There have been a lot of information releases regarding the NDIS and disability sector recently.
They all point to one thing, best practice does not exist. The NDIS isn’t currently working for the government, it isn’t working for people with disabilities and it isn’t working for providers.
It is time to try new things for both disability service providers and mainstream organisations looking to be more inclusive.
- Do things differently because it will save you money.
- Do things differently because it will make you money.
- But most importantly, do things differently because it’s the right thing to do.
The below is a very quick snapshot of some of the recent reports that have been released. These reports will only increase in frequency as we get nearer the Royal Commissions’ final report and the NDIS Review report.
Bottom line, we are being warned that BIG changes are coming.
The Royal Commission released their research report on ‘Restrictive Practices – A pathway to elimination.
The University of Melbourne, University of Technology Sydney and The University of Sydney collaborated for nine months to fundamentally answer the questions; why do we use restrictive practices and how can we stop?
The report starts by calling out what is a common problem for many of the attempts to define what is best practice in disability support. There is very little research, specifically:
“While there are a range of ‘high-level’ frameworks and principles for reducing and/or eliminating restrictive practices outlined for implementation in Australia across a range of different settings, including mental health settings, disability services settings and educational settings, there has been little to no research conducted to date on the effectiveness of these approaches”.
The overarching sentiment of the report is that restrictive practices should be outlawed and raises important questions about the standards and quality of contemporary disability services and supports.
“Restrictive practices are permitted and regulated via law and policy. This permission sustains institutional cultures of silence, and further enforces the unequal power relationships between people with disability and service providers”.
Any behaviour Support Practitioner worth their $193.99 per hour should be able to tell you that positive outcomes for people with disability occur when:
(a) Staff are nonconfrontational and consistent in their communication with the person with disability.
(b) Staff do not impinge on the autonomy of the person with disability.
(c) People with disability are enabled to participate in meaningful activities of their choosing.
(d) The wishes of the person with disability are listened to and acted upon.
(e) Behaviours of concern are often driven by distress, protest and resistance.
The NDIA released their research report titled “Having a go: Exploring the use of support to make individualised living a reality”
The NDIA partnered with service provider Scope to determine how NDIS Participants can build their capacity to their own home and living goals.
The key headlines from this paper are:
- The number of people accessing SIL supports has grown by roughly 20% since June 2021 and 71% of all participants who claimed SIL funding were either on the autism spectrum, or had cerebral palsy, down syndrome, intellectual disability, or a psychosocial disability.
- About 35% of people currently utilising SIL supports may be better suited to other program styles
- Only 29% of NDIS participants and family and carers reported that they were living where and how they wanted. Compare this to an Australians without a disability, where 83% report being happy where they live.
- Contributing to this, the study found:
- There is too much complex information surrounding home and living support options
- “Affordable housing, public housing waitlists and unavailability of suitable rentals are barriers to NDIS participants living how and where they want”
- When deciding where to live and how to be supported NDIS participants need the following:
- Safety, security, and privacy
- The right location
- Having support available when needed
- Choice in who they live with
- NDIS Participants need support to improve their confidence and therefore, life experiences
- The solutions could include:
- Increasing transition programs and short-term accommodation to allow NDIS Participants to trial different models
- More person centred active support and less passive support
The report states that “The current NDIS-funded Capacity building supports seem to assist NDIS participants with intellectual disability the most, although the effects are small. Benefits can be seen with greater length of time accessing the supports rather than a higher level of intensity.”
If this paper doesn’t open the door to more innovation and creativity for people with disability to lead an ordinary life comparable to Australians without a disability, I don’t know what will.
The NDIS review released their interim report titled “what we have heard, moving from defining problems to designing solutions to build a better NDIS”
In it they have highlighted that there will be key challenge areas that they are going to focus on:
- How to broaden disability supports so that NDIS isn’t the only available mechanism for people with disability to receive the supports they need
- More clearly defining what is reasonable and necessary
- Understanding the pathway of children in the NDIS and how to improve the impact of early intervention. It is likely that this area will work simultaneously with point 1
- Why hasn’t competitive markets improved quality, innovation or diversity of services received by NDIS Participants?
