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Joint Standing Committee on the National Disability Insurance Scheme
Siewert, Sen Rachel
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Joint Standing Committee on the National Disability Insurance Scheme
(Joint-Wednesday, 6 April 2016)
CHAIR (Mr Billson)
- Ms Owen
Content WindowJoint Standing Committee on the National Disability Insurance Scheme
GLANVILLE, Ms Louise, Deputy Chief Executive Officer, Stakeholder Relations, National Disability Insurance Agency
O'BRIEN, Mr James, Director, Market Engagement, National Disability Insurance Agency
STEELE-WAREHAM, Ms Pam, Regional Director, Far North Queensland, National Disability Insurance Agency
SPAVEN, Ms Lea, Director, Stakeholder Management, National Disability Insurance Agency
CHAIR: Ladies and gentlemen, thank you. Apologies for being a few minutes over. Congratulations to all of those who participated in the speed dating service that was the feature after our morning session! Just so you are aware, Senator Lindgren is joining us on the phone, so we can keep things moving. I particularly want to offer a warm welcome to the officials from the National Disability Insurance Agency. I have to go through this spiel which is terribly unenthusiastic in its influence on people, but we will do it anyway. I remind officials that the parliament has resolved that an officer of a department of the Commonwealth or of a state or territory shall not be asked to give opinions on matters of policy and shall be given reasonable opportunity to refer questions asked of them to superior officers or to their minister. This resolution prohibits only question asking for opinions on matters of policy and does not preclude questions asking for explanations of policy or factual questions about when and how policies were adopted. Thank you for appearing before our committee today. I invite you to make a brief opening statement if you wish.
Ms Steele-Wareham : Thank you for the opportunity to provide a brief overview of where we are at currently. We had our memorandum of understanding signed on 22 October for the early transition of the scheme. We have recently done a readiness check on how ready we are to commence planning and implementing the scheme. Together with the Queensland government, we are really feeling confident that all of the key elements required to be in place for the early transition are in place. We have started making people eligible in Townsville, Charters Towers and Palm Island, and we have started planning with people. We have our first person with a plan and supports through the scheme. We have a number of other participants who have been made eligible and who have been referred to us. We are starting to work with them in planning. So it is really exciting to be at that stage.
To be able to do that we need to have infrastructure in place. We have our staffing complement—we have 32 staff in the early transition site. The majority of those staff are local area coordinators and plan support coordinators. Twenty-two of the staff are seconded from the state Department of Communities Child Safety and Disability Services, and that has been important and beneficial for us, because they bring with them knowledge of the local communities, the disability sector and a number of the people they will be working with. That has really built the competency of the team of planners and LACs.
We also have initiated the early childhood, early intervention approach here in North Queensland with our access partner, Uniting Community Care. That is a really important new approach for the agency to look at working with families—0-6 year olds—to have a more responsive family focused early intervention approach. Children under the age of six are being referred to our access partner, Uniting Community Care, who will do the early intervention work with them, information linking and support generally, along with small amounts of intervention, if necessary. If children require more intensive disability support, they will then work as our agent and do a plan up for the child with recommended supports and that will come through to the agency, as we have the delegation for the approval of those reasonable and necessary supports. We have a number of 0-6 year olds who are eligible and have been referred to Uniting Community Care. They have started contacting and working with those families.
CHAIR: What are the early numbers for that?
Ms Steele-Wareham : There are approximately 20, I think, who have gone out to Uniting Community Care at this point.
We have had a very strong partnership working with the Queensland government and particularly the Department of Communities Child Safety and Disability Services. We have worked together on the implementation team, which has been important for us, and on a number of engagement activities with participants and the sector. As we have heard, there is always more work to do in that space. It is important that we have been able to get the benefit of a lot of learning from other trials sites. I was previously in the Western Sydney area—the Nepean and the Blue Mountains—implementing a new early transition and some of the learning from there I have been able to bring here to help us be ready with the time frames that we need. As you saw yesterday on Palm Island, we have utilised a lot of learning from the Barkly area as well to have a community-based implementation on the island with local support. They are the key things I would like to say to commence.
Ms Glanville : I am the deputy CEO of the NDIA, based in Geelong. In this role, it is important to move around the country and there are certain jurisdictions that I spend quite a bit of time in because that is where a lot of our learning is. It is great to come up here to see the progress we have made. I think about the rollout of the early childhood, early intervention approach, for example, as a trial in the Nepean-Blue Mountains area, where Pam was; we now have about 170 families and children who have gone through that wide gateway and we know that is something that will significantly contribute to a national approach to an area that is very contested and challenging. It is wonderful that we are now also rolling it out here.
