Cerebral Palsy Education Centre Inc.
End of Beacon St (PO Box 211) Glen Waverley
VIC 3150
Phone 03 9560 0700 | Fax 03 9560 0669
Email: info@cpec.org.au | Internet:
ABN: 81 553 364 708 | ACN: A0040915L
Submission to the Joint Standing Committee on the National Disability Insurance Scheme
– NDIS Planning
5 September 2019
Background
The Cerebral Palsy Education Centre (CPEC) is an NDIA registered provider delivering specialised physiotherapy, occupational therapy and speech pathology supports to Participants and their families living with cerebral palsy and similar neurologically based movement challenges.
CPEC provides supports to babies, young children, school aged, adolescent and adult participants and their families. The majority of Participants accessing CPEC services come from metropolitan Melbourne and have complex support needs.
CPEC was previous a state government funded Early Childhood Intervention Service (ECIS)
Thankyou for the opportunity to submit feedback to the Standing Committee.
a. the experience, expertise and qualifications of planners The Early Childhood Early Intervention (ECEI) partners in metropolitan Melbourne should be congratulated on their approach of only employing trained therapists or early childhood professionals as planners. While the experience level of planners is mixed, the ECEI partners have the expertise and qualifications to conduct successful planning sessions and the skill to develop effective plans for Participants. Critically, the communication skills and strategies used by the ECEI partners are effective in enabling, often highly stressed families access to the NDIA. The turnover of ECEI Partners appears to be lower than the turnover of LACs.
This is not reflected outside the ECEI space. The experience, expertise and qualifications of Local Area Coordinators is widely variable, with LAC’s from a variety of unrelated backgrounds, creating a wide range of Participant planning experiences. In these cases families often report not feeling heard or that the planner did not understand the complexity of their family’s situation. Unfortunately, the chance of meeting a planner with enough experience within the disability sector appears average and the turnover of LACs appears very high.
b. the ability of planners to understand and address complex needs This is dependent upon the planner’s previous experience, their ability to navigate the changing NDIS systems and the ability of the planner to communicate both their understanding and the outcomes they have achieved to the Participant and their family.
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Within the ECEI space this is high, within the LAC space this is low.
c. the ongoing training and professional development of planners CPEC would like to see a higher degree of training for LACs in the communication with and support for families living with complex needs. Planners often comment on the constant need to update their knowledge in relation to the frequently changing operations of the NDIA. Often, CPEC is aware of new NDIA procedures, especially related to Assistive Technology and price guide updates, prior to planners - indicating the need for improved internal communications.
d. the overall number of planners relative to the demand for plans CPEC is unaware of the ratio of planners to number of plans, however based on the delays in plan activation, gaps between plans and planner comments about workload, it appears that there are too few planners for too many plans.
e. participant involvement in planning processes and the efficacy of introducing draft plans CPEC’s experience is that participant involvement in the planning process relies heavily upon the skills, expertise, experience and qualifications of the planner – which as previously stated is variable.
CPEC is unaware of draft plans and can provide no comment.
f. the incidence, severity and impact of plan gaps Out of a population of 120 participants, CPEC currently has 2 participants experiencing a gap between plans (1 in 60 plans). The impact on services is severe, with CPEC, as a service provider, taking a moral stance and covering the full cost of ongoing supports so that the young children do not miss out on vital therapy supports at a critical age. Plan gaps become an administrative burden for providers and a stress for families with an already reduced capacity. This financial and situational stress is increased as there appears to be no process to resolve plan gaps and no identification of a resolution timeframe.
g. the reassessment process, including the incidence and impact of funding changes While the reassessment process is less demanding on participants and families than the initial planning sessions, the changing NDIS processes around assistive technology has meant significant delays in plan submission as families and providers were unaware of the current need to present quotes for all required equipment at the meetings.
CPEC has seen a common and frequent trend of reduced capacity building (therapy) and core (in home and community assistance) supports between first and second year plans and second and third year plans. Planners have stated that this is due to “over-funded” plans in the first insistence. To date, planners have been unable to provide rationale as to how the NDIA fairly calculates whether left over funds existing at the end of a plan period is the result of initial over-funding or an inability to access supports due to lack of market supply.
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Additionally, the funding around assistive technology continues to fluctuate widely as processes continue to evolve. Due to the changing NDIA processes in the area, CPEC is not concerned about variable funding levels contained within plans related to assistive technology. However CPEC is alarmed by the large timeframes involved with the approval of funding for assistive technology and the direct negative impact this has on the development of the Participant.
h. the review process and means to streamline it The ability of the participant to track the process of their review application, accountability of the NDIA to comply with the advertised timeframes and communication of the agency with the ECEI Partner or LAC would greatly improve the participant experience of undertaking a review.
CPEC’s experience is that review meetings with a senior planner or an NDIA delegate have always helped resolve the review issue. The challenge has been obtaining a timeline for the meeting.
i. the incidence of appeals to the AAT and possible measures to reduce the number CPEC has had no participant appeal to the AAT. This is not due to the lack of issues with NDIA plans, it is reflective of the capacity of families raising children with complex disabilities – majority simply do not have the time and resource to follow an issue through to this level.
j. the circumstances in which plans could be automatically rolled-over & k. the circumstances in which longer plans could be introduced For the population of people living with cerebral palsy (and like disabilities), CPEC would not recommend automatic plan rollover or longer plans until the participant’s abilities have plateaued and their living situation has become stable (often after the age of 25 years) or at the Participant’s or Nominee request. This is due to the effects of physical growth varying a participant’s functional abilities (and their need to relearn skills at critical peak growth periods) and the growth related need for assistive technology to be regularly replaced. Generally every year in the life of a child and young person growing up with cerebral palsy, there are a range of different needs that need to be considered and addressed.
l. the adequacy of the planning process for rural and regional participants CPEC has limited experience on this issue and is unable to provide a comment. The main concern of a couple of rural families is access to the right therapy and supports that they require.
m. any other related matters. None at this time.
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