Disability advocacy can and should play a role in supporting people to plan and argue for the NDIS supports they need This session was part of the advocacy Sector Conversations forum held at the Jasper Hotel on 1 March 2016 which was designed to give disability advocates an understanding of the NDIS planning process, the plan review and complaints handling process and how disability advocacy organisations can prepare for the NDIS.
Other sessions included:
- NDIS review and appeals processes, panel session
- NDIS training workshop series, Catherine McAlpine, Senior Manager, NDIS Disability Loop, AFDO
- Q&A with the Office for Disability, Fleur Campbell, Project Officer, DHHS
Toni Van Hammond, Assistant Director – Engagement & Community Strategy, NDIA Barwon office, explained the role of an NDIA planner and took us through what happens during the planning process.
- Operational Guidelines, NDIA
- Getting Started planning Workbook, VALID, August 2015
- NDIS Planning Workbook, NDIA, August 2015
- Features of the NDIS Price Guide (includes explanations of the support categories and sub categories), NDIA
- NSW Vic Tas Price Guide (includes support type and hourly rates), NDIA
Given that we need to start first of all with planning with the NDIS – what happens in the planning process, today Toni Van Hammond, the Assistant Director – Engagement & Community Strategy, NDIA Barwon office joins us to take us through that planning process. So I will now hand the microphone over to Toni. Thank you Toni.
TONI VAN HAMMOND:
Thank you and it was really great to hear the introductions of the variety of representation here today. Before I start, I want to acknowledge the traditional owners of the land that we stand on today and pay my respect to their elders past and present.
A little bit about my role and the Barwon Trial site. I have been at the trial site since July 1, 2013. When the doors opened with no manual, no instructions, no rules well there were rules but we didn’t know about them. We have literally learnt and built and we still have learning and building to go.
I really think it’s important that people understand that the trial has been a trial not only for us as staff within the agency but for participants coming into the scheme for their families and for advocates. I want to acknowledge James and the other advocates that are in the room that have had to go through the process of learning with us.
I represent the agency on the Barwon Disability Advisory Network and I meet with them every – James, is it about every 6 to 8 weeks? Something like that. I have a philosophy that we’re in this together. We need to learn together, we need to communicate. Can’t fix what we don’t know is broken. That journey is going to continue and I think we really need to be very clear of that.
Even though the full scheme roll out is going to commence July 1 there are things that are still going to need to be trialled and changed to get the scheme right. How it has been in the journey at the beginning will be different as we start roll out and will be different over the 3 years.
So part of my team and that’s why I bought Jerad and Liam not because I needed some support staff because of all of you in the room it’s because after this we’re heading to Bacchus Marsh. We’re doing a forum in Bacchus Marsh because people don’t know about the NDIS. There is a presumption that everybody understands it, they don’t. We need an engagement team to start communicating in regards to it.
I’ve also started to accept that I can’t read without glasses so I have a habit of on and off because there is a bit of denial.
Today I’m going to talk about a couple of things and go through the legislative framework. It is really, really important to understand that we are underpinned by legislation, the NDIS Act, which was endorsed, made legal in 2013. We are bound by legislation. I’m going to talk about just briefly access. The participant pathway. A little about complaints and then hopefully sufficient time for questions.
You need to know there may be something you ask that I don’t know. I will let you know I don’t know. But what I will do is give a commitment if I can’t answer something to take the question away and I have asked Jerad to take notes and then I will provide the feedback back to Robyn, maybe not Robyn but somebody at DARU in regards to something I can’t answer.
There is a few principles of the NDIS that underpins everything we do. The scheme is about enhancing and supporting people with a disability to get greater independence, social and economic participation. It’s about providing reasonable and necessary supports including early intervention supports for participants. It’s also enabling people with disability to exercise choice and control.
Now I need to explain the reasonable and necessary decisions come before the choice and control. That’s in the legislation. Originally, it was I can come in and ask for the world and get everything I want. It has to be within a reasonable and necessary context. Hopefully at the end of this it will be a bit clearer for you.
Not everything will be the responsibility of the NDIS to fund. We are also having to improve services in the mainstream. When I talk mainstream, I talk health, education, justice, child protection. We have to ensure those mainstream organisations improve their responsibility of service provision. We are i.e. – NDIS, are not to replace or duplicate the responsibility of another Department. Does that make sense? So we’re not going to fund health related issues.
The choice and control is in regards to who chooses to do your services. So when you have your plan who is going to help you get your services delivered, who is going to be your provider, how are you going to manage your plan. That’s the choice and control component.
So in regards to reasonable and necessary, a delegate – so a delegate is a person within the agency that is able to approve plans. Generally, they are planners or now we hear of plan support coordinators. Now it’s really important that you understand that all of these components of support must be met for a delegate to ensure it’s a reasonable and necessary support to be funded by the agency so that this support will assist the participant to pursue the goals, objectives and aspirations.
I’m trying to keep this in plain language because as you know, acts are wordy etc. So trying to keep this as basic as possible.
That the support will assist the social economic participation of a participant. The support represents value for money. It is effective and beneficial and I think you’re going to hear about this when Kylie talks. She really from a participant perspective in regards to the effectiveness and beneficial components of her needs and how she got that through her experience. It’s also that the funding or provision of the support takes into account what is reasonable to expect families, carers, or informal networks and the community to provide.
