David Meldrum www.mifa.org.au

Executive Director www.MiNetworks.org.au

THE BIG PICTURE – where we started

NDIS transforms a muddled landscape of psychosocial disability supports

into a participant driven, cost effective insurance model which is consistently

delivered across Australia.

In the process the new system doubles the funding available.

SO

Health and clinical services continue to be state managed.

Eventually, the rest of the ‘mental health system’ is managed and funded by

NDIA – like aged care.

BUT

Most jurisdictions have not agreed to that scenario – at least not yet.

SO

Where has the NDIA begun implementation?

With what we are agreeing to call ‘Tier 3’ in the trial sites

Who is in Tier 3?

People with a diagnosis (current) and associated permanent disabilities.

This has proven to be a dangerously wrong assumption.

Wrong because so many people in need of hands on services don’t fit either of

those descriptions - ie they are in Tier 2.

Dangerous because Commonwealth funding and possibly some state funding for

Tier 2 services has been committed to Tier 3.

THE TRIALS

You all know about these

I am going to focus on the Hunter

More than 60 people there have been allocated NDIS packages (very

few elsewhere)

Important progress has been made

•NSW MHS relationships

•PiR relationships

•Clarification of eligibility

• Building a community of practice

TIER 2

Federal Govt and NDIA now recognise the importance of ‘Tier 2’ services.

In fact they recognise the case for expanding them because they are•Effective•Preventative•Efficient•Largely participant driven

Some arrangements to ensure this outcome will emerge soon.

BUT

Tiers 2 and 3 need much better definition - in the interests of funders,

participants and service providers.

My view is that where services cost in excess of around $10,000 pa, the

person should become eligible for Tier 3.

I don’t believe that the insurance model works for Tier 2. Block funding

should continue within the usual contract management frameworks.

This way we may end up with a clearer picture of Commonwealth/State

responsibilities.

WHAT WE DON’T KNOW

How many Australians might be eligible for Tier 3.

Anybody who says they know the answer to this, is kidding themselves.

All available data sets come to different answers – NMHSPF, AIHW etc

Prescriptions for anti-psychotic medications shed some light on this complexity.

If we build it right, some of them will come

SUMMARY

Agree to protect and grow ‘Tier 2’ services.

Keep talking constructively about the number of people – settle on a

number for now but keep under continuous review.

Keep talking about ‘permanence’ and diagnosis.

Learn as much as we can from the trial sites about assessment,

choice and control, about eligibility and costs.

Properly and continuously engage with people who may be eligible for

these services.

David Meldrum www.mifa.org.au

Executive Director www.MiNetworks.org.au