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Joint Standing Committee on the National Disability Insurance Scheme

JOYCE, Mr Ross, Chief Executive Officer, Australian Federation of Disability Organisations

Evidence was taken via teleconference—


CHAIR: I welcome you to this public hearing via teleconference today. Thank you for appearing before the committee. Information on procedural rules governing public hearings has been provided to you and is also available from the secretariat. I invite you to make some opening comments.

Mr Joyce : Yes, thank you. I'll do a quick intro about AFDO, as we are known. AFDO is a Disabled People's Organisation, DPO. We're a cross-disability representative organisation, and we're the national voice representing people with disability in Australia. Our member organisations are all national and state disability systemic advocacy organisations run by and for people with disability in their families and representing Australians with disability.

Our vision is to achieve a community where people with disability can participate in all aspects of social, economic, political and cultural life. AFDO and our member organisations have a combined reach of probably over 3.8 million Australians, being people with disability, their families and supporters. We also make sure, at every occasion we can, we indicate that AFDO and our members fully support the introduction of the NDIS and back it 100 per cent as being a vast improvement on the fractured system that existed pre its establishment.

We think that there have been a lot of positive things that the NDIS has been able to achieve. But we do think that, of course, like with any major change process that you're bringing in on the national basis, there is a need to look carefully at some of the issues that are resulting from that and also where there may be some unintended consequences from that. That is our view where things are in the state of play. Workforce is a critical element of that. I am pretty sure you would have heard a number of speakers already saying, and we are well aware, that COVID 19 has really highlighted issues with workforce, particularly the workforce in the disability sector, such as casualisation and its implications in ensuring continuity of supports for people with disability during this pandemic.

I think aged care is another key example that everyone is well aware of, where casualisation has meant a number of workers have to work across multiple settings in order to achieve the level of income that they need for their and their family's support. That is one critical issue that I think needs to be addressed. We need to have a serious look at that, because that also leads into how many people we have available to provide supports. The more casual and the more split we have these services being provided, essentially the more pairs of hands we need to fill the gaps to ensure that continuity of support continues.

As you know, the projections are that the disability workforce needs to basically double to meet the future demands of the next few years. Clearly, it is the frontline support workers where that investment needs to be made. A range of issues that occur as a result of that. Looking at the workforce size, which I mentioned, which we need, and its composition, we have a lot of work ahead.

I know you have heard all this before but there is a lot of work needed on the skill development for those support workers. We need appropriately recognised national accreditation of training and we need to ensure that all of the support workers have gone through that training. But that is not to take away some choice and control of people with disability. We are very supportive of people with disability also being able to select people that they feel comfortable with to provide their supports. Obviously I'm not talking about medical supports. If it requires any sort of medical intervention then you must have appropriate training for that. What I'm talking about are other daily support tasks—showering, changing, helping them in and out of bed et cetera. We are getting strong representations through our members that their members want to ensure that they still have that choice and control. It is a difficult one, because if you talk about ensuring registration or accreditation or qualifications, you still need to ensure that people with disability have the right to select their most appropriate support person. That said, we do have an issue with ensuring that we work on that. We think that the NDIA has to have a key role as a lead market steward to ensure that we have appropriate supply of services. It must do that and it can do that by a range of mechanisms such as incentives for providers to go into areas where there are thin markets or no markets or only one provider of choice available. We think that sort of intervention would be good. We would encourage others to get into those areas, where we know there are a lot of gaps currently.

The other side is looking at how do you attract, retain and develop that workforce? That obviously requires a whole-of-government approach because we cut across all jurisdictions with the NDIS, so we must make sure that everybody is involved in that.

I heard the discussion on the workforce strategy. We fully support a national workforce strategy. As I said before—you have heard this a few times, I would think—we also think, like the last speaker, Romola from PWDA, that people with disability need to be firmly involved, so it must be included in the planning work for workforce strategy people with disability and their relevant representative advocacy organisations. We agree that PWD also need to be in roles within the workforce. Part of that is about ensuring that people as part of their training become more disability aware. The training to date has been very patchwork. People with disability haven't been involved in delivering any of that training as well, and that would be a great improvement to any of the training that is provided to support workers.

We think that people with disabilities also need to do part of the service support and that they do have a valued role in that. They have a great depth of understanding and they can relate to people with disability and also highlight issues for people with disability for other support workers within a particular service agency. So I think there's a real bonus there. That certainly fits with an inclusion model. It fits with ensuring that people with disability are part of the solution to the issue of workforce participation and workforce development.

