NDIA Accountability Project

Response to the Joint Standing Committee on the National Disability Insurance Scheme: Current Scheme Implementation and Forcasting for the NDIS

‹ PrevPage 1 of 12 · Source p. 1Next ›

Response to the Joint Standing Committee on the National Disability Insurance Scheme: Current Scheme Implementation and Forecasting for the NDIS

29 October 2021

Contents

__________________________________________________ …………………………………. 1

Response to the Joint Standing Committee on the National Disability Insurance Scheme:

Current Scheme Implementation and Forecasting for the NDIS ……………………………………. 1

About Queenslanders with Disability Network (QDN) ……………………………………………… 3

Overview ……………………………………………………………………………………………………………. 3

Current strategy and vision …………………………………………. Error! Bookmark not defined.

Guiding principles and community attitudes ………………… Error! Bookmark not defined.

Strengthening accountability, measuring outcomes and reporting . Error! Bookmark not

defined.

Putting policy into action ……………………………………………. Error!Bookmark not defined.

Conclusion and Recommendations ……………………………… Error! Bookmark not defined.

Appendix 1. QDN’s Value Statement on People with Disability ……………………………….. 11

                                                             2 | Page

About Queenslanders with Disability Network (QDn)

QDN is an organisation of, for, and with people with disability. The organisation’s motto is “nothing about us without us.” QDN operates a state-wide network of over 2000 members and supporters who provide information, feedback and views from a consumer perspective to inform systemic policy to Government and peak bodies. All QDN’s voting members are people with disability.

QDN’s submission is informed by the lived experience of QDN members with disability and key allies. QDN’s work in providing feedback and input into National Disability Strategy (NDS) is based upon the organisation’s core values (Appendix A) and the place of people with disability in an inclusive Australian society.

Overview

QDN welcomes the opportunity to provide feedback to the Joint Standing Committee on the National Disability Insurance Scheme: Current Scheme Implementation and Forecasting for the NDIS. QDN acknowledges that, over the past three decades, all levels of government have been working towards improving outcomes for people with disability and delivering more inclusive communities. QDN’s response will particularly focus on terms of reference (a), (b), (c), (d), (f)- (i)

The cross-jurisdictional and cross-portfolio responsibilities of governments for ensuring good outcomes for people with disability are clearly expressed in the 2008 United Nations Convention on the Rights of Persons with Disabilities (CRPD). The CRPD provides the framework for Australia’s international obligations across all levels of government. It also guides the implementation of the National Disability Strategy of which the National Disability Insurance Scheme is one mechanism to achieve these obligations. It focuses on the direct funded supports for people with disability, and also the scope of non-NDIS service provision including tier two supports, Information, Linkages and Capacity Building, and interfaces with mainstream, non-NDIS services provided by States, Territories and te Commonwealth.

QDN and our members are committed to ensuring people with disability and their carers have an enhanced quality of life and can participate as valued members of the community. Within this changing legislative and policy landscape, it is critical that people with disability, families and providers are able to continue to provie their feedback and be active stakeholders at the table to inform, design and evaluate the scheme and have input via this inquiry with regards to how the NDIS is implemented and funded, and what supports are or should be available for people with disability in addition to the NDIS.

At its core in the design and development of the NDIS is choice and control by people with

disability and their families, to enable them to be empowered customers in this new system

and citizens fully included in the social and economic life of their communities.

Each level of government has a responsibility for delivering not only on the NDIS but also

accessible, affordable, safe and quality services for all people with disability. While the NDIS

focuses on specialist disability supports, there remains problematic interface issues with

mainstream services and challenges for Australians with disability in accessing these services.

QDN acknowledges the ongoing work of Commonwealth, State/Territory Governments,

the NDIA and the broader sector to improve the scheme, its implementation and more broadly

work toward achieving the goals of the National Disabiltiy Strategy.

