NDIS Review – What’s It All About?

NDIS Review – What’s It All About?

Written by: Anthea Taylor l NDIS Plan Management Team

 

Ten years ago, the National Disability Insurance Scheme Act received Royal Assent enabling it to become legislation.  The concept of the scheme is brilliant, and world-leading, but the highs and wins of the initial years have been overshadowed by the lows and frustrations experienced in the last few years.

As NDIS Participant numbers have increased, along with the federal funding, the bureaucracy and understaffing at the National Disability Insurance Agency, and the lack of knowledge and understanding of the NDIS Act and Operational Guidelines by agency staff, NDIS participants and providers have resulted in the National Disability Insurance Scheme getting off track.

What’s Going On With The National Disability Insurance Agency?

The brewing issues with the National Disability Insurance Agency and the National Disability Insurance Scheme became an election issue in the 2022 federal election campaign.  If you can remember back 12 months, election promises were coming at us every day ranging from ending climate change, improving relations in the pacific, recognition of our First Nations people, making women a “national economic and social priority” and “betting the National Disability Insurance Agency“.

These were and remain worth issues, especially the promise relating to the National Disability Insurance Agency, and the National Disability Insurance Scheme.

You can be forgiven for being a bit sceptical about election promises – who isn’t?  They are easily given, but much harder to deliver.  Labour’s promise relating to the NDIA and NDIS was framed around a 6-point plan, with a few other commitments for good measure.

1. Revitalising the National Disability Insurance Agency through the lifting of the staffing caps, increasing the number of permanent staff, and reviewing the design, operation and sustainability of the scheme.
2. Stopping the waste by reviewing the use of external lawyers, “cracking down” on criminal and fraudulent activity, and reviewing consultancy contracts to ensure value for money.
3. Boosting efficiency by streamlining the planning process to result in better initial plans for NDIS Participants, and improving the planning pathway and appeals.
4. Stopping unfair cuts to NDIS Participants’ plans through the introduction and expert review that will guarantee NDIS Plans will not be arbitrarily cut.
5. Fixing regional access by appointing a senior office with the National Disability Insurance Agency to tackle the concerning barriers to service delivery in regional areas of Australia.
6. Putting people back into the National Disability Insurance Scheme by engaging people with disability to co-design changes to the scheme, including representation on the National Disability Insurance Agency board.

In addition to the six main policy initiatives, commitments were made to:

• Increase advocacy funding by investing an additional $10 million for disability advocacy.
• More flexibility housing by pausing the changes to Supported Independent Living and identifying solutions to the red tape and increasing waitlists preventing people with disability from accessing appropriate housing.
• Boost employment by creating an evidence-based Centre of Excellence to assist more people with disability in gaining long-term jobs.
• Not leaving anyone behind by ensuring action and support to measure the progress on a National Disability Strategy, develop a National Autism Strategy, backing research, and a central coordination point for disability.

We are now ten months into the not-so-new federal Albanese government.  Unlike many election promises which do not see the light of day until well into a government’s term if at all, the commitment to improving the National Disability Insurance Agency and National Disability Insurance Scheme officially commenced on 18 October 2022 with the Minister of the NDIS, Bill Shorten announced the National Disability Insurance Scheme Review.

A Good Start for the NDIS

So, how’s it going so far?

Canny Plan Management, like many stakeholders, were pleasantly surprised by the announcement of the NDIS Review.  Not only did the review commence, it was much earlier than anyone really expected.  A good start so far.

But really, what is it all about?

The overarching purpose of the NDIS Review is to examine existing problems and potential solutions and put people with a disability back at the centre of the National Disability Insurance Scheme – where they were meant to be, and where they should be.

In a video announcing the NDIS Review, Minister Shorten refers to:

…making sure our national disability safety net is strong and responsive, generous and reasonable… do what it’s meant to do – provide choice and control for people with disability.

To ensure transparency, an Independent Review Panel consisting of seven people with a range of expertise and experience was appointed.

It was headed up by two co-chairs, Professor Bruce Bonyhady and Ms Lisa Paul.  Professor Bonyhady, a disability reformer was one of the initial designers of the NDIS and the founding Chair of the National Disability Insurance Agency.  An excellent choice.  Is it fair to say the NDIA and NDIS lost their way after he left?  Maybe.  Here’s hoping he can again be instrumental, in getting it back on track to putting people with disability, their families and carers at the front and centre of the scheme.

