HOW TO GET THE NDIS ON

TRACK

MAY 2017

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How to get the NDIS on trackThe vision of the National Disability Insurance Scheme (NDIS) is compelling:

• choiceandcontrolforpeoplewithdisabilityandtheirfamilies;

• doublethefundingfordisabilitysupporttorespondtothehighneedforservicesandequipment;

• aninsuranceapproachthatinvestsinearlyintervention;and

• increasedequityandlifeopportunitiesforpeoplewithdisabilityacross Australia.

TheNDISistherightreformforAustralia;butthescaleandcomplexityofimplementationisplacingenormouspressureonallstakeholders.Someofthispressureisaninevitableconsequenceoflarge-scalechange,butsomeisavoidable.TheroadtotheNDISisrougherandriskierthanitneedstobe.

CriticaltorealisingthevisionoftheNDISisthegrowthofadynamic,sustainableandvalues-drivendisabilitysector.Withoutthis,peoplewithdisabilityandtheirfamilieswillnothavethechoiceandqualityofsupporttheNDISpromises.Therisksfacingthedisabilitysectorareriskstotheschemeasawhole.Theyaresubstantialandrequireurgentmitigatingaction.

Inthispaper,NDSproposespracticalmeasurestoreducetheavoidablepressureandrisk–andsoimprovetheimplementationandsecurethefuture of the NDIS.

DisabilityserviceproviderscampaignedfortheNDISalongsidepeoplewithdisability,theirfamiliesandcarers.Theirmotivewastoimprovethelifeopportunitiesandwell-beingofpeoplewithdisability.Thatsamemotiveunderpinsthispaper.

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RecommendationsNDSrecommendstogovernmentandtheNationalDisabilityInsuranceAgencythattheytakethefollowingactionstogettheNDISontrack:

Trialplanningpartnershipswithspecialistdisabilityserviceproviders,utilisingtheirexpertiseandknowledgeoftheirclientswhilstmanagingpotential conflict of interest

Commenceplandevelopmentwithanaccuratedescriptionofcurrentsupports,sourcedfromtheparticipantandhisorhercurrentproviders

Allowparticipantstheopportunitytocommentontheirplanbeforeitisfinalised

Includecoordinationofsupportsintheplansofparticipantswithcomplexconditions

Withconsent,informthecurrentprovidersofaparticipantassoonassheorhehasanapprovedplan

Reducethehighnumberofquestionsaskedofparticipantsduringtheassessmentandplanningprocess

Adopta‘workfirst’approachinplanningtoincreasetheproportionofplanswithemploymentsupports

Commence access to School Leaver Employment Supports (SLES) as earlyasYear10andextendSLESbeyondtwoyearsifaparticipant’semployment is the probable outcome

SecureaviablefutureforjobsinSupportedEmploymentEnterprisesbyresolvingfundingandwageassessmentissuesandpromotetheprocurementofgoodsandservicesproducedbypeoplewithdisability

EstablishanemergencyresponsesystembyextendingtheNDIS1800phonelineto24hoursadayandformingresponsepanelsofdisabilitysupportprovidersinallregions

Compensateproviderswhentheyincurasuddenescalationofsupportcostsinrespondingtoanaturaldisaster

Subjecttocertainconditions,streamlineregistrationbyprovisionallyapprovingdisabilityserviceprovidersthatmeetqualityrequirementsinonejurisdictiontooperateinotherjurisdictionsand/ordelivernewsupports

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Do not compel the future separation of Specialist Disability AccommodationandSupportedIndependentLivingbeyondseparateserviceagreements(andtherequirementthatprovidershavesoundprocesses for resolving conflicts)

Fundtheusercostofcapitalforrespitehousesanddaycentres

Discontinuein-kindarrangementsthatlimitparticipantchoiceandcontradicttheprincipleofcompetitiveneutrality

PendingthederegulationofNDISprices:

• setindividualparticipantbudgetsbasedonreasonableandnecessarysupports,realisticcosts(derivedfromrealdata)andevidence-basedreferencepackages;

