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The Tasmanian trial site
This chapter presents the committee's evidence from the Tasmanian trial
site. Again, the focus is on the achievements and the challenges of the
National Disability Insurance Scheme (NDIS) in the trial site in its first nine
months of operation.
The public hearings
The committee held public hearings in Hobart on 16 and 17 April 2014. On
16 April, it took evidence from 3 participants, a carer and 15 service
providers. On 17 April, the committee heard from Tasmanian Department of
Health and Human Services officials and Tasmanian-based National Disability
Insurance Agency (NDIA) officials.
On 16 April, the committee held an 'in-camera' session to take evidence
from an NDIS participant and from service providers in the Tasmanian trial.
The committee's public hearings in Hobart raised a number of issues
specific to the progress of the Tasmanian trial site. These include the
challenge of supporting people with disability in making the transition from
study to a work environment, and providing NDIS participants with services in
remote parts of the State.
Progress of the Tasmanian trial site
The first stage of the NDIS in Tasmania started on 1 July 2013 and will
provide support for people with significant and permanent disability between
the ages of 15 and 24. This is a critical life stage for young people with
disability, their families and carers. The Tasmanian trial will provide
valuable information about how best to support young people in the transition
from school to work or further training.
Table 3.1 presents the statistics of the Tasmanian trial site up until
31 March 2014. It shows that the bilateral agreement between the Commonwealth
and Tasmanian Governments planned for a total of 792 participants over 2013–14
in the trial site. Up to 31 March 2014, there had been 744 access requests, 685
participants had been accepted into the Scheme, and 585 participants had plans.
The committee notes that Tasmania is on track to meet its intake target under
the bilateral agreement.
In the first nine months of the Scheme, the Tasmanian trial site
recorded the most number of days of the four trial sites in terms of the
average length of time from the access request to plan approval. Notably, there
was not a single request for a review of a decision in Tasmania until 31 March
Table 3.1: Key statistics of the Tasmanian trial site (after 9 months)
Number of participants in bilateral agreement
Number of participants with plans, 31 March
Accepted as eligible
Average days from access request to plan approval
Average time from application to commencement of
Review of decisions
Participants accessing mainstream services (% of
Source: National Disability Insurance Agency, Quarterly
Report to COAG Disability Reform Council, 31 March 2014.
The committee observed a relatively smooth and well planned
implementation process for young people transitioning to the NDIS in the
Tasmanian trial site. The NDIA appears
on track to meet the targets in the bilateral agreement. The Tasmanian trial
site manager, Ms Sue Ham, told the committee that 'we will be phasing in
80 per cent of the around 1,000 young people that will be involved in the
trial in the first year'.
The committee was particularly impressed by the relationships that have
been forged between the NDIA and the non-government sector and the maturation
of non-government service providers.
Of particular note, with the exception of housing and respite services,
there are now no waiting lists for young people with a disability in Tasmania. The
issue of waiting lists for equipment is discussed later in the chapter.
One of the key challenges for the NDIS is to effectively manage complex
life transitions. The main transition in the 15-24 age cohort is the shift from
a school to a work environment. The Tasmanian trial site manager and her team
demonstrated to the committee a very good appreciation of this issue and are
Table 3.2: Phasing arrangements in the Tasmanian site
Category of participant
Date of transition
1 October 2013
1 January 2014
1 April 2014
1 June 2014
A person who is receiving, or on the needs register for, an individual
support package or a community access package
A student with a disability who has finished school in 2013
A person receiving formal out of home care provided by the Tasmanian
A person who is receiving community based mental
health services provided by the Tasmanian Government
Client of Australian Government Personal Helpers &
A student with a disability aged at least 15 and under 18;
A person who is receiving flexible respite assistance
A person who is receiving therapy funded through Tasmanian specialist
A person living in large residential care facilities; A person who is
receiving therapy funded through Tasmanian specialist disability services
A person living in large residential care facilities
A person who is receiving supported accommodation services and
doesn't live in a large residential care facility
Source: Fact Sheet: Entry
for existing clients of Australian and State Government funded disability
programs – Tasmania, http://www.ndis.gov.au/document/234
Phasing participants into the
Table 3.2 (above) shows the phasing schedule for participants in the
Tasmanian trial site for the first year of operation (2013–14). The gradual
intake has been designed to ensure that everyone who meets the access
requirements of the Scheme receives the appropriate level of supports. The
priorities for the first year have been young people with disability in the 15–24
year old age cohort with Individual Support Packages or Community Assistance
Packages, those transitioning from state care (formal out of home
arrangements), and 2013 school leavers.
Table 3.3 shows that all 58 Tasmanian respondents to the NDIA's survey
indicated that their experience of the planning process was either 'very good'
Table 3.3—Participant feedback
Overall, how would you rate you experience with the planning process
Source: National Disability
Insurance Agency, correspondence received 8 July 2014.
The committee was interested in the extent to which the Tasmanian trial
site's success to date can be attributed to geographic and demographic considerations
(the 'contained' nature of the trial site, the small population size and stable
community of clients who do not move as frequently). Ms Ham acknowledged that
although it was a contained space with fewer participants, the comprehensive
used to build strong relationships could be just as effectively employed by
She noted that close arrangements with peak bodies, such as the Mental Health
Council and National Disability Services, and regular conversations with
participants, families and providers had meant that key issues were dealt with
effectively through a number of channels.
The committee notes that the Tasmanian trial benefitted both from the
'contained' nature of the trial site as well as the engagement strategy. These
aspects facilitated strong relationships across a range of stakeholders. The
committee is of the view that this framework of engagement could be effective
in other jurisdictions.
The committee recognises that the Tasmanian trial has benefitted from
the availability of comprehensive data from the state government and the
Tasmanian gateway service about people with disabilities. In particular, having
access to participants' contact details enabled tailored consent processes and
early planning measures to be established prior to 1 July 2013.
The General Manager of Baptcare, Ms Marita Scott, stated that:
We have identified early indicators of unmet need which
include accommodation, respite and access to services in rural areas. Rural areas
require recognition of the cost implications of providing services across large
geographic regions with small participant numbers.
