Spinal Works is conducted as an embedded component of
the larger Community Participation
Project (CPP) being undertaken by the NSW Motor Accident Authority (MAA)
and the Department of Disability Ageing and Home Care. Funded by the NSW Board
of Vocational Education and Training (BVET), the Spinal Works project was delivered by the NSW Department of
Education and Training (DET) Disability Programs Unit and the Western Sydney
Institute of TAFE, Open Training and Education Network (OTEN.)
Two previous phases of the SpinalWorks program have
been completed and documented. The report of the 2005 NSW BVET-funded phase of
this project is available on the NSW BVET website. The current SpinalWorks Phase 3 project follows on
from, and builds on, this previous project.
In 2006 BVET committed a further $60,000 to the
project to engage a Project Officer to:
- effectively
disseminate information about the completed phases of the project
- facilitate
future provision of vocational training to spinal injury unit patients
until the introduction in July 2006 of the Commonwealth Government Welfare to Work and Skilling Australia packages and
introduction in late 2006 or early 2007 of the NSW Motor Accident
Authority Lifetime Care Package
The facilitation of provision of vocational training
was to encompass:
- Dissemination
of information about the completed phases of the SpinalWorks project
- Research
into the implications of the Lifetime
Care Package for provision of vocational education and training
3.
Education
of TAFE NSW personnel based on research findings
4.
Maintenance
of coordination, relationships and interagency linkages
The 22 participants in Spinal Works Phase 3 project have been again drawn from the Prince
of Wales Hospital Spinal Unit, Moorong Spinal Unit within the Royal
Rehabilitation Centre located in Ryde and Royal North
Shore Hospital.
In consultation with the project Steering
Committee milestones were developed for Phase 3 of the project in 2006. These
milestones have been achieved. These milestones were:
- Milestone
1: Production of an information sheet for TAFE NSW staff
- Milestone
2: Design of Teacher/Consultant Physical Disability telephone survey
- Milestone
3: Conducting Teacher/Consultant Physical Disability Survey
- Milestone
4: Analysis and reporting on
findings
- Milestone
5: Research in response to further information requests from Teacher/Consultants
on Welfare to Work, Skilling Australia
Workforce Act and the Lifetime Care Package.
- Milestone
6: Feedback of research findings to Teacher/ Consultants
- Milestone
7: Ongoing and developing SpinalWorks coordination
- Milestone
8: Preparation of final report
- The
project was envisaged to operate as a transition mechanism until the
introduction of the Lifetime Care
Package for motor vehicle injuries in late 2006 to early 2007. The
introduction of Lifetime Care Package
has been delayed until October 1 2007. A gap in provision of coordination
and ongoing information dissemination may now occur, as funding for SpinalWorks coordination has now been expended.
- When the
Lifetime Care package is introduced in October 2007, there is a risk of a
two-tiered system of delivery of VET and other services occurring, as only
people who have acquired their injuries in motor vehicles will be eligible
to participate. This risk must be managed by TAFE NSW to ensure equitable
provision.
- Individual
circumstances mean that individually tailored solutions must be found and
a flexible approach maintained. For example:
- rural
people with spinal injury returning home after lengthy stays in
rehabilitation units have extra challenges in relation to course
availability and meeting Centrelink and other requirements. This impacts
on their ability to achieve vocational goals
- early
intervention in regard to vocational education and training is the goal
but is not always possible. If the client’s
priority is physical health, built environment adjustment, pain
management or family issues, then pushing the client into the vocational
planning and training too early may be counterproductive.
SpinalWorks has over several years been developed and
refined into a highly effective tailored option enabling people with acute
spinal injury to engage in vocational education and training options that
extend outside rehabilitation units and result in outcomes that reach into the
community.
Provision
of training to people with spinal injuries will continue beyond SpinalWorks Phase 3 using core funding
from TAFE NSW. Without the coordination role provided through this project,
however, other mechanisms will need to be found to maintain the significant
gains made through the ‘whole of life whole of government’ SpinalWorks
approach.
SpinalWorks is an early intervention approach to
vocational education and training after traumatic spinal cord injury. It
expanded on earlier TAFE NSW projects which have delivered training and support
to people who are in spinal acute and rehabilitation units after spinal cord
injury.
As detailed in the Executive Summary above, SpinalWorks is conducted as an embedded
component of the larger Community
Participation Project (CPP) being undertaken by the NSW Motor Accident Authority (MAA) and the Department of Disability
Ageing and Home Care. Funded by the NSW Board of Vocational Education and
Training (BVET), the SpinalWorks
project is delivered by the NSW Department
of Education and Training (DET) Disability Programs Unit and the Western Sydney
Institute of TAFE, Open Training and Education Network (OTEN.)
The current Phase 3 SpinalWorks project follows on from, and builds on, the previous
phases of the project.
This project has been conducted in tandem with the
ongoing TAFE NSW Spinal Cord Vocational
Rehabilitation Project, in which three TAFE NSW Institutes (Western Sydney
Institute OTEN, Northern Sydney Institute and Sydney Institute) have
collaborated since 2000 to deliver vocational education and training to clients
in spinal acute and rehabilitation units.
A high proportion of SpinalWorks participants were initially enrolled in introductory
computer and adaptive technology subjects using the TAFE NSW umbrella course
Employment Skills - 9422. The Employment Skills course has flexible delivery and
includes vocational subjects, adaptive technology assessments and training,
teaching and tutoring options and individualised vocational planning. This vocational
planning entails making contact with clients when they are in rehabilitation
units and maintaining VET involvement after they are discharged and return home
to their community. SpinalWorks participants move on to a variety of courses and
training areas based on individual vocational goals and training needs.
The governance arrangements for the SpinalWorks
project involved a Steering Committee, which met quarterly and comprised
representatives from key stakeholder groups including the Disability Programs
Unit and Skill Strategy Unit of the NSW Department of Education and Training, Western
Sydney Institute Open Training and Education Network (OTEN), and the Lifetime
Care and Support Authority. A project management plan was developed to guide
the project and endorsed by the Steering Committee. It was the responsibility
of the Project Coordinator to report on the key milestones of the Management
Plan at each Steering Committee meeting.
Phase 3 of the Spinal
Works project identified four project objectives.
1. Dissemination of information about the
Spinal Works project
Information on insights gained and systems
established in the Spinal Works pilot project were to be effectively disseminated
to TAFE NSW Teacher/Consultants Physical Disability, with the aim of
ensuring the uniformity of transitional planning and student placement when
returning to the community after spinal cord injury.
This phase of the SpinalWorks project involved a state-wide engagement with TAFE NSW Teacher/Consultants
Physical Disability, who provide expert support services to students with a
physical disability enrolled in TAFE NSW courses.
2. Research into the implications of the
Lifetime Care package;
The
Lifetime Care Package scheme is
administered by the Lifetime Care &
Support Authority (LTCSA), which was established on 1 July 2006. The case
management approach adopted provides for whole of life planning with retraining
and vocational outcomes a key aspect of long term goal planning.
As stated on the Motor
Accident Authority of New South Wales website:
The
LTCS Scheme was established under the Motor Accidents (Lifetime Care &
Support) Act 2006 to provide treatment, rehabilitation and attendant care to
people who have been severely injured in a motor accident regardless of who was
at fault in the accident. Eligibility for the scheme is determined by the
severity of the person's injuries. Most people who are eligible will have a
spinal cord injury or moderate to severe brain injury, or in some cases serious
burns or amputations.
The scheme
will be implemented in two stages: it will apply to children where the
accident happens on or after 1 October 2006. It will apply to all severely
injured people from 1 October 2007. The scheme will be administered by the
Lifetime Care & Support Authority (LTCSA) which began on 1 July 2006. (http://www.maa.nsw.gov.au/default.aspx?MenuID=249)
Implications of the Lifetime Care package for VET
delivery were to be examined and documented as part of SpinalWorks Phase 3. Issues included:
- effect
on client demand
- the
interface of vocational planning and case management conducted by the MAA
with the VET system
- how TAFE
NSW can position itself to continue to deliver client services, possibly
by tendering as a provider for the MAA
3. Education based on research findings
Feedback and information were to be effectively
provided to the TAFE NSW system on the post 2006 framework. The goal was to
optimise outcomes for clients through TAFE NSW gaining awareness of the
structures and opportunities that will occur in the new environment and by identifying
any environmental factors impacting on service provision.
The research undertaken in the SpinalWorks Phase 3 project identified that there are a range of
external issues impacting on people with spinal injury and their interaction
with the VET sector and associated service providers. Two recurring issues emerged,
however, as the focus of the information requested by Teacher/Consultants. These
two issues were Welfare to Work legislation
and the Motor Accident Authority Lifetime
Care Package.
4. Maintenance
Interrelationships and linkages
established were to be maintained to ensure equity to existing participants,
and to provide a link to the post 2006 model for participants who may
experience injury during this period. A
base co-ordinating presence was to be maintained in the spinal units to achieve
this objective.
The following milestones were developed to
achieve the project objectives.
Milestone 1:
Production of an information sheet for TAFE NSW staff
An information kit was developed and distributed to
relevant TAFE NSW staff working with people with spinal injury informing them
of the completed phases of the project and the ongoing aims of the project. (See
Appendix 1)
Milestones 2 & 3: Design
and conducting of surveys
The aim of these surveys was to access feedback from
TAFE NSW Teacher/Consultants Physical Disability and to identify any gaps in
knowledge regarding the post 2006 framework for people with spinal injuries.
A set of semi-structured questions were
developed to elicit qualitative data. Full-time Teacher/Consultants Physical
Disability across NSW TAFE institutes were contacted and asked to participate.
The options for response were telephone, email and mail. The key findings and
recommendations are based upon the survey results. There was a 57% response
rate. (See Appendix 2)
Milestone 4: Analysis and
reporting on findings
Data collation and analysis of TAFE NSW Teacher/Consultants
Physical Disability responses was completed and a report prepared to feed back
findings and provide recommendations to survey participants. (See Appendix 3)
Milestone 5: Research in
response to further information requests on Welfare
to Work, Skilling Australia Workforce
Act and the Lifetime Care Package.
This research and the associated report focussed on
the impact of the above policies and programs on the VET sector and on the
participation of students with spinal cord injury. (See Appendix 4)
Particular issues emerged for the over 50% of 2006 SpinalWorks participants from rural
areas. These issues related to meeting the requirements of the above acts and
policies and the availability of required courses in rural areas. (See Appendix
5)
Milestone
6 Feedback
Feedback was provided in a number of formats
including presentations, hard copy information and sessions at Disability expos.
One of the significant achievements in this area is
the ongoing SpinalWorks website
development. Usage of the website by SpinalWorks
participants, their service providers and TAFE NSW Teacher/Consultants Physical
Disability is steadily increasing. Accessibility is the key factor for SpinalWorks participants and the web
development focussed on ease of site navigation, specifically for people using
head pointers and puff-and-blow switches. As participants may have more than one
disability, the needs of people with visual, hearing, psychiatric and cognitive
disabilities have also been considered in the website development.
Milestone 7: Ongoing and developing SpinalWorks coordination
The SpinalWorks
project maintained and developed the interrelationships and linkages
established to ensure equity to existing participants, and to provide a link to
the post 2006 model for participants who may experience injury during this
period, with a focus of a base co-ordinating presence to be maintained in the
units. This was achieved in Moorong Royal Rehabilitation Centre in Ryde, and
the spinal units at Prince of Wales Hospital and North Shore
Hospital.
This entailed:
·
designing
an information sheet for newly injured people in spinal units and provides
information on how they can access computer training during their time in the
spinal units. The information sheet is soon to be developed into a brochure.
(See Appendix 5)
·
Spinal
Unit coordination in the area of enrolment tracking, training delivery, and
adaptive technology assessment and provision
·
consistent
record keeping in relation to progress and contact records, Individual Education
Plans and referral documents
·
post
discharge coordination including systemic follow-up to enable individually
tailored enrolments and liaison with local TAFE NSW Teacher/Consultants
following discharge from spinal units
Milestone 8: Preparation of final
report
The most frequent and consistent key finding was in
regard to educational
barriers for students living with spinal cord injury. The three significant
barriers that were clearly identified by the Teacher/Consultants were:
· access to the built environment (84% of respondents)
· transport issues - cost, reliability and access (75% of respondents)
· lack of appropriate courses and loss of courses that were
appropriate and without financial barriers (50% of respondents)
In addressing the above barriers, the most common
strategy identified by Teacher/Consultants is to modify attendance
requirements, class locations and timetables. It is important to note that the
flexible delivery of courses organised by Teacher/Consultants is more often
associated with built environment issues, available courses and transport
barriers, than with the need for a reasonable adjustment directly related to
the individual’s physical disability.
