Men Women and Dogs! 
Submission # 3
to the Productivity Commission’s enquiry into Disability Care and Support
By John Homan,
speaking for the Capricorn Community Development Association, Rockhampton
Executive Summary
In the community services sector workforce shortages are already an issue, and many sources predict that it will get much worse over the next five years or so. A NDIS will have an additional impact as, being a universal scheme, it will be a catalyst for considerable growth in the disability sector.
Several suggestions on how to address these issues have been made, and might work, but may take time. A means of reducing, not solving, the workforce shortage will be to reduce dependence on human support and expand the engagement of ‘man’s best friend’, the assist, or service dog.
A dog that has been specially trained to assist a disabled person with certain daily tasks, that he is unable to perform for himself. The employment of assist dogs has expanded from the vision impaired into all areas of physical, intellectual, neurological and psychiatric disabilities.
Employing assist dogs has many positive benefits for people with disabilities:
1.	People with disabilities with an assist dog require fewer hours of attendance of support workers.
2.	An assist dog, on duty around the clock, creates a safer environment.
3.	An assist dog  is less expensive to employ than human support workers.
There are other benefits which, although not within the definition of assist dog, are still very real, and very positive:
4.	The relationship between owner and dog can be rich and rewarding.
5.	With support workers the authority tends to be with the worker, with an assist dog this is reversed, with the person with the disability in charge. This can lead to an increased sense of worth.
6.	A (disabled) person with a dog is more likely to build linkages in the community than one accompanied by a ‘carer’.	
There is more: 
7.	The disability sector may expand its capacity without a proportional increase in staff numbers; 
8.	Expansion of the assist dog breeding and training sector will increase economic activity and employment
9.	Use of an assist dog may open up employment opportunities for a person with a disability. 
Assist dogs, starting with guide dogs have been part of the landscape for many decades, however it has not grown beyond a ‘cottage-industry’ in Australia: a number of not for profits, dog breeders and trainers scattered around the landscape without the capacity to promote, and grow their sector with people with disabilities, the disability services sector, or government.
The NDIS can be the catalyst in growing this sector with win-win outcomes for all stakeholders.

Recommendations:
1.	The assist dog sector must be fully included in the disability sector through
a.	Inclusion in the NDIS legislation,
b.	National regulation,
c.	National standards,
d.	National certification,
2.	Establish a national web-site, linked to the NDIS website, to raise the sector’s community profile. It may include:
a.	Profiles and contact details of all organisations that raise, train and/or supply assist dogs,
b.	Local, national and international news items in relation to the sector,
c.	Linkages to international peak bodies’ web-sites,
d.	Interactive blog pages so dog owners can tell their stories, and aspiring dog owners may be mentored by them,
e.	A Dorothy Dix section,
3.	Establish a national Peak Body with state and territory branches, to be the interface for the sector with the NDIA,
4.	Support the reasonable costs of being assessed for a dog, acquiring a dog, user training and veterinary costs, and
5.	Support travel and accommodation costs where assessing, acquiring and training a dog and new owner require major travel,
6.	Provide training and mentoring for NDIA assessors/coordinators; and key personnel of service providers,
7.	Provide support for assist dog raisers, trainers, and providers, so they can expand their organisations with a focus on good governance and quality outcomes. 
8.	Fund apprenticeships in the sector.

1.0   The Workforce
Once the National Disability Insurance Scheme (NDIS) is introduced the sector will expand and demand for support workers will increase dramatically. It will exacerbate an already existing shortage, where service providers at times are unable to meet their contractual obligations because of an inability to provide staff.
