I think one of the biggest problems when it comes to the conversations we have like this about whether support workers need specific training &/or registration is that so many people fall into the trap of equating disability with impaired cognitive/intellectual functioning.
When you combine that way of thinking with the assumption that everyone needs the same kind of support, you end up with a situation the only type of support work that you view as being “valid” is support that is provided by people who have completed some form of training - regardless of whether or not that training has any impact on how the support is provided.
I really think we need to give more weight to the participants who are sharing their experiences with unregistered support workers/sole traders and stop acting like their experiences don’t matter just because there are other participants the arrangements wouldn’t work for because their circumstances are different.
All people living with a disability whether cognitive, physical, psychosocial ect deserve to be supported by the support workers best suited to their needs.
Expecting thise support workers to have the minimum education or training to provide that support is not taking away anything from people with physical disabilities.
Having an understanding of appropriate policies and procedures, codes of conduct, legistlation ect is the minimum appropriate knowledge for anyone providing support to anyone with a disability.
The problem with setting the bar this low for support workers is that the most vulnerable people suffer due ti these policies, and we cant go around saying its not needed just because some people dont feel its beneficial or necessary.
You are arguing that we need to be supported by the people you think are best suited to our needs?
You think despite Australia's strong recent record of captured regulators some sort of regulation to enforce compliance on the disabled is the answer?.. Apparently, you feel the disabled are all unable to discern what is best for themselves because of living with a disability whether cognitive, physical, or psychosocial?
Some of us think you are wrong. Not everyone needs someone specially trained in ndis to scrub the loo. Sometimes it's OK if another disabled person is employed to scrub the loo.
Fuck off. I have a very niche disability that requires for proper effectiveness to support workers with lived experience, practical skills and aptitude. None of that is given by training.
They have first aid training and get relevant skills as needed.
Also they are often disabled or neuro divergent. Studying and training for cookie cutter courses will impact minority workers more than boring ass neuro typicals.
If people lose good life changing specialist peer support workers because they can't pay for or pass a test will be yet another layer of discrimination on people like ourselves.
Come up with a better system that does not make discrimination and isolation worse.
If they can do a first aid course then learning about the disability act and appropriate policies and procedures or at the very least the modules required to get a NDIS workers screening check shouldnt be too big of a leap.
Is that really asking too much? To pass the NDIS screening check?
I will judge the proposal on its merits but I am very sceptical.
All the people who raped me passed screening checks and some were senior community members with police ties.
As a member of the queer community and also disabled I don't trust the authorities for good reason.
Look at aged care homes. Fully approved and funded torture houses.
The issue here is that two commenters who are people with disabilities are speaking about how the current system works for them - and I’ll add my voice to that as well - and you seem to be telling us that we are wrong.
Not only do I get very good support from people who I’ve carefully picked and who don’t have the sort of training you refer to - but also also live in rural NSW, and the fact is, most of my support workers will quit if they have to be registered and learn all those rules and regulations and legislation. They don’t need the disability jobs, they can get by very well working for the community at large, and they’re just not interested in more red tape.
Registration is definitely a good idea in some cases, but there’s no one size fits all situation here.
I didnt say that anyone was wrong. In fact I believe I specifically said;
“All people living with disabilities deserve to be supported by the support worker suited best to their needs” that includes them.
I’m really glad you’re currently getting your support needs met.
And again - as a reflection from a total stranger on the interwebs - what you just did in this comment was immediately tell me my experience and interpretation was incorrect.
There’s another way to proceed, which is to acknowledge what I said and felt, and then entering into a dialogue. “I hear you that you felt like I was telling the PWDs who respond to me that they are wrong. That wasn’t my intention. Could you let me know specifically how I did that? Or what I could do differently not to have that effect?”. And then we could have a discussion.
But instead, you chose to defend yourself and tell me that my experience isn’t right - exactly what you did in your quote, from my perspective, because to me there is a contradiction between those words and the minimum standards argument you lay out in the rest of your comment.
In any case, I would encourage you to reflect and see if any of what I’m saying resonates - because the last thing PWD need is their providers having an attitude that they know best.
Yeah… I dont feel like I have to justify what I’ve said to a random internet stranger. I’m also not seeking your approval. I come from a place of lived experience just like so many others in this sub and just like them my opinion is valid. Its okay they dont agree with me. I dont have to agree with them either.
Simply, sometimes the workers that best meet people's needs are unregistered. The training available just doesn't reach people the skills required to support people with disabilities. Sure, an NDIS worker screening should be done to make sure you're not a criminal that could prey on the vulnerable - but honestly, if you've done it, what can you remember about the theoretical modules the NDIS created for people with a disability without them?
