Counties Manukau District Health – Disability Support Advisory Committee Agenda

Counties Manukau District Health Board Disability Support Advisory Committee Meeting Agenda Wednesday, 21st May 2014 at 3.30pm – 4.30pm, Manukau Board Room, Lambie Drive Time Item Page No

3.30pm 1. Welcome

3.30pm – 3.40pm 2. Governance 2.1 Attendance & Apologies 2.2 Disclosure of Interests/Specific Interests 2.3 Acronyms 2.4 Confirmation of Previous Minutes (16 April) 2.5 Action Items Register

1 2-5 6 7-9 10-12

3.40pm – 4.00pm

3. Presentation 3.1 Health Literacy – Mr Alan Kuyper & Dr Siniva

Sinclair

13-26

4.00pm – 4.15pm

4.15pm – 4.20pm 4.20pm – 4.30pm

4. Discussion Papers 4.1 Definitions and Meanings about Disability –

Colleen Brown 4.2 Disability Support Stocktake – Martin Chadwick 4.3 Be.Accessible Update – Martin Chadwick

27-36 37 38-47

Next Meeting: Wednesday 18th June 2014, Lambie Drive

1

BOARD MEMBER ATTENDANCE SCHEDULE 2014 – DiSAC

Name

Jan 26 Feb 26 Mar 16 Apr 21 May 18 June 16 July 20 Aug 24 Sept 22 Oct 26 Nov 17 Dec

Lee Mathias

No

Mee

ting

Colleen Brown (Chair)

Sandra Alofivae X David Collings

X *

George Ngatai

Dianne Glenn

Reece Autagavaia

X

Mr Sefita Hao’uli

X

Ms Wendy Bremner

Mr Ezekiel Robson

X

* Attended part meeting only

2

BOARD MEMBERS’ DISCLOSURE OF INTERESTS

21st May 2014 Member Disclosure of Interest

Dr Lee Mathias • MD Lee Mathias Limited

• Trustee, Lee Mathias Family Trust • Trustee, Awamoana Family Trust • Chair Health Promotion Agency • Deputy Chair Auckland District Health Board • Director, Pictor Limited • Director, iAC Limited • Advisory Chair, Company of Women Limited • Director, John Seabrook Holdings Limited • Chairman, Unitec

Sandra Alofivae

• Chair of the Auckland South Community Response Forum (MSD appointment)

• MSD Member, Auckland Social Policy Forum, Auckland Council

• Member, Fonua Ola Board • Appointed to the Ministerial Forum on Alcohol

Advertising & Sponsorship • Board member Pacifica Futures

David Collings

• Chair, Howick Local Board of Auckland Council • Member Auckland Council Southern Initiative

Colleen Brown • Chair Parent and Family Resource Centre Board (Auckland Metropolitan Area)

• Member of Advisory Committee for Disability Programme Manukau Institute of Technology

• Member NZ Down Syndrome Association • Husband, Determination Referee for Department of

Building and Housing • Chair, Early Childhood Education Taskforce for

COMET • Member, Manurewa Advisory Group • Member, Child Advocacy Group – Manukau • MSD Member, Auckland Social Policy Forum,

Auckland Council • Deputy Chair, Auckland City Council Disability

Strategic Advisory Group • Chair ECE Implementation Team Auckland South • Chair 11Much Trust

3

George Ngatai • Arthritis NZ – Kaiwhakahaere • Chair Safer Aotearoa Family Violence Prevention

Network • Director Transitioning Out Aotearoa • Director BDO Marketing • Board member Manurewa Marae

Dianne Glenn • Member – NZ Institute of Directors • Member – District Licensing Committee of Auckland

Council • Life Member – Business and Professional Women

Franklin • President – National Council of Women

Papakura/Franklin Branch • Member – UN Women Aotearoa/NZ • Vice President – Friends of Auckland Botanic

Gardens and Member of the Friends Trust • Member – Friends of Regional Parks • Life Member – Ambury Park Centre for Riding

Therapy Inc. • CMDHB Representative - Franklin Health

Forum/Franklin Locality Clinical Partnership

Reece Autagavaia • Executive Member, Pacific Lawyers’ Association • Member, Labour Party • Member, Auckland Council Pacific Advisory Group

Sefita Hao’uli

• Trustee Te Papapa Pre-school Trust Board • Deputy Chair: Anau Ako Pasifika Inc. (Pacific ECE

provider) • Member Tufungalea Tonga Inc. (Promoting and

Growing Lea Tonga) • Member Tonga Business Association & Tonga

Business Council Advisory roles: • Counties Manukau District Health Board • Toko Suicide Prevention Project (Ministry of Health) • Tala Pasifika (NZ Heart Foundation Pacific Tobacco

Control) • (On short-list for the Pacific Advisory Board, Auckland

Council) • Primary ITO & MBIE: Ola e Fonua Project. Consultant: • Government of Tonga: Manage RSE scheme in NZ • Alliance Health: Community Engagement &

Communication Advice. • Ministry of Business Innovation and Employment:

4

Policy Advice and Leadership Training • Pacific Perspectives/Auckland University: Health

research projects • NZ Heart Foundation (Tala): Communication Strategy

and Advice. • NZ Translation Centre: Translates government and

health provider documents. • Mana Trust: Advice on health literacy collaboration

between Maori and Pacific providers.

