NDIS Archives - Queensland Advocacy Incorporated

NDS and NDIS Outcomes Frameworks – QAI Submission

QAI made a submission to the Department of Social Service regarding their consultation paper on the NDS (National Disability Strategy) and NDIS (National Disability Insurance Scheme) proposed Outcomes Frameworks.

QAI agreed with the Department’s stated intention to focus on improving the implementation of both the Strategy and the NDIS, with renewed attention on measuring, monitoring and reporting of outcomes. QAI stated that if the Strategy and NDIS are to genuinely improve the lives of people with disability, there must be tangible change that facilitates the self-determination of people with disability and ensures the accountability of all stakeholders.

QAI made several recommendations, including the following:

The principles of universal design must be applied to all policy-making. The extent to which they are adhered to throughout the built and natural environment, services and programs and the provision of information is a quantifiable measure that could be incorporated into the Outcomes Frameworks.
The autonomy of people with disability must not be lost amid efforts to quantify progress in the Outcomes Frameworks. Rather, progress under the Outcomes Frameworks should be relative to the extent that people with disability exercise choice and control over their lives.
All people, regardless of their disability status, have a right to a basic standard of living. The level of payment under Australia’s welfare system and its equivalence with the minimum wage is a quantifiable measure that could be included in an Outcomes Framework. The eradication of ADE’s and the abolition of productivity-based wage assessment tools, when coupled with the expansion of meaningful employment roles in open employment, could also be indicators of increased economic security.
Progress towards achieving equitable access to suitable housing for people with disability can be measured through a reduction in the number of tenancies in congregated, segregated and Supported Independent Living (SIL) settings.
Measuring health and wellbeing requires more than quantifying a person’s access to health care services. The Outcomes Framework must be nuanced enough to decipher the quality of healthcare services that are accessed by people with disability as well as improvements in mortality rates.
A person’s ability to feel safe and have their rights promoted, upheld and protected is integral to the CRPD and must be ensured through robust accountability measures. The ongoing funding and uptake of a well-resourced disability advocacy sector is fundamental to achieving success in this domain. With Article 12 of the CRPD enshrining the right to equal recognition before the law and the model of supported decision-making, the level of a paradigm shift away from substitute decision-making approaches should be tracked under the Outcomes Frameworks through measures such as reduced applications for guardianship and administration, involuntary treatment and the use of Restrictive Practices.
The Australian Collective for Inclusive Education (ACIE) has produced a roadmap for achieving inclusive education in Australia, outlining six core pillars where efforts for change should be focused and providing a comprehensive list of short, medium and long-term outcome measures that will track progress over a ten-year period. As a member of ACIE, QAI endorses the roadmap and the outcome measures contained therein.
Personal and community supports must remain person-centred. This is in keeping with the diverse needs of people with disability and their right to self-determination. Continuity of service provision, together with the clarification of the interface between NDIS and mainstream services and education and training regarding this issue are important outcome measures. The introduction of the NDIS should not have the unintended effect of absolving state and territory governments from their responsibilities and the Outcomes Frameworks must remain alert to this throughout the life of the new Strategy.

Supported Independent Living – Position Paper

QAI has released a Position Paper on Supported Independent Living (SIL) arrangements. The below Position Statement is an extract from the paper.

You can read the full document here.

Position Statement

The following position statement is based on the values, beliefs and aspirations that Australians with disability can have a good but ordinary life when they have personal power, control and are
supported to exercise their autonomy and rights as other citizens.

Supported Independent Living (SIL) has become the mechanism for the proliferation of the archaic block funded group home. Rather than enabling a person to live ‘independently in their home’, it is in reality shared care in a congregated setting, often not of the person’s choosing but instead organised, negotiated, and created by the NDIS system and the service providers.
A dearth of truthful information about the inflexibility of SIL, has reinforced the misconception that a person with high and or complex support needs must therefore enter a SIL arrangement. Most people do not have any independent unbiased information about SIL and have the mistaken belief that because they live in shared accommodation they must continue in the existing arrangements.
People formerly living alone and supported for 24 hours of support, 7 days per week under the state system, are pressured by NDIA Planners as unwilling participants into SIL arrangements and costing Plans accordingly.
In most instances, the avoidance of information about alternatives and benefits of accessing the NDIS with a non-SIL funded Plan, and lack of transparency regarding the over-inflation of SILS quotes is forcing more people back to the archaic model of group or shared home living.
If a participant wants to share with another person and articulates a desire to share
some supports with their chosen housemate, (ie: overnight support only, or a combination of one or two activities), each person is very possibly able to obtain a Plan that is not only going to meet their needs but also be less restrictive, more flexible should either housemate wish to relocate, and is possibly more efficient and effective.
The solution to the abovementioned is to abolish Supported Independent Living (SIL) from Plans.
Replace it with individualised NDIS Plans for everyone including people who wish to share accommodation and support. When and where people who choose to live together, wish to share supports they merely state that intention in their Plans.

