Good Afternoon,

I am a non-registered Support coordinator / Recovery Coach. I worked as a Support Facilitator in the Partners in Recovery (PIR) program in Central Qld and worked transitioning people with serious and long term mental Illness into NDIS as it became available here. I have worked as a support coordinator in NDIS since then with registered organisations and over the past 2 years as an independent, non-registered sole provider.

Here are some feedback notes based on my own experiences and observations:

Some of the problems I commonly observe in NDIS as it stands are (I detail these issues after the dot points): Inordinate spending on activity transport time and kms. • Providers spending Plan funds doing things for people that they can do for themselves. • People becoming more dependent instead of independent. • Plan funds running out before time (until very recently, early finishing Plans were nearly • always renewed with very little questioning). Lost opportunities for genuine skill building and the achieving of goals which will • ultimately increase the participant’s self esteem. The unhealthy expectation that an ideal life is all about pleasure seeking and “feeling • good”.

Solutions to these issues may include: NDIS reviewing the “Choice and Control” concept by incorporating into it the notion of • mutual responsibility and making this clear in all its communications. Making training (time and content) available to providers and support workers to increase • understanding of skill building support and how to genuinely increase independence for participants. Requiring providers demonstrate that “assistance with social and community access” • involves interaction with other people (groups) in the community and is not just “going for a drive” , or to the shops with a support worker. NDIS needs to clarify rules around “going shopping” and whether this is “assistance with daily life” or “social and community“ activity. Requiring that providers demonstrate they are not doing things on NDIS time that a • person ordinarily does for themselves. Clearly limiting Activity Transport funds for participants who have the ability to drive, • catch public transport and walk. Plans could recommend workers support participants to access a Companion Card if they need assistance with using public transport. Make it a requirement that non-registered support providers provide a schedule of • support confirming their hours and the amount they will take from the Plan across the life of the Plan.

It needs to be first said that the policies discussed below are possibly quite appropriate for some people and not for others. People with physical disabilities and some with psycho social disability may have reasonable and high levels of intellectual functioning. While others have less sophisticated reasoning skills caused by intellectual disability, drug abuse, ABI or severe and long term mental illness etc.

(Which points to an overall issue in relation to NDIS policy- that it is arguably not reasonable to develop policy that applies to all disabilities equally).

For example, NDIA’s policy to “make information accessible” is manifested in the

evelopment of “Easy Read” documents. These can be very helpful to people with mild ntellectual ability but may be somewhat insulting to someone with schizophrenia whose ntellectual capacity under normal conditions may be high and academic but impaired in ocus and concentration by the mental illness. The information choice for participants is ither to refer to an inordinate overburden of information in Government-Speak, (intelligible to only a small administrative minded proportion of the general population, let alone the disabled population) or learn-to-read type children’s brochures.

It has been observed that the amount of pages in the Easy Read versions is considerably daunting for many participants for whom written text in any from is challenging. A second example is based in the fact that someone with a biological intellectual disability an improve, but not recover entirely from that disability; people with psychosocial isability, on the other hand, can and often do recover totally. This points to a need for ignificantly different approaches to these disabilities. The concept of Choice and Control needs addressing because there is no such thing in real life where a person has choice and control without a corresponding level of responsibility. The “Choice and Control” catchcry of NDIS has misled many participants into thinking they can have “anything” they want and “do anything” they want with NDIS. This misconception is reinforced by the business model that underpins NDIS because providers can use the “choice and control” mantra to curry favour with clients by not challenging them in any way that causes discomfort. Yet learning and growth, and genuine skill building requires some discomfort to be confronted. There is nothing in NDIS that supports this sort of challenge A common example is clients who are obese, for example, due to their disability affecting the self regulation skills needed to manage their weight. Providers often support the maintenance of the unhealthy weight and associated health conditions by always driving them even walkable distances, helping them to access fast food outlets or unhealthy food choices and assisting them to apply for various AT that makes them more comfortable with their excess weight. Providers justify doing this because the participant has “choice and control”. There is a risk for providers that drawing any boundaries around the client’s choice and control will cause the client to seek an alternative provider, which they have every right to do. Many unscrupulous providers are increasingly attracting clients by promising to give them anything they want because they have “choice and control”. But it also makes things easier for providers because true skill building support requires significant training and monitoring of staff, which is NOT accounted for in the NDIS business model. Another common outcome of the “choice and control but no responsibility” is the inordinate amount of “social and community participation” hours that is spent on “going for drives” with a support worker, or being taken to things that they can and do access themselves when worker is not present. This results in participants who ordinarily visit friends, or go fishing without a worker being “supported” to do these things without any work done on the daily life skills a person needs, nor on public transport use, nor on the social interaction skills the person needs by mixing with people other than the support worker. Many people, given the choice between “ we can go for a drive to the beach“ or “we learn to cook a meal, vacuum the carpet, wash the dishes, or do the laundry”, will readily choose to go drive to the beach. This is another issue that arises from the business model, which focusses on the provider “pleasing” the client in order to keep the income from their Plan. It is exacerbated by poor quality supports, or simply lazy ones who can escape all accountability for skill building by referring to the client’s “choice and control”. Canny and unscrupulous participants can themselves abuse the “choice and control” policy by

