SUBMISSION TO THE PARLIAMENTARY JOINT STANDING COMMITTEE ON THE
NATIONAL DISABILITY INSURANCE SCHEME
SUBJECT: NDIS PLANNING
About Somerville
Somerville is a non-government, not for profit organisation that provides specialist services in the areas of Disability Services, Financial Counselling Services and Housing and Homelessness Services. Somerville has a long history, spanning over 50 years, of prioritising and advocating for access to resources to assist disadvantaged Territorians to improve their circumstances.
Somerville’s Disability Services division includes the following programs:
A Supported Living and Accommodation Program which operates 15 supported living and accommodation houses in Darwin, Palmerston, Howard Springs and Katherine and provides 24 hour support to 49 NDIS participants. Within this program we have also successfully developed an alternative housing model which provides greater flexibility around training support for those NDIS participants able to gain greater independence in the community.
A Life Skills Development Program currently assists 29 people with disability to establish mutually beneficial relationships, networks, support systems and friendships within their local communities. The program also provides support to people with disability who wish to acquire the skills necessary for daily living and/or work readiness. Somerville partners with community groups, mainstream and specialist providers wherever possible to ensure a focus on inclusion within our communities.
A Support Coordination Program has been operating in Darwin since 2017. Following approaches from guardians and families for Somerville to provide a Support Coordination Program in Central Australia, we opened an office in Alice Springs in July, 2018. As at 30 June, 2019 Somerville was providing Support Coordination to 51 NDIS participants in Darwin and 29 NDIS participants in Alice Springs.
Somerville has also worked with the NDIA in the provision of Specialist Disability Accommodation under legacy arrangements. We are currently exploring potential growth in this area, both in Darwin and Katherine, to provide additional accommodation options for people with disability in the Northern Territory.
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Somerville’s experience with the NDIS
The NDIS is a ground breaking scheme that was long overdue and Somerville has welcomed its introduction. Under the NDIS we have witnessed many positive changes to the way that services are provided to support people with disability. Increased choice and control for participants has opened up many opportunities and options that were previously out of reach for the majority of people who are now eligible for the NDIS. However, there are clearly many areas of the NDIS that require urgent improvement, both for participants and their support networks and service providers like Somerville.
The NDIA as it currently operates lacks the ability to provide the level of responsiveness within acceptable timeframes required for participants, their support networks and service providers. Critical issues around the quality of plans, plan gaps caused by lengthy review points and the high level of administration associated with the NDIS needs to be addressed as a matter of urgency over the coming 12 months. We note the work being undertaken by the NDIA in terms of improving participant pathways and investigating remedies to address ‘thin markets’ and offer the following information to assist the Committee in its consideration of further refinements to what should be a world class support system for people with disability.
Responses to matters of relevance for Somerville
a) the experience, expertise and qualifications of planners Where planners have had lived experience within the disability sector, and understand planning and opportunities related to service provision for people with disability, interaction with these officers has generally resulted in a positive outcome for participants and the development of good quality plans. Where NDIA planners have had limited knowledge of the sector, this lack of awareness has in some cases resulted in poor quality plans that ultimately required review.
We note that the position description for NDIA planners requires ‘a positive contemporary attitude to people with disability along with an understanding of disability and its impact on individuals’. As the participant’s plan is the entry point into the NDIS we suggest that this criterion is well tested with future candidates to ensure that planners have the skills and knowledge to successfully undertake the duties required of these positions.
b) the ability of planners to understand and address complex needs The provision of services to people with disability in the Northern Territory can be complex and planners need to fully comprehend the challenges posed by local geography, climate and culture. While Somerville does not provide services to people with disability living in remote communities, a significant percentage of NDIS participants accessing our programs identify as being from Aboriginal descent. Many of these people were born in remote communities and due to their high level support needs had no other option but to relocate to urban areas to access essential supports. An emotional connection to family, country and culture remains an enduring feature in the lives of many of these people and should be considered in the development of participant plans. Our experience is that many planners do not fully understand these connections for Aboriginal people who may have not lived on their country for many
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years. We have received inconsistent advice on whether ‘return to country’ for short visits to connect with family, or participate in ceremony, is funded under the NDIA as some planners have considered those visits as a holiday rather than a cultural, necessary and reasonable support requirement.
c) the ongoing training and professional development of planners Further to comments regarding the need to recruit suitably skilled and knowledgeable people in the first instance, we suggest the following in respect to the ongoing training and professional development for NDIA planners, if this is not already in place:
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Training programs that involve people with disability telling their stories of the challenges that they face in their everyday lives and in achieving their goals and their aspirations.
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Experiential learning based training in person centred practice.
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Information sessions that move beyond cultural awareness to an approach that combines person centred principles with cultural safety to more readily understand the potential cultural goals and aspirations for Aboriginal people with disability.
d) the overall number of planners relative to the demand for plans The inadequate number of planners relative to the demand for plans has been an issue in Alice Springs and appears to be directly related to the turnover of NDIA staff. We acknowledge that the recruitment and retention of staff in regional areas of the Northern Territory is difficult and often requires additional effort from employers with regard to on the ground support and incentives to attract and retain quality staff.
e) participant involvement in planning process and efficacy of introducing draft plans Participant involvement in planning processes has improved, with a greater emphasis by planners on the participant and their support networks being at the centre of the planning process.
