Submission 72 — Queensland Government — Transitional arrangements for the NDIS | External submission

Joint Standing Committee

on the National Disability

Insurance Scheme (NDIS)

inquiry into Transitional Arrangements for the NDIS

Queensland Government

submission

Table of contents Table of contents ………………………………………………………………………………………………… ……2

Introduction ……………………………………………………………………………………………………….. 3
Transition experience in Queensland …………………………………………………………………….. 3
Queensland’s transition framework ……………………………………………………………………….. 5
Investment in participant and provider readiness ……………………………………………………… 6
Investment in workforce readiness ………………………………………………………………………… 6
Boundary and interface issues between the NDIS and other parties …………………………… 7
Consistency of NDIS planning process and plans ……………………………………………………. 9
Planning and delivery of NDIS for participant cohorts ……………………………………………… 10 Aboriginal and Torres Strait Islander peoples ………………………………………………………… 10 People living in rural and remote areas …………………………………………………………………. 11 People living in inappropriate settings …………………………………………………………………… 11 People who are homeless …………………………………………………………………………………… 12 People with psychosocial disability ………………………………………………………………………. 12 People with complex needs, including children, and those with newly acquired injuries … 12 People from culturally and linguistically diverse (CALD) backgrounds ……………………….. 13 Housing …………………………………………………………………………………………………………… 14
The rollout of the Information, Linkages and Capacity Building (ILC) Program ……………. 14
Conclusion ……………………………………………………………………………………………………….. 15 Page 2

Introduction The Queensland Government submission to the Joint Standing Committee on the National Disability Insurance Scheme (NDIS) inquiry into transitional arrangements for the NDIS should be read in conjunction with the Queensland Government submission to the Productivity Commission’s June 2017 Position Paper (Attachment 1). As the Productivity Commission’s June 2017 Position Paper notes, the scale, pace and nature of the changes being driven through the NDIS are unprecedented in Australia. Queensland’s responses in relation to transitional arrangements for the NDIS are intended to highlight issues as part of constructive discussion on opportunities to improve the scheme’s implementation.

It has been prepared in consultation with the following agencies:

Department of Aboriginal and Torres Strait Islander Partnerships
Department of Communities, Child Safety and Disability Services (DCCSDS - lead agency coordinating Queensland’s transition to the NDIS)
Department of Education and Training
Department of Health
Department of Housing and Public Works
Department of Justice and Attorney-General, including Office of the Public Trustee1
Department of the Premier and Cabinet
Queensland Treasury.

Transition experience in Queensland Queensland acknowledges that the NDIS is a complex and highly valued national reform. Queensland agrees that, if implemented well, the NDIS will substantially improve the wellbeing of people with disability and Australians more generally.

Queensland’s response to the Productivity Commission’s position paper supports the proposal to reconsider the staffing cap on the National Disability Insurance Agency (NDIA), as more staff will enable the agency to progress the implementation of the scheme as intended.

The Queensland Government is an active partner with the Commonwealth Government and the NDIA in the rollout of the NDIS – at the national policy level as well as at the state and local levels.

Slower than anticipated transition Unfortunately, the NDIA has transitioned significantly fewer Queenslanders to the NDIS than the bilateral agreement’s estimates, which estimated a total of 14,966 people would enter the scheme in the first year.

By 30 June 2017, a total of 12,334 Queenslanders had entered, or were engaging with, the NDIS, including:

7,249 Queenslanders in the NDIS with approved plans
A further 1,342 people who are in the planning pipeline
3,382 who have an access decision in progress
1 The Office of the Public Guardian and Office of the Public Advocate are making separate submissions to the inquiry. Page 3

254 children who are in the NDIA’s Early Childhood Early Intervention stream. Of the 7,249 participants with approved plans, 5,390 people, or 74 per cent, were existing clients of the state’s disability services; Queensland notes its bilateral agreement estimated that only 47 per cent of participants would be existing clients of the state. These figures also reveal that existing Queensland participants are transitioning into the NDIS at a higher rate than the other large states. Even so, the 7,249 participants with approved plans represented only 48 per cent of the 30 June 2017 bilateral estimate.

