the NDIS An Invitational Roundtable Eddie Bartnik, Mary Hawkins, - - PowerPoint PPT Presentation

Mental Health and the NDIS

An Invitational Roundtable

Eddie Bartnik, Mary Hawkins, Belinda Krause & Mark Rosser

November 2016

Agenda

Invitational Roundtable on Mental Health and the NDIS

DATE: Wednesday 2nd November 2016 VENUE: Pullman Sydney Airport

Time Items Presenter 09:30 – 10:00 Registration and Morning Tea 10:00 – 10:30 Welcome, acknowledgement of traditional owners of the land, introduction of National Office staff and delegate introductions Mary Hawkins NSW and the NDIS context 10:30 – 11:30 Markets and Providers Update Question and Answer Session Mary Hawkins 11:30 – 11:40 11:40 – 11:50 11:50 – 12:00 NDIS Overview Strategic Update: NDIA Mental Health Work Plan Strategic Update: Scheme Actuary’s Data on Psychosocial Disability / Insurance Question and Answer Session Eddie Bartnik Belinda Krause 12:00 – 12:45 Table Discussions:

• NDIA Work Plan 2016 / 17
• Scheme Actuary Data
• Markets, Providers & Pricing

12:45 - 1:30 Break for Lunch 1:30 – 1:40 1:40 – 1:50 1:50 – 2:00 Project Update: Operational Access Review Project Update: Psychosocial Supports Design Project Update: NDIA Products Mark Rosser 2:00 – 2:45 Table Discussions:

• NDIA Work Plan 2016 / 17
• Support Design
• Overall Priorities

2:45 – 3:30 Feedback Session & Close 3:30 - 4:00 Networking Session and Afternoon Tea

Welcome – Mary Hawkins

• Acknowledgements
• National Office staff introductions
• Delegate introductions
• NSW context

NSW

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2016-17 2017-18 2018-19 NSW 14,921 9,628 9,276 9,397 17,150 13,448 15,014 14,608 6,601 6,601 6,601 6,601

5K 10K 15K 20K

NSW (phasing by area) 2016-17 Central Coast Hunter New England Nepean-Blue Mountains South Western Sydney Southern NSW Western Sydney Northern Sydney 2017-18 Illawarra Shoalhaven Mid North Coast Murrumbidgee Northern NSW South Eastern Sydney Sydney Western NSW Far West 2018-19 New participants JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN Total 2016-17 8,417 3,252 3,252 3,210 3,209 3,209 3,092 3,092 3,092 3,133 3,132 3,132 43,222 2017-18 8,206 4,472 4,472 4,483 4,483 4,482 5,005 5,005 5,004 4,870 4,869 4,869 60,220 2018-19 2,201 2,200 2,200 2,201 2,200 2,200 2,201 2,200 2,200 2,201 2,200 2,200 26,404

Markets and Providers

Mary Hawkins

2 November 2016

Introduction to the NDIS

• The National Disability Insurance Scheme (NDIS) is the new way of

providing individualised support for people with disability, their families and carers.

• The National Disability Insurance Agency (NDIA) administers the NDIS.
• People with disability choose the providers they work with.
• Over 460,000 Australians with disability will enter the NDIS in coming

years.

• There are growth opportunities for providers who respond to this new

demand.

• Resources and tools will be available to help providers adjust to the new

market environment.

The NDIS path ahead

Projected Growth in NDIS participation - Source: NDIA Actuary

Context Context

Overall Context

Sourced from: Parliamentary Library The National Disability Insurance Scheme: a quick guide

How does the NDIS market compare with other comparable markets?

Types of services funded under the NDIS

• For a support to be funded it needs to be reasonable and necessary and be

linked to an outcome in a participant’s plan.

• Supports must be related to the participant’s disability and help them to

reach their goals.

• They must help a participant to build the skills they need to live the life they

want, including opportunities to work, further their education, volunteer or learn something new.

• This may include undertaking activities or funding equipment aimed at

increasing their independence, inclusion, and social and economic participation.

• The funding model that underpins the NDIS is designed to be flexible and to

allow service innovation. Importantly, the supports delivered will be chosen, and paid for out of an individually allocated budget to each participant.

What doesn’t the NDIS fund?

