Organisations which support hundreds of Canberrans with disabilities are under threat and need immediate assistance to help them through a lengthy reform process, their leaders have warned.
Canberra NDIS providers say they have really had to "tighten their belts" and have been forced to take drastic changes to keep up with cost pressures, including cutting staff wages, stopping weekend services and ceasing supports altogether.
The NDIS has been running for 10 years in the nation's capital and four organisations who provide support to people with disability say costs are making it increasingly difficult to deliver services.
Data is showing an increasing number of providers operating at a deficit.
The federal government has promised a wholesale change of the scheme's operation, following a review last year, but this could take up to five years, which providers say they do not have.
Providers are calling for financial support and an immediate uplift in pricing to help them over the coming years as organisations are using their reserves to fund the costs of providing services under the NDIS.
Koomarri chief executive Nadine Stephen said the cost model was "fundamentally flawed" and there was a growing divide between what the organisation could claim from the National Disability Insurance Agency and the actual cost of delivering services.
She said Koomarri, which supports about 300 people, had already restructured and reclassified wages in response to increasing costs. The organisation had been subsidising gaps for many years.
"Koomarri will never compromise on quality or deliver substandard care to the people we support but working in this incredibly tight fiscal arrangement where the sector is operating in a deficit. That is quite concerning," she said.
Ms Stephen said the organisation needed funding to help them through the five-year implementation of the recommendations from the NDIS review.
"In order for the sector to be in a strong, financially sustainable position at the end of that transition period I would be strongly encouraging and requesting some type of transitional funding for organisations to make it through the series of reforms," she said.
"I don't want to be in a position into the future where we're having to continually reclassify people's wages down. That's not how we maintain a good quality workforce. We want people to stay in this sector."
Marymead CatholicCare Canberra chief executive Anne Kirwan said the organisation had to make the decision to cease providing supports on weekends and after hours.
"It was incredibly difficult for our staff who've worked with people for over 30 years but also very disruptive for the clients who have their entertainment and their lives in a routine and we've had to disrupt that," she said.
The NDIS provides funding to participants who are then able to choose and how they want to be supported.
The NDIS is designed to provide disability-related supports to participants, who then have choice and control on how they are supported and by who.
The National Disability Insurance Agency works with providers to ensure participants can receive value for money support.
But the organisations are also contending with fraud and non-compliant providers.
"We have all the quality and compliance obligations that we meet and quality costs money and the challenge we have in this space is that there are a larger number of unregistered providers who don't have the same compliance obligations," Ms Kirwan said.
"We're very concerned about what's happening in that sector because there's an ethical aspect to registration. We're required and willing to meet all our continuous improvement obligations, risk management, reporting of incidents and that's not necessarily required of unregistered providers."
'Complete rethink'
A review into the NDIS, released late last year, recommended a series of significant changes, with the report's authors saying the proposed reforms recommended a "complete rethink" of the scheme.
The changes recommended included changes to pricing frameworks to improve incentives for providers, incentives for continuous quality improvement and to "attract, retain and train" the workforce.
The 26 recommendations would be delivered over a five-year period.
"These reforms are significant. Taken together, they represent wholesale reform of the disability ecosystem. To work, they need to be implemented as a package, with careful sequencing to ensure the most important foundations are in place before other reforms occur," the report said.
"It took 10 years to get to where we are today, and we should not expect changes of the scale we are proposing to happen overnight."
But the organisations say they don't have five years to wait.
"There are a number of providers in the ACT who are saying we can't keep doing it, we don't have five years," Ms Kirwan said.
A report from National Disability Services found disability service providers reported the most recent financial year was the worst one yet.
It found 34 per cent of organisations reported a loss over the period and 18 per cent were only able to break even.
It also found 82 per cent of respondents received requests they were unable to fulfil with a lack of staff a main reason for this, as well as not enough resources.
The federal government allocated $10.2 million towards repairing the market and better ways to access support in January. This includes funding for the Department of Social Services to design and consult on a new NDIS pricing and payments framework.
There is also the annual pricing review for the sector being considered by government.
National Disability Services chief executive Laurie Leigh said while the changes were needed and supported organisations needed financial support to help through the changes.
"Whilst changes are absolutely needed to improve the NDIS for people with disability and the sector, without funding supports between now and the five-or-so-year-long timeline in which they are meant to be adopted, there will be substantially fewer good quality providers left to implement them," she said.
"This financial strain is already materialising in major providers ceasing NDIS services, leaving individuals and families without essential supports.
"NDIS pricing is being reviewed right now - we need an immediate uplift in pricing for the sector to remain viable. If this is delayed, market failure is already occurring and will snowball further."
Canberra provider Hartley Lifecare has already been forced to make drastic changes to remain in business, including reducing wages of staff by up to 5.7 per cent and removing allowances.
Hartley Lifecare chief executive Eric Thauvette said the organisation would not have lasted beyond 2024 if the changes were not made but even with the changes there is not much room for growth.
"The measures we have taken over the last six months is ensuring Hartley's viability into the future but barely. It doesn't leave us any money to do anything innovative," he said.
"It doesn't give us any money for anything to expand on our projects."
The lower wages also mean the organisation is struggling in attracting staff and the cuts also mean there are fewer training opportunities for staff.
"We really really had to tighten our belts. I truly believe that you get what you pay for and in the ACT where you are competing with government salaries we're not getting the quality of people that we used to get when we paid at the higher level," he said.
"We've also had to cut back on training a lot and that's another thing that's a bit worrisome since we're not training our employees as much."
Mr Thauvette said the cost assumption models in the scheme were flawed and not representative of the industry. He said fraud was a huge issue but reputable organisations were taking the hit.
"They're struggling with fraud and the NDIS being overspent and I do understand that. It's a challenge for government," he said.
"It's a challenge for government to be able to try and rein in the cost of the NDIS. We're told the numbers of fraud is really high, nobody can say exactly how much it is but I've heard some really big numbers."
"As a society we need to be able to rein that in."
Woden Community Services has been forced to cut direct NDIS support services due to costs. The organisation's chief executive Jenny Kitchin said the organisation had suffered financial losses year-after-year and could no longer subsidise the direct support programs.
"Direct support service to people has just become increasingly difficult to remain financially sustainable," Ms Kitchin said last month.
"The funding that we receive from the NDIS... just cannot cover some of our most basic costs."
- with Miriam Webber
