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Joint Standing Committee on the National Disability Insurance Scheme
National Disability Insurance Scheme oversight
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Joint Standing Committee on the National Disability Insurance Scheme
Hall, Jill, MP
Macklin, Jenny, MP
Urquhart, Sen Anne
Reynolds, Sen Linda
Siewert, Sen Rachel
Gallacher, Sen Alex
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Joint Standing Committee on the National Disability Insurance Scheme
(Joint-Thursday, 9 April 2015)
CHAIR (Mr Brough)
Mr O'Merea Smith
- Senator REYNOLDS
Content WindowJoint Standing Committee on the National Disability Insurance Scheme - 09/04/2015 - National Disability Insurance Scheme oversight
GLANVILLE, Ms Louise, Deputy Chief Executive Officer, National Disability Insurance Agency
STOPHER, Ms Kerry, Director, Engagement, WA trial site, National Disability Insurance Agency
WALKER, Ms Marita, Manager, WA trial site, National Disability Insurance Agency
CHAIR: I welcome the National Disability Insurance Agency. Information on parliamentary privilege and the protection of witnesses and evidence has been provided to you. I remind witnesses that the Senate has resolved that an officer of a department of the Commonwealth or a state shall not be asked to give opinions on matters of policy and should be given reasonable opportunity to refer questions asked of the officer to superior officers or to a minister. This resolution prohibits only questions asking for opinions on matters of policy and does not preclude questions asking for explanations of policies or factual questions about when and how policies were adopted.
I now invite you to make a short opening statement. Louise, you know how these things work—not a dissertation of everything. What we are really interested in, in the first instance, is addressing the many points that have been raised and that we have been alluding to along the way, and getting some answers on the record to that, and then having an open dialogue.
Ms Glanville : I have taken quite a bit of interest in the Perth trial site since it started. I have been over here numerous times. I have been very keen to be present today.
CHAIR: Can I kick it off. Clearly, the most important thing are the people who were here today who were deeply disturbed. Can you give us some reassurance as to what is going to happen from here for those individual cases?
Ms Walker : We have spoken to each of the individuals who raised their concerns today. We have taken appropriate steps for them to talk further with us about wherever things are up to for them and to assist them to resolve the concerns that they have. So we have spoken to all the people.
CHAIR: You feel the process has commenced to get those things back on track?
Ms Walker : The first lady has gone back to our office now to talk with my colleagues and her planner, and I will be contacting the second lady tomorrow.
Ms Glanville : I would add to that. Clearly, there are some systemic learnings from those individual examples as well. The beauty of having these hearings is that you get that information directly. On the point about visits to people's homes, we do do that around the place. I think the learning from that is to make sure that people know that that is an offer, if it is difficult for them to come in. So there are some simple things like that that we can do as well as addressing the individual issues.
Ms Walker : Yes. We certainly provide the opportunity for people to have that discussion in their home. We make an open invitation for everyone when their appointment is being made by asking who they will be bringing along with them. It is an open invitation as to the family members, the supports, the service providers or whomever they wish to invite, and they are welcome to join them at their discussion.
Ms HALL: That open invitation may be there. You may feel that people are being given an open invitation and you may feel that people are getting information about the fact that they can have an interview at home, their first assessment at home and their plan developed at home. But in reality people are not hearing that. From the perspective of the NDIA here, you need to work out checks and balances to make sure that people hear that even though you are doing that, and I have absolutely no doubt that that is what you intend. Sometimes you can say things one way and people do not hear and do not understand the message that you are giving them. So it is really important to clarify and make sure that they understand that they can bring someone with them, that they understand that they do not have to come in, and that you understand it is difficult for some people to come into the agency and that you have the ability to develop the plan at their home. Sometimes it is not necessarily about what you do; it is about perceptions and what people hear, and I say that in a non-critical way.
Ms Glanville : Clearly, another systemic learning from those examples is really about the way we communicate generally. I know you have heard the evidence about what we are doing in the ACT, Easy English and those sorts of things, but—and Kerry knows this from her role—it is vitally important that we look at how we communicate not only with participants and their families but with providers. I think we make good strides in that space, but we always have to work to improve. So we are very, very aware of those sorts of issues as well.
CHAIR: Let us fill this in. When this all started, there was no assistance; she came in, did not want any conflicts of interest et cetera. So, nationally, not just here in WA, you are now saying that when a participant comes in they can bring a cast of thousands, including service providers, should they wish to?
Ms Glanville : Absolutely. I am talking generally now, but Marita is the best authority locally. She is the one who deals with these.
CHAIR: We understand there are still communications issues. That is obviously not out there, but I just want to know the policy. The policy now is, 'We do not care who you bring, we do not care if there are perceived conflicts of interest at all,' which is a big change.
Ms Glanville : Yes, that is right. When the agency started, there was a much more rigid approach about who came to those conversations, and I think we have moved quite some distance away from that. People need to bring whoever is going to assist them with the process of planning. That is certainly the overarching—
Ms Walker : Yes, that is how it has been from the beginning here.
CHAIR: You have seen, though, Marita, that clearly there are a lot of people who do not feel that is the case here at the moment, so there is a communication issue that continues. Well, we have heard it today, so there is no need to repeat it.