• allowparticipants(theirrepresentatives)andproviderstonegotiatepricesforsupportswithoutexceedingtheparticipant’sbudget;

• publishapriceguidebasedonmarketinformationtoenableparticipants(andtheirrepresentatives)tocompareandnegotiateprices;

• basepurchasingonhoursorondeliverables

Revisethemethodfordeterminingremotelocationsandpriceloadingstoreflectthefullcostimpactoflocalconditions

EstablishanindustryadvisorygrouptodesignandtestICTsystemchangesbeforetheyareintroduced

Useco-designtoworkouthowparticipantswithcomplexneedsorwholiveinregionalorremoteareascanbestbeassistedtotravel

CeasetherequirementthatprovidersmustquoteforallSupportedIndependentLivingparticipants,notjustforthosewhosesupportexceedsthebenchmarkpriceandworkwiththesectortoimprovetheSupportedIndependentLivingtemplate

Establishadedicatedandresponsivetelephoneserviceforprovidersandastate-widepointofcontactfamiliarwithissuesinthatjurisdictionwhohastheauthoritytoresolvethem

Fundandassistthedevelopmentofanindustryplan,ledbythenon-government sector

Expandtheprovisionofmarketdatatoassistproviderswiththeirplanningandinvestmentdecisions

Establishanationaldisabilityresearchentity,structuredsimilartotheAustralianHousingandUrbanResearchInstitute

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The pressure on the NDIS has four principal sources:Speed: TheNDISisaccelerating.InthesixmonthstoDecember2016,theNationalDisabilityInsuranceAgency(NDIA)approvedasmanyparticipantplansasithadintheprecedingthreeyears.Thisdemandingpaceisbeingsetbyambitioustargetsininter-governmentalagreements.WhilepeoplewithdisabilityshouldnothavetowaitanylongerthanisnecessarytoaccesstheNDIS,thehasteinprocessingnewentrantsisaffectingthequalityoftheirplans.

Funding:AlthoughtheNDISwillachievelargeeconomicandsocialreturnsovertime,itisasubstantialinvestmentbyAustraliantax-payers.Whenfullyimplemented,itwillcost$22billionayear.EnsuringtheaffordabilityoftheschemeisakeyfocusfortheNDIAandFederalGovernment.Whiletheschemecurrentlyoperateswithinbudget,theNDIAhasidentifiedseveralcostdriverswhicharetestingthebudget.Forexample,therelativelyhighnumbersofchildrenseekingtoenterthescheme.Underfiscalpressure,theFederalGovernmenthasestablishedaspecialaccounttoquarantinesavingsfortheNDIS.Thisisawelcomedevelopment.Findingsavings,however,amidstthemanyclaimsontheFederalBudget,isanongoinganddifficulttask.

Systems:IndependentreportsoverrecentmonthshaveraisedconcernsaboutthecapacityofNDISsystemstofunctionatthescalerequiredforthescheme’sfullimplementation.Inits2016reviewoftheNDISMyPlacePortal,PwCstated:“thereisrealriskthattheNDIAoperatingmodelwillnotbeabletocope…whenthefullschemeisexpectedtobeoperating”.WhiletheflowofpaymentsthroughthePortalhasimproved,usingthePortalremainscumbersomeandslowatatimewhenefficiencyisimperative.Thequalityofparticipantplansisinconsistentandtherehasbeenaback-logofregistrationrequests:of8,000registrationrequestsfromprovidersattheendofDecember2016,3,000hadnotbeenprocessed.

Supply:Thegovernment-commissionedreportfromRobynKruk,‘IndependentReviewoftheReadinessofNDISfortransitiontoFullScheme’,states:

Inrelationtothemarketandproviderreadiness,alldocumentationreviewedandintervieweeshighlightedhighriskinthisarea.Thereviewerrecommendsbothimmediateandshort-termactionstostrengthenmitigationandresponsesinrelationtopotentialmarketfailureorprovidercollapse;andtosupportproviderreadinessandmarketdevelopment.

