NDIS Capacity Building Project Update 4 - December 2013

Welcome to the MHCA NDIS Capacity Building Project Update 19 December 2013, the final update for this year.
                                                                                
Integrating Mental Health into the NDIS Conference – statement from delegates

If you attended this conference on 2nd and 3rd December, you will know that conference delegates agreed to issue a joint statement, in the form of a letter to the Prime Minister and State Premiers, outlining their concerns about the design and implementation of the NDIS. The final version of the letter is attached for your reference. Many of the sentiments in the letter reflect the MHCA’s thinking on the NDIS, as set out in a position paper released at the same conference.

NDIS and mental health information portal

The Policy and Projects Team have been working hard over the past few months to develop an online information portal for consumers, carers, service providers and NGOs on the NDIS and mental health. The portal is now live on the MHCA website and contains a substantial amount of information about the NDIS, providing an easy to navigate access point to key information.  One thing members have been telling us is that it can be difficult to find the right information on the NDIS website, particularly on complex issues.  Our portal is designed to address this by being a ‘one-stop shop’ for all information of interest to the mental health sector, covering policy issues, the NDIS Rules, eligibility and assessment, pricing and advice on how to resolve problems. It will be updated regularly and we welcome contributions from members. So if you have any queries about the portal or would like us to post information (eg upcoming events, resources and materials) please contact Travis Gilbert on 02 6285 3100 or at dca@mhca.org.au.

MHCA NDIS Project Advisory Group and Working Groups meetings in December 

The MHCA NDIS Project Working Groups all teleconferenced for the first time on 2-4 December and addressed the following priority areas:

1. Scheme design and administrative arrangements
2. Assessment and eligibility
3. Monitoring and Evaluation and service quality
4. Supported decision making and diverse groups
5. Organisational readiness and workforce

The working group chairs  had a challenging task to cover the issues of interest to each working group at short notice and within a short timeframe and the MHCA would like to thank the chairs and working group participants. The minutes from these discussions will be made available in the new year.

The MHCA NDIS Capacity Building Project Advisory Group (PAG) met face to face for the first time on 10 December in Melbourne to discuss the priorities for the MHCA’s NDIS Capacity Building Project. Information on actions arising from this meeting will be available on the MHCA website soon.

COAG Disability Reform Council Communique

The COAG Disability Reform Council met in Melbourne on the 18 December.  The meeting was chaired by Senator the Hon Mitch Fifield, Assistant Minister for Social Services, and Senator the Hon Arthur Sinodinos AO, Assistant Treasurer. All jurisdictions reaffirmed their strong commitment to implementing the National Disability Insurance Scheme (NDIS) across Australia and recommended work continue including a focus on building the scheme’s service delivery capability, improving the pace of client transitions to the scheme, ensuring the fiscal sustainability of the scheme and preparing a report for the next COAG meeting on the cost drivers of the NDIS.  The communique from the meeting is attached.

NDIS Support Clusters and Associated Pricing

On November 7 the NDIA released a new version of the ‘Support Clusters Definitions and Pricing’.  The MHCA is also aware that the NDIA is working on a review of pricing supports and has been consulting with National Disability Services (NDS) about the pricing of NDIS services – though we do not believe that mental health service providers or peaks have been consulted.  A recent article from NDIS Ready, a newsletter of NDS Victoria dated 9 December, outlined the process:

NDS continues to highlight the inadequacies of the one-to-one support prices and appreciates the work undertaken and shared by many service providers in supporting the case for the review. Additionally, NDS has sought clarification on the NDIA’s position as to whether some services and supports will continue to be block-funded after transition. How this transition is managed will be critical for service providers.

As NDS’s negotiations with the NDIA continue, members operating in the launch sites are encouraged to provide NDS with feedback on NDIS prices, particularly those prices relating to accommodation support, group-based community participation and employment. We thank members who have already assisted us with information. NDS will inform members as soon as the outcome of the review of prices for one-to-one support is available.

The revised Support Cluster items reflect some improvements of interest to the mental health sector including the following (summary reproduced with kind permission of NDS Victoria):

• A new category for supporting participants with challenging behaviour or with high medical support needs. This covers support with daily personal activities and support to participate in community, social and civic activities. NDS is pleased that the NDIA has accepted our argument that supporting participants with challenging behaviour or high medical involves a higher cost than supporting other participants.
• A new support item that recognises that some individuals require higher intensity complex support coordination. The price for this has been set at $83.00 per hour, more than $30 per hour more than the standard coordination price. In addition, the NDIA has acknowledged that where “such support is provided or guided by a health professional because of the needs of the participant, the health professional rates apply for that support.”
• The expansion of the number of items under the ‘Assistance to access and maintain employment’ cluster reflecting the assistance that people with significant disability require to find and maintain employment, including ‘Assessment to identify vocational potential and suitability’ and ‘Workplace assessment’ are particularly welcome, along with the items for ‘Post-school employment assistance’.
• The prices related to work in an Australian Disability Enterprise (ADE) have been revised to reflect current ADE case-based funding levels. This at least will clarify pricing arrangements for ADE providers during the launch phase of the NDIS.  