Submission to the NDIS Workforce Inquiry

In April QAI made a submission to the Joint Standing Committee on the National Disability Insurance Scheme Workforce Inquiry.

Below is an excerpt from the submission with our key recommendations. You can read the full submission here.

QAI’s Recommendations

Abolishment of Supported Independent Living (SIL) from plans. SIL funding for NDIS
participants should be replaced by open and individualised funding for everyone,
including people who wish to share accommodation and support.
Restructure pricing for supports at the top and bottom of the market with particular
emphasis on mental health supports, therapy supports and services for people with
complex needs.
Restructure pricing for regional, rural and remote regions to strengthen service delivery
which has higher overhead costs than their urban counterparts.
Provide adequate funding to participants in regional, rural and remote regions to enable
delivery of service.
Work with Indigenous councils to train service providers and staff to deliver services, by
building the capacity of local people.
The NDIA ensure each state and territory has a well-equipped, well trained and person-centered human rights based ‘provider of last resort’.
Provide both financial and physical support to participants to learn how to self-manage
their plan to enable maximum flexibility.
Provide support and guidance to self-managing participants to understand Australian
Taxation Office rules, Fair Work rules and other employment issues resulting from
directly employing staff.
Provide information to the mainstream and community on services that can be provided
under the NDIS to encourage mainstream services in a disability setting.
The NDIA (and Quality and Safeguards Commission) provide assistance to providers
and sole traders to participate in the auditing process which can be timely, costly and a
hindrance to staying in the NDIS market.
The Quality and Safeguards Commission to scrutinise service providers providing
housing and supports and restrict registration to ensure no provide is able to provide
both functions.

NDIS decision delays have deadly consequences, says QAI

16^th January 2020

For immediate release

Following today’s report that more than 1200 Australians – including 65 children – have died while waiting for NDIS packages, leading disability advocacy organisation Queensland Advocacy Incorporated (QAI) says urgent reforms are needed to introduce greater accountability for the government agency managing the scheme.

“Too many people living with disabilities are waiting far too long for support they need to live the ordinary life they’re entitled to,” says QAI director Michelle O’Flynn.

Part of the problem, O’Flynn explains, is that while the legislation governing the NDIS imposes strict timelines on people who need support (to respond to NDIS requests for more information, for instance), in most cases the National Disability Insurance Agency is not subject to the same timeline requirements.

O’Flynn says further that the NDIA will often reject applicants’ claims at first instance, only to reverse its decision on internal review or appeal to the Administrative Appeals Tribunal six or even twelve months later.

“As a result, we often see clients who, in our view, are needlessly put through additional and unwarranted stress – and when someone is already trying to manage with very little support, that additional stress may be the last straw,” says O’Flynn.

While it’s impossible to attribute some of these deaths directly to their experience of waiting for NDIS support packages, O’Flynn says that what it does highlight is just how important adequate, resourced and appropriate supports are for people living with disabilities, many of whom experience lower life expectancies compared with other people.

“The NDIS does have the ability to immediately improve a person’s quality of life,” says O’Flynn, “by implementing and sticking to timeframes, by communicating properly with people about how their applications are going, by being as consistent as possible about their funding decisions, by respecting decisions of the Federal Court and generally by removing as much uncertainty about the process as possible.

“At QAI we’ve seen that the NDIA is capable of doing the right thing, and its facilitation of funding and quality personalised supports have certainly improved the lives of thousands of people, but it shouldn’t be attained after a protracted and delayed fight to the finish. On far too many occasions the NDIS has, in our view, needlessly delayed or obstructed the process. And delays in this area can have dire and tragic consequences.”

QAI welcomes the reviews (by parliament’s Joint Standing Committee on the NDIS, and by David Tune) currently on foot, and is hopeful that they eventually result in better accountability being built into the governing legislation.

“But the NDIS doesn’t need to wait for the reviews to report,” O’Flynn says. “It could commit to timelines today.”

Contact: Michelle O’Flynn, Director, QAI

QAI Submission to the Inquiry on the Impact of Changes to Service Delivery Models

QAI made a submission in August 2019 to the Senate Standing Committees on Legal and Constitutional Affairs on the inquiry on the impact of changes to service delivery models on the administration and running of Government programs.

QAI’s Recommendations re outsourcing of NDIS call centre to Serco Asia Pacific:

Improve the quality of service by improving recruitment and training of call-centre staff. Focus on knowledge and understanding of the needs of people with disability (NB: Not diagnoses, but understanding of support needs) and the interpersonal skills of call takers.
Review the gate-keeping function of the service.