We view the Tasmanian approach as scalable and able to
respond to some of the issues experienced within the other launch sites. The
key element that underpins the Tasmanian success is the creation of a robust
partnership between government and the non-government sector.
Local Area Coordinators (LACs) in Tasmania operate in a different
structure than in the other trial sites. Ms Scott noted that she believed that
outsourcing of the LACs should be expanded into all jurisdictions and that
Baptcare would encourage the outsourcing of other key functions of the NDIS
such as assessment and planning.
Achievements of the Tasmanian trial site to date
As in the Barwon trial site, the committee heard various achievements that
had been made in the rollout of the Scheme in Tasmania over the previous nine
months. This section discusses the following achievements:
participants' positive feedback;
waiting lists reduced;
the pre-existing 'Gateway' model in Tasmania;
the interface with mainstream services and the School Transition
the NDIA's improving communications with service providers.
As in Barwon, the Tasmanian trial site manager commented that
participants had expressed strong satisfaction with the planning process and
Ninety-five per cent of participants who have completed the
surveys that have been undertaken by the agency have indicated their strong
satisfaction with the process in the planning conversations that they have had
with the agency and with the outcomes that they have had to date.
Chapter 6 notes some suggestions to improve the NDIA's surveys.
At the time of giving evidence, the NDIA reported they had received two
compliments and 12 complaints, but no requests for internal review.
The committee also received some very positive stories from participants
and their family members about the impact of the NDIS in the Tasmanian trial
site directly. Mr John Coyle, a father and full time carer of three children,
two of whom have severe intellectual disabilities, spoke of the challenges of
the previous block funded system:
...in accessing the block funding we always found ourselves at
the tail end. You are triaged and put on what was available, and you got what I
would deem the minimum. You were always filling in forms even though my
children are deemed permanently disabled from a congenital condition. We were
asked to fill in forms and confirm that every two years. That is with
Centrelink, that is with disabled services and that is with state government.
You tell your story over and over and over again. 
Mr Coyle explained that under the NDIS, his situation has now improved
With the advent of the NDIS we are given a lot more
individual control. We go armed with the funding; so, when we approach a
service provider, we are spoken to differently, we can tailor our situation and
my children's development can be targeted... That was non-existent before...
The NDIS is probably a godsend for us and I hope it
continues. This is not about holidays overseas or new cars; it is about the
basic quality of life, lifting it up to become a community member, accepted at a
basic level just to get out there and enjoy the sunshine. Now I have one-on-one
support for my daughter, I can be the carer for my son. We can go out as a
family unit and I do not have to constantly worry about traffic and people's
Mr Coyle had immense praise for his NDIA planner and a planning process
which facilitated the development of a flexible, 'living' document:
All in all, from inception to now, the NDIS has been nothing
but positive for us. It has been hard work. There has been a lot of negotiation
and there are some absolutely wonderful people behind it. I tell you what, my
planner at the NDIA was second to none—compassionate and caring, someone who
came to my home, sat down and got every detail. The result is a living document
and, for me, that is the beauty of it. It is a living document. We have already
fine-tuned it once and it is still an open book. So while that is happening, I
am a more relaxed person and I have a better and more positive outlook for my
Mr Coyle also told the committee of some of the changes which he is
seeing in his children as a result of having more choice and control in the
selection of providers:
That is a crucial key with my kids—being repetitive and
consistent. If you chop and change that, you go three steps forward and two
steps back. This is about a slow progressive development. When they employed
someone, they included me in the selection process. They let me read the
résumés and they thought about how the applicant was going to adapt to my
child's needs. We have never had that opportunity before. It puts so many
positives into my children's lives in that they are not second-guessing who is
coming the next day and how they are going to be treated.
Ms Ham also told the committee:
One compliment that I can recall was high praise for their
planner—the creativity and the approach that that planner took with a
participant and family. This planner is a very visual planner and so works in a
very visual way with those participants to draw out what the goals and
objectives are. So she went back to do the final plan presentation, and the
family still had the sticky notes up on the wall because they had such
confidence in that planning process.
Waiting lists reduced
The NDIA told the committee that with the exception of those seeking
housing and respite services, there are no waiting lists in the Tasmanian trial
However, the committee had heard that there can be long wait times for
equipment in Tasmania, particularly for prosthetics.
The committee asked the Tasmanian Government to comment on the
strategies that it has available to assist a participant if equipment cannot be
made available. The Tasmanian Department of Health and Human Services (DHHS)
The former State Government committed an investment of $1
million per annum over four years to reform the current service provision and
to provide additional funding for equipment and assistive technology...
The program is expected to be fully operational by December
2014. In the interim, any waiting lists are currently being managed with high
priority clients being targeted for funding.
Mrs Ganley of DHHS told the committee that there may be waiting lists in
terms of NDIS participants accessing equipment. As she explained:
Our equipment program is run through the health side of our
business, so it is sitting outside the trial.
The access to a package would assist with purchasing
equipment, but if there is a waiting list to get that piece of equipment to the
state, then that would apply.
The pre-existing 'Gateway' model
A significant factor contributing to the success of the Tasmanian trial
site has been the State's 'Gateway' model, which has been in operation since
July 2009. The Gateway model is unique to Tasmania. It is a centralised intake
point for people with a disability providing an entry point for the intake,
referral and allocation of disability care packages.
Under this model, the delivery of disability services is a collaborative effort
between the Tasmanian government, Mission Australia and Baptcare.
Baptcare and Mission Australia work with mainstream and specialist disability
support organisations providing services to more than 6,500 Tasmanians with
Previously, these services were run by the State Government. The committee was
told that the current arrangement will continue for another three years.
The information from the Gateway has assisted to expedite the process of
moving eligible people with disability in Tasmania into the NDIS planning
process. Ms Scott told the committee that outsourcing
Local Area Coordinator (LAC) functions to the community sector has led to
positive outcomes for participants. She elaborated:
The LACs have been involved in the development and
implementation of high-quality plans, they participate in handover and ensure
that accurate information is available during the planning process.
