Comments on: The NDIS: ethics, dignity and choice: some dilemmas for social workers

By: Steve

Steve — Sun, 07 Aug 2022 03:35:37 +0000

Massive concerns within the NDIS. Just focusing at this stage on SSC, as the lead actor for participants with with complex needs, most lack the requisite knowledge skills and experience. The barrier of qualification has been reduced with teachers, social scientists, exercise physiology graduates joining the fray as sole traders or contractors earning $193 per hour (or majority percentage as a contractor). Most SSC are contractors now even though the chief economist of the NDIS built the SSC model around employees working in an office supported within a team lead by a team manager with professional supervision, access to a senior practitioner, able to facts and perception check decisions made which potentially have significant impact on their participants. As a contractor they work in isolation wielding significant influence over participant plans and lives. They also lack understanding around the NDIS legislative best practice guidelines or even their role as SSC – registration processes are undertaken by their host organisation. As contractors they operate from a time based perspective, not needs based. This is usually a pragmatic approach to NDIA planners approving “just enough” funding. More SSC funding can be requested at review to try and achieve the values NDIS promises however outcomes are unknown with submission time usually unbillable. Easier just to take on another participant. Within this environment collaborative practice, self affective practice, robust consultation, case conferencing, and other professional standard practices rarely see the light of day. Conflict of interest also has suffered with most contractors referring therapy to the stable of contracted practitioners working with in the same organisation. Even if this wasn’t the case how is a SSC who does not understand the impact of complex developmental trauma on the life of an individual living with other compounding cognitive impairments meant to choose therapeutic interventions of best fit when they themselves do not understand the issues and cannot find the answers because they work in isolation? Finally given the outline of SSC practice standards within NDIS guidelines is very thin and they occupy the lead role position in a complex service delivery, SSC have limited accountability. The word responsibility is not used in the NDIS legislation. As I have asked myself on a number of occasions with regard to the Anne Marie Smith tragedy, where was the coordination services allocated to vulnerable people in all this? What should their responsibility have been given the vulnerabilities involved that checked the boxes for coordination eligibility (lack of insight into her own support needs, inability to establish services of need and lack of capability to advocate on her own behalf should service delivery fail). The coordinator, in particular specialised, is the lead agent. Best practice includes reporting protocols including having sighted your participant every 3 months. Simple really, and saves lives.

By: Pathmaker

Pathmaker — Sun, 15 Apr 2018 05:10:58 +0000

As an independent support coordination business, our service item within the NDIA is being manually re-adjusted following the planning meeting by the Agency, resulting in less hours provided. Complex cases demand energy, experience, time and effectiveness to build self-determination and responsibility.

By: Gina

Gina — Sun, 15 Apr 2018 02:13:49 +0000

The NDIA just wipe their hands of all problems and walk . In a slightly rural area PWD that need short amounts of help find that they can’t get carers because the carers prefer to look after clients that offer full days etc…. No fall back care. No responsibility. Personally I prefer larger org they ensure that someone comes and if I don’t like the person I can get them changed/

By: Gina

Gina — Sun, 15 Apr 2018 02:08:42 +0000

Thank you for this my daughter had funding under ADAC and it was 100% brilliant full control and choice and NO pressure to spend. Her year long package lasted 3 years. Less $$$ but full choice. Now we have buckets of $$$ that can’t be used and can’t buy the smallest of items as no allocation. Clearly the NDIA planner didn’t read the file as even need to get a quote for something she patently can’t use. My experience is that the OT’s are now charging $1500 per item per OT report. I asked for a schedule of low cost items to be added to the report which I provided and was told that the service agreement would need to be re-written and $1500 added. Plus another visit. NDIA suggest getting someone else -well there is a huge shortage of OT’s with all the report writing and that is not possible. No OT report NO wheelchair.

By: Tanya Denny

Tanya Denny — Sat, 18 Nov 2017 05:28:04 +0000

Thanks Vittorio
As you say
Workers who already have specialist support coordination credentials, are given no recognition, or advanced standing in applying for generic support coordination; an illogical anomaly that also has important consequences for participants.

I’m in the process obtaining 3rd Party verification. It costs around $5000 to be verified. If you’re a sole practitioner (As I am) or seeking verification as an NGO – no difference. I would like to the AASW working with NDIA to streamline the TVP process for Social Workers because you are right, we are already trained to do this work and verified by AASW.

Maybe it’s time for AASW to take up the fight for advanced standing in the NDIS space.

By: vittorio1

vittorio1 — Mon, 28 Aug 2017 03:49:40 +0000

Heartily agree Mary! A coalition of unions, professional associations and consumer bodies is urgently needed.

By: Mary Drake's

Mary Drake's — Sun, 27 Aug 2017 23:06:54 +0000

An early stage issue is the lack of transparency and accountability in decision making about who should or should not be a participant in the NDIS. Applicants receive rejection letters stating they have a health issue not a disability, even though they currently on the eligibility list for the DSP. No legislation, regulation or policy is properly cited, making appeals very difficult for the average person.

All the issues raised above are further complicated by the inability of NDIS advisors on their 1300 number to give consistent information and advice. This is underlined by their refusal to give out last names and phone numbers so that they can be held accountable.

I too think the NDIS has the potential to be the biggest positive social policy change change in Australia since Medicare. But surely we have learned how to run a government department well since then? Why are these basic procedural problems impeding equitable and timely delivery of services?

And what are we, the members of the AASW, doing about it?

By: vittorio1

vittorio1 — Fri, 04 Aug 2017 22:18:53 +0000

Mick Small asked me to post this comment for him
The biggest problem with the NDIS is the greed of the so called service providers which are preying on NDIS customers for their percentage.

Many organisations are not viewing the NDIS rollout as empowerment for the clients new independence but as an imposition on themselves due to the reduction in bulk funding.

As soon as Social Workers enable more clients to self manage their NDIS packages, the better. Unfortunately many professionals sell their souls to Bureaucracy for the security of tenure and superannuation rather than supporting clients to the best of their ability.

Mick Small OAM.

By: Elizabeth McEntyre

Elizabeth McEntyre — Fri, 04 Aug 2017 12:31:56 +0000

Thank you Vittorio for your important article.

One of my family members who has mental and cognitive disability and complex support needs has an NDIS package that, at this stage, has no funding attached other than for support coordination to secure supported disability accommodation. However, they have been unable to secure any such accommodation from either of the local providers (Flourish or New Horizons) to meet their needs and remain institutionalised. Because they are institutionalised and therefore under the care of the Local Health District, they can not use the NDIS to access proper and meaningful cultural activities and the Local Health District provides no cultural activities. Their 82 year-old mother is however able to take them fishing every now and again. They have never accessed ADHC services and live in the Newcastle area which as we know was one of the first sites to commence the NDIS. I guess we should be grateful that they didn’t end up in prison.

By: Joy Stevens

Joy Stevens — Thu, 03 Aug 2017 08:24:06 +0000

Thanks again Vittorio for another interesting article.

I think the roll out of the NDIS in NSW has been driven by idealogues, placing their pursuit of privatisation above the needs of NSW citizens with disabilities. In NSW they plan to completely closed down all government disabilities services. I understand this is not the case in other Labor States.

The NSW Public Service Association has finally got itself on the front foot and is standing up for the many workers and communities around NSW who will lose out from this cold-hearted policy.
Much of your argument can be applied to other human services sectors, notably out of home care services.

There is a hidden agenda in these privatisation policies and it is to decrease worker’s opportunity to organise and thereby reduce the cost of the service – more money to the private sector, less to the workers and a poorer service to individuals and communities.

I think the community will wise up and they won’t stand for this in the long run.