29November2017

NDIS v. Health services

The division of responsibilities between the NDIS and the
Health system is marked by misinformation and
inconsistencies within and between regions. Many participants
and services providers find themselves confused about where
to turn to meet their support needs.

Auslan 'Sign Guy' delivers emergency

messages to the deaf community
Meet the man who makes it possible for deaf people to know
what's happening during QLD emergency broadcasting for
cyclones, floods and severe storms.

Travel can be bad for hearing

Excessive noise exposure leads to significant systemic
pathology, such as depression, anxiety, increased risk of
chronic diseases and increased accident risk.

Deadly Ears
Queensland's indigenous child hearing program has been
helping children to listen, learn and talk for 10 years. Australia
has one of the highest rates of recorded middle ear disease in
the world.

We acknowledge the traditional custodians of the land, community, sea, and waters where we live and work. We pay our respect to
elderspast,presentandfutureandvaluethecontributionsIndigenousAustraliansmakeinoursociety.Weacknowledgethechallengefor
IndigenousleadersandfamiliestoovercometheunacceptablyhighlevelsofearhealthissuesamongfirstAustralians.
The National Disability Insurance Scheme and Health
services interface issues
The division of responsibilities between the NDIS and the Health system is complicated to
navigate.

It is marked by misinformation and inconsistencies within and between regions. Many participants
and services providers find themselves confused about where to turn to meet their support needs.

The systems are designed to complement each other, with Health responsible for short-term care
and the NDIS looking after long-term supports. The NDIS factsheet Mainstream Interface:
Health (http://deafnessforum.org.au/find-out-about) outlines what healthcare supports the
Scheme intends to fund. It classifies diagnosis and clinical treatment of conditions, time-limited
recovery services, and pharmaceuticals as the responsibility of the Health Department.
Meanwhile, NDIS will cover supports necessary to prevent functional decline, achieve incremental
gains and assist daily living.

There are points in a person's journey where active cooperation between NDIS and Health will
become crucial. Discharge planning is a prime example. The healthcare system will be
responsible for the discharge planning. However, the NDIS will need to get involved in situations
where discharge can only occur once additional supports are in place.

The division of responsibilities between the NDIS and the Health system is complicated to
navigate. Of course, when dealing with two complex systems, things very rarely run smoothly.
We have outlined below three key problem areas that have the potential to undermine
cooperation in service provision.

1. Inconsistencies in Key Documents

Two key documents outline the interface between NDIS and Health; these are the COAG
Principles to Determine the Responsibilities of the NDIS versus Other Service Systems and the
NDIS Operational Guideline on Planning.

The documents set the guiding principles underlying on who will cover what. However,
ambiguities remain. For example, the COAG Principles state that pharmaceuticals covered by the
Pharmaceutical Benefits Scheme (PBS) are the responsibility of the health system. In contrast,
the NDIS Operational Guideline says this applies to all pharmaceuticalslisted and not listed on
the PBS.

We see a similar inconsistency in Participant Plans. This can partially be attributed to the
variances in state health systems. Nevertheless, it is undoubtedly also due to the varying
interpretations by planners of the COAG Principles and NDIS Operational Guideline.
2. Evidence and Impact of Disability
The onus is on the Health system to provide NDIS with the evidence and impact of a participant's
disability. Participants are expected to obtain the necessary reports from their current health care
providers with whom they have an existing relationship. While this might sound good in theory, in
reality, not all people with a disability have had consistent and ongoing relationships with their
health care providers. Rather, care is often provided by the first health care professional available
to attend to the situation.

No additional funding is available to compensate health care providers conducting assessments

and writing the reports. For a participant to receive all the supports they require, these reports
will need to cover all areas of a persons functional capacity. Obtaining reports that encompass
this level of detail is likely to be quite costly and time-consuming. The time factor is of crucial
concern in inpatient settings where resources are already at capacity. Consequently, patients are
at risk of being discharged without contact being made with NDIS or the reports and assessments
they need to make an application.

3. Role of Allied Health

Allied Health professionals are sometimes described as the gatekeepers of the NDIS. They are
often responsible for conducting assessments and justifying a participant's funds. However, when
it comes to the delivery of services, things become a little murky.