The second key finding was in relation to the
referral system for the SpinalWorks project.
There was wide variation in responses by Teacher/Consultants regarding where
students were arriving from. The data indicate that Teacher/Consultants and
prospective SpinalWorks students were
utilizing all the available pathways to the project.
Teacher/Consultants indicated that the most important
need in the referral of students with spinal injury was for early notification and
consultation to provide time for preparation of equipment, transport
requirements and personal care assistance.
This requirement was followed in frequency by
Teacher/Consultants placing value on a clear Individual Education Plan for the
participant and being supplied with the contact details for the participant’s
supporting professionals.
These findings suggest that Teacher/Consultants are
aiming, within their allocated resources, to provide a holistic training
environment to students living with a spinal injury. The data demonstrate that
TAFE Teacher/Consultants have naturally progressed towards the ‘whole of life’ service
delivery model and have been using innovative techniques to support a holistic
training platform within a mainstream VET environment.
This theme of the need for a holistic training
environment is reinforced by the response by Teacher/Consultants on their use
and impressions of the SpinalWorks Information
Kit. Forty two per cent of respondents found the Information Kit very useful,
17% of respondents made improvement suggestions. The most frequent improvement
suggestions were for information on Personal Care Assistance within the TAFE
environment, and information on access to adaptive technology and training.
The recommendations derived from these key findings are:
·
The
need to systemically address the environmental factors that Teacher/Consultants
are identifying as the most significant educational barrier for students living
with spinal cord injuries. The information provided by Teacher/Consultants may
be disseminated to the existing infrastructure of TAFE Access Committees. The
medium term goal should be to bring VET facilities in line with the minimum
requirements of the Building Code of Australia and the proposed Disability Discrimination
Act Disability Standard on Access to Premises (Premises Standard.)
·
Information
collated by the SpinalWorks project should
be made available to other projects exploring pathways in VET for people with
physical disabilities. Teacher/Consultants for Physical Disability could make a
useful contribution towards inclusivity at the stage of course design.
·
SpinalWorks will implement the improvement suggestions that
Teacher/Consultants have offered in the survey project. These improvement
suggestions include providing further information on personal care assistance
in VET environments, and consistently updating information on access to
adaptive technology and training. (This recommendation has been implemented.)
The
introduction of this package will substantially decrease resource demands on
TAFE NSW, as motor vehicle accidents account for approximately 50% of the
existing caseload of people with recently acquired spinal injuries.
However,
there will be a significant group of students with spinal injury who will not
have acquired their injury through a motor vehicle accident. Consequently, it
is important that the VET sector embraces the opportunities offered by the Lifetime
Care and Support Authority (LTCSA) while minimising the risk of delivering a
two-tiered training model.
The LTCSA
pilot has demonstrated that it is an effective and holistic best practice
model. SpinalWorks students who have
had access to this pilot program are able to participate in vocational
education and employment planning at an earlier stage, and to a much greater
extent, than those who have not had access.
Students
with spinal injuries who fall outside the pilot project have presented issues
with service providers, personal care assistance coordination, homelessness,
access to home modifications, access to adaptive technology, transportation and
car modification barriers and advocacy skills to link up their requirements in
the rehabilitation phase. As many of these issues are critical, vocational
education and employment planning have to be moved down the list of priorities
for such students.
As the Lifetime Care and Support Authority program for adults will not be launched until
October 01 2007, the effect on client demand and the amount of disparity
between people who have access to this best practice model and those who do not
can only be estimated at this stage. It would be hoped that once the
vocational, economic and life quality outcomes of the holistic and ‘no fault’
approach can be documented, then other sectors may emulate this model to bring
equitable outcomes to those with spinal injury from causes other than motor vehicle accidents.
Findings from research
into how Welfare to Work and the Skilling Australia’s Workforce Act may impact on delivery
of VET to people with spinal injuries
The SpinalWorks project meets a
number of the federal government priorities for people with disabilities
in both the Welfare to Work and broader
Skilling Australia reforms.
The Skilling Australia’s Workforce Act
sets participation targets for people with disabilities, and this may have
implications for TAFE NSW resourcing of services for students with
disabilities.
Welfare to Work presents a changing landscape for people living with spinal injury and
the impact of these changes may flow on to TAFE institutes and associated
service providers.
For the VET sector, current issues include uncertainty about whether some
current course frameworks will meet mutual obligation requirements for Centrelink
customers, whether flexible delivery of courses will in some instances exclude
people with disabilities from Pension Education Supplement (PES) payments, and
how courses will be identified as having a direct employment outcome within a
12 month timeframe.
Since 1
July 2006, people with disabilities seeking a Centrelink payment
who are assessed as capable of working 15-29 hours per week have had an
obligation and payment reflecting their assumed capacity to work. There is an
associated new payment and compliance framework. These people will not receive
the Disability Support Pension (DSP). They will receive the Newstart Allowance,
and, if assessed as having a partial capacity to work, they may receive a
Pensioner Concession Card.
People assessed as not being able to work, or to be
retrained for work of at least 15 hours per week within two years, may be
eligible for the DSP. For people to receive the DSP they must also have lived
in Australia
for a total of 10 years as an Australian resident (of which five years need to
have been continuous). The Youth Disability Supplement is paid to Youth
Allowance recipients with a partial capacity to work. It is also paid to DSP
recipients under the age of 21.
For those students with a disability
who are in the Newstart allowance category (assessed as capable of working 15-29 hours per week) there are
requirements to show that they are actively seeking work in order to remain
eligible for a payment.
All of these issues present may impact on students in
spinal rehabilitation units seeking to undertake VET programs. The nature of
their injuries means that they face added difficulties in complying with
requirements to complete courses within a given time. Rural students who return
to their home communities after lengthy periods in rehabilitation in Sydney also face a range
of added challenges, such as in some cases being deemed ineligible for payment
as they are moving from an area of high employment to lower unemployment.
The level of complexity of the reporting requirements
for VET providers on mutual obligation compliance means that ongoing education
of all TAFE NSW teaching staff needs to occur to support students with spinal
injuries in meeting these requirements.
