Self-managed vs Agency-managed supports in the NDIS

This was the final session at the Advocacy sector Conversations forum held at the Queen Victoria Women’s Centre on 18 May 2017.

Other sessions at this forum included:

 

Overview

Carl Thompson from Australian Federation of Disability Organisations (AFDO) provided an   in-depth overview, including pros and cons for the various support management options, that would assist advocates when working with people with disability through their NDIs plan implementation phase.

Felix Neighbour from the Office for Disability then updated the sector directly on key government initiatives including ongoing work to strengthen the Victorian Disability Advocacy Program.

 

 

References mentioned in  this session:

 

Transcript

Jump to OfD Update

 

 

MELISSA HALE:
OK everybody, I hope you enjoyed the break and now we’re on to our next session.

The NDIS is a mine field that we’re all trying to navigate with all the twists and turns and we’re trying to do as many NDIS sessions as possible to assist you in your work.  You’ll also note that we are basing our next Strengthening Disability Advocacy Conference in September on the NDIS too so make sure you grab some information on that  outside the door.

today we have Carl Thompson from AFDO to give us an in depth overview of the pros and cons of self managing or opting for the Agency to manage your NDIS plans.  Welcome Carl.

CARL THOMPSON:
I believe we’re already in a room full of experts so I don’t really need to explain what the NDIS means, or is, but I like doing it anyway.  It’s the National Disability Insurance Scheme and it’s called that because it’s now Australia-wide, it’s for people with a disability and it’s an insurance scheme because anyone in Australia may already have, or acquire a disability at some stage of their life. So it’s not just for people who already have a disability, it’s about everyone and that’s why it’s funded by our taxes.

I’m not going to talk about how it all came about, or how to apply for the NDIS, this is all about actually managing your NDIS plan.  So I’m going to have to assume that you’ve already been given access to the NDIS, you’ve already gone through the planning process in the NDIS,  and you’ve actually got your plan and, people say, “I’ve got my plan but what now?” and that’s a very valid question.

At AFDO, so that’s the Australian Federation of Disability Organisations, that’s who I work for. I work on the Disability Loop project and Disability Loop is a way of getting information about the NDIS to more people in a variety of formats and trying to dispel some of the jargon and making things a bit more accessible and easy to understand for a wider variety of people.

We’re doing some workshops around Victoria at the moment. DARU was kind enough to put these workshops in their recent e-news communication that goes out so we’re really thankful for that.  I was going to say that there are a few places left in Box Hill but they are selling out but I can promise that we’ll hopefully be coming back very soon. And, of course, these are sessions that are free so for people with disability and their families shouldn’t be expected to pay for this type of information.

AFDO itself, so we are the Australian Federation of Disability Organisations is a peak body of disability organisations in Australia so we don’t take individual members but our members are organisations, groups like Blind Citizens Australia or Downs Syndrome Australia, so peak information and advocacy groups around Australia, they are our members. I mentioned before about the Disability Loop project, which is a part of AFDO. So again, we’re running some  workshops, so I had to give that a plug obviously or I wouldn’t be doing my job properly.

One of the workshops that we run is called ‘I have my plan, what now?’ and we also have two workshops called ‘Plan management’ and ‘Is self management for me?’.  So this afternoon I’m going to be running a very, kind of cut down version, of this. A little less interactive than, obviously, the workshops will be but I think it’s important to talk about this.

So, plan management, what is plan management? The NDIS calls plan management ‘managing the funding for supports’ and every person’s NDIS plan must include a  statement about how supports in a person’s plan will be managed. But what does it actually mean?

It means actually purchasing things in your plan, purchasing supports.  It means administering the funding in order for you to purchase things and at the end of the year, it means aquitting  any funding, so letting the Agency know what you did with the money and that you spent it in the right way. But, more simply, plan management involves budgeting, keeping records and paying for supports that you have been given an allocation for in your NDIS plan. And again, people call it ‘managing your money’, ‘paying for your supports’, and it doesn’t really matter what you call it, but it’s all a type of plan management.

And it’s really important because most of the time we think about getting into the NDIs, we think about making sure you have all the supports in your plan and we tend to kind of neglect the very important step afterwards where you’ve actually got, or hopefully got, enough supports in your plan but how can you actually use it. An I know that the NDIA, the National Disability Insurance Agency, they were a little surprised early on because some early plans had lots of funding in them but people weren’t actually utilising, or using the funding, and they were a bit shocked, they were saying, “why is this?”. And that’s because, historically, people with disability and their family members have been told where to go, what to buy, who to talk to and with the NDIS, although there is some support, it’s a lot more dictated by you rather than by someone else and that can be really challenging.  But it’s a good challenge I think.

