NDIA Accountability Project

Key barriers to accessing and using the NDIS effectively for people with disability in regional areas - Community Bridging Services (CBS) Inc.

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Inquiry into the NDIS participant experience in rural, regional and remote

Australia - Community Bridging Services (CBS) Inc. Response

21 Dec 2023

Background

Community Bridging Services (CBS) Inc. was founded on a strengths-based model, with a strong focus on consumer leadership and Positive Interactions. Demonstrating our robust commitment to inclusion and consumer lead service provision, two of eight members of the CBS Inc. Board of Directors are clients with lived experience of disability, along with 23% of the workforce. With 39 service outlets located across South Australia, CBS Inc. has established and nurtured strong connections within local communities. Coupled with our expertise in the disability sector, including NDIS, DES, and Social Enterprise, this extensive reach allows CBS Inc. to address the unique needs and challenges faced by people with disability (PWD) in regional areas. Our staff currently support 2,866 clients, with 2,146 active and an additional 720 suspended. Through our ILC grant funded program ‘Aim Higher’, we also regularly work with young PWD in remote schools, including Coober Pedy, Roxby Downs and Ceduna. In response to this important inquiry, our Founder and Executive Director, Freddie Brincat (OAM), chaired a meeting of key staff with significant years of experience in regional and remote supports, including Liz Loizeau (Pt Pirie), Craig Love, Dillon Wright (Murray Bridge), Simone Grantham (Pt Augusta), Lucy Pennell (Pt Pirie), and Mathilde Eldridge. Three of our CBS Inc. contracted psychologists also provided feedback at a meeting on Wednesday 20 December 2023.

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In summary, the key barriers to accessing and using the NDIS effectively are as follows:

  1. Low levels of education, and particularly the low literacy levels of many people eligible for the NDIS, leading to significant difficulties with responding to related questions.

  2. The reliance on access to primary and allied health professionals in the regions to complete applications and related assessments for the NDIS.

  3. Allied health professionals having to actively support PWD with their actual written NDIS applications including helping to explain and answer questions effectively.

  4. A lack of primary and allied health professionals in the regions to obtain the support stated in points 1-3 above. PWD having to wait too long to gain access to those available.

To assist with our response to this inquiry, we have provided dot points to the relevant questions below. A: The experience of applicants and participants at all stages of the NDIS, including application, plan design and implementation, and plan reviews.

  • The application process is tailored to People with Disability (PWD) with the skills and experience to navigate the NDIS application process.

  • The complex application process requires increased education for consumers, families, and allied health / primary professionals to navigate the process and provide the necessary evidence for applicants.

  • NDIS eligibility remains unclear and confusing, leading to delays, frustration and difficulty accessing essential services.

  • Regional and remote areas experience a high turnover of Local Area Coordinators (LACs) and lack sufficient independent Support Coordinators with regional/remote cultural awareness, including Aboriginal people. For example, the local NDIS office for Coober Pedy is 478 km away in Port Augusta.

  • LACs experience high caseloads in regional and remote areas and travel long distances, leading to increased burnout and staff turnover. 2

  • The above factors reduce the availability of LACs for regular plan reviews. Participants regularly complain that their plans have ‘rolled over’ without adequate review/updating.

  • A lack of understanding of the NDIS and how to access it leaves regional communities with greater numbers of families struggling to use the services, even when they are eligible. This lack of understanding leaves those who need the NDIS unable to access and harness the scheme to its full potential.

  • Families with higher education are more likely to access NDIS services. They may often relocate to metropolitan areas, where more services are available at a higher quality standard. This makes attracting the services needed in regional and remote areas even more difficult.

  • The lack of NDIS education and resources disproportionately impacts PWD from Aboriginal communities and others with Culturally and Linguistically Diverse (CALD) backgrounds.

Recommendations:

  1. The NDIA should facilitate community education programs in regional and remote areas, emphasising face-to-face delivery where possible.