• There are rules for the NDIS that mean some supports cannot be

funded in an NDIS plan

• The NDIS will not fund:

– Supports that are not related to a person’s disability – Supports that are funded by a different mechanism or system, such as Medicare or the Health system – Day-to-day living costs that everyone pays for such as food, electricity and water – Things that may cause harm

Establishing the service approach

Information and Community Linkages (ILC) supports will be delivered through five streams of activity:

• Information, linkages and referrals
• Capacity building for mainstream services
• Community awareness and capacity building
• Individual capacity building
• Local area coordination

Partners in the community: Local Area Coordinators (LACs) and Early Childhood Early Intervention (ECEI) partners will support some participants and their families to join in and contribute to the life of their community and assist with the planning process, plan implementation and community participation.

Local Area Coordination

• Local Area Coordinators (LACs) will support participants and their families to join

in and contribute to the life of their community and assist with the planning process, plan implementation and community participation.

• The NDIA has already partnered with Uniting and St Vincent de Paul Society

NSW to deliver NSW LAC services during transition from January 2016 – 30 June 2018.

• LACs will support participants through all steps on the pathway, except access.
• LACs will assist all NSW participants transition to the NDIS, except participants

living in large residential centres.

• Most participants (60%) will also have an LAC assist with plan implementation,
• thers (30-40%) may need more frequent and funded support coordination.
• The LAC partner for the Murrumbidgee Area will be announced in the coming

months

Support Coordination

Primary roles of Support Coordinator are:

• Support implementation and identify options for all supports in the plan, including

informal, mainstream and community, as well as funded supports.

• Strengthen and enhance the participant’s abilities to coordinate supports and

participate in the community, reach decisions and develop agreements with support providers.

• Ensure mainstream services meet their obligations (i.e. housing, education, justice,

health).

• Build capacity of the participant to achieve greater independence, self-direct supports

in the longer term and understand funding flexibility.

• Be available – to ensure new support arrangements endure and in times of ‘crisis’.
• Provide NDIA with reports on outcomes and success indicators within agreed reporting

frequency.

Differences between LAC, Planner & Support Coordinator

LAC Planner Support Coordinator  Uniting and St Vincent de Paul Society NSW until 30 June 2018.  NDIA Staff  NDIA Registered Service Providers  Conduct information gathering process for participants streamed as general, supported and intensive.  Conduct information gathering for participants in large residential centres and those who are streamed as super-intensive. X Do not conduct information gathering X Do not make reasonable and necessary decisions or approve plans.  Make reasonable and necessary decisions in accordance with the NDIS Act 2013, approve plans. X Do not come into contact with NDIS participants until they have an approved plan.  Support participants streamed as general or supported to implement and review their plans. X Do not support participants to implement their plans.  Support participants streamed as intensive and super-intensive to implement and review their plans.

Early Childhood Early Intervention (ECEI) Approach

• The process of providing specialised support and services for

children aged 0-6 years with a disability or developmental delay, and their families, in order to promote development, well-being and community participation.

• Focuses on family centred practices delivered in a child’s natural

settings.

• Builds on family strengths and growing the capacity of mainstream

and community services to support children with developmental delay or disability, leading to greater inclusion for children.

ECEI pathways

Meet with your local Transition Provider to discuss concerns Be supported by the Transition Provider to set goals for your child and family Be assisted to understand which supports will help achieve those goals The supports and services will look different for every child because they are based on the individual child and family needs but may include Help accessing individual supports under an NDIS Plan Initial Early Childhood interventions & strategies eg: therapy sessions Information, guidance and connection to services in the community Your child’s progress will be tracked against your goals, and the support team will work towards improving your child’s functional outcomes, so they can achieve greater independence and participation in their everyday activities.

Providers: a key partner in the NDIS

• Provider is a term used to describe an individual or organisation that

delivers a support or a product to a participant in the NDIS. Participants have an individualised plan that identifies the outcomes they wish to achieve, the supports that will be funded by the NDIS and other supports the person requires.

• Providers are key to delivering high quality supports to help participants

realise their goals.

• The NDIS requires providers to change their business and service models;

this creates both challenges but great opportunities for new products, innovations to support NDIS participants.

• The NDIS provides the opportunity for the development of a strong, diverse,

mixed market providing lots of choice for people with disability.

The Provider Pathway

Get ready checklist

• Do I have a basic understanding of the goals of the NDIS and the role of a

provider?

• Do I provide services and supports that are covered under the NDIS?
• Do I understand what NDIS participants want and need from me/my
• rganisation?
• Do I have the right qualifications and/or experience to deliver services?
• Am I registered with a relevant national professional body?
• Do I meet the other criteria in the NDIS ‘Declaration of Suitability’?
• Do state or territory accreditation requirements apply to the services I wish to

deliver and do I know what documents I need to supply to the NDIA as evidence?