So, through plan management, and of plan management, self management is one method, we’ll talk about that soon, but no matter which way you use your plan, no matter which plan management method you use, it’s a really good way of actually improving your skills.

It involves improving your organisational skills, your budgeting skills, your people skills as well because it involves talking to people and negotiating supports and that kind of thing.  It’s also a really important step in negotiating and resolving any conflict.  If you’re actively involved in managing your plan, you have to be actively involved in managing any problems that may arise, as we’re not under the illusion that there’s never any problems. But what’s important to know is how to deal with any problems if they do come up.

Really, you hear about it again and again, this is about choice and control.  You’ve got your funding in your plan and plan management is about using your choice and control to actually live the life you want to live whether that’s an ordinary life or an extraordinary life.  I know, personally in my NDIS plan, one of my goals is getting out of bed every morning. It’s not very dramatic, exciting  or flashy, but goals don’t have to be, they can be if you want, but they can be simple things as well.

I’m going to go through the actual methods of plan management.  The most common method, I’m not quite sure of my numbers, but I think around 80% of all plans, so by far the largest method, is where the National Disability Insurance Agency, or the NDIA, manage your plan on your behalf.  If you do this, if you choose this method, importantly, you can only use providers, using your NDIS money, who are registered with the NDIS.  So that means that the providers you use have to be registered with the NDIS in order for you to use your NDIS funding to pay for those services.

But what does registering for the NDIS mean? It means that a business has applied to the NDIS and said that “we believe we can offer these services” and they have shown evidence that they can do that and the NDIS has said “yes we believe you’ve given us enough evidence that you can offer these services”. so it’s a safeguard because they have done the checks and balances to show they can deliver the services that they say they can deliver.

But, at the same time, it can be a bit limiting as well, because lots of businesses may not be so well organised or maybe it’s a bit difficult, but lots of businesses haven’t actually registered with the NDIS which means that if you have an NDIS plan that’s managed with the NDIA, so it’s plan managed through the NDIA, it means you can’t use these businesses with your funding unless they are registered with the NDIS.  So it’s really a bit of a catch 22.  Slowly over time, businesses are registering which is good, but there’s always going to be a delay until everyone gets their systems in order and more businesses register.

So in this case, you do everything, so you pay providers, you engage with providers through the NDIS porthole. It’s called the ‘My Place’ porthole and we’re going to talk about the ‘My Place’ porthole a bit later on, but that’s one of the key differences when you use the NDIA to manage your plan.  But I’m going to skip straight to the second plan management method and that’s when you use a registered plan management provider.

So they are called ‘registered plan management providers’, that’s because they have to be registered with the NDIS. And if the plan management provider registers with the NDIS, again it means that the NDiS believes they have the skills and resources to actually do the things they say they can do.

In this case the plan management provider pays bills on your behalf, they generate records of how much money you have left over in your plan and, in some cases, they can do some level of conflict resolution and help you make decisions, and that type of thing.  If you choose this method, you have extra funding in your plan that is dedicated towards using this method.

Some people were worried that if they used this method it would cost them more money or eat into their useable funds in their plan but, no, that’s not the case. It’s extra funding on top of the money you already have in your plan to purchase supports and services.

Does anyone know about Moira? In Victoria? Anyone? Yeah… So they used to be called Moira FI, Moira Financial Intermediary and now they’re called Moira PMP.  Moira are a little bit excited I suppose, maybe a bit worried because now they’re not the only plan management provider in town any more.  Now other providers can register with the NDIS for a similar service to Moira.  So when I’m explaining what a plan management provider does, in Victoria anyway, I say that it’s like Moira.

So they pay your bills for you on your behalf and they can help you with some basic queries around how many funds are in your ISP, in Victoria, or in your NDIS plan. But, if you’re using a registered plan management provider, you no longer have to use the one company that is available in Victoria.  There are now multiple and there will be more every month, every week, every year, available for you to choose.

So I’m pretty much a male, middle class white person, but if I was someone who spoke English as a second language, I was a recent migrant maybe, and I wanted somebody to  help me manage my plan, there’d be nothing stopping me from using a plan management provider who was bilingual or who lived 5 minutes away from where I lived.So we’re opening up a lot more options as well so no longer do you have to use the one option presented to you through the Victorian based system. So again, choice and control with the NDIS.

A plan management provider, they’re a middle man, they’re a middle person.  they exist between you and your provider of supports.  Say it might be personal care.  You engage with the personal care provider, the personal care provider invoices you or your plan management provider and the plan management provider pays those bills.  It’s boring, a little bit, but it’s functional and not everybody wants to do this themselves.  For many people it’s a really good option.