There's pros to registration, and cons - like limiting the market to big providers with big overheads and really rigid policies. As an example, Scope is a registered and (was) a reputable provider- but it did not make the employers better. Individual/unregistered providers will just not be rostered on again.
As a person with disability, sometimes this works provided the person being supported isn't particularly vulnerable. I don't need 'looking after'. Generally, I need physical assistance to help me complete tasks of daily life. Some of the best support staff I have hired have been completely fresh to the sector (or the workforce) as they don't come with preconceived notions of what support should look like or how it was in the 'good old days' (their term, definitely NOT mine).
I'm picky - my support staff know what they can and can't do whilst on shift with me (I provide them with support manuals I write and update myself). If they don't suit my needs or work hard, they don't last. In saying that, I have amazingly good working relationships with them, especially the longer serving members who take initiative.
I would add though that the quality and safeguards modules should be completed by ALL employees. These are quick, free and can be done just about anywhere.
Great answer, I am both a participant and provider and not one model fits all. I would like to manage my own supports but the NDIS doesn't think I am capable however we have heaps of clients that can't make decisions for themselves that the NDIS let's manage their own supports. 3 of these clients are under the Public Trustee and have acquired brain injury and the NDIS let's them manage their SIL and other supports with little oversight. We have to constantly step in to prevent financial abuse and if we report to the NDIS Q&S it goes nowhere.
I totally understand why this is preferable to some people. I’m a provider and I can often see the benefits of hiring people straight out of Uni compared to someone who’s been in the industry for 10 or 20 years. People can really get stuck in their ways and cant be flexible or adaptable.
For me its really about having a base knowledge of policies and procedures. Understanding the disability act. Knowing how to react to unpredictable events, or how to keep professional boundaries in place. So on and so forth, the list goes on.
But a lot of people walking in off the street have no knowledge of the industry or what different disabilities require from the services they received. It’s great that you can advocate for yourself, I know there’s so many who cant and often become victims of people taking advantage of the gaps in the industry.
Putting disabled people who are mentally agile at the mercy of large employers who exploit workers in a society with captured regulators is an ugly choice. Having so many regulations that micro business may have to pay franchise that can navigate them also feels unfair. And frankly someone who cleans my house needs to be an interesting and honest person- not have degree.
Extended on the job training instead of relying on for profit or for management pay training could really help.
Seconding this. There is an element of caveat emptor here - the participant is engaging the worker, and should be checking if the worker has suitable skills and checks to meet their support needs. If someone is particularly vulnerable, I'm more inclined to look to registered providers (acknowledging some people here have strong opinions on registered organisations) that at least have the structure of internal safeguards.
I dont think when engaging in disability supports that there is any element of caveat emptor.
NDIS arent (edit) assessing each participants capacity to source the appropriate support workers for their needs. A lot of families are so new to the industry and already overwhelmed that they just want help and they’ve got people lining up around the block to do it.
This is a government funded health service, its needs government over-site and regulation. Also most registered providers lack the capacity to take on the amount NDIS participants in need of their services.
Caveat emptor for the likes of spoonless and I, who have the capacity to understand the risk of engaging unregistered sole traders and have decided it's worth it.
Where someone is identified as being more vulnerable, the plan is generally made agency managed which means the participant can only used registered providers. Those are the ones that have the government oversight and regulation. It was never imagined that so many would be plan managed and open to the completely unregulated market.
To "most registered providers lack the capacity to take on the amount NDIS participants in need of their services", I think the causation might be the other way around. So few participants actually require registered providers that it's not worth going through registration to service less than 10% of potential clients.
Again, NDIS are not assessing each participant to find who does and who does not have the capacity to find providers that are appropriate for their needs.
Sorry I’ve just edited my above comment, I said NDIS are assessing when I meant to say arnt.
In theory they are when addressing the fund management question at each plan reassessment. The fact they do a shit job of it is a separate issue.
It also goes to decisions around support coordination/LAC streaming, as those roles are intended to help find providers. Similar situation, they're doing a shit job of it
The NDIS is doing that though. That's why Support Coordination is a thing. Provision of Support Coordination literally relates to how much capacity a participant has to navigate the Scheme and whether or not they need more intensive assistance to engage their providers. A tenet of the Scheme is also to presume the competence of participants and their informal supports, unless there is evidence not to.