The LACs work with the participant providers and planners to
implement a plan that is responsive to their individual needs. We note that
participants are often anxious about current and future needs, and our role is
to reassure participants that the planning process will accurately respond to
their needs and that over time different supports are built in as required.
We see considerable value to LACs being embedded in the
community as they act as the bridge between the agency and the sector. On the
occasion that a plan requires adjustment, the local area coordinator supports
the participant to advocate for these changes. LACs are able to be the conduit
to assist a conversation between participants, service providers, the agency,
and to rapidly amend plans to ensure they meet the clients' needs and reduce
any potential perceptions of conflict of interest. LACs work with the service
providers to be flexible and creative in their response to individual
Experience over the trial period has been that LACs provide a
seamless client pathway. The community development aspect of the LACs role
assists service providers and mainstream agencies to include people with
We have received feedback from the sector of high
satisfaction with the roles and function of the LACs.
Interface with mainstream services
The NDIA's Third Quarterly Report shows that 76 per cent of
Tasmanian participants with plans are accessing mainstream services (447
participants of 585 people with plans).
The NDIA in Tasmania reported some success in establishing an interface with
mainstream services by establishing early, strong working relationships with
mainstream partners, particularly education providers. The trial site is
currently piloting the School Transition Project which looks at improving the
pathway for young people from school into employment through an integrated
This model is also being replicated with mental health and employment services,
although the committee was not provided with specific details. The committee is
encouraged by this approach and emphasised the importance of continuing to
ensure that all parties maintain a concerted effort to resolve the challenges
posed by complex interface arrangements.
The School Transition Project
The School Transition Project was developed to integrate planning for
students with disability in years 11 and 12 through a series of meetings. It
brings together a number of key stakeholders including the NDIA, Disability
Employment Services, the Department of Human Services, Australian Disability
Enterprises (ADEs), the school and the student. This model looks to streamline
an otherwise complex transition process which potentially involves up to four
different plans: one with the NDIA; another with the school; one with a
disability employment service provider; and a fourth related to the receipt of
the Disability Support Pension (DSP). The NDIA's primary function in this project is to:
...ensure that relevant personal supports are in place. A
student’s Individual Education Plan is updated by school staff to reflect their
integrated goals. A final school/NDIA planning session is held in term 3 of
year 12 to ensure that all efforts are aligned in preparation for a student to
transition from school. A representative of the chosen post-school activity
(e.g. TasTAFE, DES (open employment) or ADE (supported employment) may also be
present if appropriate.
The committee asked the NDIA for examples of how the School Transition
Project for people with disability in Tasmania is working and how many people
have successfully made this transition, compared to the previous capped system.
Ms Ham told the committee that 130 young people are now getting these services
under the NDIS.
Through close collaboration and a Project Advisory Group that includes key
stakeholders, the approach to developing these separate plans is reported to be
On notice, the NDIA listed the following achievements of the School Transition
Project to date:
the establishment of a Project Advisory Group;
the development of a Best Practice Guide endorsed by key
stakeholders, incorporating the Integrated Planning Model;
an engagement strategy developed and commenced with State and
Catholic Education Colleges and High Schools: “Informing Aspirations” Forums
scheduled for the week of 10 June 2014 to:
develop a clear implementation plan and working arrangements for
State-wide roll-out in term 3 of 2014; and
establish roles and responsibilities state-wide; and
commencement of negotiations with Department of Social Services
(DSS) to gain limited access to ESS for NDIS staff.
Communication with service
Service providers in the Tasmanian site noted the evolutionary nature of
the planning process, and were optimistic that recent measures would improve
the planning process. In particular, providers welcomed the apparent shift in
the NDIA's attitude to consulting with them about the planning process:
...there has been a fairly significant shift from not talking
to providers and not seeking the appropriate information to actually now coming
and talking to us, because the tos and fros between the agency and service
providers—of which the family are the tennis ball in the middle—were pretty
complex with up to as many as four or five iterations. That is not anyone's
fault. We are learning as we go; and, through that process, sometimes clients
who are not able to advocate well for themselves or their families who do not
fully understand the service suite or do not have the language of the sector
come back with a plan that is not sufficient to meet their needs. A lot of our
clients and their families are disadvantaged. They are not working. They have
poor literacy. There are a number of compounding factors that make that journey
a lot more difficult for those families under the arrangement as it is. It is
improving, but there has been a process of learning and getting that right.
Challenges for the Tasmanian trial site to date
As with the Barwon trial site, there are several challenges facing the
Tasmanian trial, many of which relate to the capacity of the market to deliver
services. This section discusses the following challenges:
the planning and assessment process;
the role of advocacy;
the flexibility and self-management of plans;
the enactment of plans;
providers' transition to a fee-for-service model;
gaps in service provision, particularly respite services;
achieving greater economic participation for participants;
training and qualifications for disability support workers;
service providers and travel costs;
the interface with mainstream services; and
accommodation and housing.
The planning and assessment process
Notwithstanding the positive accounts discussed earlier, further work is
still required in Tasmania around the planning and assessment process. Ms Ham
acknowledged that one of the shortcomings of the planning and assessment
processes, in the early stages at least, was the absence of a proper method or
adequate data to identify all the existing supports for people transitioning into
the Scheme. Amendments to the plan were frequently required as a result.
At times this occurred when participants and their families did not know which
of the supports they were receiving were funded. To address the issue, the NDIA
has been working with the state implementation team to obtain more information
about the funded supports each individual is currently receiving through the
The NDIA also reported it has been trialling pre-planning workshops in
Tasmania, drawing on the successes of these workshops in Barwon and South
Australia. In these launch sites, these workshops had a positive impact on
preparing participants for the planning process. It is hoped that these
workshops will assist participants better prepare for the planning conversation
by encouraging them to look at their goals and aspirations and receiving
Ms Ham told the committee that as part of the trial site team's engagement
strategy over the next three years, the intent is to have a more structured
approach to receiving ongoing feedback. She explained that as part of this
approach, the NDIA will continue to support its staff through training and
development that embeds the culture and values of the agency as a learning
The committee did hear from a service provider that NDIA planners were
under some workload pressures, which had meant less access to the planner for
the service provider. Ms Louise Sullivan from Able Australia told the committee
that while planners are 'really hard working', her preferred option of working
with the planner was not always possible. Instead:
...we have to work with a case manager. One of the reasons we
have been told is, 'We're too busy now because it was trickling in and now
there's a tsunami of clients, so we can't talk to you,' so we have to go
through a case manager.