Ms Walker : Many people do come to those conversations with providers. I take your point.
Ms HALL: It is about what people hear.
Ms Walker : It is what people hear. But the situation is that the invitation has been there since we opened in July last year.
Ms MACKLIN: You know as well that there are many circumstances where the person with the disability does not want a particular person or a particular provider to come. What I think is important for us to put on the table—and I know you know this, but I do not want the record to be incomplete—is that there are circumstances where the person with the disability really still has to be the primary person, and their wishes are what is paramount. We cannot have a situation where pressure coming from others outweighs that primary purpose. I know you know this; I am not trying to suggest you do not. We heard from people with disability today and from some other advocates about how important it is to remember that sometimes a family member is not welcome; sometimes a service provider is not welcome. So, what is critical when you conduct the planning sessions and in the ongoing discussions is making sure that that is still the prime consideration, and I would be interested, from a systemic point of view, Louise, in how you do that. That is the first thing.
CHAIR: One second. Linda, did you want to comment on this issue? Anne, was yours on this issue or on a separate one?
Senator URQUHART: It was about information.
CHAIR: I think Linda has something on this particular issue.
Senator REYNOLDS: Picking up on Jenny's point, could you clarify for us what the procedure is currently. When someone makes contact in preparation for that first visit that Jenny is talking about, how do you communicate with them? As we heard, people do not always know they can bring somebody or, as Jenny said, they might not want to bring somebody. How do you work through that first appointment and make sure that subsequently they know who they can ask to have or bring with them? How does that process work?
Ms Walker : It is not one size fits all. Particularly in this first three-quarters, the focus has been on the people who have been invited to transition into the NDIA—those people who have had contact with a local area My Way coordinator. That has been the most significant target group.
We have liaison with the DSC managers and ask them to let us know if there are people who will need particular specialised support for whatever the range of reasons is. So we will know from that exchange who will need an interpreter, who will need a visit at home, absolutely, and a range of other particular circumstances that we need to take into account. That is the first bit of personalisation of the sort of support and the nature of the first contact.
Senator REYNOLDS: Just on that: if someone has complex needs and they engage with multiple providers, for example, do you engage with all of the providers?
Ms Walker : No.
Senator REYNOLDS: So you basically pick one?
Ms Walker : No, we do not engage with a provider. I am talking about the people who have had a local area My Way coordinator.
Senator REYNOLDS: Sorry, I missed that.
Ms Walker : That is a My Way coordinator who will be able to alert us about whether it is particularly essential that the My Way coordinator is there because of their previous relationship because of some home circumstances. For those who do not have those very high particular circumstances, we will make a phone call. The information that we have provides us with the name and contact and the primary contact person. The primary contact person may not be the individual. That will be a common circumstance. We will phone and have a conversation, 'Have you heard about the NDIA?' and talk about how it is the opportunity for them to transition. We will ask: are they in a position to make an appointment? We will say: 'This is what the first meeting would be about. This is the sort of information we will send out'—which will be the access request form. And we will talk about the fact that, if they are interested and able to fill in some of that information about their plan, that would be helpful, but it is not essential; there are a range of ways in which we can assist them to fill in the information. That can be done prior to their meeting, or they can come in earlier or ask for assistance. We will talk in that conversation about who you would like to have with you when you come for the appointment, and what are the sorts of options that you would like to have for your appointment?
Senator URQUHART: Prior to that, do you send out any information about the NDIA to those people, or is it that first contact and phone call? You are asking them: do they want to transition? Do they at that stage have any idea what you are asking them to transition to?
Ms Walker : We will not have sent out material to them individually. We have had a range of information sessions in many different venues and forums. We have an opportunity that operates on a fortnightly basis for people to come and drop in to the office to talk about what it will mean, what it might be and what some of the preplanning could be for them. So, no, we do not do a mail-out, but we do—
Senator URQUHART: But how do people find out about those information sessions? What is the process for that?
Ms Walker : They are available. We have had some sessions that we have had Valued Lives do on our behalf, and we will mail out, to those people that we have contact with, the availability of those sessions.
Senator URQUHART: Valued Lives is a provider?
Ms Walker : Valued Lives is Bronia, who spoke earlier. It is a peer-to-peer family organisation that we have contracted to provide a range of sessions that are about information, about preplanning, about plan implementation.
Ms Stopher : And we go to those sessions with Valued Lives, so we are able to provide a lot of information about the planning process and so on. But also, as Marita said, we offer fortnightly conversation coffee mornings at the office, which I run with a planner. We would get generally between four and 12 people coming to those on a fortnightly basis. In those we are able to really provide an overview—what is the NDIS; what does it mean for them; what might the planning process look like?—and run those fairly informally so any questions can be answered.
Senator URQUHART: How many people have you had that have transitioned to NDIS?
Ms Walker : We are in a position to talk about our statistics for the end of the second quarter, which is the end of December. At that point, we had 688 people who had been found eligible and 502 people who had an approved plan at the end of December.
Senator URQUHART: Out of those 502, how many would you have effectively sat down with and had a discussion with about the transition process—the whole lot of them?
Ms Walker : No.
Senator URQUHART: How many?
Ms Walker : I cannot answer the question as a statistic.