That is the beauty of a national scheme, if I can put it that way—to be able to take those learnings. We hope that it will become fully national in the not-too-distant future. It has been really helpful. I think we are just very keen to meet our targets here. We know the targets are quite challenging, as they always are when we are asked to do things reasonably quickly, but I think the agency is well positioned and well on track with our ICT developments and with our service delivery operating models. Really, the way in which we are engaging locally, I think, is far more sophisticated than we have historically. I think we have learned; our mantra of listen, learn, build and deliver has been one which has really helped us to get to where we have got to today.
Ms Spaven : I am the director of stakeholder management in North Queensland; most recently I came from South Australia where I had been working in the same role there. Again, it is very much an agile workforce, working across the country in different roles and bringing that experience from that trial site. In South Australia, of course, we were a children's trial site—and state-wide—so there are similarities here to the environment that we were working in.
Mr O'Brien : Until last week, I was the director of market engagement with the market and providers division within the agency. As of this week, I have taken up a new role with the agency, setting up the North East Melbourne site, which is coming online shortly. In the last year or so I have been working on the transition of the sector from their existing state-based arrangements into the new, more market-driven, open and competitive model of the NDIS. I have been spending a lot of my time with the existing providers, but I have also been working with prospective providers about the sort of advice and information they need to get involved with the NDIS, to ensure that we have sufficient supply to meet the huge amount of growth that will come through with new participants seeking supports in the scheme.
CHAIR: Pam, perhaps you and your team heard some of the conversation this morning. I can try and rattle them off, but I am sure you have some notes of those as well. Could you bring an NDIA perspective on that range of issues, and then I and Senator Siewert might backfill a little bit, if there are things that we want to talk further about.
Ms Steele-Wareham : I think I will just summarise, in terms of some of the issues that were raised from the service system and from families and people with a disability around the engagement activities that have happened and around the readiness work that has been done. Just for some context, the agency invested in three engagement staff in Queensland early in 2014. In the absence of having a trial or anything underway in Queensland, we saw the importance of starting to engage with the Queensland community. We had an officer up here from 2014 as well—one officer in North Queensland. To maximise that approach, we have worked very closely with the Queensland government. They have put in place a number of participant readiness activities that they have funded across Queensland. We maximised our effort by coordinating that work together with the Queensland government.
We have been here in Townsville since October last year and we have had a number of forums for service providers, in terms of readiness. Our local area coordinators have held, I think, approximately 24 readiness workshops for prospective participants—about 77 to 80 people have attended that. It was an attempt by us to do as much work as we can to have people understanding the scheme and being more confident about the planning conversation. The local area coordinators have been working broadly in the community, with community groups also looking at how we can build the capacity more broadly in the community.
CHAIR: Just on that, if I may: Merle was making the point that for some it was not quite front of mind—what is going on in the background—but that people are only just beginning to engage and they are feeling a little overwhelmed, perhaps, by navigating the system and by the choices and the opportunities before them. Is it the intention to reactivate those readiness processes now that it is more front of mind for some participants and families?
Ms Steele-Wareham : Yes, certainly as we start to plan with people we are looking at being able to have those small groups of people come together. What we have learnt from some of the earlier engagement we did was that people got overwhelmed. They were fairly big groups of people and there was a lot of information and PowerPoints and people just got overwhelmed by that. So this work that we did recently had a maximum of six people and working through—
CHAIR: It was more of a workshop kind of thing, was it?
Ms Steele-Wareham : A workshop: a personal approach sharing 'What does this mean to you?' The feedback we had from that was very positive, so we will be looking at replicating that. The approach that the LACs and planners take in planning is also about acknowledging that this is a new experience for people and it takes time for people to be comfortable about thinking about the future, let alone what it means tangibly for them. There is that balance of bringing people through and also making sure we are doing it in a timely way for people, and it is reflecting where we are at.
CHAIR: I am getting some traffic on the phone about whether there was some discussion about cohort specific engagement—increasing the relevance of the information for people with particular circumstances that may be in common. Is that part of this more intense workshop style engagement? Is that what you are doing as well?
Ms Steele-Wareham : We are modifying the tools that we use when we are engaging with people. We have actively changed the formatting of a number of the tools that we have so that they are less busy and so that they concentrate on the key things that we have learnt that families actually need to understand. We have modified that to something that is meaningful for people and that is where we have had the good feedback. They have said, 'I now understand what it is that this is all about,' so that is a learning for us as well.