These numbers demonstrate a slow transition to the NDIS by new people and Commonwealth Government existing clients. While Queensland acknowledges that new participants are entering the scheme at their own time and pace rather than in line with the bilateral estimates, only 1,859 or 26 per cent of year one participants with approved plans were new and Commonwealth Government participants (against an expected 53 per cent).

Queensland has worked consistently with the Commonwealth Government and the NDIA to improve transition rates, including assisting the NDIA to resolve data management issues, assisting existing clients to transition and by seconding DCCSDS staff to the NDIA to enable Local Area Coordinators (LACs) to be available to support potential participants with pre-planning. The Queensland and Commonwealth Governments also agreed to bring forward the transition commencement date in Ipswich to May 2017, Rockhampton to November 2017 and Bundaberg to September 2017 – in order to transition 1,150 existing clients sooner than planned.

Slow commissioning of Local Area Coordination

The terms of Queensland’s bilateral agreement requires NDIS LACs to commence in locations six months prior to transition. To date, this has not occurred in the transition areas in Queensland. As a result, participants have not been well prepared during their pre-planning, and a significant lag in new participants entering the scheme has been experienced. Queensland understands the NDIA Board is considering ways to improve this in Queensland.

Given Queensland is now in its second year of transition, delays in establishing this critical support infrastructure at least six months in advance of each of the upcoming phasing areas will be an unacceptable risk.

During the 2016-17 transition period, Queensland supported the NDIA with continued staff secondments as well as the filling of four NDIA LAC positions with staff from DCCSDS. In 2017-18, 29.5 departmental LAC positions will continue to support people with disability in local areas that are yet to transition.

NDIA’s data management process Queensland provided the NDIA with data which met the NDIA data standard. Over the period of transition, there have been ongoing issues with how the NDIA has used and uploaded the data. These include:

incorrectly loading data that Queensland provided for modelling purposes only
changing the data standard on two occasions requiring Queensland to reformat and resend data.

Queensland assisted in resolving these issues by making direct contact with clients at a local level to help people make access requests to the scheme.

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Queensland’s transition framework The Queensland Government NDIS Operational Plan (operational plan) identifies a program of work and the responsibilities of the Queensland and Commonwealth Governments and the NDIA during the transition to the NDIS. The operational plan addresses the bilateral agreement and its 11 supporting schedules.

Risk Framework

The Queensland NDIS Reform Leaders Group (RLG), established in June 2014 and comprising Directors-General of Queensland Government agencies impacted by the transition to the NDIS, has responsibility for leading Queensland’s preparation and transition to the NDIS. The RLG is the key decision-making governance mechanism and assists in setting priorities and overseeing the development and implementation of whole-of-government plans and activities for Queensland’s transition to the NDIS. The RLG focuses on the management and resolution of strategic issues across government in relation to transition. These issues are monitored and treated through Queensland’s Risk Framework.

The risk framework identifies key risks associated with Queensland’s transition to the NDIS. The risk framework describes the high-level risk for participants, providers and workforce, and for government and mainstream services. The risks are described and the treatments or mitigations detailed with each given an effectiveness rating. The primary purpose of managing risks through transition is to ensure the benefits of the NDIS are realised for Queenslanders with disability.

Governance

To manage risks that might arise during transition, the Queensland Government has established governance mechanisms to ensure all Queensland Government agencies are engaged in NDIS planning and preparation and supporting staff and clients during transition. The Queensland Government works in close partnership with the Commonwealth Government and the NDIA on the implementation of the NDIS in Queensland.

In addition to the national governance bodies, Queensland-specific governance arrangements include:

Queensland Trilateral Steering Committee, comprising Chief Executives or their delegates from the Queensland and Commonwealth Governments and the NDIA - oversees the Bilateral Agreement between the Commonwealth and Queensland (bilateral agreement)
Queensland Transition Steering Committee, comprising senior representatives from the Queensland and Commonwealth Governments and the NDIA - ensures transition planning and implementation is managed effectively across Queensland and in line with the bilateral agreement, operational plan and other agreed frameworks
Regional Operational Steering Groups, comprising representatives from NDIA, DCCSDS and DSS - responsible for the operational and administrative arrangements of each phasing location. Additional representatives are invited as required.