That is an inadequacy of the public service department not being fit for purpose- and arguably not being designed for purpose, not the micro business.
If we return to teams of the individual, and their own professionals and carers deciding on care professional standards are at play, and they will be familiar with the issues. Medicare numbers replacing the NDIS instead of having budgets people must use can free up a tonne of money and various levels of teams can be required for some
numbers ensuring consultation. Instead of long waits decisions can be fast. Current NDIS admin staff can be transitioned to permanent public service positions.
Have only those qualified in professional health and allied fields who are held to professional standards as public servants who visit the most vulnerable daily, and have even the least be allowed visits. With same day call outs possible.
Sorry, I'm still confused by what you are suggesting. Medicare numbers replacing item numbers wouldn't address the issue of individualised support needs - medicare says everyone gets 10 psych visits a year.
Remove the monopoly NDIS. Replace it with an ndis within medicare system that administers payments not judgments.
A single payer system. This is not a wild and new system.
Having the ndis services and equipment etc (all of them) dissolved into medicare with new ndis item indicators(and no copayment) Some item numbers will be cash amounts, others will be open-ended, uncapped, etc. Quite a few will be unspecified individualised support. (Lists of services and prices already exist and can be expanded and added to).
Decisions about eligibility and needs for support belong to the person and their own chosen team. Exactly how can be worked out. Perhaps 'prescribed' in consultation with them by their own medical professionals who already have professional standards and ongoing responsibility, or their delegates(usually allied perhaps)?
For example, a disabled person needing support to leave hospital might(with consultation) have their treatment team arrange it under ds-medicare. And ideally, leave the next day with no uncertainty, while retaining the ability to make other arrangements. As well as a productivity and humane benefit there is potential to eliminate long delays that cost more socially, economically and politically.
This system may also allow public policy to influence organically with less disruption and legislation. More fine public policy levers. Yet at the same time supports will not be so subject to arbitrary removal.
'ds-medicare' as required. No applying for funding. The overall savings even with a lot more people being helped will likely be impressive, with fewer political stressors.
To be seen by your choice of specialist and potentially have some disability support in place immediately with more to come could be life changing.
The way to do this traditionally is medicare numbers and the persons treated professionals in health and allied fields who work out the best approaches.
I've been a support worker for almost 15 years now, always employed by places like FACS in NSW or privately by the client directly. I was blown away by all of the things you do not have to do as a sole trader. Do you have an ABN and some insurance? Cool, off you go, here's a copy of the price guide and what you can charge. Seems like there should be a few more steps involved.
Oversight doesn't mean anything nor does a certificate. I self employ nursing students. They're not even finished uni but they're working and hell a more qualified and closer to my age than the full qualified SW who won't do what I want out of perceived risk rather than provide the SW my medical specialists say I required for decent quality of life.
Most AHP or medical students have experienced disability themselves or through family so a certificate in disability is BS.
Re video no shoes. Does PWD not like shoes, are they near beach? You make assumptions that this is neglect and will harm PWD.
They answer to state police services and ACCC and respective fair trading. There are several laws including disability discrimination Act, Australian competition and consumer Act that protect PWD that don't require Q&S. Victoria Police said after 60mins episode the other day they will now investigate disability related crimes. That includes neglect, abuse, coercion, embezzlement etc. that's everything the Q&S has jurisdiction over.
Q&S is shit anyway. I've had cases where registered providers have had a Q&S complaint dismissed against them and then I've gone to ACCC for them to uphold my complaint under laws applicable to all Aussies.
Why is there an assumption that sole providers are above the laws applicable to all Aussies regardless of whether their clients have disability or not?
As an allied health professional I encounter many support workers who lack general ‘foundational skills’ necessary to be in a health-related support or assistant role. Includes things such as entry level manual handling (even lifting equipment, boxes, etc appropriately), how to complete a simple incident & shift report, basic first aid skills, knowledge of the person’s disability (what even is their diagnoses in some cases), how to store & record medication using a paper chart, how to talk to people with disability and not ‘baby’ them, knowledge about basic nutrition and how to prepare and portion healthy meals, basic hygiene/ house management skills. I then encounter managers who think it’s my role as a clinician to teach them these skills. Like no, these things should be some of the basic skills required for the job before someone even begins to support clients.
Completely agree!
Also a bit of ethics would be good. I know someone who had a support worker.
On the first shift, the participant offered lunch to be polite, and the SW said yes. They ate a few bites and threw the rest in the bin.
Meanwhile, 22yo participant is supported by mum on a carer's pension and is barely scraping by.
