NZ Association for Study of Intellectual Disability

Disability Issues Minister Ruth Dyson
Address to NZ Association for the Study of Intellectual Disability
Holiday Inn, Christchurch
1.30pm Friday 1 October 2004

Tënä koutou katoa.
Tënä koutou ngä tängata hauä me o koutou whänau, hoa, häpori hoki, tae atu ki te hunga e tautoko ana i te whakakotahi i a ngäi tätau.

Tena koutou, tena koutou, tena koutou katoa.

[Greetings to all people with disabilities, their families/whänau, friends and communities, and all those who support a fully inclusive society.]

Good afternoon. It gives me great pleasure to join you today at your 2004 annual conference. Your theme of Journeys aptly describes our endeavours to build a society that is fully inclusive.

I’m sure you’ve been inspired by the keynote conference speakers over the last two days.
Stephnie Roberts, Dr Patricia O’Brien and Professor Bob Davis all have extensive experience in the disability field, and it is vital to have opportunities such as this conference to share that knowledge.

It is also heartening to see the emphasis on self-advocacy, and I am delighted to have had the opportunity to hear David Corner speak and report back from the self-advocate discussion groups.

A committed government
Since we became the government almost five years ago, we have made huge strides in the disability area:
·We have a Minister for Disability Issues.
·We have the New Zealand Disability Strategy providing a vision and a framework for action.
·And we have the Office for Disability Issues operating out of the social development ministry, with a broad, cross-sectoral approach to disability issues.

The office is working alongside government departments and agencies to help them develop more comprehensive plans to implement the strategy and ways to measure their activities, and the progress being made is encouraging.

This is very much aligned to the approach in the National Health Committee’s report To Have an Ordinary Life - Kia Whai Oranga Noa, focusing on the individual and their needs - now and in the future - in all areas of their life.

To Have an Ordinary Life is a landmark document and, as you prepare to leave today, I hope to encourage you with a brief update of the government’s response to a number of the recommendations in that report.

Improving healthcare
Recommendation 3 seeks urgent attention for the health of adults with an intellectual disability.

The safer use of medication is most important, and the Ministry of Health has developed CARE PLUS in conjunction with Primary Health Organisations, to focus on improving ways medicines are used. This programme will also provide special coordination of healthcare for people with an intellectual disability who have complex health needs.

Medication will come under the spotlight further in a planned joint project between the Office for Disability Issues, Ministry of Health, Health and Disability Commissioner and IHC Advocacy to investigate inappropriate prescribing practices.

And to gain a more flax roots reach within healthcare, along with my colleague Annette King, I have asked each District Health Board to consider and act on the recommendations of To Have an Ordinary Life.

Employment and training
Ensuring adults with an intellectual disability have access to full income support, employment assistance and training is the focus of Recommendation 5.

The Ministry of Social Development is reviewing access and take-up of income support by people with an intellectual disability. This review covers the Accommodation Supplement, Disability Allowance, Special Needs Grant and Community Services Card.

We know how important vocational services are for people with disabilities and we are committing over $8m over the next four financial years to this initiative.

This year’s budget introduced streamlined funding for vocational services for people with disabilities.

We want to remove the need for people to use their Disability Allowance to pay for these services, so that it is available for other costs arising from their disability, as was always intended.

Pathways to Inclusion
Recommendation 6 seeks to ensure people with intellectual disabilities have access to vocational services and non-vocational community participation.

Pathways to Inclusion was launched in 2001 to provide a new direction for employment and community participation by people with disabilities. As you all know, repeal of the Disabled Persons Employment Promotion Act is on the agenda, to ensure that people with disabilities who are in employment have the same rights and entitlements as everyone else.

This year, the government is investing more than $9m in additional funding to support the Pathway goals.

