Quality Assurance and Safeguards
Working Arrangements for the
Launch of the NDIS in Tasmania
As agreed between the Department
of Health and Human Services
(DHHS) and Launch Transition
Agency (TASMANIA)
As at 8 April 2013
Table of Contents
1
Background:.................................................................................................................... 4
2
Guiding Principles ........................................................................................................... 4
Individual Safeguards ......................................................................................................... 4
3
Launch Specific Considerations ...................................................................................... 5
4
Service Provider Requirements....................................................................................... 5
4.1
Existing arrangements for specialist disability services ............................................ 5
4.2
NDIS launch arrangements for existing providers .................................................... 6
4.2.1
Arrangements for existing providers to expand service provision during launch .. 6
4.3
Arrangements for new service providers during launch ............................................ 6
4.4
Activities to implement this arrangement .................................................................. 7
5
Complaints Management ................................................................................................ 8
5.1
Existing Arrangements ............................................................................................. 8
5.2
Arrangements during Launch ................................................................................... 8
6
5.2.1
Protocols for the sharing of complaints................................................................. 8
5.2.2
Protocols for the sharing of complaints – serious ................................................. 8
5.2.3
Agency Complaints Management processes ....................................................... 8
Quality Frameworks ........................................................................................................ 9
6.1
Existing Arrangements ............................................................................................. 9
6.2
Arrangements during Launch ................................................................................... 9
6.2.1
6.3
7
LTA internal Quality Assurance Arrangements .................................................. 10
Future Arrangements ............................................................................................. 10
Child Protection ............................................................................................................ 10
7.1
Existing Arrangements ........................................................................................... 10
7.2
Arrangements during Launch ................................................................................. 11
8
Restrictive Practices ..................................................................................................... 11
8.1
Existing Arrangements ........................................................................................... 11
8.2
Arrangements during launch .................................................................................. 12
9
External Accountability Arrangements:......................................................................... 12
10
DHHS In-Kind Contribution to NDIS .......................................................................... 12
11.
Implementation of the Working Arrangements ........................................................... 12
LIST OF APPENDICES ....................................................................................................... 13
Appendix 1 ....................................................................................................................... 13
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Appendix 2 ....................................................................................................................... 13
Appendix 3 ....................................................................................................................... 13
Appendix 4 ....................................................................................................................... 13
Appendix 5 ....................................................................................................................... 13
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1
Background:
The Bilateral Agreement dated 7 December 2012 between the Commonwealth and Tasmania
for the NDIS Launch notes the following in relation to quality assurance and safeguards:
“12. The existing Tasmanian quality assurance framework, the Quality and Safety Standards
Framework for Tasmania’s Department of Health and Human Services (DHHS) Funded
Community Sector, will apply in the Tasmania launch site to relevant new and existing funded
client support programs for the launch, subject to further development of, and transition to, a
nationally consistent risk-based quality assurance approach in the longer term. Under
Tasmania’s existing quality assurance framework, service providers are required to undertake
and demonstrate quality and safety activity against recognised standards, report serious
consumer-related incidents to DHHS and have systems and processes in place to ensure that
learning from incidents and feedback contribute towards enhancing service delivery.
13. In addition, Tasmania will identify details of the existing client support programs in the
launch site and provide this information to the Agency for the purposes of registering providers.
Working arrangements between Tasmania and the Agency to ensure appropriate management
and monitoring against these quality assurance frameworks will be developed.
14. Tasmania’s existing statutory safeguards for children and young people include the Health
Complaints Commissioner, Commissioner for Children, the Public Guardian, the Public Trustee
and the Anti-Discrimination Commissioner and will continue to operate in Tasmania through
the NDIS launch subject to further development of and transition to a nationally consistent riskbased quality assurance approach in the longer-term.”
2
Guiding Principles
The Agency is working to ensure high quality services for people with disability in a choice and
control environment. The Agency will ensure that processes for disability service providers in
interacting with the Agency are not overly arduous but that they do ensure appropriate
standards for individuals particularly where risk for the individual is identified.
Individual Safeguards
Consistent with the choice and control principles, individual, service and some system level
safeguards will be applied on an individual risk-basis and will be based on a presumption of
capacity unless there is evidence to the contrary or where there is a high risk of harm.
