NDIS Capacity Building Project Update 2 - October 2013
Welcome to another edition of our National Disability Insurance Scheme Mental Health Network e-newsletter.
New name
Some of you may be aware that with the change of Government has come a change of name. DisabilityCare Australia has now been re-named the National Disability Insurance Scheme (NDIS) and the agency responsible for its implementation and oversight will be known as the National Disability Insurance Agency (NDIA). Confusingly, the branding of the organisation will apparently remain DisabilityCare Australia until further notice for cost reasons.
Website update
New information on the MHCA NDIS Capacity Building Project is now on the MHCA website. MHCA NDIS Capacity Building Project
Survey
Some people have noted that there is no date on the survey that MHCA is using to collect information from the sector. This is because we intend to continue using the survey to collect information for some time so we would be happy for you to continue to promote it to your networks. Please click here to view the survey.
Project Advisory Group and Working Groups
We are pleased to announce that the members of the MHCA NDIS Capacity Building Project Advisory Group are:
Margaret Springgay - National Mental Health Consumer and Carer Forum
Lyn English - National Mental Health Consumer and Carer Forum
Jayne Gallo - Care Connect
Kim Koop - Vicserv
Ara Cresswell - Carers Australia
Rod Astbury - WA Association of Mental Health
Richard Nelson - Queensland Alliance for Mental Health
Tina Smith - Mental Health Coordinating Council of NSW
John Downie - Malee Family Care
Daryl Lamb - Anglicare Tasmania
Wendy Kipling - ACT Mental Health and NDIS Taskforce
Stephen Brand - Allied Health Professionals Association
Josh Fear - Mental Health Council of Australia
Thank you to all those who applied. It is hoped the Project Advisory Group will be able to have a preliminary teleconference in the next few weeks.
The Mental Health Council of Australia would like to thank everyone for their expressions of interest to join the Project Working Groups. We have received an overwhelming response from people and nominations are now closed.
The MHCA is now in the process of finalising membership for the various working groups. Some groups received a very large number of nominations (especially the eligibility and assessment working group) and we are working through these at the moment. We plan to provide you with more information about the membership and next steps for working groups in the next couple of weeks.
Barwon Workshop
During September the MHCA attended a joint workshop convened by National Disability Services (NDS) and Psychiatric Disability Services Victoria (Vicserv) for community managed mental health service providers. Links to final report of the workshop will be made available on the MHCA website in coming weeks. However many of the issues raised at the MHCA workshop in Canberra on the 27th April were evident in Barwon, along with some state-specific issues arising from ongoing negotiations between the Commonwealth and Victorian Governments and from reforms to the mental health sector in that state.
NDS summarised the issues raised in the workshop as follows:
- Eligibility criteria – What will happen to people with mental health issues who are not eligible for NDIS or people who do not wish to voluntarily engage with the NDIA? Which government department is responsible? What support will be offered to carers, families and support networks that do not fit the NDIS eligibility criteria?
- Model of Care – How will the NDIS incorporate the mental health recovery model and the critical role and support of the carer?
- Transition and implementation – What engagement strategies will be implemented to support people with mental health to register for the NDIS? Will the NDIA staff have the knowledge and skills to effectively support people with mental health to undertake complex care planning? Will existing mental health providers have the capacity to operate in the new environment? Will there be continuity of care? What review processes will respond to service gaps and issues identified in Barwon and across launch sites?
- Pricing – Can NDIS pricing reflect the costs of providing holistic support to the participant and carer? Can NDIS pricing reflect a mental health model of care including; case management, advocacy, staff training and peer support?
- Community mental health service provision – How will the NDIA effectively engage with specialist services such as housing, homelessness, drug and alcohol and family support? How will the NDIA monitor and understand how the transition to the NDIS impacts on the availability and quantity of community based mental health services? Will the NDIA have the capacity for research, innovation and response to emerging mental health issues?
Representatives from the Victorian State Office of the NDIA also presented at the workshop and affirmed their commitment to making the NDIS work for people with a psychosocial disability. Interestingly NDIA officials noted that the decision not to fund early intervention in mental health (as set out in the NDIS Rules) will be reviewed throughout launch and that the agency will report on whether there are non-clinical early interventions that could be consistent with the insurance approach. This is heartening news given a strong belief in the mental health and other sectors that early intervention for people without a sufficiently “permanent” disability can indeed deliver cost saving effects for the governments in the long term by ensuring that these disabilities are not exacerbated due to a lack of appropriate and much needed support for people with psychosocial disability.
