19 April 2016

The NDIS will transform lives – here’s why

| Kim Fischer
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NDIS

The National Disability Insurance Scheme (NDIS) is expected to be in full operation in the ACT by July 2016. All children are now eligible to join the NDIS, with only adults born after 1 July 1965 yet to be inducted into the scheme. All other States and Territories will commence their full implementation shortly afterwards (with the likely exception of WA due to ongoing negotiations).

Unfortunately the NDIS is still a mystery to many who aren’t directly impacted by the changes. While the underlying funding model involves a lot of accountants and actuaries, the way it works for individual participants is both simple and revolutionary.

The big change is in who controls the money.

Previously, funding was provided to disability care and support organisations. These organisations would offer programs and services which people with disabilities would have to apply for. The onus was on individuals to discover what options existed to get help.

As the 2011 Productivity Commission report into the NDIS noted, this placed people with disabilities at the mercy of government budget cycles and annual funding allocations. If a budget got cut, services would be cut too, regardless of the number of people in an area requiring support. The unlucky ones would simply miss out.

When talking to carers and guardians of people with disabilities in the ACT, this view of the old system certainly rang true for them. Stories of carers simply not showing up to appointments for weeks at a time, and uncertainty about how to apply or check eligibility for available care programs were common.

People have been reluctant to complain about the system because they often felt lucky to get anything at all. As one carer put it, “You don’t want to seem ungracious.”

Under the new model, the National Disability Insurance Agency (NDIA) administers access to the NDIS. Each participant in the scheme documents their “goals and aspirations”, after which a proposal for ongoing funding support is approved by the NDIA that is “fair, reasonable and necessary” and “in line with community expectations”.

Each “individualised support package” allocates an annual amount of funding which is tied to a range of particular support needs of that participant. The person (or their plan nominee) can then select an approved provider of their choice to perform the service at a time and place that suits them.

By having certainty about funding, as well as the freedom to select and change providers, the power relationship between care providers and the client is rightfully inverted.

Providers will need to learn to market their services and ensure the satisfaction of their clients in order to get paid. This is likely to be the biggest challenge for organisations unused to operating in a market environment. Ultimately though, the pressure to evolve and improve their service delivery approach should lead to better outcomes for both carers and clients.

The switch in funding arrangements will lead to major changes in the ACT. As just one example, Therapy ACT will cease provision of therapy services by the end of 2016, with clients assisted to find new non-government therapy providers during this transition.

Bill Shorten needs to be acknowledged and commended for being the key architect of the NDIS. The 460,000 people around Australia with disabilities who are expected to make use of the scheme will have better lives. It’s a great example of how politics at its best can deliver transformational and inspirational outcomes for our society.

Are you signed up to the NDIS? What have your experiences been like?

(Image from NDIS website.)

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Kim Fischer said :

dungfungus said :

dungfungus said :

Can you advise the size of the federal bureaucracy that will be needed to run the “new, improved” system?
I understand it will not be based in Canberra.
What will be the annual cost of running it?
Is it true that unpaid and unqualified volunteers can no longer participate in caring for the disabled?
Should care for the disabled be run in a market environment?

I would appreciate a response.

For the NDIS in particular, it is the net benefit to the community that matters, not the size of the bureaucracy. As mentioned in the article, the current system is not working well and the Productivity Commission review found the NDIS benefits to be substantial. From page 2 of their report:

The benefits of the scheme would significantly outweigh the costs. People would
know that, if they or a member of their family acquired a significant disability, there
would be a properly financed, comprehensive, cohesive system to support them. The
NDIS would only have to produce an annual gain of $3800 per participant to meet a
cost-benefit test. Given the scope of the benefits, that test would be passed easily.”
http://www.pc.gov.au/inquiries/completed/disability-support/report/disability-support-overview-booklet.pdf

I can’t find anything to suggest that volunteers won’t be able to participate. However, it is true that organisations need to be registered providers in order to receive payments through the NDIS scheme.

And the alternative to having a marketplace of providers is the system we have now, where disabled people aren’t given the choice to ask for help from someone who meets their needs.

Surely the easiest way to ring-fence money for the care of the disabled is to stop making it so easy for junkies, malingerers, and outright scammers to sign up for it, thus reducing what is available to spend on those in genuine need?
When the UK recently did a reform, they found that well over half of those on benefits were just scrounging. They also found that the best way to help those with disabilities was to not encourage them by rewarding them for being sick/disabled, but by rewarding them for trying to lead normal lives.

http://ukcatalogue.oup.com/product/9780198515548.do

“…malingering is believed to contribute substantially to fraudulent health care and social welfare costs.”.

This book has a chapter about monkeys – monkeys get no reward for malingering, and it is observed that they lead far more normal lives than do humans suffering from similar disabilities.

Australia has long way to go to develop a good care system for chronic conditions and disabilities.

Kim Fischer said :

dungfungus said :

dungfungus said :

Can you advise the size of the federal bureaucracy that will be needed to run the “new, improved” system?
I understand it will not be based in Canberra.
What will be the annual cost of running it?
Is it true that unpaid and unqualified volunteers can no longer participate in caring for the disabled?
Should care for the disabled be run in a market environment?

I would appreciate a response.

