Transcript Document

FURTHER UNRAVELLING
PSYCHOSOCIAL DISABILITY:
EXPERIENCES FROM THE NSW
HUNTER NDIS LAUNCH SITE
Tina Smith, Senior Policy Advisor/Sector Development
Presentation to SFNSW
16 April 2014, Sydney
“ … we are yet to really see the NDIS land on the
ground for mental health consumers and we've
really got to see how services will work together
…." Mr Bradley Foxlewin, Deputy MH Commissioner (3/7/13 Media Release)
What is the NDIS/NDIA?
• NDIS is National Disability Insurance Scheme
• NDIA is the National Disability Insurance Agency
• The NDIS and NDIA is an insurance scheme to
increase the social and economic participation of
people with disability/s (< 65 yrs)
• MH (psychiatric/psychosocial disability) is included
• Change from block to personalised funding (‘choice
and control’)
• Tiers 3, 2 & 1
NDIS Launch Timing
MHCC & NSW MH Commission
Partnership outcomes are to better understand …
1.
2.
How will PSD be understood and included under the
NDIS?
The wider NDIS and health services interface (eg, physical
health, substance use)
3.
People with co-existing difficulties (eg, intellectual,
physical, sensory and other disability)
4.
5.
The suitability of the assessment tool/s
Contribute to the national discourse regarding the
situating of psychosocial disability within the NDIS
… what is the NDIS and how it will affect people
living with mental health concerns?
NDIS Eligibility (Tier 3)
• Is the person’s condition permanent or likely to be
permanent i.e. are there any known … medical treatments
that would remedy it?
• Is there any future treatment planned? If yes, please provide
details of the expected outcome of the treatment.
• Is this condition likely to have a significant impact on the
person’s functional capacity for the rest of their life?
• What is the functional impact of the condition on the
following areas of the person’s life: communication/social
interaction; learning; mobility; self-care, selfmanagement?
NDIA presentation to HMH Interagency Meeting, July 2013
MH: Guiding principles
NDIS/NDIA:
Health system:
Managing a person’s ongoing
functional impairment
Diagnosing and treating a mental
health condition
• ongoing functional impairment
• diagnosis
• enable activities of daily living and
participation
• clinical treatment (in the community or
in health settings)
• community-based, non-clinical
• residential care, including inpatient
treatment or clinical rehabilitation
• all early intervention
Examples: assistance with planning and
decision making, community access.
Examples: general practitioner,
psychiatry, psychology,
pharmaceuticals.
NSW Hunter Trial Site
• Trial commenced July 2013 and there has been a lot of
MH/psychosocial disability (PSD) related activity
• 10K people of all disability types
• Yr 1 2013/14 Newcastle – 3K
• Yr 2 2014/15 Lake Macquarie – 5K
• Yr 3 2015/16 Maitland – 2K
• Only Year 1 launch site nationally with high levels of MH
activity
How many people might be helped?
Psychosocial Disability (13% of NDIS population?)
• 1,300/10K in launch site 2013/16
• The number of ‘existing’ and ‘new’ clients is unknown (ie, the total number of
‘transitioning’ people with ‘primary’ psychosocial disability is unknown as is the number of people
receiving Commonwealth ‘phasing in’).
• Commonwealth clients are considered to be ‘new’?
•
•
•
•
19/140K in NSW
57/430K in Australia
Intersect with Partners in Recovery?
Intersect with existing state funded community MH programs?
Hunter Launch Site Activity
Learning
•
•
•
•
Learning from consumers, carers and service providers in the launch site
Liaison with the NDIA, HNELHD/MH , FACS/ADHC, NDS, etc.
Reconciling ‘permanent disability’ with the philosophy and practice of psychosocial
disability and & recovery support service delivery
Engagement with 2013/14 MHCA NDIS Capacity Building Project (now extended)
Watching
•
•
•
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Tracking ‘transitions’, ’phasings’ & ‘new’ referrals of people to the NDIA (eg, PHAMS)
Interface between NDIA and the new Partners in Recovery program
Understanding ‘in-scope’ and ‘out-of-scope’ community sector programs
What the NDIS means for people that are not Tier 3 eligible
Influencing
… establishment of the
Hunter NDIS and MH ‘Community of Practice’
Hunter NDIS & MH
‘Community of Practice’
• 70 participants
• Process
• Sharing and reflecting on NDIS/NDIA
experiences
• Client transitions and new referrals (eg,
planning)
• Organisational readiness (eg, price)
• NDIA processes and liaison with current services
providers (eg, portal)
• Other implementation issues?
• NDIA Update
• HNEMH Update
• MHCA Update
Hunter Access & Eligibility
NDIA Hunter data
• As at February, 89 people at NDIA Hunter with ‘primary’ PSD and 75
now had plans (what happened for the other 14?)
• Processes to assess whether someone meets the access requirements
for permanent PSD (eg, length of period of illness, and the level of effect it
has on someone’s life and how this is measured)?