While the introduction of draft plans as another step in the process could potentially slow down finalisation and activation of plans, we believe that it is a significant and important step in getting the plan right in the first instance. We are aware of feedback from some participants and their families that the development of plans were rushed through and ultimately were insufficient to meet participant needs, requiring them to go through the lengthy review process.
We support draft plans on the grounds that the plan is essentially a contractual arrangement between the participant and the NDIA. To finalise such an important document prior to the participant and their support networks being able to check its accuracy is highly inappropriate and is, in our opinion, a contravention of the NDIS principles which rest on the values of choice and control.
f) the incidence, severity and impact of plan gaps Somerville has a commitment to continuity of service, irrespective of plan gaps. To date, Somerville has been able to meet the financial and administrative costs associated with gaps caused by delays in plan approvals for participants currently receiving services under the NDIS. However it is clear from our experience that some organisations, particularly those small organisations who exclusively provide disability services, could quickly become financially unviable if this situation was a regular occurrence.
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Somerville is currently supporting two participants in our Supported Living and Accommodation Program who are both awaiting plan reviews to include SIL. One participant was discharged from a hospital setting with a plan that did not include SIL and the other relocated from another provider and the SIL was not transferred to Somerville.
We have also experienced gaps between the expiry of plans and the development of new plans. Our Support Coordination team have reported on the nervousness of service providers in the provision of support where the guarantee of funding associated with new plans is uncertain.
We suggest that processes related to plan gaps and plan reviews be considered as an urgent priority for investigation under this Inquiry.
We are happy to provide more information on these matters if required.
g) the reassessment process, including the incidence and impact of funding changes The following example is provided to illustrate the difficulties associated with securing a reassessment of participant plans and the impact that delays have on individual participants.
As part of an initial NDIS plan, a participant was provided with funding for an allied health assessment and the development of a mobility plan. The assessment identified the potential for the participant to walk again, or at a minimum support himself to sit up. The achievement of this important life changing goal will require additional funding for an allied health professional to train staff, additional staff hours ongoing to support the participant to meet the milestones of the mobility plan and some assistive technology.
A period of ten months has passed and the participant is still awaiting a reassessment of his NDIS plan to determine if the mobility plan and associated supports will be funded. In the interim, progress toward his therapy goals has ceased.
h) the review process and means to streamline it Streamlining of the review process is critical to ensuring adequate services are provided to participants. The main cause of delayed reviews appears, in the main, to be a NDIA human resource issue, with insufficient staff to manage the process of review. However, streamlining of the review process should also incorporate a full review of the current NDIA electronic management system and associated processes.
i) the incidence of appeals to the AAT and possible measures to reduce the number Appeals to the AAT could potentially be reduced through the development of good quality plans in the first instance and ensuring that reviews are undertaken in a timely manner.
j) the circumstances in which plans could be automatically rolled over We urge caution in the automatic rollover of plans and suggest that all participant plans need to be reviewed prior to the end of the plan period.
k) the circumstances in which longer plans could be introduced Somerville supports the introduction of longer plans, with associated funding indexed across multiple years, for those participants with more stable support needs. The quotation process, particularly for SIL, is administratively complex, requires additional resources and quotations are
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then often the subject of lengthy negotiations with the NDIA. However, longer plans will need to be supported by a more streamlined and responsive process to ensure that reviews associated with changes to circumstances are undertaken during the period of the plan when required and within reasonable timeframes.
l) the adequacy of the planning process for rural and regional participants The planning process for rural and regional participants can be challenging and complex and requires highly skilled and experienced planners able to support participants to access core supports as well as achieving their goals and aspirations.
Currently the planning process for participants in rural and regional areas is compromised by the lack of services available and this becomes more problematic in remoter regions with many participants not being able to fully utilise the supports detailed in their plans.
We note the work being undertaken by the NDIA in respect to ‘thin markets’ and suggest consideration of alternative funding models for areas where services are limited or non-existent. Those alternative funding models could include ‘joined up’ services as described in the Joint
Standing Committee on the National Disability Insurance Scheme, Progress Report, March
- A further suggestion is the consideration of hybrid models that provide recurrent funding for non-government organisations or Aboriginal Community Controlled Organisations to underpin individual packages for NDIS participants, as proposed by PricewaterhouseCoopers Indigenous Consulting in its ‘NDIS Communities of Practice: the NDIS in remote Northern Territory’ report which can be accessed at https://digitallibrary.health.nt.gov.au
m) any related matters While the NDIA funds interpreters for planning meetings, language interpreting supports are not part of participant plans. Given that many NDIS participants in the Northern Territory are Aboriginal who have English as a second, third or even fourth language, access to interpreters is a reasonable and necessary support. Specific areas where interpreters are required includes pre-planning and where accessible communication is essential, for example allied health assessments and the development of therapy plans.
The ability to communicate is a basic human right and as such we request immediate consideration of the incorporation of funding for interpreters into participant plans where English is not the first language of the participant.
Contact:
Lawson Broad
Chief Executive Officer
Somerville Community Services
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