TheAustralianNationalAuditOfficereinforcedthisviewinitsNovember2016reportontheTransitionoftheDisabilityServicesMarket,which

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concludedthatthescheme’simplementationisoutpacingthepreparatoryworkneeded.

ThegrowthindemandforNDISserviceswillseverelytestthecapacityofthemarket.ResearchbyCurtinUniversityandNDSsuggeststhatmanynon-governmentdisabilityserviceproviderslackthecapacitytoinvestinmajorgrowth1;two-thirdsreportthattheyareworriedabouttheircapacitytoprovideserviceswithNDISprices.2Newprovidersarealsohesitanttoinvest.Unlessthenon-governmentsectorhasthecapacityandconfidencetogrowsubstantially,thegapbetweendemandandsupplywillincrease.

Therecommendationswhichfollowareguidedbytheneedtobepragmatic,flexibleandlessbureaucratic;tore-invigoratetheprincipleof co-design,toimprovecommunication;andtoboostsector development.

NotallthepressuresandproblemswiththeNDIScanberesolvedovernight.NDSisproposingpracticalresponsestoimmediateproblems.

• Partner with specialist providers to undertake planning

Thequalityofparticipantplansisinconsistent.Someareexcellent;othersarepoorandabsorbsubstantialeffortbyparticipants,theirfamiliesandproviderstorectify.

Thequalityofplansisimpairedbythreestructuralfactors:

• ambitiousNDISimplementationtargetsaredrivingrapidhigh-volumeprocessingofparticipantplans;

• plannerslackdirectvisibilityofthesupportspeopletransitioningintotheNDIScurrentlyreceive,causingthemattimestoomitessentialsupportsfromplansinadvertently;and

• newly-recruitedplannersoftenlackexperienceandknowledgeofdisabilityservices.TheNDIAmandatesthatLocalAreaCo-ordinators(LACs)whichundertakemostoftheplanninggenerallycannotbedisabilityserviceorganisations,arguingthatsuchorganisationswouldhave a conflict of interest.

Thequalityofplanningwouldimproveifdisabilityserviceorganisationswereinvolved.Providersofspecialistsupportshavedeepknowledgeofdisability–andtheyknowtheirclients.Usingthisknowledgetoinformplanningwouldmakesense.Thisisparticularlytrueforpeoplewithcomplexneeds.

TheNDIArecognisesthevalueofexpertproviderinputinlimited

1 National Disability Services and Curtin University, Australia’s Disability Services Sector 2016, Report 1: Financial Sustainability summary of key findings

2 National Disability Services, State of the Disability Sector Report 2016

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circumstances.Forexample,ithasissuedguidancetoNDISplanners–developedwithproviders–specifyingthesupportsthatshouldbeinabasicplanforpeoplewithMotorNeuroneDisease.

PlanningpartnershipsbetweentheNDIAandspecialistprovidersshouldbeextended.

TheNDIAisreluctanttoinvolveprovidersinplanningbecauseofthepotentialforconflictofinterest.Conflictofinterestcouldbemanagedwithoutexcludingproviders’expertise.Otherhumanservicessystems,suchashealth,achievethisbalance.

TheNDIAcouldmanageconflictofinterestby:

• maintainingtheauthoritytoapproveindividualbudgets;

• continuingtodevelopevidence-basedreferencepackages;and

• supportingparticipantstoexerciseinformedchoiceofprovider.

Themanagementofconflictofinterestshouldextendtogovernmentprovidersaswellasnon-governmentproviders.

• Useproviders’knowledgeofexistingsupportstoinformplans

Topreventinadvertentgapsinparticipantplans,planningshouldcommencewithanaccuratedescriptionofcurrentsupports,sourcedfromtheparticipantandhisorhercurrentproviders.Theapprovedplanshouldmaintainorbuildonthesesupports,omittinganyonlywhentheparticipantmakesadeliberatedecisiontodosoorthesupportisclearlynolongerrelevant.

