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Support for all people with disability to better navigate mainstream and disability supports

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Finding the right supports can be complex, costly and time consuming

We have heard about the complexity people with disability and their families face navigating poorly integrated service systems every day. This includes services across different levels of government and different departments and programs.

Complexity acts as a barrier to social and economic participation. Despite being highlighted multiple times by previous reviews and inquiries, change has been slow, complexity persists and little help has been provided to help people navigate the system.94

Most people with disability have multiple interactions with other government service systems. Participants and providers alike find the interfaces between the NDIS and other systems confusing.

The NDIS currently has multiple functions to help participants navigate in and outside the NDIS. However, these roles are split, and sometimes unintentionally duplicated, across Partners in the Community, Support Coordinators, Specialist Support Coordinators and Community Connectors, as well as Plan Managers. National Disability Insurance Agency (NDIA) Health and Justice Liaison Officers also play a role working with hospital and correctional service systems.

I think what makes that particularly worse for the person with a disability is it's complex and there is no single service or someone that can represent their views other than an advocate to navigate those complexities. So be it, you know, NDIS and SDA, social housing, access to the private rental and those processes, so you are pretty much on your own navigating all of that, unless you get a good advocate.

– Person with disability 95

Splitting these roles into so many pieces has added unnecessary complexity and resulted in considerable variation in the type and quality of navigation support. The level of access or availability of these functions is also inconsistent. Some participants are not funded to access Support Coordinators and Partners in the Community are constrained by significant caseloads and aren’t present in all locations. This means there is often no single point of contact to help people access supports.

Not having a consistent contact point means that I feel like I have to repeat my story on multiple occasions, and that I am just a random client, not a family and a human with a story, cause and knowledge that I bring, and a plan.

– Carer 96

We have heard from participants and their families that additional external support is required to successfully navigate the NDIS and interfaces with other service systems.

Support Coordination isn't just an option for NDIS participants, it's a must have thing. Participants need an advocate on their side who knows the system, how to interact with providers and to book services. Not having this is wasting the NDIS's money, as participants who don't have these services are left spending their funding without guidance and are open to exploitation.

- Participant 97
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There are issues with the implementation of the Partners in the Community program

Issues with the implementation of the Partners in Community program have been raised in previous reviews.98 We have heard the same issues from participants, families and other technical experts. Partners in the Community are community based organisations that work with the NDIA to deliver the NDIS. They include Local Area Coordinators who assist people 9 years and older and early childhood partners who assist children under the age of 9 and their families.

The Productivity Commission originally envisaged the local area coordination model as having a key role as ‘the scheme’s case managers’. Their purpose was to provide “broad services, including individual or family-focused case management and capacity building within a specified geographical area”.99

Funding and staffing constraints in the NDIA have led to Partners in the Community being diverted from their intended role to focus almost entirely on access and planning tasks. This has left people with disability without support to implement their plans and prevented community capacity building. Very high caseloads have meant Partners in the Community spend limited time with each person. As a result, relationships have become transactional rather than relational, and people with disability are not being supported to achieve the outcomes that matter to them.

The large-scale contracting of Partners in the Community means they can often lack the deep local knowledge and disability expertise needed to provide people with support that meets their needs.

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Support coordination is not available consistently and not proportional to need

Support coordination is currently funded by the NDIS to assist participants to understand their plan and make the best use of their budget, connect people to supports and build individual capacity. We have heard many participants do not receive enough help to coordinate and implement their plans effectively. Support coordination is only available to some people and there is not a consistent approach to ensure people receive support that is proportional to their needs.

"For many participants there is no, or inadequate, support coordination funding. Families and carers of participants with no, or inadequate Support Coordination funding, face difficulty navigating the complex NDIS service market." – NGO 100

Decisions about the level of support coordination funding can be influenced by how well participants and their supporters - or Support Coordinators - can advocate for funding. There can also be inconsistent application of the concept of reasonable and necessary supports and unclear guidelines to determine what level of support coordination is needed.

"Many Participants who are in desperate need of support coordination funding, either receive no such funding or inadequate funding. The fact that some Participants are reluctant to use their allocated funding, due to being considered as a “burden to society” means that they might leave things until they escalate into a crisis situation. Thus ultimately needing an increase, not decrease in support coordination funding." – Person with disability 101

There is mixed feedback on the quality of support coordination. We have heard of some providers that are very highly valued by participants and their families, as well as other providers that are not providing support with sufficient care, skill or integrity. There is little consistency in the support coordination market and participants can experience a lottery of whether their provider or specific Support Coordinator is effective or not.

There is also strong concern about conflict of interest and client capture when providers or other NDIS services also provide support coordination to participants. This is of particular concern when participants have limited natural safeguards.

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The Complex Support Needs Pathway is not meeting the specialised needs of some participants

There were approximately 10,400 participants in the NDIS on the Complex Support Needs Pathway as at June 2023.102 This pathway was designed to provide specialised assistance from the NDIA for participants who have many different challenges in their lives. These may include mental health, incarceration, homelessness, or a higher level of specialised supports required to meet their needs.

People with disability and the broader disability community have told us there are many challenges with the Complex Support Needs Pathway, including that the number of participants eligible is surprisingly low. Limitations on NDIA resources have meant that the additional support isn’t available for many participants with higher needs.

There is a support gap to help people with disability with many different challenges meet access requirements. This is because streaming to the Complex Support Needs Pathway happens after access has been granted. Those who are transitioning from hospital or justice are supported by specialist Health and Justice Liaison Officers, but this is not consistently available to support broader access requests.

These challenges are compounded by a lack of coordination between different government service systems to provide a continuum of care outside the NDIS. The people with the most complex needs generally have the most complex support arrangements and require person-centred rather than system-centred support to manage this complexity.

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