Launch site news
At this early stage it is difficult for the MHCA to provide a comprehensive overview of what is happening in the launch sites, where we know there are numerous activities taking place and where service providers are often involved in almost daily networking meetings. The MHCA is however keen to pass on some of the key insights that we have gleaned through talking to people in and in contact with the launch sites, and we hope to bring you more considered perspectives on launch site activity throughout the year through our website.
We are beginning to hear stories and perspectives from service providers as they register and begin to provide services under the NDIS. While this information does not answer many of the questions and potential challenges raised by stakeholders at our national workshop, we know that service providers and NDIA officers are encountering the same questions and challenges as they start their work with mental health consumers and carers in the Scheme. The message from the NDIA is that local solutions and innovations emerging in the launch sites will contribute substantially to whatever nationally consistent approaches are developed.
We have heard about a few cases of quite disabled mental health consumers receiving packages of funded support and of others having their support hours increased after undergoing the assessment and planning process with the NDIA. At the same time, we have heard about cases of people receiving less support in aggregate after being assessed by the NDIA, sometimes because certain of their needs are not taken account of in their participant plans. At this stage the NDIS is not able to provide details about these because numbers are too low to protect the confidentiality of participants, but as numbers grow more data will become publicly available.
It is alarming that we are also hearing some stories from service providers that consumers are falling through gaps and that service providers are having to provide unfunded referral and supports for people who are not eligible for NDIS, so that these people are not abandoned without crisis support. We are also concerned that there appears to be no central formal way of the NDIA monitoring how well issues are being resolved for people with psychosocial disability and their carers and what is happening to people who are being assessed as not eligible for support.
These issues will be a focus of MHCA efforts and no doubt of great interest to the Working Groups for the MHCA NDIS Capacity Building Project. We are, therefore, very interested in hearing about any experiences you may have had in a launch site and especially from consumers and carers.
Pricing of supports
Stakeholders have raised pricing issues in launch sites as a key priority and service providers in each state have indicated that they are considering their position in relation to the prices and support types offered by the NDIA. Members have noted that prices do not currently include the valuable monitoring and coordination functions that many services play to ensure that consumers are able to access appropriate and timely supports when required to maintain their recovery. Partners in Recovery services may play a role here for some consumers but are not intended to provide an ongoing role.
These are likely to be issues for consideration by the MHCA Working Group considering organisational readiness.
Prices for supports in participant plans are developed and published by the NDIA in Support Clusters Definitions and Pricing lists (see below) and are different for each launch site (reflecting estimated market prices in each).
Prices are based on existing market prices in each launch location so as not to disrupt existing markets.
A number of frequently used supports have a maximum price – that is, the highest price the NDIA will pay for these supports.
Prices are published online and updated periodically. From our understanding some of these updates have been made in response to new information about launch site conditions coming from participants and service providers in launch sites. If you are in a launch site it is worth keeping in mind both the opportunity to provide such feedback and the fact that pricing structures appear to be far from final and will continue to be adjusted for the forseeable future.
The NDIA describes reasonable and necessary funded supports as those beneficial for the participant and offering value for money. To determine what they are, the NDIA focus on:
- The participant’s goals and aspirations;
- Independence, social and economic participation;
- Strengthening the sustainability of family and community supports; and
- Early intervention supports to enable the participant and their family to reduce the future need for disability support.
Our interpretation of this is that the quality and type of supports available to individuals may depend on how well participants or service providers are able to make a persuasive case for the above criteria. The MHCA will continue to monitor this situation to ensure that the rights of mental health consumers and carers are enforced and that the full range of relevant factors is taken into account when decision are made about what supports are funded.
To stay informed about pricing, please visit: http://www.ndis.gov.au/providers/pricing-and-payment-supports
Indicative prices for support types in each of the launch-sites are available to download via the links below:
Stay in touch!
If you have any information that you would like to disseminate to others members of the network or contribute to these updates please contact Travis Gilbert on travis.gilbert@mhca.org.au.
As always the MHCA remains eager to hear about your experiences on the NDIS as it evolves.