• Alwaysallowaparticipanttorespondtoadraftplanbeforeit’sapproved

DuringthetrialphaseoftheNDIS,participantswereinvitedtocommentontheirdraftplanbeforeitwasfinalised.Thatpracticehaslargelyceased.Theconsequenceisthatparticipantscanendupwithaplanthatdoesn’treflecttheirneedsandgoals.Someparticipantsreceiveplanstheydon’trecognise.ConsistentwiththeNDIS’sfocusonchoiceandcontrol,participantsshouldalwayshavetheopportunitytocommentontheirplanbeforeitisfinalised.

Peoplewithcomplexconditionsshouldhavecoordinationofsupportsintheirplan.ThisincludespeoplewithprogressiveneurodegenerativediseaseswhoseconditionischangingandwhohavetocombineNDISsupportswithhealthservices.

• InformproviderswhenparticipantshaveanapprovedNDISplan

TheNDIAstatesPrivacyLawpreventsitfrominformingproviderswhenaparticipanthasanapprovedplan.Thisposesafinancialriskforproviders.

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ManyprovidersonlybecomeawarethatatransitioningparticipantwhomtheyaresupportinghasanapprovedNDISplanwhenstateorterritoryfundingforthatparticipantceases.SomegovernmentsceasepaymentfromthedayanNDISplanisapproved.Unawareoftheapprovedplan,theproviderwillcontinuetoprovideserviceswhichmaynolongerbefunded.

ServiceprovidersneedtoknowwhenaparticipanthasanapprovedNDISplansotheycanbilltheNDIAandalignthesupportstheyareprovidingwiththeplan.Consentfromparticipantstoinformtheircurrentprovidersshouldbesoughtduringtheplanningprocess.

• Reducethenumberofassessmentandplanningquestions

Theplanningandassessmentprocessrequiresparticipantstoanswer126questions.Theintentionofsomeofthequestionscanbeeasilymisunderstood.Forexample,‘whatisyourhouseholdincome?’Thequestionnaireimposestoogreataburdenonparticipants,particularlywhentheyareinterviewedoverthephone.Thenumberofquestionsshouldbereducedsubstantially.

• Strengthenthefocusonemployment

Employment–openandsupported–mustbecomeaneasyandattractivechoiceforNDISparticipants.Inits2011reporton‘DisabilityCareandSupport’,theProductivityCommissionarguedthattheNDISwoulddeliversubstantialeconomicbenefitstoAustraliathrough“increasedeconomicparticipationforpeoplewithdisabilities(againstabackgroundofAustralia’slowperformanceinthisareacomparedwithmostotherdevelopedcountries)andtheirinformalcarers.”3

Todate,theproportionofNDISplanswithemploymentsupportsisdisturbinglylow.Inthefirsttwoquartersof2016-17,only2%ofcommittedsupportswereforemployment4andintheOutcomesFrameworkpilotonly13%ofrespondentsreportedthattheNDIShadhelpedwithwork,thelowestofanydomain.5

Abroadspectrumofemploymentoptionsshouldbeopentopeoplewithdisability,includingSupportedEmploymentEnterprises.SecuringaviablefutureforSupportedEmploymentEnterprisesandthethousandsofjobstheycreaterequiressatisfactorilyresolvingwageassessmentandfundingissuesandpromoting(acrosspublicandprivatesectors)theprocurementofgoodsandservicesproducedbypeoplewithdisability.

Buildingemploymentaspirationsandengagementbeginsatschool.

3 Productivity Commission, Disability Care and Support, July 2011 Overview and Recommendations pp 54-55.

4 NDIS, January 2017, COAG Disability Reform Council Quarterly Report, p. 70

5 NDIS Annual Report2015-16, p. 60

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Internationalevidencepointstotheimportanceofworkexperienceandpart-timeemploymentinbuildingworkconfidenceamongyoungpeoplewithdisabilityduringtheirsecondaryschoolyears,beginninginYear10.TheNDIAhasintroducedSchoolLeaverEmploymentSupport(SLES)–awelcomeinitiative.However,accesstoSLESshouldbeabletocommenceearlierthanYear12andanoptionintroducedtoextendtheprogrambeyondtwoyearsifemploymentistheprobableoutcome.

