NSW Health Implementation of the National Disability Insurance Scheme · 2017-05-02 · National...
Transcript of NSW Health Implementation of the National Disability Insurance Scheme · 2017-05-02 · National...
James Stormon
Social Policy Implementation Unit
Government Relations Branch, NSW Health
NSW Health
Implementation of the National Disability Insurance
Scheme
National Disability Insurance Scheme
Most significant social reform since the introduction of Medicare
Delivered in concert with other disability reforms – National Disability Strategy
(Disability Inclusion Action Plan1) and the National Carers Strategy (NSW
Carers Strategy2)
Social insurance scheme providing a package of supports for people with
disability found eligible, with funding in part from a dedicated income tax levy
Aims to support, independence, social and economic participation and
enable choice and control
NSW and the Commonwealth agreed to support 140,000 people, including
50,000 currently not receiving NSW disability supports
NSW full scheme roll out planned by July 2018
1 http://www.health.nsw.gov.au/disability/Publications/disability-action-
plan-16-19.PDF 2https://www.adhc.nsw.gov.au/__data/assets/file/0017/300077/NSW_C
arers_Strategy_2014-19.pdf
W
Where have we come from?
Disability Care and Support
Productivity Commission
report proposes the NDIS
2011
2013
Bilateral Agreement between
Commonwealth & NSW,
Transition to NDIS 2015
NDIS Act and NSW enabling
Act 2013
July 2013 NDIS trial commences in the
Hunter region
Applied Principles and Tables of
Supports (APToS) – delineates
the responsibility of mainstream
services and the NDIA
2015
Early Launch commences in
Nepean Blue Mountains LHD –
children and young people 2015
2016 Full scheme commences
with the roll out of Year 1
districts / networks
2016 Operational Guidance for NSW Mainstream
Services on the Interface with the NDIS
(Mainstream Interface)
2017 Year 2
districts
transition to
the NDIS
NDIS history
Projected NDIS expenditure (2019–20)
Adapted from the Department of Parliamentary Services, Parliamentary Library, Research Paper,
The National Disability Insurance Scheme: a quick guide, 1 September 2016
James Stormon
Social Policy Implementation Unit
Government Relations Branch, NSW Health
NSW Health
Implementation of the National Disability Insurance
Scheme
Health Executive Management Group (Meet as required)
Men
tal H
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le
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ity
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ive
Imp
airm
ent
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mm
un
icat
ion
s MoH
Working Group
NDIS Reform Group
(DPC/TSY)
Government Relations
Branch
MoH Governance
NSW Governance
Dis
abili
ty P
olic
y
NDIS Steering Committee (Deputy Secretary)
NDIS Transition Board
(Secretary)
Local Governance (LHD/SHN SteerCo)
Implementation Steering Committee
(NNISC)
ROWG - Central
ROWG - North
Senior Officers’ Group
Alli
ed
Hea
lth
Ab
ori
gin
al H
ealt
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AC
I
Info
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ion
M
anag
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ROWG - Sydney
ROWG – South & ACT
PMO
Bilateral Steering Committee (BSC)
Health
Implementation Governance
Regional Operational Working Groups
• Seek to resolve
operational
issues
• Escalate
issues / risks
• Report to the
NSW NDIS
Implementation
Steering
Committee
(NNISC)
NSW Bilateral Agreement - Applied Principles
and Tables of Support (APTOS3)
3 Schedule I (pg 47) http://ndis.nsw.gov.au/wp-
content/uploads/2015/07/Bilateral-Agreement-between-the-Commonwealth-
and-New-South-Wales-2.pdf
Health is responsible for:
Diagnosis and clinical treatment
of health conditions (including
ongoing or chronic)
All supports directly related to
maintaining or improving health
status
Rehabilitation and support after a
medical or surgical event
Medications and pharmaceuticals
The NDIS will fund supports that help
a participant to manage ongoing
functional impairment that results from
their disability, which includes:
Supports that enable participants
to undertake activities of daily
living
Aids and equipment
Therapy supports that enhance
function for children
Other therapy directly related to
maintaining functional capacity
Role of the NSW Ministry of Health
Achieve our objectives by:
Working collaboratively with NDIA and others to ensure effective
implementation of the NDIS
Maximising opportunities and minimising impacts on health services
Communicating with staff across NSW Health on the changes that are needed
to get the best outcome for individuals under the NDIS
Guiding transition planning – consulting with LHDs/SHNs, creating transition
deliverables, providing support and advice
Creating a range of formal tools e.g. Implementation Toolkit, Provider Tool
Monitoring, evaluating and modelling the impacts on the health system
Monitoring of service provision market development
Operational Guidance for NSW Mainstream
Services on the interface with the NDIS1
Working arrangements between the NDIS and other mainstream service
systems is crucial for the success of the NDIS.