• Can I comply with the NDIS Terms of Business?
• Do I have any potential conflicts of interest to declare or manage?
• How much will I get paid, and how do I get paid, for the services I want to

provide?

• Do I need to become a Registered Provider?
• What is involved in becoming a Registered Provider?

Quality and Safeguards

Quality and Safeguards cont.

• Compliance with the Transitional Working Arrangements will be a condition
• f your ongoing registration to provide NDIS services
• Registration of new providers that are not currently operating under a

funded service agreement, but wish to provide specialist disability supports in NSW, will need to provide evidence of third party verification (TPV) against the NSW Disability Services Standards (or comparable standards).

• The NSW Government and the NDIA take quality assurance and

safeguards very seriously, and regard compliance with the NSW Disability Service Standards as essential to protect and promote the interests of NDIS participants.

• The NDIA will not register specialist disability support providers until

evidence that TPV has been undertaken is uploaded to the NDIS Provider Portal.

Registering as a provider in myplace checklist

• Register for a PRODA (Provider Digital Account) through the myplace

provider portal NDIS website

• Create a myplace account
• Submit an ‘intent to register’ through myplace
• Select the registration groups to register for (types of services or supports

you will offer)

• Read and sign the ‘Declaration of Suitability’ and upload to myplace
• Provide supporting evidence and documentation (as required) and upload to

myplace

Portal Home Page

Stay informed

• www.ndis.gov.au/ndis-ready
• Sign up for newsletters
• Webinars
• Social media
• Check state information

www.ndis.gov.au

• Sign up to the NDIS Provider

Newsletter marketandsector@ndis.gov.au NDIA resources

• New provider toolkit

– Registration information – Terms of Business – Guide to suitability

• Price guide and support lists
• Specialist Disability

Accommodation Decision Paper

• Updated Operational Guidelines

(incl. supports that can be funded)

• Information market activities on

web: Market information and useful links

NDIS ready

Questions?

Visit: www.ndis.gov.au Phone: 1800 800 110 8am-8pm eastern standard time weekdays Email: enquiries@ndis.gov.au

Mental Health and the NDIS

Eddie Bartnik, Strategic Adviser

November 2016

Welcome – Eddie Bartnik

• Purpose of the day
• The National Disability Insurance

Scheme (NDIS) gives effect to Australia’s obligations under the United Nations Convention on the Rights of People with Disabilities (2006), which includes people with psychosocial disability their families and carers.

NDIS Overview

Eddie Bartnik

November 2016

Role of the NDIA

The National Disability Insurance Agency (NDIA) administers the National Disability Insurance Scheme (NDIS). The Agency’s job is to:

• Deliver the NDIS
• Build community awareness of disability
• Ensure financial sustainability of the NDIS
• Develop and enhance the disability sector

The NDIA Board governs the NDIS

Transforming systems – transforming lives

• An insurance approach
• Supports tailored to individual needs
• Assurance of lifetime supports
• Choice and control is central
• Needs driven
• Delivered in local communities
• The importance of mainstream and community
• Nationally consistent

Building an NDIS

• 2008: Commonwealth 2020 Summit proposes a national disability scheme
• 2010: Productivity Commission conducts enquiry in to long term disability care
• July 2011: Productivity Commission submits report to government
• Oct 2011: COAG agrees to need for reform – taskforce develops scheme design
• Dec 2012: COAG sign agreement to trial the Scheme
• Mar 2013: NDIS Act 2013 establishing the NDIS and NDIA passed
• Apr 2013: Bilateral agreements with trial sites signed
• 1 July 2013: Trial sites in VIC, NSW, SA and TAS start
• 1 July 2014: Trial sites in ACT, NT and WA start
• 1 July 2015: Early transition in Nepean Blue Mountains NSW begins
• Sept 2015: VIC and NSW bilateral agreements signed
• Dec 2015: SA and TAS bilateral agreements signed
• April 2016: Early transition in QLD begins
• July 2016: Roll out begins in VIC, NSW, SA, ACT and Tas

Insurance Principles

• 1. The Scheme will be sustainable because the its funding base will be driven

by actuarial estimates of reasonable and necessary supports for participants

• 2. The Scheme will minimise costs by focusing on lifetime value for

participants

• 3. The Scheme will invest in research and encourage innovation

4. The NDIA will support the development of community capability and social capital

Insurance principles

• The risk of disability affects all Australians. Resulting financial costs may be

too much for any individual or family to bear

• The NDIS is a way of pooling these risks
• Each year, all tax payers pay a premium to cover the costs of running the

NDIS and providing care and support to participants

• We are all at risk of being affected by disability. We all share the risk and the

cost of disability. We are all covered if and when we need it

Matrix of change

From trial to transition

• We are moving from nine trial and early transition sites to

preparing for full Scheme roll out from 1 July in New South Wales, Victoria, Queensland, Tasmania, South Australia and Northern Territory.

