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The whole person

By Paul O'Neal and Fiona McDermott - posted Tuesday, 20 June 2006


Consumer controlled individually tailored budgets (care packages). An allocation of funding should be put under the control of consumers, with support from their carer(s) and an organisation of their choice. Funding allocation should be based on the consumer’s assessed level of need on a graduated scale:

  1. Low Need
  2. Moderate Need
  3. High Need
  4. Very High Need

The use of care packages is not new. It has been used in aged care for some time. In particular, the Victorian Department of Human Services’ Support & Choice Initiative appears to be an example of direct funding allocations working well. The inclusion of tailored budgets, as a complement to existing services, ensures consumers receive specialist services they may need and provides some choice and control over their lives.

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Avoiding classifying and funding disabilities according to disability types. Government policy should plan and fund disability programs according to need, not prescribed disability types.

Commitment to disadvantaged and vulnerable groups. An integrated policy response will uphold a commitment to the most disadvantaged and vulnerable groups within Australian communities. People with dual and multiple disabilities are among the most severely disadvantaged in Australian society on a number of levels, among them health status, access to services, employment-economic opportunities, and social and relationship opportunities.

Avoidance of marginalisation. An unfortunate dimension of living with a disability of any kind is being marginalised when attempting to enter mainstream society. While blatant discrimination in Australia appears less apparent than it was several decades ago, there are, nonetheless, significant barriers to full participation for people with disabilities. For example, two key issues effectively impeding people with disabilities from full social participation are sheltered workshop-type employment and security of housing tenure.

Social justice. The concept of social justice underpins this discussion, in that it seeks to target the needs of people living with disabilities within the structure of a service system. “Justice” in this context refers to a person’s ability to access and receive a responsive and timely service, without structural barriers.

Sensitivity to difference. An integrated policy response for people with disabilities aims to accommodate differences among people, including consumers, carers, and referring agents, who use disability services. The hallmark of a comprehensive and responsive disabilities service system is its ability to accommodate difference and individualise service delivery according to the specific needs of consumers and carers. These differences are likely to be reflected as differences in disability as well as ability, emotional requirements, expectations, capacities, wants, motivations and personality.

“Need-For-Service” should determine service provision. “Need-For-Service” is another key principle in developing a policy response for people with disabilities. Not all people with disabilities need support. Many are near independent. This principle reflects not only the idiosyncratic nature of disability, but, equally importantly, the contexts within which needs are socially constructed and deemed by service providers to either warrant, or not warrant, service provision at a given time.

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Equality of outcomes. “Outcomes” refers to observable (positive) changes in a person’s quality of life through intervention. Potential users of a service or program may come from different backgrounds and starting points, but the goal is to meet individual needs and achieve the best results for all users.

To conclude, an integrated policy response for people with disabilities will dispense with planning and delivering disability services based on an arbitrary classification of disability types. Second, it will encompass a range of dimensions which take into account consumer and carer needs as well as functional abilities and living environments. This will pave the way to an adequate and effective policy response to the complex needs of people living with disabilities.

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Article edited by Virginia Tressider.
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About the Authors

Dr Paul O’Neal has a background in social work practice in the mental health and disabilities fields. He has completed a PhD at The University of Melbourne and works for the Victorian Department of Human Services and is also a sessional lecturer at The University of Melbourne School of Social Work.

Fiona McDermott is the deputy head and senior lecturer at the School of Social Work at the University of Melbourne.

Creative Commons LicenseThis work is licensed under a Creative Commons License.

Photo of Paul O'NealPaul O'NealPhoto of Fiona McDermottFiona McDermott
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