NDIS participant experience in Rural, Regional & Remote Australia

AUSTRALIA

Community Living Australia Submission

Joint Standing Committee -

a. The experience of applicants and participants at all stages of the NDIS, including application, plan design and implementation, and plan reviews;

Many participants’ plans have rolled over and not considered their changing needs. This happens generally, but in the context of their locations, see examples below:

Participant A: SIL service, declining due to progressing Huntingdon’s has resulted in multiple change of circumstances processes to ensure the Roster of Care meets even the most basic of safety needs. Access to timely meetings and, in turn, follow up action by the Support Coordinator has hampered progress

Participants B & C: SIL service where plan lacked consideration of the remoteness. This impacted on access to therapeutic supports, NDIS supports and the cost of delivering them in a remote area where there is significant travel needed. Relevant information about these factors was provided to the NDIA, but the plan did not account for these regional nuances. On one occasion it was necessary to pay a Support Worker for travelling over 200kms with one of the participants to access therapeutic supports.

Participants who have SIL plans cut and are expected to share with others when:

Their current home does not have room to share, forcing a move, and/or
There are no other participants in the regional/remote area (nor any who wish to move there), and/or
There is no suitable housing to accommodate a shared living arrangement in the regional/remote area

b. The availability, responsiveness, consistency, and effectiveness of the National Disability Insurance Agency in serving rural, regional and remote participants;

Regionally participants and Support Coordinators are reporting variable response times, and where time is crucial due to progressive health or disability conditions this is leading to lag times that create stress for participants and their families. One family are worrying about affording assistive technology for monitoring/alerts of emerging seizure activity because the plan review has not been forthcoming in time to keep up with this developing need. With fewer opportunities for participants to have face to face meetings, their needs are not as well understood, and the plans do

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not address the real priorities for them. Any delays are worse for regional participants who will almost always have an additional lead time to source any supports once they have a plan that confirms these are funded.

Participant D has been in a SIL accommodation service for many years, and positive behaviour support required to assist with aggressive behaviour. A succession of changes of Support Coordinator and Behaviour Support Practitioner resulted in stalling of progress towards securing a plan review, disruption to evidence collection, and ultimately loss of evidence. Their two housemates moved to another SIL for their wellbeing, and safeguarding, something the Quality & Safeguards Commission also supported. The delays in obtaining a plan review leave Participant D in a vulnerable position and still with a 1:3 ratio in their plan. The Guardian (OPA) and new Support Coordinator chose to approach this by bringing in two new housemates, whilst starting the evidence collection cycle of Participant D’s behaviours again. The likelihood is that a similar situation will reoccur with the new housemates, so this is proactively recreating an unsuitable living arrangement.

Many regional areas have Support Coordinators who lack expertise and knowledge of the sector and funding arrangements, particularly for SIL services, and this is worsening an already disadvantaged position for participants.

c. Participants’ choice and control over NDIS services and supports including the availability, accessibility, cost and durability of those services;

Many participants already have a lower ceiling of choice and control that is governed by their remoteness, immediately putting them at a disadvantage from the outset. Their location and associated travel to reach them makes delivering their services a less attractive choice to providers in all fields in their network of supports and therapies. When they are available, the obvious additional costs for travel are a barrier, and the plan funding usually does not take this into account, and they get less for their dollar than clients in metropolitan areas. They are waiting longer for services due to the thin workforce and then underutilising the plan.

In many remote areas, there is an acute shortage of high-quality workforce, and attraction of workforce to the regions is extremely challenging. Consistency and continuity of service suffers as a result.

Many participants are faced with the reality that if they wish to continue to live in a regional/remote location, they will struggle with access, continuity, and quality of services in all aspects from Support Coordination through to actual service delivery.

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d. The particular experience of Aboriginal and Torres Strait Islander participants, participants from culturally and linguistically diverse backgrounds, and participants from low socio-economic backgrounds, with the NDIS;

The obvious additional expense of accessing services and therapeutic supports for participants in remote and regional areas adds instant disadvantage where they are from low socio-economic backgrounds. There are little to no opportunities for supplementing NDIS funded supports with other paid for services, and in-kind supports can also be slim to none in many cases, so there is no buffer and risk is exacerbated.

Participant E’s circumstances are heavily influenced by intersectionality: LGBTQI; cultural and linguistic diversity and a strong interface with out of home care. Participant E’s behaviour support needs were particularly complex, however their access to a high-quality behaviour support plan was delayed by turnover, and then a delay in access behaviour support practitioner staff.

e. Any other related matters Public transport can be a good solution for participants but is rarely suitable for needs in rural and remote areas due to availability, frequency and reliability. Access taxi services are also few and far between.

Unreliable internet in remote locations has impact, for example Client F who had to use plan funding for supports to attend the library to complete a plan review, because home internet could not be relied upon.

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