NDIS - Mental Health Perspectives

National Disability

Insurance Scheme

(NDIS)

Psychosocial disability & the

NDIS Informa Conference 2016

Deborah Roberts

Director of Mental Health, Mainstream Interfaces & Behavioural Economics

Insurance Approach

Choice and Control

Community and

Mainstream

Pillars of the NDIS

The New System

Features Former system NDIS

Access Criteria Varies from state to state Nationally consistent

Choice and control Varies from state to state(most people had little say over the supports services they received)

Individuals have control over the type and mix of supports, delivery and how their funding is managed

Level of assistance Capped – people may be eligible but may spend years on waiting lists

Demand driven – people with disability get the support they need, when they need it.

Funding Multiple programs within and across governments

Single pool of government funding –administered by the NDIA.

Scheme Achievements

ContextContext

Overall Context

Projected Growth in NDIS participation - Source: NDIA/ NOUS report

The Path Ahead

NDIA Hubs and Expansion

• Regional model, with a ‘hub and spoke’ regional presence.

• 14 regions across the country (similar to other Commonwealth Agencies such as DHS.

• Regions are not necessarily defined by state/territory boundaries.

• Participants will engage with the Agency based on their usual consumer habits and preferences.

• NDIA offices will be a mixture of standalone sites, co-locations (with DHS and State/Territory governments) and visiting services.

• In addition to the Regional Hubs and other offices, the Agency will have a range of visiting services and outreach services into other locations.

NDIA Hubs and Expansion(Continued)

Region Potential Regional Hub

Region Potential Regional Hub

NSW South and ACT

Braddon VIC East Dandenong

Sydney Burwood VIC North Broadmeadows

NSW Central Penrith VIC West Geelong

NSW North Newcastle South Australia Adelaide

QLD South Southport Tasmania Hobart

QLD Central Chermside Northern Territory Casuarina

QLD North Townsville Western Australia*

Midland

*Note: Western Australia has not yet signed a Bi-lateral agreement. An expansion of the Trial Site has been agreed.

Psychosocial DisabilityNational Disability Insurance Agency

Background: NDIS and Mental

Health

A. Inclusion in the NDIS legislation and planning within the

scheme was later than for other disability groups but as a

direct result of the advocacy of consumers and carers.

B. Alongside the roll out of the NDIS, the NDIA is aware that

the mental health sector is undergoing significant parallel

reform.

• Review of Mental Health Programmes and Services

• Fifth National Mental Health Plan

The NDIA mental health team is actively engaged in these

processes.

Key Data: Psychosocial

Disability

(as at 30 June 16)

• The Productivity Commission Inquiry into Disability Care and

Support estimated that 411,250 people who would meet the

access requirements for Tier 3 funded supports in 2011-12.

• Further, the Productivity Commission estimated that

approximately 56,880 people would be participants with a

significant and enduring primary psychosocial disability (13.8%).

• In 2019-20 the number of expected participants in the NDIS is

approximately 460,000 of which approximately 64,000 participants

are estimated to be participants with a significant and enduring

primary psychosocial disability (13.9%).

Key Data: Psychosocial Disability

(as at 30 June 16)

• Across all trial sites 3,615 (10.1%) of all scheme participants have a

psychosocial disability, and 2,747 participants (7.7%) have

psychosocial disability recorded as their primary disability.

• However, in the New South Wales-Hunter and Victorian trial sites

the proportion of participants with a primary psychosocial disability is

12.2% and 14.2% respectively.

• Note, these numbers need to be treated with caution as NDIS trial

sites support variable age cohorts and psychosocial disability is still

being phased into the Australian Capital Territory and Western

Australian trial sites and potential participants continue to approach

the scheme.

Key Data: Psychosocial

Disability

(as at 30 June 16)

• 78% of participants with a psychosocial disability submitting an

access request have been found eligible for the scheme (noting that

a further 3% are in the process of having their eligibility assessed).

• 2,173 (79%) participants with a primary psychosocial disability

currently have an approved plan.

• Across all trial sites, $147.6m (6.2%) of approved committed

supports is for participants with a primary psychosocial disability.

Key Data: Psychosocial

Disability

(as at 30 June 16)

• Participants with a primary psychosocial disability have a range of

package values, with the highest proportion in the $10,000-$30,000

range, followed by the $30,000-$50,000 range.