Ms Glanville : Could I add two points to that. The first is we very much hear the comments about the disability support organisations, and I think that peer-to-peer support is a really important one.
CHAIR: Yes, I was going to come back to that.
Ms Glanville : You will probably remember, or be aware, that the agency funded those 18 DSOs a couple of years ago now. The agency no longer has the sector development fund. That was administratively moved to the Department of Social Services, but the feedback we are getting from those projects, which we are still managing, is very similar to what you heard here. That is that they are very valuable, they are really helping build this awareness of the sorts of things that need to be thought about and they are really assisting in that way.
CHAIR: So a sense of a need to revisit that and re-energise that?
Ms Glanville : Yes, I think it is a good initiative. It has still got a little bit of time to run, but I think it is something that is very powerful in helping people think through the sorts of things that will help them make the most of the NDIS. The second point is about the national front—for example, the early childhood early intervention approach, where we developed materials that can actually be used in different parts of the country. For example, we are in the process of developing a whole series of case studies, which come, in large part, from Nepean Blue Mountains but also elsewhere, that try and give life to how this approach will work with different groups in different communities. I think that is important so that often people can see themselves reflected in the material that is being presented because, while we want consistency, we do not want one size fits all, and it is all very much about the individual and their reasonable and necessary needs.
Senator SIEWERT: You went to a place I was going to go to begin with. How is the changing to smaller forums being conveyed to people? How do you engage the people in the smaller workshop type approaches? Are you reaching out to specific groups, which goes to the cohort issue, or to families?
Ms Steele-Wareham : How we have tried to manage the number of people who can come through into the scheme initially is we have worked from the data that we have around people who are receiving existing services, who we know will be coming through into the scheme, and people who have registered an interest with the agency through our national access team. So we are able to target our energy, if you like, to maximise the experience for people who are coming through the scheme as part of our first 600 people.
CHAIR: Essentially, they are the people that are in the frame now, and there is work to be done to find others.
Senator SIEWERT: Obviously, there will be other potential participants out there. Are you trying to get the first group and work with them through and then start doing some more engagement with the broader group once you have got that group more underway?
Ms Steele-Wareham : There are concurrent activities happening. We are working with the people who are coming through initially, because it is important that this is an authentic process for them and it is maximised. But we are also continuing to do, through our engagement team, broader forums in the community for families, family groups, and, certainly, I have listened to Merle's comments. Merle and I worked together about 20 years ago, so that is an example of how we will be in contact with parents groups and saying, 'Bring those people together, Merle, who aren't understanding and are unsure and let's have an engagement with that group of people.'
CHAIR: Do you know who frames that a little bit as well, with a mix of clients—those that are transitioning from existing service and those that are new?
Ms Steele-Wareham : Yes. There is an ongoing engagement schedule that we have, so, while we have got our planning people coming through, there is broader engagement happening concurrently with the sector and with families, family groups, and service providers also have a really important role here. We work with service providers so that they can start working with the families that they are supporting to prepare them.
CHAIR: I will ask you to pause there, because we will come back to service providers. I just want to make sure Senator Siewert has had a turn.
Senator SIEWERT: I just want to go back to the peer-to-peer support program and go back to DSS. Do you feed back to DSS that this had come up here, for example? How do we now progress this issue? It seems to me there is a need for more peer-to-peer support programs and funding. Do groups here then have to go to DSS? Or is there a process where you can feed back to DSS?
Ms Glanville : I think it is always useful for people to go directly to departments. That is right. But we certainly indicate from our perspective in our trial experience what we think has worked and what has not worked, and that can be quite useful. The point I make is that it is no longer our responsibility to just make decisions about those resources.
Senator SIEWERT: I totally understand that, and I understand it is being shifted. I also understand the need for its happening. But, for the broader community, I know they then see a multiplicity of agencies.
Ms Glanville : That is right. The other way this type of information is relayed is that the chair of our IAC, Rhonda Galbally, has a keen interest in peer-to-peer support, as do a number of members of her council, and she would meet from time to time with the minister and others in the department. She would convey those views as well I am sure. We will see what the results show, but clearly we get this consistent feedback that it is something that is highly valued.
CHAIR: Pam, could you move on to the service provider piece, please.
