The NDIS – Two for a Dollar

The National Disability Insurance Scheme, or the NDIS, is the new thing in the disability sector. It’s kind of like Medicare where people pay a proportion of their salary which is then used to fund support for people with a disability.  This funding is then given to people with a Disability and their carers to control – self directed funding.  If it works well consumers will have all the control. They will have the money to buy services they think they need. No longer can services dictate to us what we need. Our deaf services will have to meet the market that we demand. Competition for the dollars that we control may well see services offering special deals. BOOK TWO INTERPRETER JOBS – GET ONE ABSOLUTELY FREEEEEE! This may well be the way of the future.

The concept of “self directed” funding is exciting. Imagine you, the Deaf or hearing impaired person, receiving X amount of dollars per year – say $25 000. The Government gives you some guidelines as to what you can spend this money on. Perhaps you want an interpreter at your sister’s wedding.  You don’t need to worry that the Deaf Society in your state is crying poor and unable to fund such interpreting. You just book one and pay for it from your funding. Your hearing aids are on the brink. No matter – use your funding to buy some more. Your work has a meeting and you need live captioning. There is no need for you to get it all approved through Jobaccess. Just book it yourself and you are away.

Of course it will never be that easy. It will have criteria and guidelines that must be followed. No doubt they will set up a panel of assessors who visit you to verify that what you want to spend your money on is a valid reason. There will be paper work and Doctor’s certificates and so on.  In short the process will be painful and cumbersome. Perhaps I am too cynical but experience tells me that this will be the case.

And you can bet your bottom dollar that our service providers – our Deaf Societies and our Deaf Children Australia are in a right old quandary about it all. Potentially they will lose funding as this is directed to NDIS to be controlled by consumers. If all goes to plan, consumers will have the money and decide which service is worth their dollar. These services will have to sell themselves as the best thing since sliced bread to get us to buy what is on offer.

Everyone will be out for a slice of the pie. Hell, it is happening already. Currently there is a Productivity Commission review of the NDIS concept underway. Service providers and stakeholders are voicing their views and concerns on the NDIS. One of our major service providers recently presented their views to the Productivity Commission consultation. You can see their views at –

http://www.pc.gov.au/__data/assets/pdf_file/0004/107932/20110405-melbourne.pdf

This organisation was represented at the consultation by three people including one who played the role of a living Deaf example. Two senior management representatives presented their arguments for and against the NDIS. Go to page 75 of the document. You will see their views about the benefits of “self directed funding”, a model that is currently used in parts of the UK.

They use terms such as “Empowerment”, “Choice” and “Reduced Barriers” and then go on to flog some of the organisation’s services as options that consumers might purchase if the NDIS is established.  Examples included mentoring, Auslan tuition and respite care. The NDIS has not yet been passed in any shape and form and here we have one of our major deaf service providers already positioning themselves as a key provider for consumers to spend their “self-directed” dollars.

The Rebuttal has no issue with this. It is astute marketing. But how much of it is driven by the possible loss of funding for services that the NDIS may bring with it? Organisations may well find they receive less Government funding as dollars are directed to consumers to control. It is a real fear for them and one cannot blame the organisation for wanting to be at the forefront if the change happens.

On page 76 the organisation goes on to promote itself as a possible agency to carry out assessments that will be required under the NDIS. They allude that current assessment processes are carried out by medically based operators such as occupational therapists and physiotherapists who have very little understanding of the specific communication needs of the deaf. What the organisation is trying to do here is point out that these assessments need to be carried out by professionals that “know” and not just any old assessor. Who might they have in mind for this? Well, themselves of course. Even if this is not said, it is pretty obvious. The baby has not yet been born and already people are selling themselves as its saviour.  “Mentors – two for a dollar!!”

It’s not just this organisation. It is just about everyone. One major service provider can be found marketing the NDIS to death through their Facebook connections. They clearly are on the NDIS bandwagon. Does this service want the NDIS? You bet it does because if it gets passed they will have any number of services that they offer to be purchased from NDIS funds. Live captioning in employment is one. Captioning for community functions is another. Possibly students at TAFE will want video learning material captioned so they can access it, although copyright factors may be an issue. Possibly consumers will be able to “self direct” their dollars to this service to make this happen.  The service must be rubbing their hands with glee at the prospect.

The Rebuttal is not writing this to be cynical. Rather we write this only as an observation of what is being seen. These organisations have to survive somehow so it is quite right that they are positioning themselves and preparing for the change. But spare a thought for the poor consumers who are looking on and wondering what benefits the NDIS will bring them.

