Thursday 31st August 2017
Committee Secretary
Joint Standing Committee on the National Disability Insurance Scheme
PO Box 6100
Parliament House
Canberra ACT 2600
Re: Submission to the Australian Parliamentary Inquiry into the provision of services under the NDIS Early Childhood Early Intervention Approach.
From
Kalparrin Early Childhood Intervention Program Inc. ‘Kalparrin’
Dear Madam, Sir,
Please find following our brief submission to the Joint Standing Committee on the National Disability Insurance Scheme regarding the provision of services under the NDIS Early Childhood Early Intervention Approach.
Introduction:
By way of introduction Kalparrin is a specialist early childhood intervention service that has been operating in the north east of Melbourne for 41 years. Kalparrin entered the full scheme NDIS in October 2016 and 100% of its clients are NDIS recipients. Early childhood intervention is Kalparrin’s core business and purpose.
Kalparrin invested significant time, resources and training into preparing for the NDIS years before it commenced and is now widely considered a sector leading example of operational success under the NDIS in the state of Victoria.
In the past 3 years Kalparrin has grown from 18 staff to 48 staff, from 86 families to 312 families and from a $600,000 turnover to a $2,000,000 + turnover. Kalparrin is about to build a $600,000 extension to our facility to help meet client service demand under the NDIS.
Kalparrin employs a significant allied health team including physiotherapists, occupational therapists, hydrotherapists, speech pathologists, specialist teachers, dietitians, psychologists, social workers and therapy assistants. The majority of staff within Kalparrin are expert in the early childhood, early intervention approach.
Kalparrin is an avid supporter of the NDIS, believes fully in its ethos, ideals and values, and is committed to playing its part in assisting the Scheme in whatever way it can, to achieve the best outcomes possible for people with a disability.
Kalparrin ECIS (Early Childhood Intervention Service)
ABN 61 827 714 605
Our General Concerns:
Since entering the NDIS Kalparrin has faced one very significant barrier … the inadequacies of a poorly resourced, poorly trained and poorly functioning NDIS.
It is Kalparrin’s observation that because of a deficit in resources, training and operational efficiency the NDIS is still failing many of the very clients it was formed to support, in addition to the NDIS Registered Service Providers who are trying desperately to work with the NDIS and make the new system ‘work’ for participants.
There is however daily evidence that 10 months into the Scheme, processes and systems in the early childhood early intervention sector of the Scheme are beginning to improve. The introduction of the ECEI process along side LAC’s has in Kalparrin’s view transformed the quality control of NDIS Plans and reflected a significantly enhanced understanding of the importance, priority and cost effectiveness that early childhood intervention plays in the life continuum of a child with a disability or developmental delay. Kalparrin applauds this development and encourages the NDIS to further strengthen the role of ECEI providers in the assessment and allocation of NDIS Plans.
However despite these general improvements, there are many examples remaining within our experience of the NDIS ‘system’ that are in our opinion of cause for concern.
These include :
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families being unable to access approved funds within reasonable timelines
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significant, ongoing, daily functional issues with PRODA
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an inadequate NDIS Help Line for participants and Service Providers
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funding such as Support Coordination being given to clients who don’t want it
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Financial Intermediaries holding back funds from Service Providers, sometimes for 90+ days
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KeyWorking funds not being allocated when needed
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Significant inefficiency and inequity in NDIS Plans between clients of exactly the same background and disability or diagnosis
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Poorly trained and constantly changing NDIS staff
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The de-personalisation and almost ‘faceless’ nature of the Scheme for Participants and Service Providers (our most significant concern).
Specific Concerns:
Term of Reference: m: the timeframe in receiving services under the ECEI pathway;
Time delays and cost of administrative processes to access vital yet basic equipment:
Children who require basic equipment, such as orthotics, following the implementation of their plan need to submit for a full plan review to access funds for this to be added. One recent instance of this was for a 3yr old who needed orthotics, as identified by their Physio. The Physio had to write a support letter for the NDIA as evidence the orthotics were needed (30mins, costing family $90), then had to submit the application through SWEP (an hour $175) in order to lodge the request. This cost the family’s plan $265 for administrative processes when the orthotics themselves only cost $400. This was lodged in April and the family has only just received their new Plan in August.
Kalparrin ECIS (Early Childhood Intervention Service)
ABN 61 827 714 605
In summary, it cost the family $265 for NDIA administrative processes and 5 months to access funds for orthotics. Under the Federal Better Start system, this family could have used their Better Start funds without question, with no administrative costs at all, and simply gone to an Orthotist and received their fully funded orthotics within a week.
Term of Reference: b: the service needs of NDIS participants receiving support under the ECEI pathway;
Lack of triage system for accessing vital equipment:
SWEP used to triage and prioritise client referrals based on need. Currently there is a “first in best dressed” situation, with no regard for need nor therapeutic outcome measures. A recent example is an 2 yr old who required a walker to promote her beginning to walk. The referral for the walker was submitted to SWEP but with a lengthy delay, the Physio contacted SWEP who stated that the referral was in the queue and there was no way to escalate it higher based on the needs of the child. This is contrary to the previous SWEP system that was responsive to the needs of individual clients and circumstance. This has detrimentally effected the development of this 2yr old because of the lengthy delay in processing the referral.