Some plan management providers would have already been a disability service provider in Australia or Victoria and some would be completely new. They don’t really need any prior experience, just as long as they have met the registration requirements with the NDIS.  So it wouldn’t surprise me if some accounting firms are going to move into the disability space.  They might have the computer systems already, they might have the financial skills, they mightn’t have the disability skills but they might be willing to learn.  So again, it’s a market place and more and more options are becoming available to people with disability.

Knowing about these options and knowing the pros and cons is a different thing.  But it doesn’t mean we shouldn’t give people options because it’s a lot better to improve people’s skills and their ability to research, than it is to limit people’s choice.

If you want to do the most yourself, you can move on to the next option and that is self managing.  This is an option of plan management and this is where you, as a person with a disability, or maybe a parent, or legal guardian or nominee in the NDIS, you manage the plan yourself.  It’s called ‘self management’.

What it means is that you pay the bills, you deal with providers, you keep check of your budget and you do more for yourself.  For some people, they might say, “I can’t be bothered doing all that, I already work full time, I’ve already got 3 kids and I just want to enjoy my retirement”, but for some people, they might really want to self manage their plan.  Again, it’s options, available to you if you want to use it.

Importantly, when you self manage, as well as when you use a registered plan management provider, you can use providers who are not registered with the NDIS.  So you don’t have to limit yourself to service providers who are registered with the NDIS.  So why am I using dramatic pauses here? I’m doing it because it’s a big deal.  It means that you’ve got more options available to you.

One of my favourite topics, which might take, well I have to be careful of time because I might go on about it forever, is using the mainstream, mainstream products, mainstream services  and I think people with disability can benefit from using the mainstream a bit more.  Lots of mainstream providers won’t have registered with the NDIS, mainly because they might not know about the NDIS, or mainly because they mightn’t have disability specific skills that they might need.

But I challenge people and I say, “why do you need a disability specific gardener?”.  Can anyone tell me what a disability gardener is?  What does that actually mean? If I’m in the NDIS because I have a physical disability and I can’t mow my lawns and the NDIS sees it as a reasonable and necessary need, so I have money for some basic lawn maintenance – no you can’t get funding for a hedge maid or topiary or anything like that – simple garden maintenance, why should I go through a disability service provider to get that done for me?

You might disagree and there are some reasons why, I know of some people who face discrimination from the mainstream because mainstream providers might not be equipped to, you know, have the right attitude or experiences with people with disability and that’s a legitimate concern. But if you want to use a mainstream provider to get some things done, why shouldn’t you?

So when you self manage your plan, or use a registered plan management provider, you can use a mainstream provider regardless of whether or not they have registered with the NDIS.  And it does not meant that this mainstream provider can’t register with the NDIS, it just means that so far not many of them have.  So if you self manage, or you use a plan management provider, you can have more choice and more control of the funding in your plan. So, yes, you have access to a wider range of supports and services if you self manage.

In the NDIS there are these things called ‘service agreements’ and a service agreement is normally a written document between you, as a person with disability, and a provider of your choice. A good service agreement should talk about how the relationship should go. It should talk about what you want from the provider, it should talk about what the provider wants from you and it should be a negotiation. It should not be a form that gets put in front of your face saying “sign here” and if you do that then I will consider going somewhere else because you don’t have to worry about that, you don’t have to use the same provider again and again under the NDIS.

A good service agreement should involve some compromises maybe, for both parties, it maybe could involve preferences for gender for your personal care.  If you’re doing community access and you’re 15 then you might want to go out with cool 20 somethings rather than people who are older than your mum.  It doesn’t mean that you’ll get what you want with the NDIS but you’re allowed to ask for it.

But if you’re self managing, you have to do this yourself, you actually have to negotiate with what you want and, I’m sure you’re much more of an expert at this than I am, for many people with disability, there is chronic disempowerment where people have been told again and again, what they should be doing, or what they can do or what they’re not allowed to do, that over time, people with disability and their families settle for suggestions and options that might be OK, but they mightn’t be optimal, they might ’not be the best.  So over time, I’m really hoping that the NDIS encourages people to strive for more and to demand more.  I’m sure you’re all the same because you’re all related to advocacy in some way or another and that’s important that we can slowly drag the standards of services up over time.

So a good service agreement, I always joke and say, a good service agreement means that both parties leave really unhappy because they’ve both compromised enough to mean that they’ve made a deal with each other and it’s good, but both have compromised something through the process.  But if you’re self managing you don’t have anyone there to help you make this service agreement whereas if you use a registered plan management provider, you might have someone there helping you to check the terms and read what they’ve written and be a bit of a support for you.

I’m sure you’re all saying, “why don’t they get an advocate in?”, and that’s a good idea, but again, with chronic disempowerment, some people don’t actually know that advocates exist and there might be things like waiting periods and that type of thing as well.  It’s definitely a concern for some people.

