There are many issues confronting service providers managing the transition to the NDIS. Organisations 100% reliant on NDIS revenue are struggling most with viability. Those with other forms of revenue have greater opportunity to build economies of scale and distribute their overheads across different functions but many are still underwriting NDIS losses.
Pricing, the adequacy of plans, inconsistency in planning, the ability to employ the people with the skills necessary to provide supports for the price on offer, are just a few of the issues. Transport is a nightmare particularly in rural and remote areas for which there has been no answers from the NDIA.
Of particular concern for providers is the pricing for 1:1 supports. The 2016 Market Position Statement released by the NDIA indicates that the NDIA never intended for people to be supported 1:1. Regardless of the region, the ratio of average expected staffing to the number of expected participants is around 1:2.7. In addition, the hourly rate per person allowed for group support (which is needed) would encourage providers to adopt group support ahead of 1:1 support which is reducing choice for participants and as many have indicated, also reduces the quality of support. This leaves providers with little choice but to offer group support ahead of 1:1 support in an attempt to be viable.
The Monash Modified Model of Classification is not helping prices either in rural and remote areas. In one case the town (in what we would call a remote area) is standard classification with some streets in the town classified remote. In another town, the situation is reversed.
Inconsistency in assessments continues to be a problem for many. Some people have had multiple reviews to get anywhere near the package required to meet need. One person living in a remote area received a phone call for the purpose of undertaking a review, the conversation resulted in the loss of 65% of their package because the supports were deemed to be mainstream. This person is now too scared to spend any money for fear of running out!
Providers are having difficulty competing for staff especially in mining areas where wages are higher while others are feeling pressured to reduce the standard of employee they are able to employ or need to employ to meet the demands for support. None of this is helping people with disabilities or providers.
The sector has been raising issues such as these for years. However, the Joint Standing Committee has heard these concerns which have been acknowledged in the report. The Committee has made 29 recommendations. The one that is somewhat amusing is that “an evaluation of the independent pricing review be undertaken at the next pricing review.”
Review the review at the next review!!! Doesn’t sound promising! And it will be interesting to see if anything changes as a result.