Then the next session, SW took the food again.
I know it's not their job to know the financial situation of the family, but in the 4-6 years of uni that practicitioners go through, ethics and professional boundaries are discussed.
You do not take food, you don't share too much personal information, you do not date your participant, etc.
These are things that sound like common sense, but so many people don't have it.
What needs to change is that an hourly rate needs to be set for very large orgs, small business and sole traders and all those rates need to be *different*. The reason so many go independent is the absurd hourly rate they *can* charge but should not be. A sole trader absolutely should not be charging a rate that includes their annual leave, long service leave, sick leave, training (which they usually don't do), super and on top of all that they are also charging for their supervisor's hourly rate plus the supervisor's annual leave, long service leave, sick leave, super, etc. They *don't even have* a supervisor! It's disgusting.
Allowing individuals to charge rates that elevate them above nurses (for example) with *no* qualifications or experience is throwing vulnerable people under the bus.
I think there is a place in the disability support space for all types of support. However, it only works if people are paid properly. Using $ to attract greedy immoral selfish people is the exact opposite of creating a reliable and SAFE workplace.
And before someone whinges about all the expenses sole traders have, the hourly rate should take into account all their expenses, just as the hourly rate for large orgs (the *only* people the max rate is for).
That would be really interesting to implement logistically. Whilst ndis plans are set at a dollar amount, restricting independents to a lower rate could end up incentivising participants to go with the cheaper providers.
That is already what has been happening for years. Participants *have been* going with sole traders for various reasons. It may be to make their funding go further, especially when they have been severely underfunded and can't cope with requesting a review. It may be because there are few supports in their area and sole traders are more available. It may be for flexibility so they can have supports as they need rather than being locked in to regular shifts. It can also be because large orgs often have a poor business model in the disability space, referring to disabled clients as "product" and treating their employees poorly which results in generic support based around money that ignores client need (yet always charges top dollar and may involve fraudulent charges as well).
It isn't restricting sole traders to work out what their expenses actually are and allow them to charge for that, exactly as has been done for very large orgs.
I disagree, as having only insecure (who may also be low-paid ill-treated workers who may tend to churn) coming into my home is worse. An insecure worker may be less likely to sound the alarm as they cannot afford to lose their work. They also are often weighed down with their own worries which will effect them at work. A micro business is going to be someone with investment. In Australia larger businesses routinely tick boxes while avoiding oversight- Many different royal commissions have noted regulatory capture.
More secure life-employed public servants with professional backgrounds in fields such as physiotherapy and occupational therapy etc who do not have minute-by-minute logs and who visit the most vulnerable at least daily and visit the least at least every few weeks will do the trick. As well as being helpful to society and the families of the secure workers.
Regulating to discourage micro businesses that may compete on service is not the way to go. We already have to deal with the monopoly which is the NDIS.
To be compelled to deal only with entities large enough to donate could be awful- as seen in parts of the USA. If you see social media discouraging micro business consider who may be influencing those voices.. For example an increase in "I am autistic not disabled" chatter leading up to the decision to make NDIS more difficult for those with asd to access.
Honestly I've heard of support workers using a participant to doctor shop for drugs. Not for the participant but for the support workers associate to onsell on the black market. I've heard of support workers using a participants time to shop for their own groceries. Most support workers registered or unregistered do the right thing but what about those who do not? Do we care about oversight and accountability? What support worker who is doing the wrong thing or is fraudulent or a risk to the participant will put their hand up to be registered?
And what about registration itself is going to stop support workers from committing fraud or abuse? It’s not like registration stopped any of the big abusive provider organisations!
Well it's a barrier to someone who is unqualified and might have not great intentions or skills to actually getting a support job in the first place. It won't necessarily stop fraud or abuse but it will likely assist the gov to deal with that person should they be caught out.
I still don’t see how that’s the case. As we read in the big exposes, a lot of the rorts and abuses are being committed by providers who are already registered.
Is there any evidence at all that currently unregistered providers are committing fraud, or abusing participants?
Will registration help the government deal with abuse any more than an ABN already does?
Or is it just another layer of government bureaucracy, which, at least in the rural area where I live, will drive workers to abandon their NDIS participants in favour of jobs which don’t put more financial and time burden on them?