HMH data
 As at March, 63 referrals of people to NDIA from HMH inpatient sites
 19 accepted and some are still being assessed
 Uncertain of how many have been deemed ineligible (some of the
reasons why are: insufficient evidence; over 65; outside of launch site; not a
permanent disability; not substantially reduced functional capacity)
 Now auditing HMH community team referrals and also their caseloads
to identify potential referrals
… thank you NDIS, HMH & Partners in Recovery!
Current Hunter environment
What’s working well?
•
•
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Relationship with NDIA is a very open learning environment
Increasing collaborative practice with existing service providers
Greater understanding of psychosocial disability related to mental illness
Maturing implementation/operational structures including those required for
strengthening the health/mental health & NDIS/NDIA interface
What’s not working so well?
• Concern about pricing and support clusters
• Inconsistencies in eligibility and access processes and planning
• Costs related to eligibility/assessment/care planning for NDIA access (transitions,
phasing and new referrals)
• Advocacy (especially where a person does not have family/friends)
• Problems with NDIA ‘portal’ and claims in arrears
• Data collections including outcome monitoring
• Consumer, carer and community engagement
NDIA Priced Support Categories
1. Accommodation/ tenancy assistance
2. Assistance in coordinating or managing life stages, transitions and supports
3. Assistance to access and maintain employment
4. Assistance to integrate into school or other educational program
5. Assistance with daily life tasks in a group or shared living arrangement
6. Assistance with daily personal activities
7. Assistance with travel / transport arrangements
8. Community nursing care for high care needs
9. Development of daily living and life skills
10. Interpreting and translation
11. Early intervention supports for early childhood
12. Management of funding for supports under a participant's plan
13. Household Tasks
14. Participation in community, social and civic activities
15. Physical wellbeing activities
16. Specialised assessment of skills, abilities and needs
17. Therapeutic supports
18. Training for independence in travel and transport
19. Behaviour support
In-scope for NSW NDIS
ADHC ‘MH programs’ (ie, ‘existing’ clients)
Mostly Boarding House Reform related client group
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CBA (100%) – Community Based Activities (mostly ‘day centre’ type services for ex-BH
residents)
SA (100%) – Supported Accommodation (ex-BH residents, they typically also receive CBAs)
ALI (100%) – Active Linking Initiative (for remaining BH residents)
Commonwealth MH programs (‘new’ clients?)
DSS, previously FaHCSIA, Target Community Care
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•
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PHaMS (100%) – Personal Helpers and Mentors
MHRCSP (50%) – Mental Health Respite Carer Support Program
(NOT FMHSS – Family Mental Health Support Services)?
DOH
•
•
PIR (70%) – Partners in Recovery
D2DL (35%) – Day to Day Living in the Community
DEEWR
•
DES Disability employment programs; these are shifting to DSS
NOT NSW Health funded community sector MH programs
Out-of-scope for NSW NDIS
NSW Health funded community sector MH
programs:
NGO Grant Program
Tendered Programs
NSW Health Housing and Accommodation Support
Initiative (HASI)
The Mental Health Family and Carer Support Program
(MHF&CSP)
Resource and Recovery Services Program (RRSP)
‘Ad hoc’ grants/programs?
Other MH disability support programs currently
delivered by NSW Health?
Emerging Sector/Organisational Issues
• Very new way of doing business
• Maximising opportunities (1,300 launch site, 19K NSW, 57K nationally)
• Services for people who are not NDIS Tier 3 eligible (Tier 1 & 2?
services for families and carers?)
• Community sector engagement with NDIA, HMH and PIR on
referral, assessment & care planning pathways (consent issues)
• Safeguards and collaborative practice approaches
• How to increase sector/organisation readiness (competition vs
collaboration)?
• Workforce development (casualisation)
• Parallel community sector reforms (new service delivery models)
• Potential impacts on MHCC (and other peak structures)
MHCA Capacity Building Project
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2013/14 from $440K NDIA Sector Development Fund
Stage 1 ‘scoping’ - June and December 2013
Project Advisory Group
5 workgroups:
Scheme design and administrative arrangements
Assessment and eligibility
Monitoring and evaluation/service quality
Diverse groups (including ATSI)/supported decision making
Organisation readiness and workforce
• Stage 2 January to June 2014 (sector readiness report and
recommendations)
• Now funded for 2014/16 ($1.5M)
http://mhca.org.au/general/mhca-national-disability-insurance-scheme-capacitybuilding-project
MH Sector Implications
• NDIS/NDIA will effect organisations and
providers delivering services to people
with a range of complex and disabling
health and social problems
– The way services are delivered
– The way services are managed
• Opportunities to better understand the
interface and have clearer pathways
between health and disability
– Interface with Health
– Interface with MH
What do we need to do to be NDIS ready?
THANK YOU FOR LISTENING
For more information:
http://mhcc.org.au/policy-advocacyreform/influence-and-reform/ndis-and-mentalhealthpsychosocial-disability.aspx
….. Or Google ‘MHCC NDIS’
… or contact Tina Smith:
[email protected]