The RLG mentioned above is an important component of Queensland’s governance arrangements.

In 2014, the Whole-of-Government NDIS Implementation Program Management Office (PMO)

was established within DCCSDS to coordinate the transition to the NDIS across Queensland Government departments.

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Website

DCCSDS provides online information and resources via the Queensland NDIS website – www.communities.qld.gov.au/ndis. The website contains information and resources for Queensland participants, providers and businesses, including an online calendar of readiness information and events for participants and their families and carers, providers and workforce, including in rural and remote communities; jobs and career information; rollout schedule; quality and safeguards during transition; frequently asked questions; fact sheets; brochures; videos; business development resources; and up-to-date news.

Investment in participant and provider readiness Between 2014-15 and 2016-17, Queensland provided $10.87 million to deliver the participant readiness initiative. Activities undertaken include information sessions, home visits, telephone support and online information to help people with disability and their families find out about the NDIS in Queensland and prepare for when the NDIS comes to their area. The initiative delivered upwards of 1,900 workshops to more than 25,700 attendees. In 2017-18, Queensland will provide $2.2 million to continue the initiative in locations still to transition to the NDIS.

In 2016-17 and 2017-18, Sector Development Funding (SDF) of $1.5 million will enable the delivery of targeted strategies to assist hard-to-reach people with disability to engage with the NDIS, including Aboriginal and Torres Strait Islanders, people from culturally and linguistically diverse backgrounds and people experiencing social isolation.

Since 2013, Queensland has allocated $5 million for provider readiness activities to build the capacity of the sector to understand and prepare their business for the NDIS market-based approach and adapt their service models. The provider readiness activities have resulted in the development and implementation of business development tools and the delivery of more than 130 workshops and 180 one-on-one coaching sessions across Queensland. In 2016-17, 80 per cent of one-on-one business coaching was conducted with small and medium-sized service providers. In 2017-18, funding will support a further 70 workshops and 60 days of one-on-one coaching. The funding will continue in 2018-19.

In 2014-15, 2016-17 and 2017-18, the provider readiness activities were augmented with a total of $2 million from the SDF to develop tools and resources to assist providers to understand the market and respond to consumer demand; and build community response and service provider capacities in areas with thin markets, including rural and remote locations, discrete Aboriginal and Torres Strait Islander communities and for people from culturally and linguistically diverse backgrounds.

Investment in workforce readiness Queensland considers that the workforce constitutes one of the biggest risks of the rollout of the NDIS and, in its submission to the Productivity Commission’s Position Paper, calls for national workforce infrastructure and governance as part of the Commonwealth’s oversight role of workforce development policy, noting that investment, infrastructure and governance should be commensurate with the level of risk generated by the workforce element.

As noted in Queensland’s submission to the Productivity Commission’s Position Paper on NDIS Costs (Attachment 1, pages 15-16), Queensland has actively pursued strategies to ready the workforce in this state. Notably, Queensland has invested $2.8 million to establish

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WorkAbility, a consortium of four Queensland industry peak bodies2 to drive the expansion and diversification of the Queensland workforce over the transition years, by engaging, attracting and connecting people to jobs in the sector. Links to information about the WorkAbility strategy are provided for reference: http://workabilitityqId.org.au/about; and http://workabilityqld.org.au/wp-content/uploads/2016/04/Fact-Sheet-NDIS-NGO-Workforce Strategy.pdf.

In 2015-16, DCCSDS made an initial investment of $1.03 million to a sector consortium to enable the implementation of the Queensland NDIS Workforce Strategy (WorkAbility Qld) and delivery of statewide and local initiatives to build workforce supply and capability to meet demand under the NDIS. This work continues in 2016-17 and 2017-18 with $2.8 million Commonwealth NDIS Sector Development funding.

Boundary and interface issues between the NDIS and other parties In December 2015, the Principles to determine the responsibilities of the NDIS and other service systems (the Principles) were agreed by the Council of Australian Governments (COAG); the Principles also constitute Schedule I of Queensland’s bilateral agreement. During transition it has become evident that different interpretation of the Principles is resulting in individual plans not including supports that Queensland considers should be included. This is most evident in relation to health supports, but also transport assistance and education support.