The role of advocates
The committee heard in Hobart of the need for better advocacy and
support through the planning stage and in the process of self-management. Mr
Coyle told the committee that while his experience was overwhelmingly positive,
there is generally a lack of advocacy and information about the supports that
What is needed is someone who understands the system to sit
down with people and actually explain to them what is available and how it is
going to work.
I was fortunate I had a wonderful planner and a lot of people
I spoke to said the planners who worked with the NDIA were just wonderful. But
some people cannot convey their message, they cannot get across what their
needs are, so I think there is a need for advocacy and a keener assessment of
what support is out there to tailor for these people. What I struggled to find
was the information that was available about what was provided by service
providers, how many of them there were, how they were funded and who has access
to them. That is quite confusing.
The local area coordinator should have all that information
about everyone that is available, about who was providing what in Tasmania.
Mr Coyle told the committee of the need for independent, trusted and
well-founded advice for participants about the nature of services provided by
all organisations, not just those in the mainstream.
To this end, he recommended the development of a handbook.
The Chief Executive Officer of Guide Dogs Australia, Mr Daniel English,
suggested drawing on the existing model used by the Department of Veterans'
Affairs of a 'trusted intermediary' for an automatic assessment of the suite of
services available to them prior to the planning conversation.
The flexibility and self-management
The committee also received evidence in Hobart on the level of
flexibility associated with the self-management option, and the assistance
offered to those who choose this option. The experiences of those who have
chosen this option have varied.
Mr Coyle expressed satisfaction at the level of flexibility he has had
as a self-manager of his children's plans. In contrast to the experience of
some witnesses at the hearing in Geelong, Mr Coyle was informed that any need
to change times or dates of a pre-arranged activity could be achieved by
approaching the service provider directly (instead of the planner). Although he
was also aware that he could employ someone himself if he wished to, this
raised other challenges around the legislative frameworks in place at a state
level that did not necessarily support this from happening in practice:
I have spoken to a few parents who have said, 'We are
thinking about employing someone ourselves and creating a contract and doing
all that sort of stuff', but they would then have to look at what the business
overheads are, with workers compensation, public liability and all those things
that come into it. That is why I opted for established businesses.
The committee was pleased to see that the NDIA is working toward
improving the process for self-managing with participants and
The enactment of plans
Tasmanian service providers reported incidences of participants not
enacting their plans for substantial periods of time. Participants did not
always seem to understand the process for activating their plan. Ms Linda
Glover told the committee:
So there was that step: 'I've got my plan; how do I enact
it?' That plan is a couple of months old and not much seems to have happened
from the perspective of the individual.
Mr Symonds agreed:
That is an experience that we had. We have had a number of
people rolling through our door: 'What do I do with this?' I can back up what
Linda [Glover] said.
The NDIA has identified plan implementation as a challenge for
participants and their families, service providers and the Agency itself in its
six month review with the Tasmanian Gateway.
Ms Ham noted that Local Area Coordinators can play a greater role in explaining
the requirements for plan implementation.
The committee is concerned about the number of NDIS plans that appear
not to have been activated and recommends that independent work be undertaken
to establish the veracity of the evidence that plans have not been activated
and what the causes and consequences this may have on the Scheme.
As in the Barwon trial site, in Tasmania, the committee heard of the
challenges that face service providers in their transition from a block funding
to a fee-for-service model. While there are common challenges of access to
capital and timely payment for services, other issues are specific to
OAK Tasmania offers both lifestyle and training and employment services
for Tasmanians with disabilities. Its Chief Executive Officer, Mr John Paton,
told the committee:
I think the issue for us in Tasmania is that, as a day
service provider, we get—on 1 July—40 per cent of that annual grant, which
actually sustains the organisation through a whole range of ups and downs
throughout the year. What is going to happen in the NDIS world is that you will
get it on payment of invoices. So the ability to have a cash injection at a
particular critical period in time is certainly not going to be there. The
viability of a whole range of providers in Tasmania, and probably around
Australia, is going to be called into question, particularly issues to do with
a whole range of things, like the SACS [Social and Community Services] award
issues that are happening now. The impact on service providers is absolutely
monumental at a time when there are so many critical issues happening in the
sector. In a way, the NDIS could not have happened at a worse time from the
prospect that there are so many other things happening. It obviously has to
happen. Service providers need to now get their act into gear and come up with
viability issues. We can talk about mergers, alliances and whatever needs to
happen, but the lack of choice that is potentially out there for people with
disabilities is a bit of an issue too.
Mr Ralph Doedens of STAR (Supported Tenancy Accommodation and Respite)
Tasmania also highlighted the challenge of both the quantum and the timing of
payments under a fee-for-service model. He told the committee:
One of the big challenges with NDIS is the rates that they
have established based on the block-funded amounts that were given. The
block-funded amounts given were just enough, but the good thing about block
funding is that it covers all the beds you have and all the houses you support,
regardless of whether somebody actually vacates it or you have a vacancy for
three months, and you are paid up-front. So we are getting interest on the
money we are given, we are guaranteed money for the beds we provide and we
obviously try to fill them, but they are not always full. Under NDIS, they will
not be all full, there will be more vacancies and you will get paid in arrears.
So the rates have to be looked at and they have to take into account those two
things. If they do not, most of our service provision will go broke. We are
supporting around 20 NDIA clients at the moment, and I can tell you that we are
losing money on the whole lot. It is just not covering it.
Mr Doedens also noted that substantial work needs to be done to market
the organisation, to have in place record keeping system for regular billing of
clients and to ensure that staff are recording this information. He also noted
the importance of having staff that recognised that they are now part of a
business and that work needs to be undertaken with the business model in mind.
