NDIS and aged care reform

Speaker 1 00:29

I'm Vaughan Benison, welcome back to New Horizons for 2024. This week we discuss the NDIS and Aged Care Reform, joining us to provide more information as regular visitor to New Horizons, Jonathan Craig. Jonathan is the Policy Advisor with Vision 2020. Let's talk a little bit about the NDIS review. What were the key points from your perspective that people should be thinking about in the context of the review and moving forward from here as far as the NDIS goes?

Speaker 2 01:00

It's important to note two things. Firstly, the recommendations that were made by the review are kind of interdependent. That is, the way that they designed them is that they should all work together. And secondly, that still doesn't mean that all of the recommendations are just going to be accepted. So the NDIS review has made recommendations, but the government still has the power to decide which of those recommendations it accepts, even though the review has kind of suggested that the recommendations should all work together, and in various ways they are tied into each other.

One of the things that the review has recommended, which I think will be fairly unanimously praised, is that actually the person who makes the decision should be the person who is talking to the participant, which hasn't actually been the case for a while now in many cases. Often the person who you have the planning conversation with doesn't end up delivering your NDIS plan. So that's a really positive thing. Perhaps a little bit more controversial is the way that they're proposing the planning process works. And what they are describing is a two -step process where in the first step, your overall budget is decided based on your assessed need. And then in the second step, the planning process is actually working out what you can use that budget for.

But after that process is complete, you will have much more freedom to move your money around within your plan, according to your changing circumstances. One of the big elements of frustration has been the fact that since the inception of the NDIS, there was always meant to be this kind of set of supports that existed outside the scheme for people who weren't in the NDIS. And that would include for us, that's people who have some kind of vision impairment, but that vision impairment may not always be making them eligible for the scheme. And maybe some of those people don't actually need full ongoing NDIS support.

Maybe they just need a little bit of help. But the thing that's happened is that there's no option for just a little bit of help anymore, because over time, all of the supports that are outside of the NDIS have gradually eroded away based on the assumption that anyone who needed help could go into the NDIS. So the review has said, actually, no, this, we need to think about support for everyone with a disability, not just people in the NDIS. And so they've recommended basically the introduction of what they call foundational supports, which is supports for people with disability, regardless of whether they're in the NDIS.

For some NDIS participants, that will create some efficiencies, because there's some supports which might not necessarily be most efficient on that individualized basis. But really, most importantly, there'll be a lot of people who are outside of the scheme, who at the moment are missing out on help and having to apply multiple, multiple times. And those people, if foundational supports are introduced as intended, are going to get a lot more help. For example, one of the big things that is currently a problem for people with vision impairment outside of the NDIS is assistive technology.

Say you want a portable magnifier or something like that, that's quite an expensive product. And at the moment, there are 108, at least, state based assistive technology schemes, all with different access criteria, all with different rules as to what products you can get, and all being paid for with different administrative fees and things like that. So there's a real strong case for the government to actually save money by fixing all of this into one more easily accessible national assistive technology scheme. And that's the case for people under and over 65 as well.

Speaker 1 05:48

What do you think is likely to be the government's response to the key messages coming out of the review?

Speaker 2 05:56

I think that the government is likely to be supportive of a lot of what the review says. It's really hard to predict what they'll say. I think one of the most interesting and controversial ones where it's not, we're not completely sure how this will play out yet is the idea that registration of providers of services and supports through the NDIS should be mandatory for all providers. Now, I think this is something that's going to be perhaps a little bit alarming to some people. You know, there's an over a greater proportion of blind and vision impaired participants who are self managing their plans and certainly the vast majority who aren't self managing are plan managing and that allows them to use unregistered providers.

Now, the review is proposing that all NDIS, NDIS providers will have to be registered to some degree, though what they are suggesting is a much more proportionate system where currently if you register, you have to go through a really complicated process. And that may not be, that won't be the case for all providers in the future. Um, I think that's going to, there's a real challenge there and there's going to be some pushback on that with, you know, does, if you're not able to use say, you know, the gardener that you like because they are not registered with the NDIS, is that really choice and control?

