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National Disability Insurance Scheme
62
JCPSLP
Volume 18, Number 2 2016
Journal of Clinical Practice in Speech-Language Pathology
Meeting the planning needs
of people with complex
communication needs
Hilary Johnson and Denise West
Hilary Johnson
(top) and
Denise West
THIS ARTICLE
HAS BEEN
PEER-
REVIEWED
KEYWORDS
ADULTS
COMPLEX
COMMUNICA-
TION NEEDS
NATIONAL
DISABILITY
INSURANCE
SCHEME
PLANNING
people with a disability. The ILC aims to build community
awareness and capacity building, assist primary carers or
families to obtain information or referrals for service through
mainstream services and community support groups,
and provide local area co-ordination. Tier 3 is focused on
providing individualised funded packages (IFPs) to enable
eligible people with disability to receive the
reasonable
and necessary supports
to achieve life goals. Funding will
be provided to 460 000 people with a disability who need
specialised individualised supports determined through a
planning process (New South Wales Government, 2015).
The IFPs have been piloted for eligible participants since
July 2013 at various sites across Australia, with the full
scheme scheduled to progressively roll out across New
South Wales, Victoria, Queensland, South Australia,
Tasmania and Northern Territory from July 2016 until 2019.
Many of the participants targeted to receive individual
support packages in the NDIS have complex needs and
cognitive difficulties.
The NDIS estimate that 60−70 % of participants have
an intellectual disability (Bigby, 2014; Bonyhady, 2015).
In Australia 2.9% (668 100) of the population have an
intellectual disability, of which 417 100 people (or 62%)
have a profound or severe core-activity limitation. Of
these people with profound or core limitation, 67.3% have
speech difficulties (Australian Bureau of Statistics, 2012).
Not all of these people will be eligible for the NDIS as
people who acquire a disability after the age of 65 years will
receive funding for services through the aged care sector.
The NDIA’s 2015 report of the trial data demonstrated
that people with cognitive and associated impairment
constitute a large number of those with established plans
which reflects the population data (NDIA, 2015). For
instance, “Autism and related disorders represent the
highest proportion of approved plans overall, at 31%. The
second highest proportion is represented by participants
with intellectual disability (including Down syndrome and
other intellectual/learning disability) at 25%” (NDIA, 2015,
p. 29). As many participants will require communication
supports (as clearly reflected in the top two diagnostic
groups with completed plans), Speech Pathology Australia
has recognised that the NDIS will have an impact on
service provision and established a project officer, based
at national office, dedicated to inform the profession and
oversee developments (Olsson, 2015; Speech Pathology
Australia, n.d.). Speech-language pathologists (SLPs) have
commenced providing services in the trial sites, with some
reporting positive outcomes. For instance, there have
The introduction of the National Disability
Insurance Scheme (NDIS) in Australia is
changing service provision for people with
disabilities. The scheme has been operating
at trial sites since 2013 and will roll out
nationally in 2016. The aims of this paper are
to explore some of the current challenges
presented by this scheme in the provision of
services for adults with complex
communication needs and provide
recommendations for change. Examples of
lifestyle planning are outlined and essential
elements highlighted to ensure adults with
complex communication needs successfully
identify their goals and receive the
reasonable and necessary
individualised
supports they require in order to achieve life
goals. Recommendations for the NDIS
include specialised training for planners and
inclusion of the person with complex
communication needs in the process.
Recommendations for speech pathologists
include developing appropriate
communication tools and resources for
planners, individuals with complex
communication needs, and advocates.
S
ervice provision for people with severe disabilities is
rapidly changing within Australia due to the National
Disability Insurance Scheme (NDIS). The National
Disability Insurance Agency (NDIA) is an independent
statutory agency, whose role is to implement the NDIS.
A Commonwealth Government initiative, the NDIS was
set up to redress the inequities people with disabilities
face in receiving supports that have been described as
“inequitable, underfunded, fragmented, and inefficient”
(Productivity Commission, 2011, p. 2). The NDIS aims to
improve outcomes for people with a disability through what
was initially termed a three-tiered model. Tier 1 is aimed
at all Australians to create more inclusive opportunities for
people with a disability (Productivity Commission, 2011,
p. 11.) Tier 2, now renamed Information, Linkages and
Capacity Building (ILC), targets approximately 800 000