BigDog Newsletter July 2023

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Welcome to the new financial year The Independent Review into the NDIS handed down its Interim Report, ahead of its final Report that’s due in October. It’s exciting times, as we’ve all been wanting a peek inside the heads behind this high-stakes Review. The Report includes a summary of the issues raised during the consultation process, and a call-out to the community for help developing solutions.

We can be damn sure that every topic identified by the Review will be the focus of considerable government and NDIA attention over the coming years.

You only need to watch the NDIS Minister Bill Shorten when he’s asked a curly question in media interviews- he makes it pretty clear he’s expecting the Review to fork out the big answers.

The first part of the Report is dedicated to what the Review Panellist’s consider the top 5 most pressing challenges the Scheme faces. The second half explores the 10 areas of improvement raised during community consultations. Each section includes consultation questions focused on finding solutions.

This Report in many ways marks a turning point, with the Review putting a line under ‘problems’ and a question mark next to ‘solutions'.

The Report details the 10 areas of improvement that came up during the consultation process. While the bulk of the it focuses on what’s going wrong, the questions for the community centre around possible future solutions.

In This Issue 2 Editor’s Notes 3 NDIS Independent Review 4 NDIS NEWS 5 Pricing 6 Our Community 7 WhatsUp in Disability 8 Virtual Health 9 NGO Training Infographic 10 Toowoomba Group 11 Rockhampton Group 12 Total Knee Replacement 13 Staff Updates 14 What’s happening in July

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BigDog Support Services Magazine

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Applying and getting a plan

The Review has heard that access and planning processes basically… well… suck. Applying to the Scheme is ‘confusing and difficult’, overly focused on diagnosis and people aren’t clear about what evidence is required. And once you are in the Scheme, the planning process often divulges into an argument. It also focuses on what people can’t do, rather than what they can. In both stages, participants are not recognised as the experts of their own lives, with a higher emphasis placed on expensive reports from specialists.

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A complete and joined up ecosystem

Apparently in 2021-22, 93% of all disability funding went to the NDIS. The Report also says that more time is spent arguing over who should pay for what than figuring out how to make the entire ecosystem work.

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Defining reasonable and necessary

There is not a shared understanding of what reasonable and necessary means. It touches on one of the curliest questions facing the Scheme: how to ensure the NDIA’s decisions are both individualised and consistent.

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Early childhood supports

Early intervention is ‘frequently not best practice’, and that there are few incentives or mechanisms to ensure supports are evidencebased.

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The support and service marketplace

There is a lot that’s not working in the NDIS marketplace. For one thing, participants and governments don’t really have a good way of figuring out whether a provider is delivering

high quality services. Price caps are also criticised as a ‘blunt and non-transparent’ instrument, that does not incentivise innovation or supporting people with complex support needs.

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Measuring outcomes and performance

We don’t have a good mechanism to measure how well the NDIS is working. Moreover, provider’s services are not measured or rated, making it hard to incentivise offering great supports.

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Achieving long term outcomes

The planning process is more focused on a person’s immediate needs, rather than the long term outcomes that might help them live a good life.

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Help accessing supports

The roles of intermediaries- like LACs, early childhood partners, support coordinators, plan managers and remote community connectors‘overlap, leave gaps and are confusing.’ People need the support of intermediaries because they do not have the information needed to independently choose providers.

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Supported living and housing

Contemporary housing models haven’t really got off the ground, and Supported Independent Living (SIL) homes where ‘there is significant risk of harm and abuse’ still dominate.’

10. Participant safeguards The NDIS has not done enough to ensure the safety of participants. Many people felt the system focused too much on compliance and box ticking. The regulatory framework has not responded well to the growing unregistered market.

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By Rob Woolley DSC There’s been some key pricing changes that are effective 1 July 2023. First, the good news. Price limits for supports delivered by disability support workers will see a real-terms increase of 5.3% to account for:

+ The Fair Work Commission’s increase to minimum Award wages by 5.75%. The NDIA has fully covered this wage increase to workers employed under the Award, meaning providers don’t need to cover it themselves. This change will also come into effect for level 1 support coordination (support connection).

