NDIA Accountability Project

This project is in DRAFT

Ministerial Brief for Noting

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Ministerial Brief for Noting

For: Minister for the National Disability Insurance Scheme

Support Coordination market reform

Key Issues:

On 5 July 2024, you met with Mr Dougie Herd, Executive Director of Community Connections to discuss his concerns regarding the current pricing arrangements for National Disability Insurance Scheme (NDIS) support coordinators. During the meeting you asked that the National Disability Insurance Agency (NDIA) investigate options and provide advice on the feasibility of a temporary loading for registered providers of level 2 and level 3 support coordination services. As foreshadowed in the release of the 2023-24 Annual Price Review (APR), and consistent with your request, the Agency is commissioning quality services for vulnerable participants. A key component we are now progressing is establishing a pilot of prequalified and quality providers. Finalisation of the pilot is subject to NDIS Board approval.

Recommendations:

That you:1) Note that the NDIA is establishing a pre-qualified and high quality support coordinator panel with a 4.75% price increase for level 2 and level 3 support coordination.

Decision:

Noted / Please discuss

Media Considerations: Yes

On 10 July 2024, the NDIA received a media enquiry from news.com.au seeking a comment on the “…300 providers that have pulled of offering support coordinators following the APR pay freeze” citing that their businesses were no longer viable. The Agency is currently drafting an op-ed for you outlining the rationale for not increasing support coordination prices in response to media and public criticism.

Signed by Minister:

Signature ………………………………… Bill Shorten ……./……./2024

Minister comments

                              OFFICIAL: Sensitive
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OFFICIAL: Sensitive

FOI 24/25-0208

MB24-000472

Cleared by: Penelope McKay, Deputy CEO Partners, Providers and Home and Living Group

Contact: Penelope McKay, Deputy CEO Partners, Providers and Home and Living Group

Signature: ………………………………………

Date cleared:

Sensitivity: Yes

  • Pricing and fees remain a sensitive issue for providers.
  • Providers which do not prequalify for the panel may feel the arrangements are inequitable.

Financial Impacts: No

  • There will be no budget impact as participant plans will not be increased to reflect the higher price paid to panel support coordination providers.
  • There is significant underutilisation of support coordination in participant plans. For the 12 months to 31 March 2024, the total annualised budget for support coordination was $1.41 billion while total payments over the same period was $1.05 billion.

Regulatory Implications: No

Consultation: No

Attachments:

  • Attachment A: Summary of support coordination panel pilot

OFFICIAL: Sensitive

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Background:

Support Coordinators

  1. Support coordination is a NDIS funded capacity building support which helps participants make the most of their NDIS plans and pursue their goals.
  2. Support coordination plays a key role in assisting NDIS participants who may have complex support needs or have additional complexity in their circumstances that impacts their capacity for effective use of their NDIS plans.
  3. The use of support coordination has been steadily increasing, with 46% of current NDIS participants utilising this support, and a 16% increase in payments for support coordination in the last year compared to the previous year.

Annual Pricing Review (APR) 2023-24

  1. The NDIA conducts an APR each year using a combination of market data, research, public consultation, and industry engagement to inform changes to pricing arrangements and price limits. The 2023-24 APR recommended that level 1 support coordination services be indexed, whilst payments under levels 2 and 3 remain at the existing price limits. The primary reason for maintaining existing limits was to constrain the growth in the support coordination market prior to changes in the delivery model as the NDIS Review recommendations are considered and implemented.
  2. The APR also found that 13% of support coordination services are being delivered below the current price limits and there is no evidence to suggest supply of services is not meeting demand.
  3. In terms of quality of services, participant feedback from APR consultation found that 63% expressed satisfaction while 22% of participants reported dissatisfaction, attributing their discontent with high costs, frequent changes in coordinators, and a lack of responsiveness, which sometimes led them to consider changing providers.

Financial implications of a temporary loading increase

  1. The agency has modelled the impact of applying a 3.75% indexation (i.e., National Minimum Wage increase for 23-24) to level two and three support coordination price limits.
Estimated impact of indexation Financial Year 2024-25
Registered providers +28m
Unregistered providers +6m
Total +34m
  • Estimates are based on increases to existing payments

Options to support quality providers in the support coordination market

  1. The NDIA acknowledges the need to retain quality providers in the support coordination market. There is evidence to suggest emerging risks in the quality support coordination services. The number of unregistered providers in the market has grown rapidly, with the proportion of registered providers decreasing from 79% to 42% between January 2021 and December 2023. In addition, the unregistered support coordination market seems to be dominated by smaller providers and sole traders, compared to the registered support coordinator market that is predominantly larger companies.

OFFICIAL: Sensitive

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OFFICIAL: Sensitive

FOI 24/25-0208 MB24-000472 9. The NDIS Review recommended establishing Navigators which would take on some aspects of support coordination, such as level 1 support connection. If such a reform is implemented, there will continue to be a need for quality providers to support participants with more complex needs.

  1. The NDIA Board approved a commissioning approach for quality services for vulnerable participants. This pre-qualified panel of quality support coordination providers is being piloted to improve the quality of support coordination services and retain quality providers in the market while future reforms are implemented (see attached for a summary of the recommended approach).

OFFICIAL: Sensitive Page 167 of 352

Ministerial Brief

Office: Minister for the National Disability Insurance Scheme
Subject: Transition to Future State of Navigators
PDR: MB24-000472
Critical date: N/A
History: Nil.
Consultation:
Contact officer: Penelope McKay
Deputy CEO
Partners, Providers and Home and Living Group
M: redacted
Comments: