Suchergebnisse

AbstractA rapid review of the literature on inter‐organisational collaboration was undertaken to identify and describe key barriers and enablers of relevance to current disability policy developments in Australia. Term searches of four databases resulted in the identification of 433 articles published between 2009 and 2019. After removal of duplicates and refinement, 17 peer‐reviewed articles underwent full review, data extraction and synthesis to distil barriers and enablers of inter‐organisational collaboration at three levels. At the macro‐level, policy instruments, institutional arrangements and resources were salient. At the meso‐level, clarity of organisational purposes and roles, and organisational systems and processes were important, as were factors of leadership, management, power and workforce. At the micro‐level, values, trust, culture and personal relationships could be either barriers or enablers, depending on context. The review indicated that meaningful and sustained collaboration across organisations is unlikely without careful planning, clear actions and significant investment at all three levels, providing important learnings for the Australian National Disability Insurance Scheme context.

AbstractBeyond the initial euphoria of the National Disability Insurance Scheme (NDIS), tough choices will be needed for sustainability. Although the spirit of the NDIS is to deliver choice and control, the Australian government's objective is to ensure that rights and aspirations are proportionate to expectations of best practice, aptness of mainstream services and cost effectiveness. The position in this paper is that this test of 'reasonable and necessary' when determining funded supports, raises value dilemmas for government and citizens. The objective is to demonstrate this through a critical scrutiny of the reviews and decisions regarding reasonable and necessary funded supports of the Administrative Appeals Tribunal (AAT). In this paper, a synthesis and critique of 35 appeals to the AAT and one Federal Court Appeal are used to make explicit the decisional ambiguities and contestations in the scheme and the values and priorities that are currently dominant in the allocation of reasonable and necessary support. This in turn is used as a basis for a discussion about the operation of rights in the scheme and what counts as legitimate support. The benefit is for scheme transparency and fairness but also broader debate about core principles and values to inform decisions about scarce resources in society.

AbstractDisability support is often provided at the interface with other human services such as health, education, and employment agencies. This can present many organisational problems for people receiving support and the organisations that provide it. Individualised funding is one attempt to ease problems of fragmentation and unmet needs, but perversely, it introduces further interface complexities as organisations consider how to manage their service provision and financial structures. Drawing on interviews with 28 managers, the focus in this paper is on organisational and interface changes and challenges following the introduction of the National Disability Insurance Scheme (NDIS) in Australia, and the adaptive strategies of organisations to provide individualised and coordinated supports. The three themes derived from the thematic analysis, adopting a commercial mindset, finding a business niche, and working across complex interfaces, epitomise the benefits, constraints, and consequences of new market mechanisms for the delivery of supports, and how organisations are adjusting to a more commercial‐orientated sector while also creatively negotiating multiple funding and governance systems. The findings contribute to understandings of how individualisation is creating new dynamics of local disability support governance and collaboration in service provision.

Support coordination for people with disability and complex needs should assist in personalising and implementing individualised funded supports in a coordinated manner. Yet, this also relies on policy and organisational arrangements being conducive to good practice. Designed according to street-level policy research, this study sought to explore challenges and adaptations associated with the implementation of support coordination in Australia's National Disability Insurance Scheme through interviews with 20 support coordinators and front-line personnel. Findings suggest that more explicit oversight of, and attention to, norms of practice and capacity to work collaboratively with choice and control are warranted to enhance support coordination.