+ An extension of the temporary loading for a further 12 months at 1%. The downside is that it’s been halved from last year (previously 2%) and will cease on 1 July 2024.

+ Inclusion of paid family and domestic violence leave of 0.1% to reflect the new National Employment Standards entitlements for workers.

+ Passing on the increase in superannuation guarantee charge of 0.5% in full.

+ Overall this is positive, as it could have been worse in the context of many conversations about 8% growth cap / target / framework / [insert another murky synonym here].

Therapy Supports The NDIA has stated after “extensive market analysis and consultation”, there will be no ad-

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justment to the pricing arrangements and price limits for therapy supports on 1 July 2023.

The party line is that the market for therapy continues to attract new providers entering the market. The Agency says results from extensive benchmarking analysis suggest the current NDIS price limit of $193.99 is above the average fully loaded hourly cost of most types of therapy professionals. This may not reflect the experience of participants on the ground, who often struggle to find allied health and therapy services. Or the therapists that choose to remain unregistered because the NDIA price cap doesn’t cover the costs of being registered.

The NDIA’s comparison to other government therapy schemes and private billing rates suggest that NDIS price limits for therapies remain competitive. The Agency also says they have invested significantly in the therapy market, with the amount claimed rising by 26% to $1.6 billion July-December 2022, compared to the same period in the year prior.

Support Coordination and Plan Management Supports Level 1 support connection will be indexed in line with the NDIS DSW Cost Model. We often say not many people access support connection, and the Pricing Review confirmed that only 777 participants used support connection in the 6 months prior to December 2022 compared to more than 200,000 participants using support coordination (level 2).

After “careful market analysis and consulta-

BigDog Support Services Magazine

tion” - that phrase again - there will be no adjustment to the pricing for support coordination level 2 and 3 (that’s support coordination and specialist support coordination), or for plan management. This will be disappointing to many providers and sole traders who are seeing the complexity of their role grow.

A consistent growth in a market doesn’t necessarily mean many service providers aren’t skating on increasingly thinner ice. The final report and recommendations from the NDIS Review may cast more light on what is in store.

The NDIA says it invested significantly in the markets for support coordination (the amount claimed rose by 15% to $428 million) and plan management (where the amount claimed rose by 14% to $228 million) over the six months leading to December 2022, compared to the same period the year prior.

Why is the NDIS an oasis in the desert?

One of the great unknowns of this pricing update: what is the NDIA saying about the future and role of level 1 support connection by increasing its price, but not levels 2 and 3? The service and business models of many support coordination providers cannot work with level 1. We await further information about the larger intent of this move, either from the NDIA themselves (who have said they see merits in establishing cost models for level 2 and 3 supports) or the NDIS Review.

Disability Intermediaries Australia (DIA) stated that this is the 4th consecutive price cut in real terms for plan management and support coordination - grim reading for those who are already grappling with moving goalposts, wage inflation, and increased business costs.

What is a concern is the uncertainty of the future of the intermediaries markets: an increase in the price for support connection but another year of no increase to support coordination, specialist support coordination and plan management will push many of those providers closer to the edge.

5 Key Challenges The Report notes that there are very few supports available for people with disability outside the NDIS. This is ‘deeply unfair’ and has significant impacts for Scheme sustainability.

What does reasonable & necessary mean?

Can you imagine a world where we are not constantly fighting over what’s reasonable and necessary? I find it easier to picture world peace, but that’s probably a failure of imagination on my part.

Why are there many more children in the NDIS than expected?

The Report speculates that this is partly due to higher than previously identified levels of disability amongst children and the lack of supports outside the Scheme. They also found that Early Intervention supports are not always best practice.

Why aren’t NDIS markets working?

The Review found that competition has not always produced ‘improved quality, innovation or diversity of services’ in all locations.

How do we ensure that the NDIS is sustainable?

Particularly, how can we provide certainty for participants and families that the NDIS will remain an uncapped, needs-based Scheme, while also ensuring costs are acceptable to the government and the public.