Terms of Reference

Like any good review, the NDIS Review is collating and examining information and evidence, in particular engaging and consulting with NDIS Participants and stakeholders.  It is not an open-ended generic review to tick the box exercise.  The Review and the panel are accountable to the Terms of Reference as per the NDIS Review Terms of Reference: Building a Strong, Effective NDIS.

Context

The NDIS aims to improve the well-being of Australians by investing in and empowering people with disability and supporting them to achieve their goals and participate in the community and economy.

The NDIS takes a lifetime approach to achieve these outcomes, investing in people with a disability early to improve outcomes later in life and improve system sustainability.

An effective NDIS will improve outcomes for:

• People with disability and their families and carers, helping them achieve their life goals and participate in social and economic life; and
• Society, by strengthening communities and reducing avoidable system costs, including social security, employment, health, housing and justice.

There will be two parts to the Review:

Part 1: will examine the design, operations and sustainability of the NDIS covering issues outlined in the full-Scheme bilateral agreements between the Commonwealth and jurisdictions.

Part 2: will examine ways to build a more responsive, supportive and sustainable market and workforce.

An overarching objective for both parts of the Review will be to put people with disability back at the centre of the NDIS, restoring trust, confidence and pride in the NDIS amongst them and their families and carers as well as the broader Australian community, while ensuring the sustainability of the scheme so that future generations receive the benefit of the NDIS.

Part 1: Design, operations and sustainability of the NDIS

Objectives

The Independent Review Panel will make findings and recommendations to Disability Reform Minister on:

a. the participant experience and costs of engaging with the Scheme and opportunities to rebuild trust and improve key scheme design and administration, including by examining:

• the user journey, including awareness and access to the scheme, assessment, planning, review process, and navigation of supports and key transition points;
• ways to improve the evidence-based understanding and usage of services covered in a plan now and over time;
• ways to improve and make more timely decision making in relation to home modification, assistive technology and accommodation; and
• ways to ensure participants are well informed and supported as relevant remaining in-kind services are transitioned into the NDIS.

With a review to putting people with disability back at the centre of the NDIS.

b. the effectiveness and sustainability of the NDIS, including the achievement of participant meaningful employment and lifetime outcomes and broader social and economic benefits, through the provision of reasonable and necessary supports and consider:

• the effectiveness of: Information, Linkages and Capacity Building; Local Area Coordination and Community Connectors; and early childhood early intervention; and
• the suitability of the NDIS outcomes framework and data to measure effectiveness, and options to improve the ongoing monitoring and evaluation of the Scheme’s effectiveness, including economic and social participation for participants and their families;
• the fiscal sustainability of the scheme, including the longer-term fiscal trajectory.

c. ways to better ensure the delivery of value and outcomes for participants and government, including capacity building and assistive technology supports;

d. scheme governance arrangements and the extent they support effective operation of the scheme, including the roles and interactions between the NDIS and NDIS Quality and Safeguards Commission and DSS, and the NDIA’s and the NDIS Quality and Safeguards Commission operational models and costs;

e. efficiencies within the Scheme and improving the interaction between the NDIS and other significant related policies and systems, including mainstream services delivered by the Australian Government, the states and territories, local government, and the community sector;

f. whether there has been any service and financial impact, positive or negative, on other service systems and programs and the adequacy of supports for people with disability outside the NDIS; and

g. financial risk and the drivers of cost pressures, and the most appropriate levers to manage these risks and cost pressures.

Part 2: Building a more responsive and supportive market and workforce

Objectives

The Independent Review Panel will make findings and recommendations to Disability Reform Ministers on reforms to:

a. foster and steward an innovative, effective and sustainable market where providers (commercial or otherwise) invest, grow and improve outcomes for participants and the Scheme;

b. improve the pricing and payment system to incentivise providers to improve outcomes for participants, improve productivity, support workforce development and ensure market and system sustainability;

c. improve access to supports in thin markets – including cultural and regional, remote and very remote communities and service categories – and ensure participants with complex needs have continuity of support where a provider withdraws from the market;

d. attract, build and retain a capable workforce, including employment and training models that enhance participant experience and worker attraction, retention and career pathways;

e. ensure adequate supply of appropriate and cost-effective accommodation and supports, including specialist disability accommodation, medium-term accommodation and supported independent living and individualised living options;

f. improve consumer information and dissemination on supports/services (types of service, price, quality and availability) and the role of intermediaries to make it easier for participants and carers to find value for money supports that meet their needs and deliver outcomes;

g. ensure the adequacy and effectiveness of the operation of the Quality and Safeguards Framework ensuring quality, addressing conflicts of interest, and providing appropriate protection for participants;

h. improving the efficiency and effectiveness of current price setting and regulatory functions (market oversight, monitoring and enforcement), including interaction with other relevant Commonwealth, state and territory regulatory systems; and

i. improve performance monitoring, compliance, reporting and responses to breaches, and unscrupulous behaviour, including the detection of fraud and sharp practices.