When you self manage, you have to manage your budget as well.  Even the word ‘budget’ can send chills up people’s spines, but when you get the NDIS, you get your NDIS plan, it’s a plan for a year from the date your plan is approved.  It’s not a calendar or financial year, it’s a year from the date that your plan is approved and it means that you have money, or resources, in your plan that you can then use to purchase things, products and services. But you have to make sure that you don’t blow it all in the first, you know, 3 months.  you have to make sure that you use it evenly, or relatively evenly, over the course of the year.

You might be like me and be like a hermit in the winter and not use any community access support but when the weather gets a bit nicer you might use more in the summer months.  So it doesn’t mean you have to use the same amount every month, but it means you still have to keep track of the amount of money in your plan. Again, if you’re self managing, you’re doing it more alone, you have less support than if you were having a plan management provider help you out with that.

But some people really love this, they love being actively involved in their life and we really can’t discount how empowering and how much positive change this can bring to people’s lives.  They feel a lot more involved in their lives, a lot more in control of how they live their life and that’s really important.  But at the same time, people might say, “I have to look at budgets at work as it is and i don’t want to have to worry about my own personal NDIS budget all the time” so, pros and cons…

So when you self manage you also need to keep a record of your purchases.  The NDIs is our taxes at work and we want to make sure that our taxes are being spent in the right way.  That naturally means that any purchases made using NDIS money should be spent on the right thing and the right thing is determined during the planning process.  You have to make sure that you’re spending the right things using your money in your plan.

I’m self managing my plan and, as much as I would love to use it to buy me a new computer or a holiday or that type of thing, I can’t.  And that’s OK because we want to make sure that the Scheme is sustainable and being used in the right way.  You have to maintain purchases, or records of purchases, for at least 5 years and that can be harder than you think.

Has anyone ever put receipts in a shoe box or stuck them under their bed and eventually cleaned out their room and found out they have all faded, all the ink has run off or they’ve been eaten by snails, or, maybe that’s just me and I’ve just got a really dirty room, but what I’m trying to say here is that keeping records is harder than you think. You might have to scan them, you might have to back up your computer so that even if it crashes you’ve still got evidence of the things you’ve bought. It’s a way for the NDIS of being transparent around the funding that they have given you to use to purchase reasonable and necessary things. So if you are self managing you have to be more actively involved in managing your records and keeping your records and things that you buy.

One of the negatives, I think, of self management is that you have to do more for yourself.  I mentioned this before but some people just really don’t want to do all this.  They might want to get all the benefits of of having more choice and control over the providers that they use but they might not actually have the skills, or the need, or the want, to actually keep records and organise providers and deal with any conflicts and that type of thing.  So if that’s the case, what are the options available?

Luckily with the NDIS, if something is your goal and you can’t or haven’t been able to achieve your goal because of your disability, then you can often have capacity building supports but into your plan. so what I mean by that is that, say you are a person with an intellectual disability and your parents have been a little bit conservative and they haven’t given you much education around finances and you want to move out of home.  But you don’t even know how to use internet banking or you don’t have very many financial skills, so what do you do?

They can’t just simply say “you can’t self manage”.  The NDIS would say, “if self managing is one of your goals, how can we build your skills so that you can eventually do that yourself?”.  It might be financial classes, it might be getting software on your computer to help automate some of this record keeping approach or duties. So what I’m trying to say here is that just because you don’t have the skills, or you feel like it might be too difficult, it doesn’t mean you can’t get the benefits of self managing.

One of the really big benefits of self managing is you can actually directly employ your own staff.  You can become the employer, or the boss or the manager or whatever you want to call it, of your own team of staff.  this is normally for personal care workers or community access workers where you employ them. If you’re employing someone, it’s not something to be taken lightly.  Bosses often get told that they’ve got an easy job of bossing people around, but if you’re in charge of someone, you’re responsible for someone.

If you’re self managing and you’re directly employing your own staff then you need to make sure that you’ve got the right insurances for yourself and for them, you have to make sure that you’re paying them, not just minimum wage but the appropriate award wage as well, you have to make sure that if they are casual workers that they get leave loading and entitlements if they are full or part timer workers.  There are so many, you know, arduous, important but complicated things you have to worry about.

But this is an option available to you if you self manage.  Only about 5% of people self manage and, I think, only about 5 or 10% of people actually directly employ their own staff.  So this is quite a small number but that’s OK for some people, this might be really important,  Maybe they live in a rural area and they really need to lock down staff for a long period of time, they might pay them extra in order to make sure they don’t leave and go somewhere else.  They might want more control over their staff because they don’t agree with the communication policy of the personal care agency in the area.