Ezekiel Robson • Auckland Council Disability Strategic Advisory Group • Department of Internal Affairs Community

Organisation Grants Scheme Papakura/Franklin Local Distribution Committee

• Be.Institute/Be.Accessible ‘Be.Leadership 2011’ Alumni

Wendy Bremner • CEO Age Concern Counties Manukau Inc

• Member of Auckland Social Policy Forum • Member of Health Promotion Advisory Group (7 Age

Concerns funded by MOH)

5

DISABILITY SUPPORT ADVISORY MEMBERS’ REGISTER OF DISCLOSURE OF SPECIFIC INTERESTS Specific disclosures (to be regarded as having a specific interest in the following transactions) as at 21st May 2014 Director having interest Interest in Particulars of interest Disclosure date Board Action

6

Glossary

ACC Accident Compensation Commission ADU Assessment and Diagnostic Unit ARDS Auckland Regional Dental Service BT Business Transformation CADS Community Alcohol, Drug and Addictions Service CAMHS Child, Adolescent Mental Health Service CNM Charge Nurse Manager CT Computerised Tomography CW&F Child, Women and Family service DNA Did not attend ESPI Elective Services Performance Indicators FSA First Specialist Assessment (outpatients) FTE Full Time Equivalent ICU Intensive Care Unit iFOBT Immuno Faecal Occult Blood Test MHSG Mental Health service group MoH Ministry of Health MTD Month To Date MOSS Medical Officer Special Scale OHBC Oral health business case ORL Otorhinolaryngology (ear, nose, and throat) PACU Post-operative Acute Care Unit PHO Primary Health Organisation PoC Point of Care SCBU Special care baby unit SMO Senior Medical Officer SSU Sterile Services Unit TLA Territorial Locality Areas WIES Weighted Inlier Equivalent Separations YTD Year To Date

7

Minutes of the meeting of the Counties Manukau Health

Disability Support Advisory Group Wednesday 16 April 2014

held at Counties Manukau Health Boardroom, 19 Lambie Drive, Manukau

commencing 3.30pm

COMMITTEE MEMBERS PRESENT: Dr Lee Mathias (Board Chair) Ms Colleen Brown (Committee Chair) Mr George Ngatai Ms Dianne Glenn Ms Wendy Bremner Mr Ezekiel Robson Mr Sefita Hao’uli Mr Apulu Reece Autagavaia

ALSO PRESENT: Mr Geraint Martin (Chief Executive) Mr Martin Chadwick (Director Allied Health)

APOLOGIES: Apologies were received and accepted from Mr David Collings and Ms Sandra Alofivae.

WELCOME The Committee Chair welcomed those present. 2.2 DISCLOSURE OF INTERESTS The Committee noted Mr George Ngatai’s disclosure that he has been appointed to the Manurewa Marae Board. 2.2 SPECIFIC INTERESTS There were no specific interests to note with regard to the agenda for this meeting. 2.3 ACRONYMS The acronym list was noted. 2.4 CONFIRMATION OF PREVIOUS MINUTES Confirmation of the Minutes of the Counties Manukau Health Disability Support Advisory Committee meeting held 26 March 2014 (agenda pages 6-8).

8

Resolution (Moved Ms Colleen Brown/Seconded Ms Dianne Glenn) That the minutes of the Counties Manukau Health Disability Support Advisory Committee meeting held 26 March 2014 be approved. Carried 2.5 ACTION ITEMS REGISTER Mr Martin and Mr Ezekiel Robson to do a ’walk through’ of the hospital to see how the new way finding signage works/feels for a disabled person and update the Committee. 3. UPDATES 3.1 Health Passport Mr Martin Chadwick provided this update. The HDC recognised that there was a gap insofar as there was nothing for a patient to give over to a health professional to say “this is the desires I have” or “this is how I want to be treated in your services”. The passport was promoted by the HDC and rolled out by a DHB by DHB basis however, the HDC have now had a change of tact and as from 1 July 2013 this is now being rolled out through the NGO sector. The Committee agreed to the following actions:

• Mr Martin and Mr Chadwick will approach some patient groups (3 or 4) about trialling the health passport (stroke/residential homes).

• Mr Martin to have a conversation with the Advanced Care directorate in relation to the health passport.

