NDIA Accountability Project

Submission regarding NDIS legislation and service delivery

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Submission to

The Senate Standing Committee on Community Affairs Legislation Committee in response to the Inquiry into the National Disability Insurance Scheme Bill 2012

By the Australian Association of Social Workers January 2013

                                © Australian Association of Social Workers
                                                                  National Office – Canberra
                                                                    Level 4, 33-35 Ainslie Place
                                                                Canberra City, ACT 2600

                                                     PO Box 4956
                                                                              Kingston, ACT 2604
                                                               T 02 6323 3900
                                                               F 02 6230 4399
                                                   E advocacy@aasw.asn.au
                                                                  www.aasw.asn.au

                                              Enquires regarding this submission can be directed to:

                                                Senior Manager, Social Policy and Mental Health:
                                                                         Stephen Brand

                                            AASW Chief Executive Officer:
                                                                         Glenys Wilkinson

Introduction

Thank you for the invitation to provide feedback on the National Disability Insurance Scheme 2012 Bill. Through this response the Australian Association of Social Workers (AASW) comments on:

  • the NDIS Bill itself;

  • the NDIS eligibility requirements; and

  • implementation issues.

This response is informed by the AASW’s Position Paper on Disability (Attachment 1) and its submission to the Productivity Commission on the draft Report on the Disability Sector (Attachment 2). Included in these papers is a description of the social work profession.

The National Disability Insurance Scheme (NDIS) Bill 2012

The objects and the principles expressed in the Bill are sound and are consistent with a number of values and aspirations of the Social Work profession. Apart from a much-needed facilitation of access and consistency of service provision, NDIS also has the potential to enable some people with significant disabilities to remain in the community rather than be prematurely accommodated in residential care.

It is pleasing to read that the NDIS Bill recognises the inherent dignity of people with a disability and their need for autonomy by stipulating their central role in making decisions about their goals, the support services they require and in managing the NDIS funds, where able to do so. The provisions to safeguard the interests of children and those who may require assisted decision-making are also appropriate.

The NDIS legislation states it is intended for people with a permanent disability, which results in ‘substantially reduced functional capacity’. Among other objectives, it aims to support the independence and social and economic capacity of people with a disability. By focussing on this group across the nation, NDIS could simplify service access for people with disabilities.

One important way of achieving this is for services provided by registered support agencies (identified in ‘participant plans’) to avoid repeating assessments of the kind planned to be undertaken by the NDIS Launch Transition Agency. At the moment, service providers often conduct similar assessments to those already undertaken by referring agencies, thereby duplicating processes and creating barriers to service delivery. The NDIS Launch Transition Agency is in a position to negotiate the suite of intake and assessment tools that are essential to their role and agreed as sufficient by support provider agencies. (This does not apply to the more specialised assessments used in support provider agencies.)

The AASW has identified three main areas of concern regarding the NDIS legislation, two being in sections of the Bill.

  1. Lack of Transparency in Meeting Specified Timelines The first concern relates to Section 20 where the CEO can either decide an access request or seek further information within 21 days of the request being lodged. This places the onus on the Agency to deal with requests expediently. Similarly Section 26 requires that the further

Eligibility of People with a Disability for NDIS

Although the government has estimated the number of people who are likely to participate in the first stage of NDIS and the accompanying budget allocation, it is not clear if NDIS is anticipated to be an uncapped program. The limits signalled in the legislation appear to be centred on the person having a permanent ‘substantially reduced functional ability’ and the intention by NDIS to provide ‘reasonable and unnecessary services’. This gives rise to questions, including:

  • What constitutes ‘substantially reduced functional ability’?
  • Will there be threshold criteria or a prioritisation of access to NDIS?

What are ‘reasonable and necessary services’?

What happens to people with a disability who are not eligible for NDIS? The first three points may be covered by the rules to be developed by the NDIS Agency. The final point is raised because the objects and principles of the Bill appear to refer to all people with a disability. At the moment there are vulnerable groups that could be at risk of being excluded from NDIS or given low priority due to the absence of family or other formal advocates. One example refers to the residents of private, pension-level supported residential accommodation and some types of boarding houses. These compromised settings often house adults with Acquired Brain Injury, mental illness and other forms of disability. Residents use most, if not all, their Disability Pension in fees, leaving little or no capacity for social and economic participation. Another example is the small proportion of people aged over 65 years presently in receipt of disability services and often residing in group homes. The legislation is unclear as to whether they will be eligible for NDIS. This ambiguity should be rectified and provision be made to enable them to continue receiving disability services until such time as the more intensive care and services offered by residential aged care are required. It is understandable that the new Bill confines itself to the legislative requirements. However the NDIS Bill, rules or policy should underscore the importance of the Agency and disability, mental health and aged care services in other jurisdictions working together with people who are on the interface of their systems.

Implementation of NDIS No doubt experiences in the launch sites will provide valuable information in regard to implementation. Among the implementation issues that need to be planned for and monitored are:

 - managing transition from block funding to individual funding packages without threatening the viability and sustainability of the current service system;

 - assessing the impact of the new funding arrangements on the workforce – increasing casualisation, with the attendant risks of not attracting qualified staff or investing in professional development;

 - potentially losing useful group programs or collective responses due to individualising the funding arrangements;

 - responding to the needs of people with a disability and the issues of ageing;

 - avoiding a possible reluctance for registered support providers to share knowledge and experience in a competitive environment;

 - the diversion of funds to marketing rather than service provision in order to attract the greatest number of clients and ensure service provider viability.

From a social work perspective, service delivery should balance the need for greater client choice and autonomy with a co-operative, system improvement approach. In its April 2011 submission to the Productivity Commission on their draft Report on the Disability Sector (see Attachment 2), the AASW noted that market forces may not ensure the elimination of shortcomings in service quality,

Conclusion

In summary, the AASW endorses the NDIS for:

  • recognising people with disabilities’ rights to be self-determining;

  • ensuring access to resources for people with disabilities and their families;

  • committing to facilitate innovation, research and best practice.

However, the AASW encourages the Commonwealth government to consider:

  • clarifying of meaning of key terms, particularly ‘substantially reduced functional ability’ and ‘reasonable and necessary services’;

  • modifying the content of sections 21, 104 and 105 to be more transparent and respectful of people with a disability or at a minimum allowing the CEO more discretion in their interpretation;

  • being responsive to the local circumstances of people with a disability in terms of costs and funding allocations;

  • monitoring access to NDIS by vulnerable, marginalised groups;

  • monitoring the impact of the NDIS on the disability, mental health and aged care service sectors and any flow-on effects to people with a disability.

Thank you again for the invitation to comment on the NDIS Bill.

Submitted for and on behalf of the Australian Association of Social Workers Ltd

Glenys Wilkinson Chief Executive Officer