• Rollout in ACT is now complete.
• More NDIA offices will be established across Australia with

many more participants beginning their journey with us.

• WA agreement expected shortly.
• Stages include trial/transition/development/maturity.

Scheme Achievements

NSW

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2016-17 2017-18 2018-19 NSW 14,921 9,628 9,276 9,397 17,150 13,448 15,014 14,608 6,601 6,601 6,601 6,601

5K 10K 15K 20K

NSW (phasing by area) 2016-17 Central Coast Hunter New England Nepean-Blue Mountains South Western Sydney Southern NSW Western Sydney Northern Sydney 2017-18 Illawarra Shoalhaven Mid North Coast Murrumbidgee Northern NSW South Eastern Sydney Sydney Western NSW Far West 2018-19 New participants JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN Total 2016-17 8,417 3,252 3,252 3,210 3,209 3,209 3,092 3,092 3,092 3,133 3,132 3,132 43,222 2017-18 8,206 4,472 4,472 4,483 4,483 4,482 5,005 5,005 5,004 4,870 4,869 4,869 60,220 2018-19 2,201 2,200 2,200 2,201 2,200 2,200 2,201 2,200 2,200 2,201 2,200 2,200 26,404

Mental Health and the NDIS

• Alongside the roll out of the NDIS, the mental health sector is undergoing significant

parallel reform.

• National Health Reform (LHN’s and PHN’s)
• National Mental Health Reform (NMHC Review, National Recovery Framework, 5NMHP)
• State and Territory Mental Health and Drug and Alcohol Plans
• NDIS – builds on Recovery Framework, provides additional opportunities
• “Recovery oriented, disability focused support”

Strategic Update: NDIA Mental Health Work Plan

Eddie Bartnik

November 2016

National Mental Health Sector Reference Group (NMHSRG)

• The engagement stream of the National Mental Health

Workplan includes the establishment and continuance of a National Mental Health Sector Reference Group (NMHSRG)

• The purpose of the NMHSRG is to ensure a strong partnership

between the mental health sector and the Agency. Members of the NMHSRG provide expert advice from a cross-section of the mental health sector to the NDIA about the national work required to integrate mental health into the Scheme.

• NMHSRG member representatives include: consumers,

carers, Mental Health Commissions, Commonwealth Departments of Health and Social Services, the NDIS Independent Advisory Council, Mental Health Australia (MHA), Community Mental Health Australia (CMHA), the Mental Health Drug and Alcohol Principal Committee (MHDAPC), and key NDIA staff.

• Communiques 3x year and a new data attachment

NDIA Mental Health Work Plan

• The NDIA has established a robust plan (NDIA Mental Health Work Plan

2015-16) to systematically address emerging policy and operational issues. As per the NDIA’s co-design framework, people with psychosocial disability, their families and carers are a critical reference group in the development and implementation of the plan. The plan includes overarching streams, addressing: – Mental Health sector engagement – Key reviews and projects (scheme access, support design, reference packages) – Programme transition, data, and mainstream interfaces or reforms. – Community of Practice for the Inclusion of Psychosocial Disability – Note MHA and Sector Development Fund – Key emerging areas – PHN/LHN’s, transition of programmes, supporting transition and the role of LAC partners, market and supply data, pricing/funding/service mix, forensic/hospital discharge, outcomes framework.

• Initiatives of the plan aim to enhance the Agency’s administrative

arrangements and capacity to respond to people with psychosocial disability, their families and carers.

Strategic Update: Scheme Actuary’s Data on Psychosocial Disability/Insurance Principles

Eddie Bartnik and Belinda Krause

November 2016

Scheme Actuary’s Data

• The Productivity Commission Inquiry into Disability Care and Support

estimated that 411,250 people would meet the Scheme access

• requirements. Further, the Productivity Commission estimated that

approximately 56,880 people would be participants with a primary psychosocial disability (13.8%)

• In 2019-20 the total number of expected participants is approximately

460,000, of which around 64,000 participants are estimated to be those with a primary psychosocial disability (13.9%).

