UnitingCare Community Options
Submission to Community Affairs Legislation Committee
National Disability Insurance Scheme Bill 2012
Contact: Eddie Chapman
Principal Policy & Research Officer
UnitingCare Community Op0tions
UnitingCare Community Options
Submission to Community Affairs Legislation Committee
National Disability Insurance Scheme Bill 2012
UnitingCare Community Options (UCCO) is a not-for-profit provider of community-based support for people with disabilities, older people and the carers who support them. It is part of the wider UnitingCare network, which provides social services to over 2 million people each year in 1,300 sites in remote, rural and metropolitan Australia. UnitingCare has 35,000 staff and 24,000 volunteers. We have been operating in the Eastern Metropolitan Region of Melbourne for 25 years and are leaders in person-centred planning and support in disability and aged care services.
UCCO strongly supports the draft Bill and believes it is a major step forward in further developing and putting into practice the essential requirements of a National Disability Insurance Scheme. The vast majority of measures and processes outlined in the Bill have UCCO’s full support and would create a support system which UCCO would be comfortable providing our services and serving participants in.
There are some areas within the draft Bill that we would like to see further work in developing and some significant changes which we believe would be beneficial to the long-term effectiveness of the scheme. We have taken the opportunity in this paper to outline these and expand upon that, and would be happy to discuss this further with the Committee as required.
In conjunction with this submission, UCCO also strongly supports the submissions of National Disability Services and UnitingCare Australia, with whom we have worked collaboratively in examining the Bill and discussing possible changes and recommendations.
Summary of Recommendations:
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Clarify within or separate draft bill to create clear distinction between ‘transition’ and ‘full scheme’ elements of the Bill.
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Remove the age limitations for access to NDIS supports.
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Permit scheme to allow for participants aged 65 and over to be able to receive both NDIS and aged care (residential or community based) supports.
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Require a participant’s plan to be approved by the participant in addition to the CEO.
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Permit those whose supports are managed by the Agency to access informal, low-risk services from non-registered providers.
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Prohibit a provider from being both a manager of support funds and provider of supports (or at least from doing so for the same participant).
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Extend provision related to suspension/cancellation of Nominees to cover issues related to conflict of interest between the participant and their nominee in regards to their support package.
‘Transition’ or ‘Full Scheme’ bill
With the intention to utilise this bill as both covering the implementation of the National Disability Insurance Scheme, and its ongoing functioning once implement, we believe there is the risk of mis-interpretation and confusion. While reasonable measures have been outlined in the Bill, such as outlining the difference between ‘National Disability Insurance Scheme’ and ‘National Disability Insurance Scheme launch’ – with the key difference through our interpretation being the limitations of the NDIS arrangements to a prescribed area of residence – there is currently potential for confusion in what measures relate to the implementation, and which are ongoing.
A key issue in this is the description of the Agency and its functions, being defined as the NDIS Launch Transition Agency, yet with functions which appear to be ongoing – and without reference to a roll-over from transitionary to ongoing arrangements within the Bill. A clarification of these issues (or a separation of Bills into transitionary and ‘full scheme’ bills) may benefit clarity of interpretation and thus increase community understanding, agency compliance and avoid potential conflicts.
Eligibility requirements
While UCCO understands the pragmatic requirement to limit access to the scheme to the age of 65, UCCO would encourage an ongoing evaluation of the scheme in relation to the age requirements. With the ageing population and an extension of people’s working lives to beyond the age of 65 in many instances we believe that the scheme would be more equitable, create greater equality, and be more in line with Australia’s human rights obligations if the age requirements were removed or extended significantly so as to broaden the concept of disability and enable those who are ageing with a disability (rather than experiencing age-related diminishment of capacity) to receive the sufficient support for a full life. This would apply both both those people who have a disability before the age of 65, and to those who acquire a non aged related disability after the age of 65.
In terms of the definition of disability requirements necessitating that the disability is permanent, we would seek that the definition is clarified to ensure that those who have permanent, for-life impairments which are episodic in nature will not be considered ineligible for support.
NDIS and Aged Care interaction
As a provider of both aged care and disability support packages, UCCO is concerned about the ramifications of the Bill (s29) not allowing an individual to receive both an NDIS and community/residential care packages.
As the NDIS is designed to provide people with disabilities with the adequate support to enable them to have the same rights, certainty and opportunities that the rest of Australian society enjoys, this should also include access to aged care services as required. Ageing, while sharing some similarities with disabilities, is a different process and thus should be treated as a separate range of supports to work alongside the NDIS as a person with a disability ages. This should be the case for both residential and community based care. UCCO has seen this approaching working well
in overseas jurisdictions and would be happy to discuss this further if helpful.
In addition, to require someone to move from a system of supports which may have been in place for their entire lives, to an aged care system which may not deliver the same quality or quantity of services, and which would undoubtedly operate within a different framework and philosophy, is an unreasonable and inequitable choice to force upon a participant at this point in their lives.
Planning
UCCO strongly supports the Bill’s indication that plans can be described specifically or generally, whether by reference to a specified purpose or otherwise. We believe this general approach is ideal and should be supported in the implementation in allowing the flexibility and creativity in addressing participant need which would ensure positive outcomes for participants. While there will be in some cases the need for specific supports to be provided to participants, we would encourage a general approach which is focused more on the goals, objectives and aspirations of the participant, in the context of their living arrangements.
In section 33(2) we have observed a use of language which is contrary to the person-centred philosophies behind this legislation, where reference is given to the CEO approving a participant’s plan, where a participant is indicated to have only been participated with. Given that the participant, as part of the planning process, is to prepare a statement outlining their goals, objectives, aspirations and personal context, we would also seek that the participant’s plan be not only prepared with the participant and approved by the CEO, but also seeks the approval of the participant to ensure that it is a person-centred and person-directed plan. We would further encourage a review of the language used in the legislation to ensure it respects and upholds person-centred approaches.
In section 33(6) there appears to be the limitation that when funding for supports is managed by the Agency that supports will only be able to be provided by registered providers of supports. In regards to informal services (and the understanding that low-risk informal services will not have to be provided only be registered providers) this creates a potential disadvantage in both choice and price for those having their funding managed by the Agency. We appreciate that the Regulatory Impact Statement provides the option for low-risk services to be obtained from informal, non registered services. We would therefore encourage a higher degree of equity by ensuring that all participants can access low-risk informal services from non-registered providers, regardless of how their funds are managed.
Providers of Supports
UCCO would argue strongly in regards to section 69 that a person or entity should not be able to provide both function of managing the funding for supports and the provision of supports. We believe this raises significant risks in terms of conflict-of-interest and has the potential to reduce choice to participants. At the very least, if providers are going to provide both functions they should not be able to do so in regards to the same individual participant. We would however encourage a stronger separation between support funding managers and the providers of supports.
Nominees
Having examined the provisions in the Bill related to the cancellation or suspension of a nominee, we are concerned that there are not explicit references to issues related to conflict of interest – an issue which is of significant concern in relation to disability. While the Bill has references to nominees being suspended or cancelled if they do not comply with a requirement of the notice, or in cases of severe physical, mental or financial harm, we believe that this should be broadened to cover issues related to conflict of interest between the participant and their nominee in regards to their support package. This is currently sufficiently protected within the Guardianship arrangement, and we would seek to see this confirmed within the NDIS legislation to ensure that no conflict of interest or abuse is allowed to continue under the nominee arrangements.