NDIS Prices to be deregulated in mid-2014

The following announcement on pricing has been reproduced from the National Disability Services newsletter dated 9 December 2014:

The current regime of fixed maximum prices for NDIS supports in launch sites will end in mid-2014. David Bowen, CEO of the National Disability Insurance Agency (NDIA), announced this at last week’s CEO Meeting in Sydney in a session on lessons from the NDIS launch.

The NDIA will continue to set an individualised budget for NDIS participants, but will allow increased flexibility for participants to negotiate with providers about the quantity and type of supports they receive. David Bowen said that deregulated pricing will increase choice for participants. The NDIA will outline further details of the change in coming months.

NDS welcomes the announcement. As members are aware, NDS has raised concerns with the NDIA that some current prices in the launch sites are unsustainable for providers and will erode choice and quality for participants. As the NDIS expands, it will be very difficult for a centralised price-setting regime to reflect adequately the diverse circumstances and preferences of participants. There is therefore merit in testing price deregulation during the launch.

David Bowen confirmed that the NDIA will adjust prices immediately to reflect the Equal Remuneration Order wage payment due on 1 December 2013. He indicated that the review of one-to-one support prices will conclude shortly. 

The announcement that prices will be deregulated does not obviate the need to develop prices which are transparent and based on reasonable costs. The NDIA will continue to employ price assumptions in developing individualised budgets, so it is important that these assumptions are robust. NDS is planning to develop a national pricing project with external expertise, early in 2014.

Contact Information:
Ken Baker, Chief Executive, Ph: 02 6283 3203, ken.baker@nds.org.au

Lessons learnt from NDIS launch sites

The National Disability and Carer Alliance recently published this interesting article on lessons learnt from the launch sites: http://disabilitycareralliance.org.au/national-disability-services-national-ndis-launch-co-ordinator-deborah-hoffman/.  

Concerns described reflect many held in the mental health sector, however they also omit key lessons around the experience of consumers and carers in the assessment and planning processes and that of service providers working with the NDIA.  We acknowledge that NDIA is working hard on a very complex task and so hope that this extremely important issue of monitoring and improving the quality of NDIA services will be much more of a focus as implementation progresses in launch sites.  

National Disability Services also summarise their learnings from launch sites in the NDS Victoria Newsletter of 9 December, and highlight that they continue to maintain a watching brief on the following issues:      

• identifying and supporting people assessed as ineligible under the NDIS, and the practicalities of the ‘continuity of support’ commitment under the intergovernmental agreement;
• monitoring the impact on providers as cash flows change in the transition from payments in advance to arrears;
• potential ‘gaps’ between NDIA-funded services and inadequately funded mainstream and community services;
• clarifying which mental health services and support will be offered for those eligible under the scheme; and
• providing quotes for shared accommodation support options and the issue of affordable housing supply.

Outcomes of the National Disability and Carer Alliance Survey

A recent National Disability and Carer Alliance survey on participant information needs reveals that participants said that they would definitely value more information on the NDIS rollout, eligibility and assessment, the planning process and case studies.  This finding of course reflects feedback from mental health stakeholders and we are working with the NDIA to make sure this sort of information is more accessible to consumers and carers.  An article on the results of the survey can be found here: http://disabilitycareralliance.org.au/results-of-the-national-disability-and-carer-alliance-ndis-information-survey/.

Draft consumer and carer information resources

The development of information resources targeted to the needs of mental health consumers, carers and families is one way where the MHCA hopes to ensure that better information is available about the NDIS and psychosocial disability.  The MHCA has been developing these resources in collaboration with the National Mental Health Consumer and Carer Forum (NMHCCF) Psychosocial Disability Working Group.  Because issues around eligibility, permanence of disability and recovery are so unclear at this stage, the MHCA and NMHCCF have agreed to release these resources as draft documents for consultation with consumers and carers.    We welcome input from consumers and carers on this information and hope to have them available on the MHCA website in January 2014.  

New fact sheets on NDIS website

The following new fact sheets, which may be of interest to mental health consumers, carers and service providers, have also recently been made available on the NDIS website:

1. Australia Disability Enterprises
2. Support for D2DDL
3. Mental Health Respite
4. Mobility Allowance
5. Personal Helpers and Mentors
6. Partners in Recovery
7. Young carers respite and information services

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 we remain eager to hear about your experiences on the NDIS as it evolves.

Season’s greetings!