• As at 30 June 2016: Across all trial sites 3,615 (10.1%) of all scheme

participants have a psychosocial disability, and 2,747 participants (7.7%) have psychosocial disability recorded as their primary disability.

• 2,173 (79%) participants with a primary psychosocial disability

currently have an approved plan.

Snapshot – 30th June 2016

• Across all trial sites, $147.6m of approved committed supports is for

participants with a primary psychosocial disability.

• 78% of participants with a psychosocial disability submitting an access

request have been found eligible for the scheme (noting that a further 3% are in the process of having their eligibility assessed).

• The New South Wales trial sites at 30 June 2016
• In the Hunter trial site there are 1,318 participants with a psychosocial

disability and 1,022 participants with a primarily psychosocial disability.

• In Nepean Blue Mountains there are 26 participants with a psychosocial

disability and 22 participants with a primarily psychosocial disability.

The Agency’s insurance principles

Aligned with the NDIS 2013-2016 Strategic Plan:

• The aggregate annual funding requirement will be estimated by the Scheme Actuary’s

analysis of reasonable and necessary support need, including a buffer for cash flow volatility and uncertainty.

• The NDIS will focus on lifetime value for scheme participants, and will seek to maximise
• pportunities for independence, and social & economic participation with the most cost-

effective allocation of resources.

• The NDIS will invest in research and innovation to support its long term approach and
• bjective of social and economic participation, and independence and self-management,

for participants.

• The NDIS will support the development of community capability and social capital so

as to provide: – an efficient, outcomes-focused operational framework and local area coordination, and – a support sector which provides a high quality service and respects participant social and economic participation and independence.

46

Developing a Statement of Support takes into account

Identify the Reasonable and Necessary Supports Provides funding for reasonable and necessary support to achieve goals Assist independence, social, economic, community participation Effective or beneficial for the participant, having regard to current good practice Sustainable informal care Records informal care arrangements Talk with the family about sustainable arrangements into the future. Reasonable expectations of care provided by family Optimise mainstream supports Not funded by NDIS Plan records nature, referral and support required to access other supports NDIS will not provide supports that should be provided by other systems General supports provided by NDIA Provision of information Local area co-ordination to assist person to access mainstream

Definition

Financial sustainability

• The scheme is successful on the balance of objective measures and

projections of economic and social participation and independence, and on participants’ views that they are getting enough money to buy enough goods and services to allow them reasonable access to life

• pportunities – that is, reasonable and necessary supports; and
• contributing governments think that the cost is and will continue to be

affordable, is under control, represents value for money and, therefore, remain willing to contribute.

48

How do we monitor what is ‘reasonable and necessary’?

• Collect data on the number of

participants, the characteristics of these participants (to allow analysis of reference groups), the outcomes for these participants, and the cost of supports provided to participants

• Detailed understanding of deviations

between actual scheme experience and expected scheme experience and hence identification of cost drivers

• Identify drivers of outcomes – benefits

to participants, their families and the community

49

Monitoring and managing financial sustainability

Developing the NDIS Outcomes Framework Guiding Principles

• Two ways of measuring progress

– The distance from “an ordinary life” – Progress towards an individual’s own goals

• Indicators must be

– Meaningful: widely accepted as important measures of progress – Informative: able to indicate what is working to improve outcomes and what is not – Feasible to collect and report: avoid over-surveying participants and undue burden on staff 50

Developing the NDIS Outcomes Framework

51

Review existing frameworks, Review ABS & other surveys Outcomes framework: domains, questions, indicators Consultation, feedback Special cohorts Piloting

The NDIS Outcomes Framework: Lifespan approach

• Independent Advisory Council (IAC) report: Reasonable and

necessary support across the lifespan

• The lifespan approach recognises that participants, their families

and carers have the potential to grow and develop at any stage

• f life
• The lifespan approach guides the NDIS to enable each

participant to positively experience the key features of a life stage that their peers without disability take for granted

• Reasonable and necessary support by age group is the support

required for participants to meet the same milestones and achieve the same goals and aspirations as their peers without disability

52

Outcomes across the lifespan and twelve questionnaire versions

53

Participant: Birth to school entry Participant: school entry to age 14 Participant: 15 to 24 Standard & Easy English/pictorial Participant: 25 to 55 Standard & Easy English/pictorial Participant: over 55 Standard & Easy English/pictorial

Family: participant aged 0 to 14 Family: participant aged 15 to 24 Family: participant aged 25 and over (residing & not residing with participant)

• 1. Choice and control
• 2. Daily activities
• 3. Relationships
• 4. Home
• 5. Health and wellbeing
• 6. Lifelong learning
• 7. Work
• 8. Social, community and civic

participation

54

Adults (15 and over): Participant Domains

Pilot study

• Piloting was undertaken in the Barwon, Hunter and Tasmanian trial

sites.