The other side is really looking at how there need to be quality and safeguards, which are always key components. We do have the quality and safeguards commission. We would propose that there needs to be more work undertaken by the quality and safeguards commission in terms of workforce and workforce development and compliance. I think it's a little bit more than a policing role. I think there needs to be a little bit more of a role in the quality and safeguards commission sitting in that space only. But clearly there needs to be somebody who must control that, so the Q&S is the important one in that role. But, again, I think there needs to be greater interaction between people with disability and the quality safeguards commission and with people working and engaged there as well.

The other part of workforce which still hasn't happened is looking at community technical experts. That is another phase that I know the quality and safeguards commission has to look at. That is having an audit team which will audit to standards. We want to ensure that people with disability have roles as community technical experts on any of those audits that are being undertaken of service providers. That would reflect their experience and their expertise. They would be trained to be auditors as well. They would come in and ensure that there's a person with disability as part of any audit team. They would have a real understanding about what services are being delivered, how they are being delivered and how those people with disabilities are being supported and engaged by those services. I think that covers most of my points.

CHAIR: Thank you very much. I will lead off before I go to Senator Brown. In terms of the development of the workforce, who should be primarily responsible for the leadership of this? The NDIA would probably say that it is largely a funding body. You've got the choice and control principle as the basis of the scheme, and this gives much more authority and direction to the participant. You've got various governments which are involved through the national disability council and other organisations. It's struck me over the years that one of the deficiencies of the scheme is that ultimately nobody's in charge. There are various bodies and organisations that have responsibility for certain parts of it, but it relies on goodwill and coordination, and it could well be an area of workforce where development falls through the cracks because no-one's responsible. Is that observation accurate? If there is a need for some primary leadership, where should it come from?

Mr Joyce : That's a good question and a good observation, because it's spot on. It really seems to be the issue with the workforce that nobody does have the single charter on that. Who should do it? That's a good question. I think it really sits at a federal level. The appropriate department for that is probably the Department of Education, Skills and Employment, but it would be up to the government to work that out. But certainly everyone you mentioned—the NDIA; NDIS, which is the Department of Social Services running through that; and other levels in the government—are all responsible for that. I think somebody needs to take that leadership position on workforce and I believe that's really the federal level. It's for the leadership. That doesn't mean they're solely responsible for the undertakings, but we do need somebody to take that leadership, and I would think it's appropriate to be at that level through a relevant federal department doing that.

That would then mean that other jurisdictions, of course, have a responsibility to be engaged in that as well and also must commit to being engaged in that, because if we don't have all the states and territories as part of that then we'll end up again with a bit of a hotchpotch affair happening with the workforce training and development.

CHAIR: Thank you. Senator Brown.

Senator CAROL BROWN: Thank you again for your submission and presence here today. Are you aware that the Department of Social Services is currently in the process of developing an NDIS national workforce plan?

Mr Joyce : Yes, I am.

Senator CAROL BROWN: Does your organisation have any involvement in the development of the plan?

Mr Joyce : We've had some involvement, but I wouldn't call it large-scale involvement.

Senator CAROL BROWN: Can you quickly outline what sort of involvement you have had?

Mr Joyce : We had an opportunity to provide some input into the original taskforce that was looking at what was being developed there. We certainly made some good commentary on that. I think then there was COVID, so that could be one of the reasons why we haven't had much engagement since before March.

Senator CAROL BROWN: Okay. We've had some evidence and comments from other submitters that have talked about paid work and placements while completing training or studies. Would you agree that people who are complaining training or studies should be given paid work placements?

Mr Joyce : I'm not against it and I think our members would say that, as long as the person has been trained to an appropriate level to start with, that could work well. I think it would probably work better if they were part of a team providing that. In other words, somebody else who has been trained and has appropriate quals as needed was going with them in a shadowing role and also providing some supports. I think we would think that's okay. I don't believe we would agree that in-training placement would be suitable if somebody hadn't had appropriate training such as certain levels for daily support needs et cetera. Also, as mentioned earlier, that training of disability awareness needs to be a key part of any training that people are going to have. We would see those sort of things as just a workplace induction process as not the way to go.

