THE state government has answered more than 50 questions about the shake-up of disability services in NSW after Wednesday’s forum in Newcastle.
Public Service Association organiser Paul James said the answers had been posted on a government website and distributed to staff of the Ageing, Disability and Home Care agency, which is planning to hand responsibility for disability services by 2018.
The agency’s chief executive, Jim Longley, said it was ‘‘important to bear in mind that the National Disability Insurance Scheme (NDIS) will fund people with disability to levels appropriate to meet their reasonable and necessary needs, and will recognise complexity and specialist needs’’.
‘‘The NDIS will require meticulous planning over many years,’’ Mr Longley said.
‘‘It will include a national safeguarding framework to ensure that the rights, safety and wellbeing of people with disability are protected.
‘‘Equally, we have a responsibility to ensure we transition people into the new system only when there are appropriate arrangements in place for them.’’
More than 150 people attended Wednesday’s forum at Newcastle Panthers and a large crowd is expected today at a similar gathering hosted by the National Disability Insurance Agency.
Today’s forum starts at 10.30am.
Mr James said Wednesday’s forum had shown both the state and federal governments the amount of concern over the disability shake-up.
‘‘The thing that came out of the forum was that nobody knew what was going on,’’ Mr James said.
‘‘People thought they must have been the only one who didn’t know but it was obvious that nobody had been told anything meaningful by the authorities and even those who had been to two or three previous briefings were no clearer because they’d been told different things each time.
‘‘[Lake Macquarie state MP] Greg Piper hit the nail on the head when he said there had been a general lack of consultation but an absolute lack of consultation when it came to the clients, and they are the ones that this whole thing is supposed to be about.’’
Mr James said the Newcastle Herald reported the existence of more legislation, in the form of a Disability Inclusion Bill, yet no one in the disability sector appeared to have been consulted about it.
Q & A
The Minister for Disability Services undertook to provide responses to questions posed for an independent forum in Newcastle on 4 December 2013.
More than 50 questions were posed against the main themes set out below. We have published the questions unedited.
Q: What guarantees has the Government given that current service levels will be maintained, and that this is not a savings exercise?
The introduction of the National Disability Insurance Scheme (NDIS) across NSW and Australia will see a significant increase in current service levels.
In NSW, funding for disability will grow. The current NSW spend is $2.5bn. Under the NDIS, there will be a total of $6.4bn by 2018/19.
This investment will create a bigger, more diverse sector.
At present, the type and level of supports that people receive is determined by what the government funds or provides within the limitations of the available budget.
Under the NDIS, people who get support now will have the chance to receive all reasonable and necessary supports they need, based on their own choices about the types and levels of supports they require.
For some people, this may mean an increase to the current amount of support received.
It will also enable more than 50,000 people who do not receive any services now to become participants in the NDIS.
The investment in disability by both the Commonwealth and State Government will grow, not shrink, under the NDIS to enable this change.
The NSW Government will meet its obligation under the NDIS agreement to provide over $3.1bn each year indexed annually to meet its share of the costs of the NDIS.
Q: What evidence is there that the NGO sector is able to take on all the services currently delivered by the NSW Government?
There are over 650 NGOs across NSW currently delivering services to thousands of people with disability.
NGOs already deliver over 60 percent of services across NSW to people with disability, their families and carers in NSW.
Already, NGOs provide around 70 percent of the supported accommodation services in NSW, and well over 80 percent of other services, such as therapy. In other cases, the NGO sector is the only provider of some types of supports, for example transition to work supports for young people with disability leaving school, and day program activities.
The majority of people living in ADHC-provided supported accommodation also receive supports and other disability services from NGOs. This is because the disability law in NSW, which has been in place since 1993, does not allow one provider to provide all supports to a person with disability.
Other NGOs work with thousands of people with disability to give them the skills and confidence to self-direct their support arrangements.
NGOs are also well placed to engage with local communities to find all possible avenues of support for people with disability to participate in the activities they want to do in their life.
We have invested in helping NGOs shift to the NDIS. We have directed almost all the growth in funding to the NGO sector over this time. We have also invested in strategies to build the capacity of the NGO workforce so they can recruit and retain skilled workers.