In 2006 22 people with spinal injuries were case
managed through the SpinalWorks coordination program. These people were
provided with the required computer and adaptive technology training, advice on
pathways, assistance in locating and enrolling in the courses that best met
their individual vocational goals and linkages into other relevant support
services.
As in previous
SpinalWorks phases, the TAFE NSW Employment
Skills course (9422) allowed access to a wide range of vocational subjects as tasters
for people who were unsure of their future vocational direction and has provided
a pathway into a range of mainstream vocational
courses.
Student progress was assisted by the Spinal Works
Coordinator who, as in previous phases, undertook a range of duties including:
- coordinating
the delivery of vocational courses across the three spinal units in Sydney
- working
closely with coordinators from the MAA
- facilitating
interagency partnerships
- visiting
the rehabilitation units to provide vocational counselling and course
advice
- enrolling
students in flexible and appropriate learning programs
- liaising
with TAFE NSW vocational teachers and teacher consultants
- providing
advocacy to ensure students receive equitable treatment and reasonable
adjustment
- dispatching
learning materials to participants
- procuring
and distributing adaptive technology and other project equipment
- supporting
clients after discharge from rehabilitation units.
In 2006 the
need for increased diversity of course options for people with spinal injuries from
rural areas emerged as something of an issue. In 2006 53% of people in the
three spinal units were from rural areas. Many of these people were previously
employed on agricultural properties and associated businesses. Their family and
social networks are firmly in their local areas. SpinalWorks has endeavoured to provide training options which
ensure that these people return to their localities with relevant and
applicable skills. This issue of course diversity for rural areas needs further
investigation and work in any future development of the SpinalWorks project.
Phase 3 of the SpinalWorks
project achieved its project aims and outcomes as outlined in the above report.
The project also identified a number of key areas for project improvement.
Twenty-two people with serious spinal injuries were
referred to SpinalWorks by the Community Participation Project in 2006 and
received case-managed and holistic support to achieve their vocational goals.
The implications of the Lifetime
Care Package for VET delivery have been examined and documented with a view
to developing vocational delivery that is inclusive of all students with spinal
injury whether or not they are eligible for assistance through this scheme.
The support and knowledge of Teacher/Consultants for Physical Disability across
TAFE NSW Institutes has been a key factor in the outcomes achieved by SpinalWorks to date. Phase 3 of Spinal Works project is drawing to a
close. However, the continued involvement of Teacher/Consultants Physical Disability
in remaining engaged and up to date with the Lifetime Care Package and
other best practice models is a key factor in the future resources available
for students with spinal injury.
The Spinal Works website http://www.spinalworks.net.au/ is now being utilised by students in spinal units,
teachers and service providers. This resource needs to be maintained and be
continually updated, so that it can continue to serve as an important
communication and networking tool.
Spinal Works Phase 3 has further developed partnerships with NSW spinal
units and their staff, the Lifetime Care and Support Authority, NGO service
providers and NSW TAFE teaching sections.
Sustainability remains the biggest
challenge to the SpinalWorks
project. The timeframe for the
introduction of the adult MAA’s Lifetime
Care Package is now the 1st October 2007. This leaves a coordination gap
for people currently receiving support through the project. The coordination
gap threatens the provision of consistent service to current students and makes
the maintaining of established partnerships and resources more challenging.
There is also the important issue
of people with spinal cord injury who will not be eligible for the support
provided through the Lifetime Care
Package.
The SpinalWorks Phase 3 project has provided
real VET outcomes for people with spinal injuries.
TAFE NSW
is positioning itself to continue to deliver high quality client services for
students with spinal injury and to access the future client benefits of the Lifetime Care Package. To succeed in this, all stakeholders need to maintain
their currency of knowledge on the development, progress and opportunities
presented by the Lifetime Care Package.
Contact
Sandra Mackay
Manager Equity Support
OTEN – Western Sydney Institute TAFE NSW
51 Wentworth Road
STRATHFIELD NSW 2135
02-9715 8488
sandra.mackay@tafensw.edu.au
This report has been cleared for submission by:
Susan Hartigan
Institute Director
Western Sydney Institute
TAFE NSW
Signature: ___________________________________
Date: ________________________________________
SpinalWorks and Vocational
Rehabilitation for People with Recent Spinal Injuries Project
Information for Teacher
Consultants - Physical
This information kit contains:
1.
Introduction
2.
General information on
traumatic spinal cord injury (SCI)
a)
Traumatic SCI in NSW –
treatment after injury
3.
TAFE involvement in the
spinal units and the SpinalWorks project
4.
Case Studies
Introduction
SpinalWorks was an early intervention
approach to vocational education and training after traumatic spinal cord
injury. It expanded on earlier projects which have delivered training and
support to people who are in spinal acute and rehabilitation units after spinal
cord injury.
In
2006, the Board of Vocational Education and Training (BVET) has provided
funding for a project officer to do the following:
1)
Maintenance of service and coordination to existing and new Community
Participation Project (CPP) clients
2)
Dissemination of information about the SpinalWorks project
3)
Research into:
project improvements
to maximise client integration into vocational education and training (VET)
implications of the
Lifetime care package
4)
Education based on research findings
The underlying objective is to ensure that TAFE is
strategically placed to be a frontrunner in the new environment for the
provision of early intervention VET to people with spinal cord injury.
To
continue improving our service we need your help.
From
late May and continuing into April the project officer will be contacting
TAFE Teacher Consultants (Physical) to gain insights into current practice
and need.
|
|
This research is particularly interested in:
the
referral process
co
enrolments
skills
availability and shortfalls
potential
areas of collaboration
attitudes
and experiences related to distance learning and e learning
highlighting
and utilising best practice.
General information on traumatic spinal cord injury
Each year in Australia,
there are about 300–400 new cases of SCI to an estimated prevalent SCI
population of about 8,500 cases. Based on 1988 cost estimates,
the ongoing costs associated with the long-term care of the prevalent population
of about 8,500 is estimated to be about A$285 million per year.
About 60 – 65%
(>230) of new SCIs cases are acquired from traumatic causes.
The main
causes are approximately:
50% Motor vehicle accident or road use
30% Falls
10% Water and sports injuries
10% Other causes
The following
graph shows the distribution of spinal injury from traumatic causes in Australia
in 2003-2004.
The national distribution closely mirrors that of the SpinalWorks group. This is
significant considering that the high number of higher level injuries, as seen
in both graphs, has greater needs in terms of technology and assistance.