  2. The NDIA should incentivise the delivery of allied health services to these regions.

  3. The NDIA should encourage and promote greater use of technology to provide regional and remote allied health support; local Community Centres should be adequately resourced to provide access and technology support for online sessions if needed.

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

  • Who are the people in the NDIA? Our observation is that many individuals do not know who they are or what they do in the regional areas.

  • The NDIA is fundamentally a faceless government bureaucracy that is not present in the community and represents a culture completely detached from the people it’s there to serve.

  • There is a real problem culturally with the NDIA, its establishment, and its lack of reality in our community. This needs to be addressed to improve the NDIS, making it difficult to answer this question.

  • While CBS staff previously met with the NDIA during the Quality and Safeguarding Commission rollout, no CBS staff have personally met or interacted with anyone from the NDIA in the past two years. Our consumers and their families support this experience.

  • LACs act as the access point and key communication link between the consumer and the NDIA. Regional and remote communities have difficulties connecting with a face-to face representative.

Recommendations:

  1. To incentivise LACs, allied health, and other service providers to move into regional areas, the NDIA could request that government tenders prioritise organisations that intend to establish and embed community-led services.

  2. Demonstrate a commitment to recruit and train LACs in remote areas, incentivising career development so LACs can provide the necessary support to people in remote areas.

  3. Educate and support consumers to communicate with the NDIA through technology. 4

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

  • South Australia has historically low populations in remote and regional centres, making the development of inclusive group interaction and providing diversity and choice with activities more challenging.

  • Service providers face challenges developing genuine service choices for clients due to the lack of participant numbers. This, in turn, results in an absence of competition between service providers and a lack of choice and control for participants.

  • Lucrative financial incentives for Supported Independent Living (SIL) encourage providers to establish themselves in these areas but discourage other community access services that are more individualised. Many SILs are also Support Coordinators, resulting in SIL participants being referred to their current accommodation providers for additional services. This prevents consumer choice and competition, also reducing quality. These sharp practices represent a dangerous shift towards re-institutionalisation; choice and control driven by the service provider, not the participant, is a concerning step backwards.

Recommendations:

  1. The focus on profit will naturally lead most in this conflict-of-interest situation to refer clients to their own services. SILs referring clients to their own services results in more people doing activities within their own NDIS service.

  2. It is time the NDIA stopped this ongoing conflict of interest where SILs and other direct service providers are also running support coordination for their clients. From our interpretation, this was never intended to be the case.

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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.

  • Aboriginal people must have leadership and development roles within the NDIA to allow for culturally relevant solutions and to increase active participation and self determination.

  • The impact from a lack of education for people in regional areas is magnified for PWD from Aboriginal communities and those from a CALD background, particularly regarding required evidence for NDIS assessments. This can lead to under preparation, leaving Aboriginal people and CALD populations outside of the NDIS when they should be accessing support.

Recommendations:

  1. Regional conferences and community sessions would allow for valuable input on how to better support Aboriginal people with disability in accessing both local and remote NDIS services.

  2. Encouraging development and financial support for Aboriginal and CALD community led specialist services with expertise and experience of cultural needs (E.g. ITEC Group,

Multi-Cultural Communities Council of South Australia and Nganana Inc.)

Summary

The NDIS is crucial to unlocking the talent and potential of people with a disability in the long term. It has helped give more voice and connectivity to PWD as real and valued citizens of our country. It is in its developmental, adolescent stage where reports like this, if acted on, can only help to improve access to and quality of NDIS supports. CBS Inc. Inc is keen to lead by example in our efforts to listen and increase choice, power and control by including PWD in all aspects of our service to increase quality and independence. For further information, please

contact Freddie Brincat

Thank you for reading our response.

Authors from CBS Inc.

Freddie Brincat (OAM), Liz Loizeau, Craig Love, Dillon Wright, Mathilde Eldridge, Simone

Grantham and Lucy Pennell

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