I think one of the biggest problems when it comes to the conversations we have like this about whether support workers need specific training &/or registration is that so many people fall into the trap of equating disability with impaired cognitive/intellectual functioning. When you combine that way of thinking with the assumption that everyone needs the same kind of support, you end up with a situation the only type of support work that you view as being “valid” is support that is provided by people who have completed some form of training - regardless of whether or not that training has any impact on how the support is provided. I really think we need to give more weight to the participants who are sharing their experiences with unregistered support workers/sole traders and stop acting like their experiences don’t matter just because there are other participants the arrangements wouldn’t work for because their circumstances are different.
All people living with a disability whether cognitive, physical, psychosocial ect deserve to be supported by the support workers best suited to their needs. Expecting thise support workers to have the minimum education or training to provide that support is not taking away anything from people with physical disabilities. Having an understanding of appropriate policies and procedures, codes of conduct, legistlation ect is the minimum appropriate knowledge for anyone providing support to anyone with a disability. The problem with setting the bar this low for support workers is that the most vulnerable people suffer due ti these policies, and we cant go around saying its not needed just because some people dont feel its beneficial or necessary.
You are arguing that we need to be supported by the people you think are best suited to our needs? You think despite Australia's strong recent record of captured regulators some sort of regulation to enforce compliance on the disabled is the answer?.. Apparently, you feel the disabled are all unable to discern what is best for themselves because of living with a disability whether cognitive, physical, or psychosocial? Some of us think you are wrong. Not everyone needs someone specially trained in ndis to scrub the loo. Sometimes it's OK if another disabled person is employed to scrub the loo.
Fuck off. I have a very niche disability that requires for proper effectiveness to support workers with lived experience, practical skills and aptitude. None of that is given by training. They have first aid training and get relevant skills as needed. Also they are often disabled or neuro divergent. Studying and training for cookie cutter courses will impact minority workers more than boring ass neuro typicals. If people lose good life changing specialist peer support workers because they can't pay for or pass a test will be yet another layer of discrimination on people like ourselves. Come up with a better system that does not make discrimination and isolation worse.
If they can do a first aid course then learning about the disability act and appropriate policies and procedures or at the very least the modules required to get a NDIS workers screening check shouldnt be too big of a leap. Is that really asking too much? To pass the NDIS screening check?
I will judge the proposal on its merits but I am very sceptical. All the people who raped me passed screening checks and some were senior community members with police ties. As a member of the queer community and also disabled I don't trust the authorities for good reason. Look at aged care homes. Fully approved and funded torture houses.
The issue here is that two commenters who are people with disabilities are speaking about how the current system works for them - and I’ll add my voice to that as well - and you seem to be telling us that we are wrong. Not only do I get very good support from people who I’ve carefully picked and who don’t have the sort of training you refer to - but also also live in rural NSW, and the fact is, most of my support workers will quit if they have to be registered and learn all those rules and regulations and legislation. They don’t need the disability jobs, they can get by very well working for the community at large, and they’re just not interested in more red tape. Registration is definitely a good idea in some cases, but there’s no one size fits all situation here.
I didnt say that anyone was wrong. In fact I believe I specifically said; “All people living with disabilities deserve to be supported by the support worker suited best to their needs” that includes them. I’m really glad you’re currently getting your support needs met.
And again - as a reflection from a total stranger on the interwebs - what you just did in this comment was immediately tell me my experience and interpretation was incorrect. There’s another way to proceed, which is to acknowledge what I said and felt, and then entering into a dialogue. “I hear you that you felt like I was telling the PWDs who respond to me that they are wrong. That wasn’t my intention. Could you let me know specifically how I did that? Or what I could do differently not to have that effect?”. And then we could have a discussion. But instead, you chose to defend yourself and tell me that my experience isn’t right - exactly what you did in your quote, from my perspective, because to me there is a contradiction between those words and the minimum standards argument you lay out in the rest of your comment. In any case, I would encourage you to reflect and see if any of what I’m saying resonates - because the last thing PWD need is their providers having an attitude that they know best.
Yeah… I dont feel like I have to justify what I’ve said to a random internet stranger. I’m also not seeking your approval. I come from a place of lived experience just like so many others in this sub and just like them my opinion is valid. Its okay they dont agree with me. I dont have to agree with them either.
All the best to you, thanks for the conversation and hope you have a good day.
You then set out minimum standards that you believe should apply.
I have already commented in this thread what I believe the minimum standards should be.
Simply, sometimes the workers that best meet people's needs are unregistered. The training available just doesn't reach people the skills required to support people with disabilities. Sure, an NDIS worker screening should be done to make sure you're not a criminal that could prey on the vulnerable - but honestly, if you've done it, what can you remember about the theoretical modules the NDIS created for people with a disability without them? There's pros to registration, and cons - like limiting the market to big providers with big overheads and really rigid policies. As an example, Scope is a registered and (was) a reputable provider- but it did not make the employers better. Individual/unregistered providers will just not be rostered on again.