Traumatic SCI in NSW –
treatment after injury
1. In NSW when someone has an accident
affecting their spinal cord, they are first placed in one of the two spinal
acute care units in NSW; either Royal
North Shore
hospital or Prince of Wales (POW) hospital.
2. Once the person has stabilised, they are
then transferred to a rehabilitation unit (Moorong or POW) where physiotherapy
and occupational therapy occur. In addition it is during this time that
discharge planning occurs. Necessary home modifications, home care and
equipment are also organised at this point.
3. 
Once the person’s home and equipment are
sorted out, they are discharged.
TAFE
involvement in the spinal units and the SpinalWorks project
The spinal unit
based teaching initiatives have been in operation for several years. Since 2000 these
projects have utilised Australians Working Together and BVET funding to provide
vocational education and training
opportunities and intensive learning support to over 200 people with spinal
injuries.
The goal of
SpinalWorks was to assist participants in the transition through VET programs, commencing in the acute rehabilitation
phase through to community placement; including career planning and
employment transition planning.
The Community Participation
Program (CPP)
SpinalWorks is
closely linked to the CPP which is a joint initiative between the Motor
Accidents Authority (MAA) and the Department of Ageing, Disability and Home
Care. The overarching goal of the Community Participation Project is to improve
rehabilitation through early intervention and efficient co-
ordination
among interagency services working with people with recently acquired spinal
cord injuries.
The CPP is also a pilot
and precursor to the LifeTime Care and Support Authority which has recently
been legislated into existence by NSW State Parliament.
Teaching and learning
Delivery
occurs in three TAFE NSW institutes: WSI-OTEN, Sydney
and Northern Sydney. Approximately 25 to 30
clients are receiving support and training each week. Over 30 hours
face-to-face teaching is delivered each week.
Many of the
project participants chose to enrol in distance education courses, which means
they can work at their own pace regardless of their location or mobility. A
number also co-enrolled at face-to-face colleges.
Coordination
Effective coordination of VET provision to this client group
was identified early in the Vocational Rehabilitation Project
as an important factor in
providing the integrated support which can be critical in successfully
readjusting to life after injury.
In 2004 BVET
funding allowed the commencement of the SpinalWorks program. A full-time
coordinator commenced in December 2004 and was responsible for performing the
following duties:
coordinating the delivery of
vocational courses across the three spinal units in Sydney
working closely with coordinators
from the MAA
facilitating interagency
partnerships
visiting the rehabilitation units
to provide vocational counselling and course advice
enrolling students in flexible
and appropriate learning programs
liaising with TAFE NSW vocational
teachers and teacher consultants
providing advocacy to ensure
students receive equitable treatment and reasonable adjustment
dispatching learning materials to
participants
procuring and distributing
adaptive technology and other project equipment
supporting clients after
discharge from rehabilitation units.
The project
also fulfilled formal milestones including:
A literature review into the issues impacting
the participation in VET training of people experiencing spinal cord injury
Development of a designated project website: www.spinalworks.net.au
Production
of an information pack for clients who are to be discharged from the
rehabilitation units
Case Studies
Case Study One
Student X had an
accident resulting in complete T9 quadriplegia. He was contacted by an OTEN
teacher while he was in an acute spinal hospital unit. He began training in
adaptive technologies and computer operation which he had little experience
with prior to his accident. During his time in rehabilitation he became
competent in both areas and began to explore his vocational retraining options
with the coordinator. He made a decision that he would like to retrain but stay
in the automotive industry where he had previously been employed. The
coordinator made contact with the Teacher Consultant from his nearest campus
and after discussion, it was agreed that a co enrolment would be the most
appropriate way of enabling a graduated return to face to face study. In
practice this meant that in the first semester the student studied 2 subjects
by distance through OTEN and one subject face to face on campus at his nearest
TAFE.
The teacher
consultant’s flexibility and use of co enrolment meant that the client is
nearly finished a Diploma, after which he hopes to start looking for work in
his new field.
Case Study Two
Another client from
the farming sector had an L1 injury after a work related accident. After
meeting the SpinalWorks coordinator in the rehabilitation unit and discussing
training options, he received training in computer operations and office
applications useful to running a small business. On return home he was referred
to the local Teacher/Consultant Disability and Welding teaching section. He was
enrolled and supported in an on-campus Statement of Attainment course in Farm
Welding, and has successfully completed a semester. In addition, the
coordinator organised a loan computer and Internet account, as well as ongoing
computer tuition through the local TAFE Business teaching section.
These computer and
welding courses will enable him to broaden his skill-base for working on and
managing his farm. Coordination, referral and the involvement of all teaching
and support sections when working as part of a team can maximise opportunities
for the transition into vocational planning and training after injury.
Case Study Three
When he had his
accident, the client was studying at university and was into the fourth year of
a five-year double degree in Commerce and Law. He has finished the Commerce
component, in Human Resources and Marketing. He was just about to do his fourth
year exams when he had his accident, which resulted in C 5-6 complete
tetraplegia.
To finish the Law
component, he now needs to do another one and a half years of study. He
re-enrolled in his degree but owing to the demands of his rehabilitation had to
wait until the second semester of this year to restart. Using the Employment
Skills 9422 course he enrolled in a MYOB subject to augment his Commerce
degree.
This client had a
lot of existing computer expertise but during his time in rehabilitation has
had to adapt to his changed circumstances, which he did through tuition and use
of the project’s adaptive technologies and software. In addition, with the
assistance of the SpinalWorks coordinator and his teacher, the client
successfully applied for a $5000 scholarship, which allowed him to buy adaptive
technologies and study materials for use when he returned home and to his
university studies.
The use of the 9422
Employment Skills course meant that a highly motivated student did not lose
contact with the study process while waiting to resume his tertiary studies.
Case Study Four
Another client had a high-level SCI as the result
of a sport-related accident. Due to unconsciousness at the time of injury it is
likely he sustained a brain injury in addition to C6 Quadriplegia. He is not
fluent in English, his academic achievement was not to a high level and he
appears to have some learning difficulties. Furthermore, he has a young family
and struggles financially, which although not directly related to his studies,
can have a major impact on both motivation and ability to study.
After consultation with the teacher consultant
from his nearest TAFE, it was decided to place him in a supported class. This
has provided an environment, where specialist educators are aware of, and able
to cater for, his particular needs.