• 71% of supports approved for participants with a primary

psychosocial disability who have an approved plan is committed to

assistance with life including supported independent living. 10% has

been committed to improved life choices, and 5% to each of

increased social and community participation and improved daily

living skills support categories.

Key IssuesPsychosocial Disability

Key issues: Psychosocial

disabilityNDIA has been listening to the mental health sector and understands

there are concerns about:

• Eligibility and access

• Language

• Holistic support

• Preplanning and planning processes

• Involvement families, carers, friends and informal supports

• Sector readiness

• Local Area Coordination (LAC) role

• Information, Linkages and Capacity Building (ILC)

• Mainstream interfaces

• Pricing

• Continuity of support

NDIA Mental Health Work Plan• The aim of the Work plan is to enhance the Agency’s capacity to respond to

people with psychosocial disability, their families and carers.

• The Work plan includes strategic streams which address:

– Mental Health sector engagement

– Key reviews and projects (access, support design, reference packages)

– Programme transition, data, and mainstream interfaces or reforms.

– Psychosocial Disability Community of Practice

– Key emerging areas

• PHN/LHN’s

• Transition of programmes

• Supporting transition and the role of LAC partners

• Market and supply data

• Pricing/funding/service mix

• Forensic/hospital discharge

• Outcomes framework

• MHA and Sector Development Fund

Mental Health Team Projects(not an exhaustive list)

• Operational Access Review

The purpose of the project was to review and make recommendations for amendments to the existing administration arrangements for access into the NDIS in relation to psychosocial disability.

• Joint Support Design project (in collaboration with MHA)

The broad aims of the Project were:

– To describe in detail the range of disability supports that NDIS participants with psychosocial disability may choose.

– To make evidence based recommendations, where new support items may be needed to adequately assist NDIS participants with psychosocial disability.

• Reference Packages (People with Psychosocial Disability) (with the Scheme

Actuary)

• Psychosocial Disability Website

To provide information to support people with psychosocial disability develop their own plans and self manage.

National Mental Health Sector

Reference Group (NMHSRG)• The purpose of the NMHSRG is to ensure a strong partnership

between the mental health sector and the Agency.

• The NMHSRG provide expert advice regarding national work

required to integrate mental health into the Scheme.

• Membership include:

– Consumers & Carers

– Mental Health Commissions

– Departments of Health (DoH) & Department of Social Services

(DSS)

– Mental Health Australia & Community Mental Health Australia

Mental Health Drug and Alcohol Principal Committee NDIS

Independent Advisory Council

– key NDIA staff.

• Communiques & key data summary - released Tri-yearly.

https://www.ndis.gov.au/NMHSRG-June-2016.html

Markets and PricingNational Disability Insurance Agency

Psychosocial disability market

• NDIA recognise certain professions & organisations that area staffed with

high qualified professionals do have price challenges.

• For other organisations there are service mix challenges.

• Organisations are beginning develop pricing and workforce strategies.

• In 2016/17, the Mental Health team will undertake the following work in

relation to the Psychosocial market:

– A Psychosocial Disability Market Position Statement is currently

being discussed within the Markets division.

– Research regarding ‘if Sector pricing concerns are a unit price issue

or an overall pricing and service mix funding issue’.

– Development of the concept of unit pricing as opposed to total plan

funding and service mix.

RecoveryNational Disability Insurance

Agency

Recovery and the NDISNational Disability Insurance Agency

• Recovery is about achieving an optimal state of personal,

social and emotional wellbeing, as defined by each

individual, whilst living with or recovering from a mental

health condition.

• Importantly, the NDIA understands that hope and optimism

are essential in recovery.

• The Scheme provides:

Choice and control for participants

A lifetime commitment to supports and funding as

required

Increased social and economic participation

Support a partnership approach

Completing the Access process for

the NDIS – Tips for communicating

about psychosocial disability

It’s all about assisting people with accessing the NDIA

This approach provides participants with plans quickly!!!

National Full Scheme intake by 2018-19

391,377^ Families Carers PIR LACNDIA

Partner

Mainstream

Interfaces

Mainstream Service & NDIA

National Working Arrangements• A participant’s plan may include a range of supports provided by

informal, mainstream and community networks.