• Design: stratified on questionnaire type (except Tasmania) (effective

stratification on age and whether participant had an intellectual disability).

• Almost 400 interviews were conducted (both participants and family

members/carers), either face-to-face or by phone.

• Interviews took place January to March 2015.

55

Pilot study: limitations

• Primary purpose of pilot study was to assess validity of questions

rather than to allow in-depth analysis.

• Sample sizes are small.
• Results only present a snapshot of participant experience.
• Nevertheless, some preliminary analysis was conducted, revealing

some early trends and giving an indication of the types of analyses that will be possible once full data collection commences and a longitudinal database is built up.

56

Pilot study results

• Results from the pilot study have been analysed and a summary

report released publicly: http://www.ndis.gov.au/document/outcomes-framework-pilot

• This presentation focuses on results for

– Participants aged 25 to 55 (43 interviews) – Family members/carers where the participant is aged 25 and

• ver (68 interviews).

57

NDIS Outcomes Framework development since pilot study

Based on results of the pilot study:

• Questions were refined (for example, redundant/uninformative questions were

removed, some questions/options were reworded for clarity);

• Two versions of the outcomes framework were developed: a short form (SF) (to

be asked of all participants) and a long form (LF) (to be asked of a sample of participants).

• Back-capture of the SF has been undertaken by the NAT and planners, as well

as two external contractors (Australian Healthcare Associates (AHA) in Victoria and Assessments Australia (AA) in other sites). From July 2016 collection has been undertaken in the new CRM, prior to plan approval.

• As at 30 June 2016, approximately 24,000 Short Form Outcomes Framework

questionnaires had been completed: 13,000 for participants and 11,000 for their family/carers. In addition, around 800 Long Form Outcomes Framework questionnaires had been completed. These data are being analysed and will provide a baseline for participant experience.

• Longitudinal collection of this information will allow us to track how this changes
• ver time for individual participants and for the Scheme overall.

58

Questions and Answer Session

Table Discussions Discussion - NDIA Workplan 2016/17, Scheme Actuary data & Markets, Providers/ Pricing Feedback - from tables

Lunch Break

Project Update: Operational Access Review

NDIA Mental Health Team

Mark Rosser

Operational Access Review

• Based on feedback form the mental health

sector, including from consumers and their families, the NDIA initiated an Operational Access Review for Psychosocial Disability project.

• The review commenced in November 2014 and

was scoped in accordance with NDIA’s governance arrangements and in the spirit of co- design with consumers, carers and their families.

• Contributors to the Operational Access Review

for Psychosocial Disability project included carefully selected individuals from a cross section of the mental health sector. Crucially, this included government stakeholders such as the Department of Social Services and the Department of Health.

Operational Access Review

The review produced 38 NDIA endorsed recommendations across 5 themed based topics including:

• 1. Access (for Tier 3 funded supports)
• 2. Early Intervention
• 3. Language, Processes, Products and Narrative
• 4. Engagement and Outreach, and
• 5. Population Data

Access - what’s been done?

• 1. Access (for Tier 3 funded supports)
• A. Established close working relationship with the National Access

Team to ensure processes and language are appropriate for people with psychosocial disability

• B. Reviewed all Access resources used by the National Access Team

and provided recommendations for amendments

• C. Worked collaboratively with Commonwealth Programs (PIR, PHaMs

etc.) to establish supportive processes for potential participants to prepare for access to the Scheme

• D. Implementation of the Psychiatric Hostels Project – WA specific
• E. Implementation of the ‘hard to reach cohorts’ pilot project in the

Barwon region.

• F. Developed and released the ‘Tips’ resource – included in delegate

packs

Early Intervention - What’s been done?

• 2. Early Intervention
• A. Developed a background paper on early intervention criteria and access to

the Scheme for people with psychosocial disability including

• recommendations. This paper was recently endorsed by the Executive

Management Committee and will lead to further work in this area

• B. MIND independently commissioned an EI Research report which is now

available as a resource. This was completed in May 2016

• C. Established working relationship with National Access Team to specifically

support access decisions in relation to early intervention criteria

• D. Established a data project specific to early intervention to build a detailed

understanding of access through this criteria

Language etc. - what’s been done?

