Analysis Paralysis: When NDIS Choice Becomes a Burden

Increased choice might actually reduce participants’ experience of choice and control in the National Disability Insurance Scheme, writes disability consultant Evie Naufal.

Have you ever tried to choose something and been overwhelmed by the number of options? Maybe browsed for a new restaurant but ended up back at your local, or looked for a movie only to end up choosing nothing at all?

While we sometimes think of endless choice as being an irrefutable positive force, an increasing amount of research shows that excessive choice can produce what behavioural economists call choice paralysis. Faced with too many options, people find it harder to make decisions and often report lower satisfaction with the decisions they do make, even when these decisions are good.

Global best practice in disability support clearly shows that greater choice and control for service users leads to better life outcomes and more efficient and effective services. This is why choice and control are the fundamental principles of the NDIS.

But how might increased choice actually reduce NDIS participants’ experience of choice and control? We’ve identified two market forces that are particularly problematic here.

Firstly, the current marketing practices in our sector make it next to impossible for participants to compare choices within or across providers. Most providers follow an all-things-to-all-people approach, making broad brush statements about their values without much detail about what this looks like in action. We meet very few providers who can succinctly describe what sets them and their offering apart from others. If an organisation can’t describe what makes them the right choice, how can we expect NDIS participants to do the same?

Secondly, the lack of clarity around how participants’ eligibility for core supports is calculated means participants and their families have an inordinate number of decisions to juggle.

To explain: “Core supports”, which is expected to account for 72 per cent of NDIS funds, is the NDIS support category that includes assistance with daily living, assistance with social and  community participation, consumables and transport. While early plans detailed the supports that had been combined to calculate a participant’s funding (eg 16 hours per week of group activities, two hours per week of 1:1 community access etc), recent plans simply provide a lump sum figure for core supports, with no detail as to how this was arrived at.

This leaves participants and their families to decide not just who should deliver these supports, but how often, for how long, on which days, at what price and with which staffing ratios. All while ensuring that all of these choices over the year add up to no more than the funding they have been allocated.

Cue an endless number of support combinations. Cue the choice paralysis. Cue droves of previously enthusiastic participants putting “choice and control” in the too-hard basket and simply choosing to keep their support arrangements as is.

So how can we make it easier for NDIS participants to exercise their choice and control? Is the answer to restrict the number of choices available to NDIS participants? Certainly not.

Research shows that there are conditions we can create that mitigate or eliminate the negative side effects of too much choice. Here are some of the top ones that can be applied in an NDIS context.

Behold the power of support coordinators

Research shows that for people who know a domain well, more choice is better than less. This is great for participants and families who know the sector like the back of their hand and have been itching to make the most of the opportunities available to them. For those without this savvy, however, support coordinators are a critical piece of the puzzle that makes choice and control possible.

Support coordination is so much more than merely linking participants to providers and ensuring the committed supports are spent. At its best, support coordination engages participants in exploring what’s possible, reducing the administrative burden of choice and control and supporting the participant to put together a package of supports that genuinely facilitates progress towards their goals. With an estimated $770 million allocated to support coordination at full rollout, we reckon this is a really underrated area of importance in the NDIS and we’re expecting support coordination to be one of the most important NDIS topics in 2017.

What makes you different?

Think about the people for whom your organisation has been the best possible choice. What was particular about that situation? What made it work? Are your staff particularly skilled at something or do you offer something no one else does? If you don’t know the answers to these questions yet, it’s time to start looking.

Create environments that facilitate decision making

Is your website full of lengthy paragraphs that say everything and nothing at the same time? Is it full of language specific to your organisation? Is it impossible to tell which NDIS supports you’re registered to provide? If you answered “yes” to any of these questions, it’s probably time to consider how you can better facilitate decision making online (and offline).

Consider:

• Support calculators allow participants to determine the cost of different combinations of supports (below is from Leisure Networks but sadly the calculator is no longer online).

• Be clear on how your supports fit into to participants’ NDIS plans in terms of support categories and line items and clearly communicate this. We reckon Wild Rumpus (also from the Barwon trial site) do a great job of this.
• When describing your services, don’t copy the NDIS price guide’s definition of supports. Create your own. For example, what does “tenancy support” mean to you? What does it look like for the people you work with? How is this different to other providers?

People with disability, advocates, carers and families have worked so hard for so long to make individualised funding a reality. The challenge now is to make sure we continue to break down the barriers that inhibit choice and control and ensure that participants and families can really make the most of the opportunities the NDIS presents.

About the author: Evie Naufal is a senior consultant at Disability Services Consulting, specialising in NDIS service development. She has spent the last two years working with disability support organisations around Australia to adapt and thrive in the NDIS and is passionate about using the principles of marketing and behavioural economics to facilitate participant choice and control.