ParaQuad welcomes the opportunity to address the Senate Standing Committee on Community Affairs Inquiry into the National Disability Insurance Scheme Bill 2012.
The introduction of this Bill is truly a historic milestone for disability support in Australia and the expansion of access to services and improving choices for people with a disability is most welcomed.
Clearly there are many aspects still to be clarified with the States and on reading the Bill it would appear that the main thrust is in line with expectations. However, it is difficult to provide more detailed comment without reading the Bill in association with the rules/guidelines governing the operation of the NDIS Launch Transition Agency. It is therefore important that these rules be made available at the earliest opportunity.
1 Comments on the Bill
A. It is important that the Bill recognises and retains the capability to continue to “block fund” services which clearly demonstrate a clinical benefit and also an economic benefit to Government’s budgets. In our experience this can be problematic especially when the economic benefits (aside from clinical) are shared between two Ministries.
B. At age 65 there is no magical change in the impact that having a disability has on an individual’s life. All the services required to facilitate living with a disability continue and in addition, as for the rest of society, the person with a disability continues to age. It is therefore a fundamental issue that the NDIS must continue to support a person over the age of 65. It is neither appropriate nor adequate that at age 65 a person supported by the NDIS should transition to provisions under the Aged Care Act. Currently ADHC funded Attendant Care packages continue after the age of 65 and so should they under the NDIS.
C. The composition of the Advisory Council is a most important aspect of the successful operation of the Scheme. It is not enough in my view to state that 4 members of the Council should be people with a disability. It is, however, essential that there is equitable representation across all disability types and to ensure the individuals chosen have skills and/or experience relating to disability service provision. For example: The costs of maintaining the wellbeing and functioning of a person with a physical disability in the community can be significantly more than the costs allocated to an individual with an intellectual disability. This is due to the complexity of personal care, health care and significant changes required to meet their transport and accommodation needs.
- General Comments for consideration A. STRUCTURAL ISSUE Implementing the NDIS without implementing fundamental structural changes will significantly reduce the opportunity to implement one of the most significant initiatives in our country’s history.
In the many submissions to the Productivity Council (and acknowledged in their report) is the recognition of a fragmented and un-coordinated approach to servicing the needs of people with a disability in Australia. Yet to date there has been no visible addressing of these issues and a “launching” the NDIS, without addressing this issue and making the rules available is a concern.
A fundamental issue for the Committee to address is that the fragmented and uncoordinated nature of managing disabilities services is due to the fact that there does not currently exist one authority capable of managing an end to end service delivery for people with a disability. There seems to be a misguided belief that calling a department Disability Services resolves the issue but the fact is, that to adequately provide for a person with a disability coordination of many Government departments is critical. No one Government department, to date, seems capable of providing a manageable solution as they all currently view disability out of their “own window”. Thus what persists, and will continue, is an ongoing challenge for people with a disability to understand and navigate the system. This leads to delays in critical decisions that affects the individuals health and wellbeing within their communities. Individual funding will not alter the hoops that individuals have to jump through to get a service.
he range of services that are required extend from equipment needs, housing, transport, education, health and ageing, to name a few. Each of these departments may have a section devoted to disabilities but what is required is one authority and a unified system to integrate services. This will include a seamless transfer of necessary information along the way so that people are not asked to make multiple submissions. It will also require staffing by people who have been at the coal face of service provision and have an intimate knowledge of the needs of people with a disability.
B. FUNDING FOR PACKAGES There seems to be some notion that the existing packages are adequate and in this new world of greater choice people will have the freedom to choose service providers and how their package is spent. We fully support the freedom of choice and ability by individuals to allocate resources but seriously question the adequacy of funding to adequately exercise this freedom? Our analysis of existing care packages indicates that there is little if any discretionary funds available. Furthermore, if as is proposed, block funding of certain services is discontinued, free services currently provided by charitable organisations may not longer be available and the default position would be to rely on a very stretched hospital system.
C. TRANSITIONAL ARRANGEMENTS Given that the rules for NDIS have not yet been promulgated, an important consideration will be what transitional arrangements will be put in place for existing packages. Clearly as noted above the fact that the Bill proposed a shift in support at age 65 from the NDIS to Aged Care highlights a current contradiction.
As we will be appearing before the Committee we will be pleased to elaborate on the above.
Max Bosotti
25 January 2013