The National Disability Insurance Scheme - Services and Supports
Services and Supports that may be funded through the NDIS
The MHCA has been informed that people who are eligible for tier 3 support through the NDIS for psychosocial disability can use their individualised funding packages to purchase non-clinical services and supports to enable them to increase economic and social participation and social functioning. NDIS funding cannot be used to fund clinical mental health services as this remains the responsibility of the health system.
The information below is based on what the MHCA has determined about mental health programs and services that are ‘in scope’ for the NDIS and the types of non-clinical supports listed in the pricing clusters and that we know our member services provide to people with psychosocial disability.
Commonwealth funded mental health programs that are ‘in scope’ for the NDIS.
What we know
The NDIA has informed the MHCA that the Personal Helpers and Mentors program (PHaMs) is 100% ‘in-scope’ for the NDIS. The mental health sector has expressed concerns about PHaMs being fully ‘in-scope’ for the NDIS once the scheme is fully operational. Not all current PHaMs clients are likely to be eligible for tier 3 support through the NDIS. Current clients are guaranteed continuity of support and will continue to receive support as the program is rolled into the NDIS. The loss of PHaMs as a stand-alone program raises concerns about how people not eligible for tier 3 support will be able to access this vital program going forward. The episodic nature of mental illness means a significant proportion clients move in and out of the program. If people have dropped out, what are the implications for the continuity of support? In addition there are concerns that the flexible eligibility criteria will become too rigid if it is moved into a scheme with definitive assessment and eligibility criteria attached to its access.
What we know
The NDIA has informed the MHCA that PIR is likely to be 70% ‘in-scope’ for the NDIS. PIR is an initiative designed to facilitate better coordination of clinical and community supports to deliver ‘wrap-around’ care individually tailored to a person’s needs. The person-centred approach certainly mirrors the ethos of the NDIS but the program is in its infancy and we are eagerly awaiting how referrals from PIR to the NDIS pan out on the ground in the Hunter launch-site.
What we know
The NDIA has informed the MHCA that the Support for Day to Day Living program is 30% ‘in-scope’ for the NDIS. We know that the program provides two tiers of support. One providing more intensive support and one providing more ‘basic support’ to people. We would expect that the more intensive support component would roll in to the NDIS. Similar concerns regarding ongoing access to the program that have been expressed in relation to PHaMs once the NDIS is fully operational. There will be a need to ensure that non-NDIS clients are not worse off or vice-versa.
What we know
The NDIA has informed the MHCA that the Mental Health Carer Respite Program is 50% ‘in-scope’ for the NDIS. This means the program will continue to be block-funded (equivalent to current funding) while the remaining 50% of funding for respite services (not the language of the scheme) will be purchased by participants with their individualised funding packages.
Services and supports that people may be able to purchase with individualised funding
The Council of Australian Governments developed the following set of principles to determine what should be the responsibility of the NDIS to provide versus what other service systems should be responsible for providing and what it is ‘reasonable’ to expect families to provide. The principles will be reviewed as per the process set out in part eight of the Intergovernmental Agreement for the Launch of the National Disability Insurance Scheme.
The following is a link to the COAG report setting out the principles underpinning the responsibility of the NDIS for the provision of supports for participants and what other service systems will be responsible for.
On page fourteen of the NDIS (supports for participants) rules, the following is specified:
“…Most importantly for people with psychosocial disability, the NDIS will be responsible for supports that are not clinical in nature and that focus on a person’s functional ability, including supports that enable a person with a mental illness or psychiatric condition to undertake activities of daily living and participate in the community and social and economic life. The provision of all other services and supports, in particular, clinical services will remain the responsibility of the health system…”
This means the NDIS will not be responsible for funding clinical acute, ambulatory or rehabilitation care, clinical residential care or early intervention support that is clinical in nature.
The NDIS (supports for participants) Rules provide a good overview of the areas of responsibility across whole-of-life domains (education, employment and training, family support, health, housing, independent living, transport, etc.) that the NDIS will and will not assume responsibility for funding.
The rules (other than the distinction between clinical and non-clinical mental health supports) do not outline specific types of supports that a person with psychosocial disability can purchase with their individualised funding. To do this, it will be necessary to turn to the pricing of support clusters in the launch-sites and seek advice from community based mental health services about the types of support they currently provide to people with psychosocial disability to support independent living.
The overarching ethos of the NDIS is to enable people to maximise choice and control over their lives and the supports they purchase to help maximise economic and social participation and independent living.
The following is a list of some of the supports that a person with psychosocial disability may choose to purchase with an individualised funding package:
- Assistance with self-care and day to day living
- Assistance with shopping and access to appointments and services (i.e. Centrelink)
- Support for community inclusion (assistance to join and remain engaged with community groups and activities)
- Helpers and Mentors (PHaMs is 100% ‘in-scope’ for the scheme)
- Health and wellbeing programs to help you function better
- Help with communication
- Respite (for mental health carers)
- Specialist housing support (unclear at this stage how this may pan out for people with psychosocial disability)
- Domestic assistance (cooking, cleaning, washing, etc)
- Transport assistance (there are limits on the distances that the NDIS will fund)
- Therapies (non-clinical)
- Case management and coordination (Through Local Area Coordinators employed by the NDIA or through Partners In Recovery Service Coordinators)
- Specialist employment services
- Financial counseling or assistance to resolve debts
- Crisis/emergency support
- Tenancy support and assistance to maintain housing
- NDIA Fact Sheet: Supports the NDIS will fund in relation to housing and independent living - The following fact sheet provides a basic overview of the mainstream interface between the types of services and supports that the NDIS will fund in relation to housing and independent living and those that will remain the responsibility of the housing and other service systems:
Operational guidelines: Supports in the plan
The following operational guidelines document how the NDIS will operate in relation to the following types of supports (relevant to people with psychosocial disability). They outline what people can expect that the NDIS will and will not fund:
- Operational guideline: Education, employment and training
- Operational guideline: Supports for sustaining informal support (including family and carers)
- Operational guideline: Supports to undertake household tasks
- Operational guideline: supports in the plan – interface with child protection and family support services
- Operational guideline: supports in the plan the interface with health
- Operational guideline: Supports in the plan – the interface with justice
- Operational guideline: Supports in the plan – the interface with transport
- Operational guideline: Supports in the plan – the interface with housing and community infrastructure
- Operational guideline: Supports in the plan – interface with mental health
- Operational guideline: Supports in the plan – Personal care supports
- Operational guideline: Supports in the plan – Recreation supports