote m too scared to come out of my room\'94: Preventing and responding to violence and abuse between co-residents in group homes (November 2019) 72.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9583334\charrsid9583334
we consider that a further dedication of resources would help to ensure such disability inclusive policies are translated into justice responses to violence, abuse, neglect and exploitation of people with disability.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid9583334\charrsid9583334 Recommendation 28:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9583334\charrsid9583334 Enhance the capacity of police to respond to allegations of violence, abuse, neglect and exploitation impacting people with disabili
ty. This requires, for example, an increase in the availability of Disability Liaison Officers, and disability awareness training that focuses on ensuring reasonable adjustments for people with disability.
\par }\pard\plain \ltrpar\s27\ql \li0\ri0\sa180\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13124370 \rtlch\fcs1 \af0\afs32\alang1025 \ltrch\fcs0
\b\fs32\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057\ulc20 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13124370\charrsid13124370 \hich\af1\dbch\af31501\loch\f1 Education
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13124370 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13124370\charrsid13124370 The inclusion of people with disability
in mainstream educational settings, so they receive good quality education, enables development of their capabilities for employment and other areas of life.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid13124370 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13124370 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid13124370 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid13124370 World Health Organisation, World Report on Disability (2011) 205.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid13124370\charrsid13124370 Inclusive forms of education at all levels \endash in early childhood education, schools and universities, vocational training and lifelong learning, extracurricular and social activities \endash
can also increase familiarity between people who are able-bodied and those with disability, thereby reducing prejudice and helping to promote a more inclusive society.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid13124370 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13124370 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid13124370 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid13124370 Ibid 206.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13124370\charrsid13124370
\par In our office, we particularly observe the long-term impact of a lack of educational opportunities provided to people with disability who have lived for the majority of their
lives in institutional settings including group homes. We are deeply concerned that people with disability have had limited opportunities to engage in meaningful education that develop their strengths, skills and competencies necessary to enjoy participat
ion and inclusion in the local community.
\par We consider that education provides the means for people with disability to participate in their community and to be safeguarded from violence, abuse, neglect and exploitation. It is our view that there will be poor outcomes for students with disabilities
if an educator cannot provide the supports necessary for student learning and participation, including the creation of satisfying relationships with peers.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid13124370 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13124370 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \cs36\insrsid15730590\charrsid13124370 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid13124370 World Health Organisation, World Report on Disability (2011) 212.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid13124370\charrsid13124370
\par Unfortunately, despite the evidence base and human rights imperative for inclusive education, students with disabilities continue to be excluded from mainstream education in Victoria.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid13124370 \chftn
{\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13124370 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid13124370 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590
Victorian Equal Opportunity & Human Rights Commission, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 Held back: The experiences of students with disabilities in Victorian schools \endash Analysis Paper (State of Victoria, 2017) 2.}}}{\rtlch\fcs1 \af0
\ltrch\fcs0 \insrsid13124370\charrsid13124370 This may occur through the explicit segregation of students with disabilities to a \lquote special\rquote school or class, or their exclusion in mainstream settings, where students with dis
abilities are present within the setting, however they are not treated as valued members of the school community or included alongside their peers. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid13124370 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13124370 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid15730590\charrsid13124370 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Australian Human Rights Commission, }{\rtlch\fcs1 \ai\af47\afs16 \ltrch\fcs0 \i\cf23\insrsid15730590
A future without violence: Quality, safeguarding and oversight to prevent and address violence against people with disability in institutional setting}{\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \cf23\insrsid15730590 s (June 2018) 16.}}}{\rtlch\fcs1 \af0
\ltrch\fcs0 \insrsid13124370\charrsid13124370
\par The exclusion of people with disability from mainstream educational settings is a result of a range of barriers. These barriers to participation include fu
nding limitations, lack of specialist supports, inadequate knowledge and training about disability among teachers, lack of time for teachers to provide an individualised approach for students with disabilities, and discriminatory attitudes.}{\rtlch\fcs1
\af0 \ltrch\fcs0 \cs36\super\insrsid13124370 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6032543 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid13124370 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid15730590 Victorian Equ
al Opportunity & Human Rights Commission, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590 Held back: The experiences of students with disabilities in }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid6032543
Victorian schools - Analysis Paper (State of Victoria, 2017) 2.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13124370\charrsid13124370 When there is a lack of resources or will to implement supports for people with disabilit
y, families may be inclined to seek segregated alternatives.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12006923
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid15730590 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15730590\charrsid15730590
Critically, it appears more effort is required to increase the capacity of educators to make all reasonable adjustments for students with disabilities.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid15730590 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6032543 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid15730590\charrsid6032543 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid6032543 Ibid 7.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15730590\charrsid15730590
This requires education and training to address discriminatory attitudes}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid15730590 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6032543 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid15730590\charrsid6032543 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid15730590\charrsid6032543 Ibid 4.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15730590\charrsid15730590
and it also requires investment to ensure that specialist supports and services }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15730590 -}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15730590\charrsid15730590
including integration aids, occupational therapists and others }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15730590 -}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15730590\charrsid15730590 are proactively used to address matters outside the educators\rquote
expertise.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid15730590\charrsid15730590 Recommendation 29:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15730590\charrsid15730590 Develop and implement a national action plan for inclusive education, to ensure a successful transition from parallel systems of education to one inclusive system of education, as recomm
ended by Children and Young People with Disability Australia in their submission to this Royal Commission.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid6032543 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543 {\*\bkmkstart _Toc45903193}\hich\af1\dbch\af31501\loch\f1 Employment and economic participation
{\*\bkmkend _Toc45903193}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6032543 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543 There are a range of barriers to the meaningful employment and economic participation o
f people with disability. Young people with disability typically have low rates of educational attainment and they may not receive the appropriate supports to prepare for a future career. For example, they may lack work readiness skills typically acquired
through part time work or volunteer work or there may be limited practical assistance with early career job matching and coaching.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid6032543 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11151371 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid6032543\charrsid11151371 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6032543\charrsid11151371 Australian Human Rights Commission, Willing to work: National Inquiry into Employment Discrimination Against Older Australi
ans and Australians with Disability (2016) 202.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543
\par These barriers are compounded by low expectations in the community that people with disability can contribute positively to the workplace and economy. Thus, an employers\rquote perceptions of disability may act a
s a barrier to the employment of people with disability. For example, they may lack awareness about the benefits of employing people with disability or demonstrate bias in recruitment processes. Further, an employer may be uncertain about, or unwilling to
support people with disability through making workplace adjustments.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid6032543 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11151371 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid6032543\charrsid11151371 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6032543\charrsid11151371 Ibid 180.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13124370 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543
Our office is concerned that segregated forms of engagement and employment continue to be the default option for people with disability. Participation in day services can be
a problem when the primary objective is to facilitate community and social participation, rather than skill development for future employment. Our office also notes that individuals working in Australian Disability Enterprises are not being adequately su
pported to transition to open forms of employment, and further, that they may be receiving rates of pay well below the minimum wage.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid6032543 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11151371 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid6032543\charrsid11151371 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6032543\charrsid11151371 Australian Human Rights Commission, Willing to work: National Inquiry into Employment Discrimination Against Older Austral
ians and Australians with Disability (2016) 213.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12006923\charrsid13124370
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6032543 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543
Lower rates of labour market participation as well as lower paying jobs generally are key pathways through which disability may lead to poverty.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid6032543 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11151371 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid6032543\charrsid11151371 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6032543\charrsid11151371 World Health Organisation, World Report on Disability (2011) 235.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543
We are concerned about the flow-on effect of this low income on other parts of an individual\rquote s life, for example, people with disability may lack affordable housing or access to transport, which again creates a cycle of unemployment or underemploy
ment. It also perpetuates a situation where people with disability may be reliant on others, even when those relationships are not safe.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12006923
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid6032543\charrsid6032543 Recommendation 30:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543 Increase supports to enable people with disability to transition from segregated forms of engagemen
t, such as day services or sheltered employment, into open and accessible employment, ensuring individuals receive equal remuneration for work of equal value.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid6032543 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543 {\*\bkmkstart _Toc45903194}\hich\af1\dbch\af31501\loch\f1 Community awareness-raising
{\*\bkmkend _Toc45903194}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6032543 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543 Deinstitutionalisation policies can inadverte
ntly contribute to new forms of segregation and social exclusion whereby people with disability may not feel a valued part of the community, despite their presence in it.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid6032543 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9583102 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \cs36\insrsid6032543\charrsid9583102 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6032543\charrsid9583102 Ilan Wiesel, Christine Bigby & Rachel Carling-Jenkins, \lquote \'94Do you think I\rquote m stupid?\'94
Urban encounters between people with and without intellectual disability (2013) 50 (12) Urban Studies 2391, 2393.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543
For example, the research contracted by our office highlighted that people with disability may feel disrespected when they are faced with a lack of activities in their daily programs that are meaningful and build upon their strengths and interests.}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid6032543 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9583102 \rtlch\fcs1 \af47\afs20\alang1025
\ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid6032543\charrsid9583102 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6032543\charrsid9583102 Sall
y Robinson et al, Building safe and respectful cultures in disability services for people with disability (Report for the Disability Services Commissioner, June 2019) 78.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543
\par The provision of high-quality individualised support that promotes choice and contr
ol is therefore an important precondition for living and fully participating in the community. The emphasis is on fostering a sense of belonging for people with disability, through their interactions in and with the community, for example, with neighbours
, at local clubs, and on public transport.
\par Individualised support is a way to ensure choice and control, however it is important that people with disability are able to access non-disability specific support services and facilities for the general populatio
n in the community, such as hospitals, schools, parks, public libraries, shops, transport, museums, and the Internet.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid6032543 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9583102 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid6032543\charrsid9583102 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6032543\charrsid9583102 Committee on the Rights of Persons with Disabilities, General Comment No 5 (2017) on living independently and being included in the comm
unity, UN Doc CRPD/C/GC/5 (27 October 2017) [32].}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543
Through positive encounters with people in the community, people with disability have the opportunity to extend their social space beyond peers, families and support staff, and to step outside what may be a fixed identity as a \lquote
person with a disability.\rquote }{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid6032543 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9583102
\rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid6032543\charrsid9583102 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6032543\charrsid9583102
Ilan Wiesel, Christine Bigby & Rachel Carling-Jenkins, \lquote \'94Do you think I\rquote m stupid?\'94 Urban encounters between people with and without intellectual disability (2013) 50 (12) Urban Studies 2391, 2403.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid6032543\charrsid6032543 Such encounters will also provide opportunities for the broader community to extend their societal expectations of people with disability beyond that fixed identity.
