NDIA Accountability Project

Challenges in transitioning Partners in Recovery clients to the NDIS

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Inquiry into the provision of service under the National Disability Insurance Scheme (NDIS) for people with psychosocial disabilities related to a mental health condition

Submission

27 February 2017

  1. Introduction Our core objectives include:

  • increasing the efficiency and effectiveness of health services for consumers, particularly those at risk of poor health outcomes

  • improving the co-ordination of care to ensure consumers receive the right care at the right place at the right time.

This submission focuses on issues raised with the transition of clients from the Partners in Recovery (PIR) program to the NDIS.

is a provider of the PIR program which is a community based program aimed at supporting living with severe and persistent mental health concerns.

Individuals are supported to develop their own plans for sustained recovery, and by getting local services and supports from multiple sectors to work in a more collaborative, coordinated and integrated way. Individuals who are eligible for PIR are linked in with a local PIR Support Facilitator who will work with the individual to develop their own plans based on their needs.

The Partners in Recovery (PIR) program has been in the process of transition to the NDIS over a 12 month period. A number of key learnings and concerns have emerged from this process.

  1. comments relate to the following sections of the Inquiry’s Term of Reference:
  2. That the joint committee inquire into and report on the provision of services under the NDIS for people with psychosocial disabilities related to a mental health condition, with particular reference to:

a. the eligibility criteria for the NDIS for people with a psychosocial disability; b. the transition to the NDIS of all current long and short term mental health Commonwealth Government funded services, including the Personal Helpers and Mentors services (PHaMs) and Partners in Recovery (PIR) programs, and in particular;

i. whether these services will continue to be provided for people deemed ineligible for the NDIS;

i. any related matter. 2.1 Non-Consenting and Ineligible Individuals Not all PIR participants are consenting and/or eligible for the NDIS. This poses significant concerns, post June 2017, for: o ongoing care for existing PIR participants o those in the community who are not currently engaged with services. There are very few appropriate services to support these people in the community outside of NDIS services. Stakeholders are concerned that this will result in an increased number of consumers becoming acutely unwell in the community and cycling through tertiary services. In addition to concerns regarding deterioration in the community, service providers are concerned that individuals in need of support are accessing services that have not traditionally provided the types of care coordination services that they require. This is resulting in service blockages and sub-optimal care coordination type services being provided.

2.2 Barriers to Completion of Access Request Forms There are significant barriers for individuals completing the required NDIS Access Request Forms (ARF) to commence the NDIS transition process. Most individuals require reports or additional evidence to be provided by their GP or treating mental health professional. Support Facilitators and individuals are finding it very difficult to engage with GPs and treating mental health professionals to get this paperwork completed. GPs and mental health professionals state that this paperwork is onerous for them and that there is currently no reimbursement for their time spent doing this. There are examples in the PIR program of it taking up to 12 weeks to receive information from treating clinicians to contribute to the ARFs. This impacts significantly on an individual’s ability to apply for an NDIS package and receive a plan that is adequately designed to support the individual on a day to day basis.

2.3 Delays in Assessment of Eligibility Following the submission of ARFs, individuals have experienced significant delays in the eligibility testing process, approval of application and the development of a plan. There are a number of examples in the PIR program demonstrating delays of up to 12 weeks before plans have been approved.

2.4 Variability in the Quality and Inclusions of NDIS Packages The variability in the quality and inclusions of NDIS packages for PIR participants is significant. The majority of PIR participants who have transitioned to the NDIS do not have packages that adequately reflect the level of support they were previously receiving through PIR. The variable quality of plans is further exacerbated by the experience of the NDIS planners. Many NDIS planners have little or no experience in psychosocial disability.

2.5 Challenges in Implementing Plans Following the approval of an NDIS plan, individuals have struggled to execute their plans and get appropriate supports in place. Individuals are provided with lists of potential service

providers and struggle to navigate the system. Support coordination forms a vital part of plans, to support individuals in receiving the services they require. In most circumstances, individuals require more than the single support coordination payment ($500) to be reflected in their plans.

2.6 Lack of Services for Individuals with Packages There is a lack of services for individuals to access once they have an NDIS plan in place. While individuals may have a high quality plan, workers and individuals are finding it difficult to identify appropriate services that will meet those outlined in their package. In particular there are a lack of targeted mental health services available to meet the needs of NDIS participants with psychosocial disabilities.

  1. Recommendations Based on the experiences of the PIR transition to the NDIS in the ACT and the challenges explored above, the following recommendations are made:

  • NDIS Planners working with participants with psychosocial disability require experience and a strong understanding of the needs of those with a psychosocial disability.

  • Support coordination should be a standard inclusion in all plans, with most individuals requiring more than the single support coordination payment currently reflected in a number of packages.

  • Specialised mental health based care coordination services and other support services for those who are ineligible or do not consent to transition the NDIS need to continue to be funded post June 2017.

  • GPs and mental health professionals need to be supported to complete reports and provide information for ARFs in a timely way. This could include the introduction of a Medicare Benefits Schedule item number for NDIS activities.