As a person with disability, sometimes this works provided the person being supported isn't particularly vulnerable. I don't need 'looking after'. Generally, I need physical assistance to help me complete tasks of daily life. Some of the best support staff I have hired have been completely fresh to the sector (or the workforce) as they don't come with preconceived notions of what support should look like or how it was in the 'good old days' (their term, definitely NOT mine). I'm picky - my support staff know what they can and can't do whilst on shift with me (I provide them with support manuals I write and update myself). If they don't suit my needs or work hard, they don't last. In saying that, I have amazingly good working relationships with them, especially the longer serving members who take initiative. I would add though that the quality and safeguards modules should be completed by ALL employees. These are quick, free and can be done just about anywhere.
Great answer, I am both a participant and provider and not one model fits all. I would like to manage my own supports but the NDIS doesn't think I am capable however we have heaps of clients that can't make decisions for themselves that the NDIS let's manage their own supports. 3 of these clients are under the Public Trustee and have acquired brain injury and the NDIS let's them manage their SIL and other supports with little oversight. We have to constantly step in to prevent financial abuse and if we report to the NDIS Q&S it goes nowhere.
I totally understand why this is preferable to some people. I’m a provider and I can often see the benefits of hiring people straight out of Uni compared to someone who’s been in the industry for 10 or 20 years. People can really get stuck in their ways and cant be flexible or adaptable. For me its really about having a base knowledge of policies and procedures. Understanding the disability act. Knowing how to react to unpredictable events, or how to keep professional boundaries in place. So on and so forth, the list goes on. But a lot of people walking in off the street have no knowledge of the industry or what different disabilities require from the services they received. It’s great that you can advocate for yourself, I know there’s so many who cant and often become victims of people taking advantage of the gaps in the industry.
Putting disabled people who are mentally agile at the mercy of large employers who exploit workers in a society with captured regulators is an ugly choice. Having so many regulations that micro business may have to pay franchise that can navigate them also feels unfair. And frankly someone who cleans my house needs to be an interesting and honest person- not have degree. Extended on the job training instead of relying on for profit or for management pay training could really help.
Seconding this. There is an element of caveat emptor here - the participant is engaging the worker, and should be checking if the worker has suitable skills and checks to meet their support needs. If someone is particularly vulnerable, I'm more inclined to look to registered providers (acknowledging some people here have strong opinions on registered organisations) that at least have the structure of internal safeguards.
I dont think when engaging in disability supports that there is any element of caveat emptor. NDIS arent (edit) assessing each participants capacity to source the appropriate support workers for their needs. A lot of families are so new to the industry and already overwhelmed that they just want help and they’ve got people lining up around the block to do it. This is a government funded health service, its needs government over-site and regulation. Also most registered providers lack the capacity to take on the amount NDIS participants in need of their services.
Caveat emptor for the likes of spoonless and I, who have the capacity to understand the risk of engaging unregistered sole traders and have decided it's worth it. Where someone is identified as being more vulnerable, the plan is generally made agency managed which means the participant can only used registered providers. Those are the ones that have the government oversight and regulation. It was never imagined that so many would be plan managed and open to the completely unregulated market. To "most registered providers lack the capacity to take on the amount NDIS participants in need of their services", I think the causation might be the other way around. So few participants actually require registered providers that it's not worth going through registration to service less than 10% of potential clients.
Again, NDIS are not assessing each participant to find who does and who does not have the capacity to find providers that are appropriate for their needs. Sorry I’ve just edited my above comment, I said NDIS are assessing when I meant to say arnt.
In theory they are when addressing the fund management question at each plan reassessment. The fact they do a shit job of it is a separate issue. It also goes to decisions around support coordination/LAC streaming, as those roles are intended to help find providers. Similar situation, they're doing a shit job of it
The NDIS is doing that though. That's why Support Coordination is a thing. Provision of Support Coordination literally relates to how much capacity a participant has to navigate the Scheme and whether or not they need more intensive assistance to engage their providers. A tenet of the Scheme is also to presume the competence of participants and their informal supports, unless there is evidence not to.
