September 25, 2018

NDIS – inching closer to market readiness

A parliamentary inquiry has found that neither the NDIA, disability service providers, the disability workforce nor participants are ready for the NDIS rollout and that most are not coping. It has identified deficiencies in the NDIA’s stewardship of markets, failure to address thin markets and failure to define viable provider of last resort services. It also finds that the Specialist Disability Accommodation scheme is not yet working.

The inquiry into Market readiness for the provision of services under the NDIS conducted by the federal parliament’s Joint Standing Committee on the National Disability Insurance Scheme has received more than one hundred submissions responding to the terms of reference on market readiness for provision of services under the NDIS, with particular reference to:

a. the transition to a market based system for service providers;
b. participant readiness to navigate new markets;
c. the development of the disability workforce to support the emerging market;
d. the impact of pricing on the development of the market;
e. the role of the NDIA as a market steward;
f. market intervention options to address thin markets, including in remote Indigenous communities;
g. the provision of housing options for people with disability, with particular reference to the impact of Specialist Disability Accommodation (SDA) supports on the disability housing market;
h. the impact of the Quality and Safeguarding Framework on the development of the market;
i. provider of last resort arrangements, including for crisis accommodation; and
j. any other related matters.

The findings in the final report are pretty disheartening, with no area covered by the inquiry coming out well. Some selected quotes:

Market Stewardship: “NDIA, as the lead market steward, has often failed to put in place in a timely manner the appropriate measures and initiatives to support the development and growth of the disability support marketplace to meet demand” “The roles, responsibilities and activities of all those responsible for market stewardship are unclear”

Participant Readiness: “Throughout the inquiry the committee heard that most participants are not ready to confidently engage and navigate the market. Of concern is that submitters continue to raise issues around adequacy of plans and ability of participants to activate and manage plans. It appears that the resources and supports put in place by the NDIA to help participants activating and implementing their plans are not reaching all participants and their families”

Workforce Readiness: “no clear national strategy to grow the workforce despite the need for
an additional 70 000 disability workers by 2020” and “virtually no incentives to choose a career in the disability support sector. “ and “underemployment and insecure work arrangements, inadequate wages with little or no prospect of professional development opportunities”

Service Provider Readiness: “struggling to make the necessary changes to operate under the NDIS” and “Many service providers critically lack the capacity, expertise, cash reserves and infrastructure to make a successful transition and operate in the new NDIS environment.”

In addition Pricing was found to be a significant problem, with many service providers unable to be viable under current pricing, but also service providers “cherry picking” clients for profitability, leaving the most vulnerable NDIS participants with no access to services.

The committee also noted that thin markets were still a problem and expressed concern that there is still no clear policy yet released on Provider of Last Resort arrangements.  Specialist Disability Accommodation came in for particular criticism, citing lack of data on SDA demand, poor choices of living arrangements for participants and poor information for investors.

So, in every area the committee investigated there were fundamental concerns around either policy, implementation, pricing or communication – or all of the above.

The result is that the committee has made 29 recommendations. Among the flurry of “develop a strategy” and “monitor and report” recommendations there are a few that are clear, tangible – and urgent:

Staffing: “The committee recommends the NDIA urgently allocate more staff and support to assist participants with plan implementation.”

Pathways: “The committee recommends the NDIA urgently implement the tailored pathways designed to support:
• participants with complex support needs,
• children aged zero to six,
• participants with psychosocial disability,
• participants from culturally and linguistically diverse (CALD) backgrounds,
• Aboriginal and Torres Strait Islander communities,
• remote and very remote communities, and
• LGBTQIA+ communities.”

Training: “The committee recommends the Quality and Safeguards Commission review options on how to ensure disability workers under the NDIS can access funded training, including considering the introduction of a portable training entitlement system.”

Specialist Disability Accommodation: “The committee recommends that a specialised team of NDIA planners is established to accelerate the transition of young people residing in aged care facilities to appropriate SDA accommodation which meets their complex needs.”

Eligibility to Specialist Disability Accommodation: “The committee recommends that when a person is deemed eligible for SDA, this eligible should be considered ongoing and not subject to change under the participant’s annual planning processes.”

There is clearly a lot of work to do on the NDIS – and if that’s what parliament thinks is the case, hopefully parliament is willing to do whatever is needed to fix it.