Senator CAROL BROWN: Okay. I turn to employment. AFDO has put together a number of initiatives to support employment for people with disability. Can you elaborate on some of these initiatives?

Mr Joyce : Sure. The biggest one we've done is a project called the Diversity Field Officer Service. It's a project that we have been running for about five years. We just wrapped it at the moment at the end of June this year due to funding running out for that at this point. We're looking at continuing to do work in that. That was in the Geelong region. We approached organisations to get them more disability aware and also to get them committed to learning more about accessibility needs of not only their customers but also their staff.

We ran that quite successfully. We had some really good pathway outcomes for people with disability from that, where they attained full-time employment, part-time employment, traineeships, work experience placements and casual work. We had some excellent results coming from that. But what that all resulted from was the work that we did in nurturing the understanding of small to medium enterprises of the benefits of having people with disabilities in their workforce.

It also created other conversations about inclusion and diversity from all of those who participated. We had 112 businesses participating over the course, from the pilot right through the last five years. We had some great results from that, and all of that was also measured and evaluated by Deakin University, so every year we've got a review of that and the outcomes from that. What that highlighted is that a lot of businesses just have no idea and no awareness of people with disability in the community. What we were able to do is completely turn that around with those businesses that were wanting to get engaged, and we had some great outcomes and fantastic results for people with disability, and for young people with disabilities as well, coming into the workforce.

Senator CAROL BROWN: Ross, did you say that that initiative has now come to an end?

Mr Joyce : The funding has come to an end. AFDO is still continuing to stay in touch with the 112 businesses that we have engaged, but, obviously, we can't do the level of work that we were doing in that region. We would like to see it expanded and we are putting together a proposal to go to the minister for social services to have a discussion about that as an employment opportunity to build the participation rate of people with disabilities in the workforce, which is what we've proven we've been able to do over the last five years.

Senator CAROL BROWN: Thank you. Good luck with that. It'd be excellent to see that continue. Perhaps it could be expanded but also rolled out in other areas in other states.

Mr Joyce : Yes. That's our hope.

Senator CAROL BROWN: We talk about the casualisation of the workforce and people actually leaving the workforce because of various issues around working conditions, remuneration and the difficulties of recruitment. Are there key skills or competencies that all workers supporting people with disability must possess, or does AFDO believe that required skills and competencies are entirely different for each cohort of people with disability?

Mr Joyce : I think the short answer is that there can be a level of competency, skills and requirements for all disabilities. But, obviously, with some disabilities, there is a need to have additional training to supplement that. We'd be expecting that from the actual organisation, depending upon who the clients are that they're supporting. We'd need to be aware of that and ensure that an appropriate person from within the organisation trains any key workers who are supporting the person that requires an additional understanding in order to appropriately deliver those supports.

Senator CAROL BROWN: Has AFDO identified any key gaps in skills or understanding, as you have said, within the disability workforce?

Mr Joyce : Yes. I am on a committee which is looking at the skills required of people as part of their training in the disability space. One of the key things that I put forward at that was exactly what I said earlier, and that is that what's lacking is a real understanding of different disability types. The training is really a broad-brush thing, and there is an expectation, from what I can see in the materials, that people being trained have an understanding already about people with disabilities. That's not the case, so I think it's absolutely critical that there is more emphasis put on involving people with disabilities in the delivery of that element of the training. That would be even better. It's a little bit like the show that's been on, You Can't Ask That. So it's a great opportunity for people. There are a lot of people who've never met a person with disability or aren't aware that there's a person with disability when we start talking mental health things. So I think it's an interesting one. That's a big gap, and it's not only in that; I think it's across the spectrum. If you talk about health, there's very little done. I think GPs do about one unit, which is not much, on disability.

I think there's a whole host of areas where that sort of training and awareness should be provided. As I said, in our conversations in Geelong we discovered that, even though we looked at that through a disability lens, the conversation we ended up having with the businesses and their staff—and which their staff no doubt had with their families, after some of our work with them—was a greater conversation, on diversity and inclusion, than only looking at it specifically as disability. So there's great benefit in having those sorts of awareness conversations, and we certainly would strongly recommend that that be built in as part of any training for workers that are going to be supporting people with disability.

Senator CAROL BROWN: Does that lack of understanding, or incomplete understanding, impact on the quality and safety of services and providers?