Now what that means is that as parents there is normal parental responsibility as a mum or a dad. I try and explain that in the context of swimming lessons. A really good example – most parents want their children to learn how to swim. I have two kids, and I chose to get them swimming lessons and pay for those lessons. We believe that the responsibility of parents with a child with a disability is the same to pay for the lessons but if the child needs extra support to do the lessons i.e. another person in the pool etc. we will fund that. Does that make sense? Yep.
The support is most appropriately funded or provided through the NDIS i.e. it shouldn’t be better funded through the health, education, justice, child protection or other areas.
The other component is the community. We don’t want programs happening in the community that are separate. We have new groups of people with a disability. We want programs in the community for all with or without a disability. What we’re trying to – a lot of people are coming to us saying I’m going to start this group up for people with a disability.
Well, that’s great but we actually want it for the community. So things like men’s shed, neighbourhood houses. Somebody said they were from a neighbourhood house. They’re the groups we want to work with to strengthen the action and inclusion of people in all activities.
Value for money, this is where it sounds like Government speak. I explain this in my layman’s terms. I try and explain especially in regards to equipment. So any equipment that is deemed necessary to support a person with a disability we will generally ask for an OT assessment. The OT assessment will come back with a recommendation for needs of the individual, being their positioning, their requirements, movement etc. I have discovered – I come from the mental health sector so I have had a massive learning curve in regards to the broader disability sector. But I have discovered there is an incredible array and variety of wheelchairs. So you can get the Mazda or you can get the Rolls Royce.
A lot of people will get recommended through the OT the Mazda version. That will meet their day-to-day versions. But they actually want there is accessories that are not deemed reasonable and necessary. A lot of people have been wanting those accessories. We say we will fund the Mazda but if you want some of the bells and whistles to make it look like a Rolls Royce then you fund the difference. So say you want a red one and we can only fund the black and there is $200 difference for the red wheelchair versus the black then you have to contribute the $200 difference for that extra component.
Look again I suppose in regards to I’m watching your chair going up and down. That would most likely be deemed a reasonable and necessary requirement for mobility, circulation etc. So that’s the Mazda version for you. But what the Mazda version for me is may be different. It’s again you know I really can’t emphasise enough there is no one plan, there is no one piece of equipment. There is no one assessment that is the same for anybody. Each and everyone one of us in this room today is different.
As advocates this is a bit of bread and butter of what we do in terms of supporting people to advocate for what they believe is reasonable and necessary. We find that real examples are helpful. That would be good.
TONI VAN HAMMOND:
I have some things that wouldn’t be funded in the next slide. Maybe the wheelchair Mazda versus the Rolls Royce but again I will try and check with our planners back in the PSM team in regards to what is the standard wheelchair just for the sake of the wheelchair. But everything is independent, individual. Yeah.
TONI VAN HAMMOND:
And I will take that one on board. So the funded supports must assist the participants to pursue the goals, objectives and aspirations. So things I said before – social and economic participation, value for money, effective and beneficial, reasonable to expect families, carers and formal networks appropriately funded. What we will not fund are things that are not related to the participant’s disability, related to day-to-day living costs.
This is one of great contentions in regards to we’ve had a lot of flow through in regards to the transition from the State Government ISP and how funds were funded there. We did have funds people coming in that had been able to use their ISP for Foxtel, theatre tickets, MCG Grand Final tickets. Things like that we will not fund. It is not reasonable and necessary that the Australian population contribute to activities that we all want to do. They’re the things in regards to – there is an expectation that participants family etc. will contribute.
I often get asked there is the social economic. Well there is a lot of people in the community that are also on pensions and are socially economically disadvantaged due to pensions etc. that have to do the same. So rather than having the scales and I hope I explain this in the right way, what we’ve had historically is people with a disability have been under supported, underfunded, under resourced and so hopefully we believe with the NDIS that a person with a disability comes up and we are all equal so that our day to day living requirements, our needs etc. and our inclusion in day to day living, we are all on the same page.
What we don’t want is that there starts being a perception that a person with disability gets everything funded through the NDIS. So it’s trying to put people, everybody on the same level. With a disability, without a disability, I have to pay for swimming lessons, I have to pay for theatre tickets. But if you need supports to do those things, to get to the theatre, to come to a conference then that’s something that would be considered as reasonable and necessary. Does that make sense, yep.
And obviously, we’re not going to fund things that are likely to cause harm to participants or others. Example if it’s not related to a disability, a person with a disability has a fall breaks their leg. NDIS will not fund additional care needs associated with the recovery of that injury. That will fall into the health sector.
Every day living cost, so some things here are listed – a hose winder and some of these things have been appealed and tested. Repairs to taps, standard kitchen chairs, beds and mattresses due to wear and tear, sunglasses, crockery sets, socks, sun shades for the scooter, trampoline, Bonds underpants – I presume it means all type of under pants but here it mentions Bonds. Wi-Fi, light globes, replace the carpet, new retail bed or lounge replacement. These are some things that there has been an expectation that we should do. It’s not reasonable and necessary. Does that help paint that picture? I’m sure you will hit me with questions at the end.
The first component of coming into the NDIS is about access. I need to reiterate that we’re about to embark on more change with both the access and the planning process because if you have a think in Victoria, we have had three years to get 5,102 people into the scheme by June 30 this year. In the next 3 years, there is 120,000 people in Victoria alone no hang on, in Australia, no 40,000 in Victoria roughly give or take, 120,000 nationally. No, I’ve got it wrong. 130 nationally. It is 120,000 over the next 3 years for Victoria. Now if that doesn’t scare you it gives me nightmares because that is a lot of people that are waiting for the scheme to roll out.
