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  • Writer's pictureJacqui Grant

NDIS - A System that feels very Broken

Connect and Grow Magazine: May-June 2024 Edition 9




When a system is broken, its effects ripple out far and wide. If not repaired, the damage can have a long-lasting impact on people’s lives.


Fear, stress, worry and uncertainty…



Stop, take a slow, deep breath in and then out, notice any tension in your body, and then take another deep breath in and slowly exhale!

 

As you release this tension in your body, it is important to notice where it is. Reading this article may bring some stress, and you may even need to book a massage if that is your thing afterwards. Unfortunately, the NDIS is a broken system creating a lot of stress for EVERYONE involved right now.

 

Before I discuss what is happening here and now, let's examine what has unfolded since the birth of NDIS, NDIA. It's certainly been a journey and an experience. Covering some of the history may help to understand exactly how far away it is from its original concept.

 

Once upon a time, over 10 years ago, this idea started to come to life: the idea of having a system that could support people living with a disability. That was a co-design system that listened to what people who live with a disability wanted and how services could be improved for them and their families. After all, Community health at the time was limited by the funding provided, and whilst they did their best, guidelines and policies were in place around the funding caps, especially for allied health services.


 

To make this concept a reality, there were many meetings around many different tables and many heated discussions during those meetings. So many people had other ideas, and " co-design " was words thata were often used however not always implemented, so many people saying its important to have a system that works for people with a disability.


 


Everyone in the room had an opinion and a thought, and the basis of it all was that it had to be a system that would provide a service to those with disabilities and be funded by a separate bucket of money from the government.

 

This new system would be side by side the current system at the time, which included community health services and private systems.


 

Initially, every business was an NDIS-registered provider, and choice and control were very limited. One main plan manager and all providers of services had their business compliance in order.


To say I was worried about the future of Community health in the long term was an understatement, especially when, a couple of years later, I was working as a navigator/care coordinator in a government-run trial in GP clinics. In this trial, we worked with people who had an NDIS plan or Myaged Care to find the right providers for them. Still, the choice was limited, but we made it work.

 

 

People were accessing services in community health centres, paying their $5.00, and then using other providers who paid via their NDIS Plan. Initially, it was working. The teamwork and communication were there; however, soon, the demand for services grew, and more and more people were accepted onto the NDIS. More and more businesses started to charge more if they found out the person had an NDIS plan.


As things unfolded, there were and still are today many different ideas and thoughts on how the NDIS—National Disability Insurance Scheme—could be /should have been implemented. It would be a little bit like a fairy tale or a soap opera, full of dreams and drama, with all of us watching and even involved, not knowing what will happen next. Slowly, things started to unfold, and there appeared to be a relatively smooth pathway; however, over time, that pathway became filled with twists and turns.

 

Compliance and risk assessment started to become an issue, as did fraud.

 

The ideas and suggestions on how the NDIA—National Disability Insurance Agency could manage it all themselves regarding compliance and holding providers to complete accountability, seemed to work initially with everyone NDIS registered, however over time, the decision was made that anyone could get an ABN and start working, especially as a support worker, with no business understanding, and provide services to those who in many cases are vulnerable and are treated in such a disrespectful way.


This opened everything up, creating what appears to be a huge mess. So many people are running businesses with no understanding of the consequences of their actions or risk management, and many do not even understand the legalisation and standards that apply to them and their businesses. Given what I have seen, it is very scary, as many people with an NDIS plan do not have anyone else able to advocate with them, and they are being taken advantage of.

 

Whilst businesses that are NOT NDIS registered are still held accountable as business owners, according to Australian Consumer Law and other legislation and standards, the main one that they can receive a fine on in relation to the NDIS is the code of conduct that many business owners and workers have not read.

 

Many providers have no policies, procedures or documents themselves and believe it or not, many do not even have any form of insurance, no qualifications in health or disability and no interest in having a business set up properly, nor an interest in investing in setting their business up with a strong framework and having the right tools for their business. Many have not read the pricing arrangement, we know as we see the questions on social media several times a day.

My inbox is often full with questions such as “ my client wasn’t me to work an active overnight shift how do I invoice?”

“My client had a fall and injured their leg, I don’t need to do anything do I?”