I know when I was at university a couple of years ago, well more than that now, but when I was at university I had personal care workers come in and they were middle  aged, in their baby blue uniforms looking like fish out of water and I was probably around 18 or 19 and I was thinking, “I’m gonna be so uncool hanging around these people”.  So if you directly employ your own staff you have more control over conditions of work.  You might have a casual dress code or purposely employ students or that type of thing. What I’m saying here is that you have more options open to you if that’s what you want to do.

I know I’m nearing the end of my time before we get to questions, but what I have forgotten to say is that one of the biggest benefits of self management is that you can pay providers, or people more than the price in the NDIS Price Guide.  So have we talked about the NDIS Price Guide at all?  Does anyone know about the NDIS Price Guide?  No?  A little bit, hep…

So what it is, is the maximum price that providers can charge for certain services. So personal care has a price cap, occupational therapy does, gardening does, everything you can think of has a maximum price. This    is a way of avoiding providers charging whatever they want and trying to be opportunistic.

But if you self manage you can pay providers more if you want.  It doesn’t mean that you get more money in your plan, it means that you have to use your money more sparingly.  But, say there’s an occupational therapist who is, for mathematical sak, twice as good as the next one but they cost 50% more expensive, maybe it’s worth the extra price you pay.  Again, for those who really want to drill down and get the most out of their plan, have the most choice and control out of their plan, if you self manage you can actually pay providers more than the maximum in the price guide. But you have to be careful to make sure that you are not getting ripped off.

I’m just now going to quickly touch on a few NDIS systems.  One of them is the NDIS ‘My Place’ porthole.  this is where you login and it’s linked to ‘My Gov’ that you might be familiar with through Centrelink or the ATO or Job Access, but it’s a link to service to My gov.  So when you’re in the NDIS you can set up your NDIS My Place account and that’s when you login to see how much money is left in your plan, that type of thing.

This is where, if you’re having the NDIS manage your plan, you create a service booking and then it all happens in the background, providers claim, you can monitor it if you want but you don’t need to.  You don’t need to authorise any payments once you’ve set it up.  But if you’re self managing, this is where you login and claim reimbursement from the NDIS for any costs that you’ve incurred.

Say I’m self managing, I get a bill for $2,000, I can login into the porthole and I can claim the $2,000 from my plan and then I wait for a day or two for the amount to appear in my bank account and then I can pay the bill to the provider. That means that I’m actually not going to be out of pocket because I can claim the money when I get the invoice rather than when I make the payment.  Some people feel a bit worried that they thought they had to pay first and be reimbursed later but as long as the provider invoices you and has maybe a week or two invoice terms, you can definitely get the money in your bank account before you pay them. So that’s not really a concern if you know that.

I know I’m getting very detailed and some of you are probably letting your eyes glaze over, but what i want to kind of end on is the fact that there are so many more options now with the NDIS.  this is what people forget , people spend all their time working out how to get into the NDIS and ow to make sure they have a really good planning conversation with the NDIS to work out what supports they get in their plan, and this is very important.  But what’s just as important is actually having your plan and using it.  When I say using it, when I say using it, I mean not just sticking to the same providers you’ve always used, but trying something new and maybe ringing up Jim’s Mowing rather than going through some Victorian disability provider that does gardening but charges twice as much.

If you want to self manage you can use the mainstream more and why is it good to use the mainstream? Anyone?  Please help me, why is the mainstream good to use?  oops I shouldn’t do this because now you have to run the microphone over there…

PARTICIPANT:
Cos we’re creating a more inclusive society.

CARL THOMPSON:
Yeah, people with disability are accessing the community in a non-segregated way and that’s what it’s all about.  And the more this happens, the more mainstream services will value people with disability as consumers and also as people rather than ‘the other’’ over there that’s just for disability providers or just for the medical side of things.  So accessing the mainstream is really important and I think we don’t quite talk about it enough.

How am I going for time?

MELISSA HALE:
Yes we’ve got 20 minutes..

CARL THOMPSON:
Oh, we’ve got 20 minutes… I’m talking too fast.

MELISSA HALE:
then we’ve got time for questions.

CARL THOMPSON:
Yeah, let’s have some questions and if something else pops into my head, I’ll be sure to be wordy to make up the time.

MELISSA HALE:
Please raise your hand so I can see you.

CARL THOMPSON:

Any questions? Yep, I’ll let Melissa organise the microphone…

QUESTION:
I’ve actually got two questions.  The first one is about clarifying the registered plan manager role, cos you mentioned that they pay the bills and manage budgets, but do they also choose the providers and employ the providers?

CARL THOMPSON:
No. With the registered plan management provider, if I’m getting more complicated, there are actually two varieties.