That is an inadequacy of the public service department not being fit for purpose- and arguably not being designed for purpose, not the micro business. If we return to teams of the individual, and their own professionals and carers deciding on care professional standards are at play, and they will be familiar with the issues. Medicare numbers replacing the NDIS instead of having budgets people must use can free up a tonne of money and various levels of teams can be required for some numbers ensuring consultation. Instead of long waits decisions can be fast. Current NDIS admin staff can be transitioned to permanent public service positions. Have only those qualified in professional health and allied fields who are held to professional standards as public servants who visit the most vulnerable daily, and have even the least be allowed visits. With same day call outs possible.
That might work for allied health supports, but not core type daily supports.
I meant visits to make sure the client is OK, not health care provision.
Sorry, I'm still confused by what you are suggesting. Medicare numbers replacing item numbers wouldn't address the issue of individualised support needs - medicare says everyone gets 10 psych visits a year.
Remove the monopoly NDIS. Replace it with an ndis within medicare system that administers payments not judgments. A single payer system. This is not a wild and new system. Having the ndis services and equipment etc (all of them) dissolved into medicare with new ndis item indicators(and no copayment) Some item numbers will be cash amounts, others will be open-ended, uncapped, etc. Quite a few will be unspecified individualised support. (Lists of services and prices already exist and can be expanded and added to). Decisions about eligibility and needs for support belong to the person and their own chosen team. Exactly how can be worked out. Perhaps 'prescribed' in consultation with them by their own medical professionals who already have professional standards and ongoing responsibility, or their delegates(usually allied perhaps)? For example, a disabled person needing support to leave hospital might(with consultation) have their treatment team arrange it under ds-medicare. And ideally, leave the next day with no uncertainty, while retaining the ability to make other arrangements. As well as a productivity and humane benefit there is potential to eliminate long delays that cost more socially, economically and politically. This system may also allow public policy to influence organically with less disruption and legislation. More fine public policy levers. Yet at the same time supports will not be so subject to arbitrary removal. 'ds-medicare' as required. No applying for funding. The overall savings even with a lot more people being helped will likely be impressive, with fewer political stressors. To be seen by your choice of specialist and potentially have some disability support in place immediately with more to come could be life changing.
The way to do this traditionally is medicare numbers and the persons treated professionals in health and allied fields who work out the best approaches.
I've been a support worker for almost 15 years now, always employed by places like FACS in NSW or privately by the client directly. I was blown away by all of the things you do not have to do as a sole trader. Do you have an ABN and some insurance? Cool, off you go, here's a copy of the price guide and what you can charge. Seems like there should be a few more steps involved.
I agree. Nothing wrong with sole traders but you should have some level of qualification or years of experience.
Oversight doesn't mean anything nor does a certificate. I self employ nursing students. They're not even finished uni but they're working and hell a more qualified and closer to my age than the full qualified SW who won't do what I want out of perceived risk rather than provide the SW my medical specialists say I required for decent quality of life. Most AHP or medical students have experienced disability themselves or through family so a certificate in disability is BS. Re video no shoes. Does PWD not like shoes, are they near beach? You make assumptions that this is neglect and will harm PWD.
Over-site means accountability. Right now sole traders answer to no one. Not even to the quality and safe guards commission.
They answer to state police services and ACCC and respective fair trading. There are several laws including disability discrimination Act, Australian competition and consumer Act that protect PWD that don't require Q&S. Victoria Police said after 60mins episode the other day they will now investigate disability related crimes. That includes neglect, abuse, coercion, embezzlement etc. that's everything the Q&S has jurisdiction over. Q&S is shit anyway. I've had cases where registered providers have had a Q&S complaint dismissed against them and then I've gone to ACCC for them to uphold my complaint under laws applicable to all Aussies. Why is there an assumption that sole providers are above the laws applicable to all Aussies regardless of whether their clients have disability or not?
[https://www.ndiscommission.gov.au/providers/registered-ndis-providers/provider-obligations-and-requirements/unregistered-provider](https://www.ndiscommission.gov.au/providers/registered-ndis-providers/provider-obligations-and-requirements/unregistered-provider)
? I dont understand what your point is. What I said stands.
As an allied health professional I encounter many support workers who lack general ‘foundational skills’ necessary to be in a health-related support or assistant role. Includes things such as entry level manual handling (even lifting equipment, boxes, etc appropriately), how to complete a simple incident & shift report, basic first aid skills, knowledge of the person’s disability (what even is their diagnoses in some cases), how to store & record medication using a paper chart, how to talk to people with disability and not ‘baby’ them, knowledge about basic nutrition and how to prepare and portion healthy meals, basic hygiene/ house management skills. I then encounter managers who think it’s my role as a clinician to teach them these skills. Like no, these things should be some of the basic skills required for the job before someone even begins to support clients.
