This is why we can't have nice things...

Let's talk about STA!

You probably know someone in your life who knows very little about disability. They might be the one who asks you what your child’s ‘special gift’ is, or doesn’t understand why you can’t ‘just get a baby sitter’ or why you’re always tired and your house is a hot mess!

Now imagine this person is sitting on a cold train at 7am going to work at a job they don’t particularly love so that they can pay their mortgage (and 30% tax), who then sees an add on Facebook for holidays to the Gold Coast to ride rollercoasters with the tax payer (NDIS) funding the entire trip.

Or perhaps they see an ad for an ‘NDIS cruise’ to French Caledonia to swim with dolphins, a fishing trip to Kakadu or a holiday to New Zealand to visit Frodo.

What about Friday drinks after work when the conversation turns to someones cousins neighbour who just had an NDIS funded holiday to ride camels in Broome at sunset? Does this pass the Pub Test?

How does the average taxpayer feel about their hard earned tax dollars paying for some unknown stranger to cuddle Koala’s and ride horses through the Daintree?

And this is before they’ve seen the headlines about how the cost of the NDIS is going to ‘blowout’ out and bankrupt our economy. Maybe they feel it’s the reason the Government can’t fund more towards something that feels vital in their lives like mental health or domestic violence? Disability support is not a priority for everyone. It could feel like a real slap in the face that their child has to wait 9 months for important surgery when they hear about NDIS participants spending public funding on a fun holiday in the sun.

I was speaking about STA recently on my social media, and lots of families didn’t have a solid understanding of what it actually is and how it works, so lets start with the fundamentals.

STA is an acronym for Short Term Accommodation. It is a support that can be funded in a NDIS participants plan if the NDIA consider it to be Reasonable and Necessary.

NDIS funded STA has two purposes:

1. A skill-building expertise for the participant (i.e a trip away to make new friends, try new things and practice independent living skills), and

2. An opportunity for the participant to have a break away from their usual carers, or to have care when their usual carers are not available. Because it is not typical for teenage or adult children to spend every waking moment with their parent or carer. This break will also sustain the carers in their caring role. Some people call this ‘respite’.

It is funded from a participants Core funding, usually for a length of up to 14 days at a time and up to 28 days per year with flexibility in how they are used. Because Core funding is flexible, a Participant who does not have funding for STA in their plan, can use their Core to pay for STA if they feel it meets the requirements. This means a huge percentage of NDIS participants have the ability to spend some or all of their Core funding on STA.

STA covers the cost of the participants care while they are away. This includes:

• personal care (like a support worker to provide disability related support)

• accommodation

• food

• activities you and the STA provider agree to.

In the NDIS Price Arrangement, STA is funded in 24 hour blocks as a packaged service, meaning that the cost of support, accommodation, food and activities is an all inclusive price per 24 hours. Different ratios of support and days of the week attract different charges. A person purchasing an STA package on a weekday at a 1:4 ratio could be charged up to $663.07 per 24 hours, and a person requiring the same on a Sunday at 1:1 ratio could be charged up to $3,291.21 per 24 hours.

For teen and adult participants, the focus of an STA package might be about working towards being able to live more independently, after all the intention of the NDIS is to fund capacity building support now so that a person requires less support later in life. It is an insurance scheme.

Whereas for children (who are still expected to recieve a high level of support from their parents), STA is not commonly funded, and when it is funded, the focus would most likely be more about sustaining the parents and carers in their caring role because there is a risk of carer burnout or that child being placed in residential care. Again the focus is on ‘how can we invest in this participant now, so that they will require less support later in life’ and having parents or carers who are well enough to continue to care for their disabled children well into adulthood saves the government (taxpayer) an enormous amount of money.

So whats the deal with the ‘holidays’…??

First of all lets talk about perception.

Sometimes its more important than reality.

The media never let the truth get in the way of a good headline, and much of the Australian media rely on clicks and social media outrage / engagement to build their brand, increase their subscribers and fill their bank accounts.

The Media narrative, Public Relations and the Pub Test is how many ordinary Australian’s make judgement calls about what is acceptable or not.

PR matters for our beloved NDIS because it is funded by the taxpayer.

PR also matters for the Government. Because they like to stay in Government. They need to approval of the majority of taxpayers.

Imagine the backlash and pressure on the government from the taxpayer who believes their taxes are being used for theme park holidays rather than supporting people with disability to live as autonomously as possible. 

Consider how bad the government looks if taxpayers think the NDIA are funding holidays to Movie World. I have seen estimates that the NDIS costs each and every Australian taxpayer around $3000 per year and forecasted to increase to $6000 per year without serious reform.

Now imagine how long until the government clamps down on how STA is funded, and how it can be used. (spoiler alert - not long at all).

Do you think the government cares about how the NDIS is perceived by the taxpayer? If they see it as a sustainable and genuine disability support, or a rort, or a free ride being used in ways for which is just was not designed or intended?

What is the difference between STA and a Holiday?

Ahh so glad you asked!