Ms Glanville : But can I say that one of the biggest learnings that the agency have really had about our now nearly two years of practice—of course, in other jurisdictions, not necessarily here—is that that first contact is absolutely crucial. In the beginning, of course, we had the hard, sharp: 'Here's the planner; we've got to get the plan done.' We have moved a long way from there, certainly, and we have very many and varied mechanisms for that—what we would call early engagement—in all of the trial sites. Marita has given you a few examples. One of the benefits of having a national system is of course that different trial sites look at different things and then can share that information. We continually look at the ways in which we can improve our engagement, particularly so that people, before they come to what is in effect a planning conversation, can actually get a much better idea of what this is all about. It is a big learning.
Senator URQUHART: I think I understand that. I guess my question is: if you have 502 people who are approved for transition, why don't you keep the statistics on how many you have actually had a conversation with about that total transition?
Ms MACKLIN: They would have all been in a planning process to have been approved, so they have been through all that.
Ms Walker : Yes.
CHAIR: So are there 502 that have now got a plan?
Ms Walker : Yes. That is for the end of December.
Senator URQUHART: I think she misunderstood the question.
CHAIR: Yes. So there are 502 with a plan.
Senator URQUHART: I think you misunderstood the question.
CHAIR: I know that Linda also wants to comment on something here. The other issue is—and maybe not where Anne was coming from—that we heard that there are quite a lot of people not activating their plans in full or at all. Do you see a role for yourselves in that? How much of a concern is that, and are you taking steps to try and assist with it?
Ms Walker : Yes, it is a concern, and, yes, we have a very significant role. There are many things that are happening that you would put under the heading of plan implementation.
Ms MACKLIN: Give us some examples.
Ms Walker : There is a planning and support coordinator. It is their role to do the handover meeting just to talk about what happens now once your plan is approved. We encourage people at that point to let their current service providers know that they now have an NDIS plan. It was no surprise at all that that came up as a theme this morning.
Ms MACKLIN: That is now happening.
Ms Walker : Well, it has been happening for quite some time. We also ask people. If they would prefer us to let their current service coordinator know, we will just ask for their written consent for us to do that, because the philosophy of the scheme is that it is their plan and that they have ownership of it. With permission, we would take on that role of letting their current provider know. That is the first point.
And then the next step is: are they in a position to be able to go and just confirm that they are continuing with what they currently have? Many of the people who are coming across through LAC will have some current service, so they are not starting from scratch without anything. In that case, it is really a matter of letting the current provider know and being clear that then there is a service agreement that is to be negotiated between the family and the participant and the service provider. It is very important for the provider to have a copy of the plan so that they know what the goals and outcomes are, because that has been a very strong focus of the discussion and of the planning: what is it that you want to achieve in the next while? So it is really important that the provider know that that is what their service is there to focus on. When it comes time to plan review, that is some evidence that we would be looking for from them. Some people will elect to say that that is really where they want to go away and own their plan and pick it up from there.
And then there is the opportunity for us to work and provide information to people about the various providers that they have. There are different types of services that they are now looking for that are perhaps additional to what they have had previously. If, through the process of their plan, it has been evident that they would need some support to do that or just to continue the coordination of what they already have, because that had been done in a very significant way either by the LAC or by a current service provider, then 'support coordination' is the term—a very literal term—that is used for the coordination of the supports, particularly across different service providers. It is not intended to be—
Ms MACKLIN: And you do fund that, don't you?
Ms Walker : Yes, we do fund that and have been very proactive in the site about being clear about what that means. As you heard this morning, there are probably a limited number of current providers who are geared up for support coordination, particularly support coordination across the different range of types of providers.
And then, if people want some further help, we are able to offer that. Probably it would be fair to say that, in this first little while, that has not been offered as liberally as we have been doing more recently. We are now systematically following up four weeks after the plan has been approved to have a conversation: 'You've got your plan now. How are things going? Have you been able to do things and make contact with those organisations?' So there is a four-week implementation follow-up phone call. At that point, there is another opportunity to say, 'Let's have another meeting and see what help you still need and about which providers to contact.'
The two things to be really clear and agreed about are that within our trial site we now have 130-plus registered providers, but there is not a really easy information source about who does what. We have some of that information available, not particularly easy to find or access, but again we are developing that at a site level to be more easily able to be understood and for people to then be able to contact agencies either for support coordination or for direct services so that they can make a decision about who they would like to do that.
Ms Glanville : Can I just make my comment on the plan implementation, if that is all right?
CHAIR: Yes, sure.
Ms Glanville : This is a broader issue. We are doing quite an intensive piece of work across April and into early May that looks at the take-up of plans and in particular through the expenditure of resources on those plans. We are looking, where there is low take-up, at why that might be, including issues that might relate to how well supported the participant feels but also issues from the provider's perspective—whether providers understand how they need to claim or what needs to happen, whether it is to do with our infrastructure and the way we do things; what is influencing this. It is something we are looking at across the country now to get a much better grip on that particular issue. That is something we will make available to the committee when that report is done because it is quite an important piece of work for us.
CHAIR: I will come back to that one.
