The NDIS review summary underlines specific areas demanding attention within disability services. While maintaining a healthy market is crucial, the review highlights the importance of ensuring the quality of services provided to NDIS participants.
It wants to address the prevailing "fee for service" mindset that has emerged from the price capping, that was initially thought would stop providers from driving prices up. But it hasn’t worked. There is still a inordinate amount of over-servicing and fraud in the sector.
Participants have voiced their opinion and they sum up the NDIS as having a lack of integrity with the current system that is not sustainable or benificial. Some have even stated that all the NDIS has done is paper over the cracks of the scheme since the high profile case of Anne Marie Smith in South Australia.
So, what went wrong?
Amongst the multitude of service providers, finding quality staff proves challenging for the equally numerous participants. While participants often undergo thorough assessments to even obtain supports through larger companies, the screening process for assigned staff is typically lacking, which means a participant’s choices are limited to the staff on roster. Some participants face inappropriate exclusion from providers based on support hours. Which means the freedom of choice and control for many participants is noticeably limited.
Real world example: 1) A participant employs a large support company and has used them for about three years. The participant has four hours a week with a support worker with whom they have built a good amount of rapport. The provider has now decided to cut the supports to their client because the hours are insufficient and continuing to support the client is not financially viable. |
Due to the increase in unregistered providers it has only added another layer of complexity, with deficient overseeing of their operations and worker burnout. This lack of control places complex participants at potential risk of harm. Some providers exhibit a lack of understanding regarding their responsibilities, particularly around restrictive practices. The registration process also comes saddled with large administrative requirements, offering little incentive to remain registered or compete based on pricing or the quality of supports provided.
Real world example: 2) A participant with complex mental health issues requires highly trained staff. Many companies are not geared to handle the complexities that present, so an independent support worker is hired, one who is a suitable person with years of experience in the mental health sector. Even though there is experience, understanding and empathy, this worker cannot sustain the level of complexity with the participant and burns out within a couple of months. Unfortunately, the participant does not want to work with large providers, so is without support when it is direly needed for their day-to-day routine. |
What happens next?
One significant change recommended involves transferring the responsibility of setting NDIS pricing from the NDIA to an Independent Health and Aged Care pricing authority. The aim is to enhance clarity, transparency, and predictability, facilitating better alignment of prices across the care and support sector.
Additionally, there is a proposal for a phased approach to regulating all NDIS support providers, categorised into four tiers:
Enrolment: This covers providers offering the lowest risk supports, such as those protected under consumer law, including equipment and technology.
Basic registration: Intended for providers offering lower risk supports involving limited one-on-one contact.
General registration: Applicable to providers offering medium-risk supports, including high-intensity assistance that may require additional training and skills.
Advanced registration: Reserved for providers offering high-risk supports, such as behaviour support and daily living assistance in formal closed settings.
The plan also envisions simplifying the registration process, helping providers comprehend their obligations and regulatory requirements better. Furthermore, there are proposed improvements to worker screening requirements, ensuring that workers understand their responsibilities to participants.
How will this system operate?
For Participants:
Individuals living with disabilities will experience the benefits of a coordinated system that strikes a balance between support, choice, and control. This approach encourages solutions and expands the range of quality supports available to participants. The system incorporates safeguards to prevent harm, empowering participants to choose from a wider array of high-quality supports.
For Providers:
Providers stand to gain from a consistent system that streamlines administrative tasks. The proposed changes also offer more support and guidance to enhance the overall quality of services. The goal is to create an environment where providers can better fulfill their roles, ensuring a higher standard of care and support for participants.
In summary, the proposed changes aim to bring about a more organised and transparent NDIS support system. This involves restructuring pricing responsibilities, applying a tiered regulation approach for providers, make straightforward registration processes, and enhancing worker screening requirements.
The principal goal is to create a system that benefits both participants and providers, promoting a higher quality of care and support all those living with a disability.
We wish you well, as always
The Lama Care Team
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