• The NDIS is not intended to replace the supports or services

provided by other mainstream systems

• Before any funded support is added to a participant’s plan the NDIA

must be satisfied that the support is most appropriately funded

through the NDIS.

• The NDIA is currently updating and refining the Mainstream policy

documents (National Working Arrangements):

• These documents will guide regional offices on how to navigate the

different interfaces between the NDIA and mainstream services.

Hard to Reach Strategy

(Rural and Remote, Aboriginal and Torres Strait

Islander &

CALD)National Disability Insurance Agency

Rural and Remote Strategy

• The Rural and Remote Strategy was formally endorsed in November 2015.

• A range of activities are recommendation e.g. further simplification of access.

• An Implementation plan has been developed to support the Strategy.

• The Implementation Plan is awaiting final circulation with Business Areas.

• This Implementation Plan has been developed in close partnership with:

Commonwealth, State and Territory Governments

NDIA business areas

NDIA Rural Remote Aboriginal and Torres Strait Islander Reference Group

NDIA Rural and Remote Working Group

Aboriginal and Torres Strait

Islander Strategy• The Aboriginal and Torres Strait Islander Engagement Strategy has been

approved by the NDIA Board.

• It is a statement of the NDIA’s commitment to walk with Aboriginal and Torres

Strait Islander communities in delivering the Scheme across Australia.

• It complements the Rural and Remote Strategy with it’s approach to:

– Creating Local Solutions

– Market Enablement

– Leveraging and Linking

– Tracking progress

Culturally and Linguistically

Diverse (CALD) Strategy• The draft strategy is currently being developed and reviewed by the CALD

Stakeholder Advisory Group.

• A CALD Action Plan is being designed at the moment by the section.

• Local Area Coordination Partners: CALD requirements built into LAC

contracts & staff profile is reflective of the community they service.

• Information, Linkages and Connections: One priority investment area is

CALD focused service delivery processes.

• Market development activities.

• Developing working arrangements with State Governments to transition and

engage CALD communities.

Additional

Resources

Additional Resources

• National Mental Health Sector Reference Group Sector Communiqué – June 2016 ( https://www.ndis.gov.au/NMHSRG-June-2016.html )

• Mental Health and the NDIS: A Literature Reviewcommissioned by Mind Australia for the NDIS Independent Advisory Council (IAC)

(https://www.ndis.gov.au/html/sites/default/files/files/Mental-health-and-the-NDIS-Literature-Review.pdf)

• Psychosocial Disability and the NDIS: An Introduction to the Concept of Holistic Psychosocial Disability Support by Paul O’Halloran

(https://www.ndis.gov.au/html/sites/default/files/O'Halloran%20paper.pdf)

• The NDIS Independent Advisory Council Advice on Implementing the Scheme for People with a Psychosocial Disability (https://myplace.ndis.gov.au/ndisstorefront/about-us/governance/IAC/iac-advice-mental-health.html)

• NDIS and Mental Health Webinar (http://webcast.viostream.com/?viocast=7837&auth=09bf0e32-3eac-49c5-8cbc-337067bc65ad)

• Key Themes Arising from the NDIS and Mental Health Webinar (https://www.ndis.gov.au/html/sites/default/files/documents/NDIS-Mental-Health-Key- Themes.docx)

• Completing the access process for the NDIS - Tips for Communicating about Psychosocial Disability (https://www.ndis.gov.au/people-disability/access-requirements.html)

• Carers Australia Victoria – Interview with Eddie Bartnik(https://www.carersvictoria.org.au/file-assets/interview/eddie-bartnik/)

• Mental Health Australia: Supported Decision Making, Psychosocial Disability and the National Disability Insurance Scheme (https://mhaustralia.org/general/ndis-capacity-building-project-papers)

Additional Resources (continued)

External Resources

• Mental Health Perspectives - National Disability Insurance Scheme

(NDIS) developed by the NSW Mental Health Commission

(https://www.youtube.com/watch?v=9X-ea-O50Vg)

• Mental Health Australia – Sector Development

(https://mhaustralia.org/ndis-capacity-building-project)

• Unravelling Psychosocial Disability - Position Statement developed

by the National Mental Health Consumer and Carer Forum (NMHCCF)

(http://nmhccf.org.au/publication/unravelling-psychosocial-disability-

position-statement)

Additional Resources (continued)

Questions and Answer Session

Email: Mental.Health.Team@ndis.gov.au