Ms Steele-Wareham : I will let James speak about the sector capacity work and data analysis work that is occurring, but, in terms of the work that we are doing with the sector, we work closely with Richard Nelson and the NDS. We also attend and align ourselves closely with the northern Queensland alliance, which is the representative group for all of the funded disability service providers. We have held a number of forums with service providers to prepare them for the scheme. We have held a forum with them around how you register for the scheme and what this means for the scheme, and we visit service providers individually to speak with them.
So we have quite a thorough set of engagement activities in place with the NDS, the NQ alliance and individual service providers to assist them to understand what this means for them and how they will interface with families, because this scheme is about the families having the choice and control and the families making the decision about which service provider they select to work with them. So it is about helping service providers understand that this is not about them having a contract with the NDIA anymore. They now need to be working closely with the people who are selecting them or the people who are providing the service.
CHAIR: I was looking at your non-verbals as I tried to explain that to see whether you thought I was on the right page or not!
Ms Steele-Wareham : It is about preparing providers for the very different relationship that they have where the power dynamic changes from government and service provider to the individual participant.
CHAIR: My observation—and I could be dead wrong, and I hope I am—is that there seem to be two categories of service providers. I would roughly group them as the continuously engaged service provider who is providing week-in week-out care and support and who has a level of sophistication and experience navigating funding arrangements, and then there is the episodic service provider. We heard about mobility aids. I have heard similar feedback from people doing home mods and all those sorts of things. They are kind of feeling like the cousin that is thereabouts but not quite in the groove for how they should engage and what this looks like. Is that a reasonable characterisation, or are you adopting different engagement strategies with that different kind of provider?
Ms Steele-Wareham : Yes. We have facilitated some forums for the broader business community, not just registered disability service providers. There are a number of businesses who are looking at being able to provide supports through the NDIS, including all of those types of organisations. So we have engaged with the broader business community to talk to them about: how are they going to engage with the agency; what are the economic benefits for them to do that and what will that look like? It is also to give them a point of contact so that if they have got questions and inquiries they know where to come to and who to ask.
CHAIR: Is that portfolio expertise idea that I think, Louise, we spoke about in Canberra cascading out of mission control, if I could use that term, into the regions? Is that happening?
Ms Glanville : Yes. The term we use is that it is a national scheme but it is delivered locally. We heard some questions and comments from people this morning which very much indicate that it cannot be a one-size-fits-all. In some places there will be thin markets, for example. We need to understand what is going on locally and get a really good feel for that. A good example of this—and we will soon be doing the same up north in Queensland—is the local area market statement that we recently put out for New South Wales and Western Sydney, which for the first time—and we see it as part of our role as a market steward—gives indication of what we think the demand will be for certain supports in these communities. That is a hugely powerful document and we have had a lot of good feedback on it from providers around the country. We will do something similar here. We are actually preparing something similar for this community. For people trying to get a handle, particularly the smaller businesses, of what might this work will be like—for example, what might be the spend on assistive technology in a community like this; what might that look like?— this is the sort of platform that then helps our local colleagues to be able to work within that and to encourage people to be looking at and understanding what the demand is likely to be.
CHAIR: Senator, on providers?
Senator SIEWERT: Yes. While I see the categories that you are talking about, because the big providers have got the grunt—
CHAIR: And the balance sheet.
Senator SIEWERT: and the balance sheet, they have been able to prepare. I know providers who have been thinking about this for quite a long time—some of them are national, and even the large state ones have been. Then you have the smaller specialist providers who have not had the capacity to do that. They maybe thought it was not coming or they just have not got either the expertise or resources to invest. They also provide valuable services and I know that some of them are concerned about fading away and that participants are concerned that some of these smaller providers, which they actually rely on and get really good support from, may fade away. Has that been the experience elsewhere and is it something that you have been able to work with people here about?
Mr O'Brien : Certainly, over the trial sites to date we have seen a fair bit of diversification in the number of providers and the sort of providers who are offering services in the NDIS. We have about 2,200 registered providers across the country, and they will provide a diversity of services. They are not all historically the traditional NGOs. Increasingly, there are greater opportunities for small and medium enterprises and sole traders—particularly in the allied health space, where there has been a lot more money going into early intervention and assistive technology therapies. That has certainly created opportunities in the market. We are trying to, as far as possible, understand some of the market dynamics. Noting that the scheme is very much in its infancy and participants are still building capacity in understanding how to navigate and operate in more open markets, we certainly see that at the heart of the NDIS is this notion of choice and control, and choice very much goes to choice of who provides your support. We would see that the market is certainly open for existing, traditional not-for-profits to reinvent themselves and offer new and different services or, indeed, for new organisations, individuals, sole traders or whomever it might be to enter and provide the sorts of supports that people will be increasingly demanding.