Multiple disabilities and complex needs require a
coordinated team-based approach.
Conclusion
1.
The right
time for intervention
2.
Provision
of support services across TAFE Institutes
There is a need for a consistent approach across
institutes and colleges to ensure equitable access for all. A degree of
flexibility and proactivity are also required when accommodating the reasonable
adjustments necessary to ensure students with physical disabilities have an equal chance of success
in the TAFE system.
It is recommended that the use of co-enrolments
between OTEN and face-to-face TAFE colleges be further developed and utilised
as a means of providing flexibility and maximum support for clients during
integration into training after injury.
Telephone
Survey of Teacher Consultants
(Duration -15-20 minutes)
1) Impressions
of the project information kit
2) New students: Breakdown of where
new students come from
(1
= most to 5 = least)
·
3) Exploration of T/C process: What
do you do when referred a new student?
·
What service(s) do you
typically offer newly referred students
4) Issue identification:
·
Barriers to successful
integration of students in face-to face study
·
Exploration of strategies
used by TCs to circumvent identified issues and TC recommendations for future
actions
5) What would you require when a student is being referred as
part of the SpinalWorks project
6) Any other comments you would like
to make?
Spinal
Works – Milestone 4 Report
‘Survey of TAFE Teacher /
Consultants for Physical Disability’
This phase of the SpinalWorks project involved a state-wide engagement with TAFE NSW Teacher/Consultants Physical
Disability. Teacher/Consultants Physical Disability provide expert support
services to students with a
physical disability studying through TAFE NSW.
Milestone 4 of the project includes the provision of feedback on the
collated survey information, and consideration future continuous improvements
from key survey findings. This contributes
to the wider goal of ensuring that information is disseminated regarding
the insights gained and systems established in the SpinalWorks pilot, with an aim of ensuring
the uniformity of transitional planning and student placement when returning to
the community after spinal cord injury.
Methodology
The project used a semi
structured interview of full-time Teacher/Consultants Physical Disability
across TAFE NSW institutes. The options for response were telephone, email or
mail. The key findings and recommendations are derived from the survey results.
The survey gathered both qualitative and quantitative data, with nine
questions ranging from student referral sources to impressions and expectations
of the SpinalWorks project. The survey also requested that Teacher/Consultants
identify the educational barriers for students living with spinal cord injury.
This was further explored by questions seeking information on strategies that
were currently in use to circumvent identified barriers, and by requesting Teacher/Consultant
recommendations for future actions.
There was a 57% response rate to the survey.
Key Findings
Key findings are based on thematic analysis of the frequency
and consistency of responses occurring within the survey. However, several
responses were isolated in frequency due to individual needs and geographically
specific issues.
The most frequent and consistent key finding emerged
in the question regarding educational barriers for students living with spinal cord injury. The
three significant barriers that were clearly identified by the
Teacher/Consultants are:
·
access to the built environment (84% of respondents)
·
transport Issues - cost, reliability and access (75% of respondents)
·
lack of appropriate courses and loss of courses that were
appropriate and without financial barriers (50% of respondents)
In addressing the
above barriers the most common strategy identified by survey respondents is to
modify attendance requirements, class locations and timetables. The flexible
delivery of courses being coordinated by Teacher/Consultants is more often
associated with built environment issues, available courses and transport barriers,
than with the need for a reasonable adjustment directly related to the
individual’s physical disability.
The second key finding is in relation to the referral
system for the SpinalWorks project. The
data demonstrates that Teacher/Consultants and prospective SpinalWorks students are utilizing all the available pathways to
the project.
The most frequent response to the questions on what
Teacher/Consultants require when a student is being referred was early
notification and consultation to provide time for preparation of equipment,
transport requirements, personal care assistance and other adjustment needs.
This requirement was followed in frequency by
Teacher/Consultants requesting clear Individual
Education Plans and the contact details for participants’ supporting
professionals.
The above findings indicate that Teacher/Consultants
are aiming, within their allocated resources, to provide a holistic training
environment to students living with a spinal injury. The data suggest that TAFE
Teacher/Consultants have naturally progressed towards the ‘Whole of Life’ service delivery model and are using innovative
techniques to support such a holistic training platform within a mainstream VET
environment.
Teacher/Consultant awareness of the need for a holistic
training environment is again evident in the key finding on Teacher/Consultant
use and impressions of the SpinalWorks
Project Information Kit. While 42% of respondents found the kit
informative, 17% of respondents made improvement suggestions. The most frequent
improvement suggestions were for information on Personal Care Assistance within the TAFE environment, and
information on access to adaptive technology and training.
Recommendations
The survey contained scope for Teacher/Consultants to
put forward recommendations.
The recommendations derived from the key findings
are;
·
The
need to systemically address the environmental factors that Teacher/Consultants
are identifying as the most significant educational barrier for students living
with spinal cord injuries. The information provided by Teacher/Consultants may
be disseminated to the existing infrastructure of TAFE Access Committees. The
medium term goal should be to bring VET facilities in line with the minimum requirements
of the Building Code of Australia and the proposed DDA Disability
Standard on Access to Premises (Premises Standard.)
·
Offering
of information collated from the duration of the SpinalWorks project to mainstream projects that involve the
exploration of courses and pathways for VET. The inclusion of
Teacher/Consultants Physical Disability and all relevant stakeholders in course
design projects and process would also be of benefit to students with spinal
injuries.
·
SpinalWorks project staff to implement the improvement
suggestions that Teacher/Consultants have offered in the survey project. These
improvement suggestions include providing further information on Personal Care
Assistance in VET environments, and consistently updating information on access
to adaptive technology and training.
Milestone 5 of the Spinal Works project includes the
provision for further research and development to enable the systematic
transition and reintegration of people from hospital spinal units to vocational
training and employment planning. The information below addresses requests for
further information by TAFE Teacher/Consultants Physical Disability who
participated in the survey associated with this phase of the SpinalWorks project.
The information from
survey respondents indicated that the Welfare
to Work policy and the MAA Lifetime
Care Package present opportunities and challenges in delivering vocational
education and training services for people with spinal injury.
Welfare to
Work
The SpinalWorks
project encompasses some of the federal government current priorities for
people with disabilities in both the Welfare
to Work and wider Skilling Australia
reforms.
However, Welfare
to Work also presents a changing landscape for people living with spinal
injury, and this impact will flow on to TAFE institutes and associated service
providers.