Senator REYNOLDS: I would like to come back to where we first started the discussion on the communication issue. It seems to me that, if we do not get that communication right first up for everybody, then we start to diverge and we start to get issues and problems that have to be remediated, and it is a much longer and more painful process for everybody on both sides. The way that you just described the process and how you are evolving the process here sounded to me quite reasonable for people who can clearly understand the information, who can access it on the internet and have the capacity to read and understand what you send them in the mail, and they have to have the transport to be able to attend and do all those sorts of things. That might be a majority of people, but there is still going to be a significant minority—and I think we heard from some of those people today—who do not fall into that category. You acknowledged that, yes, you do need to look at communications, but to me it seems to be: how do you communicate more effectively right up front so that people understand what it is and what they need to do? We heard about what they did with My Way. They put obviously a longer and more intense focus up front with all parties, which seemed to be a bit more of an effective way to get it right up front.
Ms MACKLIN: Do you think that is true? Do you think the comparison is valid that Linda has just drawn out—that there is that difference in approach at the front?
Ms Walker : I think there is a bit of a definitional difference because our definition of approval is when the plan is developed, as opposed to the My Way definition of approval, which is after it is ready to be fully implemented. So I think the communication—
Ms MACKLIN: I think the point that Linda is making is: very early.
Senator REYNOLDS: That is why I was just talking about very early and up front. Obviously, My Way have had a long time to develop it. But, as I understood what they presented yesterday and today, they do not just spend an hour appointment but have multiple appointments. Right up front, they get the service providers and family members in, and they spend more time explaining it up front in a way that is suitable for the individual and their particular disability and their ability to understand. It seems to be more intensive at the front.
Ms Walker : It is a combination of development and implementation through the process that they have described. Our communication and capacity for people to be in contact with us is that we could—and we do—have a significant number of people who will have two or more conversations and a significant number of people who will have service providers and others in that.
Senator REYNOLDS: Is that with the same person—
Ms Walker : Yes, absolutely.
Senator REYNOLDS: because you were talking about a hand-off before. It is just a handing-off stage; it is not handing on, person to person to person?
Ms Walker : No. When you have a relationship with your planning and support coordinator, that is the beginning of a relationship. But we have as a site only been here since 1 July, so we have not had planning and support coordinators who have had the opportunity to have long relationships. But, once they do make contact with us, they absolutely maintain the contact with the same person as long as that person is still here—and, yes, one person we heard from this morning has a planning and support coordinator who has moved from WA to New South Wales. But there is continuity of the person that they are talking to, and within the team in our office, which they maintain across their relationship with the scheme.
Senator REYNOLDS: On one further point, and it refers to the term 'systems wrangler', which Rachel and I have heard in other inquiries, as I understand it, the My Way coordinator, right up-front, will have a look at the housing issue, they will be in touch with DSS, they will look at the entire situation for that person to see what are the issues and engage other departments and agencies in that discussion to see what needs to be done. I am not sure that exists elsewhere. Is that another difference where you are looking at the disability support? Do you start right at that beginning point to find out what other agencies are involved and involve them in that discussion with the person?
Ms Walker : One of the first things that will be part of the discussion is: what is happening now in your life? We are absolutely looking to ask about, have conversations about and to note what are the informal and mainstream supports that are there now or need further development and linking. So that is a core part of what the scheme is about and is part of the conversation.
Senator REYNOLDS: Just to clarify, do you just ask the individual, or will you actually outreach to DSS or to Housing or whomever else? Do you get that information solely from the individual or their carer, or do you engage with other agencies? To access the services, if they have got a housing issue or if they have got a health issue, are you able to engage directly to sort that out?
Ms Walker : That will be part of the implementation of their plan. That is what I am saying. I think what you are seeing is that the difference between development and implementation is merged in the My Way model before you get to approval, whereas we are looking at getting a conversation and certainly at mapping those things. But, at that point, no, we might be noting that there needs to be some linking, and that will form part of what the plan includes, and then you move on to implementation, which is when you would, within the role of support coordination, be seeking to follow up what might need to be done in terms of housing or health or linking up with mainstream services.
Senator REYNOLDS: So your staff would do that role as well? They will actually engage with—
Ms Walker : The support coordination would be funded as part of the plan, and it will be mostly what we would be seeking of a support coordinator out in the provider sector, funded as part of what the support coordination role is intended to be.
Ms Stopher : I will mention too that, for people who have very complex situations or are at times of life transition—maybe wanting to move from where they are living now into another place or from their nuclear home into another independent living, or transitioning from school and that is going to be quite comprehensive—we can build in a much more comprehensive opportunity to plan through Personal Futures planning. That happens for a number of people who are in those particular circumstances. So while we are doing a more average length plan, people can go away, have a Personal Futures plan which includes a number of the key stakeholders in their life that they want to bring along, and then bring that back and then complete our planning process, and that has been working quite well.
Senator REYNOLDS: I will just clarify that. In terms of what I call the system wranglers, under My Way, the My Way coordinator does that work themselves, whereas you are saying that it is part of their package. So the big difference is that the system wrangler for a person is someone who is contracted to do it and not the coordinator themselves? Have I got that right?
Ms Stopher : It is not to do that very comprehensive level of planning.
Senator REYNOLDS: Yes, but you fund somebody to do that?
Ms Stopher : Someone with expertise in that area. That is right. I am not sure that the My Way coordinator would see that that was their role either.
