Submission to the Joint Standing Committee into the NDIS
Submission from Ian & Michelle Millner as parents of a 30 year old adult with Down Syndrome who lives with us in the family home.
It is important that we pay due recognition to the people involved in making the NDIS a realty as there is no debate it has been transformational at some level, so our great thanks need to be duly noted.
Lack of transparency
We would like to take this opportunity to shine some light into an area of the scheme to do with process. The scheme started with great fanfare and with the mantra that supports for people with a disability needed to be reasonable and necessary. To assist the process, the NDIA did from its early days publish what was referred to as a Price Guide, which has now morphed into a Pricing Arrangement and Price limits, but the main principle is there are clear line items for the majority of the supports accessed by people with a disability. In the early days of the scheme, one could map the request for supports to the line items, but this is no longer the case.
In our son’s first plan there where a range of budget items which were derived from the input we provided on behalf of our son:
- objectives, as required by the NDIA - we provided both long term and short term objectives to assist in the development of the support budget.
- weekly/monthly activities - we provided a weekly timetable to his activities and details of other activities in which he participates on an ad-hoc basis.
The budget items were broken down into the categories listed in column 1 of Table 1
| High level support categories | Mapped from plan request |
|---|---|
| Core support | Daily and weekly activities which can cover access to sport and social activities |
| Transport | Transport to and from many activities including employment |
| Capacity building support | Focus of skills development so he can work towards his gaols such as living independently ie: cooking. |
| Improve life choices | Third party to manage the bookkeeping |
| Improve daily living | Funding allied health professionals, some skills development. In our son’s case it was speech therapy and gym trainer to maintain his fitness and not hurt himself when using gym equipment. |
| Finding & keeping a job | In our son’s case, this is keeping him in employment |
| Assistive technology | In our son’s case, this is orthotics which will reduce the future cost of more invasive remedies. |
In our son’s latest plan, the categories have been reduced to those listed below:
- Core support
- Transport
- Capacity building
- Support
- Improve life choices
- Improve daily living
The bulk of the support budget is now shown under Core Supports. At face value this may seem administrative. In our view, it is a way of masking a significant reduction in the budget without any justifications. We have no idea how they mapped our request in the development of the plan budget.
We can exemplify this when we look at the plans provided by the NDIA over the past two years.
| Budget by period | New revised Plan extension for 365 days | Plan period: |
|---|---|---|
| 24-5-19 to | 24-5-19 to | 12-6-21 to |
| 23-5-21 | 23-5-22 | 12-6-23 |
| Core support | $60,119 | $107,501 |
| Transport | $7,134 | $7,134 |
| Improve life choices | $2,627 | $2,627 |
| Improve daily living | $5,367 | $5,367 |
| Finding & Keeping a job | $23,487 | $0 |
| Assistive technology | $1,500 | $0 |
| $100,234 | $122,629 |
Table 2 plans budgets
The following must be read with reference to Table 2.
Based on our submission to the LAC on behalf of our son we had a two-year plan provided to us to cover the period of 24 of May 2019 to 23 of May 2021. Towards the end of the two-year period, we had a very late plan review meeting where the LAC stated we had two options:
- If we are happy with the existing plan it can be rolled over or,
- We can undertake a full review.
We stated that we were happy with the current plan but the only shortcoming was in the category of “Finding & Keeping a job”. The issue was the initial plan was developed using the line item “finding & keeping a job” from the price guide. This line item referenced the DMI model and this line item was no longer available under the new price guide. The providers fees have gone up based on the revised price guide 1 March 2021. The increase in rates allowed for under the new price guide was now an additional $21K per annum (This was the NDIA’s recognition of the true cost of
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providing the service). We pointed out to the LAC that our son has since the inception of the NDIS listed employment as his number one objective, so, funding is critical.
After much discussion with the LAC, we opted for option 1.
Within a short period, we were informed that our plan would be extended for an additional 365 days, and the plan budget would increase by $18K, which we saw as being adequate. See Table 2 column 2.
About a week or so later, we happened to be in our son’s NDIS portal to find the extended plan was no more and it had been replaced by a new two-year plan, see Table 2, column 3. Note, there is no mention of “Finding & Keeping a job”, the highest objective in our son’s NDIS plan. In addition, the plan budget has dropped, having no consideration for the increased prices allowed for in the latest NDIS price guide and no explanation or rationale. After all, is employment support not seen as reasonable and necessary?
This inherent opaqueness is most concerning. If the NDIA expects those who have a plan to:
- validate and justify the need for certain activities in a plan
- once a plan has been issued, maintain records to ensure full transparency of the use of the allocated public funds Should the NDIA not also be transparent in their decision making. Plans should include the working out of the plan budget, what is been funded and what is not being funding and why not.
Additional comments
LAC model In our view, the role of the LAC is perfunctory and an additional cost burden on the system and creates one more layer of opaqueness. We present the objectives of our son, and we articulate the rationale for the funding of activities to the LAC which they dutifully capture into a format, but in addition provide additional input which we are not privy to leading to an additional sense of opaqueness.
The ideal model would be to have one on one meetings with properly trained planners and not dealing with an ever-changing LAC clouded in opaqueness.
NDIS portal The NDIS portal has a section to see how your plan budget is being spent, this primarily consist of a pie chart, which is uninformative and lacking on details to allow proper scrutiny of who is making claims on our plan. Better information on financial claims against line items would enhance the ability to ensure plans can be more adequately managed and increase security from scams.
Constant review of plans Whilst we understand that many participants of the NDIA may be in more fluid and challenging circumstances where regular plan reviews are necessary, this is certainly not the case for many. For example, our son, was born and will die with his disability and while every effort has been and continues to be made to improve his capabilities, the end result is limited. His needs from year to
year do not change dramatically. Our suggestion is, that participants such as our son could be given more permanent plans with the option to every 12 or 24 months simply state a need to roll over. This would reduce the stress and uncertainty leading to anxiety and the need to go through the process of seeking reports and quotes to justify what is already in place.
We are currently working through the process of getting access to SIL funding so our son can look at living independently. In addition to seeking a funding package to support his independent living, we are also looking at housing options. If we are successful in securing an independent living budget and suitable accommodation then plan budget certainty is critical.