NDIS Mental Health and Housing May 2014
Whole of NSW Transition to the NDIS July 2013 June 2016 June 2018 Hunter NDIS launch commences Hunter launch rollout NSW transition planning NSW wide NDIS transition commences Productivity Commission report - August 2011 NSW first state to sign up to full NDIS - December 2012 Launch commenced in the Hunter - July 2013 Statewide by July 2018 Whole of government transition planning and coordination. 2
How we got here - The NDIS story.. The Australian Government released the Productivity Commission s final report - Disability Care and Support - in August 2011 The Productivity Commission proposed two schemes: A National Disability Insurance Scheme (NDIS) to fund services to Australians with a significant disability; and Work was progressed in 3 areas: Building Blocks: 11 Building Blocks were identified as the basis for work towards a NDIS. A Design Working Group was established as a sub-group of the Senior Officials Working Group to progress work on the Building Blocks. NSW led the work on A National Approach to Choice and Control Funding and Governance of the long term Scheme: Funding and governance arrangements for a NDIS has been agreed. NDIS Launch Sites: Sites were agreed in NSW, South Australia, Victoria, Tasmania, ACT, Northern Territory and Western Australia A National Injury Insurance Scheme (NIIS) to fund services to Australians who have acquired a disability as the result of catastrophic injury/accident COAG established the Standing Council on Disability Reform, comprised of Treasurers and Disability Services Ministers, to: (a) Consider the report s recommendations; (b) Undertake the development of a NDIS. NSW NDIS launch site will: - Cover the Hunter Local Government Areas of Newcastle, Maitland, Lake Macquarie. - Commence 1 July 2013 - Be a phased roll out over three years. - Provide support to 10,000 people. 6 December 2012: NSW and Australian Governments reached an historic agreement which will ensure the full rollout of the NDIS across NSW by July 2018 Subsequently, all States and Territories except WA have reached agreement for full scheme roll out NDIS Act 2013 - Commonwealth legislation established NDIS and DisabilityCare Australia as an independent Authority reporting to SCoDR, oversighted by Board, supported by Advisory Council 1 JULY 2013 NDIS LAUNCH
NDIS What makes it different? National scheme consistency; portability Needs based scheme - not a rationed, capped allocation of funding / support Insurance approach sustainable; lifetime enablement approach to care and support; early intervention focus Choice and control by the person with disability Individual funding packages Consistent with existing NSW reforms 4
What the NDIS will do the 3 Tiers 3 Tier National Disability Insurance Scheme Productivity Commission proposal TIER 1 All Australians Minimise the impacts of disability through public awareness campaigns Provide information to all members of the public Assist in reducing social constraints of disability by supporting the purposeful integration of mainstream and other services TIER 2 Information, Linkages & Capacity Building Better link individuals to mainstream supports Assist services to be more inclusive and responsive to the needs of people with disability Direct investment towards evidence based interventions that improve outcomes for the individual TIER 3 Individual Funded Packages Need to meet eligibility criteria and develop a plan Assist individuals identify goals and aspirations Assist individuals develop comprehensive plans to achieve their goals Fund reasonable and necessary supports to enable goals to be achieved 5
Who is eligible? Tier 3 A person meets the disability requirements if: they have a disability attributable to an intellectual, cognitive, neurological, sensory or physical impairment or psychiatric condition AND it is likely to be permanent AND it results in substantially reduced functional capacity A person meets the early intervention requirements if: they have a disability as above, or are a child with developmental delay AND early intervention is likely to: reduce the person s future needs OR prevent the deterioration of their functional capacity OR strengthen sustainability of their informal supports, including carer capacity See for detail: National Disability Insurance Scheme Act 2013, Part 1 6
Productivity Commission recs - Mental Health In outlining who will receive funded supports under Tier 3, the Productivity Commission included people with significant and enduring psychiatric disabilities. These people periodically rely exclusively on support from the clinical services of the mental health system, but at other times are able to live in the community provided they have appropriate supports. Following expert consultation, the Productivity Commission estimated approximately 57,000 people nationally with significant and enduring psychiatric disabilities are likely to require supports under Tier 3: Around 10 per cent (almost 6000 people) would have intensive support needs. Around 25 per cent (14 000 people) would have high support needs. The majority of around 55 per cent (31 000 people) would have low support needs. For this cohort, the NDIS would have a role in meeting community-based, disability support needs, including home-based outreach, day programs, respite services and in some cases, accommodation-based supports. 7
Productivity Commission recs - Housing The Productivity Commission (PC) recommended a range of housing options be explored, given diverse housing needs of people with disability. Anticipated in a large number of cases mainstream housing services would be the most appropriate solution, and the role of the scheme would be to refer people to these services or act as their advocate in dealings with them. Scheme may also fund modifications where necessary. For a smaller cohort, the PC envisaged an integrated care and support model, or supported accommodation but suggested this could be delivered in new and innovative ways, as opposed to only traditional group home models. The PC suggested there was merit in exploring options such as cashing out the value of supported accommodation and allowing individuals to use it more flexibly, for example co-contributions from families. Given that a large volume of people with disability are expected to be accommodated through the social housing sector, the PC also recommended that innovative models be explored for social housing. Thursday, July 10, 2014 8