Health supports Queensland’s submission to the Productivity Commission’s Position Paper identified specific health interface issues emerging around wound care, medication management, catheter management, percutaneous endoscopic gastronomy (PEG) feeding, mealtime management and home modification assessment, where the NDIS will not fund services, even though the need for those services arises only because the person has a disability (Attachment 1, page 9). Work is occurring at the national level regarding these interface issues; however, the state has had no option but to establish interim short-term arrangements to ensure participants’ needs are met. This is not a sustainable approach.

There remains a lack of clarity around NDIS supports offered to people with psychosocial disability in extended treatment and rehabilitation residential settings. These clients need to simultaneously receive NDIS and mental health services to build skills to transition to community living. Similar issues in relation to effective planning for people moving from mental health, youth justice or prison facilities into the community are also arising. These individuals require supports to be available immediately when they move from the facility. Planning must commence before they leave the facility. Feedback indicates there are different processes in different areas that either facilitate or create barriers to this early planning.

In addition to these specific health interface issues, interface issues are emerging in relation to service provision for young people with very high and complex care needs, delayed access to amputee limb services and a lack of clarity regarding interface, roles and boundaries of service provision for forensic order and forensic disability clients.

2 Consortium members: Health and Community Services Workforce council; National Disability Services (aid); Community Services Industry Alliance; Queensland Council of Social Services.

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Transport assistance Specialist school transport: school transport for students is an NDIS responsibility under the Principles. Queensland and the NDIA have been unable to agree on administrative, operational or in-kind arrangements for the delivery of specialist school transport. This issue is not unique to Queensland. Bus operators are seeking information about future plans for school transport under the NDIS, and the availability of capital funding for bus replacement.

Queensland is participating in a Senior Officials Working Group sub-group formed to consider a sustainable model for specialist school transport in the market environment of the NDIS. This includes determining the appropriate share of responsibilities for this system, consideration of moving from block funding to individualised funding, how different arrangements will transition to the scheme and addressing quality and safeguards issues. The Queensland Government has agreed with the NDIA that current school transport arrangements will continue during transition to December 2019. Contracts with operators are being aligned to this date. Queensland Catholic Education Commission coordinates specialist school transport for non-state school students.

Taxi Subsidy Scheme: under the Principles, the NDIS is responsible for the reasonable and necessary costs associated with the use of taxis or other private transport options for eligible participants who are unable to travel independently. Concerns have been expressed by participants who formerly accessed Queensland’s Taxis Subsidy Scheme, as well as by disability advocates, carers and the taxi industry, that the transport supports provided in NDIS plans do not meet participant needs.

On 28 March 2017, the Federal Court of Australia (Federal Court) issued its decision in the matter of McGarrigle v NDIA [2017] FCA 3 ,where it was asked to consider the issue of ‘reasonable and necessary’ in relation to the provision of transport supports in an individual’s NDIS plan. On 21 August 2017, the Full Federal Court dismissed an appeal by the NDIA so it can amend the grounds of its appeal to include new grounds not previously argued. The actual decision in Mr McGarrigle’s case has been referred back to the Administrative Appeals Tribunal. This decision is likely to have a significant impact on the way taxi usage is considered both in participants’ plans and by the NDIA.

On 15 July 2017, the Queensland Government announced it will reinstate the Taxi Subsidy Scheme for NDIS participants until transition is completed in June 2019. Queensland is proposing to the Commonwealth that the associated cost to Queensland is treated as an in-kind contribution to the NDIS.

Education

Personal support in schools: the section covering Personal Support in Schools remained unfinished when the Principles were approved by COAG in December 2015. It was agreed this complex area would require substantial discussion in the future. These supports are managed differently in each jurisdiction. In addition, Principals in each state school in Queensland determine whether or not support workers are able to enter the school environment during school hours. Issues requiring resolution are around child safety, workplace health and safety, and the availability of space in some schools. Queensland is participating in a national working group to finalise this element in the Principles.