We have done this over the past five years to prepare for the transition that everyone expected to occur as part of our State-wide reforms.
Q: How confident is the NSW government of a service system overseen by the Commonwealth with services run by non-government providers with no experience with disabilities?
The NDIS is a national scheme administered by an independent authority β€“ the NDIA. The NDIA is overseen by a Board and an Advisory Committee of people who have vast experience in the disability area, or have lived experience of disability.
There are over 650 NGOs in NSW, and many thousands more across Australia, which currently provide supports to people with disability. Those organisations will continue to have a prominent role in the future of disability services.
A key objective of the NDIS is to have an impact on the broader community to ensure that it is inclusive, accessible and safe for people with disability.
The NDIS came out of an independent review by the Productivity Commission and reflects the overwhelming preferences of people with disability across Australia for a complete overhaul of the existing disability systems.
Q: Who will look after my Down’s syndrome brother after our mother and myself are no longer alive?
The NDIS will give people with disability who require lifelong support a package for life. The ongoing support needs of a person will be discussed with families and carers as part of the National Disability Insurance Agency (NDIA) planning process, and is reviewed when circumstances in a personβ€™ life change, to make sure there is no breakdown in support arrangements.
This means a person with disability will receive appropriate supports that recognise and value β€“ but are not dependent on β€“ informal care arrangements. Providing for life-long support guarantees appropriate provision and capacity for future planning.
Q: How will the rights of people with disability be protected when the role of the NSW Government changes under an NDIS?
The NDIS will include a national safeguarding framework to ensure that the rights, safety and wellbeing of people with disability are protected. This will include quality assurance.
The NSW Government is also putting in place a new Disability Inclusion Bill that will provide for safeguards and other mechanisms that promote the safety and inclusion of people with disability in the NSW community. This will replace the Disability Services Act 1993 and make it more up to date to reflect the UN Convention on the Rights of People with Disability.
The NDIA is supported by an independent Advisory Council comprising people with lived experience of disability. The NSW Government and other states and territories all agreed to the composition of that Advisory Council to ensure there was confidence on the part of all governments that the NDIA had access to sound and informed advice on disability matters.
Q: How is quality assurance going to be measured and managed?
The NDIA will have a role within NSW and across Australian in working with the NGO sector β€“ as a reference body as well as a market regulator. The NDIA will have a role in registration of providers who wish to offer supports to people who are participants in the NDIS.
In the Hunter launch site, the NSW quality framework applies until a national system is put in place in time for broader rollout from 2016.
Q: Why must the state abandon the most vulnerable people in society to profit-oriented NGOs who will always use such excuses as non-availability of staff to deny people with disabilities of necessary service deliver?
The NSW Government is not abandoning people with disability. On the contrary, the NSW investment in disability supports will continue to grow, and the NSW Government will continue to be a stakeholder in the NDIS and have a say in the way it evolves.
NSW will maintain safeguards for its citizens with disability, and will have a responsibility to ensure that mainstream systems such as education, transport and health meet their needs.
Under the NDIS, people with disability will receive packages of support which are allocated to them as individuals. Those packages of support will set out all the reasonable and necessary supports that a person needs. The person with disability will determine who provides those supports, and where they are provided.
If an NGO is not willing or able to deliver the supports that a particular person with disability needs, the NDIA and other decision support services will assist the person with disability to find a provider who can.
Q: How can the NSW government move away from its role in disability services?
The NSW Government will put $3.1bn each and every year into the NDIS from 2018/19, with that commitment increasing every year with indexation. These funds are to be used only for the purpose of providing supports to people with disability.
None of the money put into the NDIS by NSW is to be used for bureaucracy and expensive government administration. This means that all the money the NSW Government currently spends on government processes and infrastructure ($300m every year) will be converted into direct funding for people.
In addition, the Commonwealth is contributing over $3.3bn every year to the cost of the NDIS in NSW.
Q: If a couple of billion dollars is a big deal in Gonski the many, many billions of dollars in the NDIS have still not been explained. Is it still happening? If they put off the NDIS what happens then with ADHC?
Q: Should the federal Liberal government put on HOLD the NDIS till the economic outlook improves? (who knows when) will the State government put on hold the transfer of the ADAHC disability services to the NGO’s till then?