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Family of League exists to ensure those most in need in the rugby league community can access financial, social and emotional support. Our foundation is the charitable heart of rugby league, proudly caring for the everyday heroes who keep our game thriving at the grassroots.

First established as Men of League by rugby league greats Ron Coote, Jim Hall and Max Brown in 2002, Family of League is built on this same foundation of teamwork and giving back. Our independent grassroots organisation was created to offer a helping hand and a shoulder to lean on for those doing it tough within the rugby league community.

For 20 plus years, we have been providing over 10,000 hours of volunteer service and $10 million of financial support to those in need.

Funds for our wellbeing initiatives are raised through a combination of grants, sponsorships, membership fees, public donations and fundraising initiatives.

Since the first meeting at New South Wales Leagues Club, the Family of League has grown to a network of more than 6,500 members and volunteers, who come together for the game, and for each other.

Whether you are an ex-player, an administrator, referee, or club volunteer; whether you are a man, woman or child, Family of League protects and enhances lives while respecting each individual’s dignity.

The Foundation provides assistance with everything from surgery, rehabilitation, equipment and specialist care to wellbeing visits to homes and hospitals to address social isolation and promote mental health.

Our 39 dedicated volunteer committees across New South Wales, Queensland, Australian Capital Territory and Victoria are run by, and for, the rugby league community supported by our small team of dedicated staff in our Sydney and Brisbane offices.

Family of League welcomes all who share a passion for the game.

Whether you’re a fan, member, donor, partner, or sponsor there is space at our table for all who love the game of rugby league.

The vision was to build a foundation that provided practical assistance and social support, and this vision has been realised. https://familyofleague.org.au/ 6

BigDog Support Services Magazine

Matt Armstrong—Art of Armkeit Matt and I worked together for a number of years at Parent 2 Parent and I have a great admiration for Matt’s skills in the area of community engagement as well as his artistic abilities.

“I currently work 4 days a week there and I’m able to work with art and mixed materials in my own studio on the other day. What started off as being a bit of a hobby has now turned into a bit of a direction for me and has also allowed me to undertake Art Therapy Sessions.”

Art therapy is a form of expressive therapy that uses the creative process of making art to improve a person’s physical, mental, and emotional well-being.

It can help someone express themselves, explore their emotions, manage addictions, and improve their selfesteem.

“My work connects to the beauty and simplicity of the quintessential Australian landscape informed by my early years in the Dubbo area of New South Wales.”

WhatsUp in Disability

“Now living and working in Brisbane and the Sunshine Coast, Queensland, my paintings centre on various contemporary mark-making techniques; using brushwork, palette knife, rough charcoal, acrylic, and ink lines, to suggest landscape movements, patterns, changing light and shadows. In addition to my art centring on contemporary expression in landscapes, my mark-making has further morphed into surrealist seascapes, experimenting with chalk, pastels.”

Stories in this issue include:

“It has also included interpreting my ideas onto paper, lino prints and through clay work with ceramic tiles.”

• Being on the Spectrum

To obtain a copy of WhatsUp in Disability magazine or to be a sponsor, please contact WhatsUp via: Office

11-15 Alexander Street, Toowoomba

Email

spaull@bigdogsupport.com.au

Online

www.whatsupindisability.org

• Matt Armstrong • PATH Planning • Short Film Festival • Report on Boarding Houses • Family of League

• Special Olympics • Queensland Budget • Charity Ride Click on the above magazine cover to read this online at Issuu.

Steven Paull President 7

Virtual health, also known as telehealth or telemedicine, is a rapidly growing healthcare delivery model that leverages technology to provide remote medical services and consultations. In Australia, virtual health has gained significant prominence, especially in recent years, as it offers numerous benefits such as increased access to healthcare, improved convenience, and cost-effectiveness. This article aims to explain virtual health in Australia, highlighting its key features, benefits, and challenges.

Virtual health in Australia involves the use of digital technologies to facilitate healthcare services remotely. These technologies can include video consultations, mobile health applications, remote monitoring devices, and secure online platforms for communication between patients and healthcare professionals.