The impact of boundaries of the NDIS and non-NDIS service provision on the demand for NDIS funding including:

i. The availability of support outside the NDIS for people with disability (eg community-based or ‘Tier 2’ supports), and j. The future of the Information, Linkages and Capacity Building grants program

The National Disability Strategy has been in place for the 4.4 million people with disability in Australia. The NDIS is one element of delivering on the outcomes of this strategy, and is part of large-scale transformational change delivering much needed supports for 10 precent of Australians with disability. However, it is important that the implementation of the NDIS specialist disability support is balanced and does not overshadow the need for focus on services and outcomes needed for all Australians with disability.

Not all service delivery for people with disability sits within the NDIS nor NDIS Bilateral Agreements, so it is critical that an overarching National Disability Agreement and National Disability Strategy between State/Territories and the Commonwealth is in place to measure progress and report on outcomes of specific performance indicators that will drive change for people with disability. The mechanisms also needs to include Local Government to work towards common goals and report on outcomes.

It is critical that the National Disability Agreement/Strategy is integrated with the other National Agreements that cover mainstream services like housing, health, transport, etc with a reporting architecture which is consignant of outcome measures for people with disability and gives prominence and importance to these issues. Inclusion of requirements to implement and report on the National Disability Strategy outcomes in each National Disability Agreement and other Commonwealth/State/Territory National Agreements across cross-jurisdictional portfolios like health, housing etc. QDN believes it is important that a strong national governance mechanism is in place for all Australians with disability, that supports

Page 5

and delivers objectives, outcomes, performance indicators, roles and responsibilities and policy actions for all levels of government.

It is important that the NDIS is viewed in the context of the National Disability Strategy. Key to success of this broad strategy and the NDIS is greater investment in building the capacity of people with disability and a skilled and quality workforce to deliver on this.

A critical starting point is the original design and intention of the NDIS as a three tiered system that deliers the targeted specialist disability supports, supports for people outside the NDIS and targeted investment to improve the accessibility and inclusion of mainstream services, and more broadly for the whole community. It is important to note that the current scheme implementation has deviated from the original plan and design, and this in turn has implications and consequences that we are now seeing where the scheme isn’t working to deliver on the promises and outcomes.

QDN has observed that the implementation of the NDIS with its focus on specialist disability supports for the 10% of eligible people has taken the focus away from the many issues that face thousands of people with disability, the majority of whom will not receive funded supports under the NDIS. In Queensland, this includes all 900,000 people with disability not only the estimated 10 percent or approximately 90,000 Queenslanders with disability who will be eligible for funded supports under the NDIS.

QDN members are reporting unintended consequences around the implementation of the NDIS including gaps in services and a lack of expertise to deliver services to people with disability within the mainstream service system. There are a range of services and supports which people need to access across health, housing, transport, education, employment, justice, digital technology, culture, sport, and recreation. Because of the architecture of the bilateral agreements across these mainstream portfolio areas, since the NDIS rollout in Queensland, QDN members report the emergence of gaps in services for a broad range of people with disability. Going forward, this needs to be addressed and a focus to ensure achieving improved outcomes and experience across these key areas of people’s lives needs to ensure it is there for all Australians with disability and delivers accountability measures for everyone.

“When Australia reported recently to the United Nations on the outcomes achieved, there were many gaps across the mainstream services.” (QDN member – consultation 23 October 2020)

As the NDIS has grown and evolved, the interaction with other markets and schemes has responded to emerging needs, issues and gaps. However, the speed of transition has been challenging and system change and response has not worked at the speed required to deliver a coordinated and cohesive experience for participants. There continues to be a lack of coorindation and a sense of who is responsible in the demarcation of services. This means

That at the end of the day, people with disability are left floating without one specific agency to take responsibility and end up missing out. This has been exacerbated and highlighted throughout COVID-19.

Through QDN’s statewide member network, QDN members continue to raise the issues and challenges they face accessing mainstream services like health, housing, transport, employment, education, sport etc. Some believe that this is being further challenged by the introduction of the NDIS and the poor delineation of responsibility between individual specialist disability support and mainstream service delivery.

