What does the introduction of the NDIS mean for you?

 Changing roles under the NDIS

The introduction of the National Disability Insurance  Scheme (NDIS) affects us all. Not just through an increase in the Medicare Levy. The scheme reminds each of us we are only one serious accident away from a permanent disability and need for assistance ourselves.

Imagine if you had a horse riding accident tomorrow and your spinal cord is broken at the bottom of your neck. The good news is you survive and are eligible for assistance under the NDIS, this can be organised while you spend up to the next 12 months in a rehabilitation hospital, as one of the priorities of the funding is early intervention program to get you 'back into life again'.

The bad news is you will never be able to move anything below your lower neck again and you will need to access 24 hour care for the rest of your life. When you go to bed at night someone will need to come in and turn you every few hours so you don't get a pressure sore. You are now dependent on somebody else for everything. You can't even starch you nose. 

More bad news you have a physical disability. You intellectual process, thoughts and feelings are all as there were before.  You are lucky! You can still speak and voice your thoughts and feelings and soon every therapist, doctor and nurse is going to know about it.

Each person that walks or wheels into your room for the next 12 months is going to have the opinions on, 'how you can put your life back together'. You are forced to listen and proceed with your daily therapy. While you are feeling unheard you are also grieving for you loss of mobility and the life you once knew.

It gets worst you are a professional support worker, you know how to help people with disabilities, you know what you want and you can still communicate this clearly, but your wishes are often dismissed. Instead you receive constant reminders you are the patient. . .

Relax . . . this is not your current reality and I hope no one reading this ever experience this reality. Because the funding for NDIS is so individualized the best way to providing training and understanding of how this new system works is to provide examples.  

The priorities for funding under the NDIS are very different to what is currently here in Queensland. Under the National Disability Insurance Scheme, the funding priorities are early intervention, access to therapies, medical aids, mobility aids and technologies; education; employment; accessing public transport and buildings, meaningful community participation, access to the arts and sporting participation.

Despite popular misconception, the introduction of the NDIS is not a change in funding roles between the state and federal governments. Under the NDIS funding is assigned to and individual or family based on the goals and lifestyle choices. Rather than a diagnoses made by a doctor at birth or time of injury.  For the first time a person’s funding package will look at all their needs and how best to enable them to achieve their own lifestyle goals. 

This is not merely a changing of the guard or a change in who is paying the bills. The choices clients and their families will make about their own lives.  A change which will be directly felt by support workers who work one-on-one with clients. For the first time clients and/or their families will be able to chose the service or services they want to access for their support needs.  

These revolutionary changes will be based on the clients lifestyle choices (ie to life independently in their own home near the beach); and their goals and aspiration (eg to play basketball in the Australian Special Olympics team).  Support to attend training and travel to tournaments with be a large feature in this person support package. My recommendation is the person who supports this person will need to be both fit and a early rises.

This fundamental shift to funding being assigned based on individual lifestyle and goals, will see a big shake up in how and when clients are supported and the organisation that is most suitable to support them. 

While support has always been based on a goal, (such as to enable the client to leave the house), all their goals and how they will achieve them is now determined by them and their families or careers. This is their lives, their dreams, their goals and their choices! The NDIS is ALL ABOUT CHOICE.

MY LIFE! MY CHOICE!

SELF-DIRECTED FUNDING  

Regardless our how you view you're client’s ability to make choices, around their lifestyles. As a support worker it is your job to assist your client to achieve their goals. If their goal is to organised a surprise party for their dad's 80th Birthday, but you doubt their ability to achieve and afford the party, as a professional support worker your role is only to enable the client to achieve throwing a successful party.  Whether they then occur a debt, under the rules of the NDIS is their choice and their responsibility. 

Until now in Queensland people with disabilities and their families have had little choice on who will support them, when they will be supported and what they will be support to do.

Currently, the Department of Communities undertakes an assessment and decides the types of support you need e.g. community support, personal care, in-house, respite care and how many hours that will before. They then place you with a service that will provide that support. 

Despite popular beliefs held by support workers a number of factors which currently determine the way you support clients. This includes their diagnoses, the type of disability (e.g. physical disability); whether the disability is progressive; even their post code.  The chances are whether you are on a in-house support shift or a community access shift has not been determined by your boss, but the Departments of Communities. 

