Service Avoidance to Service Entitlement
The Productivity Commission decided it was impossible to fix the massive range of problems within the bevy of support services for people with disabilities across Australia, whilst service providers held the purse strings. So they put the consumer in the driving seat to hold the federal support service funding – giving them choice, control and service entitlement for the first time ever.
Since time immemorial, choice and control has been the privilege of support service providers, especially government direct care services who consider consumers (people with disabilities and their stakeholders) had no support service entitlement - consumers should consider themselves very lucky, and be very grateful to get anything from state government block funded services.
Consumers are frequently forced to beg for little more than mindercare, yet often get nothing more than avoidance and denial. Customer service, expectations and entitlements are dirty words. Consumers are frequently in fear of reprisals if they dare to complain. They can be sent to Coventry or PIN’ed (served a Provisional Infringement Notice) for daring to question their service level and quality. Most kept quiet to avoid intimidation.
There is little respite for consumers taking matters to pseudo government departments (so called Independent Statutory Bodies) such as the Ombudsman, VCAT, OPA and ODSC, as these are in-bed with most service providers, especially the state government’s direct care services.
So what can we expect now from consumers rather providers being funded through the NDIS from federal rather than state coffers.
Providing individual support service funding (IFP) to the consumer, in principle, places the consumer in the driving seat with entitlement. Sounds good, but don’t hold your breath. It depends on many factors, such as service availability.
NDIS trial sites gave an opportunity to suck-it-and-see. But in Victoria this was just the NDIS on trial, not the service provider transition process. This process being the transition of government managed services to non-government managed services. This is necessary as the public service cannot operate in the marketplace, and the NDIS is a marketplace process. So all disability services must be in the marketplace under the scrutiny of ACCC rather than the Ombudsman.
With the NDIS principle of support service funding being to the consumer, service providers no longer receive block funding. They must compete in the marketplace, to stay in business. Although, they are looking at ILC (Information Linkages & Capacity Building) and state governments as sources to replace some of that old cosy-zone block funding.
In group homes moving to NDIS support service funding, the state government block support service funding is replaced with an IFP (Individual Funding Package) to each resident/person with disabilities from which to pay their service provider for their support service costs. That is the cost of support staff and service provider overheads. Residential charges or Board & Lodging is totally separate and the responsibility of the consumer.
Existing NGOs (non-government organisations which include not-for-profit organisations) moving to NDIS support service funding find it relatively easily in comparison with government managed group homes which, in Victoria, are going to be held by the Department of Health & Human Services (the department) on the grounds of the department ensuring NGOs are good enough to take-over their services. This is ironical considering the department is totally unable to ensure its own service outcomes consistently equal its very extensive and very comprehensive service intent.
It is also ironical, pending the transfer of department group home direct care services to NGOs, the department intend to claim, as they are in the Barwon Region, that they are managing their direct care support services within the NDIS expectations of the consumer having, “Choice, Control” and “Service Entitlement”.
Whereas, it is the department which has always had total power and control of its consumers - who have no choice under the department’s despotic DSR (Disability Support Register) which controls all placements, funded by the department, throughout Victoria.
This state government department controls every breath consumers take. It is the funding body for almost every disability service in Victoria, it is the direct and indirect provider for the largest percentage of disability services throughout the state, it is the regulator for all disability support services and it is the landlord for the majority of group homes throughout the state.
Such a conflict of interests make it the most obdurate in the state. And has the audacity to question existing NGOs, most of whom are members of NDS (National Disability Services) who are providing their members with intensive support to help them provide support services well within the NDIS service quality intentions.
If the department does not make it as difficult as possible for NGOs, as they usually do, the process of the transfer of group home management could be relatively straight forward.
Existing department group home direct care staff need to be encouraged to remain, with the initial management transition being at operations manager level. This would be minimum disruption for both consumers and staff. Especially as there is no real reason why all department group home residents should not continue to rent their existing group homes from the department or the state housing commission. And, be permitted real residential tenancy rights under the Residential Tenancies Act – with the removal of Section 23.
Currently, where consumers find support service questionable, they have to take-on well entrenched service providers, with not right to say which staff they have in their home (RTA-S23). Whereas, under the NDIS their support service coordinator will, on behalf of the consumer, question the service provider. If the coordinator is not satisfied the service is to the standard for which NDIS is paying, another service provider will be engaged.
In respect to the transition of support service funding from DHHS block to NDIS IFP for the residents of SSA group homes currently funded by DHHS block funding, and that residents of DHHS managed SSA group homes, especially, will have their basic service assessment needs defined for, and provided to the NDIS by the DHHS. And that consumers (residents and their stakeholders) will only be part of the assessment process if they consider they need additional support features.
We, therefore, flag the need for consumers (now participants in the NDIS) to receive the defined details of the support service the DHHS is claiming to be providing the participant. As without this, the participant, (a) is unable to evaluate the service for which the participant is paying from their NDIS IFP and, (b) is unable to evaluate what additional support services they may need to seek from the NDIS through the LAC.(Local Area Coordinator).
The Productivity Commission concluded the States had made such a mess of disability service provision that future disability services must be operated and funded across Australia by the Federal Government. Yet we find the States buying a foot in the door with funding, in-kind agreements and claiming their disability service models are best. .
Whereas, state legislation, state policies, state bureaucracy, state government bodies associated with disability and traditional cosy-zone jobs for the boys need to be put in the incinerator. And the NDIS Act, the Quality and Safeguarding Framework, and the ILC (Information Linkages & Capacity Building Framework) need to be that governing, supporting and evaluating disability services across Australia.
With too many cooks, as there are buying into the action at present, the NDIS could be, a few years down the track, little more than more of the mess it was intended to resolve.
Extra 1: The Department of Health and Human Services, Victoria, by a very senior direct care worker (5Mb download)
Extra 2: Deaths in Disability Care - Who Cares?
Extra 3 NDIS phasing details for NEMA.....
Extra 4: Group Home Support Service Transition (Victoria)
Extra 5: Despotic DSR to NDIS
Extra 6: Group Home Service Evaluation & Scrutiny under NDIS
Extra 7: Further Matters of Concern for NDIS
Note: Bulletin delay is as a direct result of the endless meetings relating to the NDIS process, that we have a matter with VCAT and the myriad of regular matters needing attention.
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