\par We consider awareness-raising is imperative to challenging stereotypes and negative attitudes to
wards disability and people with disability. Awareness-raising should consist of training across public authorities, the private sector, and through the media about how to address the rights, concerns, and needs of people with disability.}{\rtlch\fcs1
\af0 \ltrch\fcs0 \cs36\super\insrsid6032543 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9583102 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6032543\charrsid9583102 \chftn Catalina Devand
as Aguilar, Report of the Special Rapporteur on the rights of persons with disabilities, UN Doc A/HRC/71/314 (9 August 2016) [74].}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543
The direct involvement of people with disability in these information-sharing campaigns, for example, in hospitals and schools may also alleviate discomfort or fear about disability within the community.
\par Awareness-raising should combat ableism, through the proactive profiling of the capabilities and contributions of people with disability. For many years, our office has been i
nvolved in the national Victorian Advocacy League for Individuals with Disability (VALID) Having a Say Conference, where people with disability share their stories, celebrate their achievements, and obtain information about their rights. We have also part
icipated in ArtAbility, an annual exhibition led by Action on Disability within Ethnic Communities (ADEC) that features artworks by artists who have a disability and are from CALD backgrounds.
\par The profiling of the talents and skills of people with disability does not frequently occur within the mainstream community, and funding is crucial for it to continue. In Victoria, we note the mixed media campaign \lquote Change your reactions\rquote
has encouraged Victorians to learn about and understand the impacts of community actions and reactions in relation to people with autism.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid6032543 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9583102 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid6032543\charrsid9583102 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6032543\charrsid9583102 Autism Change Your Reactions (Web Page) }}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543
Our office considers a targeted nation-wide public education campaign, led by people with disability and their representativ
e organisations, should be resourced to celebrate and develop community awareness about the lived experience of all people with disability.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid6032543\charrsid6032543 Recommendation 31:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6032543\charrsid6032543 Allocate resources towards a nation-wide public education campaign, co-designed with people with
disability and their representative organisations, that promotes human rights and a positive message of disability within the community. This should be complemented by adequate funding of other disability-led conferences and initiatives.}{\rtlch\fcs1
\af0 \ltrch\fcs0 \insrsid6032543
\par }\pard\plain \ltrpar\s32\ql \li0\ri0\sb360\sa240\sl301\slmult0\widctlpar\wrapdefault\faauto\outlinelevel0\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af47\afs30\alang1025 \ltrch\fcs0 \f1\fs48\cf29\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {
\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13320433 {\*\bkmkstart _Toc45903195}5. Intersectionality and disability{\*\bkmkend _Toc45903195}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid13320433\charrsid13320433 Term of Reference (g)
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13320433\charrsid13320433
The specific experiences of violence against, and abuse, neglect and exploitation of, people with disability are multilayered and influenced by experiences associated with their age, sex, gen
der, gender identity, sexual orientation, intersex status, ethnic origin or race, including the particular situation of Aboriginal and Torres Strait Islander people and culturally and linguistically diverse people with disability.
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid13320433 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13320433\charrsid13320433 {\*\bkmkstart _Toc45903196}\hich\af1\dbch\af31501\loch\f1 Intersectiona
\hich\af1\dbch\af31501\loch\f1 l data{\*\bkmkend _Toc45903196}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13320433 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13320433\charrsid13320433
Intersectionality helps us to understand how different sets of identities impact on access to rights and opportunities. People with disability comprise a heterogenous group with a wide range of impairments, as well as identity markers th
at vary according to race, colour, sex, sexual orientation, gender identity, language, religion, national, ethnic, indigenous or social origin, age or other status.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid13320433 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13320433 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \insrsid13320433\charrsid13320433 \chftn }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\insrsid13320433 Convention on the Rights of Persons with Disabilities}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13320433 , opened for signature 30 March 2007
, 2515UNTS 3 (entered into force 3 May 2008) Preamble (p)}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13320433\charrsid13320433
This diversity results in significant variability in the situation and support needs of different groups of people with disability.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid13320433 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13320433 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid13320433 128. Catalina Devandas Aguilar, }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\insrsid13320433 Report of the Special Rapporteur on the rights of persons with disabilities}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13320433
, UN Doc A/HRC/34/58 (20 December 2016) [42]}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13320433\charrsid13320433
\par Disaggregated data enables understanding about the issues that impact particular groups of people with disability. Our office has a strong history of using administrat
ive data to understand the demographics of people with disability receiving disability services, and to inquire into the quality of service delivery. We publicly report upon this data through our annual reporting mechanisms.
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid13320433\charrsid13320433 However, the capacity to use da
ta in our work to more deeply uncover intersectional issues is limited. For example, in 2018-2019 only one out of 100 of the deaths reported to the DSC were of people who had identified as being First Nations, and there were no deaths reported the year pr
ior.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid13320433 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13320433 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid13320433\charrsid13320433 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid13320433 Disability Services Commissioner, }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\insrsid13320433
A review of disability service provision to people who have died 2018-19 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13320433 (2019) 7.}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid13320433\charrsid13320433 }
{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid13320433\charrsid13320433
This low number of deaths impacting First Nations peoples in our data may reflect the low rate at which First Nations people with disability access mainstream disability services, however this is an area that is not well understood, given data collection
relating to First Nations people with disability is particularly limited.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid13320433 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13320433 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid13320433\charrsid13320433 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid13320433 Australian Human Rights Commission, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13320433
A future without violence: Quality, safeguarding and oversight to prevent and address violence against people with disability in institutional settings (June 2018) 16.}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0
\fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid13320433\charrsid13320433
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid13320433\charrsid13320433
We are further concerned that the mortality data for people with disability is not comprehensively recorded or integrated in a consistent way across the different Australian jurisdictions.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid13320433 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13320433 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13320433\charrsid13320433 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid13320433
Carmela Salomon & Julian Trollor, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13320433 \lquote A scoping review of causes and contributors to deaths of people with disability in Australia \endash Findings\rquote
(Department of Developmental Disability Neuropsychiatry UNSW, 19 August 2019) 5.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid13320433\charrsid13320433
A net effect is that the mortality data across states and territories has no
t yet been aggregated to provide national insights or to allow state-based comparisons and understanding about what is working in relation to the wide range of support services and models of disability care.
\par The establishment of the NDIS provides a critical opportunity to implement nationally consistent measures for the collection and integration of disaggregated data specifically focused on the violence, abuse, neglect and exploitation occurring in NDIS fund
ed services. Where data from the NDIS is collected and combined with other data sets, it has potential to ensure continuous policy and system improvement, if it also takes into account data about people with disability who are not NDIS participants.
\par Good quality data and research on disability is essential for providing effective policy and programs.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid13320433 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13320433 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid13320433\charrsid13320433 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid13320433 World Health Organisation, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13320433 WHO Global Disability Action Plan 2014-2021 (2015) 22.}}}{\rtlch\fcs1 \af0\afs12
\ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid13320433\charrsid13320433 }{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid9187727 }{\rtlch\fcs1 \af0 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid13320433\charrsid13320433 If data is to improve the lives of people with disability, it is importan
t that there are effective mechanisms by which disaggregated data can be made publicly available for ethical }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13320433\charrsid13320433
research. Our office is aware of a national coalition of academics and stakeholders who are better positioned to learn from and analyse disaggregated data derived from practice.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid13320433 \chftn {\footnote
\ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13320433 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13320433\charrsid13320433 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid13320433 Melbourne Disability Institute, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13320433
Democratising disability data collection mission statement (Web Page) .}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6445344\charrsid13320433
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid13320433\charrsid13320433 Recommendation 32:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13320433\charrsid13320433 Develop nationally cons
istent measures for the collection of government data that is disaggregated by groups such as First Nations people with disability, women and girls with disability, older people with disability and non-NDIS participants.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid13320433\charrsid13320433 Recommendation 33:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13320433\charrsid13320433 Public reportin
g of data about the incidence and prevalence of violence, abuse, neglect and exploitation occurring in NDIS funded services. NDIA and NDIS Commission data should be linked with }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13320433\charrsid9187727
other key databases and made available for ethical research and intersectional analysis.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13320433
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid9187727 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9187727\charrsid9187727 {\*\bkmkstart _Toc45903197}\hich\af1\dbch\af31501\loch\f1 First Nations people with disability
{\*\bkmkend _Toc45903197}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9187727 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9187727\charrsid9187727 First Nations peoples may experi
ence multiple layers of disadvantage and health disparities, influenced by their experience of discrimination and institutionalisation that limit their opportunities and life outcomes.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9187727 \chftn
{\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9187727 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9187727\charrsid9187727 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9187727 Department of Social Services (Cth), Australian Government plan to im
prove outcomes for Aboriginal and Torres Strait Islander people with disability (2017) 10.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9187727\charrsid9187727
For example, First Nations people with disability as a group experience low levels of educational attainment, low employment and poor health outcomes.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9187727 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9187727 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid9187727\charrsid9187727 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid9187727 Ibid.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9187727\charrsid9187727 This
can occur because they are discriminated against due to multiple aspects of their identity, for being an Indigenous person and a person with a disability}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9187727 .}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid9187727 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9187727 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9187727\charrsid9187727 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid9187727 First Peoples Disability Network, I}{\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid9187727 ntersectional Dimensions on the Right to Health for Indigenous Peoples \endash A Disability Perspective, (February 2016) 2.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9187727\charrsid9187727
\par As discussed in relation to the low representation of First Nations people in our data, our experience is that the kinds of disability-specific supports available, including group homes, may be diffe
rent to what is wanted and accessed by First Nations people with disability. Models of care do not typically reflect whole-of-family and community models that may be suited to First Nations people with disability and their families.}{\rtlch\fcs1 \af0
\ltrch\fcs0 \cs36\super\insrsid9187727 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9187727 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9187727\charrsid9187727 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9187727 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid9187727
Department of Social Services (Cth), }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9187727 Australian Government plan to improve outcomes for Aboriginal and Torres Strait Islander people with disability (2017) 10.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid9187727\charrsid9187727 Current models may fail to be flexible or to provide practical help such as home modifications, flexible respite and community transport.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9187727 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9187727 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \insrsid9187727\charrsid9187727 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9187727 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid9187727 NSW Ombudsman, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9187727
Improving service delivery to Aboriginal people with disability (2010) 20.
