Plugging Holes in the NDIS

Growing up I remember the tale of a young Dutch boy who placed his finger in a hole of a Dutch dike to save his homeland from being drowned by the sea on the other side of the wall. I assume at the time it was only a small hole that could be plugged by the size of a small child’s finger.  The trouble is the small holes left unchecked and not repaired can grow into larger holes creating a potential disaster.

Boundaries as I was explaining on Tuesday last week are ‘the fences’ or in this case a wall; that protect us from potential harm or abuse.  For clients and workers in the disability sector these are known as polices and procedures. Each of these links back to the laws that are unpinned by the Queensland or Federal Government’s legislation that protect the human rights of people living with significant disabilities and their families and carers.

These are also known as the Disabilities Standards, As we look forward to the introduction of the NDIS or Disability Care Australia, these standards are underpinned by the Human Rights of people with a disability by the United Nations.  In other words polices makers from the federal government down to me as a board member who is responsible for overseeing my organisations polices and procedures are written and abided by are govern by the charter of the UN Human Rights.

None of us truly live independent lives just as I am dependent on the assistance of support workers to meet some of my needs to get out the door for work in the morning, so too are we dependent on others to protect us from harm, neglect or abuse. These are important principles for clients, families, carer’s, guardians and support workers to grasp as we move away from the traditional model’s of service provision to a more open market of service delivery, which will from July 1 this year start to drive the choice of how people with disabilities and families meet their own support needs as the work towards full community participation and economic equality.

The NDIS revolution as set out by the Productivity Commission is designed to do much more than provide the support and equipment needs of people with disabilities and yet in the discussions I’ve been involve in so far; how does the NDIS or Disability Care Australia meet my needs or the needs of my child or clients. As we begin this journey over the next 5 years, this for many the have repetitively been failed by state governments over 5 to 6 decades is right so the first question being asked ‘how can I be sure my needs or the needs of my child/client be meet.   

This is a question the current ‘needs’ based funding has trained us to ask. The governments have failed to meet my/our needs for decades. What makes the new system of Disability Care any different? I have no doubt after reading the legislation under NDIS some people with disabilities and their families are going to be disappointed with what the system provides for them.  The words ‘permanent’, ‘stable’ and ‘serve’ point to uncertainly around the question of eligibility.

However the NDIS is not ‘needs’ driven but ‘goals’ driven, the very premise of disability care is about to be turned on its head and yes, for many of us that is scary. It involves a journey into the unknown and still many holes in the framework in which we will be required to work with in remain unplugged, some of the natural safeguards that protect clients from abuse have been removed.  We can not give people with disabilities the real choices they’re asking for without introducing risks. As we have seen all choices have conquences which lie with the decision maker not law enforcements.

As clients and families take greater control over the futures and services relinquish there traditional guardians roles, the risks become greater. The traditional mechanisms such as workers entitlements, awards wages, worker health and safety regulates, risk management, equipment checks and repairs, and even home modifications may now be the responsibility of the service user rather than the providers.

Not only does the NDIS promise to give people with disabilities greater choices about meeting their needs and lifestyles choices around how to meet those, For example greater choice around accommodation, how to meet their individual accommodation needs but it also allows them a voice about the postcode.  Traditionally those with high needs support have been house to close together for funding reasons.  Now people with disabilities are saying I want to live on the Gold Coast not in Brisbane. Everyone else has the right to make that choice and I want the same opportunity to live where I chose. I don’t want to be govern by where I must access the services to meet the needs associated with my disability.

To enable people with disabilities and the people that support them to determine their own lifestyle choice the NDIS has shifted the goal post. Services will be required to delivery services where the client and families needs to access them rather than require clients to travel. This is what we mean by ‘service delivery must become market driven’.  There no use setting up shop in Alice Springs if no one wants to by your goods.

In its quest to offer people more flexibility in the lifestyle choices, the federal government has responded by introduction flexibility in the way people with disabilities and their families can access the provision and delivery of their needs.

Disability Care Australia will offer three different service models

·       ‘Traditional’ ─ where the family or client will go to a website or shop front that lists all the services that offer to meet their needs and they will choice what suits them and the current goals and lifestyle. For some of these people the delivery of their services will remain the same.  Only who is paying the bill will change.  Others may chose to only change a provider or some delivery services changes to better suit their needs and goals. This is their choice and for many it gives them what they want. However others tell us they want a great say in meeting their needs, so these people may choice . . .

·       ‘The middle ground’ ─ Some where between giving all their funding to a service to provider or providers to meed all the request needs and having no responsibility for the organisational and administration for their funds.  This model has a middle person between them and the service provider that can give assistance and guidance in the areas their not sure on like employment of staff, worker compensational, repairs and maintenances of mobility and communication aids and referrals to professionals such as a speech therapist. The person or organisation will be responsible for this like quarterly reports to the Disability Care Australian office to say you have spent your money how you agreed to spend and not on a family holiday to Fiji or a new play station.

·       ‘Autonomous self-direction’ ─ will be where an agreed amount of money is payed to an individual or family by Disability Care Australia.  That individual then becomes an employer, who directly employs support workers and therapist themselves. Choosing this method of service delivery means, the person or family is responsible for training, safety standards, wages, sick leave, workers compensation, public liberty and meeting industry standards. The people need to write their quarterly reports to the Disability Care Australian office to say you have spent the money how they agreed to spend and not on a tree house of a red luxury car.

Remember the person or persons now making the choices become responsible for the results of those choices.  If you employ a support worker who drives your child to and from school in a car that in not road worthy resulting in a car accident, an absence of a road worthy certificate, results in a default in the insurance payment. You are left with your child has major injuries and you need time off work. No insurance is a result of you as a employer not doing a road worthy on staff cars.  You choosing to cut corners you are left to deal with the results. No service provider to run too.          

We as governments and service providers only have ten fingers. Human rights and the laws that protect them can on plug ten wholes.  If your creating and eleventh or twelfth holes by not having public liability insurance or not enforcing safety procedures the holes allow crack and crack without repairs grow bigger and sooner or later the wall crumbles and there’s no safety net.

I know because in the past I have failed to put putty in the hole before cracks appeared and pay the emotional toll. As the NDIS rolls out and more people make the choice to take direction over their funding, both support workers and clients need to carefully navigate the pot holes in the road.  The third umpire to ensure correct policies and procedures are followed has been removed. However, that’s what equality in.  No one makes my sister get up and get the kids off to school and then drive to work if she sleeps in being self employed she loses sales.

In my next post I might tell you about some of the cracks in the fall that can occur when you don’t put putty in the holes.