This is not only an issue in the disability area, it affects the total human services sector, and is noted by the Productivity Commission (PC) in three recent reports:
In its report on NGO’s it says:
As demand for services rises with population ageing, workforce shortages are likely to become profound, requiring major adjustment. This problem goes beyond the NFP sector and affects all human service providers.  (P XXXII)
And in the PC’s report on Caring for Older Australians:
Workforce shortages are exacerbated by uncompetitive wages and over-regulation. The system will be further challenged by an increase in the numbers and expectations of older people, a relative decline in informal carers and the need for a larger workforce. (P XX)
And the Draft report on Disability Care and Support:
The expansion in the system associated with the NDIS would increase the demand for disability support staff. Moreover, workforce pressures are likely to rise as the aged care system expands (and as economy-wide labour force growth subsides with population ageing), further increasing the demand for workers. (P 38)
There are historical reasons why care work has traditionally been undervalued. The Queensland Industrial Commission in its 2009 Disability Support Workers Award  decision says that care work has been seen as work performed by females.  It is not work that has been viewed as skilled or valued. It has also suffered from being associated with concepts of volunteer, unpaid and charitable work.
Different strategies are proposed to grow employment in the sector to meet present and future demand, but as Wallis Westbrook noted at the March Futures Forum meeting in Brisbane:
“How do we (the sector) get to be players in Economic Development: Mining will need to grow its national workforce by 28,000 in the next 5 years: the NFP sector will need 211, 500”. 
A strategy that seems to have been overlooked in addressing support staff shortages is to encourage people with disabilities to become less reliant on people, paid or volunteer, for support.
2.0   ‘Mans best friend’
Assist dogs have been employed in the sector for many decades, originally through Guide Dogs for the Blind. Now assist dogs (also known as ‘service dogs’) perform many more tasks throughout the entire disability spectrum.
An assist dog is a working dog, like a cattle, sniffer or tracker dog. An assist dog is not a pet. An assist dog performs physical tasks that its owner is not capable of, or has difficulty performing. Service dogs can assist people with a variety of disabilities. Visual and hearing impairment are readily recognised ones, but dogs are also specially trained to assist people with autism, epilepsy, balance issues, mobility limitations, intellectual impairment, or psychiatric issues. 
The definition of an assist dog in the Queensland legislation is: “A guide dog, hearing dog or assistance dog is specially trained to perform specific physical tasks and behaviours to assist a person with a disability and reduce their need for support”.
Effective March 15, 2011, the Americans With Disabilities Act says that: “Service animal means any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability”
Tasks an assist dog can be trained to perform range from the ‘ordinary’ – opening a door, picking up an object, operating a special ‘k9’ phone to summon help - to the most complex - like responding to a grand mal, and shortening the owner’s  recovery time. 
‘The End In Mind’ is two fold:
1.	Assist dogs are very economical to employ and can make a significant contribution to relieving staff shortages.
2.	Assist dogs can be a contributing travel companion on his owner’s journey towards his personal potential: his ‘light on the hill’. (P 2)
The first function is what the dog is employed for: to perform tasks, it is his job, and creates his professional relationship with the owner.
The second function is what the dog is not employed for. It is a bonus, an extra, a gift. It is the dog’s personal relationship with the owner. Dogs, like support workers, and co-ordinators, can at the same time have a professional as well as a personal relationship with their owners, without creating a conflict of interest. 
2.1    Comparative costs.
2.1.1  A support worker
The cost of employing a support worker can have many answers, as it varies between service providers, where they are located, how they are funded, and for many more reasons. The figures presented here as sector averages rely on sector information, personal experience, some assumptions, and some common sense.
A conservative cost to the organisation, allowing for a base rate, penalty rates, on-costs, and infrastructure costs is $33.82/hour.
Other costs add to the organisational costs, like the process of recruiting new staff; induction into the organisation, training and mentoring. To calculate how this affects the gross cost of employing a support worker, some assumptions were made:
•	When recruiting there are 10 applicants short-listed and interviewed, and 5 are engaged,
•	Support workers work an average of 20 hrs/week,
•	Support workers stay with an organisation, an average of 3 to 4 years,
•	Infrastructure costs including supervision is 20% of the base rate paid support workers,
The added cost per hour based on these assumptions over a 3.5 year period is $4430.00, or an extra $1.61/hr bringing the total cost per hour to the organisation to $35.43.
Of course any of these assumption may be changed under different circumstances, but it does not vastly affect the outcome.
Transport can add considerable cost but, in this context, is totally unpredictable, and for that reason any effort to hazard a guess has been carefully and deliberately avoided.  