CHAIR: No, it is done differently.
Ms HALL: I am sure I have probably read it or heard it somewhere, but how are you transitioning people in? Do you do it by postcode or must they contact you, because we have heard today that people need to contact you?
Ms Walker : No. We have a proactive approach to inviting people to transition.
Ms HALL: What is that proactive approach?
Ms Walker : Our phase-in is a little bit complicated. The first three-quarters involve those people who are already known and connected to My Way. But there has also been capacity for people to be coming in who are receiving program support from either Commonwealth programs or other programs. Now we are just starting our next quarter. The next phase-in schedule will include people who have other DSC funded programs—for example, supported accommodation, which is where people have had individual funded support to live in their community. That also will include people who have had funded support through recreational therapy but have not been connected to an LAC. That is the next phase. It is geographical. It goes by local government area.
Ms HALL: I remember reading that bit. I know how the structure works in New South Wales—
Ms Glanville : It is similar.
Ms HALL: It is similar, is it?
Ms Glanville : Very similar. Just in relation to that, the interesting thing about Western Australia is that those early cohorts were individuals who were connected with DSC. The working relationship between us and DSC is very important because, in a way, we are all engaged. However it ends up with transitioning people to a different type of system—who knows whether it will be a WA system or a national system or what it will look like ultimately—the way in which we work together and properly assist and support each other through the exchange of appropriate information will be very important to the way in which the scheme is rolled out here.
Ms Walker : There is flexibility in that. We have had a number of requests from people who were not due to phase for another quarter or so but have had some circumstances which meant that the value of them being able to have funded support that met their reasonable and necessary support needs would be better. So we have been able to have the flexibility to bring people in earlier than their scheduled phase-in. People can contact us. I saw we had a statistic that 11 per cent of the total people—rather than what is called a section 55, which means we have sought the information and got their name—came from walk-ins.
Ms HALL: This morning I asked a question of the state representatives on how they saw the difference between My Way and the NDIA. Can I ask that question from your perspective.
Ms Walker : It is difficult for us to answer that because we do not have a close working knowledge of what they are doing and how they are doing it.
Ms HALL: Do they have information about what you are doing and how you are doing it?
CHAIR: It is in their jurisdiction.
Ms HALL: I do not want you to answer, Mal; I want the witnesses to.
CHAIR: They cannot answer it, though. It is not their job.
Ms HALL: Do you have an answer?
Ms MACKLIN: Maybe I could put it a slightly different way. I think it might be useful to go through the evidence that was presented both yesterday and today from providers, participants and representatives of the commission where propositions were put about the difference. I accept the point you make that you are not in a position to answer Jill's question, but we did ask them, as Jill said, the same question. They answered it in a number of ways. I just want to put those to you. You might like to come back to us in writing, because this is hard for us to get a handle on.
I will refer to some of the examples. Some of them are very straight forward. We understand the arrears versus advance. That is easy to understand. What is essentially the difference between the role of the local area coordinator and the description of the process that you have just provided in answer to Linda's detailed questions? Essentially, it seems—I can only go on what you and what others have said to us—that that sort of role is being in part pursued by your planners, and in part pursued by people you contract to to provide detailed systems coordination. That is the way it seems, but I think it would be useful for you to draw out and explain this role of the local area coordinator versus what you do, so that when we get to the point of understanding the difference between the two trials we can better comprehend it. At the moment, frankly, it is not possible. We have not had an adequate explanation.
Ms Glanville : We would be very happy to put that in writing.
Ms MACKLIN: That would be very helpful.
Ms Glanville : We might do it at points in time, too, so that you can see the journey we have been on. We will also refer to what we understand might be intended in the future roll-out of the scheme in terms of that local area coordination function.
Ms MACKLIN: That is the second issue.
Ms HALL: Also include the population that each trial site is dealing with. I think that has an impact on the differences.
Ms Walker : I can just say something briefly about the population difference. At our trial site it is anticipated—the Productivity Commission report projected it—that we would have up to 4,300 people. That is a number which we are yet to be absolutely clear about, but we are still at the stage of transitioning people in. The other two trial sites were chosen so that they have a total, in projection, that is similar. The other two trial sites have a projected total of something similar.
Ms HALL: And they are regional, as opposed to metropolitan. I think that that is something that needs to be pointed out.
Ms Walker : The Coburg-Kwinana site is outer-metropolitan.
Ms MACKLIN: Another difference that was alluded to, which would be useful for you to respond to, is the nature of the delegated authority. There is this suggestion that you are going to be told, Marita, how to do everything from Geelong, which I suspect—
Ms Walker : I welcome the opportunity to say a bit about where decisions are made. In terms of our administration and decision-making about reasonable and necessary supports for individuals here in WA, all of those decisions are delegated here to WA. None is referred elsewhere. So, if there is a decision about someone who is unhappy with the reasonable and necessary decision, that internal review is our responsibility. Of course, if people are still unhappy then the next step is the AAT.
For decisions in relation to matters of the scheme as a whole, in terms of pricing, I do not have that delegation. It is a national scheme and there is a national area of responsibility to do that.
CHAIR: You know that that is different to what we have heard from others, where things have been escalated to Geelong. Is there a particular decision at national level to deal with it differently in this particular trial site?
