Kinds of supports and services
It is important to think broadly and creatively about the supports and services that might be provided using Scheme funds. Some of a person’s support needs may be best provided by people who are not paid and others by funded services.
The preferences and capacities of the person with disability, and of their family and peers, are important considerations to take into account in formulating the plan. For example, a young man may not wish to receive personal care from his mother even if it is seen as the most affordable option.
Natural, or informal support, refers to the assistance provided by family, friends and other community members who are not paid to provide assistance. Assistance provided in this way can be less intrusive, more flexible and build connections with others. For example, a person with a disability may need physical assistance to turn over in bed during the night, and may rely on their spouse to assist them, not a paid support worker.
Paid supports include all funded supports. It can also refer to technological responses such as home or vehicle modifications and aids and equipment. Some people with a disability need significant paid supports to undertake all aspects of daily living. Most people, however, do best with a combination of support provided by paid and unpaid supporters.
Paid supports should not be used as a substitute for friendships or intimate relationships but can, if delivered skilfully, aid in their development. People who are surrounded only by people who are paid to be there are known to have a poorer quality of life.
Community or mainstream services include services that all citizens can use. For example, a person with cerebral palsy may need weekly therapy to maintain optimum mobility and may see their local Osteopath using NDIS funding.
Consideration should be given to whether a mainstream service will meet a person’s requirements so that inclusion becomes the norm rather than the exception. In some cases, community or mainstream services will be less expensive, more convenient and more personalised than a specialised disability service e.g. the local handyman may do better home modifications than the local disability service provider. The NDIA will be particularly interested in arrangements that deliver value for money.
Disability services provide specialised supports such as assistance with planning, case management, personal care, communication and community participation. Some services specialise in assisting people with a particular disability e.g. intellectual disability, and others provide services of value to people with a wide variety of disabilities e.g. home help.
Many services now focus on assisting people with disabilities to live ordinary lives in the community, however, the understandings about how to do this well is still developing. NDIS funding will provide an opportunity for people with disabilities to influence service development into the future through their service purchasing decisions.
There are drawbacks to heavy reliance on only one source of support. Many people who receive NDIS funding will use a combination of informal supports, paid supports, assistance from mainstream and community services as well as disability services.
Developing individualised supports
It is valuable for a person with disability to have a good idea about the supports that they might want before discussing their support plan with the NDIA.
Earlier experience of service limitations may make it difficult for a person with disability to at first imagine the kind of supports and services that would allow them to live the life they desire. Some people with disabilities will benefit from the assistance of creative, open-minded and experienced people, to draw out their goals and aspirations and to articulate their support needs.
One way an individual might develop their goals and support needs is by considering each area of their life and thinking about:
- what is needed in each of those areas;
- how these needs might be met;
- who or what might meet those needs; and
- whether the ‘who’ or the ‘what’ will have an associated cost.
Areas to consider include health, home, employment, education, recreation and leisure and transport. Some people will also need funded support to maintain good nutrition, financial viability, autonomy, reputation, social roles, social inclusion, mobility, communication, spirituality, culture, rights, and relationships.
Once the kinds of supports and services to be purchased have been identified the next step is to undertake a scan of potential providers. These may include businesses, community services or specialist disability services. It is important to think creatively and beyond the standard suite of disability services.
If a person approaches the NDIA having already considered and developed views on these matters they will be in a better position to ensure that the Scheme is responsive to their wishes.