COVID-19 and the disability support sector: how StGiles have navigated a crisis

From 1935 until 1939 Tasmanians endured statewide restrictions, with about 2000 infections and 81 deaths. Sadly, one of the biggest victims was young children, with infantile paralysis leaving many lives changed forever.

But amid despair there was hope, with a small, but determined group banding together to form StGiles in 1937. At the time polio was creating similar challenges to those being experienced in 2020, with borders closed and movements restricted.

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Now, 83 years on, it has risen to the challenges of a new pandemic. Like many organisations, StGiles saw years of planning disappear almost overnight, with every major fundraising event for 2020 cancelled.

Along with the financial impact, most significantly it has had to navigate its way through the challenges of providing an essential service to some of the state's most vulnerable, in a sector StGiles chief executive Andrew Billing says has been seen, but not always heard.

Wednesday marked a year since Mr Billing came into the role of chief executive of StGiles - an organisation that has long prided itself on an ability to adapt. However, along with navigating its way through the National Disability Insurance Scheme, Mr Billing said he could have never foreseen the challenges the organisation would face in his first 12 months.

In late March, the Disability Royal Commission issued a compelling statement calling on federal and state governments to ensure the needs of all people with disability were included in the response to the pandemic. As Mr Billing put it: "We cannot leave people behind".

"Understandably, when we first heard about COVID-19 all of the focus was around the people who were most at risk. Those in the aged category, those older than 65 and those with compromised immune systems," he said.

"To be fair, the overwhelming majority of those who have died, particularly in Australia, have been in that category. So logically, government and community focus have gone towards preparing our frontline workers in healthcare and our hospitals.

"That's understandable and in actual fact, quite logical. However, the disability support sector obviously deals with extremely vulnerable people. It's certainly testament to the organisations in the sector and the people working in them, that we've been able to adjust and respond without the same sort of government focus and support."

One of the greatest criticisms to come out of the response to COVID-19 has been the lack of personal protective equipment available to the disability sector. A UNSW report, commissioned by the Health and Community Services Union, surveying more than 2300 disability services workers, found there was an urgent lack of PPE for staff.

The report also showed many workers felt their organisation's safety protocols were inadequate in the context of COVID-19, with widespread perceptions the disability workforce was being overlooked in the pandemic response.

A spokesperson for Families and Social Services Minister Anne Ruston said the government had taken decisive action to support Australians with disability. In mid-April, it released its Management and Operational Plan for COVID-19 for People with Disability, aimed at ensuring appropriate health care, support and help during the pandemic.

A $90.7 million support package to help Australians with disability with employment and other services was also announced. "We have also ensured the sector has access to Personal Protective Equipment including allocating an additional 500,000 masks to the disability sector."

While organisations like StGiles were quick to implement strategies, Mr Billing said the disability sector was lacking the same level of established protocols.

"The disability sector is a shared responsibility, which makes things difficult in times of crisis when you want clarity," he said.

"Over the last couple of years, disability support has gone through a significant change with the shift to the NDIS. As a result, some of the clarity around who is responsible for situations like PPE provision is somewhat murky. In other sectors, such as aged care, it's a lot clearer, because those sectors are more established in their current protocols and procedures.

"One of the challenging things is that most of the responses that have come back from various levels of government is 'look, there is plenty of PPE. If there is a COVID-19 situation we will get PPE to you'. Whereas, in our reality, the moment we have someone who is showing COVID-like symptoms, we need to have access to PPE. We need to treat that person as if they are COVID positive, in order to diminish infection risks."

Mr Billing said StGiles had been able to acquire PPE and had maintained good levels throughout the crisis. However, he said not everyone had been as fortunate.

"Many of our sister organisations have at various times struggled to get a hold of PPE. Our colleague organisations in Tasmania - almost every meeting we have had as CEOs - it has been those sorts of concerns expressed.

"We do feel engaged, but in terms of being heard, at times there have been some frustrations. Because we are still talking about having some troubles accessing things like PPE - weeks down the track."

As Tasmania's response to the pandemic evolved, so to did StGiles. In March, workers donned blue gloves and with "every spare moment" walked through offices disinfecting surfaces - sometimes up to four times a day. Even doors were left open to avoid unnecessary touching, as social distancing measures started to become the new normal.

While there have been no positive cases of COVID-19 at StGiles, there have been lots of tests. Some of the biggest challenges have included how to deliver face-to-face therapy; ensuring the rights of people who use their services weren't compromised, and guaranteeing the health and safety of its workforce.

While challenging, Mr Billing said StGiles had discovered new ways of working as the result of being forced to do things differently. Moving forward, he said many of these would become the fabric of the disability sector more broadly.

"What's the old saying - 'never waste a good crisis'," he said. "From a very positive perspective, it has galvanised disability support organisations in terms of working collaboratively. The efforts of our staff and the preparedness to go beyond what would normally be expected of them, has just been extraordinary.

"The governments, both federal and state, have engaged with us and have had many conversations with us. Certainly, the disability sector in terms of its shared guidelines, procedures and protocols ... will be a lot better as a result of this experience."

However, as restrictions start to ease Mr Billing warned there was no room for complacency - particularly among the disability sector.

"While the situation may be changing for the community, at the end of the day vulnerable people yesterday or six weeks ago, are still vulnerable people today. We are still very nervous, because if the community becomes complacent, then our vulnerable people are at an even higher risk."

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