• Mr Chadwick to email the HDC to inquire if they have any more resources, seek feedback about the usability of the passport and whether it is available in other languages.

3.2 & 3.3 Be Accessible Resolution (Moved Ms Dianne Glenn/Seconded Ms Wendy Bremner) The Committee approved Mr Chadwick to undertake a stocktake of other large DHBs to determine the level of support that is provided for disability issues to determine how best Counties Manukau Health aligns to the wider sector. Carried Resolution (Moved Mr Sefita Hao’uli/Seconded Apulu Reece Autagavaia) The Committee approved Mr Chadwick to engage with Be.Accessible to determine the feasibility and cost of having some of the DHB facilities audited for accessibility as per the Be.Accessible criteria. The Manukau Super Clinic is proposed as a logical start point. Carried

9

4. Other Business Emerging Issue – Ms Colleen Brown People with disabilities over the age of 65 - some have not been assessed, some are cared for at home with minimal support and then hit a health crisis and do not get good advice in the community. We need a clear process for people to follow. As people with disabilities live longer, it is becoming a greater reality. Mr Martin to talk to Ms Dana Ralph-Smith, General Manager, Health of Older People as a starting point in this regard. DiSAC Terms of Reference Mr Eziekel Robson inquired about the Terms of Reference for the DiSAC Committee. Mr Martin advised that the Terms of Reference are currently being refreshed by the Board Secretary but that a copy would be emailed to the Committee for review/comment. Mr George Ngatai asked if Ms Tangi Kingi could be invited to participate in the CPHAC Committee. Dr Mathias advised that the Board Secretary is currently developing a database of all CPHAC & DiSAC interested parties/stakeholders who can be contacted and advised when these meetings are on and where they can go to locate the papers, so people get in the habit of attending these meetings. Mr Ngatai advised that he is working on the Manawhenua representation which the Board has to yet to ratify. The Chair thanked those present for their participation in the meeting. Apulu Reece Autagavaia closed the meeting with a prayer. The meeting concluded at 4.42pm. Signed as a correct record of a meeting of Counties Manukau Health‘s Disability Support Advisory Committee meeting held 16 April 2014. Chair Ms Colleen Brown Date

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Disability Support Advisory Group Meeting Summary of Action Items as at 21st May 2014

DATE

ITEM ADDED ITEM DETAIL RESPONSIBILITY

(GM/ADVISORY COMMITTEE) COMMENTS/

UPDATES WHEN

COMPLETE

Aug 2011 Policies That policies need to be sent for review to DiSAC before implementation of policy and the Committee to receive a brief analysis to be put in papers for following meeting.

Mr Chadwick Ongoing

November 2012 Wayfinding Further update on Wayfinding Mr Chadwick/Ms Janet Kamau May/June

February 2012 Stroke Guidelines Information on the CMDHB stroke unit rehabilitation project

Mr Chadwick (Dana Ralph-Smith)

June

February 2012 Dignified Patient Handling Further update in June including info on staff training

Mr Chadwick (Denise Kivell) July

March 2012 Whaanau ora How does Whaanau Ora work to meet the needs of the disability communities and health of older people

Mr Chadwick June

26 March 2014 Health Literacy

Mr Chadwick/Mr Kuyper May

16 April 2014 Wayfinding Mr Ezekiel and Mr Martin to do a walk through of the hospital to see how the new wayfinding signage works/feels.

Mr Ezekiel Robson/Mr Martin

TBC

16 April 2014 Health Passports Approach some patient groups (3 -4) about trialling the health passport (stroke/residential homes). Contact Advanced Care directorate in relation to the health passport.

Mr Martin/Mr Chadwick

Mr Chadwick

TBC TBC

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DATE ITEM ADDED

ITEM DETAIL RESPONSIBILITY (GM/ADVISORY COMMITTEE)

COMMENTS/ UPDATES

WHEN COMPLETE

Email the HDC to inquire if they have more resources, seek feedback about the usability of the passport and whether it is available in other languages.

Mr Chadwick

TBC

16 April 2014 Be.Accessible Undertake a stocktake of other large DHBs to determine the level of support that is provided for disability issues to determine how best CMH aligns to the wider sector. Engage with Be.Accessible to determine the feasibility and cost of having some of the DHB facilities audited for accessibility as per the Be.Accessible criteria.

Mr Chadwick

Mr Chadwick

May May

16 April 2014 People with disabilities over 65yrs

Contact GM ARHoP to understand if there is a clear process for people to follow who have not been assessed or are cared for at home with minimal support etc.

Mr Martin

TBC

16 April 2014 DiSAC Terms of Reference Board secretary to distribute a copy of the Draft Terms of Reference to the committee for review/comment.

