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Ann-Marie Smith's death "would never have occurred" before Disability SA closure

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A former Disability SA staffer says the decision to shut down the state-run agency and not continue to monitor or offer services to disabled clients moved to the federal NDIS may have contributed to the situation which led to Ann-Marie Smith’s “degrading” death while under care.

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Former Disability SA after-hours coordinator Chris Pazera told InDaily he felt “quite confident” Smith’s death would have been avoided had Disability SA not closed last year following the rollout of the National Disability Insurance Scheme (NDIS).

Smith was previously under the watch of Disability Services SA, but was transferred to the federal NDIS in 2018, with the state agency subsequently dismantled.

“The death of Ann-Marie Smith was preventable, and I believe would not have occurred if the South Australian Government had retained the Department known as Disability SA,” said Pazera, who is now retired.

“I truly believe that the situation she (Smith) finally found herself in would never have occurred if the systems in place three years ago had remained as they were.

“Simply because she would have been looked after by Disability SA … which did the funding and the oversight of the non-government agencies, who would send carers into the homes.”

The 54-year-old woman with cerebral palsy died on April 6 from septic shock, multiple organ failure and severe pressure sores, and malnourishment, which developed at her Kensington Gardens home.

Despite being assigned a carer by NDIS-administered non-government organisation Integrity Care SA, SA police said Smith spent 24-hours a day, for more than a year, in a cane chair and there was little food in the house.

Her death has been declared a major crime, with police launching a manslaughter investigation.

The State Government said it did not learn about Smith’s death until a month later, sparking a row and inquiries about her level of care and gaps in monitoring or oversight between state and federal jurisdictions.

Pazera said the situation would not have happened under the previous state system.

“Prior to the NDIS, DSA provided funding to both private and government service providers to undertake care provision of disabled clients. The care provided, hours contracted and client satisfaction was always closely monitored,” he said.

“Any DSA client was free to contact us 24 hours a day, seven days a week to express any issue or dissatisfaction they had, either with their direct carer or service provider. We would then investigate this issue by a home visit, or the dispatch of the most relevant responding agency, whether this be SAAS/SAPOL or the RDNS, as examples.

 “Along with my colleagues in the After Hours Service, we campaigned long and hard to retain some form of statewide after-hours service for vulnerable clients, but our endeavours were stonewalled by both DHS executive officers and politicians alike, who were more focused on the quick closure of departments to keep to the tight NDIS timeframes.”

Pazera said Smith was previously under the watch of the Disability SA service coordinator.

“They’d have had oversight of what the carer was doing and would make regular contact with her and make sure everything was OK, as well as having regular contact with the NGOs,” he said.

“Now it falls down on the NGO to do their own oversight of what they’re doing. The NDIS as a federal body is supposed to have overacting oversight but whether they actually have face-to-face client contact or even contact with the client I’m unaware – but I don’t think so.”

Pazera said Disability SA had the power, in collaboration with the State public advocate, to direct police to physically take clients to hospital if the need arose.

“We might get a call from either an NGO or a carer or the client themselves, saying the client was ill and didn’t want any medical attention,” he said.

“The next day we got a similar call that the client is still pretty ill and the NGO or carer feels there’s something really wrong here but the client is refusing any kind of treatment or service. Then we would make a call in conjunction with the public advocate to direct SAPOL and the ambulance service to take that client to hospital for a medical assessment.”

Pazera said that when police investigate Smith’s death, “I hope they compare how Ann-Marie and other DSA clients were cared for then, as opposed to how she was cared for on her death”.

Human Services Michelle Lensink said that when South Australians living with disability transitioned onto the NDIS they became Commonwealth clients.

“It was understood by consecutive State Governments, clients would no longer be state clients when they transitioned to the federal scheme,” she said.

“The closure of Disability SA had been in train under the previous Government.

“The safety and well-being of South Australians living with disability remains a key priority of the Government. 

“We continue to advocate for national consistency to ensure our most vulnerable are being treated with dignity, respect and care.”

Lensink said the NDIA offered an after-hours response service providing “support for clients and families if they need it.”

Maurice Corcoran, who sits on the NDIS Independent Advisory Council, said the federal initiative offered provisions for “plan managers and a range of assessments to be undertaken and support for individuals” where needed.

He said Smith’s transition from Disability SA to the NDIS under Integrity Care, as well as her plan, would have to be investigated by the relevant authorities.

NDIS Minister Stuart Robert said the Smith’s death “in tragic circumstances is in the hands of the appropriate authorities.”

“The NDIS Quality and Safeguards Commission, as is appropriate, is currently working alongside South Australia Police, and has taken further action requiring the provider involved to take immediate steps to protect the safety of other people with disability that they support.”

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