So the disability requirements what we do know and I think it’s mentioned in the operational guidelines there will be some defined programs that are autoed in through the State Government. We’re not 100% clear what they are but there will be some programs that are autoed in. All we need is eligibility in regards to age and residency. There will be some disability types and programs that will be auto in.
Others we will need evidence of diagnosis, and the functional impact. I can’t emphasise enough one of the key things that we look at is the functional impact of the persons disability. Now I wear my psych nurse hat and explain this in the context of somebody with schizophrenia.
Every person again is individual and different. So somebody with schizophrenia may be really medically well stabilised and well managed and actually functioning really well, have a job full time/part time etc. At this point of time, they may not be eligible because they’re functioning quite well.
There is another scenario where a person with schizophrenia is still somewhat unstable and still needs support in regards to their self-care, social activities etc. They will potentially be eligible because of the functional impact of the disability.
So when we look at the functional component we look at self-care, mobility, communication, social activities, learning and working. They’re the sort of areas that we want to know what are the impacts in regards to the day to day functioning.
Early intervention – there has been lots in the media about that, for those who haven’t seen it – I heard a groan. The new national approach to early intervention services for naught to six year olds. That was released on Friday last week I think it was. It’s about a new model where there will be access planners to work with naught to six years old in regards to early intervention. But basically, the premise is that early intervention will allow and hopefully reduce the level of support in the lifetime of a participant if we get the right supports in there at the right time.
We’ve actually seen that in Barwon. We’ve seen some kids with intense therapy whether it be speech, physio etc. that have progressed. I know one of the teams came to me and said this mum has come for plan review and said I don’t need anything at the moment. Well that’s a win. That is a win because the intense supports at the right time were given to the child and the mum was comfortable to say I don’t need it anymore. But if she needs to come back, she can. That’s the other important point for you guys. Once you’re eligible, you’re eligible for life.
I got hit with this one when I said it once before at a mental health forum. The thing is once you’re eligible you may not want supports or you may not need supports for a period of 3, 4 years because you’re travelling okay. You are stable, you are able to self-care, you don’t need people doing things with you. That’s okay. Your plan is there – don’t need to have anything in it. We can have plans with no funds.
But then if things deteriorate, if a situation changes, a person can come back and say hey I’m not travelling that well I need supports. Plan can be enacted, the appropriate reasonable and necessary supports can be put in and a person can get that happening. They don’t have to come back and apply for eligibility every time. I think that’s a really good thing.
So early intervention I encourage you to look at that document. We’re waiting for a bit more information so if I’m avoiding the subject and not putting a lot of content into this slide it’s because there is still more meat in the sandwich to come and I know there is a lot more information to be shared both publically and within the agency.
We’re going to start talking more and more about the first plan. Keep in mind 120,000 over the next 3 years. The NDIS is a life long journey. The first plan is a start to the life long journey with the agency. The first plan will provide the participant with the supports they need now while giving them time to further explore opportunities presented by the NDIS. It may include current supports, or added supports.
An example is what we’ve seen is a lot of people will maybe have 3 days a week support for showering and self-care. Well I don’t know about you but most of us like a shower every day. So we’ve got to make sure people have that opportunity.
It’s about self-care or what we call core supports will be our priority. The ADL, assistance with daily living. Making sure everybody has the appropriate supports. So the first plan will make sure core supports and the capital needs i.e. equipment, are there in the first instance met for a person.
The first plan will give participants time to assess how the supports are working, what else they might need to achieve their goals before their plan review. The plan review will occur within the first 12 months.
That’s a bit of a difference. One of the big things was we had participants coming in and the first conversation we had was what are your goals. Many of them would look at us and say I’ve never been asked, I have never had the ability to think about what my goals are, I have just wanted to survive.
Now we’re trying to increase abilities for people to really think in regards to what do I want. What do I want to achieve, what haven’t I been able to achieve because of my disability.
It will also have time to explore options for increasing social and economic participation. You may have heard of the LAC’s in town, the Local Area Coordination. We’re waiting for the Victorian announcement in regards as to who will be providing that.
That will start in North East Melbourne and the Central Highlands. They will work with participants around 6 months before the planning starts to really start identifying what are the mainstream community informal supports a person has in their life, what would they like in regards to those areas, what’s missing so there is a clearer picture coming to the table when the plan has to be done.
We didn’t do that in Barwon. When we started I was employed as the senior local area coordinator with that very brief. Did we get a chance to do that – no we didn’t because the very nature of the demand on numbers etc. just didn’t allow us to work with people in the community and to increase that linkage with the mainstream community and informal. Thus the outsourcing of the LAC model.
We want community groups, we want community houses, gardening groups, boarding clubs etc. Jerod has done some great work with Sports Victoria, in regards to clubs, a checklist for clubs to look at how inclusive they’re making their environment. We want to challenge the norm. Geelong is all about Geelong is the insurance capital of the world now. Well I would like to still challenge Geelong because I still think there is incredible work to be done in regards to inclusion.
We might have the scheme and we might have the head office but have we got inclusion right – no, we haven’t. I haven’t seen anyone got it right yet. As I said, first plans will generally be for around 12 months.