The other aspect of this, which we are keen on given the amount of demand that we need to cater for in the scheme over the next few years, is to build strong links with mainstream businesses. As Pam mentioned, there have been efforts up here at the Townsville site and indeed some of the other trial sites to get strong relationships going with other mainstream providers, employers and other parts of the economy who could be providing supplies and supports in the NDIS.
Senator SIEWERT: You make a really good point around the allied health providers. In terms of this region, are there enough allied health professionals in that space?
Ms Steele-Wareham : We have certainly seen an increase in new players coming in here in Townsville with the registration process for service providers. That is really encouraging. We have also seen a service provider who specialises in allied health therapeutic supports and who provides support out to the west and up to the gulf registering with us as well. We are very pleased to see that as we move further out. We have engaged with the allied health professionals, through the hospital networks and their own professional networks, for some time now, giving them information about the scheme and what the opportunities are. I think the numbers that we are seeing starting the registration process show some of that work has been helpful, and I think it is a good sign.
CHAIR: Senator Siewert touched briefly on the adjustment needed among service providers. Some feedback this morning was that capacity development money was perhaps rarer than hens teeth to get hold of. Is there ongoing work there? I get a sense from the evidence we take as we travel around that a lot of people know there is a capacity development challenge ahead of them, but I would hasten to add that there are varying degrees of progress on that journey. How is that being cultivated as part of the rollout and the upscaling of the scheme?
Mr O'Brien : The overall approach around sector development is guided by what is called the Integrated Market, Sector and Workforce Strategy, which is a strategy which the Commonwealth and the NDIA—and, indeed, the states—have signed up to. It is generally to guide the development of the sector through transition and into full scheme. Different states have had some different contributions towards sector development.
CHAIR: It is my understanding that the bulk of the federal funds have been distributed, though, under that arrangement, and now—
Mr O'Brien : I would need to check in terms of that, because DSS administered the Sector Development Fund.
CHAIR: The cupboard is reasonably bare now, because it has gone out.
Ms Glanville : We do see examples of it. A good example was in Victoria last year, I think, where the state government committed $5 million to provider support in terms of transition. I think some states are continuing to do that.
CHAIR: There is a high expectation that the states and territories will be very active in that space.
Ms Glanville : There is a mix of the Sector Development Fund that exists and also other contributions that are made.
CHAIR: Are we optimistic about that transition and capacity building amongst service providers? Or, on our traffic lights of things to keep a close eye on, where is this one—is it on amber or green, or is it starting to get a red tinge?
Ms Glanville : I think the market development, in terms of having a deep and diverse and rich market that does really facilitate choice and control, is certainly one of the risks in the scheme. That has been well documented and is well known. It is a big endeavour. I think Pam's comments about what she has seen locally certainly are heartening and we have, from trials in the way that James has referred to, seen good progress in some areas. The agency thinks about its market stewardship role, though, in the context of what I term 'thin markets', and we are keeping an eye on this. We see this as a 10-year journey to develop the markets in a way that we are referring to, so we are keeping an eye on different parts of the country where perhaps we are not seeing the signals that we might want to see. But I do think things like providing data to service providers about what demand they are likely to see will help to build that business confidence. In fact, we have seen some pretty interesting examples of providers coming together and collaborating to grow their own businesses in a more networked way. That is pretty interesting.
CHAIR: We had an example of that this morning.
Ms Glanville : Exactly. That is right. It is very heartening, I would say, but I think there is still a lot more to be done.
Ms Steele-Wareham : What we have seen here locally is that, while there is a mix of readiness, we have been encouraged by the proactive approach from a number of service providers here in the region—not just the larger organisations, but some of the smaller ones as well—who have been working for some time to start to get ready for the scheme. I compare it to the starting place I have seen in Tasmania and even in Western Sydney a little while ago—I can see that the sector generally is maturing in its understanding of the scheme and its approach to readiness. So there is still work to be done here, but we are very active out in the service provider community and working with people to help to bring them on board and to answer the questions that they have.
Senator SIEWERT: The question that came up from Lincoln, from the MS Society and those peak organisations—
CHAIR: Progressive neurological disease professionals?
Senator SIEWERT: Yes, and the points they made about their engagement; I do not know who is the most appropriate person to ask this question of but, obviously, that has come up previously around Australia. Is it DSS that we should be talking to here, or is it you we should be talking to?