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conscientiously shopping around for providers which will do their bidding rather than encourage them to work towards independence goals. Here is an extract from an NDS Facebook discussion page, in relation to activity transport. As a taxpayer, I’d be interested to know what justifies 1000km of activity transport in one week. Hey everyone I’m an independent support worker located in Brisbane. I have a few clients and one of them I support I find that we travel an awful lot. No less then 250km per week I find even though we live in Brisbane we tend to always be going to either the sunshine coast or the gold coast. The community supports are based around parks and adventure playgrounds and theme Parks . Now I know as a support worker you no say in any aspect of the client’s life I just need to know if I can get in trouble for claiming so many km. Responses: If the client requests the travel and is happy to use their funding for it, there’s no problem in claiming it. It may be beneficial to contact their plan manager to verify that the charges won’t inadvertently use up too much funding. Either way you won’t get in trouble for charging for services that you deliver, even if the charges appear high. I’ve done over 1000km in a week with a client and it was never questioned so I wouldn’t stress too much. There’s no limit to activity based transport it’s up to the PWD to decide how to spend their funding. As long as they are aware that the more KMs they travel the less support hours they get it’s all good for them to choose And finally, I am dismayed at the performance of some therapists, whose recommendations are not infrequently based on what the participant or Support Coordinator or family asks for,rather than an objective analysis of genuine needs. They also seem to avoid any consideration of true capacity building, preferring rather to recommend aid and therapies to make participants more comfortable in their dysfunction rather than putting in the thought and creativity required to help the participant maximise their own resources and recovery. One example is therapist and providers pushing for an automated hospital bed and an automated recliner for a morbidly obese participant rather than challenging and assisting the participant to take clear steps to reduce her weight. Another example is an OT seeking (and getting) a motorised scooter for a man with mental health issues, but no physical disability, who could not get his license returned until his mental health improved. (He eventually got his license returned and his non disabled brother then got the scooter to use as his transport when he couldn’t afford a car). An example of a therapist exploitative pricing is the OT who charges my client for 2 OT’s as she needs a person to help steady her during sessions. When it was suggested this should be done by a therapy assistant at ¼ of the rate, the response was that “we don’t have a therapy assistant”, as if that justified the payment of $194 per hour for the task of placing a hand on the lady’s back. The same therapist offers Hydro at the local pool and charges $93 provider travel time for the 200m distance between the office and the pool. I have not been surprised to see the blowouts in NDIS spending, as there are so many examples where there are no clear boundaries and no accountability for spending. There is also so much money to be made. I only hope that in dealing with some of these issues, the remedy will not involve a whole lot more administration requirements for non-registered providers. I believe that good non-registered providers, with their small, local clientele load are in a position to offer very personalised and consistent support. I have witnessed exploitation in both large organisations and also by independents. I hope improvements will involve weeding out the wrongdoers without making everything harder for the right doers.

Thank you for taking the time to read my submission. Regards Dory