Lyn Butler

May

`

16 April 2014 Attendance at Meetings Board secretary to send out a letter to local community bodies notifying dates for future CPHAC/DiSAC meetings so people get in the habit of attending these meetings.

Lyn Butler

Health Literacy

Better Health Outcomes for All Executable Strategy Update

Date: May 2014 Created by: Alan Kuyper 013

Health Literacy In New Zealand, health literacy has been defined as: “the capacity to obtain, process and understand basic health information and services in order to make informed and appropriate health decisions”. 1

1) Ministry of Health. Feb 2010. Korero Marama: Health Literacy and Maaori Results from the 2006 Adult Literacy and Life Skills Survey. Wellington: Ministry of Health.

014

Why Health Literacy ?

1) Adult literacy and numeracy in New Zealand– A regional analysis, July 2010, MOE

55% of Counties don’t have the

minimum level of literacy to cope

with the complex demands of

everyday life 1

015

Why Health Literacy ? • There are increased expectations for patients and whānau to

take more responsibility for the management of their health. 1 • Health literacy should not depend on the skills of the individual

patient and whānau alone. It is an organisational value that should be considered core business.1

• The Executive Leadership Team and Board of Counties Manukau Health have recognised the importance of this subject through their endorsement of a strengthened population health approach in December 2012

1) Ministry of Health. 2012, p7. Proposals for a Review of Health Literacy environments in Hospitals and Health Clinics. Wellington: Ministry of Health

016

Organisational focus There is a growing appreciation that health literacy is more than a set of skills that individuals need to acquire.

System changes are needed to align health care better with the public’s skills and abilities and develop “health literate health care organisations” – that is, “health care organisations that make it easier for people to navigate, understand, and use information and services to take care of their health” (Health Literacy – An Internal Review, 2012, CMDHB)

Health Literate Health Care Organisations

make it easier for people to navigate, understand, and use information and services to take care of

their health

HLO 017

Proposed focus

What can CM Health do to:1,2

• Develop health literacy skills of consumers (starting from where they are at)

• Reduce health literacy demands of the health sector

1. Korero Marama: Health literacy and Maori. Results from the 2006 Adult Literacy and Life Skills Survey. Ministry of Health, Wellington, February 2010 (Health Literacy – An Internal Review, CMDHB, December 2012) 2. Ministry of Health. 2012, p7. Proposals for a Review of Health Literacy environments in Hospitals and Health Clinics. Wellington: Ministry of Health 018

Best value for public health system resources

System Integration (through Localities)

Ensuring Financial Sustainability

Enabling High Performing People

Achieving a Balance

Triple Aim Executable Strategies

Improved health and equity for all populations

Better Health Outcomes for All

Improved quality, safety and experience of care

First, Do No Harm

Delivering Patient & Whaanau Centred Care

019

Improved Maternal and Infant Nutrition

Reduced initiation

Better Health Outcomes for All

First 2000 Days

Smokefree DHB by 2025

Minimise harm from poor housing

Improve Health Literacy

Healthy Attachment

Planned and Healthy Pregnancy

Increased Quitting

Oral Health Health Literacy Review

TBD

Rheumatic Fever Messages

Housing Insulation

020

Smokefree 2025

Health Literacy

Better Health Outcomes for All

First 2000 Days

Planned Healthy Pregnancy

Maternity ReviewProject

Youth ?

Maternal & Infant Nutrition

Infant NutritionMOH RFP

TBD

Healthy Attachment

Universal Screening

Service Development

Oral HealthHealth Literacy

Evaluation

TBD

Evaluation Implementation

TBD

TBD

Brief PID Brief

Brief Brief Brief

RFP PID

Gwynette Pam Nelli-Ann(Abi+Carmel)

ChristineCarlaSiniva

Siniva, AlanCarmel, Pip, Alan

Vicki

Danny Amy

Doc completed

Doc required

PID

Doc in progress

PDD

Obesity

Needs Assessment

?

Implementation

TBD

TBD

Brief

Doon ?

Research, Innovation and

Evaluation

Cessation Planning and Development

Cessation Implementation

Phase 1

DHB Leadership andAdvocacy Plan

Communication and

Engagement

Cessation Implementation

Phase 2

Cessation Provision

Housing

Healthy Housing

TBD

Improving Housing Conditions

Messages

Rheumatic Fever Messaging (AH+)

TBD

Brief

Jude

WarmUp Counties

BAUProject

Jude

On Hold

Initiate

Running

Completed

Stopped

Health Promotion

HealthLiteracy

- At Risk- Primary Care- Specialist

- Health Promotion- Parenting Education

021

What have we done? 1. Collaboration with Workbase on a MOH project to develop a review guide for health literacy, and pilot it within our oral health service. • Findings and Recommendations

Report are expected by September 2014.

