Enrolment in the National Disability Insurance Scheme (NDIS) is expected to exceed the original estimate in the ACT by 23 per cent. But the implementation of the scheme in the ACT — the only state where NDIS was fully rolled out — has been fraught with issues, including shortage of support workers, faulty NDIS web portal, and low pay rates to care service providers, ABC reported.
"Given the size and scale of the ACT, if we can't sort these issues out here, we have grave concerns about what this means for the rest of the country,” Jan Chorley, Alzheimer's Australia ACT CEO, told ABC.
One issue of concerned involves the estimates for how many participants would be eligible for the scheme in the ACT. Before launching the NDIS in the states and territories, their respective governments agree on a target estimate to determine the funding required.
Originally, it was estimated that 5,075 people would be eligible in the ACT. Around September last year, that target had been reached and the scheme stopped taking in new participants. The scheme eventually started readmitting participants in the ACT when a backlog built up.
It remains unclear, however, what is happening when it comes to setting a new target, the report said.
In a statement, the ACT Government said it was "not involved in any re-negotiation of these agreements," and that costs for participants "above the target of 5,075 is a Commonwealth responsibility."
The Federal Government was in disagreement, however, saying: "The Commonwealth is in negotiations with the ACT around funding arrangements."
"There's been almost a lack of transparency around what it might look like in the future," Chorley said. "We're struggling a bit to sort of get information. And I think that's the biggest issue."
A market position statement issued by the NDIS in September said that it is expecting 6,900 participants in the scheme in the ACT.
What makes this a worry, advocates said, is that if other estimates are off across the country, it would put into question NDIS's basic assumption that it will be receiving 460,000 participants on full rollout in 2019, with a budget of $22 billion, ABC reported.
Another issue is the lack of qualified support workers.
Leslea Geary, mother of three children with varying levels of intellectual disability, told ABC that while “the NDIS came along at just the right time... the issue is that the marketplace hasn't yet caught up.”
"We haven't yet got enough workers; we haven't got a sustainable workforce. Actually getting the workers in, and keeping them, is not easy."
Adding to the long list of problems and frustrations with the implementation of the scheme in the ACT is the NDIS web portal, the report said.
Geary said there are plenty of times when the NDIS web portal does not work when she signs in to submit invoices for services she has paid for. This sentiment is shared by many participants who, voice their complaints in online disability forums.
The NDIS said problems have mostly been fixed, with successful payments to providers and participants now at 96 per cent.
One emerging issue facing the NDIS in the ACT is the low rates paid by the NDIS to care providers who employ support workers, like those who look after Geary's children, ABC said.
"Ultimately that NDIS rate is a bargain basement rate for what is expected to be a platinum quality service,” said Rob Woolley, GM of Just Better Care in the ACT.
The NDIA set the basic rate for support work at $43.58 per hour, as compared to the $52.80 per hour Just Better Care charges its non-NDIS clients.
Fergus Nelson and Rob Woolley de-registered their company Just Better Care Canberra from the NDIS saying they had no choice because it lost $200,000 last year providing services on NDIS rates.
"We think we're a prime example. If we can't make it work, nobody can,” Fergus Nelson, franchise owner of Just Better Care Canberra, told ABC.
Not everyone agrees that the rates make the scheme unsustainable, however.
"It does not follow you become a registered provider and success flows,” said Caroline van Til, leading expert on the NDIS market with PPB Advisory. “If you want to aim for success as a provider in the new NDIS world, you need to make sure you've got the fundamentals of your business right.
"[It's] about cost, it's about workforce, it's about services."
Fergus said other providers are also considering de-registering from the scheme. If that happens, the number of workers available to provide services at NDIS rates could collapse, ABC said.
"This is a great scheme. We've seen some fantastic outcomes with the people that we work with," he said. "But this pricing issue… is putting that at risk."
Related stories:
Concerns raised over functionality of NDIS in remote areas
Canberrans at risk of missing out on NDIS
Half of NDIS enrolees receive disability support for the first time