With the cash-out of a range of ‘disability’ supports, there are still a significant number of people who aren’t eligible and find themselves in a state of limbo without supports. In Queensland, the new Queensland Community Support Service, replacing the old Queensland Community Supports is a rationed and time-limited system that also has been having impacts upon people who are missing out and falling through the gaps.

NDIS participants continue to report challenges with coordinating services provided by different agencies. There are many well intentioned staff working in different Departments, services and organisations who provide good services, however, there continue to be challenges with the interactions and intersectionality of the systems. A shift in the way services are coordinated needs to be considered and service redesign for people who engage with multiple service systems.

Information, Linkages and Capacity Building (ILC)

The Information Linkage and Capacity Building Framework (ILC) under the NDIS plays a critical part of the landscape, and delivers investment in a range of fundamental and bedrock services, particularly disabled person and family organisations who are key to reforming the nature of the system and enabling people with disability and their families to be in a position to shape, lead and influence inclusion in their lives and in their communities. ILC also plays an important role in facilitating referral and linkages to and from mainstream service systems for people with disability. QDN acknowledges the importance of the ILC, however its implementation and investment is inadequate to deliver on the critically important work and outcomes for all of the Australians with disability who are ineligible for funded supports under the NDIS. QDN argues the need for ongoing substantial investment in ILC and argues for the Commonwealth to fund ILC to a level that can achieve impact and outcomes and real change.

It is critical going forward that peer support and funding for organisations that are led by people with disability needs to be a priority and continued. The funding for state/territory organisations in peer support for people with disability and families provides a vital infrastructure in those states and important support to people with disability not only for NDIS participants but also more broadly for people with disability who cannot access the NDIS. Many people do not have extensive informal support networks, therefore organisations that deliver projects under ILC individual capacity building and peer support provide essential

Peer Support and Strategic Investment

Peer support delivers valuable, user friendly, peer led support tailored to people’s needs. It contributes towards increasing people’s confidence, supports people to have more informed decision making, increases social connections and people’s feeling of support, and helps people learn information from people who have used they system themselves and can provide practical tips and information, in a safe and trusted environment.

Peer support and the place of people with disability in leadership, capacity building and subject matter experts who carry a strong knowledge of the history but also the policy and the broader context to inform and shape the system to operate at its best.

There needs to be a strategic approach to identification and planning of investment that takes into consideration what is needed for each jurisdiction. There is an important infrastructure of state/territory based organisations with local relationships, connection with local communities, services, supports across mainstream and community organisations that are not held by nationally based organisations.

NDIS participants continue to experience many issues with interacting with NDIS and is a persistent issue that will need ongoing attention and focus as NDIS system grows and matures and this ILC funding provides critical peer support for people at the various contact points they have with NDIS along the continuum.

Going forward, there needs to be a shift from short funding contracts to longer term contracts. Short term contracts lead to the environment where organisations are limited in attracting and keeping good staff and limit their ability to be able to build momentum, build upon existing work and have longer term focus to deliver good outcomes and on ILC goals.

QDN sees that the Information, Linkages and Capacity Building (ILC) continues to provide an important part of the funding envelope for the NDIS and more broadly the National Disability Strategy. Having mainstream services and community that can be more inclusive and responsive to people with disability will help deliver the outcomes and aims of both social and economic benefits as well as individual benefits to the right quality services, at the right time, delivered in inclusive, accessible, safe ways.

While Information Linkage and Capacity Building (ILC) funding is an important way to improve community inclusion for people with disability, it does not respond to the investment in workforce activities needed to deliver the increased skill, knowledge and expertise required of mainstream services like health, housing, employment, education, police, the courts, and transport so they can to deliver appropriate, accessible, quality and safe services to all people with disability. This requires additional focus, targets, strategies and measures to deliver improved accountability and outcomes across all portfolio areas within State/Territory and Commonwealth Governments.

Alongside and critical to all of this is the access to funded independent individual and systemic advocacy for people with disabiltiy and their families and carers.