Although there are provisions in the NDIS Price Guide for trained therapists to provide allied
health services, there is a push for this to be a time limited service. Ongoing maintenance
therapy is expected to be delivered by either a family member or therapy assistant. Underlying
this is the dangerous assumption that therapies can be dumbed down for people with disabilities.
There is nowhere else in the current health care system that allows for Allied Health therapies to
be delivered by anyone other than professionals with the appropriate accreditation, registration,
and insurance. This also raises the question of who is going to insure a family member or
Therapy Assistant to provide a therapy in which they have very little training.

Over time, we will have to watch the interface between NDIS and the Health system play out in
practice. It is essential to ensure all teething problems are addressed and inconsistencies
rectified. Many participants are dependent on both these services. We owe to them to ensure
they are complementing each other and working together in harmony.

The author of this article, Dr Kylie Morgan completed her PhD in 2007, and has
over 15 years experience working in the mental health, disability and aged care
sectors.

From Disability Consulting Services,

http://www.disabilityservicesconsulting.com.au/resources/health-ndis-3-
problems?utm_source=DSC+Contacts&utm_campaign=b852bc5103-
EMAIL_CAMPAIGN_2017_09_05&utm_medium=email&utm_term=0_153f43591e-b852bc5103-15606843
Indigenous children's health program milestone

Children's Health Queensland's Deadly Ears indigenous child hearing program has been helping
children in Woorabinda to listen, learn and talk for 10 years. Deadly Ears delivers outreach clinical
services and local capacity building in 11 locations across rural and remote Queensland.

The program has delivered 1454 appointments, conducted 745 hearing tests and performed 112
surgeries at Woorabinda Hospital.

Deadly Ears Program Director, Matthew Brown said the success of the program would not have
been possible without the support of the Woorabinda community.

"Collaborative approaches with Australian Hearing, Undoonoo Day Care and Woorabinda State
Schools have also worked to help children with hearing loss improve their ability to listen, learn
and talk, Mr Brown said. "We want to make sure every child is afforded the best opportunity to
listen, learn and reach their full potential.

It has acted upon the high rates of conductive hearing loss from middle-ear disease in Aboriginal
and Torres Strait Islander children across the state.

Between 2010 and 2016, the rate of Chronic Suppurative Otitis Media (CSOM), a form of middle
ear disease, in the under four age group fell from 19 per cent to 8.8 per cent.

Australia has one of the highest rates of recorded middle ear disease in the world. If middle ear
disease is left untreated, the hearing loss associated with it can have an impact on health,
educational outcomes and long-term social disadvantage.

From The Morning Bulletin, https://www.themorningbulletin.com.au/news/indigenous-childrens-

program-reaches-milestone/3276155/

Travel can be bad for your hearing
Commuters could be at an increased risk of noise-induced hearing loss and should wear
headphones to protect their ears.

A study published in the Journal of Otolaryngology - Head & Neck Surgery examined noise levels
Toronto (Canada) commuters were exposed to while using public transport, driving or while
biking.

"This study is the first to look at and quantify the amount of noise people are exposed to during
their daily commute, specifically on the Toronto Transit System," said author Dr Vincent Lin.

"We were surprised at the overall average noise exposure commuters experience on a daily basis,
especially the peak noise intensity not only on trains but also on buses," said Dr Lin.

To measure noise exposure, the researchers used noise dosimeters, which they carried on their
shirt collars about two inches away from their ears.

The researchers collected 210 measurements in total, comparing the noise on subways, buses,
and streetcars, while driving a car, cycling, and walking.

According to thresholds recommended by the US Environmental Protection Agency (EPA),

exposure to 114 A-weighted decibels (dBA) for longer than four seconds, exposure to 117dBA for
longer than two seconds and exposure to 120 dBA for longer than 20 seconds may put people at
risk of noise-induced hearing loss.

While noise on average was within the recommended levels of safe exposure, bursts of loud noise
on both public and private modes of transportation could place individuals at risk of noise-induced
hearing loss. The researchers found that 19.9 per cent of the loudest noises (peak noise)
measured on the subway were greater than 114 dBA, while 20 per cent of the loudest noises
inside streetcars were greater than 120 dBA. Noise levels from bus platforms at times exceeded
120 dBA, while all peak noise exposures while riding a bike exceeded 117 dBA.