Third party providers in schools: there has been increased demand for NDIS-funded therapy provision to students during school hours on school grounds. The NDIS Applied Principles and Tables of Support (APToS) for Education states that ‘the NDIS is responsible for funding and coordinating allied health and other therapies to support a student’s functional capacity,

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including those which may be delivered during school hours as negotiated with the school, for non-educational purposes’. The APToS for Education also states that ‘any funding arrangements for individual students will recognise the operational requirements and educational objectives of schools.’

For most schools, requests for NDIS funded therapists to deliver services to students during school hours on school grounds come from the parent and are managed at the school level. Schools have always managed these types of requests but the advent of several Medicare-funded programs and the NDIS, have triggered an increasing number of direct requests from parents and private providers to deliver services to students during school hours on school premises.

In Queensland, Principals, in consultation with parents and the school community, make decisions about the provision of external services, such as psychologists, speech language pathologists, occupational therapists, sporting coaches, tutors, and music teachers, who are not Queensland government employees. Decisions are made on a case-by-case basis considering the range of factors in relation to the best interests of the child and the good order and management of the school. Principals must consider disruption to a student’s educational program; student safety; and compliance with legislation and procedures, including the school’s duty of care and privacy and confidentiality of personal information.

There needs to be consistent messaging agreed by the Education sector and the NDIS in relation to the interpretation and application of the APToS regarding NDIS-funded therapy being delivered to students during school hours on school grounds. This is critical to ensure that schools are able to focus on the core business of teaching and learning.

Consistency of NDIS planning process and plans In 2016, Queensland took part in the independent review of the NDIS participant pathway, and identified the following issues impacting on the planning process for Queenslanders.

During Queensland’s transition, the quality of individual plans has varied depending on:

the client’s capacity to describe their support requirements
the availability of advocacy and/or other support for participants both to pre-plan and during the meeting
relevant knowledge and expertise of the planners to engage with a person with a particular disability
knowledge and expertise of the final NDIA plan approver. Participants report the planning process took longer than expected and they had difficulty activating supports in their plans. People with psychosocial disability and Aboriginal and Torres Strait Islander participants have found it difficult to navigate the access pathway, and have experienced difficulty with the telephone planning process, which may affect their access choices and participation.

Queensland’s submission to the Productivity Commission’s Position Paper highlighted the need for planners to be appropriately qualified, have an understanding of disability and a focus on functional impairment. Queensland considers specialised planning teams should be established for different types of disability (such as psychosocial disability) requiring specialist knowledge (Attachment 1, page 8).

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There have been cases where participants’ first plans did not consider imminent changes to their circumstances. For example, plans for people in hospital but who are to be discharged at a defined date only reflected the supports the person required in hospital, not the supports they would require when living in the community. These people were expected to request a review of their plan, leading to delays in discharge. This has had particular impact on Aboriginal and Torres Strait Islander participants, many of whom have to travel to major regional centres to receive services, and may have to remain in those centres for considerable periods of time following hospital discharge, to enable the provision of continuing or follow-up services by health providers.

There are instances where participants have sought a plan review which has resulted in a reduction in funding for categories that were not part of their requested review. For example a participant who sought a review due to assistive technology not being included in their plan, reported their reviewed plan included a significant reduction in core supports.

Planning and delivery of NDIS for participant cohorts The following groups are at risk of disadvantage resulting from systemic issues in the planning process: Aboriginal and Torres Strait Islander peoples, people from culturally and linguistically diverse (CALD) backgrounds; people living in rural and remote areas; people with high and complex needs, including children; people with psychosocial disability; and people with newly acquired injuries.

Factors contributing to potentially poorer outcomes are issues in the planning process, including varying knowledge of planners; a focus on transitioning people into the scheme quickly, thereby compromising planning; lack of culturally appropriate supports; lack of access to LAC community capacity building and pre-planning supports; limited service options; and the need to travel long distances to access NDIS planners.