“ How much do I charge for my services?

How do I create an invoice for the 2 months work I have done?

The list goes on! Don’t get me wrong asking questions is extremely important, however when you as a business owner are asking business questions, which take some time to explain, and are not easy to answer via a text message, and you don’t want to pay for the services of a business coach and you don’t want to pay for a resources bundle that explains all of those things and more AND you expect to be paid the absolute maximum hourly rate, I do wonder what your focus is in working in disability.


Especially when the resource bundle I have put together to support business is only $99 and covers do much!


Many business owners do not understand what to do when an incident occurs, or when they recieve a letter from the commission due to a complaint made against them and they are unable up answer questions because they do not have any documentation of shifts, no risk assessment completed, no incident forms and no complaints management system in place. Then they wonder why they are facing a fine or a banning order.


Social media really isn’t the place to ask business questions!

 

A huge concern I have is risk management and duty of care not being meet, this is about the safety of the person receiving support services. One example that still haunts me 12 months in is : When I was asked by a support worker to teach her how to do a peg feed, when I informed her she should go ahead and entorll in a proper training course, she declined and she then informed me that she didn't want to pay to go and get the training. I explained the dangers of administering a peg feed and what could go wrong and her response "Not my issue" She went on to tell me that she was just taking the job as it pays the maximum rate. I did report this call to the commission, however the information I had was limited as the person was not using the real name on social media where this call and messages came from.

1 month later though I noticed their account was deactivated.


Having said all of that I know so many amazing and incredible business , services providers in the industry, that are their working with and walking side by side with the people they provide services to.

Incredible people that are caring, respectful and honest.


 

While there are things such as banning orders that can be delivered, fines, and more, it takes a long time, and it currently feels extremely challenging to get anything investigated by the Quality and Safeguards Commission.

 

 

 


The NDIS Quality and Safeguards Commission's role was born and defined as ensuring that the services provided under the National Disability Insurance Scheme are safe and high-quality.

 

The Commission is responsible for regulating NDIS providers and ensuring compliance with the NDIS Practice Standards, which set out the expectations for safe and high-quality services


While in theory, this is great, and at times, the system does work, however more often than not, it feels disconnected and so hard to navigate, it feels like and appears ike it is getting worse.

 

The action steps that someone has to follow to get anything investigated mean the person providing the complaint needs to provide as much evidence as possible, unlike other governing bodies, which will take the raised concerns, look into them, and then determine the level of investment and whether any action is needed.

 

I submitted two complaints and concerns for participants' safety 3.5 years ago, and only this month (May 2024) did I hear an outcome for both. Over the past 2 years, I have reported businesses for things they did wrong and heard nothing. I do not know if they are still open or if anything at all has changed. I know that I am not the only one who reports business issues.

 

We have seen and heard the stories of where someone has died while in care, receiving support. In some instances, it has taken for the family to go to the media for it to be investigated. Still, limited consequences were handed down by the NDIS, leaving those living with a disability wondering who they can trust and if their loved one is safe in the hands of other people. Especially when their concerns fall on deaf ears, we have all seen the videos, which are heartbreaking and disgusting.

 

So many twists and turns!




Uncertainty of which path to take! Will I get the support I require, or will my funding be cut when I go to a plan review, is a constant stressor for many people!

Will life go back to what it was likebefore NDIS existed?


Like a good mystery novel, the NDIS is not always easy to understand and follow for the people living with a disability, their informal supports, family and friends and the providers themselves. There are so many interpretations of the one guide (the pricing arrangement guide), and the confusion continues.

 

 With the many rules for the different groups of people, self-managed, plan-managed, and NDIA-managed, let's also remember the difference between NDIS-registered and non-NDIS-registered providers. The list of what NDIS will or will not pay for continues to change, and appears to become worse, especially since the implementation of the task force to combat fraud. Sure, it is good to stop fraud; however, it also creates confusion, where some providers' invoices are declined, and others with the same service and line-item numbers are paid.

 

As the years go by like chapters in a book, there is yet another turn, another twist, with the different political parties saying how they are doing to do better and improve things. Then, in the next breath, we hear how the spending and growth of the NDIS must be slowed down… it often feels like a rollercoaster ride that doesn’t stop.