For the VET sector issues include whether
current course frameworks and delivery modes will meet mutual obligation requirements
for Centrelink clients, whether flexible delivery of courses will exclude
people with disabilities from Pension
Education Supplement (PES) payments, and how courses will be identified as
having a direct employment outcome within the required 12 month timeframe.
Under Welfare to Work legislation people with disabilities applying for
welfare who can work part-time will be required to seek part-time work or
undertake appropriate training. The federal budget reform package includes an
extra 12,300 ($43 million) vocational education and training places over 3
years. (This is a total population figure and not specific to the disability
sector.)
Since 1 July 2006, people
with disabilities seeking a Centrelink payment who are assessed as capable of
working 15-29 hours per week have had an obligation and payment reflecting
their assumed capacity to work. There is an associated new payment and
compliance framework. These people will
not receive the Disability Support
Pension (DSP). They will receive the Newstart
Allowance, and if assessed as having a partial capacity to work, they may also
receive a Pensioner Concession Card.
People who are assessed as
not being able to work or be retrained to work at least 15 hours per week
within two years may be eligible for the DSP.
People who are assessed as ‘permanently blind’ are the exception to the 15 hour
cut off and they will be eligible for the DSP.
For people to receive the DSP they
must also have lived in Australia
for a total of 10 years as an Australian resident, of which five years must be
continuous.
The Youth Disability Supplement is paid to Youth Allowance recipients with a partial capacity to work. It is
also paid to DSP recipients under the
age of 21.
The changes
have not to date affected people who were on DSP before 10 May 2005.
For those
students with a disability who are in the Newstart
allowance category (i.e. assessed as capable of working 15-29 hours per
week), there are requirements to show that they are
actively seeking work in order to remain eligible for a payment. These
requirements include:
·
accepting what
Centrelink deems as ‘suitable work offers’
·
attending all job
interviews
·
not leaving a job,
training course or program without a valid (as deemed by Centrelink) reason and
evidence of this reason
·
entering into an
Activity Agreement and meeting all the terms of the agreement.
If certain
participation or activity test requirements are not met, then students with
disabilities may have a ‘participation failure’ recorded against them. This
will result in their payment being stopped for a period of time. If the
‘participation failure’ is not resolved, then an eight week payment suspension
will result. The eight week non-payment period cannot be waived.
If people
with disabilities who receive the Newstart
Allowance change address and this change of location results in reducing their
prospects of finding work, then Centrelink may suspend their payment for 26
weeks.
If VET students were previously receiving PES immediately prior to 1 July 2006 and are continuing the same
course and are now receiving Newstart
Allowance or Youth Allowance, under
certain circumstances they may continue to receive the Pensioner Education Supplement.
At the time of writing there is a lack of clarity about whether TAFE
Statement of Attainment courses in NSW will now qualify for the PES. A number of TAFE Teacher Consultants Physical Disability have
reported students being refused PES at Centrelink due to changes in what
constitutes ‘one quarter load of study’. This issue is being investigated by
the DET NSW Disability Programs Unit.
Students may be
eligible for a one-off Education Entry
Payment regardless of whether or not they qualify for PES. This one-off payment of $208 is described by Centrelink as
assistance with the up-front costs of taking up study.
If students participate in
certain activities such as paid work, voluntary work, vocational training (or a
combination of these) and cannot use public transport, they may also qualify
for the mobility allowance.
MAA Lifetime
Care Package
As stated on the Motor
Accident Authority of New South Wales website:
The
LTCS Scheme was established under the Motor Accidents (Lifetime Care &
Support) Act 2006 to provide treatment, rehabilitation and attendant care to
people who have been severely injured in a motor accident regardless of who was
at fault in the accident. Eligibility for the scheme is determined by the
severity of the person's injuries. Most people who are eligible will have a
spinal cord injury or moderate to severe brain injury, or in some cases serious
burns or amputations.
The scheme
will be implemented in two stages: it will apply to children where the
accident happens on or after 1 October 2006. It will apply to all severely
injured people from 1 October 2007. The scheme will be administered by the
Lifetime Care & Support Authority (LTCSA) which began on 1 July 2006. (http://www.maa.nsw.gov.au/default.aspx?MenuID=249)
The case management provides for whole of life planning with retraining
and vocational outcomes a key aspect of the long term goal planning.
The introduction of this package will substantially decrease resource
demands on TAFE NSW, as motor vehicle accidents account for approximately 50%
of the existing caseload of people with recently acquired spinal injuries.
However, there will be a significant group of students with spinal
injury who will not meet the eligibility criteria of LTCSA, and who will not
have acquired their injury through a motor vehicle accident. Consequently, it
is important that the VET sector embraces the opportunities of LTCSA while
minimising the risk of delivering a two-tiered training model.
The LTCSA, as developed and delivered by the Motor Accidents Authority, has demonstrated that it is an effective
and holistic best practice model. Spinal
Works students who have had access to this pilot program are able to
participate in vocational education and employment planning at an earlier
stage, and to a much greater extent, than those who have not.
Students with spinal injuries who fall outside the pilot project have
faced issues with service providers, personal care assistance coordination,
homelessness, access to home modifications, access to adaptive technology,
transportation and car modification barriers and gaining advocacy skills
achieve their requirements in the rehabilitation phase. As many of these issues
are critical, vocational education and employment planning then tend to be
moved down the list of priorities.
As the Lifetime Care and
Support Authority program for adults
will not be launched until October 01 2007, the affect on client demand and the
amount of disparity between people who have access to the MAA’s best practice
model and those who do not can only be estimated at this stage. It is hoped
that once the vocational, economic and life quality outcomes can be documented,
then other sectors may emulate the MAA’s model to bring equitable outcomes to
those with spinal injury outside of motor vehicle accidents.
In summary, the issue for TAFE in this significant stage of development
is to maintain the interface of vocational planning and case management
conducted by the MAA with the VET system. The implications of the Lifetime Care Package for VET delivery need to be further examined, documented
and disseminated to ensure that clients’ best interests are served and with a view to developing vocational delivery
that has inclusive capacity for all students with spinal injury.