Most will have no concept of what self directed funding is. What they may well be confronted with on the introduction of the NDIS is a mass of service providers peddling their goods. They will be swamped by a mass of information and many will lack the skills to sort the wheat from the chaff. Already Aboriginal disability advocates are in fear because the NDIS does not consider their specific cultural needs. Already they have voiced concerns that culturally inappropriate organisations will try to enforce themselves on their communities in the pursuit of profit. Already they have voiced their worries that their members will lack the skills to properly navigate the NDIS because it has been designed without their cultural needs as a concern. We must all be diligent to ensure that the NDIS addresses social and cultural needs and is not just based solely on medical and care needs.

What of parents that know very little of disability? Their disabled child is very often their very first experience of disability. Who will support them to spend their “self directed” dollars wisely? Who is going to be NEUTRAL in their support without profit as their sole motive? It is scary indeed. Indeed many are going to be severely intimidated and confused by the NDIS. All we can do is hope that the Government seriously considers the issues from the consumer’s point of view and is not hurried into making a decision solely for the purpose of finding dollars to fund disability support. There is much work to be done!

EDITORIAL COMMENT

Australia’s disability support model is in the midst of change. For many years now disability support in Australia has been chronically underfunded. The National Disability Insurance Scheme is an attempt to address this blot on the Australian concept of a fair go.

Essentially the NDIS is a tax. It is a levy that will be imposed, presumably on wages. The tax will then be used to fund disability support. Central to the NDIS is the concept of Self Directed Funding. Put simply we, the consumers, will decide what services we want and purchase them.

It is not the first time The Rebuttal has written of self directed funding. In August of 2009 we wrote an article titled ‘CONTROL’ about self directed funding based on a talk provided by the late Dr Paul Collier. Dr Collier spoke of his experience of self directed funding in the UK.

Among other things Dr Collier described Australia’s disability support as being in the “dark ages”.  Bill Shorten, previous Parliamentary Secretary for Disability, also described Australia’s disability support as lacking. Mr Shorten publicly stated on numerous occasions that a rich country like Australia needed to do better.

Part of Shorten’s solution to the problem was to push the concept of the NDIS to the hilt. The Australian Government has now picked up the ball and is running with it. They are in the process of intense consultation aimed at establishing whether or not the NDIS is viable. The Productivity Commission has the responsibility of rolling out this consultation. The findings of the Commission are eagerly awaited in the disability sector.

While there are many positives about the NDIS, it should be viewed with some caution. One only needs to remember the insulation rebate scheme and the pathetic early version of the Auslan for Employment Scheme to understand just how wrong Governments can get get programs when they are rolled out hastily.

The biggest fear of the NDIS is that it will be based solely on the medical model of disability. The fear is that it will focus on heavily on CARE and REMEDIAL needs such as hearing aids and auditory needs.

The NDIS needs to also consider the social model of disability. Disability is not always something that needs to be fixed. The late Dr Paul Collier, a quadrapalegic, spoke about how he used his self directed funding to organise care so he could go on holidays and assimilate with the whole of society. He showed holiday snaps of his holiday in Canada that was made possible by directing his funding to pay for his care support.

Likewise Deaf people may want to use their funding to book an interpreter to attend a local function or party so that they can interact more freely. There is a social need as well as a medical one.

More importantly parents, who are experiencing deafness or disability for the first time, need un-biased information and support to enable them to direct their funding appropriately.

It’s exciting for sure but we,the consumers, need to be vocal and ensure that the NDIS is indeed self directed and not dictated to us by medically obsessed bureaucrats.

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7 thoughts on “The NDIS – Two for a Dollar

  1. Enlightening article.

    The truth of the matter no-one knows exactly what is going to happen. In the UK we are moving towards individual budgets which is supposed to promote choice. This is similar to what is happening in Oz.

    This is how it works. Traditionally statutory authorities have been providing organisations with exclusive funding and the target audience are expected to gravitate towards these service providers, much the same way the deaf societies get funding from their state and deaf people go there for whatever support they need.

    This is going to change. People requiring additional support are going to be assessed by either statutory authorities or contractors, with their requirements identified, an activity plan is drawn up an annual budget is allocated to them. They are then free to go to whoever can met their needs and receive services commensurate with their activity plans.

    In theory this means anyone can set themselves up as service providers, and sell themselves to the target audience, in this case, deaf people with additional needs such as letter translation, filling in forms, representation at meetings, interpreting and so-on.

    All this sounds very good and laudable. But there are inherent risks too. There is no guarantee that these Deaf people with budgets are going to go to traditional service providers, they may decide to go elsewhere, to the bloke next door, to the man in the pub, to well-meaning family members and so-on. These people may not be suitably qualified to provide these required services thus placing the general well-being of the deaf person at risk.

