Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694818709883.pdf (Australia)
Sexual Health and Family Planning ACT Inc (SHFPACT) Submission to the Senate Inquiry into National Disability Insurance Scheme Bill 2012 Introduction Sexual Health and Family Planning ACT (SHFPACT) is a non-government, not-for-profit organisation and ATO-endorsed Health Promotion Charity working in the Canberra community for over 40 years.

SHFPACT’s purpose is improved sexual and reproductive health for the Canberra community, within a human rights and social justice framework.
SHFPACT is a member of Sexual Health & Family Planning Australia (SH&FPA), and through SH&FPA affiliated with the International Planned Parenthood Federation (IPPF).

SHFPACT specifically identifies people with disabilities as priority population groups within our community who face barriers to the full enjoyment of their sexual and reproductive health and rights.
For many decades, SHFPACT has been at the forefront promoting the rights and wellbeing of people with disabilities in the Australian Capital Territory and region with regard to sexuality, sexual and reproductive health.
This work is informed by: • ACT Human Rights Act 2004 • United Nations Declaration on the Rights of Disabled Persons • IPPF and World Association for Sexual Health (WAS) Declarations of Sexual Rights and an evidence-based and client-informed understanding of the needs and desires of people with disabilities with regard to sexuality, sexual and reproductive health.
SHFPACT currently provides a suite of clinical services, professional development training programs for the health, education & community services workforces, community education and health promotion, and information services in the areas of reproductive and sexual health.
SHFPACT is funded specifically by ACT Government to provide workforce development activities information and referral services for disability sector workers and carers of people with disabilities, and to support capacity-building of school communities for the provision of sexual health education for students with disabilities in ACT schools.
SHFPACT has recently been working with Disability ACT (ACT Government Community Services Directorate) to develop a model policy framework template for disability service providers in areas of support and practice affecting sexuality, sexual expression and sexual health.

Further information about SHFPACT’s services and programs can be found at www.shfpact.org.au.
SHFPACT welcomes the opportunity to provide some brief comment on the introduction of a National Disability Insurance Scheme as proposed in the National Disability Insurance Scheme Bill 2012.
SHFPACT Submission to the Senate Inquiry into National Disability Insurance Scheme Bill 2012 Page 1 of 5 Sexual Health and Family Planning ACT Inc (SHFPACT) Objects and principles of the Bill Sexual Health and Family Planning ACT Inc welcomes in principle the introduction of the National Disability Insurance Scheme as a significant step towards achieving in practical measures the UN Convention on the Rights of Persons with Disabilities.
In particular, the transition to increased individual planning for, and control of resources by, persons with disability and/or their responsible care givers, guardians and decision-makers is a long- overdue mechanism for better ensuring that the provision of services and supports for people with disabilities is tailored to their needs, wants and aspirations.
SHFPACT affirms the objects and principles of the Bill must be understood to apply explicitly to the sexuality, sexual expression, sexual and reproductive rights of people with disabilities, because: a) Sexuality is a central part of what it means to be a human being, and that the suppression or denial of the sexuality and sexual needs of people with disabilities continues to be a form of discrimination, social exclusion and dehumanising of people with disabilities; b) Health, including sexual and reproductive health, is a resource for wellbeing and community participation.
Social inclusion cannot be achieved without recognition of the sexual and reproductive health and rights of people with disabilities; c) Access to information, education and health services related to sexuality, sexual and reproductive health is difficult for many people with disabilities, and often depending on the knowledge, good will and support of others about these issues and available services; d) People with disabilities as a population, especially women and girls with disabilities, are significantly more vulnerable to violence, abuse and exploitation, including sexual violence, abuse and exploitation; e) There is a long history of maltreatment and abuse of reproductive and sexual rights (sometimes inflicted with good intentions) of people with disabilities, including forced and uninformed medical sterilisations, which Women With Disabilities Australia (WWDA) has reported continues in some women and girls lives today; f) The Bill potentially increases the power of guardians and alternative decision-makers to make decisions with regard to the sexuality, sexual and reproductive health, sexual expression, and access to services, based on their own personal values and beliefs that are not in keeping with the needs, desires and interests of those they make decisions for; SHFPACT Submission to the Senate Inquiry into National Disability Insurance Scheme Bill 2012 Page 2 of 5 Sexual Health and Family Planning ACT Inc (SHFPACT) The failure to account for these factors leads directly to demonstrably poorer health and wellbeing outcomes.
For example: • Community stereotypes or myths about the sexuality of people with disabilities can include beliefs that people with disabilities can not or should not form sexual relationships.

Even passive acceptance of this view can lead carers, service providers and decision-makers to ignore opportunities for important social connection, or more actively, to prevent the forming of relationships that may become sexual.
The right to form intimate relationships and enjoy consensual sexual activity is both a human right and a contributor to health and wellbeing.

