The National Disability Insurance Scheme (NDIS), when designed correctly and implemented effectively, has the potential to transform the lives of people with disabilities.
However, challenges exist. Young people in aged care are facing significant barriers accessing the scheme as well as problems developing and implementing their NDIS plans. The bureaucratic processes in the NDIS, as well as a lack of service expertise and appropriate housing, are preventing hospitals from discharging people with disabilities and complex health needs back into the community.
The Summer Foundation is advocating for policy and process improvements that will improve NDIS outcomes for people with complex support needs.
Solution 1: Better coordination between the NDIS, health, housing and aged care sectors
Young people in aged care, and those at risk of entry, require a coordinated effort across sectors to meet their needs. It is not always clear which sector should be delivering a particular service. For people in rehabilitation after trauma or injury, the split of responsibilities between systems can result in delays in service delivery and an inefficient service response.
For younger people in aged care to have good outcomes, a jointly resourced approach across health and disability sectors would be more efficient and effective than the current cross-referral pathways.
For young people in aged care, who have complex support needs, planning is a difficult process. Generally speaking, this is not a group who can navigate the NDIS pathway independently. There are significant inequities emerging because of the varied skill levels of planners, the amount of advocacy or supports an individual has access to and the hasty, haphazard manner in which plans are being developed.
Governments need to commit additional funding to establish services to support younger people and their families to navigate the complex disability, health and housing systems. This will likely require a significant increase in funding of disability advocacy services and working with the sector to co-design the right approach to bring together the advocates, NDIS planners, key workers and/or support coordinators.
The NDIA needs to enable hospitals to prepare documentation on younger people’s NDIS access and their support needs to leave hospital.
Solution 2: Remove bureaucratic hurdles preventing people from accessing the NDIS
One simple change would be for the Federal Government to stipulate that if you are aged under 65 and living in aged care you automatically meet NDIS requirements. Should any young person not meet the access requirements, the NDIA retains the power to revoke access to the NDIS.
Removing hurdles for entry into the NDIS will result in cost savings by reducing the need for detailed access assessments.
The NDIA should ensure that all young people in aged care coming into the NDIS have the opportunity to leave aged care, by including funding for SDA or home modifications, support coordination and allied health assessments to explore alternative housing in participants’ plans. This is not happening at ground level.
Solution 3: Provide more support to bring younger people from aged care into the NDIS faster
Bringing younger people in aged care into the NDIS faster will have long-term social and economic benefits because leaving aged care – or being diverted away from aged care – is associated with positive health outcomes and reduces the likelihood of institutionalisation.
We are pleased that the NDIA has established dedicated teams who are responsible for making contact with people aged under 65 in residential aged care to arrange face-to-face access requests, but the NDIA should report publicly on the effectiveness of this response.
Funding to explore alternative housing options should be brought forward. This would allow young people in aged care to begin preparations to leave aged care, so their first NDIS plan includes funding to leave aged care.
Solution 4: Allocate responsibility and accountability to the NDIA
Immediately make the NDIA responsible for authorising the use of aged care for all people under the age of 65.
Solution 5: Revise targets in the Young People in Residential Aged Care Action Plan
We welcome the government move in late 2019 to revise the targets in its Young People in Residential Aged Care Action Plan to:
- Stop all admissions of young people to aged care by 2022
- No young person living in aged care by 2025 – making allowance only for exceptional circumstances. Exceptional circumstances will be most applicable in very rural and remote regions where there is ongoing market failure and where it is culturally appropriate, and the person’s choice to live in aged care