Mutual investment for quality Supported Independent Living options in a thriving NDIS market

Rigid National Disability Insurance Scheme (NDIS) plan decisions and review delays within the National Disability Insurance Agency (NDIA) remain the biggest barrier to a thriving market with a range of housing and support options for NDIS participants. Accelerating solutions solves housing issues, improves the effectiveness of paid support and addresses workforce shortages.

A thriving market will routinely evidence support delivery that improves functional gains and outcomes over time.? A great housing and support option may reduce the reasonable and necessary funding value or improve the quality of life and safe delivery of support.? Both outcomes are cost effective, and important in a care market.?

At ONCALL we are looking to the government to build trust, reliable processes and a high-quality market of NDIS providers to ensure that the scheme lives up to its key objectives to support people with disability to live with dignity and to reach their potential.?We have been calling on the NDIA to provide greater transparency, particularly within the Supported Independent Living (SIL) options to ensure decisions are made based on quality of outcomes, including real quality choice and control for participants.?

We've seen the difference a well designed property and support option delivers for people. This is the stuff dreams are made of.? Improving connection, belonging and independence. When disability supports and services work well, we see people with disability with stable support teams and increasingly in employment or occupation. We see parent carers freed from funding administration and returning to work.? We see ageing parents sleeping soundly without worry about what will happen when they’re gone.?

However in the last 12 months, over half of the people living with ONCALL have endured significant stress and uncertainty through rigid planning processes, downgrading of funding and ignoring evidence about their needs.? It is not simply downgrading of funding causing pressure, the delays within the NDIA and misunderstanding of the operating environment remain the biggest barriers to delivery of high quality and value for money options.?

NDIA is funding for hopes and dreams. Not the hopes and dreams of NDIS participants to have a good life, but their hopes and dreams that there is already a high-quality provider market that drives Scheme efficiency.? Rapid and standardised funding decisions may be possible when there are innovative and ideal arrangements that NDIS participants can regularly choose from.? Efficient pricing may be possible when there is equilibrium in the market.? But this requires getting past the current drivers of inconsistency in NDIS participant knowledge, huge variability provider quality, massive workforce shortages, managing a pandemic and cost of living driving up the costs of service delivery.

The lack of balance between NDIS funding processes and market maturity is most acute in Supported Independent Living (SIL) where the individual needs, costs and opportunities for functional improvement are the highest.? In this support type, it seems the NDIA believes rigid cuts and distance from the issue will address Scheme blowouts.? But the approach continues to comprise client and staff safety.? SIL funding decisions are still leaving providers to manage unacceptable risks or subsidise NDIS services. In a recent survey of the sector CEO Colab network, over 75% of the participating providers reported they will post operating losses this financial year due to the rigid NDIA approach in SIL funding.? This is an indicator of government misfiring on what needs to change.

Ironically, we are witnessing the NDIA cuts driving up costs in the NDIS. The current approach drives NDIS participants to push to AAT cases and a panic of ‘going for gold’ with highest possible funding. Further, NDIA continues to fund plans as a ‘market of one’ with all costs loaded for every participant with no opportunity for rationalizing or improving a value for money proposition.? A planned commissioning approach has potential for a provider to network NDIS supports and services (for example, deliver supervision or backup from a nearby site, or to combine regular supports to deliver 15 minute instances instead of 2 hours minimum).? A planned, engaged approach enables a participant to plan for a support arrangement that maximizes their community participant, and reduces reliance on NDIS funded support.??

NDIA announced recent changes that were welcomed by providers (covered in a recent blog post)? These administrative process changes will free up some time from claiming issues to focus on delivery of support.? However, they were small changes for big issues. The changes certainly did not get to the heart of the issue – a market that can deliver SIL services with the person at the centre, evidence of high quality support and prove value for money for the government.? There is a lot more work to be done.

ONCALL continues to call on the government to accelerate work and improvements to SIL.? This is a pinch point that is high cost and potentially high reward to participants, to government and to providers.?

If NDIA focuses on solving for the highest cost plans it can underpin improve efficiency of the market and the Scheme.?

Rather than small changes, reviews and delays from more talk, ONCALL?would like to see accelerated consideration for specialist responses for people with very complex needs and concrete measures to address widespread skills shortages which are further impacting the delivery of NDIS and other programs.? If NDIA focuses on solving for the highest cost plans it can underpin improve efficiency of the market and the Scheme.? Something people with disability, their families, providers and government are mutually invested in.?

Laura Green?

Executive Director Victoria, ONCALL Group Australia?

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ONCALL is a disability organisation and registered NDIS provider. We also deliver casual staffing services (specialist labour hire) to the major NDIS Supported Independent Living providers in Victoria and Queensland. We are an organisation that has been operating for 18 years. Our purpose is to be nationally recognised as the leading integrated community service provider, empowering people to live their best lives.

As an organisation dedicated to serving the needs of people with disability, we strongly support the initiative of a National Disability Insurance Scheme that appropriately funds people with disability to have choice and control over their lives. We further understand the imperative for any such scheme to operate in a financially accountable and sustainable manner. We have been actively working with the Federal Government, the NDIA and with other service providers to play our part in a community of learning to achieve efficiency in NDIS service provision, without compromise to quality of service.