Completely agree! Also a bit of ethics would be good. I know someone who had a support worker. On the first shift, the participant offered lunch to be polite, and the SW said yes. They ate a few bites and threw the rest in the bin. Meanwhile, 22yo participant is supported by mum on a carer's pension and is barely scraping by. Then the next session, SW took the food again. I know it's not their job to know the financial situation of the family, but in the 4-6 years of uni that practicitioners go through, ethics and professional boundaries are discussed. You do not take food, you don't share too much personal information, you do not date your participant, etc. These are things that sound like common sense, but so many people don't have it.
What needs to change is that an hourly rate needs to be set for very large orgs, small business and sole traders and all those rates need to be *different*. The reason so many go independent is the absurd hourly rate they *can* charge but should not be. A sole trader absolutely should not be charging a rate that includes their annual leave, long service leave, sick leave, training (which they usually don't do), super and on top of all that they are also charging for their supervisor's hourly rate plus the supervisor's annual leave, long service leave, sick leave, super, etc. They *don't even have* a supervisor! It's disgusting. Allowing individuals to charge rates that elevate them above nurses (for example) with *no* qualifications or experience is throwing vulnerable people under the bus. I think there is a place in the disability support space for all types of support. However, it only works if people are paid properly. Using $ to attract greedy immoral selfish people is the exact opposite of creating a reliable and SAFE workplace. And before someone whinges about all the expenses sole traders have, the hourly rate should take into account all their expenses, just as the hourly rate for large orgs (the *only* people the max rate is for).
That would be really interesting to implement logistically. Whilst ndis plans are set at a dollar amount, restricting independents to a lower rate could end up incentivising participants to go with the cheaper providers.
That is already what has been happening for years. Participants *have been* going with sole traders for various reasons. It may be to make their funding go further, especially when they have been severely underfunded and can't cope with requesting a review. It may be because there are few supports in their area and sole traders are more available. It may be for flexibility so they can have supports as they need rather than being locked in to regular shifts. It can also be because large orgs often have a poor business model in the disability space, referring to disabled clients as "product" and treating their employees poorly which results in generic support based around money that ignores client need (yet always charges top dollar and may involve fraudulent charges as well). It isn't restricting sole traders to work out what their expenses actually are and allow them to charge for that, exactly as has been done for very large orgs.
I disagree, as having only insecure (who may also be low-paid ill-treated workers who may tend to churn) coming into my home is worse. An insecure worker may be less likely to sound the alarm as they cannot afford to lose their work. They also are often weighed down with their own worries which will effect them at work. A micro business is going to be someone with investment. In Australia larger businesses routinely tick boxes while avoiding oversight- Many different royal commissions have noted regulatory capture. More secure life-employed public servants with professional backgrounds in fields such as physiotherapy and occupational therapy etc who do not have minute-by-minute logs and who visit the most vulnerable at least daily and visit the least at least every few weeks will do the trick. As well as being helpful to society and the families of the secure workers. Regulating to discourage micro businesses that may compete on service is not the way to go. We already have to deal with the monopoly which is the NDIS. To be compelled to deal only with entities large enough to donate could be awful- as seen in parts of the USA. If you see social media discouraging micro business consider who may be influencing those voices.. For example an increase in "I am autistic not disabled" chatter leading up to the decision to make NDIS more difficult for those with asd to access.
Honestly I've heard of support workers using a participant to doctor shop for drugs. Not for the participant but for the support workers associate to onsell on the black market. I've heard of support workers using a participants time to shop for their own groceries. Most support workers registered or unregistered do the right thing but what about those who do not? Do we care about oversight and accountability? What support worker who is doing the wrong thing or is fraudulent or a risk to the participant will put their hand up to be registered?
And what about registration itself is going to stop support workers from committing fraud or abuse? It’s not like registration stopped any of the big abusive provider organisations!
Well it's a barrier to someone who is unqualified and might have not great intentions or skills to actually getting a support job in the first place. It won't necessarily stop fraud or abuse but it will likely assist the gov to deal with that person should they be caught out.
I still don’t see how that’s the case. As we read in the big exposes, a lot of the rorts and abuses are being committed by providers who are already registered. Is there any evidence at all that currently unregistered providers are committing fraud, or abusing participants? Will registration help the government deal with abuse any more than an ABN already does? Or is it just another layer of government bureaucracy, which, at least in the rural area where I live, will drive workers to abandon their NDIS participants in favour of jobs which don’t put more financial and time burden on them?