The Mainstream Interface is informed by the Applied Principles and
Tables of Support (APToS). It outlines the agreed funding and service
delivery responsibilities of the NDIS and mainstream services.
Mainstream systems need to adjust to work with the NDIS – referral,
access, planning and service delivery for people accessing mainstream
services and the NDIS.
If the condition has not been identified as a permanent impairment/
functional capacity by the NDIS, evidence of impact is required. Allied
health professionals can complete part F of the Access Request Form or
the NDIS Supporting Evidence Form.
1. http://internal.health.nsw.gov.au/communications/ndis/
Hunter New England key learning
Local protocols to identify clients who require prioritisation by
the NDIA.
Detail and language of supporting documentation can reduce
the impact of process delays.
Clinical staff need to consider those people who may have
reduced capacity to advocate for themselves (children and
mental health clients).
The transfer of services from ADHC to NDIS will imply some
challenges (e.g. in-home supports for children deemed
ineligible for the NDIS; post-operative care to children;
continence aids and equipment, home enteral nutrition).
Rural markets may be at risk of market failure.
James Stormon
Social Policy Implementation Unit
Government Relations Branch, NSW Health
NSW Health
Implementation of the National Disability Insurance
Scheme
Early Childhood Early Intervention
• The type of supports
offered will be different
for every child and
their family according
to their individual
needs.
• Children aged 0-6 do
not need to have a
diagnosed disability to
access Early
Childhood Early
Intervention under the
NDIS.
• Providers are listed
here: https://ndis.gov.au/ecei/NSWe
ceiproviders.html
https://www.ndis.gov.au/html/sites/default/files/Early-childhood-Early-
Intervention.pdf
Mainstream Interface and the ECEI
Early childhood health professional can provide advice to the
parent/carer on possible impairments requiring professional
assessment or which could be addressed through ECEI.
Early childhood care providers to encourage families of children
with delay or disability to contact health services for an
assessment.
Early childhood partners may provide initial supports. If the child
needs more intensive supports, they will be referred to the
NDIS.
Children that are currently ADHC funded do not have to lodge an
application for the NDIS.
James Stormon
Social Policy Implementation Unit
Government Relations Branch, NSW Health
NSW Health
Implementation of the National Disability Insurance
Scheme
NDIS transition schedule
The start of transition
https://www.ndis.gov.au/medias/documents/hc6/h8e/8800064339998/Qtr-2-
Poster-NDIS-2016-17-V0.6-accessible.pdf
https://www.ndis.gov.au/medias/documents/h01/hea/8800417775646/National-Dashboard.pdf
Potential risks and challenges
Timeframes to process urgent and prioritised clients
Operationalising ‘Continuity of Supports’
Local Health staff may not have clarity on supporting information needed
for the Access Request Form
Number of external factors can affect the outcome of the NDIS plan
Information sharing
Operational issues during transition
Market development
Capability of workforce in the private market
Potential for market failure in rural and remote areas
Health and disability interface
Clarification around services that will continue to be provided by NSW
Health and services provided by the NDIS
Identification of service gaps
o barriers including Intellectual Disability, Mental Health, Justice
and ADHC disinvestment
Potential risks and challenges (cont.)
What we’ve learnt so far
Trial experience – overall positive, some issues identified, particularly system
interface, new client scheme entry and market development
Scale and complexity of the NDIS transition
All of the answers not in place – we are building new practice
Local relationships and governance mechanisms are critical to resolve issues
Good understanding of the Applied Principles and Tables of Support (APToS) at
the local level translates into effective service responses for clients and good
client outcomes
Changes to operational practices and cultures are needed to ensure the success
of the scheme