NDIS Planning Challenges for People with Complex Needs

Joint Standing Committee on the National

Disability Insurance Scheme Inquiry into

Prepared by Samaritans Foundation

Date: September 2019

Introduction ………………………………………………………………………….. 3

Planners ……………………………………………………………………………… 3

Participant Involvement in Planning ……………………………………………. 4

Plan Gaps and Plan Reviews …………………………………………………….. 5

Introduction

Samaritans is an NDIS registered charity which has been operating disability

services for 35 years. In the 2018 financial year, Samaritans provided a

range of services to nearly 1000 people with disabilities in Newcastle, the

Hunter, Central Coast and Mid-North Coast of NSW. As such, the

organisation has extensive experience working with people at all stages of

their plans and with the delivery of services under those plans.

Samaritans response to this inquiry represents the experiences of our staff

in relation to NDIS Planning and their reflections on the challenges

experienced during the planning process and the impacts on the pe ople we

support.

Planners

Samaritans observes significant inconsistency between Planners in terms of

their expertise, understanding and skills. This often results in:

tools and guidelines being applied differently for different people,
significant time periods for negotiation and review,
delays in plans being approved, and
final plans regularly falling short of the true needs of the person, particularly for people with complex support needs.

Participants with complex needs often face additional difficulty working with

Planners. Samaritans has experienced this recently with one individual we

support whose plan took 3 years to be developed and approved, and the final

plan still falls short of meeting their needs.

There are several challenges that Samaritans witness es in the current

planning processes including:

It can be difficult for a participant to provide evidence as to how complex their needs are. Asking someone to quantify their disabilit y

with data is challenging and comes from a deficit position rather than a

strengths-based position.

There is not enough direction or guidance offered around what evidence is suitable.
The generally low knowledge and understanding of Planners around complex needs results in delays in development and approval of the

plans as they must be negotiated and modified, often multiple times.

The Reasonable and Necessary test is suitable only when Planners have the expertise to recognise individual needs and understa nd the

implications of complex and multiple disabilities.

Provide additional education for Planners to improve base understanding of disabilities and respect for individuality of each

person.

Modify planning process to focus on strengths-based perspective, rather than asking people to prove how “bad” their disability is.

Participant Involvement in Planning

Participant involvement in planning could be improved by offering flexibility

for planning meetings to occur at different locations. They currently occur in

an NDIA office which isn’t always the most suitable or comfortable option for

the Participant. Allowing Participants to hold the meetings in their own home

offers a level of comfort for them and provides some context for th e Planner

to understand the environment a person is living in and how they interact

with it.

Some plans are completed without the Planner meeting the Participant at all,

limiting the understanding the Planner can have of the persons individuality

and needs.

Allow and encourage flexibility for planning meetings to be held in alternative locations that increase comfort and ease for Participants.

Ensure that where possible Planners always meet with Participants during the planning process. Where not possible, a suitable process is

undertaken by the Planner to collaborate with the Participant and

familiarise themselves with the Participant’s needs and lifestyle.

Plan Gaps and Plan Reviews

There are significant inefficiencies and issues in cur rent processes for

addressing gaps in plans. Some of these include:

No response following the submission of a Change of Circumstance beyond acknowledgement.
If the change is not accepted, no notification is provided which creates issues in the delivery of services to the participant and delays the

request for review of reviewable decision.

No notification when a plan ends or changes are made, which results in services being provided that do not align to the plan and subsequent

issues with claiming and adjustments.

Samaritans is currently working to address plan gaps with a person we

support which has been ongoing since May 2019. The Agency response

recommended that Samaritans increased supports to the participant utilising

existing funding. However, this means the participant will run out of funding

before the end of their plan, resulting in Samaritans providing support

unfunded, or the Participant having no support. This is not an uncommon

issue. There needs to be a more flexible approach to the r eview process that

gives participants greater ability to negotiate based on their lifestyle, needs

and experience with their existing plan.

The Administrative Appeals Tribunal (AAT) have overturned many decisions

made by the NDIA, demonstrating issues in the NDIA’s processes. A

thorough review of the AAT decisions would offer guidance to the NDIA on

the changes required in their decision making, education of planners and

handling of particular matters. Strengthening of the NDIS Quality and

Safeguards Commission (QSC) powers to enforce their recommendations

relating to adequacy of Participant plans should be further considered. 5

The rollover of plans should be an available option for Participants. This

would improve consistency and provide certainty for Par ticipants, as well as

freeing up NDIA resources to respond to reviews and address plan gaps. As

an alternative review mechanism, providers in consultation with Participants

should complete an end of plan report at rollover. This might identify

achievements, ongoing priorities and considerations for future reviews.

Similarly, longer plans for certain participants would be appropriate and

practical.

Improve feedback mechanisms to ensure that plan reviews, changes to plans, and decisions on Change of Circumstances are communicated

quickly.

NDIA conducts a review of internal decision-making processes to improve outcomes for Participants and reduce applications to AAT.
Develop and implement guidelines for extended plan timeframes and plan rollover that allow participants to maintain consistency in their

plans where changes are not required.

Consider development and implementation of guidelines that capture achievements and priorities periodically under extended timeframe

plans or rollover plans.

Authorised by: Brad Webb, CEO

Authored by: Emma Granger, Executive Officer

Contributors: Tammie Lawler, General Manager NDIS

For more information: ceo@samaritans.org.au