Moremustbedonetoboostdemandfor,andaccessto,NDISemploymentsupports.NDISplannersandLACsshouldadopta‘workfirst’approachwhichmotivatesandassistsanincreasedproportionofNDISparticipantstoconnectwithwork.

• Establishanemergencyresponse

Inevitably,eventsoccurwhichaperson’splancannotanticipate:afamilycarerisinjuredorfeelsover-burdenedbytheircaringresponsibilities;aperson’schallengingbehavioursescalateunexpectedly;theparticipantneedsadditionalpersonalcareorhouseholdassistance.

Stateandterritorygovernmentshaveprocessestoimplementemergencyresponses(mostlyusingnon-governmentdisabilityserviceproviders),butthesewillceaseastheNDISisimplemented.

ItisessentialthattheNDIAestablisharrangementsforrespondingtoemergencies.ItshouldextendtheNDIS1800phonelineto24hoursadayandformemergencyresponsepanelsofdisabilitysupportprovidersinallregions across the country.

Whennaturaldisastersstrike,providerscanincurasuddenescalationofsupportcosts.Floods,forexample,mayforceproviderstostafftheirgrouphomesformanyadditionalhours.Inthesecircumstances,theNDIAshouldcompensateproviders.

• Streamlineregistrationforapprovedproviders

ToregisterasaproviderofNDISsupportsrequirestheNDIA’sapproval.Thisappliestoexistingregisteredproviderswantingtoextendtheirservices,aswellastonewproviders.Iftheregistrationprocessisslow,marketsupplywon’tkeeppacewiththeexpandingdemandforservices.

RegistrationsometimesrequirescomplexnegotiationsbetweentheNDIAandstateandterritorygovernmentswhichadministerthequalitystandardsthatapplytoserviceproviders.Addingtothecomplexity,qualityaccreditationdiffersacrossjurisdictions.

Tostreamlineregistration,anyspecialistdisabilityserviceprovidermeetingthequalityrequirementsinonejurisdictionshould,oncompletionofastatementofintent,beapprovedprovisionallytooperateinother

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jurisdictionstodeliverlikesupports.Theprovisionofthesenewsupportsshouldbecheckedwhentheproviderisnextscheduledforqualityauditing.Thesameprovisionalaccreditationshouldapplytosomeservicetypes,althoughnottohigher-risksupportssuchasSupportedIndependentLiving(SIL).

• Donotprescribetheseparationofhousingandsupportbeyondseparate service agreements

ThewelcomeintroductionofSpecialistDisabilityAccommodation(SDA)paymentswillstimulatehousingconstructionandhelpcoverthecostofmaintainingspecialisthousingforabout6%ofNDISparticipants.SDAisinadditiontoaccommodationsupportorSIL.

Overtime,participantswithbothSDAandSILintheirplanwillexerciseincreasedchoiceaboutwheretheylive,withwhomandwhichorganisationsupports them.

Investorsandprovidersneedpolicyclaritytomakedecisions.Atpresent,thereisuncertaintyabouttheNDIA’sfuturepolicyonwhetherhousingandsupportmustbeprovidedbyseparateorganisations.Atpresent,organisationsthatprovidebothhousingandsupporttoaparticipantarerequiredtohaveseparateagreementsforeach.

InseveraldocumentstheNDIAstatesthatitwill“promotetheseparability,andultimatelyseparation,ofprovisionofSDAandSIL.”However,inDecember2016NDIACEODavidBowentoldanNDSconferencethattheAgencywouldnotinsistonacompleteseparationofhousingandsupport.Thiswouldmeanaparticipantcouldchoosetoliveinahouseownedbytheorganisationthatprovidedtheirsupport.

TheNDIAshouldpublishaclearstatementconfirmingthatitwillnotrequirethefutureseparationofSDAandSILbeyondseparateserviceagreements.Itshouldrequireproviderstohavesoundprocessesforresolvingconflictsifthey arise.

Thereisanunder-supplyofdisabilityhousinganddemandisincreasing.Iffullseparationofhousingandsupportwerecompulsory,non-governmentproviderswouldreducetheirinvestmentinhousingforpeoplewithsignificantdisability,thusexacerbatingtheunder-supply.