    Many Deaf community service providers also run community centres which are extremely valuable to the community in which they are based, and if half their target audience continue to patronise their services, with the other half going elsewhere, this could mean a decrease in funding to run these community centres, which may have to close thus depriving deaf people of a safe place to interact with each other socially.

    Only time will tell what is going to happen with the personalisation agenda in the UK. It is a good thing in many ways but there are inherent risks as well. Whatever happens, organisations touting services for a fee to deaf people will have to provide excellent customer services to attract their custom. They need to demonstrate that they can look after their clients well, that they are completely at ease, that the services they are providing is are line with quality standards and meets all their needs and so –on.

    All this is uncharted territory and is exciting in many ways.

    • It’s exciting indeed Paul, but scary too because the potential for our policy makers to get this wrong is huge.

      For example one of the presenters at the Deaf Australia conference spoke about the NDIS. A recommendation for the NDIS is that employment and education not be included in the things NDIS covers. For me thats scary because some of the main things that DEAF need are in education and employment and the current support in both these areas is really inadequate. They have also suggested that early intervention not be included so hearing parents of deaf kidss wont be able to get things like Auslan support at home as it may well be classified as Early intervention.

      There is a long way to go and the Deafness Sector needs to be far more active than they are now in the debate or they may welll find that they miss out.

  2. I speak on a personal note here.

    A deaf person approached me and asked whether the NDIS could impact on existing services providers such as Deaf Societies and could it mean the start of the end of these community based organisations.

    I have mixed views. Giving deaf people individualised funding which in turn will enable them to make their own decision as to which service, product that best suits their needs. Logically people like us are the best judge in determining what our needs are and potential in the future. We live and breath this every day.

    As such it could well mean that the power is back in the hands of the deaf people wh will review and judge where they should ‘invest’ their money in the services/product their need to enahnce their quality of life. This will of course no doubt has potential to impact on existing service that the likes of Deaf Socities / services provides around Australia and to an extent generate a more competitive field than in the past. They will most likely need to ensure that ‘quality of service and product’ and greater focus on customer service needs will play / form one of their ‘competitive advantage strategies’ in the future.

    But this is not new. It is already happening. In the past Deaf Socities were basically the only place you can go to book an interpreter whether the service was not up to standard or the demand didnt meet the supply. Ocer the last 10 years we have seen a few independent interpreting services popping up which provides deaf people more choice which in turn generates a competitive quality service environment.

    The individualise funding, it is occurs, could inadvertently generate better competition to so far as perhaps deaf people may well set up and provide specialise services mirrors what we have seen in the interpreting field. Deaf people could end up providing a business that can open the market and stimulate proactive ‘product innovations’ in the future.

    But the historial nature of the Deaf Societies should be preserved and still have a vital purpose to those who may still remain vulnerable and seek specialise customised services now and in the future.

    Competition is healthy. Monolpolisation is not.

    If the NDIS does go through and addresses all the key areas that is ‘expected’ and ‘needed’ by Deaf and hard of hearing Australians, then we will be living in very interesting times.

    • Dean … the bigger worry for me, having worked with families of disabled kids is how we will support them to use the dollars. You are right the concept of developing and selling quality services is nothing new. right now for example Deaf people are choosing to use certain interpreting service because it provides quality and responsive service. But with parents, who largely are on a steep learning curve, once their child is diagnosed we run the risk that they will be swamped … that the medical view, with all its financial clout and marketing dollar, will dominate … this is not a good thing as we will be stuck with biased information and parents will naturally tend to seek a FIX. The recommendation that employment, EDUCATION and, puzzlingly, early intervention, not be part of it is also a concern. The concept is great, solutions to the dilemmas are short on debate, this is the area we have to remain diligent.

  3. Gary… your concerns are fair, reasonable and valid. I would encourage you to consolidate what you know and what you think need to be considered seriously and submit such to both the Productivity Commission and also those who are campaigning as part of “Every Australia Counts”.

    There are a myraid of issues to be considered which can have its pros and cons and inadvertently impact on other areas not foreseen. The more this information is forthcoming to these respective recipients/activist/decision makers the better.

    Here’s hoping the deafness sector will also – like the cinema campaign – actively submitting and sharing their thoughts and opinions. ‘Nothing about us without us’ applies. If you dont say, you often dont get but at least have a say – who knows where this may lead.

    This may be the once and only time in our generation for such review/reforms to occur at such a large scale and level of interest so the time is now. 😉

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