National Disability Agreement: Performance report for 2009�10 by HC120929025331

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									Executive Summary
 Key points
     There is a lack of new data to report meaningfully on progress toward meeting the
      objective and three outcomes agreed under the National Disability Agreement. There are
      still a number of performance benchmarks and performance indicators for which no
      measures have been agreed.
     New data will be available for the council’s 2010-11 report, which will allow the council
      to better assess change in performance under a number of indicators.
     In this report, data available for a new measure found that people with disability had
      lower rates of face-to-face contact with others compared with people without disability.
     People born in non-English speaking countries were much more likely to report being
      housebound by their disability, and were less likely to receive income support, than
      people with disability born in Australia.


National Disability Agreement: Performance report for 2009-10
The overarching objective of the National Disability Agreement is that people with disability
and their carers have an enhanced quality of life and participate as valued members of the
community.

The COAG Reform Council (the council) is responsible for publicly reporting on the
performance of governments against the objectives and outcomes of the agreement. The council
reports directly to COAG and is independent of individual governments.

This is the council’s second year report on the National Disability Agreement. It focuses on
reporting jurisdictional progress against the agreed objectives and outcomes compared to the
baseline data summarised in the 2008-09 performance report.

In this second year report, the council finds that out-of-date data for some indicators, the lack of
any data for a number of further indicators, and the absence of agreed measures for others, make
it difficult to determine whether progress has been made toward meeting COAG’s overall
objective. The council noted in its 2008-09 baseline report that options for the provision of more
frequent survey data are being explored, and this should remain a priority.

There are three outcomes under the National Disability Agreement (Box 1).

Box 1             National Disability Agreement: outcomes

     People with disability achieve economic participation and social inclusion;

     People with disability enjoy choice, wellbeing and the opportunity to live as independently
      as possible; and

     Families and carers are well supported.




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Chapters 2 to 4 report performance information for each of these outcomes and related
performance indicators. The following points summarise key findings from each chapter.


Future data will enhance reporting about whether people with disability
achieve economic participation and social inclusion
     While data were limited for assessing progress against this outcome for 2009-10, new data
      from the 2009 Survey of Disability, Ageing and Carers (SDAC) will allow more useful
      performance assessment in the council’s 2010-11 report. The council also understands that
      options for the provision of more regular data are being explored by relevant data bodies.
     A lower proportion of people with disability (75.8 per cent) reported face to face contact
      with family and friends than those without disability (81.2 per cent)—these rates were
      lowest in Queensland, and highest in Tasmania.
     Overall, 11.3 per cent of people with disability felt that their disability hampered how often
      they could leave home, though this proportion was significantly higher among people born
      in non-English speaking countries, where the proportion was 21.3 per cent.
     People with disability who were born in non-English speaking countries also received
      income support at much lower rates than those born in Australia.


Scant data about progress toward ensuring people with disability enjoy
choice, well-being and the opportunity to live as independently as possible
     Generally, the available data for use of disability support services and employment services
      indicate little or no change from the baseline year, except for open employment services,
      where the rate increased nationally and in most States and Territories.
     There are no data, or no new data, to measure satisfaction with or unmet demand for
      disability services.


Changes in data for determining whether families and carers are well
supported
     Between 2007-08 and 2008-09 access to respite services—a key service for carers—
      increased, while access to in-home accommodation and community access services
      decreased.
     It is unclear whether these changes, overall, reflect improved outcomes for people with
      disability and their carers.


Progress toward meeting performance benchmarks
There are six performance benchmarks under the National Disability Agreement (Box 2).




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Box 2              National Disability Agreement: performance benchmarks

        An increase in the proportion of people with disability in employment
        A decrease in the proportion of potential population with unmet demand for services

        An increase in the proportion of people with disability accessing services who have an
         individualised service plan
        An increase in the proportion of younger people in, or at risk of entering, residential aged
         care assisted with more appropriate forms of accommodation, diversionary strategies
         and/or enhanced services (in accordance with Young People in Residential Aged Care
         (YPIRAC) Bilateral Agreement targets)

        An increase in the proportion of Indigenous people with disability receiving disability
         services
        All services subject to quality improvement systems consistent with the National
         Standards by 2010



       For the six performance benchmarks, data are only available for assessing progress toward
        meeting two—for another three benchmarks, there remain no agreed measures, while for a
        further benchmark there are no data.
       The rate of younger people—that is, people aged between 0 to 64 years—admitted to
        permanent residential care increased nationally from 2007-08 to 2009-10. South Australia
        and the ACT were the only jurisdictions where the rate fell, though the lack of a quantitative
        target makes it difficult to say whether the benchmark has been met.
       The number of Indigenous Australians receiving disability support services increased.


Recommendations to improve the performance reporting framework
The success of the reform of federal financial relations depends crucially upon a robust
performance reporting framework, including the development of sound performance indicators
and benchmarks as the basis for public reporting.