Some of this money will be used to expand employment services for people with disabilities. The Ministry of Social Development is negotiating contracts with service providers who will work in areas and regions currently without ministry-funded services. When these come into effect, services will be extended to Auckland South, Canterbury, Dunedin, Gisborne, Hauraki, Hawke’s Bay, Nelson, New Plymouth, Wairarapa, the West Coast and Whangarei.
Young people with disabilities face a range of barriers in making the transition from school to work. As part of Pathways, the Ministry is currently running 14 pilot transition projects to reduce those barriers, and just under 200 students have been involved in the first year.

In other initiatives, Workbridge’s employment outcome targets have been increased and the need for an advocacy service for people who apply for a Minimum Wage Exemption Certificate is being discussed with People First.

Community participation is the other focus of Pathways to Inclusion, and in the next few weeks I am hosting a meeting of providers to talk about how we can make progress in this area.

Promoting the interests of Maori and Pacific peoples
Improving understanding of, and increased responsiveness to, Maori and Pacific adults with an intellectual disability are the goals of recommendations 12 to 17.

I have given copies of To Have an Ordinary Life to the Ministers of Maori Affairs and Pacific Island Affairs, and I’ve asked them to encourage their departments to consider practical responses to the report’s recommendations.

Improving our knowledge
Recommendations 18 and 19 of the report will resonate with your association. These are the recommendations that promote improving what we know about the lives of people with an intellectual disability.

New Zealand Disability Survey
The Ministry of Health has just published the findings of the 2001 New Zealand Disability Survey.

Briefly….
·The survey estimates that around one percent of all adults living in New Zealand households have an intellectual disability. This is just under 29,000 adults.

·Seventy-one percent of these adults – just over 20,000 New Zealanders – needed help or support from other people or organisations. And just over half have been to a special school or have received special education at some time in their life.

·Thirteen percent of adults in residential facilities – around 3,500 adults - have an intellectual disability.

·Adults with intellectual disabilities are predominantly in the younger age groups, with two-thirds aged between 15 and 44.

·Around two per cent of all children living in households - some 13,000 - have an intellectual disability, with boys having a higher rate than girls.

If you’re interested in more detail on the findings, I recommend a visit to the Ministry of Health’s website.

Sickness and disability issues – benefit system
The Ministry of Social Development is researching sickness and disability issues. A number of publications will soon be available, including:

·a report called ‘Wellbeing, employment, independence: views of Sickness Benefit and Invalids Benefit clients’, which gives us a better understanding of the complexity and diversity of this group, and reveals that - while true for some people - economic independence does not necessarily equate to wellbeing; and
·a literature review of initiatives that have been trialled and evaluated internationally, and how they might be applied here.

The ministry is also carrying out a study examining barriers to employment, that will identify barriers specific to people on sickness and invalids benefits and how best to overcome them.

More research is planned for the coming year.

·A joint project between the Ministry of Social Development and the Health Council will look into the costs required for sick and disabled people to live as well as able-bodied people.

·The Ministry of Social Development is also analysing the 2001 New Zealand Disability Survey data, looking at the relationship between disability and employment. Provisionally, the results suggest that, when other factors are taken into account, people with disability still experience poor outcomes, particularly in relation to full-time employment.

Supporting the supporters
Recommendation 22 of To Have an Ordinary Life promotes the support of families and whänau of adults with an intellectual disability.

The Office for Disability Issues is leading an examination of issues around payment and support of family caregivers, in conjunction with agencies responsible for caregivers and support services. Options are currently being developed, and consultation with family caregivers, families, people with disabilities and disability sector organisations will take place later in 2004.

Recommendation 23 of the report seeks to strengthen the disability support workforce. The Ministry of Health’s Quality and Safety Project is compiling information on the demographic nature of the workforce, and various aspects of service provision and delivery, including cultural perspectives.

The project is identifying issues and needs of both the workforce and service users, and is looking at best practice examples both here and overseas.

Before I close, I’d like to talk about two further matters of direct relevance to this conference:
·the IDCC Bill; and
·progress at moving people out of Kimberley and into the community.