2.1.2   An assist dog:  
The costs associated with an assist dog also vary greatly. Figures being quoted for acquiring a trained assist dog vary from $30,000 to $60,000. $50,000 seemed credible for these calculations. The ‘maintenance cost’ for an assist dog is estimated at about $2,000 per annum. An assist dog tends to have a working life of 8 to 10 years, and an average of 9 years is used in this paper.
Based on these assumptions the gross cost of the assist dog over a working life of nine years will be $68,000, or  $  7,556 per annum.
2.2   Implications
The yearly cost of an assist dog would provide about 215 paid support hours, or just more than 4 hours per week. The assist dog however is on duty 24 hours a day, every day.
There is no expectation that an assist dog will replace paid or volunteer support. What is suggested is that their functions are complimentary and they can work in a co-production, each to their strength.
With acquiring an assist dog there is a cost of travel and accommodation involved. Prospective owners frequently must travel a long way, and spend time in residence for training, however it is so unpredictable that it has also been ignored in this paper.
So what are the potential benefits to service providers and the system at large?
Karen Allen and Jim Blascovich in their two year longitudinal study may have given some of the answers. 
The common factor in the 24 pairs of participants in their study was severe and chronic ambulatory disabilities. Beyond that participants had other disabilities like muscular dystrophy, multiple sclerosis, traumatic brain injury, and spinal cord injury. Members of the experimental group were provided with an assist dog one month after the start of the study, members of the control group twelve months later.
The introduction of assist dogs in the participants’ lives triggered many changes, including a dramatic reduction in their dependence on paid and volunteer support.
Paid support in the experimental group reduced from 87.9 hrs to19.6 per fortnight over the two years of the study, a reduction of 88%. At the same time dependence on volunteer support was reduced from 38.4 to12 hours over the same period, a reduction of 38.7%.
The figures for the control group were very similar: paid support reduced from 83.5 to 21.3 hrs, or 83.8%, and volunteer time reduced from39.8 to 13.4 hrs, or 40.1%.

This clearly demonstrates that introducing assist dogs results in:
1.	A major increase in capacity in the sector to deliver services without increasing staff numbers,
2.	A savings on paid support, after allowing for the cost of acquiring and maintaining the assist dog of $55,000, and $50,000 per annum for individual participants in the two groups respectively,
3.	The recovery of community capacity through the savings in volunteer time.
3.0   Something for nothing: the bonus.
The economic argument is compelling, but does an assist dog give better outcomes to people with disabilities? Will the assist dog make a demonstrable contribution to ‘the man becoming the man he can be’? Will an assist dog contribute to his owner reaching his personal potential, his ‘light on the hill’?
Again Karen Allen and Jim Blascovich give us some answers. Participants in their study experienced a major shift from an external- to an internal locus of control. They moved from being mere spectators to directing their own lives, and this had major flow on effects on the other variables measured in the study: 
•	Self esteem. 
•	Psychological well being. 
•	Community integration. 
•	Independent living. Some participants moved into more independent living arrangements (none to more restrictive ones), some others who tried to do the same, were impeded by external factors like group home policies on dogs.
•	Employment: 40 of the 48 participants got part time jobs.
•	Spectacular reductions in the need for paid and unpaid support (as previously noted).
3.1   Relationships. 
How can a canine be the catalyst for such a paradigm shift? It is almost inevitable! With the major reduction in paid and volunteer support comes a major reduction in the person’s assigned role of being a ‘passive recipient of care and support’. It is replaced by the symbiotic relationship with the dog. A role in which the owner directs the dog, cares for the dog, feeds the dog, and grows and enjoys the relationship with the dog. He is no longer a passenger in his own life, he has authority, and choices, and with that comes empowerment, and hope and optimism for the future. It is the shift from an external to an internal locus of control Allen and Blascovich witnessed in their study.
The shift from ‘victimhood’ to becoming assertive and gaining a level of control of the person’s life, places him in a much stronger position to assert his rightful place in community. Also, people are more likely to want to engage and develop a relationship with a person with a disability with a friendly dog by his side, than one with a friendly care worker. 