\par }}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9187727\charrsid9187727
\par While improvements to the delivery of mainstream and disability services is important, government action should prioritise the development
of culturally appropriate service models, respecting that First Nations peoples be afforded their right to make choices and self-determine their own lives. This requires direct consultation with First Nations peoples, as well as partnering with First Nati
ons staff to elicit their insights about issues in the provision of existing services within the community.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9187727 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9187727 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid9187727\charrsid9187727 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9187727 Ibid 7-9}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9187727\charrsid9187727
\par To increase First Nations peoples\rquote access to services for people with disability, there should be additional resources allocated to supp
ort First Nations people who are willing and interested to undertake training and certification in disability work, and to progress to professional and senior positions.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9187727 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9187727 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \insrsid9187727\charrsid9187727 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9187727 Ibid 12}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9187727\charrsid9187727 Employing First Nations peoples is an effective way that mainstream disabil
ity services can signal their commitment to inclusion of First Nations people with disability.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9187727 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8462528 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid9187727\charrsid9187727 \chftn I}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9187727 bid 12.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9187727
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16014488 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16014488\charrsid16014488
We consider that service providers should undertake critical education and training to develop their capabilities to provide culturally responsive an
d flexible services to First Nations people with disability. For example, the First Peoples Disability Network (FPDN) have developed the resources and workshops centered on \lquote Our Way Planning\rquote
, that can be used by management and staff to better enable First Nations people with disability to identify the types of support they need.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid16014488 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8462528 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid16014488\charrsid8462528 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid16014488 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid16014488 First Peoples Disability Network, }{\rtlch\fcs1 \ai\af47\afs16 \ltrch\fcs0 \i\cf23\insrsid16014488
Our way planning }{\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \cf23\insrsid16014488 (Web Page) .}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16014488
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid16014488\charrsid16014488 Recommendation 34:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16014488\charrsid16014488
Build the capacity of First Nations peoples and their community-controlled organisations to develop service models for the delivery of supports to First Nations people with disability, respecting that First Nations peoples be afforded their right to make
choices and self-determine their own lives.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid16014488\charrsid16014488 Recommendation 35:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16014488\charrsid16014488 Culturally responsive services \endash
Education and training of disability staff in the provision of culturally-responsive services for First Nations people with disability. This education should b
e designed and led by First Nations peoples. The NDIS Commission should consider the circumstances in which this training be mandated. }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16014488
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid8462528 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid16014488\charrsid16014488 {\*\bkmkstart _Toc45903198}
\hich\af1\dbch\af31501\loch\f1 Women and girls with disability}{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid16014488\charrsid16014488 {\*\bkmkend _Toc45903198}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8462528 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid16014488\charrsid16014488 Women and girls with disability are at heightened risk of being
victims of violence, abuse, neglect and exploitation in their various support arrangements compared to the general population, and their experience of violence tends to be more diverse and severe than for women in general.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid8462528 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8462528 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid8462528\charrsid8462528 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid8462528 }{\rtlch\fcs1 \af47 \ltrch\fcs0
\cf1\insrsid8462528 Catalina Devandas Aguilar, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid8462528 Report of the Special Rapporteur on the rights of persons with disabilities, UN Doc A/HRC/34/58 (20 December 2016) [43].}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0
\fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid8462528 }{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16014488\charrsid16014488 }{\rtlch\fcs1 \af0 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16014488\charrsid16014488 This violence may be interpersonal in nature, or it can be institutional and/or structural and used by family members or carers to keep a
woman in a subordinate position compared with other people in her family, household or community.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid8462528 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8462528 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid8462528\charrsid8462528 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid8462528 Committee on the Rights of Persons with Disabilities, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid8462528
General Comment No 3 (2016) on women and girls with disabilities, UN Doc CRPD/C/GC/3 (25 November 2016) [29].}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16014488\charrsid16014488
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid16014488\charrsid16014488 Violence against women who live in institutional settings such as group homes is not always recognised or understood as violence.}{\rtlch\fcs1
\af0 \ltrch\fcs0 \cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid8462528 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8462528
\rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid8462528\charrsid8462528 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid8462528
Carolyn Frohmader, Leanne Dowse & Aminath Didi }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid8462528 Preventing violence against women and girls with disabilities: Integrating a human rights perspective (Women with Disabilities Australia, September 2015) 15.}}}
{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid8462528 }{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16014488\charrsid16014488 }{\rtlch\fcs1 \af0 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16014488\charrsid16014488 This is because current legislative and policy frameworks in Australia may focus on preventing and addressing domestic and family violence that occurs within the
family setting, between former or current spouses and partners.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid8462528 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8462528 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid8462528\charrsid8462528 \chftn Ibid}{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid8462528 9.}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid8462528 }{\rtlch\fcs1 \af0 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16014488\charrsid16014488 While important, this framing is not representative of how violence is experienced by women and girls with disability in a range of settings that they live in and occupy}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \cs46\super\insrsid16014488\charrsid8462528 .}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs46\super\insrsid8462528\charrsid8462528 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8462528 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid8462528\charrsid8462528 \chftn Ibid}{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid8462528 14.}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid16014488
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16014488\charrsid8462528 Our office has observed the specific impacts and normalisation of gender-
based violence in group homes. For example, in 2018-2019, we received an incident report from a casual disability support worker whereby a woman had her pubic hair shaved by staff for the purported health benefit of maintaining hygiene. Our investigation
found this was a routine practice endorsed by the house supervisor for all residents on the basis of staff convenience.
\par Issues in relation to sexual and reproductive rights impacting women are typically not disclosed to our office, however, the review of de
aths provides an opportunity to learn. In one concerning 2018-2019 case, we found that a woman with an intellectual disability had her menstruation suppressed for over thirty years to prevent her perceived distress at bleeding, without the trial of other
less restrictive options. This use of menstrual suppressant drugs, without seeking the consent of the individual, can be shaped by incorrect assumptions that women and girls with disability are incapable of menstrual management.}{\rtlch\fcs1 \af0
\ltrch\fcs0 \cs36\super\insrsid8462528 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8462528 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid8462528\charrsid8462528 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid8462528 Beth Goldblatt & Linda Steele \lquote
Bloody unfair: Inequality related to menstruation- Considering the role of discrimination law\rquote }{\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \cf23\insrsid8462528 (2019) 41 (3) }{\rtlch\fcs1 \ai\af47\afs16 \ltrch\fcs0 \i\cf23\insrsid8462528
Sydney Law Review }{\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \cf23\insrsid8462528 293.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16014488\charrsid8462528
\par Our office has found that women and girls with disability who are subject to family violence may find it difficult to
report violence due to their fear that by reporting, they risk losing supports from that family member, or that they would alternatively be required to adapt to different service providers or living arrangements. This fear may be justified by funding mode
ls such as the NDIS that do not immediately wrap services around people with disability who are in crisis or emergency situations.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid8462528 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8462528 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid8462528\charrsid8462528 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid8462528 Graeme Head (11 February 2020) }{\rtlch\fcs1 \ai\af47\afs16 \ltrch\fcs0 \i\cf23\insrsid8462528
Witness Statement to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability }{\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \cf23\insrsid8462528 [188].}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16014488\charrsid8462528
\par In Victoria, we have observed the effectiveness of the Disability Family Violence Crisis Response Initiative, which provided short-term funds to secure practical supports and crisis accommodation for women and girls with disa
bility impacted by family violence. It is imperative that resourcing allows for contingency funding to be immediately accessible when crises arise. This funding for wrap-around supports could be pre-emptively built into individual NDIS plans or made avail
able through separate funding streams.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid8462528 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8462528
\rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid8462528\charrsid8462528 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid8462528
Office of the Public Advocate, }{\rtlch\fcs1 \ai\af47\afs16 \ltrch\fcs0 \i\cf23\insrsid8462528 \'93I\rquote m too scared to come out of my room\'94: Preventing and responding to violence and abuse between co-residents in group homes }{\rtlch\fcs1
\af47\afs16 \ltrch\fcs0 \cf23\insrsid8462528 (November 2019) 50.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16014488\charrsid8462528
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid16014488\charrsid8462528 Recommendation 36:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16014488\charrsid8462528 Gendered disability violence \endash
Education and training of disability staff about forms of gendered disability violence, abuse, neglect and exploitation experienced by women and girls with disability. The NDIS Commission should consider the circumstances in which this training
be mandated.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid16014488\charrsid8462528 Recommendation 37:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16014488\charrsid8462528
Contingency funding for practical supports and accommodation to be immediately accessible to people with disability who experience crises as a result of their experience of violence, abuse, neglect and exploitation. }{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid16014488
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid13251227 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227\charrsid13251227 {\*\bkmkstart _Toc45903199}
\hich\af1\dbch\af31501\loch\f1 Older people with disability}{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227\charrsid13251227 {\*\bkmkend _Toc45903199}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13251227 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227\charrsid13251227
People with disability experience are at greater risk of experiencing ill health than the general population, for example, they are at increased risk of developing secondary, co-morbid and age-related conditions.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid13251227 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5001872 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13251227\charrsid5001872 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13251227 }{\rtlch\fcs1 \af47 \ltrch\fcs0
\cf1\insrsid13251227 Catalina Devandas Aguilar, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13251227 Report of the Special Rapporteur on the rights of persons with disabilities, UN Doc A/HRC/73/161 (16 July 2018) [5].}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0
\fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227\charrsid13251227 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227\charrsid13251227
This is shaped by issues at the intersection between disability and ageing; older people with disability are more likely to be affected by high levels of poverty, discrimination, violence and social exclusion, as well as barriers to access to health care.