The NSW Government is committed to meeting its responsibilities under the agreement with the Commonwealth to implement the NDIS across NSW by 30 June 2018.
The launch is underway and progressive implementation is expected to continue in accordance with those agreements.
Q: Why are some other states and territories keeping their direct service delivery arrangements?
Each jurisdiction has a different service system, and each is making different decisions about the role that it will play under the NDIS.
A number of jurisdictions have for some years not had a role in direct service delivery, or have a marginal and reducing role. Tasmania and Western Australia have had the vast majority of direct client services delivered by the NGO sector for a number of years. Queensland is currently actively reducing and is committed to full reduction of Government operation of disability supports. All other jurisdictions have over the years sought to build and increase NGO capacity.
Q: Why has the State government chosen to ignore the productivity report where it recommended a mix of public and private disability services? Why is it that one layer of government is better in disability but not in education and health?
The Productivity Commission strongly recommended that a single layer of government be involved in the administration of the future disability support system.
The Productivity Commission recommended a simplification of the disability service system, recognising that the current system is hard to navigate. People with disability have to deal with multiple agencies, multiple programs, and multiple β€ gateways through various government agencies to access their supports.
The Productivity Commission recommended a mix of providers remain within the system with a view to creating a diverse and flexible market place, and maintaining the role of mainstream providers, including some specialist supports for people with disability embedded within other systems like Education and Health.
This is the model being adopted in NSW.
Other agreements with the Commonwealth for Health and Education are exploring ways of improving the connections between State and Commonwealth systems and funding arrangements.
Q: If the State government are so adamant they will NOT be a disability support provider why have they applied to be a support provider for the purpose of funding from the NDIS?
The Department of Family and Community Services has registered as a provider of support in the Hunter launch site. There are no immediate plans to move Hunter services to the NGO sector.
The movement of services will happen over coming years. It is important that services continue to be in place as people with disability transition their funding arrangements to the NDIS.
People with high and complex support needs
Q: Who is going to look after people with high and complex needs?
Q: Will funding for people with high support needs be enough?
Q: Will people with complex support needs have to go into institutions?
People with disability who have complex support needs are currently supported through services delivered by the NSW Government and many NGOs.
Support for people with high and complex needs is factored into our planning for the NDIS.
The NDIS will fund people with disability to levels appropriate to meet their reasonable and necessary needs, including supports associated with complexity and specialist needs.
An important aspect for transition of NSW government services to the NGO sector will involve maintaining the skills and expertise of NSW government staff to continue to deliver supports to people with complex needs, working within the NGO sector.
At the same time, both the NSW and Australian governments are investing to help develop a service system of non-government supports that includes specialist capabilities to deliver the full set of options needed. The NDIA will have responsibility to facilitate the supports that each individual requires to meet their needs.
Equally, we have a responsibility to ensure we transition people into the new system only when there are appropriate arrangements in place for them.
The NSW Government has made a commitment to redevelop large residential centres. This announcement, made in 1998 by the previous NSW Government, is unrelated to the NDIS, and is based on the legislative requirements in place within NSW and nationally to ensure that people with disability have living options that meet contemporary standards for community living and that provide the same rights and opportunities as any other member of the public.
Today, people with disability have every right to live in modern, home-like environments that are part of their local community. In these circumstances, people are supported by skilled staff to the level of each resident's need.
Although the NDIS process is separate to the redevelopment of large residential centres, the NDIS support planning process will help residents with their families begin considering choices about their living preferences in the future.
Q: How many of the politicians and the decision makers have been to homes like the Stockton Centre in Newcastle to see the extent and complexity of some of the residents’ needs?
The previous and current NSW Ministers for Disability Services and local members of Parliament have visited Stockton on a number of occasions, most recently last Saturday (30 November 2013).
ADHC has key members of its management team in Stockton on a frequent basis.
Q: What's to stop the NGOs hand-picking clients and even deciding not to support them?
The transition of services will be carefully managed through a consultative process and will include appropriate tendering mechanisms to ensure the right providers are selected to take on these supports. Any transfer of service delivery will also be subject to contractual terms and accountability measures.