Ms Glanville : I can certainly comment more generally on that. The way in which the agency approaches it is always to look at it through the lens of reasonable and necessary supports for individuals as part of their packages. In that context, that has often involved the development and the work with particular groups who may, for whatever reason, have not had a lot to do with the disability sector generally. So in a lot of trial sites we have done some more particular work when we have identified particular groups. For example, sometimes when we look at who we think should be coming in as participants in an area and we see some gaps then that might trigger us to think about who else might be out there that we would have expected to have seen as part of the scheme
A good example was, of course, what we did in relation to mental health. I think there was some early concern that people with mental illnesses were not actually getting access to the scheme and becoming participants. As a consequence of that—and I think it was actually this committee that identified that as a particular issue several years ago—we looked at who had been found ineligible in the scheme to check whether that was working well and whether there was something happening within that. We set up a reference working group on mental health chaired by Eddie Bartnik that really worked on these sorts of issues. Very happily now, we are at about the figure that the Productivity Commission said we should be at which is that 14 per cent of our participants who have as a primary disability one that relates to mental illness. It varies. I am not sure what has been done specifically here in relation to that question. I would have to defer to you about that, Pam.
Ms Steele-Wareham : Similar to what you were saying, Louise, is that where we identify that there might be some gaps in understanding or knowledge, we certainly respond and work with people to look at how we can assist and respond with that.
Senator SIEWERT: I understood that one of the points being made this morning was that some of the work being done there is being done by the peak groups and that they are not able to access funds to do that because of the change in the nature of funding—not block funding anymore and those sorts of things.
Ms Glanville : Where we most see this issue playing out is in the ILC space. I think we have given evidence to this committee before. You know the general lay of the land, that the Disability Reform Council has the framework and we are seeking to operationalise that framework. We did a lot of consulting and engagement around the country. We put a draft up around what we thought ILC should be about and now we are continuing to engage with that, with a view to having that settled by the middle of the year.
What that process is also useful for is throwing up areas where there might be some need to look more closely at how something would work. There was an example in the conversation this morning with the early childhood development program. That is an interesting one. We are working closely with the government here to figure out what that program is. Yes, it is based in schools and of course we are great supporters of the mainstream supports and that is what the National Disability Strategy is all about, with the NDIS just being one part.
With some of those more specialised areas, that is the way it is becoming known to us. It is through our commissioning framework work as we move around the country—and we are moving all around the country. That tends to be how it gets raised. Then we get a chance to look at that more specifically to see whether in fact what is being offered fits within the ILC framework. Sometimes that is—and state governments do this with us—working with some organisations so that they can think about how they could change their service model so that the—
Senator SIEWERT: To fit within the framework—
Ms Glanville : Absolutely. A good example of that is some of the work in the ACT. Technical Aid to the Disabled is the group. They do quite well through block funding, but of course there are some ways in which they could work to change their service delivery model that would fit within the individualised model. You need to look at what is going on for each of the particular groups to get a sense of that. I think that is probably right—it has been thrown up through the ILC work.
CHAIR: On the workforce issue more broadly, Paula made some points around the 'part-timisation'—I think that was the term—or a casualisation, a portfolio type work. We have heard in other evidence that the growth in pure numbers available to match increasing demand as the scheme is rolled out is an area of some concern. Have you had any early insights, either in very thin markets or even in pushing out from a major regional city like Townsville, that the staffing horsepower might not be there to operationalise some of the ambitions of the plans and the scheme?
Ms Steele-Wareham : I think it is a little early for us yet to have any tangible evidence around there not being the capacity for the workforce to be able to respond. Certainly it is front of mind for the service sector, looking at how we recruit the numbers of people that we need. The NDS, on behalf of the service system, has received some funding through the Queensland government to help work up a workforce strategy. There is a significant piece of work happening there to look at what that is going to mean for service providers and at how we can structure our staffing complement in a way that enables that flexibility but still gives people confidence that they want to be in the sector, because there is some guarantee of hours of work available.
CHAIR: Linked to that are the issues of referrals, diagnosis, reports on condition and impact on quality of life functionality and the like. We urge people in our material to start collecting and assembling that material now. Is there any early indication about whether there is a choke point in that process? We have talked about an auditory impairment and getting to see the right people to give the right reports. Are we seeing any problem in getting that material available in a timely way?
