NDIS Progress, but Plan Review Pain
Last March, before the 2022 Federal election, we highlighted some of the National Disability Insurance Scheme (NDIS) pain points for our clients, including the pressure on plan reviews. It will come as no surprise to many in the sector, that issues relating to plan reviews have not yet been resolved – if anything, the situation has continued to worsen.
Support Coordinators at Unisson have suggested that as many as 50% of plan reviews they participate in lead to major levels of frustration for all stakeholders: clients, families, advocates, support coordinators, healthcare professionals, and NDIS staff. The time wasted from appointments that aren’t kept, delays in plan review processing that lead to new allied health reports being required, and the lack of attention to changes in circumstances requested in many plan reviews, are frustrating.
In October last year, the new Minister for the NDIS Bill Shorten announced a much needed review of the NDIS. The review involves two parts:
Part 1 – examining the design, operations and sustainability of the NDIS
Part 2 – examining ways to build a more responsive, supportive and sustainable market and workforce.
The Review, overseen by two independently appointed co-chairs, is due to be handed down, along with recommendations, in May 2023. Public submissions have been sought as part of the Review to highlight the main concerns of the scheme, which according to the latest NDIS Quarterly Report now rivals Medicare in dollar terms.
Public Perception of the NDIS.
Ongoing public concerns about the NDIS relate largely to the perceived value of the scheme and particularly its economic sustainability. A lack of understanding of the benefits of the scheme, in terms of value added to the economy through jobs and economic growth was highlighted in a report by Per Capita in November 2021, which calculated that for every $1 spent, the NDIS delivers $2.25 back to our economy through associated economic activity and employment generated by the sector.
It is up to the National Disability Insurance Agency, who administers the NDIS, to ensure that the scheme operates optimally, minimises financial waste, and removes those who seek to exploit the scheme. Some progress has been made during the past year in relation to the latter, with a number of operators blocked from providing NDIS services due to fraudulent activity. Others are currently being scrutinised.
Progress on Hospital Discharge Wait Times
In the past 12 months, significant progress has been made in relation to people with disability who are ready for discharge from hospital, and are waiting for suitable supported living arrangements. According to a recent report, wait times have been reduced on average from 160 days down to 36 days. Although still too long, this outcome improves the availability of hospital beds, and means that people are not retained in a hospital environment, in most cases, for months on end. According to Bill Shorten, “One of the pressures of bed blocks in our hospitals, one of the pressures on the health dollar and most importantly one of the pressures on the welfare of [people with a profound disability] – the news is getting better, not worse.”
This claim has been backed up by Unisson support coordinators who detailed two clients who were able to move out of hospital and into supported independent living within a relatively short period of time. However, there is a disclaimer to this story: If the participant needs specialist disability accommodation (SDA), there is good availability, but for those seeking supported independent living (SIL) in suitable locations, vacancies are still few and far between.
Ongoing Issues with Plan Reviews
The NDIS plan review process still leads to a lot of confusion. According one Unisson support coordinator, who helped prepare for 18 plan reviews between September and December 2022, only a couple of plans reviews were done correctly. This has meant that virtually all new plans required a “Review of a Reviewable Decision”, doubling the time it has taken both the support coordinator and the NDIS to achieve a successful outcome, and delaying the right kind of support being provided to the participant.
Examples of some of the frustrations encountered by our support coordination team in the plan review process include:
- A revised plan being received, which clearly belonged to a different participant.
- A “change of circumstances” not being included in a revised plan, despite being well-documented.
- A plan being $30,000 short on funding for the community access component alone.
- A communication breakdown between the NDIS planner and their supervisor who needed to approve a revised plan, resulting in an incorrect plan review.
- Specialist disability accommodation (SDA) being denied to a participant several times, despite a high level of supporting documentation from allied health professionals.
- Supporting documentation, including health reports, having to be updated at a significant inconvenience to all parties, despite the delay being on the side of the NDIS.
- A participant being denied the right to a “review of a reviewable decision” because they missed the NDIS deadline by two days, due to a death in the family.
- Participants and families having to resort to appeals in the Administrative Appeals Tribunal at great cost. This can also mean up to 12 months waiting for a decision being made about a plan review.
- NDIS staff not attending confirmed meetings from time to time, without explanation.
- NDIS staff ringing stakeholders on weekends, indicating a significant backlog of plan reviews and under-resourcing.
Getting it “right” is important.
George Taleporos, the Chairperson of the Victorian Disability Advisory Council, says the community asked the NDIS to “be simple, fair and enable us to live out our lives. It’s a bureaucracy, [and] decisions are often made without explanation.” He adds a message to Bill Shorten, “Listen to the problems that we are having and work with us to come up with solutions. [Ultimately] the NDIS is an investment in people.”
The NDIS has committed to hiring hundreds of new staff and, together with the forthcoming Report from the Review of the NDIS due in May, service levels and processes for plan reviews ought to improve in coming years, despite the scheme expanding at a rapid pace. In the meantime, however, there is still a lot of work to be done.