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The tale of two systems: The overlap between NDIS and aged care

Amidst myriad issues affecting aged care providers in 2020 one matter that has somewhat stayed under the radar is the overlap of NDIS regulation with the aged care system – in particular for residential aged care operators.

The NDIS and aged care systems bump into each other on many fronts, understandably so given people’s needs and the roles played by providers. Indeed, the need for aged care providers to support people who are living with a disability will continue notwithstanding an increase in the provision of specialised disability accommodation.

Aged care providers have experienced and led many changes in the way services are delivered, however the inception of the NDIS will increasingly influence, in a direct way, provision of services to people living with a disability who are also part of the aged care environment.   

It has become very apparent that as an aged care provider willing to provide services to NDIS clients, it is necessary to meet the standards of two different compliance systems. The two systems are similar but distinct at the point of service delivery and mandatory compliance.

Dual compliance requirements for approved providers of residential aged care is challenging at best. The two systems fail to ‘dovetail’ together in a practical and viable way. This can and should be streamlined to allow providers to remain compliant within both systems. 

Part of the solution is for the government to direct that aged care and NDIS stakeholders work towards resolving these issues in a practical way. In some situations, residential aged care providers are the only choice for people living with disabilities to access care, and these issues should not impact on the level and quality of the care they require. All stakeholders need to work together to resolve these issues.

The NDIS Commission is reportedly working with other government agencies namely the Department of Health, the Department of Social Services and the Aged Care Quality and Safety Commission to develop regulatory arrangements for residential aged care (RAC) providers supporting NDIS participants from 1 December 2020 – a later date than was originally intended.

The NDIS Commission stated recently, “The aged care sector has been under significant pressure during the COVID-19 pandemic, with the focus on protecting residents from exposure to COVID-19. Because of the pandemic, the NDIS Commission have agreed to defer the commencement of mandatory NDIS registration for RAC providers supporting NDIS participants for five months (from 1 July to 1 December 2020). This has been determined in consultation with stakeholders representing NDIS participants living in residential aged care and industry representatives.”

The NDIS commission has written to NDIS providers and participants advising them of the postponement. The position of the NDIS commission is that NDIS participants in residential aged care are dual participants of the NDIS and aged care systems. Consequently, the proposed regulatory approach will afford NDIS participants coverage across all NDIS Commission functions, including reportable incidents and behaviour support. The NDIS Commission stated: “The approach will be proportionate, recognising the adjacent regulation that RAC providers will continue to be subject to under the Aged Care Act 1997.” 

Irrespective the reality is that residential aged care providers supporting NDIS clients will be subject to both aged care regulation and the NDIS Code of Conduct. There is no question of the desire to provide services that would comply with both regimes, however, inter alia, the administrative burden to do so is unnecessary and unproductive.

Residents who happen to be participants in the NDIS must, along with all residents, be empowered to enjoy the quality of life they desire and supported to participate fully in life. The commitment to all residents, including NDIS participants, from aged care providers will continue to be unwavering, however further complexities to an already inflexible system will not be conducive to optimal service provision. Authorities may forgive providers for having little confidence in multiple bureaucracies achieving an effective and efficient solution.

Related factors also need to be addressed including workforce registrations and regulations. Mandatory checks for working in one sector are currently different to the other. More significantly, the opportunity currently afforded to government and society must be recognised and seized; two Royal Commissions being conducted in parallel, the extent that workforce and skilling demands are in common for both and the reality of more choice and control being applied to residential aged care as it is already experienced through the NDIS illustrate the overlap that exists. 

Again, a more collaborative approach to these related sectors from government departments and other key stakeholders will help ensure a more efficient alignment of systems to create suitable flexibility and choice for people using services – irrespective of their age, location or need.

Marcus Riley is the director of the Global Ageing Network, author of positive ageing book BOOMING and CEO of BallyCara.

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