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Moody's Message - Embracing systemic complexity

David Moody

15/05/2018

My colleague, Savannah Jewell, and I recently facilitated the NDS Wimmera South West CEO and Senior Management Network Meeting at the Horsham Golf Club. This meeting could have run for five days in order to get through all the stuff that’s happening in the sector at present. This ‘systemic complexity’ is itself a key challenge for disability service organisations (and their clients and support networks) trying to navigate their way through NDIS transition whilst keeping abreast of concurrent changes to State and Commonwealth legislation, regulations, guidance and policy.

So this month, I’ve decided to try and chunk the issues down to bite-size pieces to see if we can embrace this complexity. Wish me luck!

Pricing, consistency and interface issues are on the boil

The Disability Reform Council focuses on national consistency and ‘interface issues’.

At its first meeting this year, the Council, comprised of Disability Ministers from all Australian governments, considered issues as outlined in its Communique.

The Communique indicates, among other things, that we’re now seeing a dawning realisation from Australian governments that for the NDIS to work, we need consistency, if not uniformity, in the implementation of the NDIS (it is a national scheme after all). This must be coupled with a significant body of (urgent) work to smooth out the interface issues between the NDIS and mainstream services that NDS continues to receive concerns about from our members (I still say that the discussion about the NDIS/health interface at a member-only working group meeting last year was the angriest I had seen members about an NDIS issue!). Further, there needs to be targeted additional investment by the Victorian Government into other service systems which need to step up their supports for people with disability. 

Pricing: the Independent Pricing Review is not where the conversation ends

As I suspect all NDS members will be aware by now, the Independent Pricing Review commissioned by the NDIA and undertaken by McKinsey’s, made 25 recommendations about NDIS prices, all of which were accepted or accepted in principle by the Agency.

NDS continues to receive calls from Victorian members expressing serious concerns about the Review’s failure to recommend an increase in the base price for services and the implications this has and will have for day services and programs. We think these concerns are well-founded and continue to argue that pricing should be revised to reflect evidence-based adjustments in the Reasonable Costs Model that underpins prices; compensation for the additional (transitional) costs imposed on organisations by inefficient NDIA systems and processes; and increased variation in prices to reflect the impact of geography, complex support, transport costs and other factors.

Let’s be clear: some of the assumptions relied upon to establish 1 to 1 support prices are contestable at best (95 per cent client-facing time anyone?). It’s therefore not surprising that the NDIA has agreed to further detailed work and/or more consultation, as a matter of priority, about several of the recommendations made by the IPR, focused on high intensity and complex needs, and therapy services. These include:

6 - Defining complexity
7 - Price tier that accounts for complexity of supports 
9 - High intensity loading for centre-based activities
17 - Therapy price limits
18 - Therapy assistants (phase 2)

Victoria: The activism continues

So much for the national scene and its implications for Victorian providers. Martin Foley, the Minister for Housing, Disability and Ageing, is on the record saying he does not intend being the last Disability Minister in Victoria, and the Government’s activism on disability issues over the last few months or so would seem to bear this out.

In the past few weeks alone, we’ve seen the release of the Government’s Disability Abuse Prevention Strategy (including a mandatory Victorian Code of Conduct for all Victorian disability workers and the flagging of a worker registration and accreditation scheme; the introduction into the Victorian Parliament of the Long Service Benefits Portability Bill; announcements of new funding for disability in the 2018-19 Budget; and the release of a Social Procurement Framework to support the procurement of goods and services by the Government from social enterprises, including Disability Enterprises. 

These initiatives complement, in part, the Government’s ramped-up focus on implementing its Victorian NDIS Workforce Action Plan prior to the State Election on 24 November. And yes, NDS continues to be actively engaged in discussions around how to implement elements of the Plan. 

Time and space do not permit a detailed consideration of all of these issues in this article, so I’ll confine myself to making a few points, and invite you to check out the relevant NDS news updates which discuss them more fully.

Implementation of the Disability Abuse Prevention Strategy in Victoria precedes the sector’s transition to the National Quality and Safeguards Framework on 1 July 2019. The National Framework will have its own Worker Code of Conduct. In regard to the Victorian registration and accreditation, the Government will seek to legislate it in this session of Parliament, giving it nine weeks to get the job done. NDS will consider the legislation and consult our members about it once it is released. 

In regard to the Long Service Benefits Portability Bill, NDS continues to seek an exemption from the Bill for NDIS-funded disability service organisations. As things stand, if the Bill becomes law, it will result in organisations being liable to pay around 1.5 per cent of their wages bill at a time when NDIS prices are capped, and many providers have limited cash reserves.

NDS has already provided a positive review of the State Budget 2018-19. We now look to the Government to identify where funding for the Structural Adjustment Fund will be drawn from to support implementation of the Multi-Employer Agreement, which we are still pursuing through Jobs Australia and our trade union partners.

In regard to the Government’s Social Procurement Framework, NDS is hopeful that the Framework, coupled with its Economic Participation Plan, signals a new era for disability employment in this State, one in which disability enterprises and their workforce are regarded as key stakeholders in supporting all Victorians to be social and economically engaged in our community.

Meanwhile, over at DHHS, we’ve heard the announcement of a new Human Services Regulator and a new Community Services Quality and Safety Office. This office is intended to assist in the delivery of safe, effective connected services across the community services system, and to share innovation, best practice and support continuous improvement. 

NDS is keen to understand how the Regulator and Office will engage with disability service organisations so as not to encumber them with red tape and new regulatory burdens. At present, a Victorian disability service organisation could find itself interviewed and/or investigated by the OPA, CSVs the ODSC, the Mental Health Complaints Commissioner, Victoria Police, WorkSafe Victoria, and potentially, the Health Complaints Commissioner.

NDS supports a zero tolerance approach to disability abuse and neglect, and has done for many years now. But let’s make sure that regulatory oversight to address this issue is being done in a coordinated and non-duplicative fashion.

NDIS is a big, hairy audacious goal – and right now, it's complex.

When thinking about the NDIS and its implications, it’s important to recognise that most of our community still doesn’t appear to appreciate just how far-reaching the Scheme’s influence will likely be: on public policy, our perception of disability as a community, and how governments may fund and regulate disability and other community services in the future.

Victorian disability organisations able to keep abreast of new developments in the NDIS, to work their way through the current complexity we’re living with, and who are willing and able to contribute to the debates around the Scheme’s future direction and policy settings, have the capacity to influence the future shape of the NDIS, for the betterment of all of us.

See you next month!

Contact information
David Moody, State Manager, 03 8341 4312,