(c ) The reasons for variations in plan funding between the NDIS participants with similar needs, including:

  i.  The drivers of inequity between NDIS participants living in different parts of
    Australia,

  ii. whether inconsistent decision-making by the NDIS is leading to inequitable variations
in plan funding; and

  iii. measures that could address any inequitable variation in plan funding;

RE (c ) ii.

Consistent feedback to QDN over the years as we have transitioned to the NDIS has included the experiences of inconsistent decision-making by the NDIS and NDIA partners and the frustration, heartache and distress that this causes to people and their families. It also impacts on variations in plan funding. QDN members have seen first hand the spectrum of skills, knowledge and expertise of the NDIS workforce responsible for making determinations and decisions about plans, funding, what’s included and what is not. QDN members identify that there are fundamental practices which are not consistenty applied in working with participants, from the way questions are asked about people’s needs through to how the planner includes the person in the planning process and checks the accuracy of their ‘interpretations’ of information, needs and goals. QDN members also have raised their observations of what appears to be an unconscious bias that exists in decision making. They have said that it is confusing the reasoning about what is considered and needed in people’s plans for one person who may experience a more stable life and present well vs a person who is homeless, been involved in criminal justice system and does not present well. Some QDN members have provided feedback that it feels like a return to situations where they are deemed ‘not worthy’ of that type of support and judgement about their life situation.

Queensland’s official transition to NDIS Full Scheme arrangements occurred on 1 October 2020 and it is acknowledged that we are some years away from maturity. Approx. 50% of participants in Queensland have never previously accessed funded disability supports and will take time to gain confidence navigating scheme and being able to interact with planners and decision makers in an informed and empowered way.

Even for new participants, and others who have been part of the old state funded disability system, there is also a lack of capacity building that has been built into individual plans to develop NDIS participants to come to this planning process with the required knowledge and skills to participate on an equal footing with the planners. QDN strongly asserts that people with disability and their families continue to require targeted capacity building, education and mentoring that is delivered in an accessible and inclusive way to enable people to operate as active consumers in this new market driven environment. While

The National Disability Insurance Scheme

The NDIS brings choice and control to people with disability and their families and carers with regards to how, when, where and from whom they purchase their supports, it also places increased responsibility upon participants. With the scheme design, it is important that people have the opportunity to understand what they need to provide, how, and in the most effective way to input into the planning process.

There are a range of funded mechanisms including supports coordination that was designed to perform this role; however, feedback from QDN members and stakeholders regarding support coordination continues to be varied, with many members reporting that they do not receive the support they need from their Support Coordinator to understand their plan, how to implement it and how to demonstrate that the funded supports they have are having impact at the next planning meeting and therefore need to be continued not cut. The importance of this function cannot be underestimated. There is a lack of sector skills, knowledge and experience to deliver quality support coordination, and a significant undersupply.

The way the scheme has been rolled out makes an underlying assumption that people with disability and their families automatically assume the required level of skills, knowledge, and capacity to behave as a customer once their plan is approved. While this may be the case for some participants, it is QDN’s view that the majority of participants and their families are finding this very challenging and this has impact upon their engagement and participation in the planning process.

Measures intended to ensure the financial sustainability of the NDIS (eg. Governance, oversight and administrative measures), including:

  • the role of state and territory governments, and the Disability Reform Ministers Meetings,
  • the arrangements for providing actuarial and prudential advice about the scheme, and
  • the way data, modelling, and forecasting is presented in public documents about the NDIS, (e.g., NDIS Quarterly Reports and Reports by the Scheme Actuary), and
  • measures to ensure transparency of data and information about the NDIS

QDN members continue to raise concern about the inference that everyone with disability in Australia is attempting to get access to an unreasonable level supports and the implications this has on public perception, impacts on funding and scheme sustainability. We need to start the conversation from a different place that does not dehumanise people with disability and their families and the critical supports that they need to live their day-to-day life.

Conclusion

QDN is pleased to provide this feedback to the Joint Standing Committee on the NDIS. The contemporary policy environment is a complex one and there have been an unprecedented amount of inquiries, reviews and reforms that people with disability have been asked to provide input and feedback upon. It is important to note that many of the timeframes for these have been short, and much of the content and nature of these have been complex. It is important going forward that the need for accessible and inclusive information and processes for engagement and consultation are built into the process.