• HL Review Guide could be used for reviewing other services. It assess the service according to the identified six key dimensions of a health-literate organisation

• Project Board provides governance

022

What have we done? 2. Health Literacy Symposium • The purpose of the symposium was to bring

people with an interest in health literacy together from across the District, to develop a common understanding of health literacy and share experiences and learnings

• A total of sixty-five participants from across the District and beyond (representing CM Health and eight other organisations) attended.

023

What have we done? 3. Established Network • An outcome of the Health

Literacy Symposium is the establishment of a network to support information sharing and future work.

• Produced a newsletter. This newsletter will be the main means of keeping in touch and inform the network of developments and future events and symposiums.

024

What’s next ? • Seek Counties wide consultation to

– Define Health Literacy workstream goals and objectives

– Define strategies to deliver objectives – Identify key focus areas

Goal

Objective Objective

Strategy Strategy Strategy

• Produce strategy document for ELT & DHB approval

025

Feedback and Questions ?

• What are the health literacy considerations that are important to the disabled community ?

026

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Of definitions and meanings about disability

Special education policy is widely understood to be complicated and challenging. However it is not the disabilities themselves that create the challenge to policy creation, rather it is the manner in which the impact of those disabilities on society in general are constructed which is the issue. Disability is not about sluices, ramps and toiletry needs. It is about the categorizing of people by those in positions of influence and the taking up of such meanings by the wider society. It is also about regulating the entry of people once they are labelled into society, and imposing on them conditions of acceptance and continuity of service. An early example was the unproblematic legitimation of exemption from compulsory schooling on the grounds of “temporary or permanent infirmity” when education was nationalised in New Zealand (Education Act, 1877, 127). This has been an on-going function of state legislation, to shore up the commonly held view held by society as to what should happen in the lives of people with disabilities.

In the 1980s it became apparent that, for many, the category of disability had become closely associated with exclusion and oppression. Early state policy had traditionally reflected three major discourses, through which disability had been understood, that had informed marginalising attitudes and practices. They were the charity, medical and lay discourses (Fulcher, 1989).

The charity discourse was a product of the Victorian era, where the state assumed the role of the benevolent humanitarian towards people with disabilities. Reflected initially in the work of religious and community voluntary endeavour, this model requires the person receiving assistance, to show appropriate gratitude for whatever is given to them; whether it meets their needs or not. In New Zealand the state took this role as provider for people in need of help. The state’s actions initially focused on those who were perceived to be of criminal disposition or vulnerable to corruption because of poor parenting. The selection for correction of those children deemed to be a threat to social order before the nationalising of state education for all settler children was also a reflection of the limited capacity of an underdeveloped bureaucratic administration to address problems of social order. (Stephenson, 2008).

The medical discourse has been the most pervasive and deeply entrenched model used to oppress people with disabilities. It influences the way many professionals use language to dominate parents, people with disabilities and their caregivers. The medical discourse uses ‘facts’ to support its position. Those factual arguments appear neutral because they seem to be dealing with un-emotional truths, but in reality serve to conceal and appear not to rely on relations of power and control (Fulcher, 1989). The medical model has been adopted by non-medical professional groups including those in education. It assesses the deficits of an individual’s capabilities and creates sub-categories of disability to justify the individual’s segregation and exclusion. By highlighting the nature of the person’s problem, their deficiencies are emphasised and it becomes the individual’s problems that are at issue and

28

therefore the target of correction, not the school nor the educational professionals. Deficits in individuals categorised as ‘disabled’ leads to their exclusion and segregation. The professionals across a range of disciplines adhering to this model had the power to inform politicians and the wider society that their way was ‘the best way’ to deal with people with disabilities.

The lay discourse, informed by both the medical and charity discourses, highlights the difference between those people with full body control and those perceived as being without that important socially accepted self-control (Fulcher, 1989). Fear, prejudice, pity, ignorance and resentment also inform the lay discourse, often creating paternalistic and maternalistic practices of professionals, which are reinforced by the perception of society towards people with disabilities as being child-like and unable to make decisions for their own well-being. Combined, the three accepted discourses promote and legitimate the power of the able and complete, who value the body with a particular image, over those who do not reflect that image. Therefore those with less easily regulated bodies or minds are denied the right by society to exercise personal responsibility. The rights’ discourse is a more recent ideology informing society from a completely different perspective from the three other discourses. The proponents of the rights discourse want the same opportunities for people with disabilities as awarded to all other sectors of the population. The expression of rights is a challenge by an oppressed minority which is aimed directly at the prevailing attitudes and beliefs. The rights discourse is openly political, linked to the civil rights movements and for special education issues it focussed on the disability policies that discriminated, excluded and oppressed people with disabilities. The rights discourse concentrated on the individual’s right to make choices and decisions. As Keith Ballard has argued:

‘The call for the right to inclusion in schools and communities should not be misunderstood as a move to hide disability or to pretend that everyone is the same. Inclusion is not a policy of assimilation but of valuing diversity. Also the right to inclusion does not mean that a person or group has to take part’. (1994, 19)

OF DEFINITIONS AND MEANINGS ABOUT DISABILITY

029

Disability meanings • It is not the disabilities themselves that create the

challenge to policy creation, rather it is the manner in which the impact of those disabilities on society in general are constructed which is the issue.