For the NDIS in particular, it is the net benefit to the community that matters, not the size of the bureaucracy. As mentioned in the article, the current system is not working well and the Productivity Commission review found the NDIS benefits to be substantial. From page 2 of their report:

The benefits of the scheme would significantly outweigh the costs. People would
know that, if they or a member of their family acquired a significant disability, there
would be a properly financed, comprehensive, cohesive system to support them. The
NDIS would only have to produce an annual gain of $3800 per participant to meet a
cost-benefit test. Given the scope of the benefits, that test would be passed easily.”
http://www.pc.gov.au/inquiries/completed/disability-support/report/disability-support-overview-booklet.pdf

I can’t find anything to suggest that volunteers won’t be able to participate. However, it is true that organisations need to be registered providers in order to receive payments through the NDIS scheme.

And the alternative to having a marketplace of providers is the system we have now, where disabled people aren’t given the choice to ask for help from someone who meets their needs.

Thanks for the response Kim. I appreciate you attempting to answer the questions I posed.
To say that the size of the bureaucracy does not matter weighed against the net benefit to the community is something I would expect only a socialist to say. Without costings this scheme promises to get financially out of control which will ultimately not benefit the disabled.
While your quote from the productivity commission indicates benefits for people who have future disability issues will be guaranteed it does not say that the current system isn’t working well. The disabled people I know have been cared for most adequately by the various services and volunteers within the community. The NDIS will dismantle this and replace it with services provided by the lowest bidder (which is how the market system operates). How can this deliver a good outcome?
As for existing volunteers, there is nothing I can find on the NDIS releases which adequately covers this issue. There is a vague statement which says ” The service assesses the suitability of prospective host volunteers, who may have no previous experience with disability…..” This indicates that existing volunteers need not apply.
I have asked prospective service providers about their policy for volunteers being part of the team and the general response I get is they can’t engage anyone who doesn’t have an appropriate TAFE certificate or anyone who is not a member of health services trade union. In other words, no volunteers.
I hope you can give me evidence that this isn’t so.

dungfungus said :

dungfungus said :

Can you advise the size of the federal bureaucracy that will be needed to run the “new, improved” system?
I understand it will not be based in Canberra.
What will be the annual cost of running it?
Is it true that unpaid and unqualified volunteers can no longer participate in caring for the disabled?
Should care for the disabled be run in a market environment?

I would appreciate a response.

For the NDIS in particular, it is the net benefit to the community that matters, not the size of the bureaucracy. As mentioned in the article, the current system is not working well and the Productivity Commission review found the NDIS benefits to be substantial. From page 2 of their report:

[from Productivity Commission Report] “The benefits of the scheme would significantly outweigh the costs. People would
know that, if they or a member of their family acquired a significant disability, there
would be a properly financed, comprehensive, cohesive system to support them. The
NDIS would only have to produce an annual gain of $3800 per participant to meet a
cost-benefit test. Given the scope of the benefits, that test would be passed easily.”
http://www.pc.gov.au/inquiries/completed/disability-support/report/disability-support-overview-booklet.pdf

I can’t find anything to suggest that volunteers won’t be able to participate. However, it is true that organisations need to be registered providers in order to receive payments through the NDIS scheme.

And the alternative to having a marketplace of providers is the system we have now, where disabled people aren’t given the choice to ask for help from someone who meets their needs.

dungfungus said :

Can you advise the size of the federal bureaucracy that will be needed to run the “new, improved” system?
I understand it will not be based in Canberra.
What will be the annual cost of running it?
Is it true that unpaid and unqualified volunteers can no longer participate in caring for the disabled?
Should care for the disabled be run in a market environment?

I would appreciate a response.

Ever had to fill in the form??? Nightmare

John Hargreaves said :

My friend Jon Crowley who was shot by the police in Chapman whilst having mental health episode, is a quadriplegic. He has been passed from pillar to post and has had disgustingly bad support services from health authorities and carers over the years since he was shot.

I hope that the NDIS gives him more say in his support and more effective services. Hopefully his life will change for the better in January when he becomes eligible for the NDIS.

I haven’t been too public about his difficulties because I didn’t want to make things worse for him but if the NDIS is not an improvement…. watch this space!

I have seen Jon Crowley and the way he is transported which gives me an idea of the problems he and his carers must face.
By referring to “hope” in what the NDIS may be able to do to improve Jon’s life you don’t seem as positive about the project as other people are.
I am glad you are going to monitoring the change.

John Hargreaves11:04 am 26 Oct 15

My friend Jon Crowley who was shot by the police in Chapman whilst having mental health episode, is a quadriplegic. He has been passed from pillar to post and has had disgustingly bad support services from health authorities and carers over the years since he was shot.

I hope that the NDIS gives him more say in his support and more effective services. Hopefully his life will change for the better in January when he becomes eligible for the NDIS.

I haven’t been too public about his difficulties because I didn’t want to make things worse for him but if the NDIS is not an improvement…. watch this space!

Can you advise the size of the federal bureaucracy that will be needed to run the “new, improved” system?
I understand it will not be based in Canberra.
What will be the annual cost of running it?
Is it true that unpaid and unqualified volunteers can no longer participate in caring for the disabled?
Should care for the disabled be run in a market environment?

I am starting to navigate my access to the NDIS. Everyone has been so helpful and patient as I make decisions I never thought I would need to make. Being a very independent soul and wanting so much for our lives to continue on as close to our old normal as possible, I am very, very grateful that this support network is now available to me and to my family.

I can continue to work for as long as I can with supports in place funded by the NDIS and by my employer. Thank you to the architects of this scheme and to those who continue to support it in its entirety. Thank you.

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