10498 – Health and Community Solutions

Health and Community Solutions

With the first raft of Annual NDIS Plan Reviews taking place in parts of Queensland, in my experience it is becoming clear that a framework of economic rationalisation is being applied to Planning decisions, especially high cost Plans which are no longer being approved at the State level but going to a National Reviews Team for Delegation 4 Approvals.

The emerging trend is to cut costs & raise the evidentiary requirements for requested supports to such an unreasonable level, that most support requests are being denied.

This approach fails to qualify either the needs based nor reasonable & necessary support Provisions central to the NDIS Model.

Yes all supports must represent value for money but the utilisation of purely cost drivers when making decisions about highly complex individuals pulls us back to the old capped, rationed & inadequate system of disability support Provision, where you may require 24 hours care but will only qualify for 4 as that level complies with the DSQ/NDIA’s reference package parameters, that only the NDIA are privy to.

Not needs based & NOT reasonable or necessary support.

The end result is a level of cruelty so unfathomable in finally providing needs based reasonable & necessary supports to individuals that have survived on the crumbs & insecurity of the previous system, only to come in at Review when they are experiencing quality care & stability, to pull it all out from under them because it’s ‘too costly’.

And create an environment of conflict for their own staff in the process by setting up predominantly financial systems & KPIs ensuring all planning decisions are cross referenced with other Planners, & under constant scrutiny by Supervisors & Audit teams completely removed from the experience of interacting with individuals with disabilities, so the Planners at the coalface see the impacts of the Planning decisions but are predominantly powerless in impacting such decisions due to the economic & evidentiary parameters that are now required to be met to qualify supports in Plan, they are also being open about these circumstances with Participants in Review meetings “we build the Plan & put up the evidence & the Del 4 Planners take it all out”.

Structurally the NDIA has manifested into an Uber bureaucracy that rather than empowering individuals in choice & control of their care & lives, is disempowering & dehumanising them.

This is all further compounded by the constant narrative in the media of the NDIS being underspent, why if the scheme is under budget are rigid cost drivers being introduced when they are completely incongruent with the Schemes ethos & purpose to provide individuals with disability needs based reasonable & necessary supports, that provide choice and control and citizenship in our communities?

o There are statements being made about regions that never include SC in Plans which is highly concerning as indicates an agency policy as opposed to needs based allocation
o As an SC provider I have a conflict of interest as it relates to my livelihood but it also means I come from an informed position
o There does not appear to be any logic to SC allocation, a risk framework/needs analysis?
o People with 100 hours that need 24 & people with 24 that need 200
o Participants with no SC distressed as limited capacity & Carers burnt out & overwrought
o LACs provide info & tell to do for selves
o Navigating the Ndis requires systemic understanding & extensive networks, negotiation skills, money management, high level organisational, coordination skills, time & capacity for continued follow up of Providers building capacity in the new scheme, to expect individuals with disability & or their Carers that are frequently Burnt out & overloaded to perform these tasks is completely unreasonable & unrealistic
o If a person requests SC they should be allocated, some people have capacity but not the time, or simply want to be family member, participant, not support organiser &manager
o Not listening to ppt, Carers or the sector
o Passing burden & cost of SC onto providers doing quasi SC unfunded & outside of contract setting up both sustainability, financial & suitability of care risks to the Provider
o The Policy of not allocating Support Coordination in all Plans for the first year of a new incredibly complex & confusing national reform is completely counter intuitive & illogical resulting in harm, trauma & underutilisation of Plans, just does not make commercial sense!

The NDIA have been a closed shop from day one with little if any engagement with the sector & participants in the schemes structure & development, or transparency around their tools & assessments for determining eligibility & Plan funding decisions.

The Community Services sector has been kept at arms length, due to a stated conflict of interest within a market based framework, & at times demonised for operating within an antiquated ‘charity’ model causing inefficiencies, poor quality services & waste.

There has been talk of ‘Reference Packages’ determining supports in Plan but again there has been little if any engagement with the sector & participants around the development or structure of such packages.

The NDIA have been unapologetic for delays, errors, incompetence & mismanagement, & the trauma & harms caused, stating clearly that the scheme is in transition & consideration should be shown for the enormity & scope of rolling out such significant large scale reform Nationally.

Which is a reasonable statement, however the same consideration or reason does not appear to apply when Providers & Participants make errors in trying to navigate the scheme with little clarity, direction or support from the NDIA, & constantly changing processes & advice, which are met with threats of audits, prosecution & ‘Fraud Squads’ going after participants self managing Plans.

The lack of any sense of co-creation, validation or engagement with sector or participants has resulted in disenfranchising not only of the extremely highly skilled & commited community services sector & workforce, but more importantly the participants or consumers of this scheme, which is human right based reform that is meant to be delivering choice, control, citizenship & self determination of our most vulnerable community members.

But the reality is, in many cases, they are being disempowered & harmed by the scheme, in some cases significantly.

Director – Health and Community Solutions Pty Ltd