Yes we see that is investments in aspects to improve things, but how does really all come together and we will be left standing at the end of the day?

 

Who do we believe? What is going to happen? No one can really answer that question as right now May 2024 all we can do is wait to see whether our voices are heard.


At taskforce has been implemented to deal with the discussion of the NDIS review recommendations of mandatory provider registration, with many independent providers sharing their opinions that they do not want to go through audits, that they cannot afford the cost of developing their business process’ which in essence they should already have in place and with the tools that people like myself have developed there is no reason why they can’t have their business compliance in place.


After attending some of the round table meetings, I found it very interesting to hear about the opposition to mandatory provider registration. The concern is that choice and control will be taken away; it doesn’t need to be for there to be governance and accountability.

 

We now wait to see what comes of the meetings, discussions, and submissions. Yes, I did submit my thoughts and submission for consideration regarding the registration recommendations. There is such a divide in the community when, really, it is a time of coming together.

 

The implementation of the task force to deal with fraud and the rollout of PACE have created even more issues and ongoing concerns. Every day, I receive messages, emails, and calls from providers and participants, each of which is close to breaking point. While many people turn to social media as a way of attempting to find answers, that has not always been a positive experience, for those people.

Often people leave there confused!

 

PACE has caused no end of issues with people’s information not being saved properly, so many self-managed participants cannot pay their staff as they cannot get the payment for submitted invoices.


Providers are not paid and sometimes this is because the participants have not endorsed them on PACE system.

Plans entered into PACE become NDIA managed – still exploring what that one is about.

 

Then we have the huge backlog of NDIS Plan reviews, with a wait time of at least 6 months, leaving people without funding.

 

In the Uniquely Me section, I shared the story of Miss A and her mother, Angela.

 

Family members have had to fill in where the business cannot keep going due to not being paid. On some occasions, I have had to help families take their loved ones to the hospital as they are burnt out while waiting for funding, and no amount of escalation is working consistently.

 

Most people are advised to go to the media; however, the media is already writing regularly about NDIS, and nothing appears to change.

 

Businesses are closing, people are becoming suicidal, and we are seeing the rules, especially around Home and Living – STA, have changed, but there are no announcements, only video interviews.

 

Calling the NDIA is also a challenge, as there is no consistent answer. Everyone is told something different—how can that be when they have the information before them?

Receiving different answers to the same question each time a person calls up leads to confusion, and we know what is actually the correct information to follow.


Impact on Participants


 


The worry is real for people with an NDIS plan.

 

I have sat and listened in my own time, completely unpaid, to people with an NDIS plan and providers alike about how the delay in invoicing being processed and the delay in plan review meetings is impacting their daily lives.





I have sat with participants in review meetings as a support person once again unpaid and listened as the planner informed them because they had used their funds early and appeared to have coped the 4-6 months without support. clearly, they do not require as much funding; their next plan has been cut in the amount of funding.

 

While it may have appeared the person has coped, many have not. Many have been at breaking point, and some have been suicidal and have been in hospital in that time, yet none of that is taken into account.


To add insult to injury, they then had their plan made NDIA, which meant their regular support worker, who had been waiting for them to get a new plan, could no longer work with them. We then hear that the change in funding management was not the planner but PACE, a system that was meant to make life easier but has only made it even more complicated. That is can be changed with an email or phone call but often it takes several calls , in the meantime the person has no support as through their choice and control they do not want a registered provider.


Impact to Providers




The current changes that appear to be occurring without any announcements are impacting people being employed, businesses being able to pay their staff and them all feeling uncertain about the future.

 

In the past 3 weeks, I have seen 22 NDIS registered providers for sale, and I have been told of 82 independent and small businesses providing services close of these numbers, 8 are support coordinators.




They continue to provide support for as long as possible while knowing that the likelihood of them ever getting paid is slim. Some have had to get their participants admitted to the hospital as they cannot carry the financial burden and provide the service. We know that the hospital system itself is in crisis and has been for a few years now.

 

To add even more stress to providers recently a letter went out to the people with an NDIS plan blaming the providers for the situation everyone is now in.

 

As with anything in life, some amazing people do all the right things, and then there are those who are just after money. I can tell you that is both providers and participants. This is not about blame; this is about a broken system, and there are so many mixed messages.