Let’s go back to the intention of the support;

• to build skills and work towards more independence

• to have a break from / give a break to your usual informal carers

Is someone going to Sea World so that they can develop the skills needed to live more independently? Does someone learning spear throwing help them find employment or increase their financial literacy so that they can manage their own budget at home?

Someone might argue ‘hey I can learn to cook for myself after I get home from the theme park in my little hotel room’. And yes you might be able to learn how to cook in your little hotel kitchenette, however is that how the package you have purchased is advertised to you? Or are they selling you this package based on the fun restaurants you will visit or the ‘all you can eat buffet’ on the cruise ship. If you’re on a trip where everything is done for you (ie a holiday) then I struggle to see where the skill building comes into it.

At the end of the day, I see the focus of the NDIA as being for disabled people to be supported to live an ‘ordinary life’ but they aren’t too fussed about anyone living an ‘incredible life’.

Yes I think they want participants to be able to get out of bed, pay their bills, keep a roof over their head and have social connections that support their mental health. It’s just unrealistic to expect that the NDIA can support 600,000 participants to tick off their bucket list of dreams.

And of course we have to talk about ‘Value for Money’

This is a key principal in the NDIS. We need the NDIS to be sustainable right?

Is it good value to fly with your sister and your girlfriend to a ‘Hinterland Escape’ so that you can have a break from needing support from your nagging parents all the time?

Is using STA (or advertising it as all expenses paid holidays to beaches and theme parks) in line with the principals of how STA was designed to function?

Does a person need to fly to another state to learn how to do their own laundry, develop the skills required to ensure catch public transport or have a break from their carers? Is that good value?

Or could they stay at a local hotel or Air B&B, and get the same outcome? 

Do you need to be on a cruise ship to make new friends, or does it make more sense to participate in a local STA where the friends you make actually live nearby so you can see them again?

Is learning how to spearfish really building the skills that will support a person to live more independently so that they require less support later in life? (Which remember is the core intention of the entire NDIS)

I recently saw an ad for a Gold Coast holiday which had 854 comments asking for more information. And I get it - most of us would love to take a holiday especially when we aren’t paying for it our of our own pocket. (hello Melbourne winter!)

And I am not saying that these companies are technically breaking any rules. But when they advertise their services like this… do you think their first priority is their participants? Or making money?

At the end of the day, the companies who are selling these packages have nothing to lose and everything to gain. 

And the NDIA will start to impose more and more rules around how and when STA can be funded and used…. And then the people who need that support may no longer have it.

Its the participants who will lose out when the backlash against the government means that the NDIA have to reign in what they will fund. It has already started.

I recently attended a webinar with Cat Wheeler (Brand Manager, Service guidance and practice, NDIA), and Jessica Walker, (Brand Manager, Policy NDIS). They spoke about how participants who chose to use NDIS Registered providers for STA can claim their food, support and accommodation as an all inclusive package is acceptable, but when using a non-registered provider (or creating a DIY package) and splitting the parts of the costs (non inclusive) then the accommodation and support only can be funded from the plan and food / activities should not be funded from the plan.

The NDIA is also developing a new set of specific Operational Guidelines to clarify the length and purpose of ‘Short Stays’ (new terminology for STA) and what can and cannot be funded. This will make very interesting reading!

"Crystal therapies, overseas cruises and dolphins – they’re out" (NDIS Minister Bill Shorten)

#confusion

I have had conversations with participants in Facebook groups about what constitutes genuine STA and some have demonstrated that they don’t have a clear understanding of the purpose and intention of STA. This then lends to circumstances where funding is being used for travel and accommodation that doesn’t align with the principals this support is designed for.

Imagine a participant who said they need to take regular holidays away because they have ‘obnoxious neighbours’. I fail to see how this is a disability related support need. I have had obnoxious neighbours in the past too. It sucks. And its not related to a persons disability. Non disabled people also can hate their neighbours and have to pay for their own holidays to get away from them.

What about someone who wants to attend a conference about Crypto and so their travel, meals and hotel should be paid for as STA. But having an interest in Bitcoin (to me) is not a disability related support need. There will be non disabled people at that conference who paid for their own ticket and travel arrangements. A disabled person might engage a support worker to assist them at that conference, but that is not STA - that is Assistance with Social and Community Participation and only pays for the time / hours that the support worker is there.

What about someone who needs to travel a long way to hospital for medical treatment and so feels their flights, accommodation and meals should be covered as STA. But there are other funding systems for this such as the The Patient Assisted Travel Scheme (PATS) and again needing to travel for medical treatment is not aligned with the purpose of STA - which is skill building and to have a break from your carers.

Many families find it difficult to understand why the entire family can’t go on the trip with the participant. And participants who live on their own have been frustrated to be told by the NDIA that they aren’t eligible for STA to be funded in their plan. And while this is one of the million grey areas in the scheme - again lets go back to the intention of this support. If the purpose of the STA is to give the usual carers a break from their caring role, then how are they having a break if they are taking their carers with them? Or if they already live independently from their informal supports, then again - how is this respite?

