David Meldrum www.mifa.org.au
Executive Director www.MiNetworks.org.au
THE BIG PICTURE – where we started
NDIS transforms a muddled landscape of psychosocial disability supports
into a participant driven, cost effective insurance model which is consistently
delivered across Australia.
In the process the new system doubles the funding available.
SO
Health and clinical services continue to be state managed.
Eventually, the rest of the ‘mental health system’ is managed and funded by
NDIA – like aged care.
BUT
Most jurisdictions have not agreed to that scenario – at least not yet.
SO
Where has the NDIA begun implementation?
With what we are agreeing to call ‘Tier 3’ in the trial sites
Who is in Tier 3?
People with a diagnosis (current) and associated permanent disabilities.
This has proven to be a dangerously wrong assumption.
Wrong because so many people in need of hands on services don’t fit either of
those descriptions - ie they are in Tier 2.
Dangerous because Commonwealth funding and possibly some state funding for
Tier 2 services has been committed to Tier 3.
THE TRIALS
You all know about these
I am going to focus on the Hunter
More than 60 people there have been allocated NDIS packages (very
few elsewhere)
Important progress has been made
•NSW MHS relationships
•PiR relationships
•Clarification of eligibility
• Building a community of practice
TIER 2
Federal Govt and NDIA now recognise the importance of ‘Tier 2’ services.
In fact they recognise the case for expanding them because they are•Effective•Preventative•Efficient•Largely participant driven
Some arrangements to ensure this outcome will emerge soon.
BUT
Tiers 2 and 3 need much better definition - in the interests of funders,
participants and service providers.
My view is that where services cost in excess of around $10,000 pa, the
person should become eligible for Tier 3.
I don’t believe that the insurance model works for Tier 2. Block funding
should continue within the usual contract management frameworks.
This way we may end up with a clearer picture of Commonwealth/State
responsibilities.
WHAT WE DON’T KNOW
How many Australians might be eligible for Tier 3.
Anybody who says they know the answer to this, is kidding themselves.
All available data sets come to different answers – NMHSPF, AIHW etc
Prescriptions for anti-psychotic medications shed some light on this complexity.
If we build it right, some of them will come
SUMMARY
Agree to protect and grow ‘Tier 2’ services.
Keep talking constructively about the number of people – settle on a
number for now but keep under continuous review.
Keep talking about ‘permanence’ and diagnosis.
Learn as much as we can from the trial sites about assessment,
choice and control, about eligibility and costs.
Properly and continuously engage with people who may be eligible for
these services.
David Meldrum www.mifa.org.au
Executive Director www.MiNetworks.org.au
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