The Intellectual Disability (Compulsory Care and Rehabilitation) Act
The IDCC&R Act provides the first significant revision of this area of law since 1954, and it was long overdue. Reform was necessary to modernise the law and bring it into line with the significant legal and social changes that have taken place in our society since the 1950s.

It was also necessary to address a gap in the law, which arose with the passage of the Mental Health (Compulsory Assessment and Treatment) Act 1992. That law generally excluded people whose mental impairment was solely due to an intellectual disability.

The act allows the court to divert people from the criminal justice system to a compulsory care order made under that act. It also allows the court to make orders transferring people currently in prison or mental health services to the compulsory care regime.

It is difficult to know precisely how many people may be subject to a compulsory care order. It’s clear that in some cases that the risk of imprisoning such people who have offended has created a disincentive to charge them with offences. Now those found unfit to stand trial, or other people with intellectual disability charged with or convicted of an imprisonable offence, can be placed in appropriate care and receive court-mandated services. The act also sets out the rights of people subject to compulsory care orders.

In preparation for this legislation coming into force, there has been a lot of work to develop procedures, mandatory guidelines, and legal arrangements between the Police, the Department of Corrections, Courts, Mental Health Services and intellectual disability services. That coordination is essential to making this system successful.

An initial round of statutory appointments has been completed, including:
·compulsory care co-ordinators who are responsible for the administration of the act;
·specialist assessors and medical consultants who will provide specialist reports on people being considered for compulsory care order by the Court; and
·a number of district inspectors (lawyers) who will safeguard the legal rights of people subject to a compulsory care order.
These are valuable checks on the system.

For the same reason, I’m very pleased with the recent publication of a booklet called You Have Rights which sets out in very simple language how compulsory care works, what rights people in care have, and how to exercise them.

To strengthen the infrastructure needed by this law change, a number of important new services have also been established, including:

·regional intellectual disability care agencies that are specialist needs assessment and service co-ordination agencies. They employ the care co-ordinator and are responsible for determining eligibility for other services provided under the act.

·regional supported accommodation services for people with intellectual disabilities, that provide community, secure, supervised and independent supported living accommodation and/or services, including vocational and day activities;

·regional hospital level services providing inpatient assessment triage and longer stay components;

·a national intellectual disability secure service based in Wellington that provides hospital-level, high forensic assessment and secure accommodation. This is attached to the Regional Intellectually Disabled Secure Services, but has a community focus, with community liaison teams that will help to bring about the rehabilitation of people from hospital level services. Further work is being undertaken at the moment to complete a business case for the establishment of a second hospital-level secure service based in Auckland.

Investment in workforce development and innovative new service designs is also required if the aspirations of this new legislative regime are to be fully achieved.
Kimberley
Finally, I want to give you a brief update on progress at Kimberley.

More than 50 people have now left the centre, and 267 residents and their families have chosen a residential service provider and location. While this process has been slower than some might have wished, my priority is to ensure that appropriate services are in place for each person before they leave Kimberley, and by the end of the year all residents are expected to have chosen where they will live, and a provider of residential services.

Throughout this process we’ve consulted widely. Families and welfare guardians are engaged in the decision-making process, which is very important for the success of this work.

People are moving to towns and cities throughout the North Island. Housing New Zealand has completed six houses, and another 33 are being worked on. There are going to be three cluster housing developments, one in Palmerston North, and probably two in Levin. Thirty-three people have moved, or will be moving, to vacancies within existing community homes.

Our work in establishing services is also underway. We have completed the tender for day services, and they are in the process of being established.
The specialist services tender process isn’t yet completed, but I do expect that these services will be operating in the new year.

Conclusion
At no other time in our history has there been as much commitment to, and investment into improving the lives of New Zealanders living with disability.

It will take the efforts of central government, local government, community and voluntary organisations, private organisations and individuals if our journey is to meet its final destination: a New Zealand where people with disabilities can say “I live in a society that highly values my life and continually enhances my full participation.”

Thank you for your contribution to this goal. I look forward to continuing to work with you in the future.

Thank you.