• In the absence of knowledge about sexual behaviour by a person within their care, carers, service providers and decision-makers may form the view that their client or ward is not sexually active and implicitly exclude sexual health screening services (such as regular cervical screening for women) from consideration and the care regime.
Given the very high levels of sexual abuse and exploitation, this can potentially leave sexually transmissible infections undetected and untreated over many years, leading to poor health outcomes and increased mortality.

• Adherence to stereotypes and myths about sexuality of people with disabilities can also lead to the overattribution by carers, service providers and decision-makers of sexual explanations for behaviours that may not have an underlying sexual cause.
In doing so, other health issues, emotional and mental health concerns, or underlying needs can be ignored because the behaviour is misattributed, especially where verbal communication is limited or non-existent.
Participant planning underpinned by workforce training SHFPACT advocates that the preparation of personal participant plans and registered providers of support services providers contracted under new arrangements established by the NDIS should demonstrate an understanding and capacity to attend and respond to the sexuality, relationship, sexual and reproductive health needs and desires of participants.
SHFPACT recommends that clear distinction be recognised in the development of participant plans between the support needs of people with physical disabilities who are otherwise capable of giving and seeking informed consent to sexual activity, from those whose capacity to give informed consent to sexual activity is in doubt.
The establishment of the NDIS offers, for many people, the first opportunity to structure support services that can account properly for their needs for sexual expression, and that this must be done with forethought, clarity of focus on the needs, and respectful of the sexuality, of the individual.

This may include exploration of the possibility of physical assistance and resources to participate in a sexual relationships and obtain sexual relief and pleasure.
A policy and training infrastructure to adequately manage these possibilities and ensure a safe and respectful work environment is central to this outcome.
SHFPACT Submission to the Senate Inquiry into National Disability Insurance Scheme Bill 2012 Page 3 of 5 Sexual Health and Family Planning ACT Inc (SHFPACT) In the case of individuals whose disability impacts their capacity to make independent judgments of consent in general, and impacts on capacity to understand the nature and implications of sexual activity to consent to it in particular, SHFPACT recommends that the work of SH&FPA member organisations in each State and Territory, particularly those in the trial launch sites, be actively engaged to advise on participant planning processes and enable assessment of capacity to consent.
Family planning and sexual health organisations have a substantial track records for information, education and training service provision directly to people with intellectual disability and to those who care for and support them.

The issue of capacity to consent to sex, and other reproductive and sexual health rights issues that flow from it, for those who may not have or be able to demonstrate such a capacity, has vexed service providers and carers over the years.
These a complex issues that require complex, sophisticated, and informed responses.

The introduction and trial of the NDIS offers an opportunity to address these issues explicitly in the early stages of the new funding, planning and service delivery paradigm, and not to leave these community challenges in the too-hard basket any longer.
With regard to the mechanisms by which a person with a disability may become a participant in the NDIS, SHFPACT believes that the processes for accessing the resources of the Scheme should not place an undue burden on people with disabilities and/or their carers/advocates, and that review or appeals of assessment for participation in the Scheme should be structured independent of or at arms-length from the original decision-maker within the Agency.
The Agency must also ensure mechanisms to ensure that the needs and desires of participants can be accurately gauged and responded to distinctly from those of other significant people in their lives where these may not align.

SHFPACT supports the position advocated by Women with Disabilities ACT (WWDACT) that a stronger gender dimension must inform personal planning to ensure the distinct and differing health needs of women and men, girls and boys, are properly attended to and met.
SHFPACT Submission to the Senate Inquiry into National Disability Insurance Scheme Bill 2012 Page 4 of 5 Sexual Health and Family Planning ACT Inc (SHFPACT) Registered providers of support SHFPACT acknowledges and welcomes broadly the improved ability for people with disabilities to structure support services that best meet their needs that the introduction of the NDIS represents.
SHFPACT cautions, however, that the introduction of the NDIS represents and major restructuring of disability support, and that there is the possibility of increased risks of abuse and exploitation as new and untried providers of services enter the ‘market.’ Currently there are some, if limited and insufficient, protections structured in the contract requirements between Governments and service provider organisations and entities, such as mandatory criminal record/’blue card’ checks for employees, that attempt to mitigate these risks.
Implementation of the Scheme must ensure that registered providers are fit and proper persons for this purpose, and as noted above, capacity to attend and respond to the central issues of sexuality, relationship support, sexual and reproductive health of clients be considered significant in determining and registering providers of services.

Thank you for the opportunity to make a brief submission to the Inquiry into the Bill.
Contact: Mr Tim Bavinton Executive Director Sexual Health and Family Planning ACT Inc (SHFPACT) GPO Box 1317 Canberra ACT 2601 Tel: (02) 6247 3077 Fax: (02) 6257 5710 Web: www.shpfact.org.au 24 January 2013 SHFPACT Submission to the Senate Inquiry into National Disability Insurance Scheme Bill 2012 Page 5 of 5