Challenges and adaptations of an intermediary: an exploration of support coordination in the Australian National Disability Insurance Scheme

Hummell, Eloise; Foster, Michele; Fisher, Karen R.; Needham, Catherine; Borg, Samantha J.; Venning, Alyssa

doi:10.1332/239788221x16504513780378

Cited by 3 publications

(5 citation statements)

References 16 publications

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“…Disability scholars have explored numerous issues stemming from the marketisation of disability services. These issues span the effects the NDIS has had on service providers (Hamin et al, 2022), the quality of the services offered (Hall and Brabazon, 2020), the skills and abilities of care workers in remote regions (Cuskelly, 2022;Hummell et al, 2023), the potential exploitation of both individuals with disabilities and support workers (Dickinson et al, 2024) and the inherent complexities that disadvantage certain groups of participants (Dickinson and Yates, 2023). As Van Toorn (2022) explains, marketising disability services may force service providers to innovate but they must also prioritise efficiency, cost-cutting and measuring outcomes to compete.…”

Section: The Ndis Neoliberalism and Accountingmentioning

confidence: 99%

“…These issues span the effects the NDIS has had on service providers (Hamin et al. , 2022), the quality of the services offered (Hall and Brabazon, 2020), the skills and abilities of care workers in remote regions (Cuskelly, 2022; Hummell et al. , 2023), the potential exploitation of both individuals with disabilities and support workers (Dickinson et al.…”

Section: The Ndis Neoliberalism and Accountingmentioning

confidence: 99%

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Accounting and neoliberal responsibilisation: a case study on the Australian National Disability Insurance Scheme

Nikidehaghani

2023

AAAJ

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PurposeThis paper aims to explore how accounting is fostering neoliberal citizenship through the participants of Australia’s National Disability Insurance Scheme (NDIS). More specifically, this paper aims to understand how accounting discourse and the management accounting technique of budgeting, when intertwined with automated administrative processes of the NDIS, are giving rise to a pastoral form of power that directs people’s behaviour toward certain ends.Design/methodology/approachPublicly available data has been crafted into an autoethnographic case study of one fictitious person’s experiences with the NDIS – Mina. Mina is an amalgam created from material submitted to the Joint Parliamentary Standing Committee on the NDIS. Mina’s experiences are then analysed through the lens of Foucault’s concept of pastoral power to explore how accounting has contributed to marketising and digitising public disability services.FindingsAccounting rhetoric appears to be a central part of rationalising the decision to shift to individualised disability funding. Those receiving payments are treated as self-governable, financially responsible subjects and are therefore expected to have knowledge of management accounting techniques and budgeting. However, NDIS’s strong reliance on the accounting concepts of funds, budgets, cost and price is limiting people’s autonomy and subjecting them to intervention and control.Originality/valueThis paper addresses calls to explore the interplay between accounting and current disability policies. The analysis shows that incorporating accounting into the NDIS’s algorithms serves to conceal the underlying ideology of the programs, subtly driving behaviours towards neoliberal objectives. Further, this research extends the Foucauldian accounting literature by revealing the contribution of accounting to reinforcing the authority of digital pastors in contemporary times.

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Section: The Ndis Neoliberalism and Accountingmentioning

confidence: 99%

Section: The Ndis Neoliberalism and Accountingmentioning

confidence: 99%

Accounting and neoliberal responsibilisation: a case study on the Australian National Disability Insurance Scheme

Nikidehaghani

2023

AAAJ

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“…Consequently, at the time of study, South-East Queensland was early in the transition to individualised funding. The data presented in this article are part of a broader study, with interviews also conducted with frontline staff and NDIS participants and families to investigate the coordination of NDIS funded supports (see Foster et al, 2021 andHummell et al, 2022). Ethical approval was gained from Griffith University Human Research Ethics Committee (GU 2019/406) and Metro South Hospital and Health Service Human Research Ethics Committee (HREC/ 2019/QMS/59522).…”