Under the NDIS the importance of natural safeguards will be recognized through the
development of an individual plan that identifies the person’s goals and aspirations and
enables consideration of the unique risks and relevant safeguards for each person. The aim
will be to identify how the different levels of safeguards including natural and formal supports
blend together to provide the appropriate level of safeguards while supporting choice and
control. Planners will work with participants through the support needs assessment and
planning process to identify risks and safeguards and Local Area Co-Ordinators will work with
participants and their support network to build and support intentional safeguards including
natural or informal safeguards.
The key steps in the process will include:
•
Understanding what is important to the person,
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•
Clarifying the capabilities and vulnerabilities the person may have,
•
Understanding the nature and possible impact of the potential risks,
•
Identify areas of concern and existing safeguards that may address these,
•
Consider additional creative measures to minimize the risks or improve outcomes,
•
Consider possible impact of existing and proposed safeguard measures.
3
Launch Specific Considerations
In addition to the objectives of the NDIS launch outlined in the Intergovernmental Agreement
for the NDIS Launch and the NDIS Bill 2012, as enacted into legislation, the Tasmanian launch
site will have the following further specific launch aims:
•
To provide reasonable and necessary supports for all eligible young people in
Tasmania between 15 and 24 years of age (‘the launch cohort’).
•
To protect and enhance individual choice and control for the launch cohort, and where
appropriate to build individual capacity to plan, make decisions and manage their lives;
•
To enhance the independence of the launch cohort and promote their participation in
the community and in employment.
•
To increase the sustainability of informal care for the launch cohort.
•
To improve the transition experience from school to further education, training, and
employment for the launch cohort through effective planning, supportive partnerships and
appropriate and timely resources.
•
To ensure that the launch cohort and their families who are existing clients of the
Tasmanian specialist disability service system experience a seamless transition, so that
wherever possible and subject to the appropriate consent, pre-existing information,
assessments and case notes will be able to be referred to or otherwise accessed under the
launch arrangements.
•
To ensure effective working arrangements with the Tasmanian Gateway Services for
the launch cohort and their families.
•
To increase the capacity of the Tasmanian disability sector to respond to enhanced
individual choice and control, and
•
To work in effective partnerships with key mainstream government and community
sector organisations which provide services to the launch cohort and their families.
4
Service Provider Requirements
4.1 Existing arrangements for specialist disability
services
Tasmanian DHHS, Disability and Community Services (DCS) does not require a registration
approval process however does require service providers to enter into a Funding Agreement
(Appendix 1) which requires evidence of formal compliance with the Quality and Safety
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Standards Framework for Tasmania’s DHHS Funded Community Sector (Appendix 2). This
quality framework acknowledges other Frameworks and accepts other Standards that are
relevant to the services funded by DHHS (detailed in Section 6 of this document).
The Quality and Safety Standards Framework includes a requirement for;
•
Reporting serious consumer related incidents to DHHS
•
Systems and processes to be in place to manage and respond to incidents and
feedback (including complaints)
•
Ensuring that learnings from incidents and feedback (including complaints) contribute
towards enhancing service delivery.
4.2 NDIS launch arrangements for existing providers
Current DHHS registered community sector organisations will be registered as providers of the
NDIS (subject to the passing of legislation).
NDIS will recognise DHHS funded providers as meeting most of the requirements for
registration with NDIS. Existing Tasmanian disability service providers delivering supports to
NDIS participants will register with NDIS by completing an abridged Application Form giving
ABN and Bank details and agreeing to the Agency’s Terms of Business.
State Government service providers of specialist disability services will register with the NDIS.
State Government agencies (excluding mainstream services) will register with the NDIS e.g.
TasEquip.
For registration with the NDIS, sole practitioners or groups of practitioners in consortiums will
be expected to be registered with their relevant professional association and will be required to
provide evidence of such registration to the Agency.
4.2.1 Arrangements for existing providers to expand service
provision during launch
During the launch phase it has been agreed with DHHS that relevant officers would monitor
any changes in delivery of service types of existing providers ensuring the appropriate quality
standards relevant to specialist disability supports are implemented by service providers.