You can read the full submission here.

Every Australian Counts taking all feedback to the NDIS review!

Every Australian Counts has made it is as easy as possible for everyone to have their say and give their honest feedback on the NDIS.

All feedback will be going to the review being conducted by Mr David Tune into the NDIS Act and Rules. Visit their website here for all the details.

From the Every Australian Counts website:

Let’s face it, there have been so many reviews into the NDIS over the past 12 months it’s all been a bit confusing and exhausting.

But this review is the most important one yet. We can’t let this opportunity go by.

It’s an independent review, which means the government won’t be able to ignore it’s recommendations. And regardless of whether we have our say or not, the government has promised the legislation WILL change next year.

That’s why this one is the important one. That’s why we need to be crystal clear about what changes we do – and don’t – want to see.

We have already spoken to Mr Tune who told us he wants to hear from as many people as possible.

But we know how tired, stressed and just over it all we all are.

So we want to make it as easy as possible for you to get involved.

So, you can leave us a message, send a video or shoot us a quick email and we’ll make sure the review team gets all your messages.

Or you can take part in the formal consultation run by the Department of Social Services.

This is our chance to help make it work.

Let’s make the most of it!

NDIS Planning Submission

QAI made a submission to the Joint Standing Committee on the National Disability Insurance Scheme on NDIS Planning.

Here is an excerpt from the submission of our recommendations:

QAI Recommendations

LAC’s and Planners must have intensive training to understand the social and other impact of disability and what makes people with disability vulnerable. The NDIA must undertake intensive training for Planners and Plan reviewers to ensure that the Scheme is implemented as it was envisioned and not as a cost savings exercise. This training must also encompass respectful engagement with Participants and plan nominees to overcome the fear and distrust that is being experienced as a result of bullying by Planners.
The NDIA should hire people with lived experience of disability and or people with experience from the disability advocacy sector.
Invest in appropriate Pre-Planning (with independence from direct service provision organisations) so that there are fewer Plan Reviews and Appeals, and to enable LAC’s to return to their intended functions of linking and connecting people with generic and specialist services. Foster smaller and consultative community-based services that engage local staff particularly with pre-planning activities.
The NDIA must randomly audit Plans developed by NDIA Planners to determine consistency of content and supports.
Participants should be asked to submit a self-assessment about what they need in order to attain their goals and should be incorporated into the planning process. Planners must have skills in ‘active listening ‘rather than self-promotion of their own experiences or purported expertise.
Planners must focus on inclusive approaches to supports while respecting the wants and wishes of Participants.
Informal Supports must not be factored into Planning as a cost-savings exercise.
The NDIA should provide funding for translation services for CALD Participants in planning and to engage with support coordination services.
Abolish SIL from Plans.
Supports that Participants and nominees discuss and agree to at planning meetings must be included in the Plan.
Draft Plans should be sent to Participants and Nominees for agreement and or negotiation.
Abolish Typical Support Packages (TSPs) to reduce internal reviews, AAT appeals and Participant dissatisfaction.
Ensure that there are no service/support gaps and provide early intervention to Participants and Nominees to ensure that supports are not withheld even if funds are expended before end of Plans.
Plans must not be reduced unless Participants disclose they no longer require specific funds or support types.
The NDIA must cease the manipulation of reviews under Section 100 by either refusing the review request or instead attempting to thwart the process by deception and inserting the review under Section 48.
The NDIA must ensure equitable access to all forms including review request forms and not restrict word limitations by the use of PDF or other means.
The NDIA must ensure that reviews are free from conflict of interest and breaches of confidentiality by warranting that no staff members involved in the original decisions are involved. Strict penalties for breaches must apply.
Whitelist formal advocacy organisations to reduce red tape and better enable Advocates to assist Participants and Applicants.
NDIA should provide a readily available means to track progress of reviews for Advocates and Participants.
Mandate an enforceable maximum time frame within which the NDIA must respond to reviews.
Improved decision-making by the NDIA in the first instance to reduce review and AAT applications.
Improved liaison between the internal review team and the Early Response Team (ERT).
NDIA staff members provide advice to Participants at critical moments such as denial of review applications, how to best utilise current Plans and gather evidence to improve their next approaches.
NDIA staff give greater attention and consideration to the issues impacting Participants, Nominees and supporters in regional and remote areas particularly with issues and costs associated with transport, thin markets and alternatives to traditional service provision.

You can read the full submission here.

Inquiry into Supported Independent Living Submission

QAI made a submission to the Joint Standing Committee on the National Disability Insurance Scheme on the Inquiry into Supported Independent Living.