Virtual health enables patients to consult with healthcare providers without the need for inperson visits, which is particularly beneficial for individuals in rural or remote areas who may face challenges accessing healthcare services.

One of the primary advantages of virtual health in Australia is enhanced accessibility.

By eliminating geographic barriers, patients can connect with healthcare professionals regardless of their physical location. This is particularly crucial in a vast country like Australia, where accessing healthcare services can be difficult for those living in remote regions. Virtual health allows individuals in rural areas to receive timely medical advice, consultations, and follow-up care without the need to travel long distances.

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Additionally, virtual health offers improved convenience for patients. Through teleconsultations, individuals can schedule appointments and have medical discussions from the comfort of their own homes. This eliminates the need for lengthy waiting times in crowded waiting rooms and reduces the risk of exposure to contagious diseases. Virtual health also provides flexibility in scheduling appointments, making it easier for patients to fit healthcare into their busy lifestyles.

Another significant benefit of virtual health in Australia is its cost-effectiveness. By reducing the need for in-person visits, virtual health can lead to cost savings for both patients and the healthcare system. It eliminates expenses associated with transportation, accommodation, and time off work for patients traveling to healthcare facilities. For the healthcare system, virtual health can optimise resource allocation and reduce the strain on physical infrastructure, leading to potential cost savings in the long run.

Virtual health in Australia has also played a crucial role during the COVID-19 pandemic. It has allowed healthcare providers to continue delivering essential services while minimizing the risk of viral transmission. The pandemic has accelerated the adoption of virtual health technologies and has highlighted the importance of their integration into the healthcare system for future preparedness.

Virtual health in Australia is transforming healthcare delivery by leveraging technology to provide remote medical services. It offers enhanced accessibility, convenience, and costeffectiveness for patients, especially those in rural or remote areas.

BigDog Support Services Magazine

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This month the Toowoomba Day Service will be kicking off our Live Big program. Exciting I know right.

We will still have all the other fun staff just a little extra in the middle. Our program will include a trip to the Ipswich art Gallery. Crazy hair day morning tea on the 3rd Wednesday of the month for cystic fibrosis. Walking club is the new in thing at BigDog day service. Id like to thank Maddie and Liam our school-based trainees well done guys you’re both doing a wonderful job. Keep it up and stay amazing.

I have a special mention to Meg she has been doing wonderful job in reaching her goal in learning how to use a washing machine to help her mum out. To our leave men thank you every much for keep our grassed are clean and tidy every day and going to the dump once a week fantastic work Lenny chicken. Let’s keep working hard as a team to kick our goals.

Birthday shout out to Cora, Dean, Maddie, Jess, Liam, Dan K, and Angus.

BigDog Day Service Toowoomba Paul Myatt Community Centre 11-15 Alexander Street North Toowoomba 4350 Coordinator Jess Wright Phone: 4512 6020 dayservice@bigdogsupport.com.au 10

BigDog Support Services Magazine

The Western Clydesdales are versing the CQ Capras on their home turf in Toowoomba on 29 July 2023 at 5pm.

As BigDog is a proud sponsor of both teams, all BigDog staff and participants as well as their families are invited to come along and support their team in their first ever clash for the BigDog Cup. Please contact the Toowoomba office if you would like to attend so your ticket can be reserved.

NADOC Week celebrations with the school holiday students and some regulars.

BigDog Day Service Rockhampton BigDog Community Centre 170 East Street Rockhampton 4700 Coordinator Taylor Phone: 4573 4611 rockhampton@bigdogsupport.com.au

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Total Knee Replacement So I find myself in the situation where I am unable to walk due to the pain and now having to use a cane to walk. My doctor has referred me to a specialist to prepare for an operation to help me. I did a little research through Dr Google and talking to some friends who have had the procedure.

When a knee replacement, also known as knee arthroplasty, is performed, the damaged or diseased parts of the knee joint are replaced with artificial components. The procedure is typically recommended for individuals who have severe knee pain and limited mobility due to conditions such as osteoarthritis, rheumatoid arthritis, or knee injury.

