The NDIS has been accused of causing deaths. Nearly 1300 of them actually. Predictably the news has caused a media frenzy. On the Today show Karl Stafanovic expressed his outrage. Everyone and his dog is calling out the NDIS for the mess that it is. The Minister has gone into defensive mode claiming that linking the deaths solely to the NDIS is inaccurate and nowhere near the truth. To counter the bad publicity the Department have begun to release information about the so-called NDIS Overhaul.
The Minister is probably right. The NDIS are not responsible for all of those deaths. Some of them probably would have occurred whether the NDIS was in place or not. Some of them possibly occurred because the NDIS was to slow. For the latter, even one is too many. The point really is that the NDIS is an inefficient beast. The Government has known this for some time and has been investigating. I have no wish to blame anyone for the deaths but if anything good can come from the media frenzy it is that it has made the Government work faster and be more transparent about the reforms that are needed within the NDIS.
NDIS Minister, Stuart Robert, has been forced to acknowledge that the NDIS simply has too many flaws. Among other things He has admitted:
- Wait times are too long.
- Inflexibility and rigidness of the scheme
- Difficulties with navigating and understanding the scheme
- Ineffectiveness of psychosocial supports
- Lack of experience of its workers
- Barriers within the legislation and processes impacting on needed support
- Poor access
And the list goes on. The Minister tried to defend the NDIS and stated that access decisions now took an average of only four days. This may well be true but an access decision is just that. A decision, it does not start support, it does not implement support and It does not provide support. It just states that someone is eligible. The average wait time for a plan is said to be 121 days. It can take up to four months. In South Australia the situation is worse with 210 days being the average wait time and 152 days for kids under six.
These figures are bad, but the situation is actually worse. I worked within the scheme for over three years. When the NDIS works it’s great but the ineptitude of the system causes great harm and delays that are even longer than the official figures.
Access decisions are said to take four days. This can be a yes or a no. If no, the person can appeal. And the appeal might convince the NDIA to overturn the original access decision. I have assisted people to appeal their original access decision. On more than one occasion it took more than a year to get an answer. I once assisted a 62 year old lady with Multiple Sclerosis appeal her decision. She had applied and was refused. Not disabled enough apparently.
She came to see me because she had no idea how to appeal. It’s a complicated process and requires the person to provide evidence as to why the original decision was wrong. This means further specialist appointments. It means reports. It means money. It means stress. It challenges ones dignity. And it means time.
Then the appeal has to be submitted. It needs to be reconsidered. A decision needs to be made. A decision is made and a letter sent out. If the decision is again no the person can chose to give up or go around again.
Now let’s consider the participant with Multiple Sclerosis that I assisted. She had an official diagnosis of MS. She tires easily. Uses a walking stick. Struggles to clean her home. Requires maintenance and therapy to maintain functioning. She needed a whole heap of stuff. But the NDIS said no. In their view she was not disabled enough. Basically they are telling her when that when she is at a point where she cannot help herself that the NDIS will help her.
This is plain stupid. Surely the approach should be to assist this person to maintain functioning for as long as possible and not wait to the point where they are ready to keel over? It took this lady over a year to get access. She got access but at what cost? In that time her condition was detriorating. This is the rigidity of the Scheme and its processes. It does great harm. Don’t be fooled by the Minsters claim that access decisions happen in four days. They might do, but that is just the beginning of the story.
Four days to decide yes, well done NDIS. What next? You then refer to the appropriate region. A LAC or planner is allocated. A phone call is made to set up a time for a planning meet. If you are lucky enough to be deaf they will call you anyway. Even if your file says text or email. After the third call that the poor deaf person does not answer they send a cannot contact email. Delays the process even further. Yes, this happens regularly and the NDIS know about it.
To set up a planning meeting you have to agree on a time to meet. More importantly you have to hope you are available to take the call. The whole process of setting up that initial meeting takes time, a long time after the four day access decision.
It is the same with reviews. The set up of plan reviews takes time. Participants are supposed to be contacted three months before their plan expires to set this up . Often contact cannot be made. Often times cannot be agreed. Often plans are near expiry or expired before a review meeting happens. You can’t blame the NDIS for all of this but. Life gets in the way. It adds to the complexity.
You also need to factor in, particularly in new roll out areas, many people that have applied have to wait. This is because the new roll-out areas focus on people in defined programs. That is people already receiving State Government support. You see the State Government want these people off the books. They want them over to the NDIS books as soon as possible. Ok, I am being cynical a bit. They do this because they want continuity of support. So they focus on defined programs first. If you are not on a defined program the wait can be even longer.
So let’s say the access decision happened in four days. It took six weeks to schedule a meeting. The meeting might be two, three weeks after the initial phone call. Thats two months from the original access decision, if you are lucky. But it doesn’t end there.
The initial meeting happens. If there is not enough evidence the participant will be told to go get more evidence. Sometimes Local Area Coordinators submit plans and then NDIA delegate says there is not enough evidence. So for the participant it is back to the therapist or back to the Doctor. Add a month, add six weeks or even longer.
There are a wholee range of scenarios that will delay plan approvals. This includes workloads and, yes, ineffective workers who are just not up to the job. There is also the issue of the NDIA being understaffed. For a whole variety of reasons getting plans approved quickly can be a lottery. One must remember here that LACs cannot approve plans, only write them – the approval comes from the NDIA employed delegate. An NDIA that is chronically understadffed.
Now the plans approved. You have too activate. You have to have the implementation meeting. You have to book services. You have to set up service agreements. You have to learn the portal. If you have support coordination, find one to help you set up the plan. Plan management too if you have it. Often there are waiting lists so that your plan does not start until nine months after approval. You might also get a crap support coordinator, and there are many, that delays things even more.
Then you have participants who have no clue what to do. You have LACs and planners who don’t follow through with implementation. You have thousands upon thousands of participants with money and support who don’t spend it simply because they do not know how.
You want to know why the NDIS has an underspend? Understaffing is one reason and the other is that participants with plans not used simply because the system is too complex and they don’t know how. Then you have over worked LACS and planners who can’t keep up with implementations. Sadly, you also have LACS and planners who are simply slack and not doing their jobs properly.
Let’s not mention quotes for assistive technology. Assessments that need completing. Quotes that need approval. It’s true that despite the NDIS best efforts people have been waiting up to three years for their assistive technology. Then the NDIA will bicker. Too expensive, above standard, need Technical Advisory Team approval. Quotes are wrong. lost, not processed – Yup a total shambles all round.
Then you have underfunded plans. Poorly written ones. Clueless LACS and planners who put the wrong things in plan. Or there are those delegates who see themselves as primarily keepers of the public purse and make cruel and often illogical cuts. Cue the review – Let’s not go there except to say it takes a very long time.
So Ministsr Robert – Thank you for cutting access decisions to four days. But quite honestly it doesn’t help all that much The real story is in the process. The real story is in the legislation. The real story is in the inexperienced staff making illogical decisions. The real story is NDIS staff not understanding that investment is about spending money to ensure quality outcomes. A cheap plan is often a bad plan and poorly spent money at that. The real story is about the Government investing in the NDIS with quality and experienced staff so that it can operate effectively.
And lets. not forget a fit for purpose computer system, hooo boy! Whats the most commonly heard scream in the LAC or NDIA office? “Fuck! The CRM’s down!”
Minister Robert I thank you for trying to sort out the NDIS. I fear that the measures you are announcing only scratch the surface. There is much, much , much that needs to change if the NDIS is to be the program that it is meant to be!