Mr Joyce : Yes, I think it absolutely does. I think people are uncertain about how to act and behave and what the support needs are of a person with a particular disability or with multiple disabilities. We don't want to see a situation where someone is starting support work and using trial and error to get it right. They need to come in with the confidence, the capabilities and the understanding to interact with and support that person appropriately.

Senator CAROL BROWN: You're aware that there's work underway to implement a nationally consistent worker-screening scheme?

Mr Joyce : Yes.

Senator CAROL BROWN: Has AFDO been contacted about that at all?

Mr Joyce : Yes, we have. We had a discussion with them. I can't remember who was doing it. But, yes, we certainly did. I think that was earlier this year.

Senator CAROL BROWN: Does AFDO believe that will improve the quality and safety of services?

Mr Joyce : I think it's a start in the right direction. The devil's always in the detail with all of that. It's essential we have a consistent approach and a national approach. At the moment, as you know, there are still different things happening. I'm in Victoria, and there's a different system in place in Victoria. In South Australia there's something else in place. I think we do need a national standard, and to ensure that quality is part of the consistency of that model. Particularly if you're in the workforce and you move from one state or territory to another, you need to be aware of what the conditions are and what you need to be adhering to. A national standard would make it easier and simpler for workers to adhere to the standards that are required.

Senator CAROL BROWN: That's all for me. Thank you, Mr Joyce, for your time today.

Senator ASKEW: I want to continue with a couple of things that Senator Brown was discussing. I wanted to ask about the training that you were talking about, which seems to be happening without the involvement of people with disabilities. I worked for a disability provider, admittedly a few years ago, and that was one of the key things that organisation was trying to do. Have you come across best-practice organisations that are doing it right? Are there any that you could suggest we look at or talk to?

Mr Joyce : I don't recall any off the top of my head, but I'm more than happy to come back and provide that to the committee. In the comments I make I'm not intending to say that there aren't any. There are some excellent service providers out there. Certainly, we think that the engagement of people with disability—and it was pleasing to hear you mention your experience with the organisation that was trying to do that—is another missing piece of the puzzle of ensuring that appropriate and aligned supports are happening for people with disability. I'm happy to come back to the committee with a few suggested employers that you could have a chat to.

Senator ASKEW: It would just be valuable to understand, where there are good examples we could be pointing to, how they do it, compared to what we're hearing from so many others where that isn't happening—which is fair enough.

I just want to touch on the new national accreditation of training. I get that that's something that's very important to you and, I think, as a committee we probably pretty much agree with you. Obviously, there is such a diverse range of disabilities and so on trying to actually upskill into different areas. What would be the best way to make sure that the training that is provided best suits this? We've heard from others about, perhaps, micro-credentialing where there are short courses in specific types of disabilities or different needs for people with disability. Would that be the sort of thing you're talking about?

Mr Joyce : Yes, it is. But also it's just about the basics: it's about having that disability awareness to start with. We've certainly developed training—and we're happy to share some of the details of that with the committee as well—which does look at disability and does take into account lots of different disability types. I think, overall, it's about people just having, first-off, that awareness of disability, and also engaging with a person with disability without the first instance of that happening when they actually walk in the door to provide support to a person with disability. I think that's going to be the one that will start to break down a lot of barriers and misconceptions—and also unlock some personal bias. We all have personal biases; we may not be aware of it. So it brings that awareness out to people and then, from that, you build a greater understanding. I think it's probably a bit of both of those. If, for example, a service provider might be focusing on supporting particular people with particular disability, then obviously it would be essential that training would be tailored from the organisation's point of view for that. I think from an accreditation point of view it needs to be broader, but then it needs to be backed up by the relevant service provider and the people that they end up supporting in whichever areas they're working in.

Senator ASKEW: That makes sense. One other quick question regarding something you said earlier to do with the NDIS Quality and Safeguards Commission. You said that you believe there should be more than a policing role required. What other things should be included in their responsibilities?

Mr Joyce : I mentioned that the audits deserve a mention in that. You could say that's a policing role, but it's a broader role, and we'd like to see that happening sooner than later. It is in the requirements of the Quality and Safeguards Commission, but there hasn't been any movement on that happening. We think that that would offer a greater sense of quality assurance across all of the service providers. That also extends into learnings—or 'lessons' as I think we're supposed to correctly refer to that as—for the service providers and it includes providers' staff as well. From that they can better train as a team. I don't think it should be a punitive approach. I think it needs to be extended to that level. There is currently an inquiry on the Quality and Safeguards Commission looking at that as well.

