This session was part of the Advocacy Sector Conversation forum held at the Queen Victoria Women’s Centre on 22 October 2015. Other sessions at this forum were:
- Reporting allegations of abuse
- Powers of attorney application and resources
- NDIS Information, Linkages and Capacity-building (ILC) Framework update
Michael Cromie, Manager Strategic Engagement, DHHS Office for Disability, introduced Noble Tabe, Acting Director, NDIS reform branch who provided an overview of the work of the Victorian Government to roll out the NDIS in Victoria.
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We’re up to our final session of today, which is our standard session, Q&A with the Office of Disability. Michael Cromie is standing with me, I will just hand the microphone over to you Michael.
Hi everyone, I’m Michael Cromie from Office of Disability and Department of Health and Human Services and I’m very very excited to see Noble Tabe just arrive. I was going to have to do some fill ins, some tap dancing.
I wanted to mention briefly before I introduce Noble that from the Department of Health and Human Services area the State Disability Plan Survey Questionnaire is out at the moment. I know definitely the Victorian Disability Advocacy Sector has been really providing that out to all their networks and really appreciate that. We’ve got a few more weeks on that to go. I think it’s the 6th of 7th of November when that closes. It’s a 6-monthly questionnaire that provides us with really useful information to try and change policy direction around whole of Victorian Community barriers that are facing people with a disability.
One last shameless plug for you and all your networks, to go into that survey and fill it out. I think we’ve had something like 600 or 700 responses so far to this survey, which is comparable to previous ones we’ve run. We really appreciate that again. Your support in that is fantastic. Give it one more plug and see if we can get a lot more responses because it does help us in guiding the way we can talk to other Government Departments about some of the barriers that still exist in Victoria.
I’ll just now introduce Noble Tabe who is the Acting Director of the National Disability Scheme Reform area. So in Victorian Government that’s assisting in the policy development around the NDIS reform. So Noble, we just had Mary Mallet speaking about some of the issues around information linkages and capacity building framework. From a Victorian perspective, it would be great if you could touch on some of that.
I would like to welcome Noble Tabe who has only been in the job for a very short time. We really appreciate your time today Noble so thank you.
Thanks very much and I’m really glad to be here. Even though I’m on the job for a very short time, I do have a long history in disability in Victoria, probably over 25 years and do see some of the familiar faces here.
So we’re happy to give you an update of a very significant historic, I think sometimes that’s the word they use in terms of the signing of the bilateral agreement. I’m just going to quickly give you an overview about what’s covered in that agreement and what’s to come. More importantly, I want to use the opportunity in terms of a bit of a dialogue because it is a very big reform in Victoria but also nationwide. I’m sure as much as we try and the staff working are very committed but we probably haven’t worked out exactly the details. I’m sure Commonwealth would say the same thing. We would probably use the opportunity, give you an update but more so happy to field some questions, where I can and have the information to provide very happy to. Where I don’t I’m also very happy to actually jot it down so we can actually get on to the list of the issue or the question that we have to work for.
So I’m not quite sure how many of you were in MCG. I think this is probably a few weeks ago now; it’s on the 16th of September, just testing my memory, that’s right 16th of September 2015. Premier Daniel Andrews was in Canberra with the Prime Minister. I think it was the brand new Prime Minister the next day and also with the NSW Premier and together they sign the bilateral agreement in terms of the National Disability Insurance Scheme. So it was a very significant moment in history I suppose.
Some of the things that got equated to in terms of the significance would be like the Medicare reform when it was introduced or like the superannuation. So it really moves to disability from if you like welfare services to actually insurance schemes. One of the things that everyone would be very pleased to hear is access to services will no longer be when it’s fully implemented to be driven by waiting list and availability of services or availability of funding.
So basically all the people who are eligible for the scheme in accordance with the criteria, they will be able to go to NDIA and get their if you like eligibility assessed and if they are eligible they would be able to get a plan developed and out of that plan will identify the resources and support they need to manage their day to day situation. I think that’s probably a very welcome change in people who either use the disability services or even staff and worker who work in the system. That’s a very significant welcome change in terms of no longer what we call a ration system, depending on waiting list, depends on funding. It’s actually moved to insurance scheme, a bit like Medicare.