• 3. Language, Processes, Products and Narrative
• A. Established the 2 page easy read quarterly communique published after

each National Mental Health Sector Reference group – available on the NDIS website

• B. Purchase and implementation of a ‘Recovery Suite’ eLearning package to

be used by all NDIA and LAC partner staff

• C. Established and ongoing quarterly meeting of an internal Community of

Practice in relation to psychosocial disability. National representation from all NDIA sites.

• D. Developing a ‘recovery’ fact sheet – soon to be released
• E. Established the ‘Tips’ resource
• F. Developing a Psychosocial Resources Online project with the Mental Health

Coordinating Council of NSW – focused to provide prospective participants and their carers and support staff with a dedicated resource about the NDIS including; pre planning, access and community supports

Engagement and Outreach - what’s been done?

• 4. Engagement and Outreach
• A. Established the NDIS and psychosocial disability information and strategic

engagement calendar 2016. The mental health sector in all states and territories will be visited this year

• B. Establishment of the ‘Psychiatric Hostels Project’ in WA
• C. Established a ‘how to reach the hard to reach’ pilot project in Barwon to

facilitate understanding specific engagement processes including outreach for cohorts including; homeless, refugee, CALD

Population data - what’s been done

• 5. Population data
• A. Established a data analyst position within the mental health team
• B. Internal Agency quarterly report produced by the Scheme Actuary specific

to psychosocial disability

• C. Established a data stream to the mental health work plan including 9

separate data projects including;

• A. CALD communities and access rates to the Scheme
• B. Analysing committed supports within participants plans
• C. Early Intervention access criteria and access rates

Achievements

• Quarterly data reports demonstrate strong access rates – 75-80%. These rates have

increased in the past year since the Operational Access Review has been implemented.

• Strong examples of engagement and access to the Scheme for people living in WA

psychiatric hostels

• Established an Agency position re the use of early intervention criteria for participants

with psychosocial disability

• Established dialogue with the mental health sector to understand; NDIS and psychosocial

disability, NDIS and recovery, Scheme access and early intervention

• Improved Agency wide understanding of recovery and recovery practice
• Increased NDIS resources tailored to psychosocial disability
• Improved NDIA understanding of key themes emerging within the mental health sector

including access for CALD/ refugee cohorts and people transitioning hospitals

• Improved Agency understanding of data and trends for people with psychosocial disability

within the Scheme

• Improved capacity to engage with the mental health sector through sharing data to

demonstrate Scheme achievements and emerging themes.

Joint Support Design Project

Mental Health Australia NDIA Mental Health Team

Mark Rosser

October 2016

Context

• Concerns from mental health providers about the applicability of the

NDIS Support Catalogue and the NDIS Price Guide to psychosocial support services

• Related concerns about the types of supports and pricing levels in

plans for participants with psychosocial disability

Project Aims

The broad aims of the Project were:

• To describe in detail the range of disability supports that NDIS

participants with psychosocial disability may choose; and

• To make evidence based recommendations, where new support

items may be needed to adequately assist NDIS participants with psychosocial disability.

Methodology

• Literature review
• Trial consultations
• National consultations
• Consolidation and synthesis of feedback
• Mapping of feedback against the NDIS Price Guide
• Response to new developments

Themes from literature review: Opportunities and challenges

• Reconciling the concepts of permanency with the fluctuating nature
• f mental illness and the recovery paradigm
• An assumption of a clear differentiation between clinical and social

supports

• Implementing the NDIS within the context of an under-developed

system for mental health

Themes from stakeholder consultations

• Engagement, readiness and pre-planning
• Service principles and skillsets
• NDIA practices and processes

Stakeholder suggestions for additional support items

• Advanced care planning
• Crisis planning
• Hoarding and squalor
• Individual advocacy
• Assistance to access and navigate

the legal system

• Emergency step-down services

upon hospital discharge

• Support items triggered at points of

transition

• Support coordination
• Peer worker support
• Supports integration
• Supportive escorting
• Planning for next plan
• ‘Hospital in the home’ support
• Life skills training and coaching
• Access to psychological therapies
• Building relationships
• Support to gain work readiness

skills

• Capitalising on periods of wellness
• Carer support
• Loading for special needs (eg

Aboriginal and Torres Strait Islanders, Culturally and Linguistically Diverse communities, involuntary treatment order, post- discharge, comorbidity)