Interfaces - other service sectors and the NDIS Australian Governments have agreed 6 general principles on demarcation of responsibilities between NDIS and other service systems. They have also agreed further specific applied principles to help determine what will be an NDIS funded support and what will be a mainstream support (continued to be provided by the state). These are set out for identified service sectors: Health Mental Health Early Childhood Development Transport Employment Child Protection / Family Support Justice School Housing/Community Infrastructure Education NDIS trial sites provide an opportunity to review interactions 9
Responsibilities of NDIS and other systems principles agreed by COAG People with disability have the same right of access to services as all Australians. The NDIS will fund personalised supports related to people s disability support needs, unless those supports are part of another service system s universal service obligation or covered by reasonable adjustment. Clear funding and delivery responsibilities to ensure transparency and accountability. A nationally consistent approach to the supports funded by the NDIS and the basis on which NDIS engages with other systems. Will have regard to efficiency, the existing statutory responsibilities and policy objectives of other service systems and operational implications. The interactions of people with disability with the NDIS and other service systems should be as seamless as possible, with a no wrong door approach, and minimising the impact of system and organisational boundaries, enabling integrated plans and supports. 10
Applied Principles Mental Health The Health System will be responsible for: supports related to mental health that are clinical in nature, including acute, ambulatory, continuing care, rehabilitation/recovery and early intervention, including clinical support for child and adolescent developmental needs; and any residential care where the primary purpose is for inpatient treatment or clinical rehabilitation, where the service model primarily employs clinical staff. The health and community services system will be responsible for supports relating to a co-morbidity with a psychiatric condition where the co-morbidity is clearly the responsibility of that system (e.g. treatment for a drug and/or alcohol issue). The NDIS will be responsible for non-clinical supports that focus on a person s functional ability, including those that enable people with mental illness to undertake activities of daily living and participate in the community and in social and economic life. Thursday, July 10, 2014 11
Applied Principles Housing Public and community housing providers will continue to provide accommodation for people in need of housing assistance in line with existing allocation and prioritisation processes, including appropriate and accessible housing for people with disability, routine tenancy support. Housing and homelessness services remain responsible for homelessnessspecific services, including through homelessness prevention and through outreach and access to temporary and longer term housing for people who are homeless, or at risk of homelessness. The NDIS will be responsible for support to assist individuals with disability to live independently in the community, including by building individual capacity to maintain a tenancy and support for behaviour management. The NDIS will be responsible for home modifications for accessibility specific to individuals in private dwellings, and in some cases in legacy public and community housing dwellings on a case-by-case basis. The NDIS is responsible for user costs of capital in situations where a person needs an integrated housing and support model and the accommodation component exceeds a reasonable contribution from individuals. Thursday, July 10, 2014 12
Housing further work The NDIA is developing a discussion paper on the NDIS and housing. NSW has provided feedback on an initial draft of the paper, and is awaiting an updated version from the NDIA. It is understood that it is intended to be a public facing discussion paper. The paper has been informed by discussions between Housing officials and Bruce Bonyhady, Chairman of the NDIA, and most notably focusses on options for the NDIS to work with housing sectors to maximise the opportunities for the NDIS to be a catalyst for growth and increase housing supply options. Boundary issues (eg, in relation to tenancy supports and home modifications) will also need to be worked through. Thursday, July 10, 2014 13
Mental Health further work The NDIA has engaged mental health and disability expert, Eddie Bartnik as a strategic adviser. There are still issues to resolve with NDIA around the mental health interface, most significantly, to quantify the number of people with psychosocial disability who may be eligible for funded supports. The NDIA has funded the Mental Health Council of Australia to deliver an NDIS capacity building project with the mental health sector. Mental Health Commission of NSW / Mental Health Coordinating Council of NSW joint Hunter Launch Site Project. Thursday, July 10, 2014 14
Mental Health further work Work with NDIA to determine how mainstream service providers and NDIA will work collaboratively to support people with complex needs, including transition of HASI and ISP to NDIS environment Community supports for people with disability and/or mental illness who are not eligible for NDIS funded supports Patients in inpatient facilities who may be eligible for NDIS funding and could move to the community with identified housing Building the capacity of mental health NGOs to deliver NDIS funded supports, eg psychosocial rehabilitation, social, leisure and recreation day programs Existing mental health workforce shortage, alongside the need to build disability sector workforce to deliver the NDIS. Thursday, July 10, 2014 15