- How to ensure the scheme is financially sustainable
- How to balance choice, control, dignity of risk and regulation
The review specifically asked for feedback on “how to best measure both the benefits as well as the costs of the scheme and how to ensure the scheme is sustainable”.
There is also a subtle undertone in the document about ‘what does good look like’, this could apply in many facets –
- What is a good experience for a person with disability?
- What is good service provision from a NDIS Provider?
- What is good management and outcome measurement for the NDIA?
Ultimately, without an understanding of what is good – the scheme lacks any rigour or accountability.
The Ability Round Table release a white paper “Insights into financial and workforce performance of the disability support sector”
The report tells the story of Ability Roundtable’s Financial and Workforce most recent benchmarking activity. The information is based on forty, NDIS Registered, participating organisations (representing around $5 billion in revenue, more than 35,700 workers and nearly 57,000 NDIS participants).
They present a bleak picture for NDIS Provider suggesting that for FY 23/24 more than 76% will operate at a loss in the 2023-24 financial year and then 50% of the would have made losses for three years in a row.
The Ability Roundtable argue that The NDIA Cost Model is fundamentally flawed. They also argue that “efficiency” and “sustainability” are now trade-offs for quality supports and outcomes for participants.
The data suggests that efficient providers were operating at 20.3% overhead/operating expenses. The NDIA suggest orgs should be operating at 12.5%. This is a nearly 8% gap between the “efficient” provider overhead rate and the NDIA’s target.
Is it possible for orgs to nearly halve their overhead? What have they previously tried? It could be argued that many organisations are operating in a similar fashion to what they did pre-NDIS, some with possibly more resources to accommodate claiming.
Individually, each of these four documents are interesting reading, but what can we deduce when reading the recent updates in a cohesive fashion?
That in ten years, the NDIS has spent billions of dollars, and in the 23-24 budget, the government has committed another $910 million over the next five years to “getting the NDIS back on track and rebuilding trust with participants, their families and carers”, but very little has shifted within the industry.
Other industries are innovating as they can see the triple bottom line benefits of catering to the market of people with disability….
We have seen great leaps in the world of adaptive fashion, ASOS first created a wheelchair-friendly jumpsuit back in 2018, Hilfiger’s disability-friendly collection includes adaptive features like Velcro closures, magnetic buttons and adjustable hems, and Nike’s Go FlyEase shoe, marks the first hands-free sneaker ever made.
We have the Sunflower lanyard program which helps people with hidden disabilities signal to the broader world that they might need some extra assistance or different communication. Initially launched in England’s Gatwick Airport in 2016, it was designed for people with disabilities that can’t easily be identified by others to discreetly flag their hidden disability.
More and more people with disability are being represented in mainstream media. And there is such a loud chorus of voices saying nothing about us without us.
We have had such great momentum forward in recent years, but perhaps this isn’t felt in all stories. By focusing on the broader NDIS Cost, without incentives for providers to collaborate and adapt to the emerging yet still often ignored voices of those that receive support, we will continue a cycle of ‘othering’ people with a disability, continuing to prove poor services and not being financially sustainable.
We understand that NDIS is a complex and ambitious scheme that aims to improve the lives of people with disabilities and their families. However, the current system is not delivering on its promise and needs urgent reform.
The recent reports highlight the challenges that lie ahead for the disability sector. But they also present opportunity. They call for innovation and collaboration from service providers and mainstream organisations to create more inclusive and individualised solutions. The NDIS is not a one-size-fits-all model. It needs to be dynamic and evolving, requiring constant learning and adaptation. Service providers and mainstream organisations that embrace this change and seek to improve their practices will not only survive but thrive in the new NDIS landscape. They will also contribute to a more just and equitable society for people with disabilities.
The time for innovation is now.
For information on the NDIS and many other aspects of the disability sector please reach out Contact – Supporting Potential