The Puzzle of the NDIS

The rollout of the National Disability Scheme has begun and some trails states have now been operating for 12 months. Like anything new some things are working very well and problem areas have emerged. Rightly, we ask the question Have we got the formula and maths right?

With stories of inconsistency among trial sights emerging, it is these inconsistency that add to the fear and confusion as Queensland awaits for the NDIS to begin. One of the biggest myths feeding this confusion is the NDIS will look the same in every state. That the blue print being used in Tasmania will be the same as the one we see role out in Queensland in 2016. This is not the case. Essentially while the principles of the NDIS underpin the scheme nationwide, each State and Territory has an individual agreement with the federal government. The priories vary from state to state.

Some feel that the overriding principle that underpins the NDIS is complete control will be handed to clients or their families where there is an adult guardian. That people regardless of their individual compasticy levels will be handed large packages to spend however the wish. They will elect to hirer unqualified staff and below awards rates and make outrages demands of staff to ensure the money is stretched to maximize service hours.

In Queensland we have what I term a double whammie where the department currently responsible for administrating the funds also provide much of the resident care in the state. This has been a highly controlled area of care for people with profound disabilities or complex behaviours requiring very high restrictive practices to be put in place by the adult guardian.  It is my thinking the Queensland government is yet to outline the role and any changes to the adult guardian.

Much fear among clients and support staff and those working for disability services centres around the “privation” of the industry. Rather amusing when some of these worker work for large Not for Profit Organisations such as Endeavour, Oz Care and the Cerebral League. In essence these are the private large corporations or the Woolworth and Coles of the disability sector. These are the fingers of feared monopolization and talk of mass takeovers are being fueled.

The truth is the only area of the disability sector that is not currently privatized is the residential programs run by the department of communities. With the disbandment of the department and arm that currently administrator the funding crossing to the NDS then common sense tells you residential facilities will to be privatised.

Just as NGO’ have compliance and surveillance audits now this will continue long after the department has been dismantles. Something tells me, fear of job losses is fuelling the fears of ‘privatization’ and ‘deregulation’ of the industry. We are not the dairy cow industry, we are dealing people’s lives, people most of us view as ‘at risk’.  A term I believe as service provides and support workers we need to grapple with in the days and weeks ahead.

Just like aged care and hospitals, models of privatization already exists and operate in Queensland and very little reconstructing needs to occur. An industry that will become driven by market forces, doesn’t necessarily mean lower prices, mass job losses and lower standard of care. It can and I believe should mean services diversity and lift stands to keep current clientele and attract new customers. The challenge for service providers is to learn to true value of the market, to value and respect the client and empower them to live quality lives.

Disability services were administers under the NDIS agreement our state government through legalization yet to be written remains the sectors regulators.

I believe another contributor to ‘fear’ in the sector is the issue an issue of control or what I ‘term perceived control’ or ‘power grab’.  So who is now in control?  May I suggest that no one is ‘in control’. As scary and challenging that sounds, the ‘control’ often decries as ‘care or care givers’ as a result of the power game we as humans play because we feel superior in some way will be disbursed over a number of bodies, in a multi-level of government approach.  When we think of clients now have ‘control’ our thinking about the ndis immediately becomes distorted.

A disbandment of control

The Department of Disability Service (Administration of funds)

Handed to administrators of the NDIS

Funded by Federal and State Governments

The NDA administrates funds

direct to clients and their families, these funds are either held in separate Business Accounts with ABN for those self administrating or held in trust by a host service provider

A system already in placed in Queensland under

My Life! My Choice!

In Queensland under the state government and the department

Some clients and families are being given choice.

The right to chose should not be seen as control

Both Federal and State Governments must

Introduce laws to safe guard all people with disability

To empower them to make choices around

WHO WILL SUPPORT THEM

(I.E. WHICH SERVICE PROVIDE)

HOW THEY WANT TO BE SUPPORTED

(IE. DEMENSTIC SERVICES, PERSONAL CARE AND DAY SERVICES)

WHEN THEY WANT TO BE SUPPORTED

(I.E. WHAT TIME THEY WANT ASSISTANCE TO GO TO BED)

None of these choices are unreasonable or exerts control over anyone.

The State Government is responsible for

State laws around property ownership

Industrial relations

Industry Regulates  

Health and Safety

The National Administration of funding does not affect state laws that protect workers, organisations and their clients in this case people with disability and their families.

Disability Services as a support provider will cease

It is predicted NGO like Endeavor, Cerebral Palsy League,

Uniting Care, Blue Care and Young Care will buy

Some of this and maybe some smaller players will emerge.

I don’t  think giant likes Masters and Coles/Myers are likely

 to pop up in the human services market.

We know under the NDIS clients will be able to chose there service providers. This choice brings empowerment clients can chose to live in an Endeavour house or a Uniting Care unit and yes some will move into private homes and with choice comes risk. Without choice the risk of control and abuse is higher.

A word on risk: Some people will always choose to do the wrong thing! Some people who break laws and abuse clients. Let’s not pretend it hasn’t happened in the past under a system dominated by state care.

