Powerless facing the wave of change: the lived experience of providing services in rural areas under the National Disability Insurance Scheme

Dintino, Rhys; Wakely, Luke; Wolfgang, Rebecca; Wakely, Katrina; Little, Alexandra

doi:10.22605/rrh5337

Cited by 14 publications

(35 citation statements)

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“…The diversity of responses of rural providers to the NDIS highlighted the diverse power relations at play. On the one hand, reflecting findings by Dintino et al (2019), participants described a sense of powerlessness to meet increased demand for boutique services or those requiring significant travel, time‐consuming preparation and non‐direct service activities. This suggests that broader health systems and geographical contexts influence rural providers' adaptability to change and possibly steer them toward a generalist care model to meet the needs of rural people with disability that are easily met but not those outside of these parameters, as seen in rural healthcare more generally (Mitchell et al 2018).…”

Section: Discussionmentioning

confidence: 64%

“…Of particular interest are the actions, resistance, changes and adaptations of rural providers to the NDIS implementation. A study by Dintino et al (2019) found rural health professionals employed by rural NDIS service providers felt powerless because they struggled to meet service demand in their community, and were limited in capacity to ensure individual people with disability received adequate service funding. Power (and powerlessness) is embedded in the other concepts and emerges through actions to change, resist and negotiate at each level.…”

Section: Framework Of Rural and Remote Healthmentioning

confidence: 99%

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Rural Victorian service provider responses to the National Disability Insurance Scheme

Quilliam

Bourke

2020

Aust J Social Issues

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The National Disability Insurance Scheme (NDIS) has transformed the nature of funding available to health and human service organisations to provide services to people with disability in Australia. However, there is relatively scant literature on the rural implementation of the NDIS, particularly how rural NDIS service providers are affected by the NDIS. Researchers conducted semi‐structured interviews with 20 health professionals employed by rural providers, and analysed data using rural and remote health and organisational change frameworks to understand how rural providers were impacted by and responded to the NDIS. The findings suggest rural providers were impacted to differing extents and responded to the NDIS in different ways. Participants reported that disability and community health services were affected more than hospitals and private allied health practices. Impacted rural providers responded by changing the nature and types of services, service processes and their workforce, and redefining organisational characteristics. Impacted rural providers may require additional support to continue providing services, and those less impacted may require other incentives to better engage with the NDIS. Rural proofing of NDIS policy could reveal suitable supports and incentives to ensure rural people with disability can access required services.

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Section: Discussionmentioning

confidence: 64%

Section: Framework Of Rural and Remote Healthmentioning

confidence: 99%

Rural Victorian service provider responses to the National Disability Insurance Scheme

Quilliam

Bourke

2020

Aust J Social Issues

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“…There were also reports of variation in service delivery and access within the region, with participants describing barriers to access for young people living in rural areas when compared to the urban centre. It could be that rural services have struggled to adapt to changes to service provision, following the introduction of the NDIS (Dintino, Wakely, Wolfgang, Wakely, & Little, 2019 ). Further research would be necessary to assess the effects of both the NDIS and regional variation in service delivery and access.…”

Section: Discussionmentioning

confidence: 99%

Navigating complexity to support justice-involved youth with FASD and other neurodevelopmental disabilities: needs and challenges of a regional workforce

et al. 2021

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Background Young people with Fetal Alcohol Spectrum Disorder (FASD) can face significant challenges in their lives, including overrepresentation in the justice system from a young age. Police questioning and court proceedings can be difficult for these young people to navigate. Practice and policy responses are necessary to identify these individuals, provide appropriate support/rehabilitation, and upskill the justice workforce. The aim of this research was to determine the unmet workforce development needs of a regional workforce providing care and support to youth involved with the justice system. Interviews were conducted with 29 participants from 14 organisations to understand the support provided to youth, existence and uptake of referral pathways, and unmet needs. Results Results revealed a workforce that wants to see improvements to outcomes for young people with FASD and other neurodevelopmental disabilities who enter the youth justice system. However more support is required through training, ongoing funding, and assistance to develop FASD informed work practices. Conclusions The workforce supporting youth to navigate the justice system requires practical interventions to achieve best practice so that young people with FASD and other neurodevelopmental disabilities receive the support that they need. Following the interviews a model of care tool was developed and piloted in the sector. The tool includes current pathways through the justice system and provides resources to assist staff in achieving best practice care for young people with FASD and other neurodevelopmental disabilities.

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“…Similarly, allied health service providers delivering services under the NDIS have raised concerns about the potential for children to miss out on funding when their parents or carers had limited or no skills in understanding the system and advocating for their needs. 5 Geographic location was identified as a barrier to 'choice and control' of services for some individuals. 2,3 There is a shortage of disability services in rural and remote areas of Australia, and concerns have been raised about how these 'thin markets' will be able to cope with meeting the needs of people with a disability in their communities.…”

Section: Introductionmentioning

confidence: 99%

Lived experience of parents and carers of people receiving services in rural areas under the National Disability Insurance Scheme

Prowse

Wolfgang

Little

et al. 2022

Australian J Rural Health

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Objective The purpose of this study was to investigate the lived experience of parenting or caring for a person with a disability receiving services under the National Disability Insurance Scheme in rural Australia. Design Qualitative study guided by the phenomenology of practice. Setting Rural areas of New South Wales (MM 3‐7). Participants Participants were 5 parents and one carer of people receiving National Disability Insurance Scheme services who resided in rural New South Wales. Design Participants engaged in a semi‐structured interview about their lived experiences caring for someone accessing services under the National Disability Insurance Scheme in rural New South Wales. Interviews were audio‐recorded, transcribed verbatim and analysed thematically. Results Three themes emerged from the data analysis. ‘More than a disability’ described the absence of understanding of family and carer challenges when National Disability Insurance Scheme plans were designed and implemented. ‘Fighting for funding and services’ described that while the National Disability Insurance Scheme increased funding support, parents and carers experienced limited support navigating the National Disability Insurance Scheme. ‘Cold as Ice’ encompassed parents' and carers' descriptions of their relationship with National Disability Insurance Scheme staff. These challenges were further impacted by the limited choice and availability of health service providers in rural areas. Conclusion Participants felt that the National Disability Insurance Scheme had created additional stress and confusion in their lives and at times had hindered the achievement of the goals of their family member with a disability. The voices of parents and carers is a critical one, and it is essential that rural parents' and carers' needs are considered and supported in future planning of the National Disability Insurance Scheme.

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Powerless facing the wave of change: the lived experience of providing services in rural areas under the National Disability Insurance Scheme

Cited by 14 publications

References 0 publications

Rural Victorian service provider responses to the National Disability Insurance Scheme

Rural Victorian service provider responses to the National Disability Insurance Scheme

Navigating complexity to support justice-involved youth with FASD and other neurodevelopmental disabilities: needs and challenges of a regional workforce

Lived experience of parents and carers of people receiving services in rural areas under the National Disability Insurance Scheme

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