And that question is, is one where that's where we're going to have a real big conversation. I think, uh, in many other cases, I think the, the government, uh, and particularly NDIS minister Bill Shorten, you know, uh, asked for this review to really find solutions. And I suspect that by and large, uh, they will, you know, accept the solutions, but it'll be the implementation of, you know, and the versions of those solutions that we get, which will be up for further discussion.

Speaker 1 08:12

They have already committed to a couple of the recommendations though, haven't they out of the review?

Speaker 2 08:19

Yes, certainly the states and territories have agreed to put a significant amount of money toward the introduction of foundational supports, which is a big step in the right direction. It's just a matter of seeing how that all plays out in practice. We are going through quite a reform agenda at the moment in terms of disability policy and particularly legislation. We've had recently the publication of the final report from the Disability Royal Commission.

Speaker 1 08:54

And of course this review. There's another review in progress though which specifically affects people over the age of 65.

Speaker 2 09:01

Yes, and that is actually, interestingly, the, probably the majority of people who are blind or vision impaired are over 65 in Australia. And, you know, that's even reflected in the data that we have from the NDIS. A good 10% of NDIS participants who are blind or vision impaired are actually people who are over 65 who've been able to stay on the NDIS. However, if you acquire your disability over the age of 65, as many people do, then you will have to go into the aged care system. And the aged care system, until recently, has been very difficult to navigate. But what is now being introduced is a new aged care act to replace the previous one, which was created in 1997 and was very provider focused.

The Royal Commission into aged care quality and safety recommended, as recommendation of one of their massive report a couple of years ago, a new human rights focused aged care act. And this is what we're now seeing a draft of with the hope that it'll be introduced later this year.

Speaker 1 10:20

And that's a really important bill because we've been talking about the lack of consistent support for people over 65 for a very long time now. Certainly since I've been doing New Horizons, it's been a significant topic of discussion for a lot of our listeners and a lot of contributors to the program. What are some of the key things that are in this exposure bill?

Speaker 2 10:42

So there's some really good news in the bill. One particular example is that for the first time there is an acknowledgement that of the existence of people who are blind or vision impaired and deaf or hard of hearing and even people who are deaf blind in the groups of people who might require special consideration by aged care providers, which I think is really good. The bill is underpinned by a statement of rights and a statement of principles and in the statement of rights one of the things that's really exciting to me is the idea that people in the system have the right to receive information in their preferred format of communication which I think is really good.

There's also going to be changes to the way that assessment is done in the system with a single assessment process and a single access point for assessments whereas currently and if you're an aged care recipient you will know there's lots of different pathways into the system depending on where you are and what you need. So that's going to be a big change. I think it would be really good for everyone who's listening who's an aged care recipient to take part and there are a number of different ways to take part. There's going to be a number of face -to -face consultations.

Some of them have already passed but there are still some ahead of us when this program comes out. There will also be some online drop -in sessions where you can come in and talk about what you think and learn more. And there's also the ability to complete a survey online or over the phone as well.

Speaker 1 12:44

And the closing date is 16 february.

Speaker 2 12:47

Yes, that's right. So it isn't, there isn't very much time. And, you know, we are aware of that and they are aware of that. But, you know, I think that it is really important to get this act underway, because it is the foundation of much bigger changes as well that are coming in the future, which can't happen without it. Go online and sign up for some of the consultation sessions or to make a written submission either via the survey or sending a document in, you can go to agedcareengagement.health.gov .au that's agedcareengagement.health.gov.au and you can also ring up and fill out the survey via phone by calling 1-800-318-209.

Speaker 1 13:44

And I very strongly encourage you to make your views on aged care reform well and truly known. The 16th of February is the closing date there. If you'd like to get in touch with Blind Citizens Australia, 1 -800 -033 -660 is the phone number, 1 -800 -033 -660, or you can email bcaatbca.org.au.

Speaker 1 14:03

Always keen to hear your ideas for New Horizons, new.horizons@bca.org.au is the email address for that. In the meantime, do take care and I'll talk to you again next week.