Here is a general overview of what happens during a knee replacement procedure: Anaesthesia: The patient is administered anaesthesia, which can be either general anaesthesia (puts the patient to sleep) or regional anaesthesia (numbs the lower body).

Incision: The surgeon makes an incision in the front of the knee to access the joint.

Reshaping the Bones: The damaged surfaces of the thigh bone (femur) and shin bone (tibia) are precisely cut and reshaped using surgical instruments to accommodate the artificial components.

Placement of Artificial Components: The artificial components are inserted into the prepared bone surfaces. The most common type of knee replacement involves three components: a metal component for the end of the thigh bone, a metal and plastic component for the top of the shin bone, and a plastic spacer to provide a smooth gliding surface between the metal components.

Patella Resurfacing: In some cases, the undersurface of the kneecap (patella) may also be resurfaced with a plastic component.

Closure: The incision is closed using stitches or staples, and a sterile dressing is applied.

Postoperative Care: After the surgery, the patient is taken to a recovery area and closely monitored. Pain management, physical therapy, and exercises to regain strength and range of motion are typically part of the postoperative care plan.

Signs that you may need a knee replacement

+ Swollen Knees: Your knees are always swollen or puffy.

+ Deformed Knees: Severe arthritis and cartilage deterioration can lead to your knees appearing bowed or “Knock-Kneed”.

+ Limited Range of Motion: A persistent limp or inability to walk up stairs.

+ Constant or severe pain

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BigDog Support Services Magazine

New Financial Year Changes Age Pension Age. If you were born on or after 1 January 1957, you must now be 67 years to be eligible for Age Pension.

Parental Leave Dad and Partner Pay are combining into one payment and increasing from 90 days (18 weeks) to 100 days (20 weeks) with a combined family income limit $350,000.

National Minimum Wage Increase to $882.80 per week or $23.23 per hour. This increase aims to ensure fair remuneration for employees across various industries and to support economic growth.

Award Minimum Wages In addition to the National Minimum Wage, award minimum wages have also been raised by 5.75% as part of the Annual Wage Review and aims to maintain equitable pay rates for employees covered by specific industry awards.

Superannuation (Super) Guarantee Rate from 10.5% to 11%. This means that employers are required to contribute a minimum of 11% of their employees' ordinary time earnings to their superannuation fund, helping individuals secure their financial future.

Staff Birthdays

July 2023 1st 2nd 7th 8th 10th 13th 16th 17th 18th 24th 26th 27th

Marcus O Julia M Maree S Madison S Jess W Liam W Mitchell D Jackson M Dylan G Trinity L Colin B Pamela W Simone H

Have a great day!

Rental Relief Queensland legislation limits rent increase frequency to once every 12 months.

Cost of Living Rebate $700 Cost of Living Rebate on electricity bills for vulnerable households, plus a further $372 under the Queensland Electricity Rebate Scheme to $1,072 and $550 Cost of Living Rebate on electricity bills for all other households.

Student Visa Holders work restrictions have been reinstated for student visa holders, limiting their work hours to 48 hours per fortnight. This adjustment aims to strike a balance, enabling students to prioritise their studies while also providing them with valuable work opportunities to contribute to Australia’s workforce requirements.

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Come and volunteer in our Big BBQ Van. Learn cooking skills for eggs and bacon muffins or our sausage sizzle. Learn food handling in preparing the items for the customers. Learn cash handling and customer service skills.

Sunday 16 July 8:00 AM—Noon

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BigDog Support Services Magazine

Justice of the Peace This service is available at the Historic BigDog House 3 Clifford Street Toowoomba (please call first to make an appointment) The JPs in the Community Program is also available through major shopping centres, libraries, court houses and hospitals.

Contact Us BigDog Support Services

3 Clifford Street Toowoomba QLD 4350 PO Box 234 Harlaxton QLD 4350

(07) 4632 9559 1800 22 44 32 www.bigdogsupport.com.au 15

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BigDog Support Services Magazine