• Fundtheusercostofcapitalforrespitehousesanddaycentres

TheNDISfundstheusercostofcapitalforlong-termhousing(SDA)butnotforshort-termaccommodation.Thelatterprovidesessentialrespiteforfamilies,enablingthemtocontinuetheirprovisionofinformalsupport.TherestrictionofSDAtolong-termhousingcouldseerespitehousesconvertedtolong-termaccommodation.Withoutaccesstorespiteservices,morefamilieswouldseekSIL,amoreexpensiveoptionfortheNDIS.

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NDISpricesdon’tcoverthecostofmaintainingadaycentre.Attendanceatadaycentre,includingasabasefromwhichtoembarkoncommunityactivities,isanessentialmeansofcommunityaccessforsomepeoplewithdisability.Itenablesthemtobeawayfromhomeduringtheday(beingaloneathomewhileparentsworkisnotsafeforsomepeoplewithdisability;othersmayliveinagrouphomewhichisnotstaffedduringtheday).Adaycentremaybetheonlybuildinginthelocalcommunitythatoffersfullyaccessibletoiletswithchangetablesandhoists.Thecapitalcostofusingadaycentreshouldbefunded.

• Discontinuein-kindarrangementsthatrestrictchoice

MostAustralianadultsexpecttochoosewithwhomtheylive,butanNDISRulepreventsresidentsofgovernment-rungrouphomesfromchoosinganalternativeproviderduringschemetransition.TheRulerequiresthatwhereanin-kindsupportisprovided,theparticipant’splan“mustspecificallyidentifythatthesupportwillbeprovidedbytherelevantproviderofthatin-kindsupport.”

In-kindarrangementsoutlinedinbilateralagreementsallowgovernmentstofundtheirgrouphomesatahigherratethantheNDIApaysnon-governmentproviders,perpetuatingadisparityinpublicfundingbetweengovernmentprovidersandnon-governmentproviders.6In-kindarrangementslimitparticipantchoiceandcontradicttheprincipleofcompetitiveneutrality.Theyshouldbephasedoutquickly.

• Allowflexibilityinpricing

TheinadequacyofsomeNDISpricesposesasubstantialrisktoserviceprovidersandthustothecapacityofthedisabilitysupportmarkettomeetthegrowingdemandforservices.

Currently,theNDIAsetsmaximumprices(exceptforthe5%ofparticipantswhoself-manage)andiscommittedtoimposingauniformpriceregimeacrossmostofAustralia.Someoftheassumptionsthatunderpinthehourlypriceareunrealisticand,unlessadjusted,willerodethequalityofsupport.Theassumptionthat95%ofasupportworker’shoursofemploymentarebillableunderestimatestheimpactofpaperwork,training,personalleaveandtravel.Similarly,theassumedsupervisionratioof1:15FTEisuntenablewhenthehighproportionofpart-timeandcasualworkersisfactoredin;anditdoesn’tallowthelevelofsupervisionnecessaryforqualityandsafeguarding.

Inthelongrun,theNDIAsayspriceswillbederegulated;butastheeconomistJohnMaynardKeynesfamouslyremarked,“Inthelongrunwe

6 According to the Productivity Commission’s 2017 Report on Government Services, state and territory governments fund their group homes, on average, at $32,510 per resident more than they fund non-government group homes.

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arealldead…”Thequestionis:whatshouldbedonenow?

TheNDIAcouldmakepricingmoreflexiblewithoutjeopardisingthefinancialsustainabilityoftheNDIS,inthefollowingway:

• setindividualparticipantbudgetsbasedonreasonableandnecessarysupports,realisticcosts(derivedfromrealdata)andevidence-basedreferencepackages;

• allowparticipants(theirrepresentatives)andproviderstonegotiatepricesforsupportswithoutexceedingtheparticipant’sbudget;

• publishapriceguidebasedonmarketinformationtoenableparticipants(andtheirrepresentatives)tocompareandnegotiateprices;

• basepurchasingonhoursorondeliverables.Ratherthanspecifyanumberofhoursofsupport,aserviceagreementcouldspecifythetasksthattheparticipantwantscompleted.Forexample,theparticipantagreestopayanamountequivalentto10hoursofsupporteachweek,aslongaseachweekdaymorningtheproviderassiststheparticipanttoshower,dressandprepareameal.Iftheprovidercompletesthetasksin9hourstothesatisfactionoftheparticipant,theproviderstillreceivestheagreedamount.