 

These past few months have been a whirlwind of changes in the NDIS, and this is just the tip of the iceberg. The changes bring a sense of uncertainty and even confusion to so many. Businesses and participants are still determining what will occur next and what the future holds.

 

Unfortunately, many of the changes have occurred, and there is no news or announcements; they are merely occurring. For example, the length of wait for a plan review for a person who has submitted a change of circumstances providers is also waiting for work, as the regular work they had for their participants has stopped.

 

 Support coordinators wonder where to go next as the funding is decreased or removed completely from the participants' plans. This impacts their ability to provide for themselves and their staff, which stresses their work and personal lives.

 

While DIA organisation representative Jess Harper has informed me that they are meeting with NDIA at ground level, the plan changes are still occurring. I look forward to hearing about the meetings and what, if anything, changes.

 

Where all of this is heading is anyone's guess; in this version of the NDIS, like a mystery novel, there are many different endings, and none really resolve everything. It is an industry where some very strong voices can rally people together, and others feel completely unheard with no voice at all.

 

Business Closing their doors.

 

 As I mentioned, over NDIS-registered providers have advertised and sold their businesses in the past week (mid-May 2024) because they cannot onboard participants after waiting over two years to register. Businesses not NDIS-registered close their doors, and support coordinators notice how their hours are being cut back, with conversations about navigators still floating around.

 

People are struggling and worried, compounding this by Australia's current cost of living; everyone is wondering how they can continue!

 

There is uncertainity around what the recent federal budget announcements really mean for everyone, including what it means for NDIS

  

The highlights of the budget for NDIS is:

 

Better advice: $45.5 million to establish an NDIS evidence advisory committee.

 

A Clearer Pathway: $20.0 million to start preliminary consultation and design work to help people with disability navigate services.

 

Fresh approach to pricing: $5.3 million to undertake preliminary work to reform NDIS pricing arrangements.

 

Architecture to implement reforms:

Co-design and fighting fraud $213.8 million of recently announced funding to fight fraud.




As we wait to hear if the Getting the NDIS Back on Track legislation is passed in parliament and if the NDIS registration task force recommends a version of mandatory registration, we can hope for a light way to remove this uncertainty.

 

 

While this story of the NDIS continues to have so many twists and turns and changes in, there will be high anxiety and stress; there will be people who are injured and people who take advantage of others; the sad thing is there are so many providers who do not have any business experience or a business framework of any description and rely on places such as social media for all their answer for FREE rather than investing properly in their business and unfortunately many of them are the ones we who charge the top dollar and complain the loudest.

 

Meanwhile, people who feel so lucky to have an NDIS plan and a support worker for even 4 hours a week are still struggling but getting on with their day.

 

Who will stay and who will go when it all comes to light even more over the coming months remains to be seen. At the end of the day, unfortunately, until things change, the calls will keep coming in asking me for support; I will do my best to help people where I can and guide them to the best of my ability. However, I am one person who relies on my network for support. I will always offer people an NDIS plan choice of service providers, and I will always listen to a business owner and do my best to guide them.

 

 

This month, we have included an additional article in the magazine as guidance for those with a plan based on all the questions and calls I have been getting these past 4 months from participants and their families to help. We also have a resource bundle for business on our website.

 

Let's do our best to support and respect each other; we do not all have to agree to work together to make NDIS the best it can be.

Keep speaking up, sharing, and supporting each other; we are doing this together.

 

NDIS resources

 

 

Useful resources and tools for business

 

As part of working with people with an NDIS plan, there are these training modules that people are required to complete, which can be accessed here: https://training.ndiscommission.gov.au/

 

Here is a link to help you understand what the proposed changes may mean for you as a provider and a person with a disability. 

 

We also have resources on our website:

If you have questions about your business, you can contact me to book a coaching session. Some fees apply for coaching services.

 

We have put together a Disability Business Success Resource bundle $99 one-time fee.

Lifetime access. Resources suitable for those starting out and growing; we will update things as things change.

 

Introductory call about our services:

 


(C) 2024 Break Free Consultancy


Disclaimer: All information is accurate at the time of publication and is subject to change where from an external source. Always check the appropriate websites for the most up to date information.

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