Inquiry into Implementation of the National Disability Insurance Scheme and the Provision of Disability Services in New South Wales
Name: Name suppressed Date Received: 9 August 2018
Partially Confidential
Submission to 2018 NSW Legislative Council Enquiry into NDIS
Requesting partial confidentially please (all names and identifying information to be removed)
Context of my submission: My siblings and I are guardians to my 50 year old brother who has severe intellectual impairment and has been living in a large residence run by ADHC.
That Portfolio Committee No.2 – Health and Community Services inquire into and report on the provision of disability services across New South Wales, and in particular:
(a) the implementation of the National Disability Insurance Scheme and its success or otherwise in providing choice and control for people with disability
I believe the NDIS has provided new and real of supports for people with disabilities, and the concepts of allowing choice and improved access to community participation have improved their lives greatly. I am very grateful the scheme has been introduced, however there are some challenges in its implementation.
(b) the experience of people with complex care and support needs in developing, enacting and reviewing NDIS plans,
My sister and I support my brother in the development of his NDIS plans, engaging providers, reviewing services, participating in planning meetings, and revising his plans. We are very capable people, and even we find this time consuming and complicated.
I thinks it important to have planners who understand the disabilities and can properly assist families, and also to have a strong governance and accountability framework for providers, as we have found reviewing /monitoring services challenging also.
(c) the accessibility of early intervention supports for children,
(d) the effectiveness and impact of privatising government-run disability services,
This is actually hugely worrying for my family at this point. My brother has been well cared for in his current residence. He is in a cottage that is part of a large residential unit. Particularly concerning to us was a request to complete a questionnaire about residential agreements between a disabled person and their non-government residential providers, which sounded very complicated and legalistic, and left us with no confidence that my brother has enduring accommodation guaranteed. I do not believe it is appropriate for these services to have the same legal frameworks as commercial accommodation agreements. I do believe there needs to be greater requirements to resolve difficulties and to guarantee to provide the person with suitable accommodation and residential services.
My brother can no longer access any allied health or support services through his ADHC large residential service, and these need to be provided from his NDIS plan. It sounds like any government required reviews will use up his allied health funding in his plan, and this has not been forecast to us as his planners previously. When his accommodation changes his doctor will not be providing services to him, which will be a great loss in continuity and quality of care. He will not be able to access specialty dental services.
My greatest concern is there is no provider of last resort. Who has to look after my brother if none of the NGOs or private providers will do so? With ADHC gone it appears no one does. Families of people with disabilities have such a difficult time; I do believe it is callous of the NSW government to remove the disability services completely from their responsibilities. Other states have not done this.
People with disabilities need a government department to oversee the services provision, and to ensure that problems, such as no service providers available, are resolved. People with disabilities deserve to have an organisation with knowledge and authority looking out for them.
I am also concerned that fully privatised services encourages corruption. We have had difficulty with one service provider whose billing is not very accurate, which requires constant monitoring. While complaints can be made to the NDIS or the Ombudsman, in reality we have no other service provider available. I think the mechanisms are not robust enough as yet to deter this behaviour. I think there are incentives for corrupt providers, or even aggressively commercial ones, to enter this area of service provision, and it is difficult for vulnerable people to manage this, such as inaccurate billing.
It is also really difficult for families to spend large amounts of time searching for, interviewing and brokering for services. It is difficult for families to judge how to engage a good service. I expect this will improve over time, with better support to assist families, but at present I think this is time consuming and difficult. I work full time, and it is certainly difficult for me to spend sufficient time on my brother’s support needs.
(e) the provision of support services, including accommodation services, for people with disability regardless of whether they are eligible or ineligible to participate in the National Disability Insurance Scheme,
See above
(f) the adequacy of current regulations and oversight mechanisms in relation to disability service providers,
I am concerned that there is not sufficient regulation of workers, qualifications or business processes. My experience has been providers are keen to get involved in new areas of business and can know very little about the clients or these types of services. For example one of my brother’s providers mostly provides services to aged care, and they have very limited understanding of people with disabilities. They have a high staff turnover, and sometimes do not know who we are. I engaged them because they were the only organisation at the time that had a worker that I could meet and know who was involved with my brother. While this worker has been great, the provider organisation is a challenge to work with, and I have no other service providers available to engage.
I have been advised when all accommodation services are changed to private providers the workers will have less qualifications required than a currently. I do not consider a six week course sufficient qualifications to work with such vulnerable people as those requiring supported accommodation.
(g) workforce issues impacting on the delivery of disability services,
(h) challenges facing disability service providers and their sustainability,
(i) incidents where inadequate disability supports result in greater strain on other community services, such as justice and health services,
I do believe removing ADHC has resulted in a greater burden on families, and on families who were already vulnerable and struggling.
(j) policies, regulation or oversight mechanisms that could improve the provision and accessibility of disability services across New South Wales, and
Disability services should have government oversight and accountability mechanism. The NDIS is an inurance scheme and a funding scheme. I believe the NSW government is quite remiss to remove themselves from disability services altogether.
(k) any other related matter.