Ombudsman – Round Table. Current Issues with the NDIA
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Lack of support for people with disabilities and their families Many people are not informed that they have transitioned to the NDIS. They don’t know how they can use their plans, or how they should read and understand the different elements. Participants often only have a minimum of support coordination, and a lot of support coordinators are not sure of their responsibilities. Some people aren’t even informed that they have support coordination or plan management, and supports just continue, without the correct systems being set up for months.
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Rush of implementation no quality Most plans that return from the NDIA need to be reviewed - how does the NDIA measure how many plans are returned immediately, as the plans do not match a person’s reasonable and necessary supports?
Rather than preparing people with disabilities for the planning process and developing an appropriate plan the first time, NDIS staff rush through the first plan (possibly to meet their KPIs). The participant then needs to put in a request for review, in order to receive the appropriate funding.
- Lack of Communication from the NDIS: People transition to the NDIS, providers are not informed until invoices to the previous funding provider (usually state) are returned. Providers then need to chase up support coordinators or people responsible to approve documentation so that we can claim through the portal. This at times can take several months, as support coordinators are holding back approval for documentation, which results in providers providing supports and not being paid for these (some clients with 24/7 supports not claimed for more than 3 months).
The NDIA places more and more expectations on providers. Providers are supposed to:
- Prepare their existing clients for the transition to the NDIS.
- Support clients once they have moved to the new scheme
- Explain the NDIS plan and what the participant can actually ‘purchase’ with the funds
- Ensure that the participant gets the most value for money
- Provide quotes, property profiles, etc. (SIL)
- Take the risk of vacancies that are not funded (SIL) This and more is expected from providers by the NDIA. Providers have historically taken on the role of many supports above, but the funding was more adequate. The NDIA is requiring providers to cut overheads to an absolute minimum, at the same time not providing the systems or communication for this to happen. Providers are not informed if a person’s plan changes (and automatically the service bookings relating to the plan). The provider only finds out, because claims are rejected. There is no communication from the NDIA and no information why these are rejected, so the provider needs to invest time and resources to investigate.
- Lack of procedures, guidelines, processes (support for small service providers): There is barely any information from the NDIS. The provider toolkit is not sufficient and only captures a minimum of information. You can’t hold people accountable, as the NDIS doesn’t have policies and procedures to refer to (i.e. issue with support coordination above).
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THE PORTAL, THE HOTLINE, THE CUSTOMER SERVICE!!!!! (no more words needed)
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Service Bookings Not enough information from the NDIS (e.g. through workshops, videos, ‘how to do them’ documents). The information in the provider toolkit is insufficient and incorrect for service bookings – it even has a section on how to change them. PROVIDERS CANNOT CHANGE A SERVICE BOOKING! The NDIA doesn’t consider people changing their mind? Does the NDIS expect that organisations employ dedicated service booking staff, who don’t do anything else? There is a significant increase in admin costs due to the NDIA’s impractical system, even though service providers are supposed to cut overheads due to the tight margins of the set prices.
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Inconsistency of plans There is no consistency in the plans that are returning from the NDIS. The plans often don’t seem to actually cover a person’s needs. The plans often include things that the person never addressed or asked for (e.g. incontinence aids for people who are continent, home modifications or equipment for people who never asked for that and also don’t need any, etc.), or lacks crucial information of a person’s disability (e.g. no mention of a person having a prosthetic leg and having funding allocated to this).
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Lack of approved Specialist e.g. only having 3 approved OTs in the Sydney area – people having assessments denied, because they used a NDIS registered OT only, and not an approved one. NDIA changing the rules, without information registered OTs, so OT provide the assessments and services, and are not being able to be paid for these.
Lengthy waiting lists – over 3 months, to get the appointment for the assessment only. In the meantime, participants might be able to return to their home, but this is being delayed because the person is still waiting for the modifications.
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No provision for nursing support (for medical needs resulting from the disability) The NDIA is and the Health Department are currently negotiating funding responsibilities. NDIA is cutting necessary supports for NDIA participants, while these negotiations are taking place. E.g. people with disabilities previously received service for crucial and life saving supports by registered nurses. These supports are cut from participants’ plans, despite the promise of the NDIA to continue previous or existing services. There are no alternative services funded at the moment, and while the NDIA and the Health Department are undertaking their negotiations, people’s medical needs significantly worsen, due to lack of funded support available.
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Respite services ‘Respite’ or short term accommodation is so poorly funded (it does not cover the costs of a provider to offer these services on weekends), that service providers are closing their short term accommodation facilities, leading to families having to permanently place their family members into supported accommodation. (this issue has been raised for a long time and has now been raised in the media).
Summary:
The intention behind the introduction of the NDIS seems to have been forgotten during the implementation and full roll out of the scheme.
People with disabilities were to have more control and choice in their lives (and yes, inherently this will be the case, as the funding is directly linked to a person and supposedly individualised to their needs), but poor implementation, lack of resources, lack of training, knowledge and understanding by NDIA staff, have taken the focus off these great intentions and left many people involved disappointed, angry, confused and worse off.
Everyone is aware that this is one of the biggest changes in the sector and possibly comparable to the implementation of Medicare. The actual scheme is not in question; it was way overdue and absolutely necessary to have an overhaul of the disability sector. However, how could it be allowed to be implementation so poorly?
The scheme was introduced for people with disabilities, who at times form part of the most vulnerable group of our society, so how could the NDIA implement this long needed scheme so poorly that it leads people with disabilities and their families to be even more vulnerable, confused, and disappointed than before?
There are many ‘great news stories’, and they show what can be possible for someone under the NDIS. Most of the times, these stories are about people though, who have strong informal supports and networks around them, which were able to support them through this mammoth change.
What happens to the people who don’t have those supports in their life? To the ones that often fall through the cracks and often don’t know that they actually have a right to receive supports? The people that don’t dare to speak up for themselves and request things?