NDIS Small Picture Decisions Massively Increase Hospital Bed Shortage

Our members see small picture decisions or disconnected decisions send people living with a disability to hospitals and nursing homes or keep them there.

This doesn’t appear to be an issue at high levels of the NDIS where the focus is on need rather than unfounded cost savings, however at a local planner level in some areas there can be an unfounded focus on costs savings rather than adequate supports.

People Happily Living in SDA Moving Out Because of Insufficient Supports

Our members report multiple instances of people who have the correct SDA approval and are happily living in their SDA property having to move out, often to a hospital bed or residential aged care, because they don’t have the correct ration of care, their SIL funding etc has been cut.

People Unable to Move from Hospital Into New Properties Because They Don’t Have Sufficient Temporary Supports

This is one of the most unbelievable ones we see and it’s something that happens constantly. In this situation there is a newly built house (shared with one or 2 others inside the dwelling) or in a newly built apartment (4-6 people in the same building but with their own apartment.

The individual will have both the correct SDA funding and the correct amount of funding for support workers, but some of that support work is shared with the other residents. Yet the NDIS won’t let the first person move in until all of the required number of people are in place to move in, this is such a chicken and egg situation. There are a whole lot of people who find themselves in this situation and would move in together if that could be co-ordinated. BUT that rarely works, what makes much more sense is to move the first person in and fund temporary supports. This doesn’t even effect the NDIS budget as the others are waiting in hospital and not receiving funding for support workers anyway.

People Whose Support Costs Could be Reduced by More than the Cost of a Higher Level of SDA Funding

At the High Physical Support Funding Level, our members put in automatic doors, blinds, lights, fans, air cons, passive and active monitoring. In Apartments there are separate OOA units for shared overnight passive care. We’ll use some examples below to show the difference in cost from Fully Accessible SDA funding to High Physical Support versus the savings in care. We will use North QLD where the location factors are high (therefore making the SDA funding difference much more expensive than most of the country)

Shared Passive Overnight Care Saving vs Cost

Apartment 1 Bed Resident – Cairns

HPS – $106,978.82

FA – $80,653.67

Difference $26,325.15

Assistance with Daily Activities – Sleepover $242.95 per day

Savings Shared with One Other – $121.47 per day or $44,338.37 per year

Add back difference $18,013.22

Two People applied to one of our members in this situation to move into HPS units where there are no FA ones available. But even though the saving in this situation is over $36,000 per year (more as shared overnight is possible between more than one person) the NDIS didn’t want to approve it. But our members dig in and actively advocate on behalf of the participants in circumstances like these.

Automation Providing Independence and Reducing 2 Support Worker Hours Per Day

By having all the automation in place so participants can adjust their blinds, lights, fans, air con temperatures, open and close doors people living with a physical disability can have some of their time alone, without having to have a support worker there just because their property doesn’t work for them. Much more savings are possible (eg having a hydrotherapy pool on site so that no travel costs are required etc). But if we just use a 2 hours per day time.

Assistance with daily activities Weekday $57.23 per hour (x2 x 5 x52 – Public Holidays) $27,484.40 per year

Assistance with daily activities Saturday $80.23 per hour (x2 x 52) $8,343.92

Assistance with daily activities Sunday $103.34 per hour (x2 x 52) $10,643.36 per year

Assistance with daily activities Public Holiday $126.40 per hour (x2 x 9) – $2,275.20 per year

Total – $48,746.88

Minus difference between FA & HPS gives annual net saving of $22,421.88

In Brisbane and other lower cost areas these saving increase by over $4,500

Home & Living Supports Approvals Should Have Fixed This

By looking at both the SDA level and the supports globally then this should have been fixed. But the decisions can only be made with the correct reports and recommendations. More work is needed to educate the planners and others at local levels making reports and recommendations to look at the big picture.

Better Participant Outcomes at No or Lower Cost are Not Only Possible But Should be the Norm

There are lots of rubbish SDA out there that do meet the minimum requirements along with providers who put the minimum in. With some more exposure to quality providers with quality SDA properties participants:

  • gain more independence
  • reduce their number of support hours required
  • while saving the NDIS money

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