Dr Lin says planners need to be more considerate of noise exposure in future planning of public
spaces and public transit routes.

"We now are starting to understand that chronic excessive noise exposure leads to significant
systemic pathology, such as depression, anxiety, increased risk of chronic diseases and increased
accident risk. Short, intense noise exposure has been demonstrated to be as injurious as longer,
less intense noise exposure," he said.

From SBS checkup medical column, http://www.sbs.com.au/news/article/2017/11/24/checkup-medical-

column-nov-24
A special day at the Open

L-R Christian Hamilton, Steve Wheeler, Nick Lorenz, Mathew Wheeler and Rex Lanthorne AM

Athletes from Special Olympics Australia and Deaf Golf Australia participated in a massive day of
golf as part of the Emirates Australian Open.

Starting at Moore Park Golf Complex, participants had the opportunity to fine tune their games at
under the watchful eye of the latest group of PGA professionals completing the two-day PGA All
Abilities Coach Accreditation.

This is a great opportunity for our group of athletes to get involved and work on their games
before the Special Olympics National Games in April next year, explained Rex Langthorne AM,
Special Olympics Golf Coordinator- NSW.

To give our athletes a day where they get to participate in a clinic, have a Q&A session with the
coaches over lunch and then be watching the best players compete in the Emirates Australian
Open is just a fantastic experience. Langthorne added.

Equally for Deaf Golf Australia, the day was a great opportunity for athletes to have a tournament
experience as the group prepares for the World Deaf Golf Championships in 2018.

The day enabled Deaf Golf Australia to build relationships with coaches and facilities and grow
participation at grass roots level, said Geoff Read from Deaf Golf Australia. To see the coaches,
adapt their communication and develop an understanding of deaf and hard of hearing golfers was
fantastic.

The PGA All Abilities Coach Accreditation has been developed in partnership with the PGA of
Australia and Golf Australia. To find a PGA All Abilities Coach visit golf.org.au/inclusion
Auslan 'Sign Guy' delivers emergency messages to the
deaf community rain, hail or shine
Meet the man who makes it possible for deaf people to know what's happening during emergency
weather events.

Mark Cave, also known as the "Sign Guy", interprets Auslan for Deaf Services Queensland during
emergency broadcasting for cyclones, floods and severe storms.

Auslan is the language deaf people in Australia communicate with.

During major weather events, including Cyclone Debbie earlier this year, Mr Cave was one of a
core group seen interpreting the Premier's announcements alongside emergency services
personnel.

"It can be stressful as usually I interpret to one person, but in an emergency broadcast it's a
whole host of cameras and you don't have an audience to immediately connect with," he said.

"You know the importance of the message you're interpreting, you can't make mistakes, you can't
mislead people and you need to make sure you keep up.

"Having the added layers of going live to TV and knowing that it's lifesaving information, the
stakes are a lot higher but I get to work with wonderful people and interpreters."

Spreading the word about Auslan

The emergency broadcasts have displayed Mr Cave's enthusiasm for his work and his previous
appearances have spurred a strong following of social media fans.
"As much as it can sometimes bring me discomfort being known as the #signguy, it's been a nice
vehicle to put Auslan out there.

"You can't boast though about something you've been given and Auslan has been given to us by
the deaf community.

"We appreciate the community's trust in us to do this job along with them not as their helpers,
but as their allies."

Mr Cave prepares for each event by researching to be able to calibrate to the language being used
in each situation.

"We stay glued to the radio like ABC and other broadcasts to keep up to date with the names
being mentioned and what possible outcomes there could be," he said.

"It's great for the hearing community to be aware that English is often a second language to this
community and as a basic human right it would be great to see it used more in every facet of life."

Mr Cave's parents are deaf and he was raised using Auslan in the home.

He weaves his interpreting work with his studies and interpreting for people struggling with
mental health issues.

"It is not English on the hands, it's an entirely different language and has its own grammar,
syntax and culture attached to the deaf community," Mr Cave said.

"As an interpreter you're given a passport into different parts of people's lives in different
circumstances as well as doing something worthwhile."

