9July2015

We acknowledge the traditional owners of country throughout Australia, and their continuing connection to land, sea and community. We pay our respects to them and their cultures, and to elders both past and present. We acknowledge the challenge that faces Indigenous leaders and families to overcome the unacceptably high levels of ear health issues among first Australians.

I would rather wear out than rust away Australia lost a champion of deaf and hearing impaired people with the passing of Cath Bonnes OAM at the age of 94. Future of crucial hearing services A new Issues Paper by Deafness Forum offers the Government a comprehensive suite of recommendations to manage risks in transferring vulnerable client groups within the Australian Government Hearing Services Program to the National Disability Insurance Scheme. Where are the role models? Why are people willing to discuss their race, religion, gender, age and sexual orientation but unwilling to discuss their hearing loss? Is hearing loss so stigmatised that we have created a culture of shame? Government funding for Deafness Forum We now have the means to maintain our focus on issues relating to a sale of Australian Hearing, build on relationships with other disability organisations, and to pursue long-term funding for a program to make hearing a National Health Priority. Beard, leathers and the bike Mr Kohei Hakamada, 65, from Yokohama is Deaf. He has visited 91 countries since he started his world solo motorcycle adventure five years ago.

Who are the role models since Helen Keller?

JANICE S. LINTZ writes for FORBESWOMANAFRICA Nelson Mandela wore hearing aids but he is only known for overcoming apartheid in South Africa. Academy Award Winner and actress Jodie Foster stood up at the Oscars to declare she was a lesbian but never mentioned she wears a hearing aid despite its prominence. There are 360 million people worldwide with some form of hearing loss. How can an issue be so pervasive but with no recognisable role models? There are great advocates within the insular hearing loss community but no person who captivates the world. Why are people willing to discuss their race, religion, gender, age and sexual orientation but unwilling to discuss their hearing loss? Is hearing loss so stigmatised that we have created what Dr Julie Gurner, a leadership consultant, calls a culture of shame? She explains: Prominent figures hide their hearing loss so perhaps other people feel maybe they should hide theirs as well. The medias handling of hearing loss and other disabilities is part of the problem. Their coverage is typically focused on inspirational stories. The person appears as a Super Crip. Just think of all the YouTube videos featuring children hearing their parents voice for the first time as their cochlear implant is activated. The message communicated is: look how this amazing crippled person overcame this horrible obstacle, and so now you too can conquer whatever is preventing you from achieving success. We might as well have the person wear a cape like a superhero. The media also likes sensational photographs of people with disabilities. The most notable being when American activists crawled up the steps of the U.S. Capitol to show it was the only way to enter a building that lacked ramps. The public seems to respond only to dramatic activism or a moment rather than common sense. We shouldnt need a moment to engender the change that is so desperately needed globally. Hearing loss shuts people out invisibly. Their needs are just as pressing and should be addressed globally. Part of the problem is a lack of understanding that one size doesnt fit all when it comes to communication access. The following three-prong approach should be offered whenever there is live voice or recorded audio - assistive listening systems such as an induction loop, captioning, and qualified interpreters. For people with hearing loss, communication access is their ramp. We need to inspire the next great leaders and role models of our world. FW The writer is based in New York and is CEO of Hearing Access & Innovations, which works to improve accessibility for people with hearing loss.

Future of crucial hearing services in Australia Community Service Obligations program and the NDIS The Government will transfer client groups within the Australian Government Hearing Services Community Service Obligations (CSO) Program to the National Disability Insurance Scheme during its national roll-out. This will happen regardless of the outcome of investigations into the potential sale of Australian Hearing to the private sector. Australian Hearing currently delivers these CSO programs on behalf of the Government. The Department of Health has issued some information to explain how the Community Service Obligations (CSO) Program client groups will be transitioned. However further information is needed about the arrangements for groups identified as transferring to the NDIS as well as for those client groups, services and activities that are not covered by the NDIS. Information issued to date has several references to hearing services for the CSO clients being contestable under the NDIS, yet the services most likely to transfer to the NDIS are for the client groups where the private market has not needed to participate before, in the delivery of hearing services to Deaf and hearing impaired children and their families. There needs to be strong evidence that there are more organisations than the current provider (Australian Hearing) with the capacity and capability to deliver services to CSO clients who qualify for services under the NDIS, before considering an arrangement where services are contestable. In its recently-released Issues Paper, Deafness Forum offered the Government a comprehensive suite of recommendations for its consideration: Outcomes measures be undertaken prior to client groups moving to the NDIS so there