Recent developments

• Refined Price Guide
• Flexibility of supports in plans
• Support coordination
• Price reviews
• Quality and safeguards
• Outcomes framework

Conclusions and recommendations

• Continuous improvement and further investigations
• Peer work
• Outreach and relationship building
• Partners in Recovery and transition to Scheme
• Addressing pricing concerns
• Workforce and sector development
• Communication issues
• NDIS vs other systems

Progress On Recommendations

Engagement and resources

• The Mental Health team has presented at 40+ engagement events this year

including events in collaboration with DSS, DoH and flinders University Transition Support Project

• NDIA resources now available – Participant Pathway, Provider pathway etc
• NDIS and psychosocial disability resources include:

– Completing the access process for the NDIS: Tips for communicating about psychosocial disability for individuals with psychosocial disability. – NMHSRG Communique and Easy read Communique – Factsheet on Recovery and NDIS ready to launch – Communique Data supplement in development – MHCC developed online resource – NDIS & psychosocial disability coming in early 2017 – Implementation of Recovery ELearning modules for all NDIA staff and community partners

Progress On Recommendations

The NDIA Markets and Providers Division have:

• engaged with Mental Health Australia (MHA) and mental health sector

providers to provide information about the Pricing Review (personal care & community participation) & benchmarking project.

• Design of the National Benchmarking project and pilot data collection will be

completed by Dec 2016.

• launched the Specialist Disability Accommodation Decision Paper.
• held Provider Engagement workshops in all States and Territories to help

providers work effectively with NDIA.

• completed the state baseline Market Positions Statements to help providers

anticipate growth and local opportunities as a result of the NDIS.

• An NDIA Price Review is underway with a focus on high cost items (such as

Supported Accommodation).

Progress On Recommendations

Next Steps:

• Develop communication materials to:

– help the mental health sector understand the responsibilities of the NDIA and other mainstream service systems. – help the mental health sector better understand LAC and ILC.

• Develop NDIA policies and projects to consider the issues of those who are

‘hard to reach/hard to engage’ and ‘complex cohorts’.

• Review of NDIA terminology will be undertaken to help the NDIA and the

mental health sector achieve shared understanding of terms frequently used and potentially misunderstood.

Progress On Recommendations

Next Steps:

• The NDIA Market and Providers division will focus on analysing specific

market modules, such as service type or topic, to encourage best practice.

• The NDIA Market and Providers division continues to act as a market

steward to support the delivery of services where there is evidence of thin markets or poor market outcomes.

Questions?

Email: Mental.Health.Team@ndis.gov.au Visit: www.ndis.gov.au Phone: 1800 800 110 8am-8pm eastern standard time weekdays Email: enquiries@ndis.gov.au

Update: NDIA Products

NDIA Mental Health Team

Mark Rosser

Mental Health Recovery Suite

Mental Health Recovery Suite

Mental Health Recovery Suite

Table Discussions Discussion - Access, Support design & overall priorities Feedback - from tables & Where to next

Where to next?

NDIS and Mental Health

Eddie Bartnik

The Future

The NDIA continues commitment to the initiatives identified in the NDIA Mental Health Work

• Plan. The plan is rigorously reviewed on a yearly basis with expert input from the NMHSRG.

Progress of the plan is reported through the Agency's key governance bodies including the NDIS Independent Advisory Council and the Agency Board. Upcoming work includes:  strengthening the links and clarifying the interface between, the mental health sector, and mainstream services and supports  strengthening the links and clarifying the interface between, the Scheme and mental health reforms including the establishment of Primary Mental Health Networks (PHNs)  deepening engagement across the mental health sector. In particular, with Aboriginal and Torres Strait Islander Peoples and the Royal Australian and the New Zealand College of Psychiatrists (RANCZP); and  building a catalogue of accessible products and resources to inform the community about mental health and the Scheme."

Around the grounds session

• The NDIA is deeply interested in hearing from you as key leaders in

the mental health sector

• The NDIA is capturing emerging themes nationally to inform the

development of the draft NDIA Mental Health Work Plan 2016-17

• Mental Health Australia (MHA) is also capturing issues to identify

sector development and training needs Thank you

Questions?

Email: Mental.Health.Team@ndis.gov.au Visit: www.ndis.gov.au Phone: 1800 800 110 8am-8pm eastern standard time weekdays Email: enquiries@ndis.gov.au

Networking Session and Afternoon Tea