A Joint Standing Committee has raised concerns around services and provider readiness to meet the demands of delivering the National Disability Insurance Scheme (NDIS). Creating a participant enabling environment and developing a competitive marketplace was said to be vital to the success of the scheme and the challenges for both participants and service providers to transition to a market-led service delivery model cannot be underestimated.
However, during the course of the inquiry, the committee heard that the National Disability Insurance Agency (NDIA) has often failed to put in place in a timely manner the appropriate measures and initiatives to support the development and growth of the disability support marketplace to meet demand. The roles, responsibilities and activities of all those responsible for market stewardship are unclear and this was impeding the development of strategies to address key emerging issues in the development of the market.
Throughout the inquiry the committee heard that most participants are not ready to confidently engage and navigate the market. Of concern is that submitters continue to raise issues around adequacy of plans and ability of participants to activate and manage plans. It appears that the resources and supports put in place by the NDIA to help participants activating and implementing their plans are not reaching all participants and their families.
When it comes to workforce readiness there is currently no clear national strategy to grow the workforce despite the need for an additional 70,000 disability workers by 2020. The committee received evidence that there are currently no incentives to choose a career in the disability support sector. Submitters reported that the disability sector is experiencing a rise in underemployment, insecure work arrangements and inadequate wages with little or no prospect of professional development opportunities.
The committee consistently heard that service providers are struggling to make the necessary changes to operate under the NDIS and llack the capacity, expertise, cash reserves and infrastructure to make a successful transition and operate in the new NDIS environment. To date, it appears that the growth in new providers is far too slow and patchy to mitigate current and projected supply gaps. The committee heard that the NDIA, as a market steward, has lacked forward planning and not adequately facilitated access to support and assistance for existing and prospective service providers to operate in the NDIS environment.
Pricing was also an issue with many service providers unable to operate even moderately profitably under NDIS pricing. The committee continued to hear that NDIS pricing is hindering market development and growth. More concerning is that, in some instances, pricing has led to service providers discontinuing services to NDIS participants. The committee heard that some service providers are ‘cherry picking’ clients and potentially leaving some of the most vulnerable NDIS participants with no access to adequate services.
The committee also expressed concern about the lack of progress on addressing the issue of thin markets experienced by some groups. The thin markets identified are not new and it is now urgent that the NDIA intervene beyond making small adjustments to pricing. The committee is concerned that the policy on future Provider of Last Resort arrangements has not been released and remains unclear.
The committee received evidence that the lack of data on Specialist Disability Accommodation (SDA) demand restricted choices of living arrangements for participants and the lack of clear and consistent information available to investors and the pricing review cycle are impeding development of new SDA dwellings.
The committee made 29 recommendations, which aim to ensure that appropriate strategies and responses are swiftly implemented to stimulate the growth of the marketplace and ensure that all NDIS participants have access in a timely manner to necessary and reasonable supports they are entitled to.
Among the recommendations are:
- the Department of Social Services (DSS) and NDIA develop a strategy document the clearly articulates the roles, responsibilities and activities of all those responsible for market leadership
- the NDIA ensure that training on how participants access services and implement their plan is included in the ongoing mandatory training for all NDIA staff and contracted partners in the community involved in the development and approval of plans
- the NDIA urgently allocates more staff and support to assist participants with plan implementation
- the NDIA monitor and report on the adequacy of its staffing levels on an annual basis
- the NDIA urgently undertake work to improve its website including design and navigation, and the quality and accessibility of content
- the NDIA urgently develop and publish a market position statement for Western Australia
- the NDIA commence engagement and provider readiness activities by January 2019 in all locations where the NDIS will start on July 1, 2019
- the NDIA work with allied health professions, peak bodies and service providers to co-design a suitable methodology for pricing supports to participants with high and complex needs
- a specialised team of NDIA planners is established to accelerate the transition of young people residing in aged care facilities to appropriate SDA accommodation which meets their complex needs