is a benchmark to gauge any changes in standards and outcomes.

Existing service locations for CSO groups be mapped so there is a benchmark to gauge any changes to service access.

Market testing be undertaken to determine whether contestability is a viable option for any of the CSO client groups. This needs to include the availability of expertise, appropriate equipment and facilities and location of services.

When assessing expertise to deliver services to children, the expertise should be identified for service delivery to specific age groups eg 0-6months, 7months 3 years, 3-6 years, 7-12 years, 13+ years.

Services to CSO client groups should only be provided by appropriately skilled audiologists.

A single service provider should be nominated as the provider of hearing services

under the NDIS for Deaf and hearing impaired children aged from birth to the time the child leaves high school. If no other competitor is identified through market testing then Australian Hearing should be nominated as the provider of services. Otherwise a competitive tender arrangement could be instigated.

The NDIS pathway be reviewed to ensure it supports the existing referral arrangements from diagnosis to treatment/intervention and does not introduce unintended delays.

If services are to be contestable then formal learning and development programs with independent competency assessment should be established before moving CSO services to a contestable arrangement. An accreditation/registration system is also needed so consumers can determine that the audiologist has the required competencies.

Appropriate safeguards need to be implemented to ensure that clients from culturally and linguistically diverse backgrounds, low socio-economic background and people in rural and remote areas will be able to access appropriate services.

Appropriate safeguards to be implemented to ensure providers are following best practice and have a system of continuous improvement. Providers need to demonstrate the clinical standards, service standards, technology standards and quality framework they will apply in the provision of services to CSO clients as part of the approval process when registering as a service provider.

Further consultations to be arranged before implementing any changes. You may read our Issues Paper, Transition of the Australian Government Hearing Services CSO Program to NDIS and access information about a potential privatisation of Australian Hearing on the front page of our website, www.deafnessforum.org.au

June newsletter is available at http://www.ndis.gov.au/node/2171/www.ndis.gov.au/NDIS-new-world-conference-2015

I would rather wear out than rust away Australia has lost a champion of the hearing impaired and deaf with the passing of Cath Bonnes OAM at the age of 94. Cath was the founder and director of the Broken Hill and District Hearing Resource Centre in western NSW. The Centre held its first Hearing Awareness Week in 1985. The not-for-profit organisation provides information, advocacy and support to deaf and hearing-impaired people and their families. Cath was in her fifties when she lost her hearing through an infection. She said that she had once contemplated taking her own life because it "just got to be difficult and miserable." "There was no help for me. I was told to go home and learn to live with it. But you wake up one morning and find out you can't hear. How do you learn to live with it? So that is what made me do something." She was awarded the Order of Australia in 2000, the Centenary Medal in 2003, and was a member of the National Disability Advisory Council. "Look, when you retire and you've got a good active brain, do you sit in a corner and degenerate and rot? I'd rather wear out than rust away." Cath Bonnes was once a chairperson of the national organisation, Deafness Forum of Australia. The current chair David Brady said, Cath brought to the role a natural dignity, pragmatism, common-sense and a dash of humour when it was needed most. She was a great Australian who embodied the volunteer spirit.

Step in the right direction on funding for disability organisations

The Australian Federation of Disability Organisations (AFDO) has secured a $600,000 funding commitment from the Federal Government to work with ten national organisations representing people with disability and their families. Deafness Forum of Australia, a foundation member of AFDO, is among recipients of the new funding.