Potentially STA is a harder time for the participant than staying at home! This could be a time where they are really challenged, to get out of their comfort zone and spend time with new people developing new and difficult skills. Can you see how this sounds very different to a luxe hotel and room service breakfast in bed?

So can’t disabled people have support when they go on holiday or need to travel?

Absolutely. Whatever disability related support a Participant requires on holiday should be funded from their NDIS plan. For example, if you want to ride water slides, buy a flight to the Goldie and a ticket to Wet an Wild. Then use your NDIS funding to take a support worker with you to the theme park for the day. That is Assistance with Social and Community Participation while you are on holiday.

If you’re travelling for medical needs, of course your NDIS funding can be used to have a support worker assist you with your disability related needs.

If you want to attend a symposium on Molecular Biology to meet like minded people - go for it! But should the taxpayer pay for you to attend a $600 per day symposium in another state staying 3 nights at a 5 stay hotel when the same outcome (making social connections) could potentially be brought about by spending far less money and going somewhere local?

Most of all, we all just need to be really clear about what the purpose of the travel is for and reserve NDIS funding for what is disability related support.

Someone once said to me “hey my entire NDIS budget is already determined ‘Reasonable and Necessary’, so however I chose to spend it is no one else’s business”.

And to that all I would say is that if you truly care about the NDIA being sustainable and you truly believe that you need this scheme to support you for the rest of your life - think long and hard about how privileged we are to have individualised support packages available to us, and just because it’s there - does that mean that you need to spend it?

Whats in a name??

The reason why so many people want to call their support STA is because then they can claim the costs of their activities, food, accommodation etc from their NDIS plan. But it is really only true STA when the purpose of the time away from home is for skill building and to have a break from your usual caring arrangements. That means that if you take your parents / carers with you then its probably not STA.

It means that if you go away but you don’t live with your parents / carers / informal supports - then its probably not STA.

A paediatrician told me last year that the waitlists in our medical systems are so long, that doctors are choosing between which child’s cancer is ‘most advanced’ to triage and schedule brain scans.

How any business or participant believes that its ethical to spend public funds just because ‘it’s there’ just blows my mind.

And we haven’t even spoken yet about the sharp practices, unethical behaviours and outright fraud….

Without getting into all the worst of the worst, there are stories circulating about providers who:

• charge the participant the full rate (more than what the holiday costs) and reimburse the extra money to participants in the form of Gift Cards so that they can spend it on shopping, alcohol, meals etc during their trip

• charge the participant the full rate (more than what the holiday costs) and use the extra funding to pay for the participants flights to get to the location

• charge the participant the full rate (more than what the holiday costs) so that family or friends can attend with the participant

• charge the participant the full rate (more than what the holiday costs and their profit on top) just cause they can…. remember the 1:1 rate on a Sunday is up to $3,291.21 per 24 hours.

So to wrap up this rant, I think its helpful to pull our focus back from all the grey areas of STA to the stark reality that the sustainability of the NDIA relies on the taxpayer continuing to accept that the scheme is a responsible use of public funds.

Its the same reason I abhor hearing about people who intentionally rort the system.

Those people are the reason we can’t have nice things.

Someone who hasn’t been supported well enough (and the Agency need to take some responsibility for this, as does the private sector who advertise these holidays) to understand what STA is, and those who just don’t care or have very short sighted thinking.

I honestly think one day soon we will look back thinking “these were the good old days of the NDIA where we had so much freedom and flexibility” and I feel a change in the wind already.

Yes providers are doing much of the damage and still the entire onus of responsibility sites with the Participant to ensure they are spending their funding in line with their plan and with NDIA legislation.

I don’t believe that STA should be an institutionalised facility type of environment where participants play monopoly or stare at the TV all day, but there needs to be that middle ground between luxury escapes to the Barossa Valley too.

So it’s up to us!

To protect the NDIS.

Because the private sector who stand to make squillions through all inclusive holidays won’t stop when we keep buying.

You can read the current NDIS guidelines on STA here: https://ourguidelines.ndis.gov.au/supports-you-can-access-menu/home-and-living-supports/short-term-accommodation-or-respite

You can report providers doing the wrong / suspect thing here: https://www.ndis.gov.au/contact/report-suspicious-behaviour

We have to remember our buying power! That we as consumers can influence the market and range of services that are available to us. If we are buying cruises to swim with dolphins, then we aren’t supporting the wonderful providers out there who genuinely are trying to develop authentic STA products that create real outcomes for participants in a cost effective manner.

You may be feeling triggered by this article - and thats okay. I accept there are many many shades of grey here and that disabled people live with so many different individual and unique circumstances.

I’m not here to tell you what to think, or believe or feel. Not everyone is taking advantage. Going on a rollercoaster is not necessarily a frivolous use of public funding. STA doesn’t need to be a sterile medical model tucked away from the mainstream world. But bigger picture - we all have to consider (and eventually live with) the repercussions.

I’d love to hear your thoughts!

x Anna