Aboriginal and Torres Strait Islander peoples

The NDIA has developed strategies for Aboriginal and Torres Strait Islander and rural and remote communities to support quality engagement and service delivery. Queensland’s participant readiness initiatives, augmented by Sector Development Funding, have increased the rate of participation of Aboriginal and Torres Strait Islander people over the last two quarters, particularly in North Queensland. Aboriginal and Torres Strait Islander peoples represent 4.22 per cent of Queensland’s population3 and now represent 9.5 per cent of Queensland NDIS participants with approved plans4.

Issues which may need specific consideration include thin markets of locally based NDIS service provision in rural and remote communities; compromising choice and control available for participants; the need for a broad range of communication strategies to target families who identify as Aboriginal and/or Torres Strait Islander; and identification of children who identify as Aboriginal and/or Torres Strait Islander with developmental delay or disability.

Under the terms of the NDIS bilateral agreement, LACS are required to be in place in locations six months ahead of the transition commencement date; however, a longer lead-in time (nine months) would be beneficial to ensure effective engagement in rural and remote areas and

3 3238.0.55.001 - Estimates of Aboriginal and Torres Strait Islander Australians, June 2011 Australian Bureau of

Statistics, June 2011

4 National Disability Insurance Scheme COAG Disability Reform Council Quarterly Report, Table E11, page 75,

National Disability Insurance Agency June 2017

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Aboriginal and Torres Strait Islander communities. Refer to Queensland’s submission to the Productivity Commission’s Review of NDIS Costs Position Paper (Attachment 1, page 9).

In Aboriginal and Torres Strait Islander communities, the employment of appropriate Aboriginal or Torres Strait Islander people (male and female) by the NDIS, would facilitate the integration of NDIS into the community and is likely to lead to improved outcomes for clients. In these communities, close relationships with existing, trusted services is also essential for engagement with potential clients and to support their participation in NDIS.

People living in rural and remote areas People with complex needs, including prescription for specialised adaptation to aids and equipment, paediatric feeding and behaviour support require access to appropriately qualified and experienced clinicians. These are often not readily available in rural and remote areas.

In addition, there are limited advocacy supports to assist vulnerable people who may be anxious, difficult to engage, disorganised, reluctant to admit their disability (psychosocial), or who are not used to articulating their needs or life goals. These people are also likely to have difficulty in using the standard access pathway of telephone contact from the NDIA and completing an Access Request Form. This impacts on scheme access and subsequently the supports reflected in their plans.

The NDIA has developed an alternative access pathway to enable people to engage face to face with an LAC or support from local regional hubs. Queensland is working with the NDIA to identify people for whom the alternative access pathway will be most suitable.

Queensland has identified that NDIS Early Childhood Early Intervention (ECEI) partners appear to have geographical boundaries of between 200 and 250 kilometres from the ECEI providers’ base; these boundaries are negotiated with the ECEI partner during contract development.

People who live outside these boundaries are expected to travel to the nearest town that has an ECEI partner, and undertake more of the planning process via telephone. The cost and stress of travel may affect families’ decisions about whether to access ECEI. Families who are required to travel will not experience the same benefits of having the ECEI partner assess their child in their natural environment, impacting on the assessment and supports reflected in their plan.

The NDIA’s strategy for providing ECEI coverage to Queensland rural and remote areas is not clear. Queensland has not been able to obtain a map detailing existing ECEI coverage and any alternative approaches. Further information about this matter is included in the Queensland Government submission to the Joint Standing Committee on the NDIS inquiry into the provision of services under the NDIS ECEI Approach.

People living in inappropriate settings The NDIA estimated 127,000 people with disability nationally (approximately 25,000 in Queensland, based on 20 per cent of the national average) are living in inappropriate or unsustainable settings - such as health, hospital or secure (justice) settings, hostels, boarding houses or are experiencing homelessness - and are requiring a housing response.

Queensland has developed working arrangements with the NDIA to support the transition of participants/cohorts with specific transition requirements. Queensland has committed to identifying people in shared support locations up to six months prior to NDIS implementation to assist clients to smoothly transition to the NDIS. This includes people who have experienced

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incompatibility with co-tenants, where the living arrangement has broken down, or where a tenant has indicated the housing is not suitable for their needs. Further work is required to enable sharing of data with participants in other settings to achieve these working arrangements.