4.3 Arrangements for new service providers during
launch
It is expected that the NDIS will attract new providers currently not registered under the existing
state arrangements. The following arrangements have been agreed to ensure that these new
providers comply with existing quality and safeguards arrangements in Tasmania:
New service providers will register with NDIS and meet registration requirements. Providers
registered with the NDIS will:
•
Have an ABN
•
Have an account with a financial institution
•
Agree to be bound by the Agency’s Terms of Business
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•
Comply with work health and safety laws
•
Have mechanisms to ensure applicant and staff compliance with laws that are subject
to criminal penalties, as they relate to the provision of, or management of, funding of supports
•
Ensure the applicant is a suitable entity to provide the kinds of supports, or to manage
funding of supports
Through launch new providers will be required to register with the NDIS and:
•
Comply with Commonwealth and Tasmanian legislation particularly relevant to quality
assurance, safety standards and restrictive practices.
•
New service providers must comply with the Quality and Safety Standards Framework
for Tasmania’s DHHS Funded Community Sector. DHHS will monitor compliance of the
Standards Framework for new providers in conjunction with the LTA.
•
New service providers may seek to or be accredited for an agreed equivalent quality
management process. DHHS will seek evidence of accreditation/compliance by the service
provider of the agreed quality management process as described in 6.2 below.
•
The NDIS will publish a list of registered service providers for disability supports to be
provided in Tasmania.
4.4 Activities to implement this arrangement
To ensure that service providers understand how the transition arrangements will work, the
following arrangements have been agreed:
•
DHHS and the Agency will jointly write to all current Tasmanian funded disability
service providers to advise that the organisation’s current funding arrangement for disability
service delivery in Tasmania will also constitute registration for the NDIS. The service provider
will then need to confirm registration with the NDIS, by completing the abridged Application
Form giving ABN and bank account details and agreeing to the Agency’s Terms of Business.
•
The Agency will write to relevant Commonwealth funded services providers, to advise
that their registration to deliver these services will constitute registration for the NDIS. The
service provider will then need to confirm registration with the NDIS; by completing the
abridged Application Form, giving ABN and bank account details to the Agency and agreeing
to the Agency’s Terms of Business. The NDIS will publish a list of NDIS registered providers in
the Tasmanian launch site
•
Information will be prepared for providers by the LTA and DHHS reporting requirements
for providers, in particular that all notifiable incidents and reports continue to DHHS and these
will constitute a notification to the Agency as required by Part 4 of the NDIS Rule for
Registered Providers.
DHHS and the Agency are currently developing a Memorandum of Understanding (MOU) with
the state TasEquip and the Tasmanian Health Organisations to ensure continuity of supply of
equipment to NDIS participants during launch.
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5
Complaints Management
5.1 Existing Arrangements
DHHS Quality and Safety Standards Framework for existing service providers requires funded
community sector organisations to have systems and processes in place to manage and
respond to complaints and use the feedback to contribute towards enhancing service delivery.
5.2 Arrangements during Launch
During the launch the Agency’s complaints system will work in conjunction with other existing
Commonwealth and State Government complaints management systems to provide an
integrated approach for participants.
•
Complaints raised with the Agency with respect to the provision of disability supports
provided by organisations contracted by the DHHS will be referred to state agency
•
Complaints concerning Agency direct service staff or NDIS registered service providers
that are not covered by the state complaints scheme will be managed through the NDIS
complaints management process
5.2.1 Protocols for the sharing of complaints
It is acknowledged there may be complaints received concerning NDIS registered service
providers that may also have reference and applicability to DHHS contracted service provider’s
service provision. A protocol is under development between DHHS and the Agency to ensure
lead and joint management responsibilities are in place to provide an integrated and
transparent approach for complainants. The protocols will also ensure all relevant privacy
legislation is incorporated to facilitate sharing of information. This protocol will be finalised for
implementation at 1 July 2013.
5.2.2 Protocols for the sharing of complaints – serious
It is recognised that an important safeguard is the sharing of information regarding serious
consumer related incidents in order that appropriate safeguarding action can be taken. The
DHHS Disability Services Funding Agreement (Appendix 1) requires that serious consumer
related incidents must be reported to the DHHS within 24 hours, or the next working day.
Working arrangements to implement this reporting requirement will be included in the protocol
described in 5.2.1.
5.2.3 Agency Complaints Management processes
During launch the NDIS will have a complaints management system for:
•
Participants or service providers to lodge concerns about Agency staff and
•
Participants to lodge concerns about service providers registered with the NDIS.
Part 6 of the National Disability Insurance Scheme Bill 2012 sets out the requirements for the
review of decisions and covers both internal processes and applications to the Administrative
Appeals Tribunal. Policies, procedures and systems for the management of complaints and
requests for review of decisions will be in place for launch.
