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.”
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