Ms Glanville : No; not really, in my view. You would need to look at the trajectory through time. It is really important that we are confident that the scheme is being rolled out in a relatively consistent way, but taking account of local differences. I am happy to talk more about what we think that means. The main role of national office is really to provide input on the policy issues that we do not control. Numbers of them were mentioned, quite understandably: transport, housing, employment—
CHAIR: We understand all that, but it is just, as you say, a moment in time, so the evidence that we have received previously has now been superseded, and what you are saying is that no longer, or very rarely—we will not say 'never' but 'very rarely'—are things then having to be referred back to Geelong for a decision?
Ms Glanville : Not for decisions around people's planning and the reasonable and necessary supports they get; the delegations sit locally, as per the comments that were made here—absolutely, that is the case. Could I say that, where I have, for example, become involved in the last year might be where there have been very challenging circumstances, like a participant who is particularly distressed. We do elevate some of those, where there have been some experiences that I would like to understand more. We take that very seriously, because that is learning for across the country, so sometimes we will work to find out what has happened in a certain location so that we can understand that. But, in terms of the actual decision making about people's reasonable and necessary supports, that happens locally.
Ms MACKLIN: Another issue that was raised was around price and the suggestion that the prices here in Western Australia are in a band rather than a particular price and that that may—as yet, that is unknown—lead to differences in the overall affordability of what is provided. That goes to the question of the timing of the evaluation. I think it would be helpful if you would inform the committee about the timing of the evaluation, because, from my recollection, the difficulty is going to be that governments are going to be expected to make decisions before they are able to answer any of the questions that we are putting to you.
Ms Glanville : Just on that: there is a joint steering committee that is jointly chaired by the Premier's department here in Western Australia and PM&C in Canberra. It oversees a number of things to do with the two schemes generally but also receives regular reports on the evaluation of the two schemes that is occurring. We have seen no data from that evaluation to date. We understand that an interim report will be made available in October.
Ms MACKLIN: Will that be public?
Ms Glanville : I do not know the details of that, so it is not something I can answer.
Ms MACKLIN: It is not for you, I know.
Ms Glanville : I am happy to take that on notice and tell you what we can tell you, but—
Ms MACKLIN: We will ask the department.
Ms Glanville : Then the subsequent or the more final report, I understand, is due in the middle of next year, 2016. So, from our perspective, the sooner we are able to look at some of the data that is coming out of that evaluation the better. We would welcome that; it would be very useful in terms of our own thinking and development.
In terms of the pricing issue that you raised, the agency, of course, has some interim transition pricing in place. We are committed, and are currently working through the assumptions underpinning that pricing to see whether there needs to be any further changes made to that pricing. And we are on the record as saying that that is what we are doing and that is what is happening as we speak.
Ms MACKLIN: You would have heard a lot of other specific issues raised, and I think it would be useful for you to come back to us on a number of the issues raised about ADEs, for example. I do not want to take up the time of the committee today, but, just for the purposes of the people who are sitting behind us who asked the questions, I want to make sure that they are responded to; we would then of course make your answers public and available to people. There were a lot of concerns about that issue.
CHAIR: Do you need us to write to you?
Ms Glanville : I have made a note of them as we have been running through, so I am happy to liaise with Mark, if that is okay.
CHAIR: If you would tick-tack with Mark, that would be good.
Ms Glanville : One comment that was made that I think it would be good to have on the record here was on the issue of driving people towards funded services. Our legislation requires us to look at family and informal and community supports, not only as the first port of call but also because it is integral to a rights-based initiative that is trying to encourage people to be more involved with their families and communities and supportive others in that way. So I think that once again maybe reflects an understanding from a point in time. I think early on in the life of the agency there was a bit of a focus on more funded supports, but certainly our data shows that over the recent past—I suppose I am talking about the last six months in particular but probably up to a year—we are much more clearly seeing the focus on community and informal support.
Ms MACKLIN: And the related issue of providing support to families, to make sure the family can cope, for example?
Ms Glanville : Yes, that is part of the planning conversation. We take that focus very, very seriously because that probably goes to one of the core differences between the two, if I can put it that way, and that is the insurance model—and we need this to be sustainable over time. Quite importantly, the legislation refers to not removing what are often well-working informal and community and family supports. They often perhaps need some additional oomph to make them work better, but it is a very important focus for us in terms of the long-term sustainability of the scheme. We do not drive people towards funded supports, even if, early on, that might have been the new bit of the puzzle that people, perhaps our own staff and others, were quite excited about, if I can put it that way.
Senator SIEWERT: One area of confusion I had yesterday was the sign-off on plans and where we are up to with the sign-off on plans. There were some comments made yesterday that plans are not signed off. I thought that we had moved forward on that one.
Ms Walker : There is a requirement for people to have agreed to their plan.
CHAIR: But not to have actually signed off?
Ms Walker : Not an actual signature.
Senator SIEWERT: But they do have to have agreed to their plan.
Ms Walker : That is right.
Ms Glanville : I think this is the only one of the recommendations in your first report that we put a caveat on. We did that after we sought advice and we looked at it very carefully. We heard how significant it was in the evidence that was given, but we felt it was not the right thing to do. That was a decision that was made to have a sign-off for a variety of reasons, and I am happy to elaborate on those. I think we did elaborate in the report.