Here is an excerpt from the submission of our recommendations:

Recommendations

Provide clear, transparent and honest information about SILS. Clarify the restrictions that SILS imposes on ‘choice and control’. Explain that SILS pressures participants to share accommodation and support. Explain that SILS hinders planning and review.
Prohibit SILs payments from going to providers who own or manage a Participant’s housing. SILs is a key part of a de facto permit system for group homes, where the dwellings and their operators become the focus instead of people with disability.
Organisations that currently deliver both housing and supported services will need to separate their services.
Housing organisations that accept a transfer of stock from state and territory governments, and/or develop additional housing, will need to co-ordinate their housing with support services delivered by other organisations.
People with disability and their networks, housing organisations and disability support organisations need information about what separating housing and support means in practice, and about good practice in coordinating service delivery when housing and disability services are provided by different organisations.
Participants and/or families may participate and control the first plan, but regardless of their conflicts of interests, service providers tend to arrange subsequent plans and reviews and inflate quotes. This is problematic and must be addressed so that Participants control all of their Plans all of the time.
Although, SIL typically relates to participant’s in Supported Accommodation Services, i the NDIA cannot instruct NDIS participants to move into group homes as this is against the underlining principles of the NDIS Act 2013 as outlined in Sections 3 and 4 that also refers to the International Covenant on Civil and Political Rights.

KEY MESSAGE: The solution to the above-mentioned is to abolish Supported Independent Living (SIL) from Plans. Replace it with individualised NDIS Plans for everyone including people who wish to share accommodation and support.

You can read the full submission here.

NDIS Thin Markets Project Submission

QAI made a submission to the Department of Social Services on the NDIS Thin Markets Project.

Here is an excerpt from the submission of our recommendations:

QAI Recommends

Provide clear, transparent information about SILS. Clarify the restraints that SILS imposes on ‘choice and control’. Explain that SILS pressures participants to share accommodation and support. Explain that SILS constrains planning and review.
The participant and/or family may control the first plan, but despite their conflicts of interests, service providers may arrange subsequent plans and reviews and inflate quotes.
The solution is to abolish Supported Independent Living (SIL) from Plans. Replace it with individualised NDIS Plans for everyone including people who wish to share accommodation and support.
Restructure pricing for supports at the top and bottom of the market with particular emphasis on mental health supports, therapy services and services for people with complex needs:
1. In regional, rural and remote regions, the NDIA must use affirmative action to encourage new providers and encourage existing providers to strengthen their service delivery. The NDIA’s regional price weighting currently does not account fully for travel costs, worker time, and the challenges of good governance.
2. Work with remote Indigenous councils to train staff and deliver NDIS services in their regions. This will build the capacity of local people and businesses and reduce under-unemployment.
3. Make it easier for Participants with small NDIS packages (for example, under $40,000 pa) to find providers that are willing to manage or provide support services.
4. The NDIS Price guide must be adhered to by all providers including sole-traders.
5. Adherence to the appropriate levels of the price guide must be monitored as the scarcity of workers has created a ‘workers’ market’?
6. The Price Guide could be restructure with a scale of fees such as what is used by Medicare but where no gap fees are applied.
Create opportunities for experienced and innovative providers to fulfil the paucity of services to these Participants and others in the community who require similar expertise.
Provide financial and logistical support1 to enable Access requests and to activate the NDIS plans of people with disabilities who are detained in prisons or in civil facilities for involuntary treatment and habilitation. Plans and supports may assist prisoners who apply for parole.
Authorise behaviour supports for prisoners with disabilities while they are in the ‘system’. The NDIA must work with state-based corrective services and prisons to ensure prisoners get NDIS Access, and supports while in prison.
Pilot research that will identify the most appropriate and effective supports for people with disabilities while they are in prison, and transitioning from prison, and determine the effects that such supports have on recidivism.
Queensland Department of Communities and Disability Services and the NDIA work together to address the transport needs of people with disability who are on NDIS plans, and those who are not.
The Quality and Safeguards Commission scrutinises agencies providing housing and support and restricts registration to ensure no provider is able to provide both functions.
The NDIA and the Quality and Safeguards Commission must examine the rules for workers acting as independent contractors, to mitigate the price gouging of Participants’ Plans.
Provide support and guidance to self-managing Participants who are grappling with ATO rules, underfunded Plans and a competitive, low-supply market of support workers.

You can read the full submission here.

chalkboard with flow chart and hand pointing to one of the boxes

New resources – NDIS process flowcharts

QAI has prepared the following 2 resources to help explain NDIS processes

NDIS access flowchart (PDF) – understand how to apply for NDIS and options for challenging decisions you are not happy with.

NDIS external appeals flowchart (PDF) – follow the process of applying to the Administrative Appeals Tribunal (AAT) for a review of an internal review decision of the NDIA