25 March 2024
Geoff Hutchinson
MSWA Manager Client Engagement
One of the most frightening words in the English language is ‘potential’.
‘Potential’ has the potential to be great, the potential to be special, the potential to be life-altering or regrettably, the potential to be terrible. Everything is on the table when people insert ‘potential’ into a sentence. But what makes this word so scary is that we often must wait to find out if something reaches its potential or not.
Take the 329-page report that was the final deliverable of the recent National Disability Insurance Scheme (NDIS) Review. Potentially, the recommendations within the report provide a five-year roadmap for a scheme that gets back to basics and becomes client-centred, with costs under control to ensure a viable scheme into the future.
While the recommendations have the potential, we still don’t know which ones will be accepted, what legislation will get through and what the final product will look like. Nevertheless, we now know more about the NDIS vision than we did previously, so what are the major outcomes potentially impacting your NDIS?
The NDIS can’t do it alone.
One of the biggest ideas to come out of the review was that the NDIS can’t do it alone and called on both State and Federal Governments to invest in ‘foundational supports’ to assist people with disability outside the NDIS. This has been a critical concern for many years, with 93 per cent of disability funding going into the NDIS, despite only a small proportion of the 4.4 million people in Australia with a disability supported by the scheme. As the report authors state “you can’t fix the NDIS without fixing everything around it”, so the introduction of foundational supports would see mainstream services (like health, mental health and education) become more accessible as part of a connected system. This would allow access to some services outside the NDIS structure more efficiently and sustainably. The NDIS or bust approach has been a pebble in the shoe of the scheme since its inception, slowing things down and making the journey quite painful. More support outside the scheme is a great thing.
This ‘connected system’ concept leads to further recommendations around the way mainstream services interact with the NDIS. This includes allowing NDIS participants who turn 65 to receive funding support through Aged Care and NDIS at the same time and improved access to aids and equipment. MSWA has been an active advocate for the needs of those outside the scheme for some time, so ensuring everyone is supported would be a big outcome. Research by the Melbourne Disability Institute found that non-NDIS programs spend the equivalent of $33 a year on services for those with disability outside the Scheme. That must change.
Scheme navigation
Another significant change within the report is the proposed replacement of Support Coordination, Local Area Coordination (LAC) and Psychosocial Recovery Coaching (PRC) services with a concept called Navigators. Navigators would be responsible for assisting both NDIS participants and those outside the scheme to connect with mainstream services, navigate the NDIS application process, and connect to services. Unlike the existing system, where a set number of hours is provided, Navigators would support everyone from diagnosis onward, coming in and out of people's lives as their needs require to allow for flexible support. Furthermore, Navigators would operate independently from service providers, ensuring nationally consistent governance, service information, monitoring, and training. Everyone is getting their own NDIS sherpas it seems.
This is big, and I can see the potential, as having one person on hand to help you navigate your way around all the different elements as your needs change would be helpful. However, the Local Area Coordinator experience has not been great, and this is a significant role with significant scope for someone who may not understand individual conditions or situations, which may lead to uneven participant experiences. Overall, this is a good concept that will help improve access to support and lessen confusion for everyone. The report also signals the potential end of Plan Managers thanks to a new digital payments system, but this seems to be a long-term change – a relief for the 1000+ active plan manager companies across Australia.
Budget management
A recommendation I did enjoy was that plan allocations should be set at the whole plan level, rather than line-by-line. This means that budget-setting would focus on a person’s support needs and provide a flexible budget (based on assessments), allowing services to go where they provide the most benefit. This all leads to the recommendation that the NDIS adopt a trust-based approach to how people use their budgets. While this sounds excellent, a concern about this new flexible approach is the introduction of ‘Needs Assessors’ who are responsible for setting these wonderful new budgets. Minister Shorten was quick to clarify Needs Assessors are completely different from the ‘Independent Assessors’ floated a couple of years ago, but the job description sounds pretty similar to me. Still, more flexibility is a good thing no matter how you look at it.
The report also suggests that the National Disability Insurance Agency (NDIA) delegate pricing oversight to the Department of Social Services and the Independent Health and Aged Care Pricing Authority (IHACPA). Furthermore, the Review recommended that a new pricing and payment structure moves away from a uniform approach to better account for varying costs, such as supporting individuals with higher levels of complexity, regional differences, staff training and other associated indirect labour expenses. This is significant as the current one-size-fits-all pricing approach fails to allow providers to adapt to individual needs as they change, bringing a lot of promise.
Improved governance
One change that may not impact your plan on a day-to-day basis but will have an impact on the quality of services is the introduction of risk-proportionate regulation. For a variety of reasons, many NDIS providers are choosing to remain unregistered, which means that they are not held to the same quality and safeguarding standards as registered providers, such as MSWA. For a scheme designed to provide funding and services to, at times, vulnerable individuals, having a significant portion of your providers operating without the same rules is cause for concern. The proposed approach would require all providers to be registered and would provide mandatory compliance across all services provided under the scheme. The report also recommends all providers comply with NDIS practice standards, which currently is not the case. This is a win, as compliance is a lot of work for an NDIS provider, but it's also the only way we can ensure the safety of all participants.
There are many, many other suggestions across the novel-length report, including government-commissioned Specialist Disability Accommodation (SDA), increases in early support for children outside of the scheme and the creation of a new Disability Intergovernmental Agreement (IGA) aimed at getting governments to work together. Overall, the report has done a great job of looking at all aspects of the disability sector and providing clear suggestions that (in my opinion) would improve things for participants, their families, and providers.
So, what does it all mean?
Well, nothing for now. The recommendations outlined in the review are well thought out, have obviously considered feedback from participants and have the potential to improve the lives of millions of people. But for now, all we’ve got is ‘potential’. The next steps are equally important in getting the Federal, State and Territory Governments to agree to these recommendations, have the NDIA implement them unchanged, find qualified people to fill these important roles, and ensure client outcomes remain the goal while we do all the above. Potential can be a killer; however, potential can also be exciting. For the moment I am excited by this report and the vision of the NDIS it represents.