AFDO CEO Matthew Wright said this is a welcome announcement which will enable specialist people with disability, representative and family organisations to keep their doors open this year and to continue to provide important support to over 200,000 Australians with disability. However there is still work to be done to secure our future said Mr Wright. This is a step in the right direction and reflects an understanding that specialist people with disability, representative and family organisations play a valuable role in supporting the community and building an NDIS. I am very pleased with what our ten organisations have achieved working collaboratively to ensure that every person with a disability has a voice. Two national organisations, through AFDO, will receive federal government funding for the first time, including Down Syndrome Australia and Autism Aspergers Advocacy Australia. Mental Health Australia will also receive funding to build the capacity of mental health consumer and carer voices. We would like to thank Minister Fifield and the Department of Social Services for this important step forward. We will work collaboratively with DSS to ensure we build the capacity of our organisations as the NDIS commences full roll out, said Mr Wright. AFDO and our ten people with disability, representative and family organisations would like to publicly acknowledge the significant support we have received from departmental staff, advisors, ministers, people with disability, carers and service organisations and the media. I have been overwhelmed with the support we have received, reflecting the value that Australians place on the importance and contribution of people with disability broadly. CEO of Deafness Forum of Australia, Steve Williamson said by this welcome action, we now have the means to maintain our focus on issues relating to a sale of Australian Hearing, build on relationships with other disability organisations, and to pursue long-term funding for a program to make hearing a National Health Priority. Deafness Forum will give evidence this week to a Senate Select Committee on Health to present the views of its members on the future of hearing services in Australia.

The deadline in the United States is this month for all online video content to have captions if it was previously captioned for broadcast on television. The online video requirements are contained in the 21st Century Communications and Video Accessibility Act (CVAA). After its passage into law, the U.S. Federal Communications Commission set various deadlines. This months deadline covers full-length programs only, but from 1 January 2016, online video clips lifted from captioned TV programs will also need to be captioned. It is estimated that up to 18 percent of the content available on iTunes still lacks captions. Earlier this year, Media Access Australia launched Access on Demand, a comprehensive report on the accessibility of video-on-demand (VOD) services in Australia and other countries. The report recommended that captioning be introduced on all catch-up TV services by the end of 2015, and all VOD services by the end of 2016 If not done voluntarily, the report recommended the Australian Government introduce legislation similar to the CVAA to make captioning compulsory.

Noisy restaurants

Noise levels in restaurants are a growing concern for patrons, employees, and restaurant owners alike.

Research shows that long or repeated exposure to sounds at or above 85 decibels can cause noise-induced hearing loss. According to Restaurant Briefing, reviewers have noted noise level averages of 80 decibels or higher in restaurants throughout the United States. A typical conversation averages about 60 decibels. These noise levels can make conversations more difficult and put diners hearing at risk.

Noise levels can pose a potential issue for restaurant workers, too. According to the Occupational Safety and Health Administration, noise-induced hearing loss has been one of the most prevalent occupational health concerns in the United States for more than 25 years. http://www.noisyplanet.nidcd.nih.gov

Deafness doesnt stop Japanese man from riding motorcycle around the world

Mr Kohei Hakamada, 65, from Yokohama has travelled to 91 countries since he started his solo motorcycle adventure five years ago. "Even though I have hearing problem, I am still eager to travel, and I want to prove that deaf people can travel around the world alone," he told reporters through a sign language interpreter. Among the countries he has visited are South Korea, Russia, Kazakhstan, Turkey, Egypt, Thailand and India. He said he would be heading to Pahang, Sabah and Sarawak before finding his way to Singapore and Australia. "Upon arriving at one particular country, I will explore some of the places to get to know the culture better," said the father of two, adding he expected to complete the mission in 2018. He said the idea to ride around the world alone on a motorcycle came after he retired from a newspaper printing company at the age of 60. He wanted to fill his free time and gain knowledge from the adventure.