One option raised by some service providers in Tasmania to adapt to the
fee-for-service model was to share resources and service arrangements. Ms Tracy
Mackey, the Executive Director of Life Without Barriers, told the committee:
The other thing that is really clear to us is that as a
sector we need to start thinking about shared service arrangements. We cannot
continue to think that we can all afford to invest in the IT that is required.
We know that even as a really large provider we are moving quite quickly in
terms of some of the quite sophisticated technology that is needed to allow
clients to opt in and manage themselves, but it is very costly. So we are
working with other larger providers, one in particular that is across four
states, to try and develop that technology and then make it available as a
shared services platform.
...[W]e see that you can work together in alliances and
partnerships and not necessarily take away what makes up the particular
organisations that are already there. It is quite a mature conversation that
the sector needs to have. There is not support for that mature conversation at
the moment because everyone is focused on the how-to, rather than on what is
the future we imagine as a sector.
The committee does foresee benefits to the disability services
sector—particularly in a small state such as Tasmania—from collaborative
arrangements that share resources and rosters between service providers. It may
be that effective delivery of services and supports to participants in regional
areas of the State will come to rely on these arrangements.
Mr Dale Eastley of the Multiple Sclerosis Society of Tasmania told the
committee that his organisation was 'probably in a better position than most'
given it had relied on government funding for only 23 per cent of its
operations. However, he noted that there are 'some real risks' in terms of
We started to make changes in terms of where we have done the
traditional fundraising side of things, but we do expect that there will be a
drop. The fundamental thing for us is to recognise that this is a new start and
that we must start from the fundamental premise that this is for the clients.
What are the services that we want to be able to provide and who might be
attracted to us as an organisation as a quality provider?
For the board to get around that, I basically went to them
and said that we have got two choices: either we close the shop or we get on
with it. They signed off on the latter, and it was reiterated at the weekend:
we want to make that fundamental change. For us to do that, we will have to
substantially retrain two-thirds of our staff because they have never worked in
a commercial environment. Our clients have never had to pay for the services
they have received. So we are going to have a cultural change, with us saying,
'Yes, you've got a care plan and we'll help you through that process, but
you're going to have to pay for the specialist advice that you receive from our
Mr Daniel English of Guide Dogs Australia feared that the
fee-for-service model will encourage for-profits to grasp commercial
opportunities and thereby pose a threat to the financial viability of
not-for-profit service providers in Tasmania. As he told the committee:
There are going to be for-profits that will move in, and they
will cherry-pick. They will take the services that are the cheapest to provide
and yield the highest returns, because they have a requirement to build a
profit for their shareholders. There are organisations in this space that do
not have access to capital, that do not have access to the resources, that
cannot run at a loss for 12 months or two years, but these for-profits can
actually run a loss leader, price us out of the market, and yet long term the
benefits for participants will be significantly less. This is why we are
looking at a process where we have got to make sure that organisations have
The organisational structure of Riding for the Disabled has led to some
uncertainty as to how it should register with the NDIS and structure its
financial arrangements under a fee-for-service model. Ms Cathy Bantick from the
organisation's Tasmanian State branch told the committee:
We are a voluntary organisation. We have no paid employees.
We are currently not a member of the NDIS. We would like to become one but we
are uncertain of the procedure and protocols for doing so, because we are a
state body with centres running under us. They are all voluntary, but we
provide equestrian activities to people with disabilities. With the NDIS
packages coming up, and I understand that the plans will be made to suit that
individual, we are not certain as to whether we should be a member of the NDIS
or whether both the state and centres should register. We do not get any
payment for those clients who go horse riding or carriage driving or vaulting.
The centres actually get it. Currently, the participants pay the centre.
We have a national body—state is a member of the national
body—then we have centres under state, which are members of the state body.
State gets funding through DHHS, currently, and the centres do not get funding
other than grants—or their local councils or whatever—but they charge the
clients to access their programs.
The committee suggested that Riding for the Disabled discuss its
arrangements with the NDIA. At the time of writing, the organisation had not
had any further discussions with the NDIA about funding arrangements.
It would seem logical that registering the state body as a registered service
provider for the NDIS would enable the state body to invoice the NDIA for rides
for participants whose plans the Agency manages, while participants who
self-manage would pay the centre directly. Riding for the Disabled is unsure as
to whether, and if so when, its grant funding from the Tasmanian Government
The committee understands that the state and territory governments are
currently participating in workshops to clarify Tier 2 arrangements.
Market information for service
In theory, markets work effectively where information is transparent and
known by all competitors. However, as economists recognise, there is often
information asymmetry, where one party has more or better information than the
In the case of the NDIS, the NDIA does—and should—hold important
information about the number and the composition of packages and where
participants and service providers are located. There is a question, however,
as to whether service providers should be privy to this information to enable
them to plan and make decisions, or whether disclosing this information may
risk giving a competitive advantage to particular providers.
These issues have not been pursued by the committee in any detail to
date, but they were hinted at in evidence from some service providers in
Tasmania. Mr Scott Harvey from the recreation service provider COSMOS told the
committee that one of his organisation's concerns was to identify the quantum
and the nature of the demand from the NDIS for his service. In his view, there
was a lack of information on these matters which was affecting business
The issue for us at COSMOS now is looking at our sustainability.
There is uncertainty around where we are going as far as the number of clients
we are going to get coming through the NDIS. We fully understand the
contestability and that sort of thing and we agree with that. Our problem is
that on the other side of that we are not getting much information about what
services are being required. So while we are doing our current services it is
very hard for us to project into the future and say what we will look like as
an organisation, because under the current funding that NDIA is providing for
our cohort, we would need to do something different or something more. That is
going to be our major issue.
I think the difficulty we are having as an organisation is
working out what the market is and where we can go. I think the details of what
types of packages have been given, what the specifics are of what people have
been funded to do, is important for us to look forward as far as deciding where
as an organisation we are going to position ourselves.
Mr Glenn Campbell, the Chief Executive Officer of Optia, also identified
this as a problem for his business:
We are largely an accommodation and respite support provider.