• Disability is not about sluices, ramps and toiletry needs. • It is about the categorizing of people by those in positions

of influence and the taking up of such meanings by the wider society.

• It is also about regulating the entry of people once they are labelled into society, and imposing on them conditions of acceptance and continuity of service

030

Disability meanings • Early state policy had traditionally reflected three major

discourses, through which disability had been understood, that had informed marginalising attitudes and practices. They were the charity, medical and lay discourses (Fulcher, 1989).

031

Disability meanings – Charity Discourse • The charity discourse was a product of the Victorian era,

where the state assumed the role of the benevolent humanitarian towards people with disabilities.

• Reflected initially in the work of religious and community voluntary endeavour, this model requires the person receiving assistance, to show appropriate gratitude for whatever is given to them; whether it meets their needs or not.

032

Disability Meanings – Medical Discourse • The medical discourse has been the most pervasive and

deeply entrenched model used to oppress people with disabilities.

• It influences the way many professionals use language to dominate parents, people with disabilities and their caregivers.

• The medical discourse uses ‘facts’ to support its position. Those factual arguments appear neutral because they seem to be dealing with un-emotional truths, but in reality serve to conceal and appear not to rely on relations of power and control.

• It assesses the deficits of an individual’s capabilities and creates sub-categories of disability to justify the individual’s segregation and exclusion

033

Disability Meanings – Lay Discourse • The lay discourse, informed by both the medical and

charity discourses, highlights the difference between those people with full body control and those perceived as being without that important socially accepted self-control (Fulcher, 1989).

• Fear, prejudice, pity, ignorance and resentment also inform the lay discourse, often creating paternalistic and maternalistic practices of professionals, which are reinforced by the perception of society towards people with disabilities as being child-like and unable to make decisions for their own well-being.

034

Disability Meanings – Rights Discourse • The rights’ discourse is a more recent ideology. The

proponents of the rights discourse want the same opportunities for people with disabilities as awarded to all other sectors of the population.

• The expression of rights is a challenge by an oppressed minority which is aimed directly at the prevailing attitudes and beliefs.

• The rights discourse is openly political, linked to the civil rights movements and for special education issues it focussed on the disability policies that discriminated, excluded and oppressed people with disabilities. The rights discourse concentrated on the individual’s right to make choices and decisions

035

Inclusion • ‘The call for the right to inclusion in schools and

communities should not be misunderstood as a move to hide disability or to pretend that everyone is the same. Inclusion is not a policy of assimilation but of valuing diversity. Also the right to inclusion does not mean that a person or group has to take part’

Keith Ballard 1994, 19

036

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Counties Manukau District Health Board DHB Stocktake for Disability Support Roles

Recommendation It is recommended that DiSAC: • Note the stock-take for large DHB’s • Discuss what this could mean for CMH in shaping any recommendations to the Board Prepared and submitted by: Martin Chadwick, Director Allied Health 1. Purpose

The purpose of this paper is to update DiSAC on the stock-take that has been undertaken with large DHB’s to determine what support is in place from a Disability standpoint.

2. Background

At the previous months DiSAC approval was given to complete a stock-take of the large DHB’s to determine what roles are in place to support and promote initiatives around disability issues. The large DHB’s have been contacted in turn and a summary of the findings is represented below:

DHB FTE Scope of Role Waitemata 0.8 FTE Reports to the joint DiSAC and functions as the

advocate for disability issues within the organisations and maintains community networks. Benefit of the role is in building within organisation relationships and linking to the community networks. Some tension as the role is employed within WDHB but does cover both so there is often difficulty in translating initiatives easily and seamlessly across the two DHBs.

Auckland

Waikato 0 FTE DiSAC sits within combined committees Capital Coast 1.0 FTE Role sits within the Service Integration

Development Unit and works across the three lower North Island DHBs. Role is not too dissimilar to the role established across WDHB and ADHB.

Canterbury 0 FTE DiSAC previously sat within a combined committee and has only with a new Board being re-established as a separate committee. They are currently in the process of determining what resource needs to be in place to support DiSAC.