• Revisethemethodfordeterminingremoteprices

TheNDIAappliesmodestloadingstopricesinregionswhichtheModifiedMonashModeldeterminesareremote.TheloadingsdonotadequatelyreflectthecostsofserviceprovisioninsomeregionsofAustralia,includingDarwin.Providershavenocontrolovermanyofthefactorsdeterminingcostsinareaswheredistancesarelargeandsuitableworkersareinshortsupply.ThegeneralNDISproblemsofpricingtravelappropriatelyandaccessingtransportaremagnifiedinruralandremoteregions.ThemethodforfundingsupportsinthesepartsofAustraliashouldberevisedtoreflectthefullimpactoflocalconditions.

• Workwithdisabilityprovidersasco-designpartners

InthehastetoimplementtheNDIS,theNDIA’suseofco-designhasdiminished.Serviceprovidersareomittedwhenco-designismentionedintheNDIA’scorporateplanandabsentfromtheAgency’sAnnualReport2015-16whenitsays:“TheSchemeisbuiltonaco-designapproachinvolvingcollaborationbetweenmanypeople(participants,community,NDISPlanners,Agencypartners).”

Whileco-designcanaddtimetothedevelopmentandtestingphaseofaninitiative,overthelonger-termitproducesabetteroutcome.ThisisakeylessonfromtheJuly2016launchoftheNDISMyPlacePortal.WhiletheflowofpaymentsthroughtheportalhasimprovedsinceJuly,poorfunctionalitycontinuestoimposecostsonusers.TheNDIAandrelevant

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CommonwealthdepartmentsshouldestablishanindustryadvisorygrouptodesignandtestICTsystemchangesbeforetheyareintroduced.

ParticipanttransportisemergingasaproblemfortheNDIS,withtaxicostsrisingandagrowingnumberofprovidersconsideringdisposingoftheirtransportfleets.Aco-designapproachwouldexploreoptionsabouthowparticipantswithcomplexneedsorwholiveinregionalorremoteareascouldbeassistedtotravel.

• ChangetheapproachtoquotingforSupportedIndependentLiving

Inachangeofpolicy,theNDIAisrequiringnon-governmentproviderstoquoteforallparticipantswhoreceiveSILfunding.TheAgencybelievesthatquotinggivesparticipantsaclearerunderstandingoftheserviceofferingfromproviders.

IfaproviderbelievesthataSILparticipantneedsfundingabovethebenchmarkprice,theprovidershouldsubmitaquote;butnotiftheproviderispreparedtoacceptthebenchmarkprice.ThechangeofpolicyimposesadditionalunpaidworkonprovidersandiscontrarytotheAustralianGovernment’sstatedaimofminimisingtheburdenofregulationon community organisations.

TheNDIAistestingadraftquotingtemplatewithanumberofSILproviders.FeedbacktoNDSindicatesthatthetemplaterequiresfurtherwork.Thereisconfusionaboutthescopeofactivitiesthataquoteshouldcoverandthedrafttemplateprovidesonlyapartialpicture.TheNDIAshouldworkwithNDSandthesectortoimprovethetemplateandclarifythatSILismorethanattendantcare.

• Establishnewpointsofcontacttoresolvetransitionproblems

Duringtimesofgreatchange,frequentandeffectivecommunicationisessential.

CallerstotheNDIS1800telephonenumber(operatedbytheDepartmentofHumanServices)oftenexperiencelongdelays,noresolutionofaproblemandfindthemselvesrepeatingtheirstory.Adedicatednumberforprovidersshouldbeestablishedandstaffrespondingtothesecallsshouldbeabletoprovideimmediateadviceandbecapableofrectifyinganarrayofportalandpaymentclaimissues.