In terms of the bilateral agreement, the significant things is in Victoria we already had Barwon in terms of the trial probably a couple of years ago, but the bilateral agreement will actually confirm the roll out schedule for Victoria, for the remaining which is the big part of the State. It will start in what we call the North East Melbourne area in July 2016 followed very quickly by Central Highlands, which is the Ballarat area in January 2017, then progressively the others come on. The whole of Victoria will actually transition, fully transition onto NDIS by 1st July 2019.
As we can imagine that’s quite a significant roll out and organising to do in the space of literally 3 years from July 2016 to about July 2019. So everyone in Victoria, who is eligible, will be moving on to NDIS during that 3 years.
The sequence, we’ve got a website which I haven’t got it right with me but we will be able to send it to you, got the entire roll out schedule area by area. As I said the first two are NEMA, North East Melbourne area and the Central Highlands then followed by others.
In terms of the roll out sequence, we still have a lot of details to work out but in order to make sure the people who really need the services will get to receive the services asap, in terms of the roll out schedule, is in each of the geographic area the people that will move on to the NDIS first are the people who are on the waiting list. The people that are already receiving existing State funded system they will continue to do so. But we’ll let all the people onto the waiting list to get onto NDIS first. That means they get their plan done, they get their resource allocated and they can actually go on to purchase.
In each of the area, the sequence is the waiting list people and then followed by the people who are already receiving State funded services. Also across the State the people who are on the most urgent list on the ACAS and the Disability Support Register, they will also transition to NDIS in the first two years of that three.
So as you can see the logic is we’re trying to get the waiting list people who are currently waiting for services to get on first, then followed by the people who are already receiving services.
Just to go back in terms of the whole scheme, by the full scheme there will be
$5.1 billion invested in Victoria in terms of NDIS. Out of that, I think roughly its $2.5 billion is the funding from the State and the remaining from the Commonwealth through the Medicare levy. So it’s a very, very big expansion during that time not just in dollars terms but also in terms of services. As you can imagine when there is more dollars for the people to buy and purchase the services, there will need to be more providers and more importantly there will need to be more workers. At the moment, some of the initial projection that is being done is to say Victoria in terms of the disability workforce will double by 2019. I think at the moment it’s about 24,000, so this will project to grow into 48,000 when the scheme is fully operational in Victoria.
The other very important distinction from the current system is at the moment, Victoria is probably in a slightly advanced stage in a sense that individualised funding package of funding, is a very well-practiced concept in Victoria for quite some time, probably for the last decade. But NDIS is entirely operating or not entirely, a very, very big part is operating on that individualised funding approach. As I said people will go to NDIA and get assessed and if they’re eligible, they will have a plan developed, then they will have a resource attached with that plan.
From the State perspective what we need to work to is when we progressively transition to NDIS, say when we get to the NEMA area some of the existing funding will need to roll in, to go onto the Commonwealth to fund the scheme. That’s quite a big exercise to organise in terms of Victorian contribution to be able to go into the NDIS pool to flow to each of the area as they develop the services. And similarly on NDIS operate on a concept that it’s no longer the Government buying the services for the people who need the services. It’s very much on the principle of choice and control of the NDIS participants. That means the person with a disability will have a plan and will have a resource allocation and then out of that they will go to purchase whatever they identify in that plan.
So we will no longer say oh well the Government will fund just say ten houses in Scope and then we will try the vacancy management and put people in there. So when the scheme fully operational, and this will take quite some time, people will say well I need accommodation and support and I got this money allocated for NDIS. So I might go to what we call registered provider and say I actually interested to purchase in terms of whether attendant care or whatever from you, out of the price that’s set by NDIS but it’s using my individualised package dollar to purchase that. If I don’t like that next year, I might decide I want to go to someone else and using the same money to purchase the services that I need or my needs might change. I might no longer need something now need something else. So if you like, the choice and control is entirely rest with the participant who actually use the services. I think that’s quite a significant shift in thinking and in the way that we actually operate.