Ms Walker : Clearly, people do need to have seen their plan and agreed to it. But I clearly heard—and accept quite openly—about whether people have understood their plan and the format of how that is presented and absolutely agreed. There is work going on again right now for the format of the plan to be much easier and simpler and, hopefully, more flexible. That has been partly an IT issue. If it had been just something we could have changed at the site, we would have, but—
CHAIR: It is a national issue, so it has been addressed.
Ms Walker : The format of the plan is where there is work going on for it to be something better and simpler.
Senator SIEWERT: One of the reasons I am asking about it now is that it came up yesterday regarding the My Way site. Certainly the feel I got yesterday from the evidence was that people seemed to understand their plans better. They seemed more across them. We did not hear complaints around them not being able to understand them.
Ms Walker : I accept that, and that also goes to that definitional difference. The funding becomes available as soon as the plan is approved, but we then have a period of implementation. Very clearly, My Way are doing development and implementation in an overlapping way. At the time when everything is agreed, that is when they approve it.
Senator SIEWERT: It does seem a way, though, that the participants have been taken along on the journey—or not taken along on the journey but are part of that development. It is certainly not the feeling I got so much today.
Ms Walker : I understand, because it is about the challenge of implementation. Our legislation requires that the approval is the first point, and then the implementation comes after that.
Senator SIEWERT: We are learning through this trial process that that can be off-putting for participants. I got the sense yesterday that people felt a strong ownership of their plans. It did not necessarily seem that everybody felt that today.
CHAIR: If I can just reinforce Rachel's point—and it is probably more to you, Louise—that is that it would seem more costly to do what you are having to do under the legislation at the moment because you develop a plan and, when you come to implementation, you may learn that it is actually not achievable for some of those issues that I think Linda addressed earlier as well, about: what is the interface with housing; that does not actually work and now we have to start again. So it is an observation. You do not need to comment, but I think it is something worth looking at as to whether the methodology that has been adopted thus far is in fact the best. It may be, but I think it is worth looking at.
Senator SIEWERT: I want to go to this issue of the conflict of interest that we traversed a little bit this morning. I actually get the issues around conflict of interest and the issues around choice of control for people, but it seems to me what we are learning both from other places and particularly from here and from My Way is that providers have been extremely important in being able to help develop plans, supporting people in the process. Certainly in My Way we got that impression yesterday, and I certainly understood that from the evidence we got this morning. Have you found that, in the Hills site, there are conflicts of interest or that the process you have to go through is inhibiting some of that development because providers are one step removed, potentially?
Ms Walker : No. I do not feel that that has been problematic. There has been a diversity of experience. One of the participants that you heard from in the earlier session mentioned that she had a very clear starting point of wanting to change her service provider and has gone through a planning process over quite a significant period of time to get to that point and for it to be all ready to go. Because of our phasing, we have had quite a high proportion of those initial plans for which the person with disability has been under 14. So the nought to 14 group has been a higher proportion than the overall. That is likely to have meant that they have had some involvement with early intervention or school age therapy services and that the involvement particularly of the therapy providers has been very helpful and positive and that there have been occasions in some areas where the service providers have been involved and that is all fine, but there have been some other areas where the discussion has been able to open up, so one area has been done really well but how someone might be included and have friends in the community and pursue their recreation interests has needed a little bit more discussion, and that has come up as part of the plan. We value the input of providers and welcome it. We do not ask them if the participant has not included them.
Senator SIEWERT: When it comes to the planning processes as well, the point was raised this morning—I think it was by Rise—about seeing the plan afterwards and saying, 'It's difficult for us to provide that.'
Ms Walker : This time lapse is something we are hearing a lot about from the providers at the moment. As I mentioned earlier, when the plan is approved then we do talk to people about what next, which is the start of implementation. So we are encouraging them strongly.
Senator SIEWERT: It is not so much that that I was looking at. My understanding of some of the evidence we had this morning was that, when they saw the plan, they said, 'It's just not possible to provide that for that amount of money.' I do not want to traverse the pricing issue again. It is more about: where do they go to get that advice about what can be provided for the price. We do not seem to be having that problem in My Way. Because of that process, they are involved in it. I am fully aware that that could be an issue on the other side of the process. The potential is that it limits choice, depending on the provider that is involved in that discussion. I understand that, and that is the issue around conflict of interest as well. The point on this one is they are saying, 'We cannot really implement that plan because we cannot provide what is in the plan.'
Ms Walker : We would then assist the person in the family to say, 'Let's try another provider.'
Senator SIEWERT: I understand that. Again, it is dancing around the issues around the provider's involvement. It may be a generic problem, that none of the providers could provide that. Is the plan being realistic if it is not involving people who can have an understanding of what services are available and can be provided?
Ms Walker : It would be fair to say that their planning and support coordinator group are a quite diverse group of people. They do not know everything about everything; I do not expect them to. But we do have people with some quite good and strong experience in disability. I would feel that it is unlikely that there are supports and strategies in plans that no provider will be able to deliver on. We just do not know yet, because it is too early, that none of them can do it for the price. I have not had an example of that at this point.