When you project that lack of information long term, we have respite clients
who are coming through NDIS and we need to be able to make provision for that
respite care, and we need reasonable lead times to be able to make those
capital investments. Notwithstanding the sustainability issue and the fact that
probably most organisations do not have the balance sheet to be able to develop
facilities, even if you are able to get access to capital to be able to do the
development, there is a long lead time with that sort of work—whether it be
around group homes or respite provision. Even beyond the current lack of
understanding of the clients that are coming through, that longer-term ability
to project where they are going to be is really critical information for us.
The committee did hear some positive stories from Tasmanian service
providers about their planning for a fee-for-service model. Optia's Chief
Executive Officer, Mr Glenn Campbell, noted that his organisation was making a
number of changes to prepare:
One of the peculiar issues here is that we are not able to
build any sort of funding reserves. We are doing a lot of the work, and we can
talk about some of the preparation work that we are doing. We are doing a lot
of work around the way we roster staff and moving to flexible industrial
awards, and we are doing a lot of work around our branding, our marketing and
rebuilding our structures. We are doing all of that work and the heavy lifting
so that in 2½ years we are able to make the transition to a market based
environment and will be ready for it.
The issue in Tasmania is that, once we have done the heavy
lifting and we are able to build surpluses in sufficient to be able to sustain
us for the shift in cash flow, we have to give them back. We have to give back
the savings under the funding. That constraints you because, if you make a
loss, then you wear your loss; if you make a profit, which is to build reserves
for the future, you have to give it back. So you are never able to get there.
One of the things for us is a real need for change in the contracting
environment with the state government. That is a particular issue.
Gaps in services
An obvious concern in a small market such as Tasmania is whether there
will be an adequate supply of services and service providers to satisfy demand
in a system based on individualised supports through a fee-for-service model.
The advent of the NDIS trial has attracted more service providers to the State.
As Ms Ham told the committee:
We do have an increased number of providers that have now
registered to deliver funded supports. I think when we started there were
around 45 specialist services in the state. We now have around 130 registered
providers, ranging from sole traders to the specialist disability sector to
mainstream organisations that are starting to register to think about what they
can offer to participants, and also the private sector.
On notice, the NDIA added :
Sixteen providers are mainland-based while the rest are all
local organisations. All organisations that provide only disability-specific
services have registered, and over the past few months many of those
organisations have increased the range of services that they are registered to
provide. The NDIA has also seen an increase of registered providers from the
non-disability-specific ‘mainstream’ service sector – for example, taxi
companies (to enable invoicing to the NDIA for participants) and the
not-for-profit sector. Disability organisations have increased the services
they were initially registered for, thereby suggesting an expansion of service
delivery. New providers are coming into the sector, either as sole providers or
new not-for-profit organisations, established specifically to meet the needs of
The NDIA told the committee that one of the problems compounding the
challenge of plan implementation in Tasmania has been the lack of services
available, particularly in transport, housing and informal supports such as
The committee highlights that the issue of adequate funding and support for
respite services has been a serious issue for people with disability for a long
Mr Glen Cockerell, a parent of an NDIS participant in Tasmania, told the
committee that the shortfall and irregularity of staff meant that continuity of
respite was a problem for his son. He noted the importance of having the same
carers for his son's development.
Ms Ham told the committee that the NDIA would be talking with providers about
how to address the inadequacy of respite service, particularly in regional
areas of the State.
The committee is encouraged that the NDIA in Tasmania appears to have a
systematic approach to identifying and responding to service gaps.
Mrs Jenny Edwards, the NDIA's Director of Service Delivery in the State,
told the committee:
What we are doing as a matter of routine is
making sure that, where there are gaps in services, and where people cannot
enact components of their plan because of that, we capture that, and that that
becomes a piece of work for our LACs in conjunction with the engagement team to
address. I come from the deep north-west, where there are fewer services than
elsewhere. So we are making sure that we collect that information and do
something with it.
The committee notes that the problem of gaps in service provision is not
unique to Tasmania. Chapter 4 on the Hunter trial also identifies some
shortfall in service provision.
The committee heard evidence that 'gaps in service' have been identified
in each of the trial sites. The committee recommends that further work be
undertaken by the Independent Advisory Council which is well-placed to identify
and inform the Agency about where there are gaps in service and possible
options for addressing these shortfalls.
Achieving greater economic
participation for participants
A critical factor in the success of the Tasmanian trial—and indeed the
Scheme generally—will be the capacity of providers to support participants to
gain and maintain employment. The committee acknowledges that there are some
complex challenges in this area, such as the link between NDIS funding on the
one hand and an employer's obligations on the other. Ms Donna Bain of the
Tasmanian Association of Disability Employment Services told the committee:
There may well be a situation that arises in the future with
a participant employee where, for whatever reasons, their funding support
changes. Their employment with me remains unchanged—I still have an obligation
as an employer under fair work legislation and all the other bits and pieces to
continue to employ them—but there may well be some viability issues that arise
if that funding package decreases substantially or disappears and that
employment obligation still exists. So probably over the next few years we need
to tease out some of those issues about how we might work those arrangements so
that we do not disadvantage people with a disability; so that they can continue
to work for as long as they want to and do a variety of things but understand
that the employment context in which that occurs in supported employment is a
little bit different to the relationship they have with a community service
provider or their accommodation provider.
Ms Bain emphasised that the NDIS is not the panacea to all the barriers
faced by people with a disability in achieving economic participation.
She told the committee that broader cultural issues also need attention, one of
which is the attitude of corporate Australia:
There are a whole series of cultural issues that we need to
change in Australia. Until businesses catch up, I will continue to have a job,
but there are other ways for the commercial world to be involved. For example,
we are constantly working with customers about providing labour force
teams—that is, taking a team of my employees out to their workplace, working
alongside their workers to do all sorts of bits and pieces, whether that is
packing timber, catering, washing cars, all sorts of things. That is part of
the way of engaging my supported workplace in their business: they are my
employee, but they are in their business. That starts to dismantle some of the
The other thing is about encouraging corporations to procure
from ADEs. For example, we have developed a wonderful relationship with a
Melbourne based company. They came to us and said: 'We would like you to cut
parquetry flooring. We will buy you the parquetry cutting machine, we will install
it at our expense, we will write the safe work method statements that go with
that, we will put in all the ducting and wiring and then we will provide you
with the parquetry flooring to cut.' They have worked out that we are really
good at providing supported employment; we know what we are doing. It does not
make sense for them as a business to try and do that in their enterprise. What
they want to do is build our capacity in our enterprise so that we can do that
and employ more people.
