National Disability Insurance Scheme (NDIS) Minister Bill Shorten announced this morning an ambitious goal to reduce the number of people with disabilities left waiting in hospital after they’ve been cleared for discharge.
More than half the 2328 NDIS participants in hospital are medically ready for discharge but lack an appropriate support system and accommodation. This costs the hospital system up to $3 million a day. In an interview with The Australian, Shorten said he aimed to “find out where the obstacles are”.
But disability advocates say the obstacles are clear and want initiatives already in place to be extended and more action to streamline the lengthy funding approval process.
Long wait for funding
Shorten said he was challenging the National Disability Insurance Agency (NDIA) to respond to disabled people within four days once alerted that they were ready to be discharged from hospital, and to increase the number of NDIS staff in each hospital from 33 to 40 to assist discharge teams.
Head of corporate affairs at disability housing advocacy agency the Summer Foundation Tim Naughtin said the NDIS was complex and understaffed. A report it produced in May found the number one reason for discharge delay was getting NDIS plans and funding approved.
“Around 30% of those waiting in hospital are still waiting for the NDIA to process their application, and another 20% are trying to find housing,” Naughtin said.
Many of those waiting to leave hospital had acquired a disability for the first time, or a new injury that meant they needed greater support. Those with brain injuries experienced the longest median stay in hospital — 161.5 days; the longest recorded stay was 1312 days.
“The systems aren’t evolved — there are parallel systems running alongside each other that don’t talk to each other … with relatively junior staff making decisions based on 30-odd pages from medical professionals,” Naughtin said.
While there are shortages of specialist disability housing in rural and regional areas, there are thousands of vacancies in metropolitan areas but people weren’t aware of their options, he said.
Shorten has pledged to lift the NDIS staffing cap and review labour hire arrangements.
More support for those with complex needs
The NDIS is not only overly complex, Jennifer Smith-Merry, the director of Sydney University’s Centre for Disability Research and Policy, said, but it lacks support for people with complex needs. An estimated 10-15% of all NDIS participants require complex support.
“[The NDIS] don’t really do the job of integrating care for people with very severe complex needs. If you can’t get the services right around the person, then hospitals are not going to discharge them because they’re not going to discharge them into something where they’re not safe,” Smith-Merry said.
“People get stuck at all points in the system.”
She called for the Complex Support Needs Pathway, which provides specialised support for people with higher levels of needs, to be extended. Implemented in 2020, it’s set to expire at the end of the year.
“There’s frustration because there are lots of time-limited add-ons that go on to the design … and when they stop the problems are still there because we’ve still got uncoordinated systems,” she said.
“If we just keep putting connectors into a system that’s complex, we’re not actually fixing the problem. We’re just connecting a damaged system that doesn’t really function efficiently.”
Are you or someone you know having problems with the NDIS or NDIA? Let us know by writing to letters@crikey.com.au. Please include your full name to be considered for publication. We reserve the right to edit for length and clarity.
In the old days, when you were disabled, you got looked after by the state directly. Now with all this farming out, creation of pseudo support businesses, which are an excuse to transfer public money to private pockets, very little trickles down to the disabled. And as a paraplegic why should I have to fight, or apply through endless private systems to get basics?
and in addition as I was over 65 at th etime i became disabled I am not even eligible for NDIS!! Have to have my battles through My Aged Care.
Much of it is spent on ‘coordinators’ (who can’t coordinate because their job turnover is so high that they don’t know the client and haven’t had proper handover), assessments and reassessments. I know someone who has been reassessed a couple of times (at about $1,000 a pop for the OT assessment and report) for his driving potential. By the time a few lessons are organised, it’s time for the next reassessment.
I’m a nurse in mental health services. A big part of the problem is state governments doing their best to offload the costs of disability care to the federal government.
Where did the vast majority of these disabled patients come from BEFORE hospital admission? They can’t all have been homeless, surely…and they can’t all have had their conditions made worse by this hospital admission, can they? So why can’t they just go back to their original place of residence? Just asking…because after 50 years as a registered nurse (now retired), I find the whole situation puzzling.
That’s ‘many’…what about the rest of them? And even of the many, surely they came from somewhere? Don’t the people who housed them previously have some responsibility for their on-going care?
It seems this is where NDIS packages fail people. Either because it takes ages for packages to be ‘negotiated’ or because the packages are basically not adequate. As an ex nurse myself the biggest failure I see is that the previous system was not for profit and provision of care was assessed based on need and supplied by providers employed by government agencies. Here in Adelaide we had the Royal District Nursing Service and the Home and Community Care. Between them they they supplied great care to many thousands of people and no one made money out of the system. It makes my eyes roll when I hear about people making money out of ‘brokering’ services to vulnerable people. I would like to see a Royal Commission into how many has been spent since this mad system got introduced. I think multi millions of dollars have been squandered.
Thanks Margaret…I too live in Adelaide, and I think the RDNS has been privatised…maybe?
Anyway, I heard somewhere in the past 12 months that ONE disability ‘package’, which was being disputed by NDIA, was worth $450,000/year! Now that is just NOT sustainable, even if there are only a few such totals.
It is like everything else these days…they close down the public institutional care facilities, decide all care needs to be done at home/privately, and it costs ten times as much.
The whole deal needs a new system, before we all go broke!!
Sgree with Drastic. It may well be a case of which departments bucket of money gets charged. Holders of buckets of budgets who could be lumbered with the cost pass the case onto other holders of budgets that could be lumbered until the file lands somewhere that it cant be moved on from. This takes time. Precious limited budgets are protected. Patients suffer. Business as usual.
Assuming those 1000 NDIS people did leave the hospitals, their places would be taken by others who would cost the hospital system the same money. In the meantime the NDIS is saving money by having their people dossing for free in hospital. There would not be a great deal of financial motive for anyone to change things. So expect no change, other than Bill Shorten doing star jumps in front of the cameras. Pretty soon the musical chairs game in Canberra will take the heat off him. He’s doing his job as per the usual regs. He’ll be doing star jumps in front of a submarine before you know it. If he can find one.