The NDIS National Quality and Safeguarding Framework has not fully addressed the separation of housing and support, to ensure no single organisation has control over all, or most, aspects of a person’s life. For example, a provider of a hostel or boarding house, an SDA provider or an existing group home provider could also provide supports. The separation of housing and support is a key safeguard for participants in the scheme.

People who are homeless People who are homeless will require support to navigate the access and eligibility processes of the NDIS, including obtaining necessary supporting documents. This cohort could potentially miss out on the NDIS if the NDIA does not outreach to locate and assist them gain access. Responsibility could fall back on other state service systems to assist these people to navigate access to the NDIS (beyond normal referral processes).

People with psychosocial disability Queensland provided a submission to the Joint Standing Committee of the NDIS inquiry into the provision of services under the NDIS for people with psychosocial disabilities related to a mental health commission. In addition, Queensland’s submission to the Productivity Commission’s Review of NDIS Costs Position Paper indicates there is a need for specialist planning teams or access to greater industry knowledge when developing plans for people with psychosocial disability, and a need for greater understanding of the evidence required to demonstrate eligibility (Attachment 1, page 9).

People with complex needs, including children, and those with newly acquired injuries All tertiary paediatric facilities have described delays to discharge directly attributable to the NDIS, particularly in paediatric rehabilitation services for children with severe brain and spinal cord injuries where lifelong disability needs are certain. Streamlining the access and planning processes to provide parents with greater certainty about what is likely to be approved, reducing the number of requests for clarification of need, and improving consistency of communication would reduce further stress on parents at a time when their readiness for planning is low (due to issues of grief, loss, trauma and hope for recovery).

There are also issues in planning for participants with newly acquired injuries. To better support people in hospital with newly acquired injuries, planners require specialist knowledge and to work more closely and collaboratively with health and rehabilitation services dealing with people with newly acquired disability, including those in, and recently discharged from, inpatient rehabilitation units, and to acknowledge the differing needs of this group when compared to people with long-standing disability who may be already well-established and living in the community.

These discussions should include consideration of modifying existing NDIS planning processes and timelines to ensure that people with newly acquired disability have a seamless and efficient transition from health and rehabilitation services to the community and NDIS participation.

There is a need to consider developing a shared specialist rehabilitation NDIS pathway through an improved collaborative process, which could contribute to clarifying responsibilities,

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improving collaboration and resolving interface disputes between state health services and the NDIA in this complex statewide setting.

People from culturally and linguistically diverse (CALD) backgrounds Through its Multicultural Queensland Charter, the Queensland Government is committed to ensuring Queensland is an inclusive and fair society with equitable access to services for people from CALD backgrounds.

While 12.1 per cent of Queenslanders with disability were born in non-English speaking countries5, they make up only 2.6 per cent of disability services clients in Queensland6. The NDIS is an opportunity to improve accessibility of services for all people with disability, including those from CALD backgrounds who will be new participants in the NDIS. Queensland notes that the NDIA’s CALD Strategy is yet to be finalised. The delay risks the continued underrepresentation of people from CALD backgrounds in the NDIS.

General NDIS information in languages other than English is available on the NDIS website for

Arabic, Auslan, Chinese, Filipino, French, Greek, Hindi, Italian, Macedonian, Samoan and

Vietnamese people. During the NDIS transition period, however, there has been little information or clear policy direction on whether or how people entering the NDIS can access language support.

Advocacy groups have noted some service providers have been advised that interpreters would only be available in the planning stages, while others were operating under the impression that interpreters would be funded to help the implementation of a participant’s plan.

In Queensland, non-government organisations (NGOs) funded by the Department of Communities, Child Safety and Disability Services (DCCSDS) can access interpreting services for clients through the service, Support with Interpreting, Translating and Communication (SWITC). SWITC enables NGOs to provide individuals with free access to interpreters. Language can be a significant barrier for people with disability in accessing services or information. Access to language support, particularly interpreters, as a reasonable and necessary support under the NDIS is important for the scheme to be inclusive and accessible for people with disability with limited English proficiency.