Mr Peter Symonds, General Manager of the Ability Tasmania Group, told
the committee that the introduction of the NDIS threatened the viability of
successful State-funded programs to transition people with disability into
work. He explained:
The rollout of the NDIS in Tasmania has created a significant
barrier for people with disabilities, who may need extra time and real
experiences to learn about real work...The COAG Reform Council showed that in the
period 2005 to 2010 there was an 18 per cent increase in the number of people
going into non-work segregated day programs. The research shows that for people
with cognitive impairments a longer transition period post school needs to
occur, as the maturation process is slower. We know that people with cognitive
impairments need real work experiences to understand what work is like in a
particular setting and how it is done. We know this not only through the study
of the successful programs overseas but from what we have done here in
Tasmania. We self-funded a program with TasTAFE in 2013, assisting 12 school
leavers in their transition to work process. Seventy-five per cent of those 12
found work two months within leaving school. The national average for people
with disabilities finding work in the employment program is 30 per cent.
Sixty-six per cent of those people will go on to hold their job for 26 weeks or
longer. The national average is 28 per cent, and here in Tasmania it is only 25
per cent. Pre-NDIS such a work experience program which produced these outcomes
was funded by the Tasmanian supporting individuals pathways program. That no
longer exists because it was taken over by the NDIS at the end of 2013.
Mr Symonds told the committee that if a person is deemed to have a work
capacity of eight hours-plus in their job capacity assessment, he is she is ineligible
to have work preparation or work in their NDIS plan, or funded through their
So...what needs to happen...is that the NDIS needs to allow work
preparation to be included in the plans of any NDIS participant who wants that
work component in there. Otherwise, we condemn or re-condemn a number of young
Australians with a disability into the segregated and disadvantaged lifestyle
that they currently experience.
The committee sought clarification on this point from the NDIA. The NDIA
noted that work and work preparation can be included in a participant's plan.
In developing a plan with a participant, all planners are
mindful of the need to address likely employment options with participants, if
this is at all feasible – from working in Australian Disability Enterprises
through to full time employment.
Some programs are available through mainstream services such
as private training colleges, TAFE or University and some are provided by
disability specific providers such as Australian Disability Enterprises and
Disability Employment Services. NDIA will directly assist or fund the means of
accessing mainstream services and will link the participant with disability
Examples of initiatives by NDIA are: funding a place in an
Australian Disability Enterprise to enable a participant to obtain specific
work skills following which he will be linked to a Disability Employment
Service to find appropriate employment; a contract with TAFE Tasmania to cost
effectively provide necessary personal care and other assistance for school
leaver students with disability commencing at TAFE colleges in 2014; a mother
who was able to return to the workforce because assistance was made available
for her child who had a severe disability.
As people transition to the NDIS, the committee is cognisant of the need
to assist people develop the necessary skillsets to enable them to successfully
move into the workplace environment and participate in the workforce, where
possible. The committee recommends that work be conducted through the relevant
Commonwealth departments of education and employment to assess what is and can
be done to help participants make these choices. The committee also recommends
working with employers to appraise issues concerning disability discrimination
in the workplace, and remove barriers through education and reform to better
integrate NDIS supports.
Training and qualifications for
disability support workers
The committee heard of the impediments facing disability support workers
in accessing appropriate and affordable training to continue providing a
quality service to their clients. Mr John Ferguson, a disability support worker
with Able Australia, noted that being able to receive direct support for
studying a Certificate IV would suit his needs better than the current system
of being funded through his employer. As he told the committee:
Able Australia have to get funding to put staff through it.
Then you attend the class once a month, through them, and it takes 18 months.
You have got to sign a contract to do that—to commit for the full 18 months
with one organisation. Personally I would find it more beneficial to do it
through correspondence or attending part-time study at night and doing it
individually. But, to do that myself, from what I have looked at, the courses
are between $3,000 and $5,000 if you go through an organisation in Tasmania
that is not polytechnic. As a support worker, the way it affects me, I know
another state like Victoria they fund courses like that for the disability
industry. So you can do the course and there is funding for it through the
private training organisation. Would there be any implementation for that in
Tasmania—so you can do it individually and you do not have to go through your
organisation and go through the processes of that?
Mr Nathan Balcombe of Anglicare noted that the lack of staff
qualification is a 'big issue', particularly given the requirement of a
Certificate IV for higher needs support positions.
The committee makes a recommendation on the need to develop a workforce
capacity building strategy in chapter six (recommendation 14).
At the Hobart hearing on 17 April 2014, the committee asked the NDIA
whether it will take into account the time it takes a carer to drive to the
participant's location and back, and to complete their paperwork, as part of
the Agency's unit pricing. Ms Ham explained the rationale for the development
of unit pricing as follows:
The prices that have largely been used in Tasmania are based
on the unit pricing that the Tasmanian government developed when they
outsourced all of the disability services to the non-government sector. As I
understand it, that unit pricing took account of back office administration
into that hourly rate.
The NDIA's responses to the committee's questions in Tasmania on how it
deals with transport costs reflect inconsistency and a lack of clarity.
At the public hearing, the NDIA suggested that if an hour is allocated, then
this is interpreted by the NDIA as time to be spent with the participant.
It had built up to ten kilometres of travel costs into the unit price of the
service being provided, but beyond this, providers were only eligible for
mileage based on the Australian Taxation Office rates.
Unless 'part of the service is to collect that participant and take them
somewhere in the car',
the NDIA indicated that providers were not otherwise compensated for travel
time beyond the ten kilometres.