Ms Steele-Wareham : To date, here with the small number of people coming through initially, we have a focus as a priority under the MOU for our phasing that existing participants coming through as a priority into the system, alongside some new people, come with a diagnosis, and they bring that across, which makes it a quick and easy process. We do not require additional information to support that eligibility decision. For new people coming through, it is early days for us yet to have a look and see whether it is a particular issue here.
Ms Glanville : Chair, it is probably also important to note that the scheme is not reliant on diagnosis. It is a functional aspect that is most important to us.
CHAIR: We have used the word 'reports', and I appreciate that, but a number of people have said to me, 'What is a report?' It is my use of mainstream language.
I am sure you are very perceptive. Did you pick up transport as an issue? I certainly picked it up. Do you have any early observations? In this vast part of our continent that this particular early transition program is targeting, this must be a topic of biblical proportions. What can you tell us, other than, 'Yes, it is'!
Ms Steele-Wareham : Availability of public transport—
CHAIR: Or private.
Ms Steele-Wareham : Yes. It is of course something that we come across in each site. It does continue to be an issue for people trying to get access to public transport. But there is evidence that people are thinking laterally about how they might approach that. Certainly with the transport that is able to be provided to participants as part of their plans, they are looking at working together with families about whether they might consider using those dollars in different ways to be able to provide some options, and for service providers and families to look at rolling up supports for two or three people to be able to do things. People are trying to be as creative as they can with that, but it does remain a difficulty in most locations—access to public, affordable transport. The provision of accessible taxis for people to be able to use is also always a challenge: to be able to get an accessible taxi as they need, depending on where they are, and then for that to be affordable for people as well.
CHAIR: We spoke in Newcastle about some service providers bundling suitable transport in as part of the service offer, and that made some sense. It reflected an appetite of the agency to be quite innovative and flexible. We modify private homes; do we modify private vehicles?
Ms Steele-Wareham : We can, yes. As part of people's plans, if part of the reasonable and necessary decision-making sees that as the most cost-effective and possible option for somebody to be able to access the community—
CHAIR: So if the need is clear, and that is the most direct, cost-effective way of meeting that need, then there is an appetite for the agency to—
Ms Steele-Wareham : Yes, we have assisted families in those circumstances, when you have explored every other option. If not being able to have some access to a modified vehicle means that you become isolated, unable to achieve the goals you have in your plan, then we have considered them under those circumstances.
CHAIR: And if that was to be accepted, is there scope to have driver volunteers trained and with insurance cover? I am just trying to think through what that would mean.
Ms Glanville : That would not be something that we would do.
CHAIR: So that would be an ILC conversation or a Rotary chat or something like that.
Ms Glanville : Yes, that is right. Capital expenditure, whether it is homes or for other stuff, is an area we are very careful with, I should say. Think of a person who might have contracted motor neuron disease, for example: it is a fast-progressing disease, the expenditure in an insurance sense has to be commensurate with, and it is very bald to say it, all of the elements of that person's life. But it certainly is possible, and has happened.
Senator SIEWERT: I want to draw this out, because it applies to accommodation—I am sure you are going there too.
CHAIR: Next cab off the rank, no pun intended.
Senator SIEWERT: On Palm Island, the two were obviously linked, but there are huge issues around transport as well as accommodation, and that applied to accommodation because there is not good transport. We heard this morning about the wheelchair that was suitable for pavements and hospital and things, but was not an all-terrain vehicle. I suppose that is why I am winding the two in together. Particularly on Palm Island, and I know it applies in other regional centres: what planning is there and where are you going in terms of addressing the issues around providing supports in those sorts of circumstances, where you have obviously got—it applies in other Aboriginal and Torres Strait Islander communities—transport interwoven with the accommodation? I know accommodation is separate, but they are obviously linked.
Ms Steele-Wareham : For transport, we really need to work with the service providers that are in place in the community to look at how we can partner, how we can leverage off what is there and what is not there and what some options might be—some new things or new ways of looking at this. There has not been an opportunity to do that before in the community because we have not had the NDIS making other options available. Certainly we would be looking at working in the community with the networks there. Dependent on the people coming through into the scheme and what their individual needs are—because their goals and their necessary supports need to be a focus too—how do we work more broadly in the community to identify where these gaps are, how can we start to partner and what might be some options there?
Senator SIEWERT: Obviously it is a question that we need to be asking the Queensland government—I know it does not just rely on you. The value of the package—of what is reasonable and necessary—is undermined if people have not got accommodation. We heard yesterday why potential participants or even, I think, some of the group that has already gone through the access requests process do not have one place of residence. In fact, they are going from—
CHAIR: You have to find them first to deliver the service.