}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid13251227 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5001872 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid13251227\charrsid5001872 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid13251227 Catalina Devandas Aguilar, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13251227 Report of the Special Rapporteur on the rights of persons with disabil
ities, UN Doc A/HRC/74/186 (17 July 2019) [8].}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227\charrsid13251227
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227\charrsid13251227 Despite this issue, disability support workers do not necessarily understand the changes associated with age-related conditions, such as dementia.
}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid13251227 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5001872 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid13251227\charrsid5001872 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid13251227 Ruth Webber, Barbara Bowers & Christine Bigby, \lquote Confidence of group home staff in supporting the health needs of older }{\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid13251227 residents with intellectual disability\rquote (2016) 41(2) Journal of Intellectual & Developmental Disability 107, 107.}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid5001872 }{
\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227\charrsid13251227 For example, we see that falls may be understood by staff as a natural part of ageing, rather than as linked to a deterioration in an individual
\rquote s health. The misconception that \lquote nothing can be done\rquote results in a lack of preventative action.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid13251227 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5001872 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \insrsid13251227\charrsid5001872 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid13251227 Catalina Devandas Aguilar, }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13251227
Report of the Special Rapporteur on the rights of persons with disabilities, UN Doc A/HRC/74/186 (17 July 2019) [21].}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227\charrsid13251227
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227\charrsid13251227
Ageing is a barrier to physical activity for people with disability. Pessimistic beliefs about ageing can contribute to older people with intellectual disability being less physically active than younger counterparts.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid13251227 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5001872 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13251227\charrsid5001872 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid13251227 Carmela Salomon et al, \lquote
A qualitative exploration of barriers and enablers of healthy lifestyle engagement for older Australian }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13251227 with intellectual disabilities\rquote
(2019) 6(2) Research and Practice in Intellectual and Developmental Disabilities 182, 188.}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227 }{\rtlch\fcs1 \af0 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227\charrsid13251227 We observe that the staffing rati
os at day programs and residential settings do not allow for effective individual support to people with disability to engage in physical activity at home or in the community; activities if they occur at all tend to be group-based.
\par Individualised supports
available through the NDIS may help to overcome barriers to the support of older people with disability, given people who start the NDIS before age 65 may choose to keep receiving services under the scheme as they age. Thus, people with disability should
be able to continue to live in their group homes as they age, however this can only practically happen so long as disability support workers are confident and able to support them.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\lang2057\langfe1033\super\langnp2057\langfenp1033\insrsid13251227 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5001872 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13251227\charrsid5001872 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid13251227
Ruth Webber, Barbara Bowers & Christine Bigby, \lquote Confidence of group home staff in supporting the health needs of older }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid13251227 residents with intellectual disability\rquote
(2016) 41(2) Journal of Intellectual & Developmental Disability 107, 108.}}}{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227 }{\rtlch\fcs1 \af0 \ltrch\fcs0
\lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227\charrsid13251227 As mentioned, we do not typically observe this level of skills and confidence.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang2057\langfe1033\langnp2057\langfenp1033\insrsid13251227
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5518317 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5518317\charrsid5518317
The ability of people with disability to age-in-place, if they are not eligible for NDIS or who are over age 65 and reside in group homes, is less clear.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid5518317 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5518317 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \insrsid5518317\charrsid5518317 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid5518317 Rafat Hussain et al, \lquote Perspectives about support challenges facing health workers assisting older adults with and without }{\rtlch\fcs1
\af47 \ltrch\fcs0 \insrsid5518317 intellectual disability in rural versus urban settings in Australia\rquote (2019) 44 (2) }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\insrsid5518317 Journal of Intellectual & Developmental Disability }{\rtlch\fcs1 \af47
\ltrch\fcs0 \insrsid5518317 174, 175.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5518317\charrsid5518317 A common t
ension occurs when people with disability are no longer able to attend day services or supported employment, because of their age, however they do not always receive the support to think about and plan for alternatives. It can also be difficult for people
to access supports and funding for ageing in place given disability support workers are not routinely rostered on in group homes during the day.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid5518317 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5518317 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid5518317\charrsid5518317 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid5518317 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid5518317 Ruth Webber, Barbara Bowers & Christine Bigby, \lquote
Confidence of group home staff in supporting the health needs of older }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid5518317 residents with intellectual disability\rquote (2016) 41(2) }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0 \i\insrsid5518317
Journal of Intellectual & Developmental Disability }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid5518317 107, 107.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5518317
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid5518317\charrsid5518317 Recommendation 38:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5518317\charrsid5518317 Older people with disability \endash Education and training of disability staff in how to support the complex health
needs of people with disability as they develop age-related health conditions. The NDIS Commission should consider the circumstances in which this training be mandated.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5518317
\par }\pard\plain \ltrpar\s32\ql \li0\ri0\sb360\sa240\sl301\slmult0\widctlpar\wrapdefault\faauto\outlinelevel0\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af47\afs30\alang1025 \ltrch\fcs0 \f1\fs48\cf29\lang2057\langfe1033\cgrid\langnp2057\langfenp1033 {
\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid3308888 {\*\bkmkstart _Toc45903200}6. Care and support of people with disability}{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid3308888\charrsid5518317 {\*\bkmkend _Toc45903200}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4158171 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid3308888\charrsid3308888 Term of Reference (h)
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3308888\charrsid3308888 The critical role families, carers, advocates, the workforce and others play in providing care and support to people with disability.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid8462528\charrsid3308888
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid3308888 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3308888\charrsid3308888 {\*\bkmkstart _Toc45903201}\hich\af1\dbch\af31501\loch\f1 Strengthening natural supports
{\*\bkmkend _Toc45903201}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3308888 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3308888\charrsid3308888 The involvement and support of family and other natural suppor
ts is integral to the long-term wellbeing of people with disability, and a critical safeguard in the provision of formal supports and services. When people with disability do not have family or other natural supports in their lives, there is the risk that
they become wholly reliant on service providers, and in some cases an individual support worker, to look out for their day-to-day wellbeing and rights.
\par While stability and consistency in staff teams is important in enabling staff to develop a deeper understanding of individuals with whom they are working,}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid3308888 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3308888 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \insrsid3308888\charrsid3308888 \chftn Sally Robinson et al, Building safe and respectful cultures in disability services for people with disability (Report for the Disability Services Commissioner, June 2019) 106.}}}{\rtlch\fcs1 \af0
\ltrch\fcs0 \insrsid3308888\charrsid3308888 in the event of a problem an individual should have a choice of people with whom they can raise important issues.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid3308888 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3308888 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \cs36\insrsid3308888\charrsid3308888 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid3308888\charrsid3308888 Ibid 103.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3308888 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3308888\charrsid3308888
This requires people with disability to build and maintain trust in a range of relationships, including with family, friends, disability staff and networks in the broader community.
\par In our office, we see a much lower rate of complaint investigations that h
ave originated with people with disability; complaints are more likely to have been raised by family. Families advocate for a range of concerns, such as when their family member did not enjoy an activity, or about more complex, interpersonal issues that a
rise, for example conflict between people using the service.
\par We have referred to some of the challenges that arise for families in relation to supported decision-making and in making complaints to service providers. Families may experience a variety of str
essors that can make it difficult to always support their family member who has a disability. For this reason, they too may benefit from supports, so they are not treated improperly or feel pressured to make a choice, in a range of settings such as hospit
als, schools and residential settings.
\par In addition to individual advocacy options, a Circle of Support is a small group of family, friends, and staff or others, who actively come together to support a person, assisting them to identify what they would like
to do, be and become in their lives. A Circle of Support can reduce uncertainty about an unknown future for an individual with disability, such as with ageing parents and siblings. It can help to reduce the over reliance on one particular member of a fami
ly for the majority of supports.
\par The Microboard model of support may develop or build upon an individual\rquote s Circle of Support, however, in a Microboard the group of supporters form an incorporated association with a formal legal structure that can endure across an individual
\rquote s lifetime.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid3308888 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3308888 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid3308888\charrsid3308888 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid3308888 }{\rtlch\fcs1 \af47 \ltrch\fcs0
\cf1\insrsid3308888 Microboards Australia (Web Page) .}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3308888\charrsid3308888 Notably, the setting up of a Microboard takes a dedication of time and r
esources; for example, people with disability may require support to form a group and supporters may benefit from opportunities to learn about how to implement the principles of supported decision-making.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid3308888\charrsid3308888 Recommendation 39:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3308888\charrsid3308888 Funding to be directed to commu
nity organisations to implement Circles of Support and the Microboard model of support. This should allow for education and training of people with disability, supporters and service providers about principles of supported decision-making.
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid3308888 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3308888\charrsid3308888 {\*\bkmkstart _Toc45903202}\hich\af1\dbch\af31501\loch\f1 A sk\hich\af1\dbch\af31501\loch\f1
illed and safe disability workforce{\*\bkmkend _Toc45903202}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3308888 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3308888\charrsid3308888
An issue with disability services, and shared supported accommodation in particular, is the workforce, which is dispersed, increasingly casualised, often without sufficient training, and relatively lowly paid
. High staff turnover brings disruption to established and valued relationships. Where a group home has a lot of different people working in it, it may become less homely.
\par We have observed that disability support workers may be in a state of constant busyn
ess and stress, due to low staff-to-service user ratios. For example, they may be responsible for providing personal assistance for up to five residents at a time. Beyond this, there are no guidelines for staffing requirements for particular situations, s
uch as when going out into the community or accessing health services, which we have found to contribute to inadequate supervision and preventable deaths of people with disability.
\par }\pard \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6512553 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3308888\charrsid3308888
A lack of staffing can contribute to the violence, abuse, neglect and exploi
tation of people with disability. We see a high number of injuries due to unwitnessed falls, including in client bedrooms and bathrooms. This is indicative that people with disability are not always receiving the support that they require for their activi
ties of daily living. For example, an individual may be provided with sleepover support \endash where help is provided if a need arises during the night \endash when a higher level of }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3308888\charrsid6512553
active night support is actually what is required.
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6512553\charrsid6512553 Staff who have been neglectful or
abusive may be identified as lacking training and experience and have a low level of competence and experience in performing essential care tasks. Insufficient supervision and a lack of reflective practice about how to practice with people\rquote
s needs and hum
an rights in mind, are common and concerning issues. For example, in one 2018-2019 investigation we found that over a one-year duration, a service provider offered supervision to support workers only once for their performance review, and the focus of pro
fessional development was limited to hygiene and handwashing.