The NSW Government has said that the Act was drafted to ensure that the transfer of services occurs in a way that is focused on good outcomes for people with disability in New South Wales and that no-one is left behind.
Q: Currently access to some services requires plans from psychologists/behaviour clinicians, speech therapists, occupational therapists and physiotherapists, and a lot of paperwork. Will families have to pay for each individual plan and the co-ordination work to access, for example, respite?
The NDIS will fully fund the cost of all reasonable and necessary supports, including planning for effective delivery of that support.
Q: Is this unprecedented as far as removing a layer of government and contracting out to non-government dept?
The NSW Government has moved some of its services to other sectors over many years.
Removing a layer of government means that people with disability will need to deal with only one agency, and can work with that agency on all aspects of their support.
Current funding for disability comes from two levels of government, which administer different programs that are part of a total service delivery system for people with disability. Those programs are subject to annual budget cycles β€” making it hard to give people with disability any certainty that they will get reasonable care and support over the long run.
Putting all the resources together for a person, in a single independent body, creates that certainty.
Q: What plan does the NSW Government have to ensure parents and guardians have input into the selection of private provider (NGO) the NSW Government "selects" to take over their son or daughter's group home?
The NSW Government is committed to putting in place a robust consultation process with people with disability, families and other significant people in the person's life.
The ultimate goal for the movement of NSW government services to the NGO sector is for minimum disruption in supports as a result of this change.
Q: How can parents be certain due diligence in selection of an NGO occurs without being integral to the process?
The NSW Government will ensure that due diligence is undertaken by suitably qualified independent parties before any services are moved to individual NGOs. There will be a full consultation process around this with families to discuss process.
Q: As a physiotherapist part of my treatment is to see the person in all aspects of their community life i.e. the whole person - who will fund such things as preschool visits, school visits, community sport visits, day care placements, etc. etc. or will the person become a "patient" having a physiotherapy consultation?
The NDIS will fund therapy that is reasonable and necessary for the participant to adjust or adapt to their disability and to become as independent as they can in their social and economic participation, or as an early investment in the participant's future capacity, noting that therapy which focuses on clinical treatment remains the responsibility of the health system.
The NDIS recognises the importance of opportunities for the participant to develop and master functional skills in their daily activities and in their usual environment such as the home, community, child care etc. The NDIS includes the cost of reasonable and necessary provider travel in the participant's plan so that the therapy may be provided in the participant's usual environment.
Q: Who will look after the most vulnerable who are unable to manage their day to day living let alone negotiate with NGOs who at the moment are cancelling visits at the last moment or choosing not to engage with the more challenging families?
It is anticipated that the numbers of support providers will grow as a result of the introduction of the NDIS and increased funding for disability support. There has already been an increase in the number of new providers registering with NDIA. This will only continue to increase as full scheme approaches.
Participants who need support with service coordination can have that included in their plan if reasonable and necessary. In the Hunter launch, the NDIA has employed local area coordinators who can also assist participants with implementation of their plans.
Q: Will the State government fund advocacy services for vulnerable people with disabilities to navigate the Commonwealth and NGO systems to have their needs met?
Assistance and support with decision making will be available in several forms, including:
* the NDIS providing information and referral to participants to enable people with disability to engage in mainstream and community activities and develop self-advocacy skills via local area coordinators
* working with community to achieve positive change to inclusion for people with disability. This work will, in part, be a key focus for the local area coordinators involved in the scheme at the local level. At the national level the Agency will work to influence national strategies and how they enable positive inclusion
* through the National Disability Advocacy Program (NDAP) which operates outside of the NDIS but is funded by the Australian Government to promote the rights of Australians living with a disability by providing an advocacy service that ensures full and equal enjoyment of all human rights. NDAP can provide advocacy services to people with a disability by making sure they have a support person
* providing legal review and representation including advocacy on agency decisions. This work, which will largely be undertaken by advocates, is also funded under the National Disability Advocacy Program.
Q: What changes will there be under the NDIS for those individuals who are unable to live by themselves?
An individualised plan would reflect a participant's goals, aspirations and needs, and there are multiple options available for participants requiring support to live in a range of accommodation settings. This can include in-home support or a group setting, or other support to achieve independence.