TAFE NSW is positioning itself to continue to deliver high quality
client services for students with spinal injury and to access the future client
benefits of the Lifetime Care Package, possibly, for example, by
tendering as a provider for the MAA. For
these options to continue to be a reality for students with spinal injury, all
stakeholders need to maintain their currency of knowledge on the development,
progress and opportunities presented by the
Lifetime Care Package
The support and knowledge of
Teacher/Consultants Physical Disability in TAFE NSW Institutes has been a key
factor in the outcomes achieved by Spinal
Works to date. This stage of Spinal
Works project is drawing to a close. However, the continued involvement of
Teacher/Consultants Physical Disability in remaining engaged and up to date
with the Lifetime Care Package and other holistic best practice
models, is a key factor in the future resources available for students with
spinal injury.
Resources
Centrelink - Disability
Entitlement Information
http://www.centrelink.gov.au/internet/internet.nsf/individuals/iid_index.htm
(Accessed 14 November 2006)
Centrelink – Pension
Education Supplement
http://www.centrelink.gov.au/internet/internet.nsf/payments/pes.htm
(Accessed 14 November 2006)
National Welfare Rights
Network - Independent Social Security Handbook
http://www.welfarerights.org.au/issh/fsissh_nsw.htm
(Accessed 14 November 2006)
Motor Accidents Authority
– Lifetime Care and Support
http://www.maa.nsw.gov.au/default.aspx?MenuID=249
(Accessed 14 November 2006)
Response to the 2005/2006
Federal Budget ‘Welfare to Work’ Package
Disability and
Participation Alliance
http://www.pwd.org.au/alliance/documents/dpa_policy_response_july05.rtf
(Accessed 14 November 2006)
Australian Network of
Students with Disabilities – current issues page
http://www.answd.com/Current-Issues/
(Accessed 14 November 2006)
Women with Disabilities Australia WWDA -
Submission to the Australian Senate Community Affairs Legislation Committee on
the Employment and Workplace Relations Legislation Amendment (Welfare to Work
and other Measures) Bill and the Family and Community Services Legislation
Amendment (Welfare to Work)
http://www.wwda.org.au/w2wsen.htm
(Accessed 14 November 2006)
TAFE Computer Training
Would you like
to learn new or expand existing computer skills?
Do you need to
learn new ways of using the computer – for the short or long term?
TAFE offers a
training program, specifically for people with a recent spinal cord injury,
within the hospital and rehabilitation environment. We have a range of state of
the art adaptive technologies and specialist teachers who come to you to teach
you, on your own, according to your needs. Regardless of the physical ability
you have at this stage and regardless of your previous computer experience we
will welcome you into the program. Everyone can use a computer.
With the help
of a computer, the internet and adaptive technology everyone CAN….
Read
Newspapers
Magazines
Free ebooks
Ebooks you pay
for
Articles on
websites according to your interest
Communicate
Communicate
with friends using email
Keep friends up
to date with a weekly/monthly newsletter
Keep a diary or
blog
Write the story
of your life/ a short story/ a novel
Speak to people
using the “voice over internet” facility. (An emerging technology)
Educate
Learn new or
expand existing computer skills
Enrol in a distance
education course with TAFE or a university
Research SCI –
in all parts of the world
Research new or
old interests
Find a recipe
to suit your current craving.
Find the
encyclopedia, dictionary and Thesaurus that best suits you.
Entertain
Create or
download music
Rip your
favourite CDs onto your computer and create playlists of just the tracks you
like.
Watch DVDs
Write jokes
Create photo
albums and slide shows
Relax
Play computer
games by yourself / with a friend / over the internet
Solve puzzles
Go surfing (on
the net)
Read to and
play games with your kids
Access services
Go net shopping
for clothes/books/wine/toys
Send your
partner some flowers
Visit the
supermarket and see your order delivered into your kitchen the next day
Manage your
finances with internet banking
Work
Learn new or
supplement existing skills for work
Try an online
careers questionnaire.
Research
training options
Find out about
workplace support
Explore
Explore your
mind – learn meditation
Explore
philosophy – who said/says what about life, the universe and everything…
Explore other
parts of the world
Contribute
Chat rooms
Share your
knowledge and experience with others
Join special
interest groups
Mentor
Computing
skills offer something for everyone. Whether for work or leisure, your TAFE
teachers can help you to learn new skills that will increase your ability to be
truly independent in accessing information and services over the internet.
We promise to take your mind away from hospital
routine, and that there will be no pressure and that we’ll plan together what
you’ll learn.
Are you
interested? Your Occupational Therapist can arrange for one of the TAFE
teachers to visit you in the coming week.
This program is funded by TAFE and
is free of charge.
.
Names and details of all people with a
significant involvement in this phase of the project, the organisations for
which they work and their individual contribution to this phase of the project.
|
Name
|
Organisation
|
Position
|
Contribution
|
|
Sandra Mackay
|
OTEN - WSI
|
Manager Equity Support
|
Project management and budget monitoring
Chair SpinalWorks Steering Committee
|
|
Graham Agnew
|
OTEN - WSI
|
Previous SpinalWorks Coordinator
(January to August 2006)
|
Project coordinator
Member SpinalWorks Steering Committee
|
|
Maya Verma
|
OTEN - WSI
|
Spinal Works Project Coordinator
(August to December 2006)
|
Project coordinator
Member SpinalWorks Steering Committee
|
|
David King
|
OTEN - WSI
|
Teacher/Consultant Physical Disability
|
Project mentor and teacher in Spinal Units
Member SpinalWorks Steering Committee
|
|
Merren Dargan
|
TAFE NSW
|
Teacher/Consultant Physical Disability
|
Teacher at Prince of Wales Hospital,
Moorong Royal Rehabilitation Centre in Ryde, and North Shore
Hospital Spinal Unit.
|
|
John Gray
|
OTEN - WSI
|
Adaptive Technology Consultant
|
Website
development
Spinal Unit
Technical Support
|
|
Carol Barton
|
DET
|
Project Officer
Skills Strategy
|
Attended several Spinal Works Steering Committee
Liaison with OTEN SpinalWorks project
team on behalf of NSW BVET
|
|
Raj Narchal
|
DET
|
Senior Project Officer Skills Strategy
|
Spinal
Works Steering
Committee member
|
|
Julia Shepherd
|
MAA Lifetime Care and Support Authority
|
Coordinator
|
Spinal
Works Steering
Committee
|
|
Maree Marsh
|
DET
Disability Programs Unit
|
Senior Education Officer
|
Spinal
Works Steering
Committee
|
