Submission: Denise Redmond
NDIS COSTS
POSITION PAPER
INFORMATION REQUEST 7.2
Respite (Supported out of home accommodation)
This submission is on behalf of the Nardy House Board. I am the CEO of this charity and I have prepared the submission. The NGO provides respite and accommodation services to people aged 0-65 with profound physical disabilities. This group of people requires assistance with every aspect of daily living; they are wheelchair confined or move only with assistance. Their physical disabilities are often in combination with intellectual disabilities and their needs are complex. They have high health needs and because of these needs require daily RN assistance.
NHI started transitioning our permanent accommodation clients in October 2016. The organization was informed that transitioning to respite would not occur until July 2017. This has not been the case and some of our respite clients have transitioned. NHI started to prepare for NDIS well before transitioning. NHI developed protocols of care related to our permanent residents. When the LAC team visited Nardy House they informed NHI that our clients were too complex for LAC and NHI was visited by the Assistant Director of Planning Southern Region.
We transitioned to NDIS only after the Assistant Regional Director of Planning and a number of his colleagues visited the house and took away related evidence. It was acknowledged that NHI needed to quote for both our accommodation and our respite service. The benchmark figure did not cover our costs in the supply of service. It was also acknowledged that the service was unique, was required and kept people within their families for much longer periods of time than would otherwise be possible (without the break that supported out of home accommodation –respite-provides).
NHi provides respite 24/7 every day of the year. In order to establish respite costs an average based on our output based acquittal requirements under ADHC was used. Our respite clients require 2:1 DSW workers for personal care; they require constant supervision outside care requirements and have high medical support needs (RN support). Our respite provision costs $57.08 per hour.
The benchmark figure for respite is one-third the baseline cost of care of clients accessing Nardy House. Further there is no draw down method for above benchmark costs via the portal even if the money has been allocated and acknowledged as required under the individual plan costs.
There is a further problem with our respite clients. Many of our clients are receiving much less respite than they have had in the past because of the costs of our service. These clients have been seriously disadvantaged, as have their carers. The end result of this disadvantage will be earlier requirement for permanent placement. Our clients, at that stage, will require nursing home or hospital care. A group home of the benchmark type cannot cater for their needs. NHI costing figure makes our respite costs of $57.07 per hour and our quoted accommodation costs a viable alternative. An alternative that is being sent into financial ruin and closure because of the inability to draw down funds when they are available and the underfunding of centre-based services under NDIS for the respite needs of the most disabled sector of clients.
NHI has experienced a severe downturn in respite placements despite the desire on the part of carers for placement of people in their care. We have had a decrease in the demand for casual employees and are presently exploring the restructuring of our organization and a further casualization of our Disability Support Worker base. NHI is based in rural remote NSW near the Victorian border (coastal). The region should be experiencing positive spinoffs from the introduction of NDIS and the opposite is occurring.
Denise Redmond
CEO