Monday, 30 October 2017

Turnbull Government overseeing yet another policy implementation cock up

ABC News, 19 October 2017:

Key Points:
The Productivity Commission is urging state governments to ensure current services are not withdrawn early
The 533-page report says the NDIA sacrificed the quality of NDIS plans while rushing to meet enrolment targets
The report found the disability sector workforce "will not be sufficient" to meet demand
The scheme was meant to be in place by mid-2020 but fell behind schedule soon after its nationwide rollout began in July last year.

The National Disability Insurance Scheme (NDIS) will be rolled out late, and migrants might be needed to plug workforce gaps, the biggest ever review of the NDIS predicts.

"The reality is that the current timetable for participant intake will not be met," the Productivity Commission report said.

"This delay could be longer if the scheme falls further behind … when the participant intake ramps up in 2017-18."

The commission urged state governments to ensure current services are not withdrawn early.

"Governments and the [agency] need to start planning now for a changed timetable," the report said.

In a 533-page assessment, it condemned the National Disability Insurance Agency (NDIA) for sacrificing the quality of NDIS plans while rushing to meet enrolment targets.

"A key concern that has emerged from our extensive consultations is the speed of participant intake," Commissioner Angela MacRae said.

"This is impacting on planning processes [and] the quality of plans," she said.

The report highlighted the agency's reliance on over-the-phone planning sessions, which hundreds of people have complained about.

Planning meetings dictate how much funding people receive and what services and equipment they can access.

"The Commission heard [on numerous occasions] that participants were called with no forewarning … or were not informed that the call was a planning conversation," the review said.

The NDIA yesterday announced it was phasing out telephone meetings, but did not specify when they would be abolished.

The Federal Government's independent research body estimated 475,000 Australians would be covered by the full scheme.

But it found the disability sector workforce was growing "way too slow" and "will not be sufficient" to meet demand.

The commission said it might not be possible in the short term to train enough allied health professionals, such as speech therapists, and skilled migrants might be needed.

Key Points in the Australian Government Productivity Commission’s 2017 final study report, National Disability Insurance Scheme (NDIS) Costs:

* The National Disability Insurance Scheme (NDIS) is a complex and highly valued national reform. If implemented well, it will substantially improve the wellbeing of people with disability and Australians more generally.

* The level of commitment to the success and sustainability of the NDIS is extraordinary. This is important because ‘making it work’ is not only the responsibility of the National Disability Insurance Agency (NDIA), but also that of governments, participants, families and carers, providers, and the community.

* The scale, pace and nature of the changes that the NDIS is driving are unprecedented in Australia. To reach the estimated 475 000 participants in the scheme by 2019 20, the NDIA needs to approve hundreds of plans a day and review hundreds more. The reality is that the current timetable for participant intake will not be met. Governments and the NDIA need to start planning now for a changed timetable, including working through the financial implications.

* Based on trial and transition data, NDIS costs are broadly on track with the NDIA’s long term modelling, but this is in large part because not all committed supports are used. While some cost pressures are emerging (such as higher numbers of children entering the scheme), the NDIA has put in place initiatives to address them. The benefits of the NDIS are also becoming apparent. Early evidence suggests that many (but not all) NDIS participants are receiving more disability supports than previously, and they have more choice and control.

* In the transition phase, the NDIA has focused too much on quantity (meeting participant intake estimates) and not enough on quality (planning processes), supporting infrastructure and market development. For the scheme to achieve its objectives, the NDIA must find a better balance between participant intake, the quality of plans, participant outcomes, and financial sustainability.

#Greater emphasis is needed on pre planning, in depth planning conversations, plan quality reporting, and more specialised training for planners.

*A significant challenge in the transition phase is developing the supply of disability services and growing the disability care workforce. It is estimated that 1 in 5 new jobs over the next few years will need to be in disability care, but workforce growth remains way too slow.

#Emerging shortages should be addressed by independent price monitoring and regulation, more effective coordination among governments to develop markets (including intervening in thin markets), a targeted approach to skilled migration, and equipping participants to exercise choice.

* The interface between the NDIS and other disability and mainstream services is critical for participant outcomes and the financial sustainability of the scheme. Some disability supports are not being provided because of unclear boundaries about the responsibilities of the different levels of government. Governments must set clearer boundaries at the operational level around ‘who supplies what’ to people with disability, and only withdraw services when continuity of service is assured.

* NDIS funding arrangements should better reflect the insurance principles of the scheme. Governments need to allow flexibility around the NDIA’s operational budget and commit to establishing a pool of reserves. [my yellow highlighting]

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