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

2. 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

3. 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)

4. 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

5. 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

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

7. Trend 2: Age profile % 24 15 55 6 15 - 24 25 - 34 35 - 44 45+ % 60 5040 30 24 20 15 10 55 6
45+ %

8. 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)

9. 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)

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

11. 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.

12. 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.

13. 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

14. 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

15. 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

16. 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

17. 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.

18. 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:
NDIA communication and resources on psychosocial disability and the NDIS:
Access snapshots available
Communiques from the National Mental Health Sector Reference Group