Term of Reference: c: the timeframe in receiving services under the ECEI pathway;
De-identified Clients:
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Twin boys changed Support Coordination from Scope to Kalparrin in May 2017.
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Scope followed correct process to end the Service Agreement and free up the funds for Kalparrin’s use (as told to Kalparrin by both Scope and NDIA).
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Kalparrin unable to claim funds, and have followed this up with NDIA on numerous occasions (email and phone). Frequent repeated attempts to make service bookings on PRODA.
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On 17th August, a service booking for C1 was able to be made. No notification from NDIA about what had changed or why this now worked.
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No service booking is able to be made for C2 to date, despite same process being followed.
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28 hours of Support Coordination service owing to Kalparrin for C2 as at 21/8/17. Term of Reference: b: the service needs of NDIS participants receiving support under the ECEI pathway;
De-identified Clients:
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Planning meeting in July for 6 year old child currently at school.
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Parents requested fortnightly Psychology, Speech Pathology and Occupational Therapy, plus school holiday therapy groups. Parents currently paying for this out of pocket. Reports written by all therapists to support this and Psychologist attended meeting as advocate.
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Planner called Psychologist after planning meeting and said she was only able to put through 10 sessions of each therapy type as the child was at school.
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Therapy groups were put under “Core Supports” when needed to be “Improved Daily Living” for therapists to be able to access. Parent requested administrative review. Planner informed parent would need to be full review, and could not guarantee services.
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Parents felt the review process was “too hard and risky” and have chosen to pay out of pocket instead of trying, as they already have enough stress to deal with.
Kalparrin ECIS (Early Childhood Intervention Service)
ABN 61 827 714 605
Term of Reference: c: the timeframe in receiving services under the ECEI pathway;
De-identified Clients:
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4 year old child given ECEI package, which was “stated” for individual therapy, despite parents requesting the bulk of service be an intensive group program.
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Kalparrin were not able to access funds until full review completed (which took >4 months).
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16 months of funding now needs to come out of a 12 month plan for participant in order to receive the recommended and chosen service.
Term of Reference: b: the service needs of NDIS participants receiving support under the ECEI pathway;
De-identified Clients:
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Single mother of child with Autism Spectrum Disorder. Mother experiencing high levels of stress and mental health issues related to caring for child. No informal support network available. Family on wait list for respite services prior to NDIS.
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Mother requested Disability Support Worker in planning meeting.
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When plan received, no “core supports” available. NDIA informed mother no respite was able to be included as participant was still a child.
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Support Coordinator supported mother to appeal decision in January 2017, and a request for review was made. No review completed to date, despite mother calling NDIA frequently.
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High turnover of planners may have contributed to this. Mother has been told of at least four different planners names as handling participant’s case this year.
Term of Reference: c: the timeframe in receiving services under the ECEI pathway;
De-identified Clients:
- Participant’s plan was plan managed, with an external financial intermediary.
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$5,000 of services provided by Kalparrin in 5 month period went unpaid.
- External financial intermediary informed Kalparrin that they were unable to load onto PRODA.
- With family permission, and at recommendation of NDIA and external financial intermediary, Kalparrin successfully loaded plan as “NDIS managed” on PRODA, and all funds were able to be claimed.
Term of Reference: d: the adequacy of funding for services under the ECEI pathway;
De-identified Clients:
- Many examples of children being given EXECI packages considerably less than those with which they were already funded. Specific example – 3 year child with ASD given ECEI package of $2500. Under previous State and Federal systems, child was eligible for >$13,500 per year.
Kalparrin ECIS (Early Childhood Intervention Service)
ABN 61 827 714 605
Term of Reference: d: the adequacy of funding for services under the ECEI pathway;
Indigenous Families x numerous de-identified clients:
NDIS Funding Packages for ECIS Indigenous Families (though substantial financially) as they need to be in most cases, are made so complex in the way they are to be managed (eg: expectations for the use of Financial Intermediaries, signing of complex (English language) documents and the way they are linked to registered Service Providers (the same way as non indigenous families which is a recipe for failure) that most indigenous families we see have had a Plan for upwards of 6-8 months before they have found someone who can help them to navigate the system, explain to them how the Plan works and are linked with a Service Provider who can structure the supports they require in the simplest and easiest means possible. In some cases we have seen indigenous families with $25,000+ packages unable to access or understand how to access the supports this funding represents.
It is crucial that indigenous families are first linked with culturally sensitive service providers (not non culturally sensitive/trained intermediaries or support co-ordinators) when a Plan is about to be approved, to enable that Service Provider to immediately assist the funded indigenous family to manage and access their Plan.
ENDS
The Hon Jenny Macklin MP has indicated Kalparrin’s interest in appearing at the Inquiry Hearing in Melbourne. Though we understand the Hearing program has not yet been finalised, we would value the Secretariat contacting us with more information in due course.
We thank you for the opportunity to make this submission.