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Counties Manukau District Health Board Be.Accessible Update

Recommendation It is recommended that DiSAC: • Note the progress to date in putting together a proposal with Be.Accessible • Discuss the initial feedback on pricing for engaging Be.Accessible to inform any proposal to the

Board Prepared and submitted by: Martin Chadwick, Director Allied Health 1. Purpose

The purpose of this paper is to update DiSAC on the progress in working with Be.Accessible to undertake a review of Manukau Super Clinic as a proof of concept of evaluating our facilities from an accessibility standpoint for the Disabled Community.

2. Background

At the previous months DiSAC approval was given to explore engaging Be.Accessible to undertake a proof of concept of evaluating some of our facilities. This will allow the organisation and DiSAC to gauge the benefit of this process and to begin to understand a pathway forward to undertake this type of evaluation in a broader context, whether it be done internally or engaging an external agency such as Be>Accessible. The primary contact at Be.Accessible (Megan) has been on leave and contact was made this week to explore how to progress this. Her initial proposal is attached. Next steps will be to do an initial walk through the Super Clinic site with her which will then allow her to put together a firmer proposal for CMH. Key points are:

• The Be.Accessible approach is very much from a client standpoint and will follow

their journey e.g. how a client/patient is initially engaged with (such as an appointment letter). Then how well is it communicated how to get to the clinic and the accessibility via public transport and ease of parking as examples. This will then lead into a more formal review of the physical facilities.

• Improvement opportunities will be fed back, but very much in line with how do we ensure we are accessible as an organisation and this is engrained as to how we do business.

• Initial pricing for the Super Clinic would be in the $2500-5000 range, but this will be firmed up after an initial walk through.

• Of interest Mid-Central DHB went through a broader approach as an organisation with a costing of approximately $20,000. I will follow through with the contact given there to obtain their feedback. After an initial engagement period they have continued to progress this initiative on their own.

Once more definite pricings have been obtained from Be.Accessible, this will be bought back to DiSAC.

Manukau Super Clinic

039

Dear Martin, Thank you for taking a big step towards contributing to a 100% accessible New Zealand. With 1 in 5 New Zealanders currently living with a disability, and the aging baby boomer generation fast becoming the super consumer of this century, your commitment to accessibility is an extremely important part of creating a fully accessible world for everyone. By making this commitment you are tapping into one of the fastest growing customer groups right now – the access customer. You are also positioning your organisation as a key influencer by contributing to how we collectively shape a new conversation and view of the world that puts accessibility at the forefront of our lives. Simply by making the decision to go on this journey, you are Be.ing the Change! Inside this proposal pack, you will find:

1. An introduction to Be. Accessible 2. An overview of the Be. Welcome Accessibility Journey 3. A tailored proposal for your own Accessibility Journey

I do hope that you find the information contained within this pack informative and compelling to help you begin a journey towards accessibility for all people. Kind Regards, Megan Barclay Be. Welcome Programme Director

040

About Be. Accessible Imagine a world where every community is truly accessible and therefore every human being has the opportunity to fulfill their true potential. That is what Be. Accessible has set out to create. At Be. we believe that true accessibility is only possible when the physical, social and personal aspects of life are addressed together. We aim to achieve this goal through our four integrated programmes:

1. Be. Welcome: A holistic business assessment programme that ensures all personal, social and physical environments are accessible and enable all people to find out, enjoy and share in all that our country has to offer.

2. Be. Accessible Campaign: A social change campaign that inspires all New Zealanders to think differently about access. We use our campaign programme to profile the innovation and improvements of our Be. Businesses.

3. Be. Leadership: A programme that builds individual and collective

leadership capacity across New Zealand in the context of access, creating capacity right through businesses and environments that enables all people to be responded to in the way we all deserve.

4. Be. Employed: An accessible employment movement that enables employers all over New Zealand to become employers of choice for individuals who live with a disability, thus contributing to the opportunity cost of low employment rates for New Zealanders living with an access need.

Through engaging in one or all of these programmes, you can be part of creating a New Zealand which is the best place in the world to Be. And.... through ensuring that your services are accessible to everyone regardless of their unique need, grow better a better service, receive more referrals, empower staff and create a strong culture of accessibility.

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Introducing the Access Customer The access customer is the world’s largest untapped market; they make up at least 20% of our population. Did you know…..?

1 in 5 of us lives with a disability

All children have unique learning styles

50% of us over the age of 65 years have at least one impairment

Parents with push chairs have many of the same access needs as a person in a wheelchair.

Research indicates that the baby boomer generation is the high value consumer of this century. With high spending power, time to travel and experience new things, but with growing access needs, this group is active, engaged and savvy.

An access customer may be:

Baby boomers * or an older person;

Someone with a hearing or visual impairment;

A person who uses a wheelchair;

A person with a learning impairment; or

A parent out with their child/children; Very often, for this group, accessing society can be a challenge, or even totally exclusive. Without realising it, you could be unintentionally excluding this group and their personal networks… their friends and family…. from accessing your business, your environment, your services and products. And unintentionally excluding this group from knowing they can access your business ! The opportunity to become a fully accessible organisation has never been greater!