Queensland understands the NDIA is considering this issue with a view to provide NDIS participants with access to interpreting to implement their plans. Further, Queensland recommends the NDIA ensures information on the new language support arrangement is appropriately communicated to relevant stakeholders, particularly to service providers who support people from CALD backgrounds, as well as individuals with disability who require language support, their family and carers.

As an interim arrangement, the Queensland Government is varying the contract with SWITC to enable participants to access interpreting and translation services via SWITC.

5 Australian Bureau of Statistics, 2016, 4430.0 - Disability, Ageing and Carers, Australia: Summary of Findings, 2015, www.abs.gov.au/ausstats/abs@.nsf/mf/4430.0 6 Australian Institute of Health and Welfare, 2017, Disability support services: services provided under the National Disability Agreement 2015-16. http://www.aihw.gov.au/publication-detail/?id=60129559747&tab=2

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Housing

There is also a risk of inadequate supply of suitable housing for people with disability as the NDIS rolls out, particularly in rural and remote areas, placing additional pressure on all forms of state housing assistance.

Social housing is the predominant form of tenure for people with disability in rural and remote areas where the options for affordable home ownership, private rental and Specialist Disability Accommodation (SDA) may be limited.

The Queensland Housing Strategy 2017-2027 includes under its “Key Pillars” the need to develop more affordable and accessible housing. One of the key outcomes of the strategy is to ensure people with a disability are adequately supported to sustain their housing and are provided with pathways out of inappropriate settings, by taking various actions including:

supporting providers to assist people with a disability to navigate complex NDIS access and eligibility processes
advocating with the NDIA to share data with government agencies on participants’ housing needs and preferences and inform future housing solutions to meet demand
collaborating with the NDIA and disability support providers through housing and homelessness hubs to enable integrated service delivery.

Queensland considers it is critical that the NDIA shares data about participants’ short and long-term housing needs and preferences, and for the NDIA to develop a housing-specific Market Position Statement for each state and territory focusing on affordable housing and SDA. This will assist the housing sector in each jurisdiction to respond to market issues. To date it has not been possible for Queensland to obtain this type of information from the NDIA.

The rollout of the Information, Linkages and Capacity Building (ILC) Program The Queensland Government is working closely with the NDIA regarding the smooth introduction of ILC into Queensland. This includes the delivery of additional ILC provider readiness activities across Queensland in 2017-18, to prepare organisations for the ILC commissioning process that will be undertaken by the NDIA. This will include ILC readiness activities for rural and remote communities.

The Queensland Government has funded existing ILC-mapped activities at current levels through to 30 June 2019. This enables organisations to consider their options and prepare for ILC commissioning. Clear messages have been provided to these organisations that funding from the Queensland Government will cease on 30 June 2019 and that organisations must apply through the NDIA’s ILC commissioning round to be considered for ILC funding under an NDIS beyond this date.

ILC block funding will enable the provision of services that would prepare people for engagement with the Scheme and / or support some individuals to gain improved social connections and skills of independence thus reducing dependence on NDIS funded support.

The Productivity Commission’s Position Paper included a draft recommendation that funding for ILC should be increased to the full scheme amount (of $131 million) for each year during the transition. Queensland agrees with this recommendation on the proviso ILC continues to remain Commonwealth-funded, that a future review does not result in greater reliance on services not provided by the NDIS and become an impost on state finances, and that a

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proportion of ILC funding is targeted to Aboriginal and Torres Strait Islander communities. (Attachment 1, page 11).

A key focus of ILC is to build personal and community capacity so that people with disability can live ordinary lives; however, it is remains unclear as to how the ILC will link to the role of the LACs and ECEI community partners.

Given the important role LACs play in the NDIS transition, it is important LACs have local knowledge and are present in each phasing area at least six months in advance of transitioning to the NDIS. Support for families and people with disability in the NDIS transition locations is critical to ensuring their smooth and well-planned transition to the scheme.

Conclusion Thank you for the opportunity to provide a submission.

If you have any further questions in relation to the Queensland Government’s response, please contact:

Ms Helen Ferguson

Senior Executive Director

Department of Communities, Child Safety and Disability Services

(07) 3027 2401 / 0411 751 261

Helen.Ferguson@Communities.qld.gov.au

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