Daily Bulletin

The Conversation

  • Written by The Conversation Contributor
imageBefore the NDIS is rolled out nationally, some major planning problems must be solved.Photographee.eu/Shutterstock

Thirteen years ago, when Paul was 17 years old, he sustained a severe acquired brain injury which left him with 24-hour support needs.

Paul now requires feeding through a tube in his stomach. His muscle tone has altered, so his movement is limited and he has ongoing continence and pressure care issues. Paul needs regular mouth suctioning to ensure he does not inhale his own saliva and contract pneumonia.

imagePaul and his family.Fred Kroh

Paul is already involved in the National Disability Insurance Scheme (NDIS) planning process; others with high-needs will gain access when the scheme is fully implemented in 2019.

But as the NDIS rolls out nationally, some major policy planning problems must be resolved.

Our research, released today, shows people with the highest physical and medical support needs risk being shunted between the heath and disability sectors, and missing out on timely, well-coordinated care.

Health care versus disability services

To date, people with significant disability have reported some of the most unmet needs in the sector. They often rely on high levels of family support, spend prolonged periods in acute hospital beds, or enter residential aged care facilities because there are no other options available to them.

Paul’s family have been willing to share their experience of the NDIS trial – and tell their story here.

To get a better sense of the care requirements among this group, we surveyed 173 people with disability and high daily support needs living in shared supported accommodation across Victoria, New South Wales and the ACT.

Respondents typically required daily support with multiple everyday activities – at times, the support of two or three staff at once. Much of this clearly falls under disability support entitlements and will be covered by NDIS-funded support packages. However, this group also experience a range of complex health support needs secondary to, but intertwined with, their disability.

Among our respondents, three-quarters (76%) experience bladder or bowel issues, 45% have special requirements for eating, drinking or swallowing, and at least 58% require access to enrolled or registered nursing staff. These medical, rehabilitation and health-care needs affect disability supports and vice-versa.

At this point in the scheme trial, it remains unclear where the line is drawn between the health and aged care systems and the NDIS for participants. When does disability-related equipment become medical equipment, for instance? And where does clinical rehabilitation finish and support to build social and economic participation begin?

In the past, Australia has made distinctions between supports funded by health versus disability systems. In part, this is a reflection of the movement to de-medicalise disability and focus on inclusion and participation when people have long-term functional impairments. In part, it reflects historical state-Commonwealth negotiations about who is responsible for what.

Delineations between the new national disability scheme and health, education, and housing sectors have also been drawn in bilateral agreements signed with the states and the NDIS Act. The NDIS is not intended – nor costed – to meet health and rehabilitation needs which state or territory health departments have traditionally addressed.

Solving the problem

When an NDIS participant is told a service is health-related and therefore out of scope, they need a clear path and assistance to seek and obtain the service from the health system.

Hospitals, general practitioners, and other health professionals need clear and robust processes for collaborating with NDIS-funded services. Discharge from a health service needs to be coordinated with entry to the NDIS, or, where the person is already a scheme participant, re-engagement with NDIS-funded services.

In the shorter term, it is vital for the scheme to engage with state and Commonwealth health departments and negotiate a framework for the health-disability interface. Cost-sharing or allocation between the two sectors will also be necessary through these transitions.

Ultimately, it may be necessary to legislate the obligation for health and disability systems to coordinate.

With new NDIS sites launching from July 2016, urgent work is needed to address these demarcation disputes and coordinate the health-disability interface to achieve the best outcomes for Australians living with disability.

Libby Callaway receives funding from the Transport Accident Commission (via the Institute for Safety, Compensation and Recovery Research) and National Disability Research and Development funding. The research outlined in this article is a joint project from Monash University's Occupational Therapy Department, the Summer Foundation, Yooralla, Wesley Mission Victoria and Multiple Sclerosis Limited.

Mark Brown works for Yooralla, a not-for-profit provider of disability services. The research outlined in this article is a joint project from Monash University's Occupational Therapy Department, the Summer Foundation, Yooralla, Wesley Mission Victoria and Multiple Sclerosis Limited.

Authors: The Conversation Contributor

Read more http://theconversation.com/sorry-not-my-department-why-the-ndis-and-health-systems-need-to-collaborate-51818

Writers Wanted

Review: Robert Dessaix on growing older well — a genial journey through a rich inner world


Why the 2000 Sydney Paralympics were such a success — and forever changed the games


The Conversation


Prime Minister Interview with Kieran Gilbert, Sky News

KIERAN GILBERT: Kieran Gilbert here with you and the Prime Minister joins me. Prime Minister, thanks so much for your time.  PRIME MINISTER: G'day Kieran.  GILBERT: An assumption a vaccine is ...

Daily Bulletin - avatar Daily Bulletin

Did BLM Really Change the US Police Work?

The Black Lives Matter (BLM) movement has proven that the power of the state rests in the hands of the people it governs. Following the death of 46-year-old black American George Floyd in a case of ...

a Guest Writer - avatar a Guest Writer

Scott Morrison: the right man at the right time

Australia is not at war with another nation or ideology in August 2020 but the nation is in conflict. There are serious threats from China and there are many challenges flowing from the pandemic tha...

Greg Rogers - avatar Greg Rogers

Business News

Top 3 Accident Law Firms of Riverside County, CA

Do you live in Riverside County and faced an accident and now looking for a trusted Law firm to present your case? If yes, then you have come to the right place. The purpose of the article is to...

News Co - avatar News Co

3 Ways to Keep Your Business Safe with Roller Shutters

If you operate your business in a neighbourhood or city that is not known for being a safe environment, it is not surprising if you often worry about the safety of your business establishments o...

News Co - avatar News Co

Expert Tips on How to Create a Digital Product to Sell on Your Blog

As the managing director of a growing talent agency, I use the company blog to not only promote my business but as a way to establish ourselves as an authority in our industry. You see, blogs a...

Adam Jacobs - avatar Adam Jacobs

News Co Media Group

Content & Technology Connecting Global Audiences

More Information - Less Opinion