\par To be effective, staff need regular opportunities to have a supervisor watch their work and provide modelling and coaching about good practice.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid6512553 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6512553 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid6512553\charrsid6512553 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6512553 Christine Bigby et al, \lquote Quality of practice in supported accommodation services for people with intellectual disabilities: What }{\rtlch\fcs1 \af47 \ltrch\fcs0
\insrsid6512553\charrsid6512553 matters at the organisational level\rquote (2020) Journal of Intellectual & Developmental Disability (advance) 11.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6512553 }{\rtlch\fcs1 \af0 \ltrch\fcs0
\insrsid6512553\charrsid6512553 We also consider that it should not be sufficient for disability s
ervice providers to assume that staff are providing high quality of care, rather this should be evidenced through observational data of staff practice and service user outcomes.
\par It is our view that a human rights approach to education can enable support wo
rkers, house supervisors and managers to be more attuned to the moral dimensions of their practice, including their ways of relating and interacting with people with disability. Indeed, the NDIS Quality and Safeguards Framework recognises such inherent te
nsions that characterise disability work and the balance, even in ordinary activities, of supporting each person\rquote s dignity of risk in decision-making, whilst also safeguarding against the risk of harm.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid6512553 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6512553 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid6512553\charrsid6512553 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6512553 Graeme Head (11 February 2020) Witness Statement to t
he Royal Commission into Violence, Abuse, Neglect and }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6512553\charrsid6512553 Exploitation of People with Disability [285].}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6512553\charrsid6512553
\par The Australian Government is currently developing the NDIS Capability Framework to stipulate how NDIS Practice Standards and associated quality indicators will be translated into observable behaviours that workers should demonstrate.}{\rtlch\fcs1 \af0
\ltrch\fcs0 \cs36\super\insrsid6512553 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6512553 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid6512553\charrsid6512553 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6512553 NDIS Quality and Safeguards Commission, }{\rtlch\fcs1 \af47\afs16
\ltrch\fcs0 \cf23\insrsid6512553 NDIS Workforce Capability Framework (Web Page, 13 April 2020) .}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6512553\charrsid6512553
This framework will inform the development of mandatory education and training that should apply for NDIS service delivery, for example, outlining a core capability set and a complementary set (for specialised supports and services).}{\rtlch\fcs1 \af0
\ltrch\fcs0 \cs36\super\insrsid6512553 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid6512553 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6512553\charrsid6512553 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid6512553 Department of Social Services (Cth) (2019) }{\rtlch\fcs1 \ai\af47\afs16
\ltrch\fcs0 \i\cf23\insrsid6512553 Growing the NDIS Market and Workforce: Supporting the market to deliver innovative, people-centred services so that participants can achieve their goals }{\rtlch\fcs1 \af47\afs16 \ltrch\fcs0 \cf23\insrsid6512553 9.}}}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6512553\charrsid6512553
\par In this submission, we have highlighted core areas of practice th
at we consider should be targeted by the NDIS Commission in their work of building the capacity of NDIS service providers. These areas include person-centred care, communication supports, positive behaviour supports, supported decision-making, end of life
care, health promotion and support for particular groups. We consider that the NDIS Commission should co-design training and resources with people with disability and examine closely the circumstances in which this information is mandated, such as for SDA
providers.
\par While the development of training and resources is critical, the extent to which the NDIS Commission can contribute to upskilling of the disability workforce may be limited by the NDIS pricing structure. Disability service providers have reporte
d that due to inadequate funding levels, they have had to reduce training of staff or provide supervision that is infrequent, irregular, less focused on reflective practice and more task focused.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid5652905
\chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5652905 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid5652905\charrsid5652905 \chftn Sally}{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid5652905 Robinson et al, }{\rtlch\fcs1 \ai\af47 \ltrch\fcs0
\i\insrsid5652905 Building safe and respectful cultures in disability services for people with disability }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid5652905 (Report for the }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid5652905\charrsid5652905
Disability Services Commissioner, June 2019) 108}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6512553\charrsid6512553 Not investing in quality care is counterproductive and not aligned with insurance scheme principles; i
t further contributes to the loss of skilled workers.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid5652905 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid5652905 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid5652905\charrsid5652905 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid5652905 }{\rtlch\fcs1 \af47 \ltrch\fcs0 \cf1\insrsid5652905 Joint Standing Committee on the National Disability Insurance Scheme (Cth), }{\rtlch\fcs1 \ai\af47
\ltrch\fcs0 \i\insrsid5652905 Progress Report }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid5652905 (March 2019) 3.16.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6512553\charrsid6512553
\par We consider that the NDIA should consider how to better reflect in its pricing of supports the additional costs of professional development, and that this training should be continuous throughout all stages of a staff member\rquote
s employment at an organisation. For training to remain front of mind it needs to be embedded in the organisation\rquote s culture, induction processes, at meetings, and at individual or group supervision.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid6512553\charrsid5652905 Recommendation 40:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6512553\charrsid6512553 Human rights approach \endash Education and training of staff in the human rights model of disability. This training should be co-designed by people with disabil
ity and their representative organisations. The NDIS Commission should consider the circumstances in which this training be mandated.
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid6512553\charrsid5652905 Recommendation 41:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6512553\charrsid6512553 That consideration be given to how NDIA pricing of supports can be improved to accommodate the additi
onal administration and professional development costs incurred by disability service providers as a result of operating in an NDIS environment.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6512553
\par }\pard\plain \ltrpar\s41\ql \li0\ri0\sb360\sa240\keep\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0\pararsid9191374 \rtlch\fcs1 \af0\afs26\alang1025 \ltrch\fcs0
\b\fs40\cf25\lang3081\langfe2057\loch\af1\hich\af1\dbch\af31501\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9191374\charrsid9191374 {\*\bkmkstart _Toc45903203}\hich\af1\dbch\af31501\loch\f1 Organisational culture
{\*\bkmkend _Toc45903203}
\par }\pard\plain \ltrpar\s30\ql \li0\ri0\sa120\sl360\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9191374 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \f1\fs24\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9191374\charrsid9191374
Shared supported accommodation is a home for its residents, but it is also a workplace, with its associated routines, rules and regulations. We have found this can sometimes lead to a prioritisation of staff needs and preferences, including staff safety o
r OH&S issues, over the needs and preferences of the residents. In turn, this can lead to a poor culture within services.
\par While residential settings may support a good quality of life for people with disability, there is wide variability in how residential
settings are managed and whether they create an environment that is protective of human rights. Entrenched abuses in service systems and poor evidence of change in response to various inquiries into abuse and neglect indicate that a different approach is
needed.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9191374 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9191374 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid9191374\charrsid9191374 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9191374\charrsid9191374
Sally Robinson et al, Building safe and respectful cultures in disability services for people with disability (Report for the Disability Services Commissioner, June 2019) 26.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9191374\charrsid9191374
\par Under the NDIS Commission\rquote s auditing program, an auditor will invite information about service quality directly from NDIS participants or their natural support networks (with participant consent).}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid9191374 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9191374 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid9191374\charrsid9191374 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9191374\charrsid9191374
Graeme Head (11 February 2020) Witness Statement to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability [142].}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9191374\charrsid9191374
However, we remain cautious that auditing typically focuses upon the degree of compliance with government policy, according to a predetermined set of guidelines and regulations.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9191374 \chftn {\footnote
\ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9191374 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {
\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid9191374\charrsid9191374 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9191374\charrsid9191374 Sally Robinson & Lesley Chenoweth, \lquote Preventing ab
use in accommodation services: From procedural response to protective cultures\rquote (2011) 15(1) Journal of Intellectual Disabilities 63, 69.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9191374\charrsid9191374
This is different to evaluation, which encompass open dialogue and reflection with people with disability about how to improve the quality and effectiveness of supports.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9191374 \chftn {\footnote \ltrpar
\pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9191374 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1
\af47 \ltrch\fcs0 \cs36\insrsid9191374\charrsid9191374 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9191374\charrsid9191374 Ibid.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9191374\charrsid9191374
\par Our office recently undertook a pilot research project, \lquote Building safe and respectful cultures\rquote that aimed to learn more about the culture of services for people with disability and to identify
some practical approaches in primary prevention of abuse.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9191374 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9191374 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid9191374\charrsid9191374 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9191374\charrsid9191374
Sally Robinson et al, Building safe and respectful cultures in disability services for people with disability (Report for the Disability Services Commissioner, June 2019).}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9191374\charrsid9191374
After speaking with pe
ople with disability, family members, staff, and managers we learnt that people with disability felt they had little personal capacity to positively change their circumstances; families and disability support workers similarly lacked agency in their roles
.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9191374 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9191374 \rtlch\fcs1 \af47\afs20\alang1025
\ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid9191374\charrsid9191374 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9191374\charrsid9191374 Ibid 112.}}}{\rtlch\fcs1 \af0
\ltrch\fcs0 \insrsid9191374\charrsid9191374
\par We found that staff and management are typically keen to have more guidance on what they were doing well and what they could improve on in relation to their organisational culture. In our research, it was the development of strong mutually re
warding relationships that was critical to the culture within services. In particular, the community of practice approach and use of music therapy in the workshops created a sense of equality and community and helped all participants to hear perspectives
and concerns from others more clearly.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs46\super\insrsid9191374\charrsid2169741 \chftn {\footnote \ltrpar \pard\plain \ltrpar
\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9191374 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0
\cs36\insrsid9191374\charrsid9191374 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9191374\charrsid9191374 Ibid 130.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9191374\charrsid9191374
\par The research showed that building safe and respectful cultures also requires a focus on learning about the early indicators of concern; including the small indignities and low-level worries impacting people with disability.}{\rtlch\fcs1 \af0 \ltrch\fcs0
\cs36\super\insrsid9191374 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9191374 \rtlch\fcs1 \af47\afs20\alang1025 \ltrch\fcs0
\f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid9191374\charrsid9191374 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9191374\charrsid9191374 \lquote Early indicators of concern\rquote
were developed as part of research in disability services in the United Kingdom to prevent abuse from occurring. The indicators are a tool to record concerns and put them together with other observations to catch concerns early.}}}{\rtlch\fcs1 \af0
\ltrch\fcs0 \insrsid9191374\charrsid9191374 The sharing and discussion
of personal experiences enabled people to recognise potential patterns that should be addressed to improve service delivery as early as possible. It also prompted their action and minimised the likelihood of violence, abuse, neglect and exploitation from
occurring.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \cs36\super\insrsid9191374 \chftn {\footnote \ltrpar \pard\plain \ltrpar\s37\ql \li0\ri0\sa120\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid9191374 \rtlch\fcs1
\af47\afs20\alang1025 \ltrch\fcs0 \f1\fs16\cf25\lang3081\langfe2057\cgrid\langnp3081\langfenp2057 {\rtlch\fcs1 \af47 \ltrch\fcs0 \cs36\insrsid9191374\charrsid9191374 \chftn }{\rtlch\fcs1 \af47 \ltrch\fcs0 \insrsid9191374\charrsid9191374
Sally Robinson et al, Building safe and respectful cultures in disability services for people with disability (Report for the Disability Services Commissioner, June 2019) 130.}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6512553\charrsid9191374
\par }{\rtlch\fcs1 \ab0\af0 \ltrch\fcs0 \b\insrsid9191374\charrsid9191374 Recommendation 42:
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9191374\charrsid9191374 That the NDIS Commission consider highlighting
the report by our office, Building safe and respectful cultures as a community of practice approach and collaborative methodology that can be used to improve organisational culture within disability services, and to identify and address early indicators
of violence, abuse, neglect and exploitation.