It always amuses me when my staff complain they weren't told what we were we're doing on a particular day. As they are always informed Debbie will tell you what she needs when you arrive at her place. The fact that my support plan clearly states my support will be center around my needs at the particular time of the shift (I might wake up vomiting and that will change what I had planned for the day.) I am a real person and real people get sick).  The change with the introduction of the NDIS is that clients no longer need to negotiate with the scope of what 'my needs at the time of the shift' means. 

Self-directed funding means the client choose who will support them, which what activities the will be supported and when they will receive their support. Without a support service being in control of a client's funding, the division of funds will be directed by the client or their guardian. So if a client wishes to be supported at a time when higher penalty rates are paying and receive less hours of support, under the NDIS that is their choice.  

The major priority for funding under the new NDIS is to ensure the human rights of all Australians with a disability and their families are upheld. Just as you have the right to choose things like where you send your children to school and what type of work you do. People living with disability and their families have the same basic rights regardless of the intellectual ability.

Under NDIS even the Adult Guardian Board will be held more accountable to ensure its client have access to choice and the way they are cared for. The NDIS is very much about empower people with disabilities to exercise their right of choice.

It may interest you to know current there are 30 articles on the Human Rights For People with Disabilities. Currently there are hearings occurring in Geneva around Australia's record in upholding the rights of people living with disabilities. As recently as September the Australian Government was using the introduction of the NDIS as its defence and omission that until now it has been in violation of the convention and these articles. The stakes for getting the implementation of the NDIS spot on are very high.

The changes we are about experiences are fundamental and will be felt far beyond the disability sector. These are changes that demand dignity and respect of all people living with disabilities and a goal of social inclusion.  Therefore will be felt:-

• The Public Health System 
• The Public Trust
• Private Therapist
• Education System
• Public and Private Schools
• Transport System
• Equipment Providers
• Public Housing
• Telecommunications 
• Technology Specialist  
• Medical Providers 
• and Support Services Providers of course.  

As the framework for this new model of social reform was being developed under the guidance of the Productivity Commissioner, people with disabilities and their families were very clear the things they wanted the NDIS to achieve the most is social inclusion with meaningful participation in their community.  

They have asked for specific things to be included such as education, employment, an end to underemployment, accessibility to bookshops, libraries, restaurants; recreational activities, sports, sporting venues, gyms, and theaters.

People were very, very specific and very clear on what the visions was for the future. Remember the person in the hospital who was told they would need 24 care, their minds, their thoughts, the feelings, their passions and their dreams are still present. Their vision about a future living with a disability is now taking shape. Their ideas to will be wishes on how they want to be supported will too clearly stated at the right time.    

The person you next support to develop a lifetime support map, could be your husband, your daughter, your grandson or your father. What kind of choices would you want to enable them to make?

Would you be happy for them to go see a movie every day?  Or sit fishing in the summer sun for six hours? If you was the person with the spinal injury and you wanted to stay in bed an hourly longer or have a PJ day; how would you feel if you were made to get up and get dressed? 

With the National Disability Insurance Scheme, trips to the beach, a night at the movies or local pub aren't on any agenda under this reform. The game has changed. Yes, I am sure some clients, who will chose to be continued supported in same way they have always been supported.

The NDIS means We're no longer debating over a clients right to watch an adult movie or get drunk. Our role is now about demanding buildings are accessible. Assisting the client to apply for work or choosing a swimming coach; engaging an advocate so your client can join a choir (as an  intellectual disabilities doesn't affect the voice, just the way you need to teach the person the words.)

If clients are genuinely continuing disappointed with the service receive and/or if the feel their choices are not herd,  NDIS gives them the freedom to go to another service.

I know there are people who like to complain and nothing ever seems good enough for them.  Want to know how I know this? 

Well, I spend about 10 hours every listing to support workers complaining about everything from the husband not putting the wheelie bin out the night before; the neighbours setting traps for the cats because they’re not keeping them in at night; being cheated on by boyfriend; clients not answering the door; shifts either being too short or too long and then of course there’s the weather.

Excuse me - I the one sitting in the wheelchair, I really need to start charging counselors rates, as my degree is in Behavioural Science. For some workers . . . should I chose to complain, I am accused of being hormonal! The fact I have a disability somehow the gives me a hassle free life. Go figure! (For the record that was the week I wrote three grant submissions!) 

If clients are upset for the right reason they will change their provider, just like you won't return to the hairdresser who didn't listen to you. The game has change!