Submission by Ballarat Community Health
JOINT STANDING COMMITTEE ON THE NDIS
The provision of services under the NDIS for people with psychosocial disabilities related to a mental health condition
Ballarat Community Health (BCH) promotes health and wellbeing in the community and provides quality and affordable health care. BCH is a company limited by guarantee, registered under the Corporations Act 2001 that delivers a broad range of integrated primary care programs. The annual operational budget is $13,600,000. BCH is a not for profit organisation and a social enterprise that employs 170 staff.
BCH is governed by a Board of Directors drawn from the membership. There are three committees; Finance and Audit, Governance and Strategic Development.
Services are provided across 5 sites in Ballarat to allow better access to GP Clinics, Sexual Health, Community Health nursing and services including diabetes management, dietary counselling, smoking cessation, exercise and fitness, counselling services, alcohol and other drugs services, youth services, podiatry, health promotion and mental health services. BCH is the lead agency for headspace Ballarat and is a provider of care coordination in the Grampians Partners in Recovery program in the Central Highlands area of Victoria
Ballarat Community Health welcomes the opportunity to contribute to the committee’s enquiry. We provide the following comments from our 23 years’ experience working with people with mental illness and as a member agency in the Grampians Partner in Recovery Program. These services are provided in a regional city and surrounds in Victoria.
BCH acknowledges and supports the intent and principles inherent in the NDIS, our comments are reflective of the issues identified in the implementation of the NDIS which commenced in our area in January 2017.
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
Ballarat Community Health is accredited against the National Mental Health Standards and we employ experienced mental health clinicians who are able to engage and support people with severe and persistent mental illness in the community. Our vision is to empower our clients and connect them with the community. This requires respect for the client and their support people and a high level of skill and expertise in understanding the behaviours and consequences of severe and persistent mental illness.
The Grampians PIR client demographic profile for the six months 1 July 2016 – 30 December 2016 illustrated that
31% of the clients lived alone 65% had no carer and 95% were not working (either unemployed or not working in the labour force).
As a PIR agency we welcomed the opportunity to work, as a commonwealth funded service, alongside the Local Area Coordination Service to plan, and transition our clients to the new service. Our expectation, as per our PIR contract, was that we would be able to provide continuity of care as the care coordination provider for these vulnerable members of our community. Our experience to date is that
The LAC is communicating that they will be the only service coordination provider and clients will have limited choice and control on this issue. There is a risk of clients losing their support and links to agencies (continuity of care) and the therapeutic and trusted relationships with key workers The LAC does not have the capacity, the skills or experience to support clients with enduring mental illness in the community. This includes functions such as outreach and advocacy and attending care coordination meetings
The current LAC approach in the Central Highlands does not reflect a deep understanding of mental health, the client group and their carers.
The eligibility criteria for the NDIS for people with a psychosocial disability
There is discrimination and stigmatism associated with mental illness. Access to NDIS is reliant on evidence of permanent disability and this does not support recovery. That the eligibility process does rely on participants accessing MyGov, the Portal and using I.T. skills that they do not have (or lack confidence with) is further isolating and will ensure many do not commence or proceed with NDIS. Costs for assessments that provide evidence of the disability are also a barrier for this group.
The planning process
BCH is concerned that our agency is at risk of losing essential skills and expertise that are required to support people in our community and their recovery journey. Currently PIR Facilitators have flexibility in their approach to people with severe and persistent mental illness. This allows for the episodic nature of mental illness and engagement on the client’s terms rather than a rigid plan that is only reviewed on an annual basis. The annual plan approach does not support the episodic nature of mental illness and does not build in supports to intervene early and prevent relapse.
The transition to the NDIS of all current long and short term mental health state and territory government funded services, and in particular; whether these services will continue to be provided for people deemed ineligible for the NDIS
Our understanding is that Victorian funded community managed mental health services will no longer be funded in Victoria, in a staged process as client’s transition to the NDIS. This means that there will be less state funded support for this client group including those who are ineligible or those who are eligible but are unable or unwilling to access the NDIS. It is also difficult to identify pathways (other that acute services) for people who are new to the mental health sector, or have recently become unwell or relapsed in the community. BCH would advocate for continuing community based mental health services in some form to provide supported entry points into care as well as ongoing advocacy and support.
Jane Measday
General Manager Social Support
Ballarat Community Health
26 February 2017