So there’s a, what’s the word?, there’s just a financial one who just pays the bills and just generates invoices, sorry that’s statements for what they’ve paid, and there’s one that’s a bit more involved.  they may do some emailing on your behalf or fixing any issues that may arise. It’s often quite low level support, it’s funded at quite a low level so it’s not full-on advocacy , or it’s not support coordination either, some of you might know about support coordination, so it’s less involved than that but, no, they don’t employ anyone apart from their own staff.  They just just pay bills using your funds in your plan

Does that answer your question?

QUESTION:
Yes thanks it does. Another question, you mentioned that if you are self managing, you could pay a provider above the NDiS price, can you pay them, do you have to use your own money or can you use the money allocated in the plan? Maybe sacrifice something else?

CARL THOMPSON:
yes, so say you have 50 hours of personal care a week but your provider that you really like charges a bit more, so functionally you can only at that rate you an only get 45 hours of personal care.  But if you feel that that trade off is worth it, then you can do that.  So you’re actually reducing the amount of purchasing power in the amount of hours you can get but, if you feel it’s worthwhile you can do that.

And, as an extension of that, eventually, you know we say the price guide is a price limit so some providers will, and already are, charging less than the price guide.

So I’m imagining a situation on a Saturday night you need some personal care and you need someone who has got really good skills, they can do your hair and your make up, and they charge lots of money.  But you find it worth it because you’re going out on a date but during the week, in the morning, you might just want the bargain basement agency because you’re going to be in your pyjamas all day anyway and you don’t care about being seen with someone who perhaps isn’t so cool.  So you can save money in one area and then use that extra money in another area if you want.  It’s about being creative.

QUESTION:
Yep, thank you.

CARL THOMPSON:
no worries.

MELISSA HALE:
Other questions?

QUESTION:
I’ve had a plan management provider since I was registered in January…

CARL THOMPSON:
In the NDIS?

QUESTION:
Yes, and the delays for payment to my carers and providers have been 2-3 months for that whole period and I’ve asked them about what the issue is and they’ve said that this is a problem with all PMPs and a to of it’s technical problems with the NDIA but when I speak with the NDIA then they say it’s the problem with the PMPs not coming up to scratch.  Do you know very much about this?

CARL THOMPSON:
Yep I know last year in July the NDIS was switched on, if you will, in my area so the full roll out began and they also implemented the new porthole, so the My Place was introduced then it replaced what was already there.  That was very problematic to say the least, there were delays with payments for providers, some of them needed to get emergency funds or they would have gone under, lost business, that sort of thing.  I’ve been told that that has been resolved now but I think the issues with plan management providers, for some people, still exists.

I’m not an expert on how they interact with the NDIA, but what I do know is that some have had more success than others and, I don’t want to say that yours isn’t any good, but what I want to say to everyone else is that if you choose one and they’re not working for you, there’s nothing to stop you calling up another one and saying “so and so is having problems with this, what’s your solution to this problem?” and if they have a solution, and you can read reviews online and you can ring a customer and get a testimonial and if you think they could be better, then you can use them.  You can swap your plan management provider if you want.

so that’s not really answering your question, but at the same time, if you feel like now that you might be able to do it yourself, you might be able to move to self management cos that would be a way of getting rid of that problem as well.

But all I can say is that the NDIS needs plan management providers, it’s a big part of the NDIS, so it should be their priority to try and fix some of these issues because it’s unacceptable for providers not to get paid for 2-3 months.  that’s bad cash flow no matter what way you look at it.

CHRISTIAN:
My name is Christian from the Diversity and Disability program at the Migrant Resource Centre Northwest.  A quick question I would like to ask you, before the NDIS come here in Victoria we had a system called the ISP, Individual Support Package, and I am receiving and I self manage it.  Basically it works in a way that at the beginning of each month a pool of money goes into my bank account  automatically and of course I need to keep track of all the expenses and receipts and invoices.  Would there be a similar system available under the NDIS?

CARL THOMPSON:
Thanks Christian. In the Victorian system prior to the NDIS if you were self managing, well not self managing but if you were receiving direct payments through the ISP system, each month you received 1/12 of your budget in your bank account and that was pro rata, or whatever you want to call it, that was paid once a month.  And that meant that you could use that money to purchase things and at the end of the year you had to aquit your funding.  So you had to either carry some of it over or pay some of it back or at least prove how you have been using that money because there were no checks and balances as the year was progressing.

With the NDIS, when you self manage, you only claim reimbursement or you claim money from the NDIS after services have been delivered.  So again if I’ve spent $2,000o on personal care for that month or that period, I claim that exact amount on the invoice out of my plan and I tick a box saying that this is an accurate reflection of what I spent my money on in line with my goals on my plan, bla, bla bla and then that means you are quitting your funding as you go along because you’re only claiming for what you already have evidence of what you’ve spent  it on.  That means at the end of the year, you don’t have to do any acquittal because you’ve already been aquitting as you go.

