The uncounted costs: Choice and control for people with behaviours of concern

Valuable reading here for anyone living in rural, regional, and remote Australia, and who cares deeply about having adequate support for people with developmental, intellectual, and other disabilities.

The recommendations of the report speak about the higher needs of clients with behaviours of concern who live in regional Australia, accurately suggesting very high service needs over extended time frames.

Existing models in NSW have a four tier systems approach.

  1. Local support workers implementing behaviour plans daily basis,
  2. Local behaviour staff trained to prepare basic planning and interventions,
  3. Regional specialist behaviour clinicians doing intensive and extended work with complex cases and supervising others in the region,
  4. State wide specialists who provide advanced remediation and training when needed, and mostly in crisis intervention situations.

The report is based on the experiences of Anglicare Tasmania and Optia. They examine what kinds of supports are currently engaged for people with behaviours of concern.

They define the field as including “verbal and physical aggression, damage to property and vehicles and self injurious behaviours… [that are] often volatile and can change from day-to-day.” Support services find these behaviours concerning.

The overall wisdom of the report suggests the “necessity to get NDIA costing models right for people with behaviours of concern.” This is particularly troubling and is not yet addressed adequately in rural, regional, and remote Australian contexts.

As anyone with a brain might guess, the costing concerns and pragmatic issues are very real when making good on the NDIS national claims for service availability in regional and remote areas, including allowing for extended travel times for practitioners to visit clients (and where most clients in this population do not have the capacity for travel to a practitioner).

The report further stresses the challenges ahead in actually making good on the promise of “choice and control” for people with complex behavioural concerns in regional areas with very little actual services and little actual choice or control. Recommendations are put forward on “how to create an NDIS environment where people living with behaviours of concern have choice and control over how their support needs are met.” Much of this is tied to funding concerns and careful allocation of resources.

Visit the report here.

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