Senator SIEWERT: friends and relatives, because they have not even got a permanent address.
Ms Steele-Wareham : One of the opportunities with the scheme—and the people coming through under the scheme—will be that this will be an opportunity for those gaps to be evidenced very clearly. We will gather, in time, a quantum of information that will say that in any community, really, we have specific issues around accommodation and around transport. That data and evidence, I think, will be very powerful in our ability to work with our mainstream partners in the departments of housing, transport, state and Commonwealth, around the evidence we are seeing over time. We have not really had an opportunity to enter into that discussion in a systemic way with evidence.
CHAIR: With the appetite of the mayor, for instance, it is conceivable, with that unmet need being quite compelling, that the agency would assess accommodation as being reasonable and necessary and provide support for accommodation services. Then the council might finance a facility, knowing that there will be some capacity at least to fund a portion of that over time. Is that the kind of scenario that you are anticipating might be realistic on a place like Palm Island?
Ms Steele-Wareham : It is; definitely. I think it will be a matter of us working with council and the community there to look at what this evidence is telling us. One of the things that is different about this scheme in terms of accommodation, which has not necessarily been the case before, is that this is support for somebody across a lifetime. There is certainty for people, and certainty for people who are making decisions about investing in accommodation. The support needed for somebody to maintain a tenancy successfully depends on there being strong support in place for people to make sure the rent is paid, to make sure the home is looked after and to make sure that somebody is not vulnerable in that home. That lifetime of support, and the certainty of that, changes the dynamics of people who are looking at whether this an investment and an opportunity that they should now be taking notice of.
Ms Glanville : I think the bigger picture example of that is the release last week of the Specialist Disability Accommodation paper that the agency has put out, which, once again, is within the framework that governments around the country have given us. That, really, is a document which says, 'Well, this is how the agency will price for housing.' It poses lots of interesting things in that position paper. It is out for some consultation. It sort of looks at things like what risks should the agency bear in terms of vacancies or not—
CHAIR: That has come up in Canberra where there is a bundle of gentlemen in a place—and sadly one passed away and that was a tragedy in its own right, but then all the cotenants were traumatised by that. Then their carers were traumatised because they were one down they might not be able to fund the accommodation any longer and it was quite a difficult time for them.
We have run out of time. Could we have a couple of quick responses to two outstanding issues? One is the observation around service withdrawal or tapering, if I could use that term, some examples of that. Then the other one is around pricing, whether you are in the gulf or on Palm Island, and the remote pricing platform framework that is being used until at least the middle of the year. I picked up a suggestion that that might still struggle to fund activities. Any quick comments on either of those two, please?
Mr O'Brien : In relation to pricing, the agency released the prices for Queensland a couple of months ago. Concurrently, there are a couple of reviews of key pricing areas at the moment in relation to supported independent living and in relation to group activities, so whether they be delivered in community or centre based. In particular, looking at what we call the 'intensity mechanism,' so how do you appropriately price supports for people who have, for example, complex and challenging behaviours. That is across the board nationally. Those price reviews will inform any changes to the price guides, which will come out for 1 July for the next financial year. There is also an examination of remote and very remote pricing as part of that. At the moment we have higher loadings for services delivered in remote and very remote settings. There is an examination of their adequacy at the moment. Without pre-empting where that review might go, we would hope to have pricing arrangements in place.
CHAIR: So some visibility around that as an issue?
Mr O'Brien : Yes, so there has been some consultation with some of the peak bodies, and indeed some of the providers, around some of those aspects. We would hope that we would have at least draft pricing out, I think, in May.
CHAIR: Service tapering or withdrawal—have you seen any of that yet or is there—
Ms Steele-Wareham : No, we have not seen any specific evidence of that. I could only suggest that maybe organisations thinking about their business model, and thinking about what are we going to focus on and make our core business, might be making some of those business decisions about what their future service delivery will be like.
Ms Glanville : It is interesting. If anything, I have seen the opposite of that. It was interesting to hear that evidence and that is something we will watch. We are in a situation of competition and I accept that competition is different around the country, but I have seen organisations actually looking at enhancing their service offering in order to provide the choice and control for pick up—
CHAIR: Charm offensive—
Ms Glanville : Yes, we had a couple of great examples from Tassie recently in that vein.
CHAIR: Thank you also for your facilitation yesterday, it was very generous. Thank you for putting that time in to make providers, participants and local government available for conversation. We are very grateful for that. Thank you very much.