Adequacy of existing residential care arrangements available for young people with severe physical, mental or intellectual disabilities in Australia

Acknowledging that the NDIS alone will not be able to solve the issues faced by young people in nursing homes, this review makes 12 recommendations including establishing a joint taskforce to ensure the recommendations are put in place. LIST OF RECOMMENDATIONS Recommendations to the Australian Government Recommendation 1 6.7 The committee recommends that the Australian Government compile a database of all young people under the age of 65 years living in residential aged care facilities using the data held by the Aged Care Assessment Team (ACAT) program. This list should be provided in a regularly updated form to the National Disability Insurance Agency (NDIA) and to state and territory governments. This data should include the following information: name; age and age of entry to aged care; diagnosis; length of time spent in the aged care system; and the factors that need to be addressed for the person to move out of the aged care facility. Recommendation 2 6.8 The committee recommends that the Australian Bureau of Statistics (ABS) conduct a Longitudinal Survey of Disability, Ageing and Carers in addition to its triennial survey of Disability, Ageing and Carers. Recommendation 3 6.10 The committee recommends that the Australian Government develop and implement a comprehensive assessment and placement tool or residential assessment instrument to assess the care and accommodation needs for all young people living in or at risk of entering residential care. Recommendation 4 6.12 The committee recommends that supplementary assessment guidelines and tools are developed for the ACAT program to ensure that all young people being considered for an aged care placement are properly assessed. As part of this process, the committee recommends that: all young people placed in aged care are intensively case managed; and all ACAT placements for those aged under 65 are reviewed on an annual basis. Recommendation 5 6.13 The committee recommends that the accreditation standards for residential aged care are amended to include standards relating to the clinical outcomes and lifestyle needs of young people. In order to assist with meeting these new accreditation standards, the committee recommends that the Australian Government: • provide a supplementary payment to residential aged care facilities to ensure that these accreditation standards can be met; and • invest in disability specific training for all staff involved in the care of young people living in aged care. This training should focus on building improved awareness of the needs of young people and those living with disability in order to provide better support. It should also lead to improved connectivity between the aged care sector and other service sectors including allied health and disability services. Recommendation 6 6.17 The committee recommends that the Department of Social Services\u27 current discussion paper on disability housing consider capital funding options for construction of specialised disability accommodation. 6.18 The committee recommends that the discussion paper is released as a matter of urgency. 6.19 The committee recommends that the Australian Government establish a supported disability accommodation fund similar to the Supported Accommodation Innovation Fund. Recommendations to the Joint Standing Committee on the National Disability Insurance Scheme Recommendation 7 6.21 The committee recommends that the Joint Standing Committee on the National Disability Insurance Scheme (NDIS) conduct an inquiry into the issue of disability housing after the release of the discussion paper on disability housing. Recommendations to the Council of Australian Governments (COAG) Recommendation 8 6.23 The committee recommends that the COAG develop and implement a national rehabilitation strategy including a framework for the delivery of slow stream rehabilitation in all jurisdictions. Recommendation 9 6.28 The committee recommends that the NDIS, in all NDIS trial sites, and the relevant state or territory government in all other areas: • assign an advocate to all young people living in residential care to provide information to a young person and their families about their options. If appropriate, the advocate can act on behalf of the young person; • assign an advocate to all young people at risk of entering residential care to provide information to a young person and their families about their options. If appropriate, the advocate can act on behalf of the young person. The advocate should be made available as early as possible after diagnosis of an illness or disability and be assigned before any placement commences; • extend the National Younger Onset Dementia Key Worker Program (YODKWP) to all young people identified as being at risk of placement in residential care to provide collaborative case management. The key worker should be assigned before any placement commences; and • these programs should be proactively extended to young people living in residential care facilities under the age of 65 years by June 2017. Consideration of the mental health status of young people should be prioritised with appropriate support provided where necessary. Recommendation 10 6.30 The committee recommends that the NDIS, in all NDIS trial sites, should consider how it supports those with Foetal Alcohol Spectrum Disorder (FASD). 6.31 The committee also recommends that the NDIS, in all NDIS trial sites, and the relevant state or territory government in all other areas work closely with community health services to provide the following for those with FASD agreement on a standardised diagnostic tool; and provision of early intervention services and other health services such as speech pathology, physiotherapy and occupational therapy. Recommendation 11 6.32 The committee recommends that the COAG establish a joint taskforce for young people living in residential care. This taskforce will: • facilitate the development and implementation of integrated service pathways involving a range of portfolios at a state and federal level including housing, health, aged care, disability, and transport; and • facilitate the collation and development of information packs outlining support, transition and placement options for young people. These packs should be made available to young people, their families, health practitioners and other relevant professionals in hospitals and aged care facilities. This process should collate all information and tools developed by the states during the Younger People with Disability in Residential Aged Care (YPIRAC) program and lead to the development of a standardised national information pack and make available to all state and territory governments for deployment. 6.33 The joint taskforce will also be responsible for oversight of the following for young people living in a Residential Aged Care Facility (RACF):  access to appropriate prescribed specialist services including speech pathology, physiotherapy, occupational therapy and other allied health services; the national rehabilitation strategy; the provision of advocates; the expanded key worker program; access to fully funded equipment as part of all state and territory Aids and Equipment schemes; • a cross sector approach is adopted to explore options for the provision of short term respite services; and • that all young people who indicate that they do not wish to live in residential care are transitioned into appropriate alternate accommodation by June 2018. Recommendation 12 6.34 The committee recommends that the joint taskforce issues a half yearly report on the progress of Recommendation 11 to the COAG

Additional file 5 of Implicating genes, pleiotropy, and sexual dimorphism at blood lipid loci through multi-ancestry meta-analysis

Additional file 5: Table S4. Frequency of lipid-related publications for the PoPS+ prioritized genes

Additional file 2 of Implicating genes, pleiotropy, and sexual dimorphism at blood lipid loci through multi-ancestry meta-analysis

Additional file 2: Table S2. Association results for the multi-ancestry index SNPs with the gene prioritization

Additional file 17 of Implicating genes, pleiotropy, and sexual dimorphism at blood lipid loci through multi-ancestry meta-analysis

Additional file 17: Table S9. PheWAS UKB-MVP meta-analysis results for each index lipid variant at Bonferroni threshold for multiple testing