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The NDIS complaints management system will draw upon best practice in complaints
management such as the Commonwealth Ombudsman’s Better practice guide to complaint
handling. The Agency will:
•
Use data from the complaints and review process to examine policy and practices to
improve the delivery of the scheme, and
•
report on the nature of these complaints and the changes made in response to these
processes in the Agency annual report.
6
Quality Frameworks
6.1 Existing Arrangements
The Tasmanian DHHS, Disability and Community Services (DCS) requires service providers to
enter into a Funding Agreement which provides evidence of formal compliance with the Quality
and Safety Standards Framework for Tasmania’s DHHS Funded Community Sector.
This
quality framework acknowledges other Frameworks and accepts other Standards that are
relevant to the services funded by DHHS as described in 6.2 below.
As part of this Framework service providers are required to have systems and processes in
place which record and monitor their improvement activities. The DHHS funding agreement
manager will at least annually meet with the service provider to discuss and monitor
performance and to ensure that the service provider has systems and processes in place to
facilitate continuous improvement. A quality and safety audit is conducted at least once in
every three year cycle by the independent DHHS Quality and Safety Team with the audit report
provided to the service provider and DHHS funding agreement manager and may contain both
mandatory and negotiable improvement activity.
6.2 Arrangements during Launch
The Tasmanian Bi-Lateral Agreement stipulates a launch cohort of young people between 15
and 24 years of age state-wide. An analysis by DHHS and the Agency evidences that all
existing service providers will continue a formal service agreement with DHHS for service
arrangements funded by DHHS for clients outside of the NDIS launch cohort.
As the cohort of young people transfer into the NDIS over time and where their support
arrangements remain unchanged the funding agreement between the provider and DHHS will
cease. However the provider will still be bound by the requirements of the Quality and Safety
Standards Framework for Tasmania’s DHHS Funded Community Sector as a funding
agreement continues to exist with DHHS for clients funded outside of the launch cohort.
During the launch phase and until a nationally risk-based quality assurance approach is
formalised, the DHHS relevant departmental (ie funding agreement managers) will continue to
monitor and manage compliance with the Quality and Safety Standards Framework for the
launch cohort within NDIS.
Future service providers delivering supports through the NDIS will be required to comply with
the Quality and Safety Standards Framework for Tasmania’s DHHS Funded Community
Sector. DHHS will provide the monitoring and audit functions for these providers in
conjunction with the Agency.
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The NDIS will recognise a range of other State Quality Assurance schemes e.g. Child
Protection service providers undertake review through the Children and Youth Services Quality
and Safety Framework. Other recognised schemes may include; Attendant Care Industry
Management System Standards (ACIMSS), ISO9001, National Standards for Mental Health,
Community Care Common Standards and the National Standards for Disability Services.
Some organisations are already engaged in processes to seek accreditation or are accredited
with national standards bodies such as the Quality Improvement Council (QIC), The Australian
Council for Health Standards (ACHS) and the Industry Standards Office (ISO). (Ref. Appendix
2) For these providers, DHHS will seek evidence of their accreditation to these Quality
Assurance schemes on behalf of the Agency.
Protocol arrangements to ensure regular sharing of relevant information between DHHS and
the Agency will be developed and implemented by 1 July 2013.
6.2.1 LTA internal Quality Assurance Arrangements
The Agency is developing quality management processes that will be assessed both internally
and externally. The key components of the Agency’s internal quality assurance arrangements
will be
•
Adoption of the National Standards for Disability Services
•
Operational guidelines
•
Delegation frameworks
•
Practice standards, peer review and Communities of Practice
•
Sample case audits, feedback loops linked to training and guidelines
•
Identified roles responsible for quality assurance
•
Ongoing cycle of Internal QA linked to performance management signed off by senior
agency management, and
•
Client feedback and complaints linked to QA processes with Continuous quality
improvements processes through Agency
6.3 Future Arrangements
There is a commitment from the Commonwealth, state and territory governments to work to
develop a nationally consistent quality management framework in the longer term. This will be
underpinned by the National Standards for Disability Services which will implemented by the
Agency.
7
Child Protection
7.1 Existing Arrangements
Funded community sector organisations providing services to children in the care of the State
enter into a DHHS Funding Agreement (Appendix 1) and are required to comply with the
Children and Youth Services Quality and Safety Framework (Appendix 3). This Quality and
Safety Framework is aligned to the Quality and Safety Standards Framework for Tasmania’s
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DHHS Funded Community Sector (Appendix 2). The complaints process for Child Protection
mirrors that of DHHS Disability and Community Services.