Senator ASKEW: Excellent. That's all my questions. Thank you very much for your time this afternoon.

Ms COKER: Mr Joyce, thank you for sharing your thoughts and expertise with us this afternoon. If you could give your top three things that you believe need to be done to achieve a well-trained, full-time, quality workforce that provides disability care in metro, regional and remote areas, what would those three things be, and who should drive that change?

Mr Joyce : Good question; it's a tough one. I think if I were doing the three things—clearly, everybody's talked about the workforce strategy. I suppose I talked about who should lead that; I think it should be federally led. That needs to include all states and territories in that role, plus all the other key players and stakeholders—the NDIS, the NDIA, the service providers, people with disability and their relevant advocacy agencies, et cetera. That would be the first one that I think is really critical. I wouldn't call workforce in remote and very remote rural settings a wicked problem. It's not unsolvable. I think it is solvable. I think it's a question of looking at and speaking with those people that have been delivering service provision there for a long period of time about how they go about doing that and what the differences are, because you can't put a metro or even a regional mould over something in those areas. It's a very different way of operating and it requires a different sensibility to that.

I think that there need to be some incentive payments—that would be one way of looking at that—to encourage greater service provision in those areas. I'm sure people have mentioned that the NDIS pricing structure certainly can be limiting in how services can be provided and needs greater flexibility for those remote and very remote areas, in order to encourage other service providers to get involved in that. So I think incentives would be No. 2

No. 3 would be, again, listening to the communities there, listening to people with disability from those communities and ensuring that what they're looking for is taken into account—not just what somebody else might think is required there. To me, those would be the three key areas where we need to do things. As I said, I think there needs to be a federal leadership role in that.

Ms COKER: That was very succinct and helpful. I also have a question picking up on your point about listening. How do you think we ensure that people with disabilities are meaningfully involved in workforce planning?

Mr Joyce : I think you need to do that in a couple of ways, because we don't tend to do it very well as it is. The big buzz word is co-design, but we've yet to see really good co-design happening. What we think is important is that people with disability need to be at the table discussing the issues. That can be done in a range of ways, of course. You can operate it with focus groups and you can operate it with a whole range of mechanisms to get in touch with people. AFDO and our members can, obviously, get in touch with up to 3.8 million people, or more, that we have a connection with, so we can easily come back with what they want to do.

The other side of it, though, is that it needs time. It needs appropriate time for that engagement. Unfortunately, we're always pushing for deadlines and trying to rush things through. But, in order for us to ensure that people with disability have a say in and a real contribution to that workforce planning, it's going to take a bit of time to work that through with them and to give them the appropriate time to allow for accessibility and to allow for the support that organisations such as ours and our members have to provide to ensure that their voice is heard. So it does take time. It does take a fair bit of work. We're more than happy to get involved in that and happy to assist in leading and developing a really well-based, well-founded and thorough workforce strategy.

Ms COKER: The committee has heard that some participants have concerns about funding in plans being for activities that are not directly client-facing, such as training, completing paperwork and debriefing. Are these concerns shared by AFDO and the people you represent? If so, should staff training and other non-client-facing activities be funded separately from direct support?

Mr Joyce : That's a good question. We get a lot of concern from people about the management fees in their claim, which is what that's covering. I've looked at a number of invoices that people have received, and sometimes the management fee is as much as the support component, where they're actually getting direct support. That's a worry, because their plan is being utilised for that. I'm not sure that it's as easy as just separating that out, but I would agree that there needs to be work done on that, because that creates a real tension between people with disability and the service providers along the way, because, again, when you're looking at your bill and you're getting X of service and your management fee is X, exactly the same, that's going to cause you a bit of concern when you're looking at that. I do think that that needs to be looked at, and one of the resolutions could be, as you said, that maybe it's a separate area that is funded. I gather you mean that it's funded directly to the service provider and that it doesn't affect the person's claim.

Ms COKER: Yes. It seems a pity that the admin costs are taking away from that face-to-face client support, so it's something for us to be thoughtful about. Thank you so much for your responses.

CHAIR: Mr Joyce, I believe that's exhausted our questions, so I thank you for participating in the discussion today. We greatly appreciate it.

Mr Joyce : Thank you. It's been great, and thank you for the work the committee is doing.