Willing to Work national inquiry

The Willing to Work: National Inquiry into Employment Discrimination Against Older Australians and Australians with Disability is now open for submissions and conducting consultations. The call for submissions follows the release of two Issues Papers. These can be accessed at https://www.humanrights.gov.au/willing-work-how-make-submission. Consultations are being conducted in every capital city and some regional centres. Visit https://www.humanrights.gov.au/willing-work-consultations for details.

National General Social Survey The fourth General Social Survey (GSS) was conducted in 2014 with Australians aged 15 years and over. A report was released last week. The main purpose of the survey was to provide an understanding of the multi-dimensional nature of relative advantage and disadvantage across the population. The GSS measures resources that reflect the wellbeing of individuals and communities, with social capital being a particular focus. Social capital is conceived as a resource available to individuals and communities, and founded on networks of mutual support, reciprocity and trust. Research links strong social capital to increased individual and community wellbeing. It includes elements such as community support, social participation, civic participation, network size, trust and trustworthiness, and an ability to have a level of control of issues important to them. PEOPLE WITH DISABILITY Disability can impact a person's access to services and participation in social or community activities. In this analysis, people with disability include those who identified some restriction to their core activities, a schooling or employment restriction as well as those without a specific restriction. In the 2014 GSS, one of the issues to emerge as significant for this group was access to services. In 2014, about three in ten people with disability had difficulty accessing service providers compared with about two in ten people without disability. People with disability were far more likely than those without to experience a barrier to accessing healthcare (11% compared with 2.8%). For those with disability who could not get healthcare when they needed it, medical specialists and doctors/general practitioners were the most common types of healthcare that could not be obtained most recently. The cost of the healthcare service and waiting times that were too long or having no available appointments were the main reasons people with disability could not obtain healthcare most recently. People with disability were also less likely than those without to have participated in sport or recreational activities or to have attended a sporting event as a spectator. They were also less likely than people without disability to have attended a selected cultural venue or event in the last 12 months. When compared with people who did not have disability, people with disability were also:

less likely to have had daily face-to-face contact with family or friends living outside the household (16% compared with 20%)

more likely to have cared for a person with a disability, long term health condition or old age in the last four weeks (22% compared with 17%)

more likely to feel that people could not be trusted (34% compared with 24%)

more likely to experience some form of discrimination (23% compared with 17%) more likely to assess their health as poor (13% compared with 0.8%) or fair (23%

compared with 5.8%). HOW DO AUSTRALIANS WITH DISABILITY FEEL ABOUT THEIR LIVES AS A WHOLE?

http://www.abs.gov.au/AUSSTATS/abs@.nsf/Latestproducts/4159.0Main%20Features12014?opendocument&tabname=Summary&prodno=4159.0&issue=2014&num=&view=

Beethoven was one of the world's greatest composers, but he was also plagued by Tinnitus - a condition where someone hears a range of noises in their head. Listen to Chris Smith on ABC Breakfast Radio, http://www.abc.net.au/radio/programitem/pg8AV3ayLG?play=true

A case for making hearing health a National Health Priority in Australia

We communicate to live. We live to communicate. Hearing enables humans to interact with our environment at all levels. Of the three primary senses, hearing is the foundation sense used for communication between people. A loss of hearing acuity fundamentally limits the ability of the individual to communicate, and through this, limits their ability to interact with society. This has social and economic consequences for the individual, their family and for society. Reduced communication abilities impact on a persons life opportunities to equitably participate in education, to gain competitive skills and employment and to participate in relationships. Hearing impairment is highly stigmatised The effects of reduced hearing are often misperceived by the affected people and significant others as interpersonal conflicts. People are reluctant to acknowledge hearing difficulties. As a result of these barriers, people often do not seek professional help in order to improve their situation. While interventions such as hearing aids and cochlear implants enhance a persons ability to communicate, the majority of people with hearing loss (85%) do not have such devices. Today, one in six Australians is affected by hearing loss With the damaging effects of noisy environments, young peoples music listening habits, and an ageing population, hearing loss is projected to increase to 1 in every 4 Australians by 2050. Hearing loss ranks as a major cause of years of healthy life lost due to disability. An Australian Institute of Health and Welfare study of the burden of disease found that adult-onset hearing loss was the fifth highest cause of years of healthy life lost due to disability.