So getting plan ready. One of the key things I say in regards to preparation for the NDIS is to have a think about what have I got in my life now. Week by week what have I got, what do I do and who do I do it with. So a bit of a calendar in regards to what do I do, who do I do it with, where do I get supports. So mapping out what you currently do.
What are my goals – start thinking the unthinkable for many. There is many a participant that I have had the pleasure of working with and that’s one of the joys of my role. I do get to work and hear the good and the bad of the NDIS journey thus far. I have to say that there has been more good than bad in regards to achieving goals and achieving outcomes and achieving quality of life.
Core capacity or capital. I call them the three C’s. Core needs – your day to day, your self-care, showering, meals, house cleaning, yard cleaning. They’re your core, your day to day, what do you need support in there.
Your capital – what equipment do you need or should you have. I met a lady her husband had made her shower chair with a piece of wood and a bit of metal something. The most unsafe thing I had ever seen. She needed a proper shower chair, rails in the corridor, guide dogs etc. what do I need in regards to support for my disability from an equipment resource perspective.
The capacity is related to your goals. What skill development is what we call, could we look at supporting to help you reach your goals.
Who can I bring – you can bring whoever you want. You will be involved in people’s plans because it’s quite clear that you are essential in a person to help them express and get the support of what they want. There was a lady over here from Intellectual Disability, we know that a voice of a person with a disability has not always been heard.
There is currently a project it’s with OPA in regards to the oval, so an informed decision making project. It’s with Valid and OPA have got I can’t remember the ladies name that’s involved but about developing a model to help people with an intellectual disability have informed decision-making. Again, a work in progress but it’s something that’s been identified and something we’re working towards.
You are essential in the role of assisting people coming into the scheme. Ask James, you will be busy. One of the big issues we often debate with is we don’t fund advocacy. Because you’re often arguing with us and it’s really quite clear that you guys need to be separate from the agency in regards to the role of the voice to assist the participant to work with us.
Look James, I’m picking on James because he is there to be picked on, I think it’s really important that you can have robust discussions. You have contacts in the agency that can communicate clearly and honestly. I would like to think that I’ve tried to provide that. I think it’s really important, not all staff do it well. There are some staff that cause headaches and make life difficult for James and everybody else etc. but it’s important that we do have a culture of being able to communicate and clearly address issues and concerns. I will talk about complaints in a minute.
Planning – this is what a plan sort of, well it’s snippets. I tried to get the key component. When the planning in this section – the first section is about who I am, whose my support, how I’m going to use or get my funds managed. So you can have your funds managed through the agency, self-managed or provider managed. That means a financial intermediary.
So on this page it’s talking about your goals, so my goal for daily living – I would like to get better at managing and organising myself in the mornings as this will make me feel better during the day. During this plan, the plans will change because you will get regular reviews. Don’t try and squeeze your whole life goals into one plan. It won’t be achieved. Every year your plan can change according to the goals you set. Or every year the plan can stay the same because it’s satisfying what you want.
So during this plan I want to learn to be able to follow a routine in the mornings without much help from my mum. I wish my daughter learnt that.
My goal for social and community participation – I would like to have more friends so I can have people to play with on the weekends.
During this plan, I want to learn communication skills so that I can initiate conversations in different social settings and feel confident when I am with my classmates.
Obviously, this is a child’s plan. They’re the sort of things. You can have as many goals or as little goals as you want in your plan.
This is a really wordy one. What this page shows is the budget. Here in this corner, the right hand corner facing you there is a budget of $4,056 and this is for improving daily living skills. So keep in mind that person’s goals, this is the budget to help them support those goals.
Amy will receive 12-hour sessions of OT occupational therapy to support independence in support care and organisational skills. So remember her first goal being more organised. This is what’s being allowed to be used by Amy to get her to meet that goal.
This support is including a functional assessment, therapy program, resource development and recommendations for family to implement in the home, community and liaising with other professionals involved. So there is $4,000 just for this bit in Amy’s plan for her to use to start reaching her goal.
Each goal will have – so you could have four different funding blocks for improved daily living skills. It could be against – you could have improved daily living skills for times in a plan with different funding because it’s to support different goals. Does that make sense? I know Liam is looking at me but I’m trying to explain that you can have the amounts four times to do different things in the living thing.
You will have one budget for improved daily living skills for all the supports that are directed to a provider, an agency managed funding option. And so if you’ve got multiple goals, that are attached within that it will sit within that one budget and the dollar amount there.
So if you’re able to see what’s on the board you will see there is a second level of supports, a further 12 hour sessions of speech. That speech and the occupational therapy all have to come out of that one budget and the goals associated with that are within that one budget. The goal may be represented again in another budget. But you may get another budget in that same improved daily life skills area the 00004, as in that reference number if you have funds in a different funding option.
So you might have self-managed funds, you might have plan managed funds where a service provider is managing the invoice and payment for you. Whatever is in that budget has to stay in that budget. The supports in that budget need to be used against those dollars.
TONI VAN HAMMOND:
Now are you confused?
TONI VAN HAMMOND:
Cool, speak to Liam at lunch.
How are complaints received – come in, pick the phone up, ask us, tell us, email us. Anyone can provide feedback or lodge a complaint. Can do it in person, use the website, there is a complaint form on the website.