From ABC News, http://www.abc.net.au/news/2017-11-16/the-man-who-gets-auslan-emergency-

messages-to-the-deaf-community/9148556
Stories from Australian Aboriginal and Torres Strait
Islander People with Disabilities
The issues confronting Aboriginal and Torres Strait Islander people living with a disability are
featured in Unfinished Business, a multimedia documentary exhibition in Canberra.

Following on from its national tour, the Department of the Prime Minister and Cabinet in
collaboration with award winning artist Belinda Mason, is supporting the Unfinished Business
exhibition to mark International Day of People with Disability on 3 December 2017.

Unfinished Business gives a powerful voice to Aboriginal and Torres Strait Islander people living
with a disability. Through 3D photography, the exhibition highlights critical issues that impact
their lives.

The stories told in Unfinished Business reveal a normalisation of disability. As a collective group,
the exhibition has the power to change attitudes towards disability and show there is no shame in
talking about disability and that asking for help is okay.

The exhibition provides a unique platform that explores different perspectives and experiences of
disability. It prompts meaningful discussion about Indigenous disability and the work being done
to improve outcomes for Aboriginal and Torres Strait Islander people with disability. Visit
http://unfinishedbusiness.net.au/

Conexu worked with the artist to enable the exhibition to be accessible in Auslan, Captions and
Audio Description via its OpenAccess Tours app. Check it out at http://openaccesstours.com.au/
Global Hearing Aids market to reach US$9.78 billion in 2022
The hearing aids market is dominated by big players such as Sonova (Switzerland), William
Demant (Denmark), and GN Store Nord (Denmark).

Some of the players operating in this market include Cochlear (Australia), Starkey (US), Widex
(Denmark), MED-EL (Austria), SeboTek Hearing Systems (US), Audina Hearing Instruments (US),
RION (Japan), Horentek (Italy), Microson (Spain), and Arphi Electronics (India).

Global hearing aids market is projected to reach USD 9.78 Billion by 2022 from USD 6.97 Billion in
2017. Asia is expected to register the highest increase. Factors such as high prevalence of
hearing loss, rising geriatric population, and technological advancements in hearing aids are
driving the global market. Based on product, the market is segmented into hearing aid devices
and hearing implants. The hearing aid devices segment is expected to account for the largest
share of the global market.

The hearing aids market is segmented into sensor neural hearing loss and conductive hearing
loss. The sensor neural hearing loss segment (SNHL) is expected to dominate this market, due to
high prevalence of SNHL and increasing initiatives by companies and regulatory authorities to
develop hearing aid devices for SNHL treatment.

The hearing aids market is segmented into adult patients and pediatric patients. The adult patient
segment is expected to account for the largest share and is projected to register the highest CAGR
due to the high prevalence of hearing loss in the adult population due to ageing.

Survey
Child and Youth Mental Health Service (CYMHS), part of Children's Health Queensland is
conducting a project looking at Deafness and Mental Health of infants, children, young people and
their families and carers.

A survey has been developed to look at:

Programs and pathways currently available to support local deaf children, and their families
How to increase the ability of services to recognise mental health difficulties and the
support needed for them
Ways of working together to support the mental health needs of deaf children

The survey is suitable for anyone that may have worked or is working with Deaf and/or children
with hearing disability.

https://www.surveymonkey.com/r/GHTFS5K
Become a member in 2018
If you enjoy One in Six and like the work we do, give a thought to becoming a financial member
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Over a year ago we began the campaign to make hearing health and wellbeing a National Health
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Annual general meeting

Thursday 14 December 2017, 6pm 7pm
HEARing CRC, Australian Hearing Hub, Macquarie University Sydney

Agenda Approve the minutes of the 2016 annual general meeting; matters arising; chairs report;
annual report and financial statements; appointment of auditor; and declaration of directors in
2018. The draft minutes of last years AGM and the financial statement are available at
http://deafnessforum.org.au/welcome-deafness-forum-australia

If a member of Deafness Forum is unable to attend in person, they are encouraged to nominate a
representative, called a proxy (this can be someone you know who will attend, or the chair of the
meeting). A form to register your representative is available at
http://deafnessforum.org.au/welcome-deafness-forum-australia

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