A significant component of acquired hearing loss (nearly 40%) is due to excessive noise exposure due to inappropriate listening behaviours, and this is entirely preventable. Hearing loss is associated with increasing age, rising to three in every four people aged over 70 years and this statistic will worsen in the near future. 20% of the population has Tinnitus. For some it is so debilitating that it affects their family and social lifestyle and their employment. Hyperacusis, specifically affecting people with noise-induced Tinnitus, causes some to become housebound, basically dropping out of society. Menieres Disease, although not as common as Tinnitus, can also have devastating impact on a persons health. Acoustic Neuromas affect over 300 people each year in Australia. Educational expenditure on prevention of hearing loss could be effective in reducing the projected increase in prevalence. Hearing loss does represent a significant and quantifiable economic cost and impact to Australia, one which far outweighs current expenditure. In particular, given our ageing population, and the need for all Australians to stay productive longer in their life, the key impact of hearing loss on lost productivity in the workforce must be viewed as a critical matter than can be addressed through targeted programs of expenditure. Most importantly, given that a significant component of hearing loss is in fact preventable, there is a clear argument for identification of hearing loss as a National Health Priority and for a cross-jurisdictional approach to awareness, prevention, and remediation of hearing loss. Such an approach would be consistent with the World Health Organisations recommendations encouraging countries to establish national programs for prevention, and to raise awareness about the level and costs of hearing impairment. Economic Impact Hearing impairment or deafness is a grossly underestimated public health problem in Australia. Recognition of this, and the implementation of strategies to stem the rising incidence of acquired hearing loss, offers the potential of long-term significant savings to both the public health and social security budgets. It is time that hearing health became a national priority To achieve this, hearing health needs to be dealt with as a mainstream health issue. The establishment of Australian National Health Priority Area(s) by the government focusses

attention on particular health issues, raising their public profile and increasing research available to direct government policy. For example, diabetes was positioned as a Priority in 1996, and this has led to increased research focus and national strategies for diabetes management such as through the National Diabetes Strategy. Cancer control, cardiovascular health, injury prevention and control, mental health, diabetes, asthma, arthritis and musculoskeletal conditions, obesity and dementia are all important areas, so it is right that they are all part of the Health Priorities program. However, deafness and ear disorders are also important.

Hearing health needs to be dealt with as a mainstream health issue. Hearing loss increases risk of depression, dementia, blood pressure and heart

conditions. The Government has nine National Health Priorities Areas - Hearing health should

become a Priority too. This will raise public profile, education, prevention, supports, and research to direct

government policy. The Commonwealth government has recognised the associated issues to some extent in respect of the Indigenous population at least, by adopting a policy principle to position ear health within a comprehensive, population-based approach to family, maternal and child health. Similar policy principles need to be adopted in respect of hearing health for the entire Australian population. When hearing health is made a National Health Priority it will be important not to forget about the health of people who are already deaf.

Know someone who might like to receive One in Six? Send an email to info@deafnessforum.org.au Items in Deafness Forum communications may incorporate or summarise views, standards or recommendations of third parties or comprise material contributed by third parties. Such third party material is assembled in good faith, but does not necessarily reflect the considered views of Deafness Forum, or indicate commitment to a particular course of action. Deafness Forum makes no representation or warranty about the accuracy, reliability, currency or completeness of any third party information. We encourage organisations to be deafness friendly. In planning meetings and events, choose venues that have reliable hearing loops, and add real time captions and interpreters to meet the communication access needs of the 4 million Australians we represent.