Australian researchers call for National Disability Insurance Scheme service support
The Australian National Disability Insurance Scheme funds positive behavior support (PBS) for people living with disabilities with challenging behavior support needs.
Led by Flinders University, a new study of 392 NDIS-registered behavior support practitioners highlights the complexity of their role, calling for more support and training to carry out their work effectively—and, ultimately, provide better safeguards for people under the Australian scheme.
"The recent Disability Royal Commission reported an over-reliance on restrictive practices to manage behavior and the need for adopting 'person-centered' and 'rights-based' approaches," says Flinders University Disability and Community Inclusion senior lecturer Dr. Alinka Fisher.
"However, PBS is a person-centered and rights-based approach, so this raises questions about whether its implementation in Australia reflects the intentions and rigor of evidence-based practice, and the capacity of the workforce to meet the aims of PBS in the current service system."
The barriers outlined by behavior support practitioners included current NDIS service systems—such as inadequate and inefficient resourcing, and difficulties engaging with stakeholders including the person, support staff and family members. They also reported limited PBS expertise across the sector as well as the need for more access to supports and practice guidelines.
"These insights are timely, with behavior support under the spotlight and the need for systems reform now widely acknowledged," says Dr. Fisher, from the College of Nursing and Health Sciences at Flinders University.
The individualized funding model adopted by the NDIS may have unintended consequences for PBS service delivery, the research team warns, as PBS is promoted as an individualized and comprehensive approach that does not build upon important foundations of behavior support.
"We need efficient behavior support systems and a skilled workforce to enable best practice and safeguard a person's rights and that takes sophisticated knowledge and skills and close collaboration with stakeholders."
The study, published this month in the Australian Journal of Social Issues, suggests priorities to improve behavior support systems and practices, towards promoting rights-based practices and reducing restrictive practices. This includes:
- A shift toward tiered and system-wide PBS models, with funding allocated to building capable environments, active supports and community-based resources that address systemic issues and minimize the need for specialist intervention.
- Reform of the individualized funding model, exploring options such as block funding for core support service and tiered funding models that provide additional resources based on individual needs.
- Increased transparency and accountability in funding allocations to ensure clear guidelines and reporting mechanisms to track resource utilization and promote efficient use of funds.
- Streamlining compliance activities, implementing efficient and effective procedures that minimize administrative burden for PBS practitioners.
- Development and implementation of accredited PBS training programs, with standardized benchmarks and credentials for PBS practitioners (consistent with other professions) to ensure a skilled and qualified workforce.
- Investment in ongoing professional development, with regular training and support opportunities for practitioners to stay up to date on the best practice and evidence-based strategies.
- Establishment of a regulatory body for PBS, exploring options for an independent regulatory body outside the NDIS Quality and Safeguards Commission to oversee PBS practice and hold practitioners accountable.
- Development of clear roles and responsibilities for all stakeholders involved in PBS service delivery to avoid confusion and support efficient systems.
- Promoting collaboration between stakeholders, encouraging better communication and coordination between practitioners, the person, support providers, families and other relevant stakeholders.
- Reviewing and revising the NDIS practice standards and guidelines for PBS to ensure that policies and guidelines are consistent with best practice PBS and promote a rights-based approach to service delivery, which prioritizes the involvement of people in their behavior support planning.
More information:
Alinka Fisher et al, Positive behaviour support under the National Disability Insurance Scheme in Australia: Barriers, enablers and support needs from the perspective of practitioners, Australian Journal of Social Issues (2024). DOI: 10.1002/ajs4.316
Provided by Flinders University