\par This is the end of the document.
\par }{\*\themedata 504b030414000600080000002100e9de0fbfff0000001c020000130000005b436f6e74656e745f54797065735d2e786d6cac91cb4ec3301045f748fc83e52d4a
9cb2400825e982c78ec7a27cc0c8992416c9d8b2a755fbf74cd25442a820166c2cd933f79e3be372bd1f07b5c3989ca74aaff2422b24eb1b475da5df374fd9ad
5689811a183c61a50f98f4babebc2837878049899a52a57be670674cb23d8e90721f90a4d2fa3802cb35762680fd800ecd7551dc18eb899138e3c943d7e503b6
b01d583deee5f99824e290b4ba3f364eac4a430883b3c092d4eca8f946c916422ecab927f52ea42b89a1cd59c254f919b0e85e6535d135a8de20f20b8c12c3b0
0c895fcf6720192de6bf3b9e89ecdbd6596cbcdd8eb28e7c365ecc4ec1ff1460f53fe813d3cc7f5b7f020000ffff0300504b030414000600080000002100a5d6
a7e7c0000000360100000b0000005f72656c732f2e72656c73848fcf6ac3300c87ef85bd83d17d51d2c31825762fa590432fa37d00e1287f68221bdb1bebdb4f
c7060abb0884a4eff7a93dfeae8bf9e194e720169aaa06c3e2433fcb68e1763dbf7f82c985a4a725085b787086a37bdbb55fbc50d1a33ccd311ba548b6309512
0f88d94fbc52ae4264d1c910d24a45db3462247fa791715fd71f989e19e0364cd3f51652d73760ae8fa8c9ffb3c330cc9e4fc17faf2ce545046e37944c69e462
a1a82fe353bd90a865aad41ed0b5b8f9d6fd010000ffff0300504b0304140006000800000021006b799616830000008a0000001c0000007468656d652f746865
6d652f7468656d654d616e616765722e786d6c0ccc4d0ac3201040e17da17790d93763bb284562b2cbaebbf600439c1a41c7a0d29fdbd7e5e38337cedf14d59b
4b0d592c9c070d8a65cd2e88b7f07c2ca71ba8da481cc52c6ce1c715e6e97818c9b48d13df49c873517d23d59085adb5dd20d6b52bd521ef2cdd5eb9246a3d8b
4757e8d3f729e245eb2b260a0238fd010000ffff0300504b030414000600080000002100b6f4679893070000c9200000160000007468656d652f7468656d652f
7468656d65312e786d6cec59cd8b1bc915bf07f23f347d97f5d5ad8fc1f2a24fcfda33b6b164873dd648a5eef2547789aad28cc56208de532e81c026e49085bd
ed21842cecc22eb9e48f31d8249b3f22afaa5bdd5552c99e191c3061463074977eefd5afde7bf5de53d5ddcf5e26d4bbc05c1096f6fcfa9d9aefe174ce16248d
7afeb3d9a4d2f13d2151ba4094a5b8e76fb0f03fbbf7eb5fdd454732c609f6403e1547a8e7c752ae8eaa5531876124eeb0154ee1bb25e30992f0caa3ea82a34b
d09bd06aa3566b55134452df4b51026a1f2f97648ebd9952e9dfdb2a1f53784da5500373caa74a35b6243476715e5708b11143cabd0b447b3eccb3609733fc52
fa1e4542c2173dbfa6fffceabdbb5574940b517940d6909be8bf5c2e17589c37f49c3c3a2b260d823068f50bfd1a40e53e6edc1eb7c6ad429f06a0f91c569a71
b175b61bc320c71aa0ecd1a17bd41e35eb16ded0dfdce3dc0fd5c7c26b50a63fd8c34f2643b0a285d7a00c1feee1c3417730b2f56b50866fede1dbb5fe28685b
fa3528a6243ddf43d7c25673b85d6d0159327aec8477c360d26ee4ca4b144443115d6a8a254be5a1584bd00bc6270050408a24493db959e1259a43140f112567
9c7827248a21f056286502866b8ddaa4d684ffea13e827ed5174849121ad780113b137a4f87862cec94af6fc07a0d537206f7ffef9cdeb1fdfbcfee9cd575fbd
79fdf77c6eadca923b466964cafdf2dd1ffef3cd6fbd7ffff0ed2f5fff319b7a172f4cfcbbbffdeedd3ffef93ef5b0e2d2146ffff4fdbb1fbf7ffbe7dfffebaf
5f3bb4f7393a33e1339260e13dc297de5396c0021dfcf119bf9ec42c46c494e8a791402952b338f48f656ca11f6d10450edc00db767cce21d5b880f7d72f2cc2
d398af2571687c182716f094313a60dc6985876a2ec3ccb3751ab927e76b13f714a10bd7dc43945a5e1eaf579063894be530c616cd2714a5124538c5d253dfb1
738c1dabfb8210cbaea764ce99604be97d41bc01224e93ccc899154da5d03149c02f1b1741f0b7659bd3e7de8051d7aa47f8c246c2de40d4417e86a965c6fb68
2d51e252394309350d7e8264ec2239ddf0b9891b0b099e8e3065de78818570c93ce6b05ec3e90f21cdb8dd7e4a37898de4929cbb749e20c64ce4889d0f6394ac
5cd829496313fbb938871045de13265df05366ef10f50e7e40e941773f27d872f787b3c133c8b026a53240d4376beef0e57dccacf89d6ee8126157aae9f3c44a
b17d4e9cd131584756689f604cd1255a60ec3dfbdcc160c05696cd4bd20f62c82ac7d815580f901dabea3dc5027a25d5dcece7c91322ac909de2881de073bad9
493c1b9426881fd2fc08bc6eda7c0ca52e7105c0633a3f37818f08f480102f4ea33c16a0c308ee835a9fc4c82a60ea5db8e375c32dff5d658fc1be7c61d1b8c2
be04197c6d1948eca6cc7b6d3343d49aa00c9819822ec3956e41c4727f29a28aab165b3be596f6a62ddd00dd91d5f42424fd6007b4d3fb84ffbbde073a8cb77f
f9c6b10f3e4ebfe3566c25ab6b763a8792c9f14e7f7308b7dbd50c195f904fbfa919a175fa04431dd9cf58b73dcd6d4fe3ffdff73487f6f36d2773a8dfb8ed64
7ce8306e3b99fc70e5e3743265f3027d8d3af0c80e7af4b14f72f0d46749289dca0dc527421ffc08f83db398c0a092d3279eb838055cc5f0a8ca1c4c60e1228e
b48cc799fc0d91f134462b381daafb4a492472d591f0564cc0a1911e76ea5678ba4e4ed9223becacd7d5c16656590592e5782d2cc6e1a04a66e856bb3cc02bd4
6bb6913e68dd1250b2d721614c6693683a48b4b783ca48fa58178ce620a157f65158741d2c3a4afdd6557b2c805ae115f8c1edc1cff49e1f06200242701e07cd
f942f92973f5d6bbda991fd3d3878c69450034d8db08283ddd555c0f2e4fad2e0bb52b78da2261849b4d425b46377822869fc17974aad1abd0b8aeafbba54b2d
7aca147a3e08ad9246bbf33e1637f535c8ede6069a9a9982a6de65cf6f35430899395af5fc251c1ac363b282d811ea3717a211dcbccc25cf36fc4d32cb8a0b39
4222ce0cae934e960d122231f728497abe5a7ee1069aea1ca2b9d51b90103e59725d482b9f1a3970baed64bc5ce2b934dd6e8c284b67af90e1b35ce1fc568bdf
1cac24d91adc3d8d1797de195df3a708422c6cd795011744c0dd413db3e682c0655891c8caf8db294c79da356fa3740c65e388ae62945714339967709dca0b3a
faadb081f196af190c6a98242f8467912ab0a651ad6a5a548d8cc3c1aafb6121653923699635d3ca2aaa6abab39835c3b60cecd8f26645de60b53531e434b3c2
67a97b37e576b7b96ea74f28aa0418bcb09fa3ea5ea12018d4cac92c6a8af17e1a56393b1fb56bc776811fa07695226164fdd656ed8edd8a1ae19c0e066f54f9
416e376a6168b9ed2bb5a5f5adb979b1cdce5e40f2184197bba6526857c2c92e47d0104d754f92a50dd8222f65be35e0c95b73d2f3bfac85fd60d80887955a27
1c57826650ab74c27eb3d20fc3667d1cd66ba341e31514161927f530bbb19fc00506dde4f7f67a7cefee3ed9ded1dc99b3a4caf4dd7c5513d777f7f5c6e1bb7b
8f40d2f9b2d598749bdd41abd26df627956034e854bac3d6a0326a0ddba3c9681876ba9357be77a1c141bf390c5ae34ea5551f0e2b41aba6e877ba9576d068f4
8376bf330efaaff23606569ea58fdc16605ecdebde7f010000ffff0300504b0304140006000800000021000dd1909fb60000001b010000270000007468656d65
2f7468656d652f5f72656c732f7468656d654d616e616765722e786d6c2e72656c73848f4d0ac2301484f78277086f6fd3ba109126dd88d0add40384e4350d36
3f2451eced0dae2c082e8761be9969bb979dc9136332de3168aa1a083ae995719ac16db8ec8e4052164e89d93b64b060828e6f37ed1567914b284d262452282e
3198720e274a939cd08a54f980ae38a38f56e422a3a641c8bbd048f7757da0f19b017cc524bd62107bd5001996509affb3fd381a89672f1f165dfe514173d985
0528a2c6cce0239baa4c04ca5bbabac4df000000ffff0300504b01022d0014000600080000002100e9de0fbfff0000001c020000130000000000000000000000
0000000000005b436f6e74656e745f54797065735d2e786d6c504b01022d0014000600080000002100a5d6a7e7c0000000360100000b00000000000000000000
000000300100005f72656c732f2e72656c73504b01022d00140006000800000021006b799616830000008a0000001c0000000000000000000000000019020000
7468656d652f7468656d652f7468656d654d616e616765722e786d6c504b01022d0014000600080000002100b6f4679893070000c92000001600000000000000
000000000000d60200007468656d652f7468656d652f7468656d65312e786d6c504b01022d00140006000800000021000dd1909fb60000001b01000027000000
000000000000000000009d0a00007468656d652f7468656d652f5f72656c732f7468656d654d616e616765722e786d6c2e72656c73504b050600000000050005005d010000980b00000000}
{\*\colorschememapping 3c3f786d6c2076657273696f6e3d22312e302220656e636f64696e673d225554462d3822207374616e64616c6f6e653d22796573223f3e0d0a3c613a636c724d
617020786d6c6e733a613d22687474703a2f2f736368656d61732e6f70656e786d6c666f726d6174732e6f72672f64726177696e676d6c2f323030362f6d6169
6e22206267313d226c743122207478313d22646b3122206267323d226c743222207478323d22646b322220616363656e74313d22616363656e74312220616363
656e74323d22616363656e74322220616363656e74333d22616363656e74332220616363656e74343d22616363656e74342220616363656e74353d22616363656e74352220616363656e74363d22616363656e74362220686c696e6b3d22686c696e6b2220666f6c486c696e6b3d22666f6c486c696e6b222f3e}
{\*\latentstyles\lsdstimax376\lsdlockeddef0\lsdsemihiddendef0\lsdunhideuseddef0\lsdqformatdef0\lsdprioritydef99{\lsdlockedexcept \lsdqformat1 \lsdpriority0 \lsdlocked0 Normal;\lsdqformat1 \lsdpriority9 \lsdlocked0 heading 1;
\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority9 \lsdlocked0 heading 2;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority9 \lsdlocked0 heading 3;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority9 \lsdlocked0 heading 4;
\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority9 \lsdlocked0 heading 5;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority9 \lsdlocked0 heading 6;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority9 \lsdlocked0 heading 7;
\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority9 \lsdlocked0 heading 8;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority9 \lsdlocked0 heading 9;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 1;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 3;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 4;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 5;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 6;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 7;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 8;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 9;
