Self-managed Plans – Evidence from Large Scale Surveys
The NDIS survey asked if any funding for disability supports was self-managed prior to the NDIS (Appendix Table A4.26) and under the NDIS (Appendix Table A4.27). Of the 2,512 NDIS participants who responded to the question about self-management practices prior to the NDIS in wave 1, 29 per cent said they did (20 per cent being managed by the family, 5 per cent by the person with disability themselves and 4 per cent by someone else), 64 per cent said they did not, and the remaining seven per cent did not know.
Evidently, only a minority of people with disability entered the NDIS with prior experience of self-management. Of the 3,253 NDIS participants who responded to the question about their self-management practices under the NDIS in wave 1, 46 per cent said at least some of their funding was being self-managed (31 per cent being managed by their family, 10 per cent by the NDIS participant themselves, and 5 per cent by someone else).
The proportion of NDIS participants who reported that their funding was being self-managed did not change over time; around half of all NDIS participants were not self-managing their plans in both waves 1 and wave 2. This finding supports the qualitative evidence presented below.
The most frequently reported benefit of self-managing funds (Appendix Table A4.28) was that it allowed NDIS participants to employ/choose their own support workers (51 per cent), access new supports that they had not received previously (49 per cent), and access better supports than they were previously receiving (48 per cent).
Self-managed Plans – Evidence from In-depth Qualitative Interviews
The perspective of NDIS participants and their family members or carer
In wave 1 the option of self-managed funding was not always fully understood by NDIS participants; nor was it discussed in all planning meetings. By wave 2 it was evident that while NDIS participants had a greater understanding of what self-management was there remained very few self-managers. The main reason for this appeared to be a reluctance to take on additional administrative activities.
Those who decided to self-manage funding were positive about the benefits of doing so, principally in relation to greater choice and flexibility in accessing non-NDIS service providers and in the support workers that they engaged. In addition, respondents mentioned that self-management allowed them to monitor how much money was being charged by service providers and for what purpose. Several respondents noticed that organisations tended to exaggerate hours of work and overcharge for services provided and that this situation could be avoided if the self-management model was taken up. Some respondents who were not self-managing their NDIS funding also requested access to the portal for the same reason.
When I realised that I could interview people and hire people with ABNs and do it that way I took a little bit more responsibility and got people who are now doing the job really, really well and effectively and efficiently and only charging me for the hours. I found that the organisations were charging me say for three hours and the person was only here for two. (A16C W2)
Feedback in wave 2 showed the increased use of financial managers, which relieved respondents of the task of paying for services but allowed them to continue to self-direct the choice of these supports.
While the flexibility of self-managed funding was thought to be advantageous, there appeared to be little guidance provided by the NDIA on the boundaries of this flexibility. Fears were expressed about the potential risk to future funding if decisions were made which were later found to be outside of the NDIA guidelines.
Respondents continued to report difficulties with the NDIS portal and the associated myGov website in wave 2, particularly in regard to logging in and accessing individual service invoices. This impacted the ability of NDIS participants and their families to keep track of money spent and to plan for future expenditure.
While respondents typically did not want the responsibility of self-managing their entire plan, it was not uncommon for them to manage discrete sections, such as transport, incontinence products or community groups. Changes to line-bundling in the second year of the NDIS resulted in decreased opportunity and increased confusion for respondents about the management of individual aspects of a plan.
The perspective of service providers and other stakeholder groups
In wave 1, disability service providers and workforce stakeholder organisations confirmed that few NDIS participants were fully self-managing their funding. This remained the case in wave 2. While these respondents believed that the self-managing of funding would eventually lead to increased choice for NDIS participants, they were concerned that providers not registered with the NDIA or otherwise accredited may not have the skills to provide the quality of service that NDIS participants expected and needed. For this reason, disability service providers and workforce stakeholder organisations continued to call for quality assurance measures to be put into place alongside safeguards.
In wave 2, providers identified both positive and negative outcomes for participants and families self-managing their NDIS funding. Some providers reported that self-management was working well and it could offer more flexibility and choice for some NDIS participants. However, other providers reported families struggling with the burden of self-management, including some who had been allowed to self-manage services when they lacked the capacity to do so.
The perspective of the NDIA staff
NDIA staff reported that most participants continued to prefer that the agency managed their funding. It was suggested that many participants and families simply did not want to fully self-manage, as it was perceived to be too hard or too much work. The self-management of funding was seen as being particularly difficult for people with intellectual disability or for those without access to the internet. It was therefore reported that it was common for participants to self-manage a component of their plan rather than all their supports. Common components of plans that were self-managed included transport, therapy services, and supports provided by unregistered providers. Staff noted the risk of fraud or mismanagement of funds by those undertaking self-management and were concerned that the NDIS lacked sufficient safeguards.
