In 2013 the National Disability Insurance Scheme (NDIS) commenced at a number of selected sites around the country. Quite rightly people with a disability and their families celebrated with gusto. The introduction of the NDIS was the end result of a strong campaign to introduce self-directed funding for people with a disability. If the NDIS ever achieves what it was established to do, no longer will service providers be able to dictate the types of support that people with a disability receive. Instead they will have to design their services and supports based on what people with a disability demand. Simple economics – supply what is demanded or go out of business.
Not surprisingly, traditional service providers are very concerned about the market based approach. Until the NDIS was introduced, service providers had a monopoly on the types of support that was provided. Not only that, they really had all the power. They and they alone decided who was eligible and who was a priority. It was essentially the judgement of the service providers as to what was provided and who should receive it. People with a disability had very little power at all. In the next few years, as the NDIS rolls out across the country, the power and control will slowly move to the hands of people with a disability.
Currently the major service providers in each state are jockeying hard to try and monopolise the disability services market. This is why we are seeing the National Disability Services (NDS) lobby so hard for its member organisations to retain the status quo. In doing so the NDS, in my view, are trying to undermine the NDIS.
Indeed the NDS have shamefully encouraged Queensland not to join up. They have encouraged Queensland to wait and see, supposedly so that they can learn from the early mistakes of the NDIS. They are fooling no one. They simply do not want the change to occur because under the NDIS most service providers will lose their block funding and will have to completely change their approach to service delivery to meet a market based approach. If they cannot compete they will fall over. It is as simple as that.
What does the NDIS mean in terms of our traditional deafness service providers? Traditionally Deafness service providers have received block funding. Block funding is a term that refers to service providers receiving X amount of dollars per year to service X amount of clients. An organisation like Deaf Children Australia might receive $500 000 to support 50 clients per year. This is not a real figure; it is only an example.
Potentially under the NDIS deafness service providers will lose their block funding. Instead they will have to develop services for clients to ‘buy’ from funding that the client has been allocated by the NDIS. Now if the client decides that the traditional deafness service providers are not providing the service that they want, they will take their money elsewhere. For the deafness service provider this is very worrying because potentially they stand to lose everything.
A bigger worry for the traditional deafness service provider is that as deaf people begin to get services under the NDIS the deaf client, and this includes parents of deaf kids, will chose to take their funding elsewhere. Consider Sarah. She is a deaf kid. Her mum and dad see the NDIS planner. Sarah might have a cochlear implant. A priority for her parents is to use any funding received under the NDIS to purchase technology to enhance her listening. It might be that they chose to utilise captioning so that Sarah can participate better in the local yoga classes. They might want to install a flashing smoke alarm. They might want extra speech therapy to improve her speech. None of these are really traditional services of the traditional deafness service providers.
Whether the Deaf community like it or not most kids who are diagnosed as deaf will receive a cochlear implant. The need for Auslan, peer support, youth camps and the like, important as they are, are really not foremost in thinking of their parents. This is because most parents are hearing and have chosen a path where they want their child to be a part of the larger hearing community. They naturally will direct their funding to areas they see as critical. These areas are not necessarily what our traditional deafness service organisation focus on.
It is perceivable that once the NDIS is up and running all block funding will cease. Some service providers may receive transitional funding for a time but once this runs out, what next? I, for example, and many like me have no need for the services of Vicdeaf apart from interpreting. There are a number of agencies that provide interpreting and perhaps provide better service than Vicdeaf. I, and others like me, will channel my funding to the service that I consider most efficient.
It is possible that Vicdeaf, and all Deaf societies, in the not too distant future, will receive income almost solely from interpreting. Auslan certificate courses may also make up part of their income stream but without the block funding will this be enough to sustain them? Will the NDIS see our Deaf Societies become increasingly specialist services that are providing services to meet the demand of the market? Without block funding, exactly what will our traditional deaf service providers be able to deliver? Will they have the means to support a community?
In South Australia they have a senior citizens group. Without block funding will Deaf Can Do have resources to continue to support the senior citizens group? In Victoria, if Vicdeaf lose their block funding, will they have community rooms for deaf community groups to meet at? Potentially organisations such as Vicdeaf and Deaf Children Australia will have to downsize and operate from smaller more cost effective premises depending on the chunk of the NDIS funding that people who are deaf direct their way.
There is a reason that Deaf Children Australia are frantically trying to get out of the old Bluestone Building at St Kilda Road. They simply cannot afford the upkeep. With the introduction of the NDIS and the likely loss of block funding the income stream of Deaf Children Australia, already challenged, is likely to be challenged even more.
Do not get me wrong, I am a big supporter of the NDIS. It is the best thing to happen for people with a disability in Australia. BUT there is no doubt that the NDIS is challenging the existence and viability of many disability organisation particularly those that received block funding in the past. Make no mistake, this includes our traditional deafness service providers.
Early evidence of the NDIS also tends to suggest that some NDIS planning personnel do not necessarily understand the needs of people who are deaf. For example a parent told me recently that she had requested mentoring and Auslan family support for her deaf child. These were written into the NDIS plan of her child but inexplicitly not funded. Luckily the mother is knowledgeable and is negotiating changes to her plan that may yet see the mentoring and Auslan support funded. But what of parents that lack her assertiveness and knowledge? Many are likely to simply accept what is on offer.
Does this show a lack of understanding of the psychosocial needs of the deaf child on the part of some NDIS planners? If these things are not going to be funded by the NDIS, will the services of Deaf Children Australia in Victoria and Townsend House in South Australia, much needed as they are, become obsolete?
Already there are stories of service providers who are shamelessly directing clients to the services provided by their own organisations. This includes deafness service providers. In this way they are trying to monopolise the support that is provided. This goes against the grain of the self directed principles of the NDIS.
However, this monopoly is likely to be short lived as people with a disability grasp the concept of choice and begin to shop around prudently to get value for their dollar. For disability and deafness services organisations, the challenges of survival brought about by the NDIS cannot be underestimated.
It is a worry, for us and for them. But these are the challenges being confronted by our deafness services organisations right now. They must adapt or perish and so must we! Watch this space!
The next article will focus on the future of Deaf Australia and Deafness Forum Australia – How will they exist under the so called ‘Consortium’???