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How can Be. Accessible work with you? We have a network of Be. Coaches and Be. Consultants located all over New Zealand, who facilitate Be. Welcome Programmes with businesses and organisations from any sector. An accredited Be. Coach will act on Be.’s behalf and take the following actions with you:-

1. Assess the accessibility of all aspects of your organisation, including the following: o Website and other resources in which New Zealanders and

customers find out about you and your services; o All marketing material, communication and information your

customers/clients need to know, and you want them to know; o Navigating to your business or organisation, including signage

and the exterior environment; o Customer service delivery and your organisational culture and

awareness of access needs and opportunities; o The physical space where you operate your services and the

environments where your customers and suppliers experience you.

o Client processes that have been deemed to be in scope for the programme.

o Any internal environments or experiences if you are embarking on a Be. Employed journey as well.

2. Provide you with a comprehensive report that is broken down into the accessible aspects that you do well, and the areas for recommendation; prioritised as short, medium and long term recommendations.

3. Meet with you to review the report and guide you on your

accessible journey to provide better experiences for your existing and future clients/customers.

4. Award you an accessibility rating ranging from Just Starting through to Platinum. Receiving a Gold, Silver, Bronze or Just Starting rating provides you with an indication as to where you are in your accessibility journey, as well as giving you something to aspire to. We will send you a Be. Welcome Sticker for your key Cusstomer touch points (website, entranceways).

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5. Be. will publish your accessibility information on our Be.

Accessible website so that: a. Access customers will know that they can come and

experience your services; b. Access customers will be able to plan their ideal

experience of what you have to offer through the access information provided;

c. New Zealanders will know that you are a business/organisation that takes accessibility seriously and wants to include all members of society;

6. We can also provide up to 15 key members of your team with an Accessibility Awareness workshop (Be. Confident) of up to two hours to build a sustainable approach to accessibility into your induction and training development programmes.

Investing in Accessibility

Investment

Be. Welcome Programme for a medium - large sized organization, e.g hotel, library, medical centre, school.

- This depends on the size and complexity of an environment.

- The pricing scale is based on time and effort to complete the programme, and the number of stakeholders involved from your organization.

Range: $1549 - $5,000.00 GST excluded

Be. Employed Programme +

- Access to networked forums that allow organizations to share success stories.

- Access to a self assessment survey - Knowledge that contributing to the

accessible employment movement for New Zealand

Annual membership of either $1,000 or $5,000

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Be. Welcome and Be. Employed Consultancy Programme for large organizations and New Zealand’s Top 100 A consultancy model that will enable each organization to tailor its Accessibility Development Programme to meet its main organizational objectives. As with the Small and medium sized programme it is holistic and takes into account all aspects of organizational functions. Be. Will commission its very experienced consultants to scope out the programme and establish priorities with organizational stakeholders. The programme approach is largely three parts:

1. Discovery 2. Implementation 3. Evaluation

Range of $15,000 - $65,000* Size and scope dependent

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The business opportunities are endless...

Attract new customers/clients from the 900,000 New Zealanders and thousands of visitors to New Zealand with access needs;

Deliver quality outcomes with each client/customer;

Know that you are providing information on your accessibility to a growing target group;

Build greater loyalty and return business from your client base including their families, friends and networks across the country;

Discover new marketing opportunities to attract the growing baby boomer market soon to be descending on New Zealand’s shores from the Cruise market and increasing visitor market;

Enable staff to give greater service to all;

Contribute to a better society for all by becoming 100% inclusive.

Finally, the Be. Team would love to work with you to help you to achieve your organisational objectives as well as enabling greater accessibility for all and contributing to a significant social change across New Zealand. Because after all why would you want to cut off 20% of the market from accessing your business and services? If you need any further information, please do not hesitate to contact us on 0800 Be In Touch (0800 234 868) or 09 309 8966. So, for you to become part of the accessibility movement and ensure that you are ensuring your business is including every of your potential visitors or customers, Email us at info@beaccessible.org.nz or phone on 0800 234 686 to engage in: -

A Holistic Assessment by a Be. Coach of your business;

A Report that outlines your results, what you are doing well, and what you can improve;

A business profile of your accessibility on the Be. Accessible website for our growing network of access customers and their networks to see;

Ongoing support from Be. Accessible to enable you to become 100% accessible for all and to be seen as a leader in this space.

Be. Accessible would like to thank the Independent Living Service Auckland, the Royal New Zealand Foundation of the Blind, IHC New Zealand, Squiz New Zealand, Deaf Aotearoa, Literacy New Zealand

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and many other national providers across New Zealand for their contributions and value feedback on our Be. Welcome Programme.

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