feasible or permissible to exclusively or mainly use fully trained, specialised nursing staff. Care staff for persons with disabilities provides support in the persons everyday life. At day homes, occupational therapy workshops, residential homes, shared accommodation and leisure facilities, they assist them in the structuring of their everyday life and carry out therapeutic and instructional interventions. When long-term clients get older, residential facilities will inevitably also face the limits in terms of legal matters, specialist expertise and structural requirements. In light of the ongoing aging of users, these challenges need to be overcome. As a result, the basic legal framework will have to undergo review. Planning and control of material resources, which is currently tied to specific segments of provision, will also have to undergo reassessment. Federal government and Laender face challenges  The life expectancy of persons with disabilities has risen over the past few decades and is essentially on a par with average life expectancy among the general population.  New, more flexible structures for elderly persons with disabilities will therefore be needed, particularly in terms of residential, occupational and leisure needs. 2.4.2.4. Inclusive access to medical care must be improved The UN CRPD takes a very clear position on what essentially should go without saying: persons with disabilities are entitled to achieve the very highest level of health. Austria is therefore firmly committed to obtaining suitable measures to ensure this. However, the NPM unfortunately found that this entitlement is not yet a reality. Right to the very highest level of health The commissions observed on many occasions that the provision of medical care at institutions and facilities is inadequate. Thus, in many cases persons with disabilities had gone for years without having a consultation with a specialist psychiatrist, and psychiatric drugs were being taken or administered without ongoing evaluation and monitoring by a physician. In one case, the persons involved had gone five years without undergoing any assessment. The problem is exacerbated by the fact that staff without appropriate training categorise and administer medications in many cases, after having removed them from blister packs and placed them in medication containers. Persons with dual diagnoses are particularly at risk. Medications administered for years without evaluation by a physician Shortcomings in terms of medical care were particularly evident in psychiatric services; there are also problems with de facto undersupply in other fields of medical services, for example, dentistry and women’s health. Lack of available specialist physicians There are various reasons for this: in principle, persons with disabilities, like everyone else, are entitled to freely choose their Inadequacies when it comes to inclusive 84