It is important that the NDIS framework maintains a balance of flexibility to change but also a balance of powers and decision making subject to parliamentary and public scrutiny. The level of powers and decision making required for rules that are fundamental aspects of the scheme must continue to require joint decision making and agreement between State/Territory and Commonwealth Ministers at Disability Reform Council and should not be changed to be Rules that can be made at the discretion of a single Minister. State and Territory Governments continue to be shareholders contributing to the scheme, and QDN believes that it is critical that decisions that are fundamental to the scheme, remain in legislation and with high level decision making across Commonwealth, State and Territory Minister.

State and Territory Governments need to continue in the role as an equal partner with the Commonwealth and therefore have an important role in decision making. The Disability Reform Council Minister’s meeting is an important function of the Governance of the NDIS which needs to continue. State and Territory Governments have an important role in representing their constituents with disability and NDIS participants and it is our model of democracy that representation and open and transparent debate and decision making will contribute to ensuring that NDIS participants in the scheme are getting the best outcomes, including access to the scheme, meeting of ongoing needs, and strong engagement with participants.

Queenslanders with disability want information and data about the funding, the modelling in a way that is accessible to everyone. QDN members have raised their concerns about the feedback in the media that says the the scheme is not sustainable without clear, accessible information to show how that determination was made. There have been occasions in previous budgets where underspent funds allocated to NDIS have been shifted to other budget areas. QDN members want to see clear, accessible information that is available to everyone, and the funds that Australian tax payers have contributed to the NDIS to stay in a future fund to be earmarked for progressing the goals and outcomes of the National Disabilty Strategy and NDIS participants. QDN believes that State and Territory Ministers need more detailed information, data and modelling to be able to gain clear insights and understanding into the arrangements for providing actuarial and prudential advice about the scheme.

QDN’s Commitment to Disability Reform

QDN believes it is important that any reforms deliver the outcomes for people with disability and their families not only as NDIS participants but also as Australian citizens accessing mainstream and community services.

People with disability are citizens who need access to all services within the community, regardless of whether they are administered by Commonwealth or State/Territory jurisdictions. Changes are needed that enables all levels of government to be accountable to deliver services, programs and policies within their purview to people with disability is critical. Alongside this mechanism, is the scope to be able to measure and be required to report on outcomes in line with Australia’s international obligations under the CRPD. It is important that a national disability strategy and national disability agreement, underpinned by Australia’s obligations under the CPRD commits all governments to work together to fund and resource policies and programs so that people with disability, whether funded by the NDIS or not, are able to: (1) live independently; (2) participate in all aspects of life; and (3) have access on an equal basis as others to the physical environment, to employment, to transportation, to information and communications and to facilities and services provided to the public in urban and rural areas of our country.

Appendix 1. QDN’s Value Statement on People with Disability

QDN’s work in providing feedback and input into systemic policy issues is based upon the organisation’s core values and the place of people with disability in an inclusive Australian society.

QDN believes that:

  • all people with disability have a right to a place in the community and have contributions to make to community. This is as empowered, free citizens who are as valued, present, participating and welcomed as members of any dynamic and diverse society
  • the place of people with disability in the community is not just about people with disability having a house in the community. Core to this is that they are welcomed in the community as ordinary citizens, where they are genuinely given opportunities to contribute and actively participate. People with disability need to be in communities where their individuality, their talents and their lived experiences of disability are recognised and acknowledged
  • culturally and historically, people with disability are not afforded the same value, opportunities or access to community life
  • any inclusion in community for people with disability is conditional and vulnerable to withdrawal
  • many people with disability in Queensland are excluded from the most basic experiences of ordinary lives
  • current exclusionary practices are unacceptable and must be challenged
  • these issues affect not only people with disability but the whole community
  • the responsibility is shared. It lies within government (federal, state and local) and the community at large, to ensure that people with disability have a place and are resourced to belong in community.

12 | Page