And this is what’s really important and some staff in the office get a bit irritated with me. Any staff member should be able to accept a complaint. You don’t need to speak to the person that’s dedicated to manage the complaints. Anyone should be able to help you deal with the complaint. That’s what they should do. Do they all do it – no, they don’t. Do we need to work on that – yes we do. But I’m being honest. My belief and those that are in senior leadership roles and management roles believe that anybody in the agency should be able to take complaint, manage complaint and lodge the complaint.
Sometimes just sitting down with the person, listening, understanding and resolving it there and then will stop the issues. It’s an area we all can do better at. So there you go. Resolve the complaints as close to possible at the time otherwise, there is 21 business days that a complaint is meant to be responded to.
Obviously, we will want more information, we want specifics. Keep in mind reasonable and necessary. This is often were we’ve had the complaints in regards to understanding the reasonable and necessary components of the legislation.
If you are dissatisfied with the outcome of the complaint, you can ask for a supervisor or manager to review your complaint and how it was handled. If you’re still not satisfied, you can go to the Commonwealth Ombudsman.
The Disability Services Commission was at the Valid conference, the Having a Say conference last few weeks ago. They had a really good small chart and the three different areas – Mental Health Services Commissioner, the Commonwealth Ombudsman and the Disability Services Commissioner.
My question to him was where are we, because we should be representative of the options available for people with complaints.
The Commonwealth Ombudsman is also there to assist people that are dissatisfied with the NDIS. We also have RIAC in Geelong that have been funded to assist with the merits review process and that’s why James is always busy.
Review of a reviewable decision – so when you’re told about an NDIS decision you will be told how to request an internal review. So I talked about a plan review before, now Robyn asked me to clarify between plan review and an internal review and a reviewable decision.
A plan review occurs automatically for your plan on an annual basis. Keep in mind what we are discovering is some people are really travelling along okay and we know their supports aren’t going to really change significantly unless there is an unforeseen circumstance.
So some of our plans coming out looking like 2 years but that doesn’t mean at the 1-year mark we don’t touch base, make sure things are travelling okay and then it’s a click of the button. The funds look like they’re in the plan there for 2 years but there is a 12-month point of contact.
If things are still status quo and they’re happy with what they’ve got and what they’re doing then it’s a click of a button for the next plan to be progressed. Some people you will hear about a 2-year plan, I just wanted to clarify that.
A request for an internal review of a decision must be made within 3 months of receiving notice of the decision from the NDIA. So within 3 months of receiving an answer about your initial complaint, if you’re not satisfied with that then there has to be a 3-month period for you to get to the next level, a reviewable decision.
The staff member who works on the internal review will not have been involved in the earlier decision. We have teams so if Team A made the initial decision, somebody from Team B may do the reviewable decision. There is separation in regards to the review.
We have 21 days to finalise the review of a reviewable decision and if a complainant remains dissatisfied, they may apply to the AAT. I’m not sure if James is speaking but James would be a guru in regards to the AAT and the process of reviewable decisions etc. Are you speaking later James?
TONI VAN HAMMOND:
Yes, so James will tell you all about his experiences and some tips of the trade I would anticipate. That’s basically a review of a reviewable decision.
The AAT I had a case that went to the AAT. Did it scare me – yes, it did but it was a great learning experience. That’s literally what we need because remember I said when the door is open in 2013, we didn’t have a manual. Part of it is about learning in regards to decisions being made as what’s reasonable and necessary and sometimes we need a third party and that’s what the AAT has done.
It’s really sent some really clear guidelines. All the cases that have gone through the AAT with outcomes etc., are on the AAT website. It’s a really good interesting read. Various cases etc. and again Kylie will probably talk about that in regards to her experience. But it’s daunting. You’re talking to lawyers. You’re checking everything etc. But it’s a part of the learning process.
Again, the AAT doesn’t get involved until an internal review has occurred.
We do believe the front line staff are there to assist you. The planner, the person’s planner or the ARC as that model comes in should be the first point of contact. We should be encouraging open communication to discuss concerns and certainly the local office.
I have a counterpart Nick who is the assistant director of quality and performance. His team manages all the requests for review. As we roll out there will be those people represented. For Central Highlands we’re about to divert to a trial site into a regional office. Our regional office will look after all of West Victoria. So we’re soon to be known as the West Victoria Regional Office. So we will look after all of Western Victoria.
My role, Liam and Jarod’s and I also have Amber for half time, will be the engagement team for the whole of Western Victoria. I think I’m going to see a little bit of the countryside.
(inaudible – too far from mic)
TONI VAN HAMMOND:
Nick Hartnell is the assistant director of quality and performance.
I thought before I finish I will quickly put the terms. I often say not only are we bringing in the biggest reform that I have ever been a part of but we’re also bringing in a new language. I think it’s really important that we try and explain that language. Acronyms I’ve come as I said mental health nurse, we’re great in the health sector with acronyms.
A PSC is a planned support coordinator. An LAC is a local area coordinator. A BSO is a business support officer. The ILC is the information linkages and it’s actually capability development. But I always call it capacity, it just flows better on my tongue. There is actually a consultation process occurring about that, I’m presuming you’re all aware of it, in April.
We talk about choice and control, we talk about reasonable and necessary, provider. Now this is another conversation, another presentation one day but providers this is a massive change for them in regards to an open market. People with a disability are now the customer. The customer is with the person with a disability and they get to choose where they go, what they get and when they get it, which is really, really exciting.
Support coordinator – I failed in the English and the typing there I’m sorry. More and more plans will have either a support connector or coordinator funded in their plan. That will be the person to assist getting the plan implemented and making sure what was meant to happen from a provider is happening.