So we will no longer be Government funding the services and then we try to match people into services. People will have total control and choice. Of course, that come with particular challenge and I think some of the information linkages issue are tied to that. It will take a while for people to actually transition into that way of understanding that they actually have the choice and control. Also, more importantly, we got to have enough provider in the sector so that people truly have choice. If you only got one provider, you don’t have much choice because you’ve got no one else you can actually purchase the services from.
As we can imagine, there is a very significant piece, actually not just a, it’s many significant pieces of work to try to get both the participant ready in terms of understanding that they have that choice and control and supporting them to have the choice and control, which I think some of the advocacy group will come in and play a very significant role in doing that.
Also, we have to organise the provider to get ready to adjust to that because the provider won’t be getting a monthly funding cheque from the Government. They will need to bill the NDIA because Noble actually use X amount of our services for the last month and therefore they will need to send a bill to the NDIA who actually use that money, out of my package to pay for those services.
So there is quite a lot of adjustment both in people using the services, the provider who are providing the services, and more importantly as I said, if we’re going to double the workforce we really need to think how are we actually going to make sure we still have a skill and committed workforce to continue to provide the services as well, to meet the demand of the growth in services. It’s not a long time to try to make sure that we have extra 24,000 skill committed worker who will continue to work in the disability sector.
That’s probably some of the challenge that we can’t say we are there, but we are definitely working with both the provider, the participants, the advocacy group and the peak body trying to put in the strategy to try to get there.
So anticipate by 2019, there will be about 105,000 in Victoria who will be in the NDIS in the scheme. That 105,000 probably make up of 76,000 who are currently already using disability or mainstream services.
The other component that I also should mention is for the quality and safeguard. Commonwealth ultimately does have a responsibility in terms of developing a national system about the quality and safeguard. At the moment, they’re not quite there. What the bilateral agreement outline is Victoria will during the next 3 years as the transition, to maintain the current quality and safeguard and it will actually administrate that on behalf of the Commonwealth. So there is a terminology what we call “in current support” in terms of the funding, that’s one of the component.
The Victorian Department of Health and Human Services will continue to manage the quality and safeguard components so some of the things in there at the moment people need to be registered with the Department in order to be able to provide disability services. That’s part of the requirement of the Disability Act. So that means that will stay in the next 3 years and as new provider come on Victoria will actually register them so they become register provider, then they can actually put their hands up and say we can provide services to the participant.
Also some of the other quality and existing safeguard that currently in disability services, like the disability services commissioner, like the DWE Disability Worker Exclusion Scheme, some of those will remain for the next 3 years with the intention that by 2019, the Commonwealth will be able to develop a national framework in terms of quality and safeguard.
I think I probably cover the main thing. It’s quite clear from July next year that will be the beginning of the transition of the whole of Victoria, starting from North East Melbourne area and then will remain in that transition phase with different groups phasing into the scheme until July 2019. They will all be in and at that point, in time the State will phase out most of the disability services that we currently fund with that money going into the Commonwealth to go into the whole NDIS scheme.
We do have other issue that we need to think from a State perspective. For example, there might be a very small number of people who actually are not eligible for the NDIS so currently one of the piece of work that we’re working on is what we call the continuity of support. So for those people State will maintain a responsibility to provide the services support that they currently receive. So we’ve got to work out how we’re going to do that.
The other piece of agreement, which probably don’t get as much as a mention, is actually the (inaudible – 20.20) for the aged care bilateral agreement for the transitioning, responsibility for aged care. So basically, services for older people will also be directly fund and managed by the Commonwealth Government through the home support program and other current arrangements. So there will be some people who are over the age of 65 who actually live in group homes and even though the funding responsibility will move to the Commonwealth, but we’re not anticipating those people will move from where they are. So for older people the responsibility for services will be a combination of home support program but also if they’re currently in receipt of specialist disability services they will continue.
Services for younger people will actually be funded and managed solely by the Victorian Government until the NDIS. It is anticipated by 2019 all of those, the younger people who are using the aged care, they will all be by then if they’re eligible to move on to NDIS. That’s actually quite a number of agreement in there that have to work through.
The other one is also NDIS apart from the traditional speciality disability services, it does also cover some of the mental health community based services so that come under the NDIS. Not counting acute mental health like hospital ward and those but the community based mental health services, they’re also in scope of the NDIS.