Again, this was based on the 'understanding [that] the unit price that was
established by the state government also took account of the fact that a
support worker may have to travel to deliver that hour of service...'.
On notice, however, the NDIA provided the following response:
Providers are reimbursed for travel beyond a 10km round trip at
their usual hourly rate (emphasis added). A calculator is available
on the National Disability Insurance Scheme website to enable Agency planners,
participants and providers to calculate these amounts.
This pricing arrangement was developed to encourage efficient
rostering by providers.
It is an aspect of the current pricing review being conducted
by National Disability Insurance Agency in conjunction with National Disability
The issue of transport costs is raised in later chapters of this report.
The committee flags here that it is an area that the NDIA needs to address the
conflicting advice and interpretation provided both to the committee and the
sector as a matter of urgency.
Accommodation and housing
Housing has long been a significant issue all across Australia (i.e.
this issue has not emerged with the launch of the NDIS). The NDIS presents an
opportunity to address the issue of housing for people with disability. This
will require discussion by participating governments through Council of
Australian Government (COAG) about appropriate strategies for developing
mainstream services to ensure an adequate supply of appropriate housing as the
NDIS rolls out across the country.
Parents of participants voiced significant concerns they held about the
lack of availability of long term supported accommodation options:
My next step now is to aim for fully-supported accommodation
for them. I am no spring chicken—I am 60 this year—and I have to project where
my children go from here and I am hoping that the NDIS will be able to provide
that. I am not demanding it or expecting it, but I am hoping. The
infrastructure in Tasmania for fully-supported accommodation seems to be
lacking. The next focus for me is to try to have built accommodation—whether it
be state or federally supported accommodation—with real estate that will allow
fully-supported accommodation to be long term and not short-term rentals with
support provided to them, an actual residence that is long term and permanent
and theirs to live in and resourced accordingly.
Mr Glen Cockerell, the father of a 23 year old man with autism, told the
committee that he had commenced discussion with his NDIA planner to try and
find long term supported accommodation. He recognised that while it is 'a slow
process', '[I]t will happen eventually, hopefully'.
In response, the Committee Chair emphasised the need for more work on
housing options through close collaboration between the NDIA, the Commonwealth
and State Governments:
We on the committee all recognise, and the whole sector does,
that that is a really big problem. We do not have the answers for that yet, but
we have to work towards those answers. The NDIA has done some work, which they
will release shortly. There are regulations around how you can build houses
that allow more than two families to live in them, and there are all sorts of
things which are different in Victoria to Queensland to New South Wales and to
Tasmania. That is why we say this has to be a holistic approach. It is at every
level. If we are going to come up with supported accommodation options beyond
what has always been there, we will need people to work together and perhaps
change some of the things that are way beyond disability. They are about
building codes and things like that which might work. That is the level of
detail that people are going into, Glen, so that people like your son can have
options in the years to come.
The Director of Disability and Community Services at the Tasmanian
Department of Health and Human Services, Ms Ingrid Ganley, outlined for the
committee some of the accommodation projects that the state government is
We have a project on the go at the moment which is called
Trinity Hill, which is a mixed accommodation model for young people, and we are
building 18 units for people with disability as part of that overall complex.
It is actually inner city, co-located near educational facilities, with the aim
to bring that in, and we are targeting that at our NDIS participants. That
should come on line. It is being conceptualised at the moment. It will take a
while to get built.
We also have a model that is being built in the Kingston area
from some SAF funding—that is the supported accommodation fund. A group of
families got some funding, and they are building a unit complex with a house.
Part of that facility is being targeted for this cohort group when that gets
In addition, Ms Ganley mentioned that she was aware of other work
currently underway at a national level through the NDIA on accommodation more
We are aware that the agency is working on a paper around
housing and housing options, and the state government housing sector has met
with the agency to discuss that. There has been a housing conference that both
Housing and the community sector were at. I think it is happening more at a
line agency and agency level at the moment about: what are the options? I think
the will is there; it is just really: how can we look at the capital investment
and get the buy in for the funding?
Mr Noel Mundy, the State Director of Mission Australia, Tasmania, added:
It is absolutely a major issue, but also the state government
started—12 months ago, Mission Australia took over 500 properties as part
of Better Housing Futures, which is a rollout of the tenancy management, and
then in March they announced another three organisations in other various
regions of the state, so there are about 4½ thousand properties in total.
Certainly I know from our organisation and from discussing with the other
housing providers as well that, as part of rejuvenating those local
communities, we will be building new properties, and a percentage of those will
be available for people with disability. Again, we will not be providing the
service, so we will be working with the various disability agencies. That is
another thing that will come online over the next few years. By the end of this
calendar year, our organisation is planning to build another six properties in
the location we are in.
The committee recognises the many achievements made in the first nine months
of the Tasmanian NDIS trial and congratulates everyone involved.
As of 31 March 2014, three-quarters of the nearly 600 young Tasmanians
with plans were accessing mainstream services. The pre-existing Gateway system
has undoubtedly helped to ensure that participants have received supports and
advice in a timely manner. The feedback from participants seems overwhelmingly
positive, and the service provider sector appears to be growing, energetic and
engaged with the challenge of moving to a fee-for-service model.
There remain some significant challenges, however, for both the market
and the NDIA to provide adequate services in regional and remote areas of the
State and to ensure that eligible participants are enacting their plans and
receiving supports. There are also challenges in Tasmania that are common to
all trial sites, such as the accessibility and readability of information for
participants and carers and the need for a more coordinated and strategic
approach to housing and supported accommodation.
The committee emphasises the importance of planners canvassing NDIS
participants' employment options. A successful transition from a school
environment to the workforce where possible is crucial in terms of the
long-term well-being of a person with disability and the outcomes for the
community as a whole. To this end, the committee emphasises two key issues:
the importance of enabling work preparation, and work itself, to
be included in a participant's plan where possible; and
that the NDIA, the Commonwealth Government and the Tasmanian
Government to work closely with those Tasmanian businesses and educational
facilities that train and employ people with a disability, and encourages
corporations to continue to procure from disability enterprises in Tasmania.
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