Empowered Choices

Provide means to speak out about abuse

And making choices about safety.

Division of control and responsibility

Should build greater protection.

Build sadly nothing stops anyone intent on breaking the law.

It’s time to recognised a system of ‘ specialize care’

for people with disabilities is not needed.

My hopes for the NDIS in Queensland and the disbandment of the department known at Disabilities Services, like many people living with disabilities who have a high compastity to function independently, is to see an end to a system which is based on a care giver model, where others make decisions for those the ‘view’ as less or ‘needy’. 

‘A care giver model’ like that of a medical model can view people as patients who are sick or mental ill and in need of nursing. Just because I need assistance to shower doesn’t mean I sick, well people take medicines many more than me. It is true that some people with disabilities need a level of care, and for some that will remain 24 hour a day care. The NDIS should ensure support, assistance or equipment needs best meet the needs of all Australians with disabilities. 

I believe this is possible thought a system that funds the individual or family not the disability.  In essence a medical or care model provide carer based on the classification of a person’s disability and their perceived inability to tasks. I liken the current system to a one size fits all system. It someone is born with cerebral palsy then the cerebral palsy league is the best service for them. Any classification system gives rise to misconceptions in the general public.  From which organisations and governments employ their staff.

Once perceptions are from and action upon, the most vigorous disabilities awareness training will not ultra myths people have convinced themselves are fact. And the fact is that Queensland’s State Care model adopted by Disability Services is long overdue for a overhaul.

In the option of many it was a system established on the floor that people who once lived in state institutions still needed a level of ‘care and protection’. That system was then adopted for all people living with disabilities, whether the person was a ward of the state or live at home with their families. After decades of critical funding shortages, under a system never designed to cater for all people living with disabilities, people with disabilities and families have driven what we now call ‘the NDIS revolution’.

It is the model of disability care the people with disabilities and their families have told the government they needed.  The needed a system where the dollar value of someone’s package was not determined by the classification of their disability or the daily tasks or decisions they were unable to complete, but a system that took a whole of life approach. A system that signed up a child at the age of there, and acknowledges as the grow their needs will change and developed what works at twelve will no longer work when they reach 32.

A system that recognises people live into old age and the impact of disabilities on the aging body is greater than the general public.  It’s a system that embraces individualists and celebrates difference, demanding individual planning in consultation with the person, their families and advocates. Where people are offered choice in the way they are supported to achieve their goals.

The challenges for us as workers who are now employed to assist people with disabilities rather than in a way ‘we’ have traditionally provided care or programs for our clients to attend, in not this privatisation and threat to jobs, but our ability to grips the NDIS revolution and transform our thinking that prevents us from believing in grade myths as truth not longer have a place in this industry.

Our customers, whether it is a person with the disability themselves or a family member is not our patient and they are not asking to be made whole. They a hear to purchase a service that they believe with improve their lives and best achieve their lifestyle goals and that as management of a direct service provider is what we will need to deliver on July 1, 2016. 

We need know what we have to offer, how we are prepared to offer it and what price is attached to the service.  We know what our hairdresser charges, out clients are going to ask how much it costs to be support at TAFE and does it include mileage? Some clients will want to know will our staff show them or do they need to engage another service provider.    

The like another ‘smart shopper’ will shop round to get value for money. Where once the carer did everything from menu planning, shopping, the housework, the shower and made the clients appointments. As a client I can go onto the NDIS website and chose a registered demotic cleaner to do the housework, a transport service to take shopping and my support work to enable me to do my hydrotherapy.

Despite there being major shifts in the industry in the way we discuss clients and people living with disabilities and changes in job titles, the job as a paid carer has at stronghold on the industry. The ‘role of a carer’ implies a sense of authority and decision makes’, name changes in job titles such as support worker under a care model approach have failed to allow staff to adapt to a role of enabling the client to make their own choices and do as much they are able. These workers are a bit like the mums who want to continue protecting the child even after their grandchildren come along.

These workers will struggle in a market place where our clients whole the purchasing power. ‘Carers’ or whatever they want to call themselves who in on walking into clients homes putting on the jug to make themselves coffee while outlining the days agenda and assigning tasks to other staff, are in for a major awaking. 

They may need to ask the family before making themselves coffee and they may be asked to hang out the washing before they take their son or daughter to the gym instead of the movie the play to see before taking mike to Macer’s for lunch.  They may need to go some physical work before being paid.

The NDIS focus on enabling people to make choices like every other person and not to many people chose to see a movie on the same day at the same time every week. This is not the type of community participation NDIS is targeting. In  my view funding would be better spent paying a cleaning and  supporting the family to go out as a family unit. Just like families without children with disability.

Support under the NDIS is intended to assist people and families living with disabilities to live and afford lifestyles similar to others their same age. Support employers who populate the old care model offered under disability services will prove to be a liability to the employer.

We know the NDIS formula is not correct, we know changes and clarifications need to be made. Both under and over estimation in the productivity budgets were made and I believe too much change dismissed the power of community attitudes and tolerance levels of anyone who is different to themselves.  

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