And goals. We’re not talking about the AFL, we’re talking about a person with a disability’s goals, what do they want to do. They’re like the admin resource, data, odds and sods, when all else fails you go to your BSO. They’re internal, they work within the office.
They started off being we had admin officers and regional support officers. We’ve merged the two and they all help us do the business – data entry, phone calls, they provide our phone. We have a system of an over flow from the 1800 number so we have staff answering the phones for initial queries and things like that.
There you go, my mobile. If I can’t be any more open, but please be nice don’t call me at midnight.
(inaudible – too far from mic) with health and education organisations because we’re just finding all the time, if it’s a health issue it needs to sit with health. Well you know we often don’t find that. People are just – taking accountability for whose responsibility it is and it’s very distressing for everyone.
TONI VAN HAMMOND:
I actually agree and we’re working on a project that I’m hoping to have up and running in the next 4 to 6 weeks.
The health sector, one of the biggest things, this is so much change that we’ve done a lot of forums etc. And what we’ve found is a lot of managers and CEO’s come to the forums and the people on the ground are not hearing the message. What this project is hoping to do is to explain for health sector whether they’re in acute, rehabilitation or primary care and GPs are a key one.
It’s been really difficult to get messaging to GPs. Some quick reference guides about what is the NDIS, what the NDIS will fund and what should be the responsibility of health.
I will give you a classic example and this really upset me. We had a social worker that submitted an ARF for a terminally ill lady with cancer. Now, legally an ARF is submitted, legally she would be eligible but she probably wouldn’t get any funds in her plan because her supports are better funded by the health service. She has terminal cancer.
I had to ring this social worker and make sure he explained to this lady that what she needs and his response was yeah I know that but we haven’t got the resources.
Now the unfortunate reality is the NDIS we’re not going to make the scheme sustainable if we’re substituting areas that are the responsibility of another sector. That’s a classic example and it’s a massive issue in regards to we’ve had participants come from the social work departments or various departments of the local Barwon Health Hospital saying they sent me down here to get a voucher for petrol or for food.
We don’t fund that sort of stuff. It’s a massive issue Leonie and it’s a work in progress.
I’m from Carers Victoria. You were going through a list of items that you said had been contested about whether they were reasonable or necessary. I understand the AAT decisions would be available on the website. I was just wondering the list you were going through, are they ones that have been under internal review and is there any way of accessing those so that we can explain kind of what’s been considered and the outcome so that when we’re educating particularly our carers, we can talk through those? That’s really useful.
TONI VAN HAMMOND:
Yeah I don’t know whether they’ve come, I doubt some of those would’ve been AAT. Again, keeping in mind that the mattress might have been appropriate for somebody that needs one of those moveable mattresses versus a standard mattress and things like that. Can I take that on board and try and clarify? I don’t believe the internal reviews are public but I can certainly provide a response back to Robyn.
I just wanted to go back to your swimming lesson example because I had a parent ask me the exact same question last week.
She has got two children. Her son took 6 months to learn to swim, two terms. Her daughter she has been having swimming lessons for four years now. She spent over $4,000 on swimming lessons and within her daughter’s goals to participate in swimming carnivals, be safe in the ocean that sort of thing.
Is there any room around her getting extra funding for that sort of thing where it’s actually in relation to her disability that it’s taken her so long to learn to swim and that parent has done the reasonable parental like you say paid for both children?
TONI VAN HAMMOND:
I would say possibly but can’t tell you definitively because every case is individual. When that family goes through that could be a part of their goals in regards to what they want to achieve. I talk about the swimming lessons but that’s the standard swimming lessons. That’s not the standard scenario for every family. So again, it might be reasonable and necessary there is a contribution because they need special intensive classes because of the disability. Not sure, of the circumstances but again it’s not concrete.
It is my understanding that the NDIA has fourteen support categories at different rates. How will this be calculated for example when a person has a shift of 3 hours and within that has a few minutes of personal care, a block of house work, a block of community access and within that personal care?
At present, I have work-based personal assistant funding which is a flat 10 hours a week, which can be restrictive as to what I need each week. Under the NDIS how will work base assistance be calculated on real need rather than a set of numbers per week?
TONI VAN HAMMOND:
We don’t fund the hours. You get a budget on what is deemed your necessary supports. You don’t get hours but the planner would probably calculate and discuss with you what is reasonable, what is it you want. It’s a bit like the showering scenario I said – three days a week of showers, what we would like is everybody gets seven days a week.
Again, not knowing your individual situation at the planning time you would explain and employment is actually seen as a mainstream because your employer may have some responsibility to provide you with some work base support as well. It may not necessarily just be the NDIS, that’s important to understand. You may get some support in your plan for NDIS for what you’re trying to achieve as well. You would get a budget and then you negotiate your budget with your provider.
This is where advocates or support coordinators are really important roles because you are negotiating and if I cannot emphasise anything strong enough for you to tell participants get a service agreement to clearly understand what the provider is providing you. Absolutely something that’s some providers are appalling at.
You are the customer, you hold the purse, you manage your budget and get what you want when you want and get that written on a service agreement so it’s clear for you and the provider what’s expected. That includes cancellation. If you’re going to cancel and say sorry, I’m going shopping instead of doing that activity then they have a right to charge you.