NDShearscomplaintsfromstate-wideormulti-regionalproviders(inNSW,forexample)thattheabsenceofastatemanagermakesitdifficulttoresolveinconsistentpractices(orinterpretationsofpolicy)amongLACsandacrossNDIAregions.WhiletheAgencyhascreatednewGeneralManageroperationalroles,theyareeachresponsibleforfourstatesandterritories.Providerswouldwelcomeastate-widepointofcontactwhoisfamiliarwith

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theissuesinthatstateandhastheauthoritytoresolvethem.

• DevelopandimplementanIndustryPlan

The‘IndependentReviewoftheReadinessofNDISforTransitiontoFullScheme’(writtenbyRobynKruk)flaggedhighrisksfortheNDISmarket,andhighlightedtheneedfor“bothimmediateandshorttermactionstostrengthenmitigationandresponsesinrelationtopotentialmarketfailureorprovidercollapse;andtosupportproviderreadinessandmarketdevelopment.”

Aclearandcoherentnationalindustryplanisrequiredtosupportthesector’sdevelopmentandtransitiontotheNDISmarket.Governmentfundingshouldbeprovidedtoenablethenon-governmentsectortoleadthedevelopmentofsuchaplan.Theplanshouldincludeastrongfocusonworkforcegrowthanddevelopment.Itshouldoutlineactions,timeframes,accountabilitiesandmonitoringarrangements.Anindustryplanshouldbuildonthecommitmentssomegovernmentshavealreadymadetoworkforcedevelopmentprojects(oftenwithafundingcontributionfromtheSectorDevelopmentFund).

• Informthemarkettoassistplanningandinvestment

ProvidersneedinformationtomakeinvestmentandplanningdecisionsastheNDISexpands.TheNDIAistobecommendedforitspublicationofMarketPositonStatements;however,thereismorethattheAgencyshouldpublish.Forexample,dataonpatternsandtrendsinparticipantdemandforsupports.Itshouldcontinuetoexpanditspublicationofdataanalysis.

• Createanationaldisabilityresearchentity

Competitionaloneisinsufficienttodevelopaneffectiveandefficientmarketfordisabilitysupports.Researchanddataanalysisareneededtoassistmarketstewardshiptoanswercriticalpolicyquestionsaboutsocialcapital,marketrisksandworkforcetrendsandexplorequestionssuchashowtechnologywillshapethedemandforsupports.

Currentdisabilityresearchfundingisinadequateandresearchispoorlycoordinated7.ExistingfundingmechanismsfordisabilityresearchsuchastheNationalHealthandMedicalResearchCouncil(NHMRC)andtheAustralianResearchCouncil(ARC)havenotassigneddisabilityresearchahighpriorityandareunderpressurefromotherresearchdemands.

Acollaborativeresearchstructureisneeded,similartothesuccessfulAustralianHousingandUrbanResearchInstitute(AHURI).Itsobjectiveswouldbe:

7 Centre for Disability Research and Policy, 2014, Audit of Disability Research in Australia, University of Sydney, Lidcombe

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• efficientco-ordinationofdisabilityresearchactivities,expertiseandspending;

• appliedresearchtoinformmarketstewardship;

• buildcapacityandcapabilityofresearchend-users;and

• facilitatesystem-wideinnovation.

Theestablishmentofanationaldisabilityresearchentitywouldrequireapartnershipapproachwithuniversitiesandothersandfundingcontributionfrom government.

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Contact:DrKenBakerChiefExecutiveNational Disability ServicesPh:0262833203M:0409606240ken.baker@nds.org.au

National Disability Services is the peak industry body for non-government disability services. It represents service providers across Australia in their work to deliver high-quality supports and life opportunities for people with disability. Its Australia-wide membership includes over 1100 non-government organisations, which support people with all forms of disability. Its members collectively provide the full range of disability services - from accommodation support, respite and therapy to community access and employment. NDS provides information and networking opportunities to its members and policy advice to State, Territory and Federal governments.