Making the NDIS work for psychosocial disability CEO Forum September 18, 2018 Gerry Naughtin Strategic Advisor Mental Health Strategic Advice, Research and Inclusion Division

Overview Update on psychosocial disability in Scheme nationally Pathway Enhancements for Psychosocial Disability (PSD) NDIS as part of a broader system of psychosocial support Making the Scheme work in each State and Territory

Update Across all States/Territories 28,433 (15%) of all scheme participants who have had their access met have a psychosocial disability 18,207 participants (8.1%) have a primary psychosocial disability recorded as their primary disability In WA there were 364 participants in Scheme at 30 June 2018 with a roll out program over the next 2 years. NDIS will fund West Australians who meet the eligibility criteria in s24 and s25 of the NDIS Act. Data trend in mature trial site locations indicating that the proportion of participants with psychosocial disability projected by the Productivity Commission (13.8%) is reliable: Hunter region 12.6%, Barwon 13.5%, ACT 13.4% (Figures as at 31 March 2018)

Trend 4: 2018\19 is the year for entry of the majority of participants with psychosocial disability Current and Projected Participants at Full Scheme Implementation 64,000 70,000 60,000 50,000 40,000 30,000 18,207 20,000 10,000 6400 367 Jun-18 Full Scheme Aust WA

Elements national approach to provision of psychosocial disability supports in Australia Provision of support to people with disabilities associated with severe and persistent mental illness through the NDIS Provision of support to people with psychosocial disabilities who do not meet the NDIS eligibility criteria to be funded through Primary Health Networks Continuity of support for people for current participants of Commonwealth funded Phams, PiR and Day to Day Living programs who are not eligible for NDIS to be funded through Primary Health Networks The provision of family and carer support through the Integrated Carer Support Strategy which is rolling out from October 2018 with phase 2 commencing in September 2019 Continued funding of psychosocial disability supports by State and Territory Governments – each state and territory has varying positions with some firmly continuing existing funding and others shifting their funding base over time

Trend 1: Reaching people who were not receiving services at time of requesting to be part of Scheme % 29 71 Existing New

Trend 2: Age profile % 24 15 55 6 15 - 24 25 - 34 35 - 44 45+ % 60 50 40 30 24 20 15 10 55 6 15 - 24 25 - 34 35 - 44 45+ %

Trend 3: Level of eligible and ineligible access decisions Across all States/Territories (70%) of access requests met the access criteria and 30% did not meet the access criteria Higher % of applicants who are current service users are meeting the access criteria than applicants who are not in receipt of services (Figures March 2018)

Trend 5: Package Values Participants with primary psychosocial have a range of committed supports in their packages, with the majority of residents receiving between $20,000 and $100,000 (Figures March 2018)

Trend 6: Types of committed supports Support type % Core supports 75 Capacity 24 Capital 1 (Figures March 2018)

Streamlining processes for applying for CW mental health service users Collaboration between NDIA, DSS and DoH to improve engagement and eligibility application processes. Changes: An access request can be commenced at a time suitable to the Commonwealth client with a trusted person/support worker present; A support worker can be the NDIA contact for the duration of the access process and provide assistance if requested and approved by the client; A new Mental Health Evidence of Disability form has been produced specifically for Commonwealth transitioning clients and is available on the Transition Support Project web portal; Opportunity for Commonwealth clients who have previously been unable to fully engage in the access process to retest access with the support of a trusted person.

Pathway Review When April 2017 What NDIA initiated a Pathway Review in response to feedback from participants and providers that their experience with the NDIS did not meet expectations. NDIA engaged more than 300 stakeholders from all states and territories. October 2017 NDIA announced a new NDIS participant and provider pathway, designed to significantly improve the experience people and organisations have with the NDIS. NDIA started piloting key features of the new participant pathway in three Victorian locations. In May 2018, over 1,000 participants entered the pilot to experience new or enhanced processes in pre-planning, planning, and initial plan implementation. NDIA conducted 37 workshops across the country, engaging more than 1,100 participants, carers and stakeholders to inform tailored pathways to inform a flexible NDIS pathway for people with different needs. January 2018 January to April 2018 August 2018 Ministerial announcement of pathways. Commitment to enhancements of the pathway for people with psychosocial disability in collaboration with Mental Health Australia.

Workshops to develop a flexible NDIS pathway After consultation about the new NDIS pathway, the NDIA conducted a further 37 workshops to inform and develop tailored pathways for early childhood and people with complex support needs, 37 Workshops and a flexible NDIS pathway for people with different needs. The workshops included participants, families and carers, partners, government representatives, providers, peaks and local organisations, advocates and expert advisors. 1128 178 154 343 338 88 27 Attendees Complex support needs pathway Early childhood pathway Psychosocial Aboriginal & Torres Strait Islander Culturally & Linguistically Diverse LGTBQIA+ Remote & Very (CALD) Key insights Integrated relationships with Early intervention principles effectively deployed Specialist functional • assessment to support access decisions Family based early intervention focus Informed parents and health professions Stronger connection with existing local Remote Staff and partners with specific cultural sensitivity Strong community and peer networks Responsive access to Interpreters and translated collateral Involving Multi- cultural Community Connectors Strong focus on staff and partner cultural awareness other service systems mental health services• Hard to reach / assertive outreach Crisis management Skilled planners Specialised support coordinators Proper engagement with Traditional Owners, Elders and communities Involving local Community Connectors Skilled planners / LACs who understand psychosocial disability, recovery based planning and episodic need

Key Findings: Needs of people with psychosocial disabilities Effective engagement for people who are isolated Clear understanding of eligibility & access requirements Relationships built on trust with consistent contacts Assistance to coordinate multiple service systems Flexible supports, given episodic nature of disability Specialist staff who understand psychosocial disability Tailored language to psychosocial disability Recovery-focused monitoring and outcomes

Ministerial Announcement - Pathway Changes Generic process improvements Details Clearer links to mainstream services Easier to understand information Face to face planning meetings Consistent point of contact with designated LAC Easier plan format Building staff knowledge and skills in PSD

Pathway Enhancements for Psychosocial Disability Change Strengthened focus on pre-access stage Access Details Better information for potential applicants, families and carers and health professionals Assertive outreach Clearer, more accessible information for people with SMI about eligibility and application process Navigation and referral role for agency for people who do not meet NDIS eligibility New Complex Support Needs branch to better manage complexity Stronger focus on the implementation of PSD in new organisational structure Staff training and practice guidance To be designed in collaboration with Mental Health Australia Planning Implementation of enhancements for PSD

Provider solutions: next enhancements Pathway Elements Pathway Improvements Clear and easy to understand policies 1 Release of Market Enablement Framework to support the development of a innovate market of competitive supports Clear registration process 2 Provider registration will be simplified and improved as states and territories start to transition to the NDIS Quality and Safeguards Commission Providers and participants are connected 3 Enhanced search capability for participants and providers through Provider Finder tool Efficient and effective payments 4 Implement recommendations in the Independent Pricing Review. Increased resources for the National Provider Payments Team. Easy to use portal and website 5 Portal enhancements, including amendments to service bookings and on-screen help for providers. NDIA website redevelopment 6 Proactive engagement Rollout of Provider Account Management Model.

Resources for the sector reimagine.today helps adults under 65 years of age living with a mental health condition to better understand the National Disability Insurance Scheme (NDIS) and what supports and services it can offer: www.reimagine.today NDIA communication and resources on psychosocial disability and the NDIS: www.ndis.gov.au/psychosocial/products.html Access snapshots available Communiques from the National Mental Health Sector Reference Group