There is a component in our catalogue of supports. That catalogue of supports is online, it’s under the provider tab under pricing and payments and you can see the different catalogues, you can see the catalogue and the different categories that are funded. Be prepared there is a new IT system coming that will provide some new portals and things like that.
Again, what I’m saying today things will look a bit different as we’re moving forward as we’re trying to mature. Does that answer your question?
(inaudible – too far from mic)
TONI VAN HAMMOND:
Okay you’re self-managing. You can choose to self-manage the same way that you get some funds in your account and you pay directly.
(inaudible – too far from mic)
TONI VAN HAMMOND:
See Liam. You might need a number Liam.
I just wanted to interrupt so we’re clear what’s happening for the next 10 minutes. Toni agreed in a meeting that we had over the phone last week that we can eat a little bit into lunchtime but she does have to get away. We are going to proceed into lunch a bit. I just want to see how many of you have questions if you could raise your hand, and Sophie could you tell me how many people have their hands up. Eight – we will try and get all your questions answered but no more after those eight. Are you happy to do that Toni?
TONI VAN HAMMOND:
Could you clarify a bit more what is going to be the direct payment system of the NDIS because I’ve got the feeling that it’s quite different from the way the ISP provide direct payment?
TONI VAN HAMMOND:
So this is about direct payments and the difference between your ISP…
Could you tell me a bit more about it please?
TONI VAN HAMMOND:
Okay to the best of my ability. I’m not in the finance department, I’m the talker not the numbers. Again, Liam I’m happy for you to step in at any point.
You will have an option of self-managing your plan. You might choose two of your categories to self-manage and the others a provider or agency managed. Or –
(inaudible – too far from mic)
You might have supports for self-care, which is one budget area. You might say I want to manage the ones on the weekend because they’re variable and the ones during the week are going to always be the same because it’s my work arrangements. So for those you can say I’m going to have the ones that are during the week set aside so that my agency or service provider can actually draw down directly from the NDIA.
But for the weekend ones you can have it self-managed. Your service agreement will be that the provider will invoice you and you will then pay on the invoice. So it’s a bit like the direct payments that’s called self-managed. Does that answer the question?
(inaudible – too far from mic) – more with the NDIS, even with self-managed I still have to send the invoice to you guys before I can pay.
That’s not the case. What will happen is you will be able to pay on the invoice and then claim from us.
There is another opportunity, which is like financial intermediary in the old system that is where a registered provider will pay the invoice for you, and then they will ask the money from NDIA. That is for someone who hasn’t got the capacity to manage the invoice and payment. They help you arrange that but you have close communication with that provider so they do the right thing. And you still have to say yes I received that service.
If you’re self-managed the fund will go into a NDIS bank account under your name and you will pay from that account and you will then claim from us directly.
TONI VAN HAMMOND:
One of the things we learnt and it’s actually happening this week, Liam is running two sessions for participants and families interested in self-managing. Now the new IT system is apparently going to make self-managing and the participant portal easier to use for claiming online. So what we’re wanting to do is to try and build capacity for people to understand self-management.
As we develop this workshop and as the workshop is progressing what I anticipate is as we roll out certainly in the areas I’m in charge of we will run those. So when we get to Bendigo, Ballarat, Bacchus Marsh etc., not Bendigo it’s not our area, but deliver those presentations to try and get people to understand.
There is a lot of fear in regards to self-management and it’s scary. What we’re trying to do with Liam’s expertise and our finance department is to run some workshops to try and support people in doing it.
One of the good things of having a trial is that people in Hunter have done things that we think that’s really good, so we’re starting to share resources. So Liam’s work will once we tweak it and work it out, get some feedback from participants that come, we will share it to other sites. So if they’re in Hawthorn or whatever, I’m hoping they’re the sort of things engagement teams will deliver.
Justin from Able Australia. Just a question on planned reviews, we know they happen 12 months afterwards. We have participants in a Newcastle site who have been part of a trial run out there. They have been informed and told there may not be an automatic 12 months review after they’ve had their initial 12 months. They’ve had their initial review and they are required to make contact for that review. Is that being confirmed as that’s happening when rolling out?
TONI VAN HAMMOND:
No, my understanding in the legislation is that plans are to be reviewed in 12 months. Whether that’s hands on or over the phone, like I said some plans are coming out with funding for 2 years but there is a 12-month point of contact.
By legislation there has to be some contact 12 monthly at this point in time unless the legislation changes. I‘m not sure where that’s coming from. My understanding etc. is that plans are to be reviewed. It’s also exceptional circumstances. Say a carer passes away etc. that is an exceptional circumstance that can get an automatic review occur. An exceptional circumstance is not I have thought of a new goal. It is about a significant change in a person’s life to get a change. That’s my understanding.
Jan, MEDA. I just have probably a simple question. In relation to funding something like interpreters for someone who has hearing impairment, is that in or out? This is an essential component or capacity for this person to actually engage in community based options.
TONI VAN HAMMOND:
Absolutely it’s in. That was an easy one.
Michael Wells, Public Advocate. Just a question about the planning process. The problem we’ve had mostly so far in regard to planning meetings has been not knowing when they’re happening or getting incredibly short notice. As an advocate being told there is a meeting tomorrow and obviously not being able to be there, I’m wondering if there has been any thought to that as the system rolls out further.
Second one is in regard to question around about the flexibility of a plan if there are unforeseen circumstances. Let’s take the example of someone who is admitted to hospital, a person with intellectual disability sometimes whilst they need medical care, they very frequently need staffing from an existing facility where they are, to support them through that process of recovery.