Funded community sector organisations and Agency staff are required to comply with the
Mandatory Reporting of Child Abuse and/or Neglect (Appendix 4) requirements within the
Children, Young Persons and Their Families Act 1997.
Section 14 of the Act provides that if a mandatory reporter –
“in carrying out official duties or in the course of his or her work (whether paid or voluntary),
believes, or suspects, on reasonable grounds, or knows –
a)
That a child has been or is being abused or neglected or is an affected child within the
meaning of the Family Violence Act 2004 (which defines “an affected child” as “a child whose
safety, psychological wellbeing or interests are affected or likely to be affected by family
violence”), or
b)
That there is a reasonable likelihood of a child being killed or abused or neglected by a
person with whom the child resides, or
c)
While a woman is pregnant, that there is a likelihood that after the birth of the child –
i)
The child will suffer abuse or neglect, or may be killed or abused or neglected by a
person with whom the child is likely to reside, or
ii)
The child will require medical treatment or other intervention as a result of the
behaviour of the woman, or another person with whom the woman resides or is likely to reside,
before the birth of the child.
The prescribed person must inform the Secretary (Child Protection) or a Community Based
Intake Service (Tasmanian Gateway Services) of that belief, suspicion or knowledge as soon
as practicable after he or she forms the belief or suspicion or gains the knowledge”.
7.2 Arrangements during Launch
The NDIS will operate in a manner consistent with the above legislative requirements which
has provisions regarding mandatory reporting of suspected abuse or neglect of children.
All NDIS support providers will comply with State regulations regarding pre-employment
screening including National Criminal checks. NDIS Support Providers will be expected to
meet the costs associated with this screening.
8
Restrictive Practices
8.1 Existing Arrangements
Currently restrictive practices are subject to the Tasmanian Disability Services Act 2011,
Regulations of Restrictive Interventions and operationalized through the DHHS, Disability and
Community Services Restrictive Interventions Guideline 2012 SDMS Id No: P2010/1082-001
(Appendix 5).
Requirements within this Guideline will continue for existing providers.
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8.2 Arrangements during launch
Further work is required to understand the current restrictive practices operating through
DHHS and how restrictive practices will operate in the launch.
New providers, during the launch phase, will be required to comply with Tasmanian Legislation
and the NDIS registration rules would require compliance with relevant State policy and
guidelines supporting the legislation.
During launch phase DHHS relevant professional staff, ie Senior Practitioner and Disability
Assessment and Advisory Teams, will continue to meet their responsibilities stipulated within
the Restrictive Interventions Guideline 2012 in conjunction with people with a disability,
families/carers, service providers and Public Guardian as appropriate.
Processes will be established between the Agency and DHHS to ensure appropriate
information sharing to monitor compliance with legislative requirements and quality service
provision.
9
External Accountability Arrangements:
Working arrangements for the launch phase are currently being developed in conjunction with
each of the following entities for implementation on 1 July 2013 to ensure that all service
provision within the NDIS complies with all required legislative and regulatory requirements of
these entities. The Agency is currently contacting and developing working arrangements as
appropriate with the following Tasmanian statutory authorities: Health’s Complaints Commissioner
Commissioner for Children
Public Guardian
Public Trustee
Anti-Discrimination Commissioner
10 DHHS In-Kind Contribution to NDIS
The activities identified to be undertaken by DHHS in these Working Arrangements will be
treated as an in kind contribution to the NDIS.
11. Implementation of the Working
Arrangements
Between March and June 2013, the LTA will also work with DHHS and other Tasmanian
departments to establish business processes and operational guidelines as required giving
effect to these working arrangements, particularly, in the areas of complaints management,
incident management and reporting, and registration. These business processes and
operational guidelines will be reviewed and refined if necessary during launch, at a minimum
annually.
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LIST OF APPENDICES
Appendix 1
Department of Health and Human Services Disability Services Funding Agreement
Appendix 2
The Quality and Safety Standards Framework for Tasmania’s DHHS Funded Community
Sector
Appendix 3
Children and Youth Services Quality and Safety Framework
Appendix 4
Mandatory Reporting of Child Abuse and/or Neglect, Disability, Child, Youth and Family
Services
Appendix 5
DHHS Restrictive Interventions Guideline 2012
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