With implementation of the National Disability Insurance Scheme (NDIS), disability service providers around Australia are facing major changes to traditional ways of operating. Successfully navigating these challenges will be a key strategic focus for organisations over the next three years. Providers will need to explore new approaches to the way that services are structured, costed and marketed.

 

What is NDIS?

The introduction of the NDIS pilot projects across Australia signals a major change in the way services are provided to people with a disability. People eligible for participation now have a significantly greater choice in the types of services available to them and the way that they are provided. They no longer need to rely on configurations of services that are pre-determined by sector funding arrangements.

This significant change honours the rights of people with a disability to determine how they live their lives across a range of domains including daily living and care, accommodation, leisure, education, and employment.

Each eligible participant works with the National Disability Insurance Agency (NDIA) to develop an individualised plan to meet their needs. Once the plan is developed then participants choose the service provider(s) who they or their carers feel will provide them with the most effective service to meet their needs. Participants formally contract with service providers for an agreed service over a designated time frame with attached costs, creating greater transparency for them. Now that funding is directed to clients in the first instance, cost effectiveness becomes more significant as participants and carers seek the combinations of services that they see as providing the best value for money.

Challenges of the model

There are a number of strengths in this new approach. In particular, the increased focus on choice, flexibility, and accountability for consumers represents an important step forwards. However, the NDIS model also presents a number of challenges and potential pitfalls, particularly for existing disability service providers transitioning to the new framework.

The pool of NDIS providers currently includes most providers that were previously block funded by government, but NDIS has also opened up the sector to non-traditional providers. Community services organisations will potentially face stiff competition from new entrants running leaner business models.

The change from block funding to participant-directed funding will put pressure on organisational budgets and require high levels of efficiency in both administration and service delivery. In addition, the cost modelling of the scheme appears to have been premised on services being provided at the attendant carer level rather than by professionally trained and supported staff. Whilst attendant care level staffing may be adequate to meet a range of people’s needs, the potential reduction in skilled professional staff could propose significant risks to both participants and organisations.

Service providers will only have access to the parts of the participant’s plan that relate to the aspects of service delivery they are funded to provide. Whilst this honours people’s right to direct the services they want, it may challenge currently accepted good practice in the community sector which focuses on reducing siloing and pursuing integrated models of care. Lack of communication amongst providers may potentially lead to uncoordinated and fragmented care, and to emergent aspects of participants’ needs not being adequately identified or addressed.

The model is premised on and only available to people who have a life-long disability. This represents a challenge for people with a mental illness. Within the mental health sector current models of service delivery are strongly oriented to recovery and step up / step down interventions that are responsive to how clients are faring. The notion that mental health is a life-long disability has the potential to either exclude people from services they currently receive or, if they are included, undermine a focus on recovery and independence.

Preparing for change

The NDIS is yet to be fully rolled out across Australia but it is clear that organisations not involved in the current pilot sites are carefully watching the implementation process and are actively preparing for significant changes that lie ahead for them and their client groups.

Service providers who wish to be part of the NDIS are required to be registered as a provider of services and meet agreed criteria including yet to be determined accreditation requirements.

Changes in funding arrangements mean that existing disability service providers need to significantly change the way they operate by:

  • Becoming more client facing in marketing their services to participants who want value for money
  • Demonstrating more transparency in the way they use participants’ funds, including allowing participants to access their accounts
  • Changing financial and budget processes from payment in advance from government to payment in arrears from participants, including strong systems for ‘accounts receivable’, and significant potential for overdue accounts and bad debts
  • Managing the lack of certainty in relation to demand and the potential impact this has on current staffing models, including training and support requirements.

Service providers wanting to maintain service models involving intensive support and/or highly qualified staff will need to clearly demonstrate the extra value that these models provide over lower cost options. This will require a strong marketing and communications strategy.

In addition, organisations may need to reconfigure service models to offer a range of support options at a range of costs. Different levels of intensity or duration of support may need to be considered, and modalities such as monitoring, brief intervention, or coaching may become more prominent. Group-based programs may continue to offer a cost-effective way to meet some types of needs.

 

Assistance in transition

How is your organisation travelling in its preparation for NDIS?

If you need assistance in thinking through the issues and preparing for change, Lirata is happy to assist.

We offer a range of services to help organisations successfully transition to NDIS, including planning, service model review, corporate systems review, data management, accreditation support, and advice on human resources and communications.

We invite you to contact us for a no-obligation conversation about your needs. Please ask to speak with Celia Clapp, our NDIS lead.

Mobile: 0403 043 390
Landline: 03 9457 2547
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Download

Disability sector: Preparing for the transition to NDIS (PDF 276 KB)

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