NDIS Self‐Management Approaches: Opportunities for choice and control or an Uber‐style wild west?

Abstract

This article examines the emerging challenges and opportunities presented by self-management options in Australia's National Disability Insurance Scheme (NDIS). We examine the three different ways in which NDIS participants can opt to self-manage their funding and services, including direct employment and emerging Uber-style online platforms, and explore the potential implications of these options for NDIS participants, service providers and the disability support workforce. In particular, we focus on these options in relation to the transition to a marketised services landscape being developed alongside the NDIS, and examine both the risks and opportunities for each stakeholder group. Through this analysis, we identify implications for policy and practice, in particular around regulatory mechanisms and the role of government within this emerging market economy and transforming service landscape. K E Y W O R D Sdisability support workforce, individualised funding, marketisation, NDIS, self-management, Uber

Deaf and Hard of Hearing Early Intervention: Perceptions of Family-Centered Practice

“…It is important to consider FCP in the context of the introduction of the Australian National Disability Insurance Scheme (NDIS) and the resulting move from block funded service provision towards individual funding models within early intervention services. The NDIS aims to enhance choice and control for participants through personalized planning and the allocation of individual funding packages, allowing participants to choose and purchase the services they need (David & West, 2017). This new funding approach reflects a major disability policy shift to a consumerism model, re-orienting funding to the participant rather than the service provider (Brien, Page & Berman, 2017).…”

Australia's New National Disability Insurance Scheme: Implications for Policy and Practice

“…increasing research interest in the scheme, with a range of papers, reports, and commentary on the NDIS being generated by different stakeholders (for example, David and West 2017;Dickinson, Needham, and Sullivan 2014;Productivity Commission 2017, 200;NDIS 2017c, 4; NDS 2017a; Every Australian Counts 2017). An audit of disability research in Australia in the time period 2000-2013 found that there was "not a critical mass of research on topics of priority to the National Disability Strategy, the National Disability Research and Development Agenda and the National Disability Insurance Scheme" (Llewellyn 2014, 6); an update just three years later found that "almost half of the policy papers addressed the National Disability Insurance Scheme (NDIS), with papers on operational issues and also more theoretical papers examining the broader social and health policy context in which the Scheme is operating" (Llewellyn 2017, 7).…”

Factors that influence the quality of paid support for adults with acquired neurological disability: scoping review and thematic synthesis

“…Quality support relies on a high quality workforce, yet traditionally the DSW role has little or no training or qualification requirements [12,21,31,32,85]; indeed in practice requisite competencies and qualities are largely defined by job descriptions authored by service providers [86]. Further, new individualised funding models enable people to directly hire DSWs who they consider suitable to their needs and preferences, but with that comes the employment responsibilities as well as the task of recruiting, hiring and managing the performance of DSWs [50,87]. Thus, it is critical to understand the qualities PWD value in DSWs but the evidence is limited, particularly within acquired disability research.…”

“…A preference for continuity of support was described by all three participant groups, as it enables better quality relationships and more individualised support. It also reduces the burden of recruiting and directing new DSWs for the person with disability, which has been shown to deter individuals from pursuing the option of direct employment [87,97]. However, the factors that are considered important to experiencing continuity of support have been shown to be variable between stakeholders, with clients putting more emphasis on service delivery and service providers focusing on the management and coordination of support [98], thus there is a need for up-to-date research to understand this concept fully.…”

“…Due to the lack of specialist disability services in rural and remote communities, this review provides evidence that geographical location can limit access to support for PWD, in line with previous research [103], as well as concerns raised by the Productivity Commission [12] in Australia with the introduction of the NDIS. Further to this, previous research has shown that people with neurological impairments, mental health problems, complex needs, with limited support to manage the aforementioned increase in administrative and financial obligations, can be disadvantaged in accessing adequate funding and supports [87,97,102]. Additionally, Mavromaras et al's [28] evaluation of the NDIS found that people with "intellectual disability and/or complex needs; from CALD [culturally and linguistically diverse background] communities; those experiencing mental health, substance abuse, or forensic issues; and older carers who were socially isolated and had their own health issues" were less likely to receive adequate supports than others with similar needs.…”