The National Disability Insurance Scheme (NDIS) launched in Queensland on 1 July 2016 and is planned to be assisting 91,000 people with disabilities by June 30, 2019.
So far, the portal fiasco has meant QLD is off to a slow and somewhat faltering start. However as these issues continue to be ironed out, QLD can look forward to the scheme picking up pace.
The Townsville region, encompassing Townsville, Charters Towers and Palm Island is the QLD launch site, its market size is estimated at $240M in 2019, growing from an estimated $110M in 2016. Prior to launch on 1 July, there were 2,525 people across the Townsville service region receiving some level of support funding by the QLD Government. NDIS Participant numbers will grow from 3,200 in 2016 to 5300 in 2019.
With its high population of Rural and Remote and Aboriginal and Torres Strait Islander participants, as well as higher concentrations of small to medium sized service providers, Townsville exemplifies some of the areas where QLD has significant challenges to overcome, but on the flip side, enormous opportunity to demonstrate innovation and leadership.
Some key issues are as follows:
No launch site. Disadvantage or not?
QLD’s tardiness with signing the bilaterals has come with some trade-offs.
On one hand, while the other states have had the benefit of trial site learning to incorporate into their transition, QLD is experiencing a sort of baptism by fire as we scramble to roll out the scheme amidst the national chaos of the full scheme roll out.
QLD’s delay means we have had limited assistance in terms of sector development (The Sector Development Fund, operated by the NDIS, has set aside A$146 million over the period 2012 to 2018, yet QLD’s absence in funded projects is notable).
It appears that many organisations (and participants) are suffering from a sort of ‘NDIS fatigue’, stemming from a prolonged sense of disbelief that the NDIS would ever become a reality for QLD. Many years of talk and no action has lead to a sense of denial about just how seismic this change will be.
On the other hand, our trial-sized NDIS population has been less affected by the portal debacle that the other states, and we are also able to learn from the mistakes of organisations who have been transitioning over the last few years. While there are some unique aspects of the QLD demographic environment where evidence to support service development is limited (such as Rural and Remote and Indigenous communities) we are no less disadvantaged than the rest of Australia, a point I will expand on next.
Silence on Rural and Remote and Aboriginal and Torres Strait Islander Strategies
There is no doubt that a Rural and Remote, and Aboriginal and Torres Strait Islander strategy is necessary, and yet the silence from the NDIA is deafening. Both populations represent areas where the NDIA’s overarching goal to let market forces drive the development of the scheme, is resulting in market failure.
How can market forces drive change where those forces don’t exist?
For Rural and Remote, geographic spread, low population density and limited infrastructure means offering financially sustainable services that don’t involve parachuting services into remote communities is a challenge.
In Townsville LGA, around 6.5% of individuals identify as being from an Aboriginal or Torres Strait Islander background. In Charters Towers the proportion increases to 8.4% while in Palm Island LGA, around 95% of the population identify as being from an Aboriginal or Torres Strait Island background. This is compared with 3.8% average across QLD.
It’s important not to generalise, however the individualised nature of the NDIS is a very coarse fit with the fundamental nature of Aboriginal and Torres Strait Islander culture. Most communities operate in a collectivist culture so singling out individuals without supporting their community is really problematic.
Programs have been trialled to help improve understanding of how these issues might be solved in an NDIS context, Tennant Creek LGA as an example, however there has been virtually no communication from the NDIA to bring the sector along on its journey of discovery. Why is nothing being reported or communicated more broadly?
These sorts of issues drive immense fear and uncertainty in the sector, however they also point to huge opportunities for experienced QLD providers to come up with trailblazing solutions that the rest of the country can adopt.
To merge or not to merge, that is the question for small to medium sized providers.
The Townsville, Charters Towers and Palm Island markets are characterised by a higher proportion of small to medium providers than the broader QLD market. This is evidenced by the largest 205 providers providing services to around 75% of existing service users whereas across QLD, the largest 20% of service providers account for 86% of existing support users.
A concern we constantly encounter amongst DSC clients is whether or not they should merge. A strong message from the sector is saying that if your organisation has less than $3M turnover, you’re out of the game.
We couldn’t disagree more.
Like any other sector in the economy, this one will have more efficient and less efficient organisations. A strong commentary has been unleashed that less efficient organisations = predominantly smaller operations. However when organisations take on the message of keeping lean, we believe a completely different outcome is possible.
Smaller organisations can have a distinct advantage, especially in such a highly heterogeneous market. Local knowledge combined with fast and open communication means small organisations can iron out issues and take advantage of opportunities much faster than their larger competitors.
Some of your greatest assets are your community linkages and your deep local knowledge. Small providers have an opportunity to find their niche, provide quality services and partner to provide referrals and support to other organisations who are providing services that complement their own. If you can match this with a flat organisational structure, you can be flexible and combat the communication issues larger organisations struggle with, keeping your workforce engaged and moving in a shared direction.
These are the perfect conditions for innovation, something that is sorely needed to tackle issues surrounding highly marginalised groups, like Rural and Remote and Indigenous communities.
Moving forward, QLD needs to strengthen its voice in the NDIS conversation, start pushing for answers where they have previously been elusive, and start leveraging and building upon its strengths to tackle the NDIS transition with confidence.
As this occurs, we will have our ear to the ground to uncover examples of where organisations are succeeding and struggling to help ensure lessons from the QLD experience are shared by all. As a provider, if you have a question or concern, please don’t hesitate to get in touch, we’d love to hear from you.