The Independent Review Panel will consider interactions across the broader care and support sector, including aged care, veterans’ care and primary health care, as well as broader community-based activities, and identify how programs could achieve better outcomes through an integrated approach.

Approach

The Review will:

• Analyse challenges to the effectiveness of the NDIS and the NDIS market and workforce, and opportunities to improve their effectiveness to support people with disability and their families and carers, helping them achieve their life goals and participate in social and economic life.  This includes an analysis of barriers to accessing and navigating the NDIS;
• Consult widely to ensure participant, provider and community feedback and, where necessary, draw on specialist expertise while managing demands on those consulted;
• Examine barriers that have affected the operation of the NDIS and the NDIS market and the development of a capable workforce, including the assessment of the impact of major policy changes, regulation and interaction with other systems;
• Co-design directly with participants, carers and their families, and providers and workers, and prioritise potential reforms to improve the responsiveness and capability of the NDIS and the NDIS market to ensure they deliver for Australians with a disability and their families and carers, and society more broadly; and
• Review the reasons for ongoing significant upward revisions of cost pressures on the scheme and identify options to ensure scheme sustainability and manage future financial risks, including growth in scheme costs.

The Independent Review Panel will be guided by Australia’s commitments under the United Nations Convention on the Rights of Persons with Disabilities, Australia’s Disability Strategy 2021-31and the National Agreement on Closing the Gap.

It will apply best practices for designing a policy that supports people with disability.  This will include consideration of the needs of First Nations participants and participants with a range of lived experiences including in relation to gender, culture, socio-economic status, age, and sexuality to ensure the NDIS is catering to the diversity of participant needs and intersections between them.  The Independent Review Panel will also have careful regard to the findings and proceedings of previous and ongoing reviews and inquiries, including the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability and the National Autism Strategy, so that input already provided by the disability community is fully taken into account.

The Panel will also identify and provide advice on ways to monitor and manage implementation risks.

Governance

An Independent Review Panel – comprising of Professor Bruce Bonyhady AM (co-chair), Ms Lisa Paul AO PSM (co-chair), Mr Kevin Cocks AM, Ms Judy Brewer AO, Dr Stephen P King, Mr Dougie Herd and Ms Kirsten Deane OAM – will report directly to Disability Reform Ministers.  Professor Bonyhady will lead Part 1 of the Review, Design, operation and sustainability, and Ms Paul will lead Part 2 of the Review, Building a more responsive and supportive market and workforce.

The Independent Review Panel will be supported by a Secretariat in the Department of the Prime Minister and Cabinet comprising Commonwealth, State and Territory officials as well as people with sector and workplace relations experience.  The Secretariat will seek expert opinions where needed, including independent actuarial advice.

Timeframe

A final report is to be provided by the Independent Review Panel to Disability Reform Ministers by October 2023.  Where specific opportunities for reform are identified prior to the final report, the Independent Review Panel may bring forward recommendations and a supporting paper on these to Disability Report Ministers ahead of the final report.

How’s The National Disability Insurance Scheme Review Going For Far?

According to the most recent Review Round-Up (February 24, 2023), the NDIS Review’s newsletter, in excess of 81,000 people have visited the Review’s website, 780+ individuals and organisations have provided feedback and 178 stakeholder meetings have been held.  Members of the panel have attended Disability Reform Ministerial Council meetings, participated in summits and presented at conferences.  So far, so good!

The National Disability Insurance Scheme at its core is an investment for all Australians.  It supports our citizens and it supports our economy.  It brings our laws to life ie. Disability Discrimination Act and realises our international commitments such to the Declaration to Human Rights and the Convention on the Rights of Persons with Disabilities.  Although in recent years it has lost its way, through the NDIS Review there is great hope and expectation that it will get back on track, and be bigger and better, a win for all!

More information can be found on the NDIS Review website Working together to deliver the NDIS l NDIS Review.