\lsdsemihidden1 \lsdunhideused1 \lsdpriority39 \lsdlocked0 toc 1;\lsdsemihidden1 \lsdunhideused1 \lsdpriority39 \lsdlocked0 toc 2;\lsdsemihidden1 \lsdunhideused1 \lsdpriority39 \lsdlocked0 toc 3;
\lsdsemihidden1 \lsdunhideused1 \lsdpriority39 \lsdlocked0 toc 4;\lsdsemihidden1 \lsdunhideused1 \lsdpriority39 \lsdlocked0 toc 5;\lsdsemihidden1 \lsdunhideused1 \lsdpriority39 \lsdlocked0 toc 6;
\lsdsemihidden1 \lsdunhideused1 \lsdpriority39 \lsdlocked0 toc 7;\lsdsemihidden1 \lsdunhideused1 \lsdpriority39 \lsdlocked0 toc 8;\lsdsemihidden1 \lsdunhideused1 \lsdpriority39 \lsdlocked0 toc 9;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Normal Indent;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 footnote text;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 annotation text;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 header;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 footer;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index heading;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority35 \lsdlocked0 caption;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 table of figures;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 envelope address;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 envelope return;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 footnote reference;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 annotation reference;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 line number;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 page number;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 endnote reference;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 endnote text;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 table of authorities;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 macro;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 toa heading;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Bullet;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Number;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List 3;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List 4;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List 5;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Bullet 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Bullet 3;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Bullet 4;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Bullet 5;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Number 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Number 3;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Number 4;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Number 5;\lsdqformat1 \lsdpriority10 \lsdlocked0 Title;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Closing;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Signature;\lsdsemihidden1 \lsdunhideused1 \lsdpriority1 \lsdlocked0 Default Paragraph Font;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text Indent;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Continue;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Continue 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Continue 3;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Continue 4;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Continue 5;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Message Header;\lsdqformat1 \lsdpriority11 \lsdlocked0 Subtitle;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Salutation;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Date;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text First Indent;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text First Indent 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Note Heading;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text 3;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text Indent 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text Indent 3;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Block Text;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Hyperlink;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 FollowedHyperlink;\lsdqformat1 \lsdpriority22 \lsdlocked0 Strong;
\lsdqformat1 \lsdpriority20 \lsdlocked0 Emphasis;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Document Map;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Plain Text;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 E-mail Signature;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Top of Form;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Bottom of Form;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Normal (Web);\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Acronym;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Address;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Cite;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Code;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Definition;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Keyboard;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Preformatted;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Sample;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Typewriter;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Variable;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 annotation subject;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 No List;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Outline List 1;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Outline List 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Outline List 3;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Balloon Text;\lsdpriority39 \lsdlocked0 Table Grid;
\lsdsemihidden1 \lsdlocked0 Placeholder Text;\lsdqformat1 \lsdpriority1 \lsdlocked0 No Spacing;\lsdpriority60 \lsdlocked0 Light Shading;\lsdpriority61 \lsdlocked0 Light List;\lsdpriority62 \lsdlocked0 Light Grid;
\lsdpriority63 \lsdlocked0 Medium Shading 1;\lsdpriority64 \lsdlocked0 Medium Shading 2;\lsdpriority65 \lsdlocked0 Medium List 1;\lsdpriority66 \lsdlocked0 Medium List 2;\lsdpriority67 \lsdlocked0 Medium Grid 1;\lsdpriority68 \lsdlocked0 Medium Grid 2;
\lsdpriority69 \lsdlocked0 Medium Grid 3;\lsdpriority70 \lsdlocked0 Dark List;\lsdpriority71 \lsdlocked0 Colorful Shading;\lsdpriority72 \lsdlocked0 Colorful List;\lsdpriority73 \lsdlocked0 Colorful Grid;\lsdpriority60 \lsdlocked0 Light Shading Accent 1;
\lsdpriority61 \lsdlocked0 Light List Accent 1;\lsdpriority62 \lsdlocked0 Light Grid Accent 1;\lsdpriority63 \lsdlocked0 Medium Shading 1 Accent 1;\lsdpriority64 \lsdlocked0 Medium Shading 2 Accent 1;\lsdpriority65 \lsdlocked0 Medium List 1 Accent 1;
\lsdsemihidden1 \lsdlocked0 Revision;\lsdqformat1 \lsdpriority34 \lsdlocked0 List Paragraph;\lsdqformat1 \lsdpriority29 \lsdlocked0 Quote;\lsdqformat1 \lsdpriority30 \lsdlocked0 Intense Quote;\lsdpriority66 \lsdlocked0 Medium List 2 Accent 1;
\lsdpriority67 \lsdlocked0 Medium Grid 1 Accent 1;\lsdpriority68 \lsdlocked0 Medium Grid 2 Accent 1;\lsdpriority69 \lsdlocked0 Medium Grid 3 Accent 1;\lsdpriority70 \lsdlocked0 Dark List Accent 1;\lsdpriority71 \lsdlocked0 Colorful Shading Accent 1;
\lsdpriority72 \lsdlocked0 Colorful List Accent 1;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 1;\lsdpriority60 \lsdlocked0 Light Shading Accent 2;\lsdpriority61 \lsdlocked0 Light List Accent 2;\lsdpriority62 \lsdlocked0 Light Grid Accent 2;
\lsdpriority63 \lsdlocked0 Medium Shading 1 Accent 2;\lsdpriority64 \lsdlocked0 Medium Shading 2 Accent 2;\lsdpriority65 \lsdlocked0 Medium List 1 Accent 2;\lsdpriority66 \lsdlocked0 Medium List 2 Accent 2;
\lsdpriority67 \lsdlocked0 Medium Grid 1 Accent 2;\lsdpriority68 \lsdlocked0 Medium Grid 2 Accent 2;\lsdpriority69 \lsdlocked0 Medium Grid 3 Accent 2;\lsdpriority70 \lsdlocked0 Dark List Accent 2;\lsdpriority71 \lsdlocked0 Colorful Shading Accent 2;
\lsdpriority72 \lsdlocked0 Colorful List Accent 2;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 2;\lsdpriority60 \lsdlocked0 Light Shading Accent 3;\lsdpriority61 \lsdlocked0 Light List Accent 3;\lsdpriority62 \lsdlocked0 Light Grid Accent 3;
\lsdpriority63 \lsdlocked0 Medium Shading 1 Accent 3;\lsdpriority64 \lsdlocked0 Medium Shading 2 Accent 3;\lsdpriority65 \lsdlocked0 Medium List 1 Accent 3;\lsdpriority66 \lsdlocked0 Medium List 2 Accent 3;
