Empowered clients do well under NDIS but older, rural people struggle: review

The majority of clients in the National Disability Insurance Scheme trial have enjoyed greater choice and control under the new program, but some have found themselves to be worse off under the scheme, an evaluation has found.

The majority of clients in the National Disability Insurance Scheme trial have enjoyed greater choice and control under the new program, but some have found themselves to be worse off under the scheme, an evaluation has found.

Some 15 to 17 per cent of participants reported having poorer outcomes in terms of their choice and control and were accessing fewer supports than they did prior to the NDIS trial.

People with mental health and psychosocial disability, older participants and those who were unable to effectively advocate for services on their behalf reported being worse off, the independent evaluation found.

Choice was also constrained for people living in rural and remote areas where there was greater unmet demand for services. On average, they were 15 per cent more likely to experience unmet demand than their urban counterparts.

Lengthy waiting lists, a lack of local providers and concerns over quality provision meant many participants experienced problems accessing supports, the report found.

Just over a quarter (27 per cent) of NDIS participants said they could not access a support for which they had NDIS funding.

“Whilst the overall picture of the NDIS trial rollout is one of increased supports and improved outcomes, not all people with disability are achieving improved outcomes under the NDIS,” said the evaluation conducted by National Institute of Labour Studies at Flinders University, which was released in late December.

National Disability Insurance Agency staff reported positive changes for those participating in the NDIS but said individuals and families who were “confident, educated” and were “able to articulate their support needs” had better outcomes than those with less capacity to understand the scheme.

Support coordinator and financial management roles were experiencing increased growth under the NDIS and were currently in shortage, the evaluation found.

Concerns over NDIS pricing

Funding constraints under the NDIS were also said to be adversely impacting support packages and the financial sustainability of providers.

Services considered underfunded were one-to-one community participation, mental health services, group services and services for people with complex needs.

The report urged the government to monitor indications by disability support providers that they would end services considered to be underfunded under current NDIA cost guidelines.

“NDIS providers were concerned about their capacity to deliver to the same standard as before the NDIS and according to need, citing NDIS funding caps and the NDIS emphasis on prices as a constraint,” the evaluation said.

Slow take up of self-management

The evidence showed that self-management was uncommon and take up was increasing at a slow rate. Half of all NDIS participants did not self-manage any part of their plans, mainly due to the perceived administrative burden.

However, those who chose to self-manage their funding found the experience to be positive, particularly in relation to greater choice and flexibility in accessing non-NDIS service providers and engaging their own support worker, the report said.

NDIA staff expressed fears over the potential risk of fraud or mismanagement of funds by those undertaking self-management and were concerned that the scheme lacked sufficient safeguards.

Switching providers

While the evaluation found the majority of NDIS participants did not switch providers after joining the scheme, participants and carers were becoming more confident to exercise their power to change service providers over time.

While service flexibility was reported to have increased, participants said providers were still reluctant to provide services on a casual “as needed basis”.

“Evidence was also emerging that participants were increasingly choosing different service providers and requesting more services at weekends, after hours and for shorter periods of time,” the evaluation found.

Taking advantage of increased demand for services, the majority of new market entrants into the trial sites were small or solo allied health practices.

In an effort to recruit more support workers into the sector, disability service providers said they were looking to tap into new sources of potential recruits such as older men and people working in the music and fitness industries.

The comprehensive evaluation was based on qualitative and quantitative data gathered between 2013 and 2016 from South Australia, Tasmania, the Australian Capital Territory, the Barwon region in Victoria, and the Hunter area in New South Wales.

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2 thoughts on “Empowered clients do well under NDIS but older, rural people struggle: review

  1. I really worry about the vulnerable people of our society as well. I have several permanent disabilities , several severe spinal disabilities and suffer restricted movement due to severe Chronic pain and this had worsened my mental health. My elderly parents who are very unwell have helped me. My disability help cut off at intro of NDIS. I was approved after 11 months of speaking with dozens of different people. (Never same person twice). You cannot contact anyone by phone. I was asked at my cost to supply further lenghthy reports. Much to my and my poor parents relief, l was accepted and they sent a lovely lady to my home to complete a plan stating assistance that l require. This was submitted and l was advised my plan was in progress. I then received a phone call that another mistake had been made and l do not qualify due to my disability may not be permanent and is not considered a disability. This is completely incorrect and for myself, my elderly parents and all the genuinely needy disabled people who are being treated so cruelly and unfairly. This really is a terrible experience and is soul destroying and takes away your self worth.

  2. hi my name is reece i am struggling to understand.so confusing.iam suffering from acute pheriphial nerve damage. fully proven. yet still being refused.have tried so hard .time to give in death looks like easiest way to deal with the cruelty of the liberal party who are the opposite of the word liberal.

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