Senator SIEWERT: I understand that, but then again, of course, you take choice away if you have to go to the one provider who can do it for the price.
Ms Walker : I just do not think we have enough evidence.
CHAIR: If I may, this has happened not just in Western Australia but across all the sites. Certain elements of a plan are not included because it might be about transportation to a particular activity. They have the money for the activity, but they cannot get there because that has been missed. I am just giving you an example. It would be useful if the people who are still in the room are able to provide those examples so that you can have a look and see where the holes are, and that is part of the communication.
Senator SIEWERT: There is another issues that came up yesterday and I think it is relevant for this site as well. It reminded me of another point. One of the providers spoke about capability, being able to have the systems and being able to develop the capabilities to engage in either My Way or the NDIS. I thought it was important to talk to you and get on the record the processes you are going through about working with providers and building capability to engage with NDIS. The other question I have is: for those encouraging new service providers, how is the process going in terms of the providers being accredited? I have forgotten the proper word.
Ms Walker : Registered.
Senator SIEWERT: Sorry—I knew I was not using the proper word. How is that process going? Are you finding it working okay or are there issues coming up?
Ms Walker : At this point, as I said, we have 130 providers. There has been a recent change at the national level in terms of the process for registration. That was for the purposes of simplifying it and putting the AUSkey together with the registration process. I think that will help those who are moving on now. Here in WA we are using the jurisdictional quality and safeguards framework. Providers who are seeking to do core specialist disability type supports need to be on a preferred provider panel with DSC as part of that framework. We are waiting now for the outcome of the latest round of that process to be announced, and there is likely to be some more people who will then come to us to register.
Senator SIEWERT: Is that more a WA thing than the federal process?
Ms Walker : They need to do that to meet the quality and safety framework in this state, and then register. Prior to that, there were some things that particular organisations found frustrating and slow. At a local level, we have looked to assist them as much as we can through the portal and the registration process. I think it is pretty good and at a place now that people would feel that it is happening okay. That was in answer to your second question. Your first question was about capacity building.
There is a capacity-building program that is happening at the moment that is jointly funded through some Commonwealth money that went to the state and DSC money. They run their sessions at our office. That has, I think, eight or 10 modules and 90 participants. That is a very significant project that is underway. We provide sessions each time for answering questions and so on. From the actual site itself we have run information sessions and workshops on particular issues in relation to support coordination, which is really important, as you have heard, and also self-management and what that looks like. It was a valid point that you heard earlier this morning. WA has had shared management, and self-management is not quite the same. But, of course, we do acknowledge that people do need some assistance and support with different aspects of self-management that would then give them the sorts of choice and control that they are really seeking. We have had joint sessions with providers around how we can ensure that we all have the best outcome in terms of having the support and assistance available to individuals and families to have their support needs met.
Senator GALLACHER: Organisationally, you have premises, you have staff, you have a full complement, you have 500 people accepted, you have a target of 4,000. If we come back in 12 months time, where are you going to be in that 4,000? Are you going to be 2,000 up the ladder? What do you think? What is happening? Are you building momentum?
Ms Walker : Yes, we are building momentum. You are right. We started off with our first-quarter numbers being low. Five hundred is our second quarter. Third-quarter numbers will show a further acceleration. In a year we will be at quarter 7, and, at that point, I think the real question will be: are there people that are eligible that we have not been able to connect with or find?
Senator GALLACHER: So we will see a J curve here? We will sink the money in and out.
Ms MACKLIN: How many are they supposed to bring in?
Ms Glanville : You can only bring in really to what we are funded. It is part of the agreement. But you are quite right. By the end of the trial period across the country, we will probably have about 32,000 participants. Then we build from there for the forward years.
Senator GALLACHER: But the lessons learned from those 32,000 will go a long way to solving some of these—
Ms Glanville : One of the best things about being in a trial is that we refine all the time. That is why we wanted to give you this plotted movement of what we have done in some spaces, because it really does help refine what we do. It is the beauty of a national system, because we have learnt an enormous amount from being in Western Australia. In fact, some of our practices are Western Australian practices because we know they have a deep history here. But we have also learnt some terrific things from other parts of the country and we have been able to bring those into developing the best possible model for Australia.
CHAIR: Does your back-of-house ICT system allow you to have a look and see on any given day how many clients have or have not accessed their money?
Ms Glanville : It will.
CHAIR: Can you give that to us, please.
Ms Glanville : Yes, sure.
CHAIR: Just give us a bit of a graph showing, for example, whether 80 per cent are accessing it. I do not need every single person. It should be, I would have thought, a quick interrogation of the system to say, 'Only 20 per cent have accessed it very little and 20 per cent have accessed it the most.' Something like that is all we need. If we could have that, that would be good.
Ms Glanville : That is fine. As you know, we have piggybacked on other systems. We are hopefully moving to the point of having our more custom-built ones. They will be able to give state-of-the-art data. We are moving closer to that all the time.
CHAIR: We look forward to getting those more detailed answers to the specific questions and observations that were raised here today. They are obviously very important both individually and systemically. Thank you for being with us today and for your evidence. I say to the rest of the audience and everyone in WA, thank you very much for your hospitality. Thank you, Hansard and the secretariat. We look forward to seeing you all again soon.
Committee adjourned at 14:41