\lsdpriority67 \lsdlocked0 Medium Grid 1 Accent 3;\lsdpriority68 \lsdlocked0 Medium Grid 2 Accent 3;\lsdpriority69 \lsdlocked0 Medium Grid 3 Accent 3;\lsdpriority70 \lsdlocked0 Dark List Accent 3;\lsdpriority71 \lsdlocked0 Colorful Shading Accent 3;
\lsdpriority72 \lsdlocked0 Colorful List Accent 3;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 3;\lsdpriority60 \lsdlocked0 Light Shading Accent 4;\lsdpriority61 \lsdlocked0 Light List Accent 4;\lsdpriority62 \lsdlocked0 Light Grid Accent 4;
\lsdpriority63 \lsdlocked0 Medium Shading 1 Accent 4;\lsdpriority64 \lsdlocked0 Medium Shading 2 Accent 4;\lsdpriority65 \lsdlocked0 Medium List 1 Accent 4;\lsdpriority66 \lsdlocked0 Medium List 2 Accent 4;
\lsdpriority67 \lsdlocked0 Medium Grid 1 Accent 4;\lsdpriority68 \lsdlocked0 Medium Grid 2 Accent 4;\lsdpriority69 \lsdlocked0 Medium Grid 3 Accent 4;\lsdpriority70 \lsdlocked0 Dark List Accent 4;\lsdpriority71 \lsdlocked0 Colorful Shading Accent 4;
\lsdpriority72 \lsdlocked0 Colorful List Accent 4;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 4;\lsdpriority60 \lsdlocked0 Light Shading Accent 5;\lsdpriority61 \lsdlocked0 Light List Accent 5;\lsdpriority62 \lsdlocked0 Light Grid Accent 5;
\lsdpriority63 \lsdlocked0 Medium Shading 1 Accent 5;\lsdpriority64 \lsdlocked0 Medium Shading 2 Accent 5;\lsdpriority65 \lsdlocked0 Medium List 1 Accent 5;\lsdpriority66 \lsdlocked0 Medium List 2 Accent 5;
\lsdpriority67 \lsdlocked0 Medium Grid 1 Accent 5;\lsdpriority68 \lsdlocked0 Medium Grid 2 Accent 5;\lsdpriority69 \lsdlocked0 Medium Grid 3 Accent 5;\lsdpriority70 \lsdlocked0 Dark List Accent 5;\lsdpriority71 \lsdlocked0 Colorful Shading Accent 5;
\lsdpriority72 \lsdlocked0 Colorful List Accent 5;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 5;\lsdpriority60 \lsdlocked0 Light Shading Accent 6;\lsdpriority61 \lsdlocked0 Light List Accent 6;\lsdpriority62 \lsdlocked0 Light Grid Accent 6;
\lsdpriority63 \lsdlocked0 Medium Shading 1 Accent 6;\lsdpriority64 \lsdlocked0 Medium Shading 2 Accent 6;\lsdpriority65 \lsdlocked0 Medium List 1 Accent 6;\lsdpriority66 \lsdlocked0 Medium List 2 Accent 6;
\lsdpriority67 \lsdlocked0 Medium Grid 1 Accent 6;\lsdpriority68 \lsdlocked0 Medium Grid 2 Accent 6;\lsdpriority69 \lsdlocked0 Medium Grid 3 Accent 6;\lsdpriority70 \lsdlocked0 Dark List Accent 6;\lsdpriority71 \lsdlocked0 Colorful Shading Accent 6;
\lsdpriority72 \lsdlocked0 Colorful List Accent 6;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 6;\lsdqformat1 \lsdpriority19 \lsdlocked0 Subtle Emphasis;\lsdqformat1 \lsdpriority21 \lsdlocked0 Intense Emphasis;
\lsdqformat1 \lsdpriority31 \lsdlocked0 Subtle Reference;\lsdqformat1 \lsdpriority32 \lsdlocked0 Intense Reference;\lsdqformat1 \lsdpriority33 \lsdlocked0 Book Title;\lsdsemihidden1 \lsdunhideused1 \lsdpriority37 \lsdlocked0 Bibliography;
\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority39 \lsdlocked0 TOC Heading;\lsdpriority41 \lsdlocked0 Plain Table 1;\lsdpriority42 \lsdlocked0 Plain Table 2;\lsdpriority43 \lsdlocked0 Plain Table 3;\lsdpriority44 \lsdlocked0 Plain Table 4;
\lsdpriority45 \lsdlocked0 Plain Table 5;\lsdpriority40 \lsdlocked0 Grid Table Light;\lsdpriority46 \lsdlocked0 Grid Table 1 Light;\lsdpriority47 \lsdlocked0 Grid Table 2;\lsdpriority48 \lsdlocked0 Grid Table 3;\lsdpriority49 \lsdlocked0 Grid Table 4;
\lsdpriority50 \lsdlocked0 Grid Table 5 Dark;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful;\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful;\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 1;\lsdpriority47 \lsdlocked0 Grid Table 2 Accent 1;
\lsdpriority48 \lsdlocked0 Grid Table 3 Accent 1;\lsdpriority49 \lsdlocked0 Grid Table 4 Accent 1;\lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 1;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 1;
\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful Accent 1;\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 2;\lsdpriority47 \lsdlocked0 Grid Table 2 Accent 2;\lsdpriority48 \lsdlocked0 Grid Table 3 Accent 2;
\lsdpriority49 \lsdlocked0 Grid Table 4 Accent 2;\lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 2;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 2;\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful Accent 2;
\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 3;\lsdpriority47 \lsdlocked0 Grid Table 2 Accent 3;\lsdpriority48 \lsdlocked0 Grid Table 3 Accent 3;\lsdpriority49 \lsdlocked0 Grid Table 4 Accent 3;
\lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 3;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 3;\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful Accent 3;\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 4;
\lsdpriority47 \lsdlocked0 Grid Table 2 Accent 4;\lsdpriority48 \lsdlocked0 Grid Table 3 Accent 4;\lsdpriority49 \lsdlocked0 Grid Table 4 Accent 4;\lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 4;
\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 4;\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful Accent 4;\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 5;\lsdpriority47 \lsdlocked0 Grid Table 2 Accent 5;
\lsdpriority48 \lsdlocked0 Grid Table 3 Accent 5;\lsdpriority49 \lsdlocked0 Grid Table 4 Accent 5;\lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 5;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 5;
\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful Accent 5;\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 6;\lsdpriority47 \lsdlocked0 Grid Table 2 Accent 6;\lsdpriority48 \lsdlocked0 Grid Table 3 Accent 6;
\lsdpriority49 \lsdlocked0 Grid Table 4 Accent 6;\lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 6;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 6;\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful Accent 6;
\lsdpriority46 \lsdlocked0 List Table 1 Light;\lsdpriority47 \lsdlocked0 List Table 2;\lsdpriority48 \lsdlocked0 List Table 3;\lsdpriority49 \lsdlocked0 List Table 4;\lsdpriority50 \lsdlocked0 List Table 5 Dark;
\lsdpriority51 \lsdlocked0 List Table 6 Colorful;\lsdpriority52 \lsdlocked0 List Table 7 Colorful;\lsdpriority46 \lsdlocked0 List Table 1 Light Accent 1;\lsdpriority47 \lsdlocked0 List Table 2 Accent 1;\lsdpriority48 \lsdlocked0 List Table 3 Accent 1;
\lsdpriority49 \lsdlocked0 List Table 4 Accent 1;\lsdpriority50 \lsdlocked0 List Table 5 Dark Accent 1;\lsdpriority51 \lsdlocked0 List Table 6 Colorful Accent 1;\lsdpriority52 \lsdlocked0 List Table 7 Colorful Accent 1;
\lsdpriority46 \lsdlocked0 List Table 1 Light Accent 2;\lsdpriority47 \lsdlocked0 List Table 2 Accent 2;\lsdpriority48 \lsdlocked0 List Table 3 Accent 2;\lsdpriority49 \lsdlocked0 List Table 4 Accent 2;
\lsdpriority50 \lsdlocked0 List Table 5 Dark Accent 2;\lsdpriority51 \lsdlocked0 List Table 6 Colorful Accent 2;\lsdpriority52 \lsdlocked0 List Table 7 Colorful Accent 2;\lsdpriority46 \lsdlocked0 List Table 1 Light Accent 3;
\lsdpriority47 \lsdlocked0 List Table 2 Accent 3;\lsdpriority48 \lsdlocked0 List Table 3 Accent 3;\lsdpriority49 \lsdlocked0 List Table 4 Accent 3;\lsdpriority50 \lsdlocked0 List Table 5 Dark Accent 3;
\lsdpriority51 \lsdlocked0 List Table 6 Colorful Accent 3;\lsdpriority52 \lsdlocked0 List Table 7 Colorful Accent 3;\lsdpriority46 \lsdlocked0 List Table 1 Light Accent 4;\lsdpriority47 \lsdlocked0 List Table 2 Accent 4;
\lsdpriority48 \lsdlocked0 List Table 3 Accent 4;\lsdpriority49 \lsdlocked0 List Table 4 Accent 4;\lsdpriority50 \lsdlocked0 List Table 5 Dark Accent 4;\lsdpriority51 \lsdlocked0 List Table 6 Colorful Accent 4;
\lsdpriority52 \lsdlocked0 List Table 7 Colorful Accent 4;\lsdpriority46 \lsdlocked0 List Table 1 Light Accent 5;\lsdpriority47 \lsdlocked0 List Table 2 Accent 5;\lsdpriority48 \lsdlocked0 List Table 3 Accent 5;
\lsdpriority49 \lsdlocked0 List Table 4 Accent 5;\lsdpriority50 \lsdlocked0 List Table 5 Dark Accent 5;\lsdpriority51 \lsdlocked0 List Table 6 Colorful Accent 5;\lsdpriority52 \lsdlocked0 List Table 7 Colorful Accent 5;
\lsdpriority46 \lsdlocked0 List Table 1 Light Accent 6;\lsdpriority47 \lsdlocked0 List Table 2 Accent 6;\lsdpriority48 \lsdlocked0 List Table 3 Accent 6;\lsdpriority49 \lsdlocked0 List Table 4 Accent 6;
\lsdpriority50 \lsdlocked0 List Table 5 Dark Accent 6;\lsdpriority51 \lsdlocked0 List Table 6 Colorful Accent 6;\lsdpriority52 \lsdlocked0 List Table 7 Colorful Accent 6;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Mention;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Smart Hyperlink;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Hashtag;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Unresolved Mention;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Smart Link;}}{\*\datastore }}