You may still get audited by the Agency, they’re not going to release the figure of the percentage of auditing that they may actually ask to see these receipts, but you’ve been aquitting as you go along.  It’s different in that you don’t have money sitting in your bank account, you only have money in your bank account after you’ve already claimed it from the NDIS.  this may be a problem, maybe you have to buy some gloves from a pharmacy out of your self managed budget but for that you’re not going to get your invoice from Coles.  They are going to want you to pay for it right then and there so for that period of time you will be out of pocket.  You’ll buy it and then you’ll claim it back that day and then get paid back in a day or two.  But if it’s a larger purchase like physio therapy invoice or personal care, you can claim it as soon as you got the invoice and then you can pay it after you got the funds transferred into your bank account.  So does that make sense?

CHRISTIAN:
yes it does.  It’s more like a reimbursement.

CARL THOMPSON:
Yeah it is a reimbursement but I’m not using that word because you don’t need to pay for it before you get paid back. You need to have actually just had the service. If that makes sense?

CHRISTIAN:
Yes.  the other question I wanted to ask you, is for people who are over 65 they are not eligible for the NDIS so they have to go into an aged care package but for some people with a disability over the age of 65, where the aged care package is not enough to provide the support they need, would they be eligible for the NDIS?

CARL THOMPSON:
That’s not really my area but I think the answer to that would be no.  The NDIS talks about no overlap, no duplication, so they won’t pay for services that should be the responsibility of another government department or universal obligation.  They are not going to pay for a taxi complany to buy their taxis and they’re not going to pay for trams to be accessible and they’re not going to pay for aged care packages for those who are not eligible for the NDIS.

So, unfortunately if your aged care package is inadequate for you as a person with a disability, then your port of call would be getting that looked at again or ringing up the media or going to get an advocate.  The NDIS could legitimately say, “you’re not eligible so we don’t have to have anything to do with you”.  That’s a way of stopping other services from withdrawing from delivering services saying we don’t need to worry about that because the NDIS will pay for it.  The NDIS is really firm around what it will fund and what should be the responsibility of other parties.  That’s actually in the NDIS Act so the NDIS law.

At the same time, aged care is going through a similar reforms anyway which is not my area but they are going through reforms as well at the moment

MELISSA HALE:
Are there any other questions?

QUESTION:
Just a clarification… If you’re self managing, or you’ve got the NDIA managing, you use the porthole, does the porthole have any role if you are using the management service like Moira?

CARL THOMPSON:
Yes you can use the NDIS porthole, the My Place porthole, no matter which method you use. If you’re self managing, that’s the only way you can actually claim reimbursement but no matter which method you use. you can login to the porthole at any time to check what’s ben happening in your plan.  You can check what payments are being made, you can check who has claimed money from your plan, you can remove a service booking, so you decide your provider is no good, you can stop them from being able to access money from your plan.  It doesn’t matter which method you use, you can still access information about your plan in the porthole.

MELISSA HALE:
We’ve got time for one last question.  Any questions?

ZENAH:
Hi, I’m Zenah from the Migrant Resource Centre. My question is just, you mentioned the management plan provider and support coordination, if you could please clarify for me?

CARL THOMPSON:
Yes so when people are going through the planning process, so they’ve already eligible for the NDIS and they are working out what supports they need in their plan, so what amount of money, what their goals are, that type of thing.  If they identify that they need assistance with actually finding providers, working out what will work well for them, what won’t work well for them, if they need assistance with this, then the person at the Agency or the Local Area Coordinator will say you have a need for support coordination and that will be funded in their plan.

Some people might get 10 hours a year, some people might get 10 hours a week, but that’s where you have, I hate to say it but a case manager as many case managers are now doing the support coordination role.  Their role is to actually implement someone’s plan if you can’t do it yourself,

Whereas a plan management provider, their primary role is just paying the bills.  They might do the occasional phone call or occasional email, but their role is mainly paying the bills whereas a support coordinator can’t pay any bills. They are there to help implement the person’s plan and most support coordinators, as well, their expectation is that they do themselves out of a job as they should build a person’s skills as they do this.  Eventually the person needs less support coordination year on year and eventually don’t need any at all.

They are similar, plan management providers and service coordinators, but they are different. Support coordinators are a lot more involved in dealing with complaints or setting up providers whereas plan management providers just do the paying of bills and generating of statements and that type of thing.

MELISSA HALE:
Thanks very much Carl and I’m sure you’ll all join me in thanking for your information and knowledge sharing today. thank you.

(Applause)

 

Office for Disability Update

 

 

MELISSA HALE:
Now for the last session of the day, I would like to invite Felix Neighbour from the Office for Disability to give an update on the Office’s activities.

FELIX NEIGHBOUR:
Thanks Melissa.  I think I know most of the people in the room and perhaps over the video, I can’t see who’s there, but, hello.