4.0   The sector
Research, conversations and anecdotal evidence seem to indicate that the sector that raises, trains and supplies assist dogs does not have a common vision or focus. It seems to consist of a number of organisations all pursuing their own agendas. Guide Dogs, and Vision Australia seem the best known, possibly because they have been around the longest, however there are many others large and small hidden in the landscape that have no public profile.
Presentations and submissions to the Productivity Commission seem to focus on operational matters and money, ‘what’s in, what’s not?’, not opportunities or outcomes.
The strategic significance of the Draft Report’s proposal that the NDIS be a national, and universal scheme, and will support: “Guide dogs and assistance dogs, including the reasonable costs of being assessed for a dog, (acquiring) a dog, user training and veterinary costs”. (P 21) seems to have been missed.
A universal scheme would mean that many more people will become eligible to have an assist dog. The financial support offered in the plan would imply that there can be less of a focus on fund raising, and more on expanding the sector and maintaining quality, to meet increasing demand.
The sector, as it operates now, seems to have little capacity to do this.
The NDIS can have a major role in bringing the sector along for the two principal reasons the scheme was proposed in the first place: 
•	To give better outcomes for people with disabilities and 
•	To achieve this at a reasonable and sustainable cost.
Truly a ‘win win’ for all stakeholders

5.0   Recommendations:
9.	The assist dog sector must be fully included in the disability sector through
a.	Inclusion in the NDIS legislation,
b.	National regulation,
c.	National standards,
d.	National certification,
10.	Establish a national web-site, linked to the NDIS website, to raise the sector’s community profile. It may include:
a.	Profiles and contact details of all organisations that raise, train and/or supply assist dogs,
b.	Local, national and international news items in relation to the sector,
c.	Linkages to international peak bodies’ web-sites,
d.	Interactive blog pages so dog owners can tell their stories, and aspiring dog owners may be mentored by them,
e.	A Dorothy Dix section,
11.	Establish a national Peak Body with state and territory branches, to be the interface for the sector with the NDIA,
12.	Support the reasonable costs of being assessed for a dog, acquiring a dog, user training and veterinary costs
13.	Support travel and accommodation costs where assessing, acquiring and training a dog and new owner require major travel,
14.	Provide training and mentoring for NDIA assessors/coordinators; and key personnel of service providers,
15.	Provide support for assist dog raisers, trainers, and providers, so they can expand their organisations with a focus on good governance and quality outcomes, 
16.	Fund apprenticeships in the sector.

John Homan
Yeppoon
290411

References
Allen, K., Blascovich, J., 1996, The Value of Service Dogs for People With Severe Ambulatory Disabilities http://jama.ama-assn.org/content/275/13/1001.full.pdf+html 	
Department of Communities Qld - http://www.communities.qld.gov.au/disability/key-projects/guide-hearing-and-assistance-dogs/about-guide-hearing-and-assistance-dogs-legislation	
Disability Support Workers Award - State 2003, Amendments 2009	
Maslow, A. H. (1943). A Theory of Human Motivation, Psychological Review 50, 370-6.	
PC Overview Draft Report Disability Care and Support, 2011 - http://www.pc.gov.au/__data/assets/pdf_file/0015/106350/draft-disability-overview.pdf	
PC Overview Draft Report, Caring for Older Australians, 2010 - http://www.pc.gov.au/__data/assets/pdf_file/0005/104882/02-overview.pdf	
PC Research Report, Contribution of the Not-for-Profit Sector, 2010 - http://www.pc.gov.au/__data/assets/pdf_file/0005/94550/02-overview.pdf	
Service Dog Central - http://www.servicedogcentral.org/content/node/297 	
SkillsInfo - Industry Reports and Charts - http://www.skillsinfo.gov.au/skills/IndustryReportsCharts/	
Submission DR643, Capricorn Community Development Association, Homan, J., 2011 - http://www.pc.gov.au/__data/assets/pdf_file/0003/107877/subdr0643.pdf 	
Wallis Westbrook, CEO Health and Community Services Workforce Council, Qld.,