Models of support under NDIS

With a change in the Australian Government the name for the new direction in disability care is now the National Disability Insurance Scheme (NDIS)

This new direction in providing support to people living with disability and their families and career givers, is designed to give people a greater say in the governance structure of the support services they access.  It is also one of the Australian's Governments response to the UN agenda to improve the human rights of people living with disabilities in Australia. 

NDIS seeks to address issues such as chronic under funding of the disability sector across Australia, through an increase in the medicare levy.  Implement early intervention strategies, the introduction of the NDIS reminds us that we are all one accident or serious illness away from living with disability.

People with disabilities have told the productivity commission that they want a more active role in the community. They are seeking a more meaning full purpose for they lives and the lives of the family.  They do not want others outside the family unit making decisions around schooling, therapies, equipment, home modifications, study vs life skills options, respite care, accommodation, recreation and employment.

These decisions are best made in consultation with the person and significant others in their lives.  Until now many of these decisions and choices have been made by therapist and government departments and far too often decisions about one area of a person life such as accommodation and personal care has been made independent of choices around respite care for the family, resulting in a disjointed and sometimes inappropriate service delivery for clients and families.

The first thing the NDIS hopes to achieve is a more holistic approach to their care and support needs. An individual is much more than their impairments. A person's inability to verbalized the dreams, doesn't mean the have no goals and aspirations for the future. Nor does the need for assistance to get out of bed in the morning, toileting, bathing, and breakfast, inpack their ability to undertake university. The need to access 24 hour residential care doesn't mean a person can't work at some level. (work can be considered a few hours volunteer work)

For the first time in Queensland from July 2016 the allocation of funds will be based on the goals and aspirations of the person with the disability or decision parents with a child make around, early intervention and schooling for their child.

Many services and the Department of Community Services in Queensland are already in a transitional phase.  The revolutionary shifts that the NDIS creates can not occur over night.  Its introduction as indicated will impact on other service areas.

• Housing
• Accomondation Services
• Schools
• Further Education
• Employment agency
• Health system
• Therapies and Early Intervention
• Mobility aids and technology assistance.
• Transport

Other issues such as access to building, the exit of young people from nursing homes, public awareness and education, staff training and a shift in how services are delivered and marketed needs address.  I think many in the sector and perspective clients still under estimate the changes that will occur as a result of the NDIS.

Some families in Queensland who receive a family package from the Department of Communities have made the shift to self-direct funding, known as the My Life, My Choice Program. The NDIS in between 2016 and 2019 for Queensland (note dates and timelines differ from state to state and you need to check the website for dates in your area). Will extend self-directed funding to all Queenslanders living with disability by 2019.

Under the current self-directed package being offend to families in Queensland there are 2 tiers to chose from in terms of managing your support needs, these will be very similar with variations under the NDIS. For example the MY LIFE, MY CHOICE, packages do not include funding for equipment and therapies.

Pathways to Self-Directed Funding (Queensland)

1. Buying services direct from a service provider. The main change under this tier is a family will chose the provider or providers. Many families have decided the happy with their current service arrangements and nothing has change for them.  Remember self-directed funding is about the individual and their family making the choices that are right for them. For each family, that will be different. Change will create uncertainly, don't look at others, focus on you, your family and meeting your goals and needs.  The advantage of this budgets and reporting is done by your providers.
2. Selection of a Host Provider (Broker) - a 'host' will hold you money in their bank account. There are responsible for providing you with information on services you can access.  A host provider many or may not also be a service provider to your family. The difference is you choice which service you will receive. Instead of the department of communities deciding you have 7 hours a week in PC, 2 hour a week respite, and 5 hours for community access for your family member. You will decide if you want to do PC for your family member so they can access the community more. This is what people are saying the want.  They want greater choice and flexibility. 
3. A family can choose to form a company, directly employ staff, do there own rosters, staff training, wages, book keeping and reporting. Some people like this choice the want a greater say in who is in their lives, hour often the come, when the come and the role the will play. Its not for everyone but it gives people another choice.  Remember your choice is about what is right for you.

Going back to the Human Rights Commission and the issue of choice under the National Disability Scheme, the scheme directly addresses the issue of choice.  However to fully allow individuals to make informed choices for their lives many changes need to be made. 

Access and opportunities need to be created, we can't just give someone a key to a house and walk away. Living independently may be their choice but we still have responsibility to make sure the house is accessible and suitable for their needs.  If a house has front steps and an inaccessible bathroom and the person is fully dependent one a wheelchair for mobility then part of their package needs to be set-aside to access appropriate accommodation  they many need to access a living skills program or assistance to deal with centrelink. In dependent living accommodation is much more than a change in address and appropriate supports needs to be funded.

To achieve this a family or individual needs a plan the need consider all the risk factors and support services needed to execute a plan and how that will occur.  This is the role of a community linking officer on the current system under the National Disability Insurance scheme their will be assign someone to enable you to map out you plan. 

This may allow you to explore some new possibilities for your family or yourself to enjoy things e that haven't been possible before. Better access to services may allow to relocated close to where you want to study or if you want to compete in the paraolympics in swimming and don't live near a pool or coach. 

Until now relocation for people with disability has meant reapply for support and being placed on waiting lists with service providers.  Moving for people with disabilities has been a very limited options and the is one reason why we needed the scheme to be national.  So if someone in the family is offered a transfer that is now possible to accept the transfer without risking a drop in support services. 

The National Disabilities Insurance Scheme ensures people with disabilities and their families have security, that other Australian enjoy, such as moving from Brisbane to Melbourne. These are choices the rest of the community takes for grants.  These are the Humane Rights Australian Governments have failed to provide.

Such choices for people with disabilities means service providers need to be more open and transparent about what they have to offer and more flexible in their delivery.  Respite is traditionally offered during the day. What about if a family wants to incropriate the possibility for shift work into their lives.  More and more services will need to adapt to a market place rather than offer standard programs.

At times even I under estimate the changes that we will see under the NDIS. We changes all of us need to be open to opportunities and threats.