Traditionally what happens I guess there has been some negotiation with DHHS around about taking some staff off line and bringing them in to spend time with the person in hospital. What sort of budgeting arrangements can be made when there are unforeseen circumstances arise?
TONI VAN HAMMOND:
Firstly in regards to appointments, appointments are generally at least a month ahead of schedule so it’s about the communication of that. If that’s the case, I’m not sure of the scenario, the participant, their family and if they have a support connector or coordinator are the key people. We communicate with the participant and then we really are trying to say to the participant it’s up to you to advise when your appointments are. It’s not up to us.
They should have a support coordinator or a role and that support coordinator that’s what they’re funded to do is to ensure appropriate representation etc. That’s what support coordinators are paid reasonable dollars for to ensure that the plan is implemented, their goals are met and the appropriate resources and supports are there when the time is with the agency. I would teach to the support coordinator and that provider.
In regards to exceptional circumstances, I don’t want this to be the blanket but I know there was a case of somebody in hospital and wanting to use their carer whilst they’re in hospital. That was deemed as the responsibility of health in regards to having appropriate resources for all in regards to supporting them. I think that’s still an area of debate as the health and the NDIS interface works. But we most likely wouldn’t fund somebody whilst they are in hospital because it is a health component. They should have the resources to support.
I really liked the list you gave of examples of things you wouldn’t fund. I was wondering if you could give some examples of I guess there is a spectrum of likely to be beneficial on one hand and harmful on the other hand and things in the middle that have been contested?
TONI VAN HAMMOND:
I haven’t got anything. I don’t know what to say to you. Maybe James could talk in regards to his experience or Leonie in regards to things you’ve gone through. I’m not trying to be difficult.
(inaudible – too far from mic)
Very similar, a person who was very unwell and had cancer but was able to go home at this point. But she required a two-person transfer to have at home. But health said it wasn’t their responsibility and NDIA said it wasn’t their responsibility too.
This went on and on and one argy bargy until she was so unwell that she was not able to go home. She had to remain in hospital.
TONI VAN HAMMOND:
That’s why I am saying there is a lot of work to be done.
There is a lot of work to be done with GPs because everything is based on evidence. You have to get your GPs very knowledgeable on what’s happening. They’re often the first linkage too.
TONI VAN HAMMOND:
The GP is really good in regards to the history of the diagnosis. No disrespect to our fellow GPs but they’re not very good in explaining functional impact. I really strongly encourage people not to go to your GP to get your functional component filled in. They will tick no, no, no in regards to self-care, mobility and communication and when we say that from an access perspective we can only go from what is before us and therefore think that there is no functional impact.
We know that that’s not correct but legally the document says no so therefore highly likely it’s ineligible. So don’t get functional. Your mum, dad, the advocates, the people working with the person, you as well can describe what are the functional supports or functional needs or functional areas of support that you need.
I suppose the other area we’re concerned about is complex care and accommodation. Accommodation is a huge area of concern and circumstances can change pretty quickly. This is where you need to be aware within the plan there is some allowance for that when those circumstances change and often it’s at crisis point and you need to have that response and funding accessible straight away. That’s another area we’re seeing a lot of.
TONI VAN HAMMOND:
It’s interesting we’re seeing at Christmas time for the last two or three, we often have children that are relinquished etc. That has not occurred whilst the NDIS has been there because of the flexibility of being able to get supports for the child or family member over that period.
We’ve had emergency agency funded to provide back up if there is an urgent situation. In the last three years including our first we have not had that occur. That means there is enough flexibility supports for people over that period of timing comparison to the old system.
Sorry just one other point and I know Toni it’s a trial site and we’re all remembering that in Barwon and all trying to work together with that. I know it’s like any workforce having stability with workforce a number of people I am working with have had on an average sometimes twelve different people that’s between a lack of planner. The worst scenario I had one that had forty-six different people. I understand the situation with staffing but it’s really important to get that stability.
TONI VAN HAMMOND:
Totally and I don’t think we’re going to get the stability that’s best practice until – well over the next few years if you look at the numbers I think there is going to be massive – we’re about to embark on another change in regards to how the team is operating literally in preparation for what we call the surge.
Until everybody is into the scheme, I think things are going to be rough. I think it’s going to be its big numbers. We had three years for 5,000 and we had issues many of them. We’re going to have 120,000 people in 3 years, we’re not going to get it right. We’re going to do the best we can. We have to work together.
We need to end here and I’m sorry for those who still have their hand up. Toni will stay a little bit into the lunch break so you can come up and approach Toni. I think Trudy you had your hand up so do you mind Toni talking to Trudy.
TONI VAN HAMMOND:
Can I also, the Barwon Disability Advocacy Network developed this resource, which is a list of all the different advocate resources that are available for people in the Barwon area. Absolutely fantastic resource. We send that out to all our participants so that we can empower them with the knowledge of your resources.
I don’t know how your networks work across Victoria but fantastic resource for you to look at and consider as a broader group.
Thanks Toni. May I say because DARU is a part of the Barwon Disability Advocacy Network and Toni always makes herself available to the Barwon Disability Advocacy Network and we certainly do appreciate the time that you do give to disability advocacy here in Victoria. Join me in thanking Toni Van Hammond.
- Date published:
- Thu 10th Mar, 2016