Section: Approach and Study Designmentioning

confidence: 99%

“…Support coordinator responsibilities – which include connecting participants with NDIS providers and services, and building skills for coordinating services (NDIS, 2021b) – suggest a critical bridging role that could assist in facilitating collaboration and overcoming multi-agency failures. However, ongoing problems with the position such as role ambiguity, variable skill and quality, time-limited funding and inconsistencies in practice have been identified (NDIA, 2021; Hummell et al , 2022). Furthermore, support coordination funding is provided when a participant has complex needs and meets ‘reasonable and necessary’ criteria, with less than half (43 per cent) of participants nationally receiving funding (NDIS, 2021a: 167).…”

Section: Introductionmentioning

confidence: 99%

Breaking Up Is Risky Business: Personalisation and Collaboration in a Marketised Disability Sector

Hummell

Borg

Foster

et al. 2022

Social Policy and Society

Self Cite

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The marketisation of disability support driven by individualised funding brings new dilemmas for multi-agency collaboration, in particular how to provide personalised supports while remaining commercially viable. This article explores the challenges, risks and adaptations of organisations to navigate the tensions of personalisation and collaboration. Framed by street-level research and using the context of Australia’s National Disability Insurance Scheme (NDIS), this article draws on interviews with twenty-eight organisational managers. Multi-agency challenges are highlighted when several providers are delivering parts of a NDIS participant’s plan, blurring organisational responsibilities and accountabilities. Interviews also revealed the paradox of organisational disconnection and organisational dependence concerning quality support provision and described the collaborative responses organisations implement to ensure their sustainability. There is commitment among organisations to build a trusted ecosystem of providers, but this is largely discretionary and there is a need for further policy mechanisms to enable organisations to negotiate a way through multi-agency dilemmas.

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“…How to make the ED safe, alternatives to the ED, training needs for ED staf, and communication practices to improve service integration between services are discussed. Tis participant group consists of people employed or self-employed as NDIS support coordinators, recovery coaches, and/or support workers [24,[46][47][48]. For the purpose of brevity, all participants of this study will be referred to as NDIS support workers.…”

Section: Introductionmentioning

confidence: 99%

Let Us Keep the Emergency Department Safe: National Disability Insurance Scheme Supports Workers’ Experiences When Supporting People with Psychosocial Disability in the Emergency Department

McIntyre,

Loughhead,

Hayes

et al. 2024

Health & Social Care in the Community

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Internationally, community healthcare is provided by personal health budgets or personalised schemes as part of a consumer-directed care emphasis. Although the introduction of a personalised scheme in Australia has improved the lives of many, people with psychosocial disability (PSD) and their families have experienced many challenges with service integration. Six focus groups with 17 National Disability Insurance Scheme (NDIS) support workers were conducted between June and November 2022. Participants were asked semistructured questions about their engagement with emergency department (ED) clinicians when presenting with a person with PSD and NDIS plan. They were also asked how they contribute to service integration to improve communication practices between the two services. A qualitative, descriptive thematic analysis approach was used. Results indicate there is a need for improved service integration pathways between the ED and NDIS services. The thematic analyses identified five main themes: the ED is harmful and not safe, but nowhere else to go; make the ED safe; further training for ED staff; improving communication across services; and alternatives to the ED. This study reports NDIS support worker’s experience when supporting a person they are caring for in the ED. NDIS support workers have an understanding of the needs of the people they care for;their wisdom can contribute greatly to ED clinical responses in crisis care. Recommendations are offered to assist with service integration between the two systems.

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Challenges and adaptations of an intermediary: an exploration of support coordination in the Australian National Disability Insurance Scheme

Cited by 3 publications

References 16 publications

Accounting and neoliberal responsibilisation: a case study on the Australian National Disability Insurance Scheme

Accounting and neoliberal responsibilisation: a case study on the Australian National Disability Insurance Scheme

Breaking Up Is Risky Business: Personalisation and Collaboration in a Marketised Disability Sector

Let Us Keep the Emergency Department Safe: National Disability Insurance Scheme Supports Workers’ Experiences When Supporting People with Psychosocial Disability in the Emergency Department

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