I feel I probably should stop here and see if there’s any question and people want to ask.
Thanks Noble, we only have a couple of minutes for questions. Noble Tabe is the Acting Director NDIS Reform Branch at DHHS. If you have a question, can you raise your hand and Fleur will come to you with the microphone.
Hi Noble, you didn’t mention advocacy. I’m not sure if you did that deliberately or not. Can you just explain how advocacy falls under the schedule, in the bilateral agreement?
The short answer is yes and no. At the moment we’re still going through an exercise, what they call is in terms of some of those individual advocacy, the Commonwealth’s interpretation is they should fall under the individualised package of the people. Say I need to go and negotiate to get a package of services for myself, but I can’t quite do it myself so I need an advocate to support me. The Commonwealth interpretation is they will fall into that.
(inaudible – too far from microphone)
There is two components. Then there is the more broader systematic advocacy, which are probably not working on individual but on a system level or a State level. Those things currently is part of that discussion with the Commonwealth, what they call the ILC, which is Information Linkages and Capacity Building. That’s some of the finer details that we’re currently discussing with the Commonwealth. They acknowledge there will be a component in there.
Thank you. I might follow up with an email. That didn’t answer my question.
PAULINE WILLIAMS, AMIDA:
Pauline Williams from AMIDA. I’m assuming if the roll out is happening in different regions at different times does that mean the DSR Disability Support Register will continue to take applications up until the time that region becomes NDIS?
Yes, but as I said we need to work out the logistics. The most important people on the register statewide will move on the first two years.
PAULINE WILLIAMS, AMIDA:
Statewide not region?
The Disability Support Register have a number of category, we have, might not be the exact one, the most urgent one and then we have the others. So the most urgent one in each of the area will move on in the first 2 years. Then when it come to the geographic roll out, say it get to NEMA the first lot of people go will be the first people on the DSR. So it depend on the time sequence. If you’re in NEMA the first layer which is the most urgent statewide they will progressively move on during the first 2 years and then when they get to NEMA if it is before, they move on to the most urgent then it will come, the rest on the DSR and then the people who are already receiving services.
I suppose the later you are in the roll out sequence the more chance that the most urgent people already on to NDIS. So it does work on, it depends on the sequence of which home you are talking about. There is quite a logistic challenge to organise. But the concept is we want the people who are most urgent get on it and then when it come to the area roll out, that will be the waiting list people, DSR people.
Does anyone have any more questions?
ANDREW, LEADERSHIP PLUS:
Andrew, Leadership Plus. My concern is there is confusion advocacy as opposed to case management. What you’ve explained is case management supporting individual and working through developing a package and making sure that’s happened. An advocate ensures that the rights are protected and there is social justice. That needs to be made clear in terms of this whole process.
I concur with the comment. I think the Commonwealth needs to understand what they call – there is slightly different terminology being used. One of the things they have is called the local area coordination and they also have the planner and for existing people case management, got a straggle a bit of both. If you like, the line of demarcation is if it is about supporting the individual you’ve got to cover on the individual packages but if it is across the whole system or across a large geographic area then that’s what they call the ILC. But you’re absolutely right and I think some of the things that individual participant need to be very clear as they move on to the scheme because it’s absolutely important what they actually get captured in their plan.
Thank you Noble, thank you everybody. Noble Tabe is the Acting Director of NDIS Reform Branch at DHHS and she was the guest of Michael Cromie, Manager of Strategic Engagement in the Office of Disability at DHHS. So thank you very much for your presentation this afternoon and for your questions everybody.
That concludes our Advocacy Sector Conversations Forum for today. Two things before you go, Natasha has already emailed everyone who is registered to attend today, an evaluation form for today. Please do take the time when you are at your email to complete the evaluation form. We really do rely on what you say in that evaluation and it does inform our calendar of conversation forums for the coming year.
Thank you so much for your participation today and especially all the regionals who took the time to come here today. It’s really amazing to see so many of you come today from all over Victoria. We do have quite a bit of food left over from lunch and afternoon tea, honestly grab some as you go out, put it in your pocket, put it in a napkin because Natasha and I don’t want to have to eat it all ourselves.
Thank you so much and we will see you next time.