Reflecting on Carl’s presentation, for people who are not aware, the role of the Office, it’s a big job, it’s to try and make Victoria an inclusive society for people with disability where they are valued and respected and a really important part of that big job is to make sure the State Disability  Plan happens.  Also to fund Victorian advocacy organisations through the Disability Advocacy Program.

These forms are so important to hear about issues that are coming up for people with disability – whether that be child protection, family violence or NDIS – so I just wanted to thank everyone for their presentations today. I’d also like to thank the DARU for pulling together the Disability Advocacy By The Numbers report that will provide a really solid evidence base for issues for people with a disability but also to help move forward.

Some of you might be aware that there was a review of disability advocacy and a big thing that came up from there was getting better at measuring outcomes for disability advocacy.  So I just want to thank DARU for that.

I’ve got a few updates… One of the updates relates to the Disability Advocacy Innovation Fund.  For people who aren’t aware of that fund, as part of the Victorian government response to the  Parliamentary Inquiry into Abuse, it announced $1.5 million to organisations funded under the Victorian Disability advocacy Program to meet 4 objectives. Let me see if I can remember them now

  • engaging diverse and isolated groups
  • managing demand
  • systemic advocacy
  • consumer protections

I want to assure organisations who put in submissions, that we are working through them.  we are running a bit late but we’ll let organisations know as soon as possible and what I can say, is that there was really strong interest and some great ideas and I think that the Innovation Fund will give us some great opportunities to build on what we’ve got to look at, in the long term, how we make the Victorian disability advocacy sector even stronger than it is. So just a quick update for those organisations and for those who were unaware that the Innovation Fund went out.

Also, pleasingly, for those who read the budget papers or VCOS’s helpful summary, pleased to say that $4.9 million has been announced to support the State Disability Plan in the budget. That’s really positive.  It builds on the $3.3 million that was announced in last year’s budget and as soon as we have further information, we’ll use this forum and other avenues to let people know about that.

That’s it really, by way of an update as i’m really aware that people need to head home.  I’m also aware that people might have questions so i’m prepared to give it my best shot.  If people have any questions.

MELISSA HALE:
If you would like to ask a question, please raise your hand and I’ll come over with the microphone.

SUSAN ARTHUR:
I don’t know if you can answer this, Felix,  it’s Susan Arthur from Reinforce, we’re greatly concerned to hear, I think it was in the federal budget, they took a lot out of the NDIA like the money that might have been supporting advocacy and we’re just greatly concerned that that money was also to help and run mainstream services and we’re greatly concerned why that one has been taken away from such a delicate sort of service.

FELIX NEIGHBOUR:
I think that might relate to Information, Linkages, Capacity Building?

SUSAN ARTHUR:
Sorry, I was using the wrong words.

FELIX NEIGHBOUR:
That’s OK. I have to say that I can’t answer that question but i do want to clarify that that doesn’t relate to advocacy perce. Victoria funds an advocacy program and there’s a separate program called the national Disability Advocacy Program and the national budget didn’t have any impact on the National Advocacy Program.

That’s the sort of thing I’ll have to follow up and I’ll need to talk to DARU to work out how we might get that back through the sector, but I’m not able to answer that because it relates to the federal budget. So I just wanted to clarify that you are talking about the ILC, Information, Linkages – yep?

SUSAN ARTHUR:
Yeah, and we’re just greatly concerned how, and i think SARU would join us, how that has significantly lost a heck of a lot of its money and and, we were led to believe, it might of, and I know there hasn’t been any final decision made, but what might of supported organisations like self advocacy and mainstream services and so forth. I knew you probably wouldn’t know the answer, but i thought, well if we bring it up that we’re concerned, then maybe someone can hear that we are concerned and somebody could get back to us about why that substantial amount was taken away from the program, if they’re not running the program, or what the answers are.

FELIX NEIGHBOUR:
We’ll see what avenues of enquiry we have and we’ll try and get back to DARU with a response.

MELISSA HALE:
Any other questions? Nothing? Going once, going twice, no?

OK, thank you Felix, we’ll close up today.

Thank you everyone for coming.  there are some questionnaires on the tables that are really helpful to inform what the next Conversations Forums will be about so please fill them out.  If you don’t want to fill them out now, there’s one in your inbox that we sent out on email today.

Thank you to all the presenters for sharing your knowledge and thank you to everyone who joined us on the live stream.  we look forward to your feedback as well. Thank you to Niaz and Tony for their live streaming and Michael for the audio.  Thank you to the Auslan interpreters and the Queen Vic Women’s Centre and safe travels home.

(applause)

 

Author:
DARU

Source:
Advocacy Sector Conversations Forum

Date published:
Thu 18th May, 2017