The COAG Reform Council has an important role in advising COAG on where changes might
be made to improve the performance reporting framework (COAG 2008b, C-30).

In its 2008-09 baseline report, the council made recommendations to improve the performance
reporting framework. At the time of finalising the present report, COAG’s response to these
recommendations was not publicly available and so could not be incorporated.

At its meeting on 13 February 2011, COAG announced that the performance frameworks of
each National Agreement will be reviewed to ensure progress is measured and all jurisdictions
are clearly accountable to the public and COAG for their efforts (COAG 2011, p. 2). The
council has been advised that a steering group of COAG Senior Officials and the Heads of
Treasuries will oversee the reviews and will consider the recommendations on the performance
reporting framework in the council’s baseline reports on the National Agreements. The council



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has also been advised that the National Disability Agreement should be reviewed in the second
half of 2011.

For this report, the council has put forward recommendations for improving the performance
reporting framework, as set out in Box 3. These are discussed further in Chapter 6.

Box 3           Recommendations to improve the performance reporting framework

 The COAG Reform Council recommends that COAG:

 1. endorse the following priorities for improving the performance reporting framework for the
    National Disability Agreement:

     develop clear and measurable targets to underpin the agreed benchmarks in the National
      Disability Agreement

     develop robust performance measures of unmet demand, and quality of services for
      people with disability, their families and carers.

 2. refer these priorities, along with the recommendations made in the council’s 2008-09
    baseline report, to the review of the National Disability Agreement announced by COAG
    on 13 February 2011.


National Disability Strategy

On 13 February 2011, COAG endorsed a National Disability Strategy. The strategy includes
draft trends indicators that will be used to track progress for people with disability at a national
level, in regard to six agreed policy areas. The reporting will include mainstream services
provided to people with disability. This contrasts with the reporting currently conducted under
the National Disability Agreement, which is limited to service data about specialist disability
services.

A number of the draft trend indicators to be reported under the National Disability Strategy are
similar to those under the National Disability Agreement.

As the council noted in its baseline report, reporting on access to and outcomes from
mainstream services for people with disability is a missing link in assessing performance of
governments towards achieving the broad social and economic outcomes of the National
Disability Agreement. Accordingly, to ensure its reports provide a comprehensive assessment
of outcomes for people with disability, the council will review future reports prepared under the
National Disability Strategy with a view to including data on mainstream service provision for
indicators that support the broad outcomes under the National Disability Agreement.


Good practice and performance—disability support services for young
children
In this report, the council has undertaken for the first time its task of highlighting examples of
good practice and performance as part of its comparative analysis of performance under the
National Disability Agreement.


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In reporting on the other National Agreements—such as for education and healthcare—the
council undertook this role by initially conducting detailed data analysis to identify good
performance, with a view to then moving to a second stage that would examine the good
practice underpinning that performance.

However, for the National Disability Agreement, the council found that the available data are
not robust enough to allow for further detailed quantitative analysis, such as regression. For this
and other reasons, the council has chosen to undertake a qualitative analysis to better understand
jurisdictional variations. This qualitative analysis focused on the proportion of young people
(those aged 0 to 4 years) accessing disability support services.

KPMG was engaged to conduct this research. The key findings are:

   All Australian jurisdictions have programs and services in place which have an early
    intervention, family-centred focus to promote the development and other outcomes of
    children with disability or developmental delay aged 0 to 4 years.
   In the main, specialist disability supports, including early childhood intervention services,
    were funded and provided under the National Disability Agreement. However, jurisdictions
    also supported this group in mainstream settings such as through early childhood education
    and care services and health services.
   Health services also play a key role. Initially this is in detection of disability or delays in
    development (or concerns regarding development) through universal maternal and child
    health services and/or primary and secondary health care. As well, specific diagnosis and
    assessment services involve a range of allied health professionals and paediatricians.
   While the Disability Services National Minimum Data Set (DS-NMDS) captures data on
    specialist disability services delivered under the National Disability Agreement, there
    remains a significant amount of support provided to the cohort group—and in some cases
    the majority of support—that is not recorded by the DS-NMDS. In addition, in most
    instances data are not available to quantify the number of these mainstream services being
    accessed by children with disability or developmental delay (usually as a result of
    difficulties in adopting a system for identifying children with disability or developmental
    delay).
   There are currently no available data on outcomes for children in this cohort group.
   The project confirms that the council’s role of assessing jurisdictional performance against
    the performance indicator the proportion of the potential population accessing disability
    services, for 0 to 4 year olds, is limited and, if based on the DS-NMDS, will result in an
    incomplete assessment of performance.
In the area of services for children with disability or developmental delay, the council’s task of
highlighting good practice and performance is a difficult one. The project suggests that all
jurisdictions provide a range of services for the cohort group. The difficulty lies in the absence
of supporting data to assess performance.

In order for governments to be adequately assessed against the outcomes agreed under the
National Disability Agreement, further data development is necessary. In particular, outcomes-
based data at a national level is necessary to support this analysis.



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