Q: The vast majority of ADHC group home clients are high support needs, challenging behaviors and limited if any communication skills. Their advocates are there families, group home staff, community visitor etc. How were these clients and there advocates consulted about the NDIS process and what it really means to them?
Support for people with high and complex needs is factored into our planning for the NDIS. The NDIS will fund people with disability to levels appropriate to meet their reasonable and necessary needs, and recognise complexity and specialist needs.
An important aspect transition of NSW government services to the NGO sector will involve maintaining the skills and expertise of NSW government staff to continue to deliver supports to people with complex needs, working within the NGO sector.
At the same time, both the NSW and national governments are investing to help develop a service system of non-government supports that includes specialist capabilities to deliver the full set of options needed. The National Disability Insurance Agency will have responsibility to facilitate appropriate and high quality specialist supports.
Equally, we have a responsibility to ensure we transition people into the new system only when there are appropriate arrangements in place for them.
Q: Public schools need more access to funding for specialised teaching and support for our children, and why is it so hard to get funding for the right for every child to have an education. Who is accountable for the costs to families who choose to look after their children who have a disability?
The Education sector will continue to be responsible for supporting students with disability. Other supports needed by a child with a disability who is eligible for the NDIS would form part of their package of support.
Q: Currently therapists advise families on purchase of equipment to ensure it meets their needs and is safe. Under NDIS will equipment be prescribed by appropriate clinicians or will families be able to self-prescribe?
Yes, assessments are undertaken by qualified therapists for participants requiring specialised equipment. The cost of these assessments is included in the participantβ€™s plan.
Q: There is no charge for centre-based respite with Disability & Home Care (FACS). Will centre based respite be subsidised? Current average daily rate in the private sector is $1000/day.
A participantβ€™s plan will usually have a sustainable blend of mainstream, informal and funded supports that fit together and reflect the amount of support that the participantβ€™s family, friends and carers are willing and able to provide. These supports are also provided in a range of different settings, both at home or out of home. If centre-based respite care is a reasonable and necessary support for a participant in order to help their family, friends and carers to provide their usual level of support, this cost is included in the participantβ€™s plan with no cost to the individual.
Q: Will supported employment continue or will individuals have to pay?
Yes, supported employment will continue at no cost to the individual.
Q: How will people with a mild-moderate intellectual disability access services if they do not receive an NDIS package?
If an individual does not meet access criteria for NDIS there are other referral pathways that they will be supported to access. This support can be provided by an NDIA Local Area Coordinators or through a referral to Ability Links NSW.
Q: Who is the Federal minister that the State government is liaising with in regard to the NDIS?
Senator the Hon. Mitch Fifield, Assistant Minister for Social Services.
Please read on for responses to questions about the impact on employees as a result of the change.
Employees of the Department have access to a range of additional information on the provisions of the NDIS NSW Enabling Act.
Q: What timeframe of notice will staff be given about the change so they can make decisions about their future?
The NSW Government is committed to an employee consultation process, so that that the timeframe for the changes are clear to everyone who is affected.
A consultative forum with all unions has been set up by the Department and will meet regularly in coming months to work through the issues and timetable.
Q: What does the definition of "transfer staff" means in the NDIS Bill?
Q: How long will our current rate of pay be maintained for with an NGO?
Q: After our wage maintenance period finishes, what rate of pay will we be offered by an NGO?
Q: NSW Government staff do not yet have a time period after they are transferred to adjust to any potential reduction in our wages.
The NDIS Enabling Act ensures a transfer agreement must contain provisions for an employee to be transferred on the same terms and conditions as applied under an industrial instrument immediately before the transfer.
These provisions in the Act are currently the subject of consultation with unions representing employees.
The Equal Remuneration Order under the Social and Community Services Award will see wages rise in the NGO sector over the next eight years by around 40 percent.
Q: Will we be 100% guaranteed of keeping our current positions with an NGO?
Q: We get transferred, then the new employer does not require our services.
The NDIS Enabling Act enables the establishment of an employment guarantee period to prevent the termination of employment for that agreed period.
The negotiation of this and other matters will be overseen by a consultative committee including nine unions representing all staff affected.
Q: Will staff still be eligible for the long service leave they have worked towards?
The NDIS enabling Act ensures that staff will maintain all provisions such as long service leave, recreation leave and sick leave.
Q: Why will these organisations take state government staff on the current awards, which includes higher pay?
Current ADHC employees have highly specialised disability services knowledge and skills, which will be valuable to the NGO sector in maintaining and improving services across the sector.
Q: How did the Enabling Bill legislation get into Parliament without the PSA knowing before-hand?
The NDIS Enabling Act enables the NSW Government to start negotiations and consultation with all unions, as well people with disability and NGOs about these changes.
It enables a range of options to be explored, while setting the clear objectives of the NSW Government for the transition to the NDIS:
* ensuring continuity of support for people with disability, and
* maintaining the current workforce in the disability sector into the future.
Q: What Union or Organisation will members be able to be associated with now that we will all be working in the private sector?
There are a number of major unions representing workers within the NGO sector, including the Australian Services Union (ASU); the Health Services Union (HSU) and United Voice. United Voice already provides representation to thousands of Home Care Service workers and is expected to continue that representation after the transition.
Q: Will experienced, senior qualified carers be attracted to stay and train new recruits by retention of career opportunity and salary status?
The disability sector is undergoing a significant period of growth.
An Equal Remuneration Order (ERO) made by the Fair Work Commission ensures substantial wages growth for disability workers until 2020.
The future growth combined with new opportunities will be an attraction for senior qualified staff to remain within the sector and pass their skills and knowledge onto new recruits.
Q: Where in the NDIS legislation does it state that State Government does not play a role in delivering services?
The commitment for NSW to withdraw from direct service delivery following the full roll-out of the NDIS is a policy decision for NSW, and was included in the Agreement made for implementation of the NDIS in NSW. The NDIS Enabling Act is one mechanism to support the implementation of that policy decision.
Q: Which NGO is going to employ, or continue to employ a 59 year old permanent full timer with almost 20 years' experience in disabilities, focusing on challenging behaviours, with 900 sick leave hours available to them?
An employee with that level of experience will be highly attractive for any non-government employer seeking to build staffing capacity.
The Act protects sick leave entitlements under existing industrial instruments and allows for the setting of an employment guarantee period.
The details of the transfer arrangements, including the duration of any employment guarantee period and the funding arrangements for leave entitlements, are yet to be worked through in consultation with the unions and the non-government sector.
Q: When will the Union and the staff learn of the real plans about what is going on?
FACS is to provide the NSW Government with a plan for the movement of services to the non-government sector.
More information about specific arrangements will be available as government decisions are made.
The Department has established a consultative mechanism with unions representing staff. At the table, we had representatives from Unions NSW, PSA, United Voice, NSW Nursesβ€™ and Midwivesβ€™ Association, HSU, NSW Teachersβ€™ Federation and Australian Salaried Medical Officersβ€™ Federation (ASMOF).
Terms of reference for that consultative committee have been agreed and will be released for the information of all staff. Unions have proposed a mechanism to get information to and feedback from their members throughout the process.
A schedule of six meetings in 2014 is to be established, with two meetings held in late 2013. The most recent consultative meeting was held on 2 December 2013.
FACS and the unions are committed to keep staff informed as discussions progress.
Q: Will all the training we have gone through with ADHC, to provide an outstanding and caring service to our clients, be recognized after the transition?
Over the past decade ADHC has run a range of training programs for staff working in disability services and in front line management. Many of these programs provide for the award of a Certificate III or Certificate IV nationally recognised qualification. Those qualifications are highly sought after in the NGO sector.
Opportunities will continue to be offered to staff over the next few years of transition to develop their skills, and get recognition of prior learning.
Q: Who are these people the Director General and other highly paid bureaucrats are meeting at regional and area offices that are so excited about the NDIS move?
Many staff across the State have expressed their support for the implementation of the NDIS across NSW. Staff are asking good questions and understandably seeking as much information as possible, as well as involvement in consultations over coming months and years.
Many staff in meetings with the Director-General and other senior executives can see the positive possibilities for joining the more than 27,000 social and community service sector employees working in disability support within the NGO sector.