Joint Standing Committee on the National Disability Insurance Scheme

Interim Report on Current Scheme Implementation and Forecasting for the NDIS

28 February 2022

                                                        104 Greenhill Road

Hon Kevin Andrews MP Unley SA 5061 Chair Joint Standing Committee on the National t: (08) 8373 8333 Disability Insurance Scheme f: (08) 8373 8373 PO Box 6100 Parliament House e: admin@purpleorange.org.au Canberra ACT 2600 w: www.purpleorange.org.au

Dear Hon Kevin Andrews MP,

Interim Report on Current Scheme Implementation and Forecasting for the NDIS

Thank you for the opportunity to comment on the Joint Standing Committee on the National Disability Insurance Scheme’s Interim Report of the Inquiry into Current Scheme Implementation and Forecasting for the NDIS.

We welcome the Committee’s interest in the long-term sustainability of the NDIS. We note that successive NDIS Ministers and the National Disability Insurance Agency (NDIA) itself have raised concerns about the projected Scheme costs. The various claims made have referenced Scheme and actuarial data, only some of which has been made public. This lack of transparency means it is extremely difficult for stakeholders to independently assess the veracity of the claims and counterclaims. This makes the role of the Committee to draw out and scrutinise the evidence extremely important.

Given this inquiry’s broad terms of reference, the complexity around the Scheme’s projected costs, and the potential consequences for people living with disability of any potential changes that may be ‘justified’ in terms of the sustainability issues raised, the Committee’s Interim Report seems to be missing much. At just nine pages and with a single recommendation, it is clear that the Committee still has a lot of work to do before releasing its final report. Therefore, we endorse the sole recommendation of the Interim Report that the Committee’s work continue in the next parliament.

However, we caution the Committee about the impact of the ongoing uncertainty and insecurity resulting from this, and other, drawn-out review or reform processes relating to the NDIS. People living with disability have told us that they feel fatigued by these ongoing issues and distrustful of those making decisions. It is essential that people living with disability are supported and involved in review processes and in planning and designing the way forward for the NDIS. While the NDIA has said it will embrace the principles of co-design, its efforts so far have fallen short of stakeholder expectations.

Below we draw the Committee’s attention to a number of important issues that we believe should be examined in more detail as part of this ongoing Inquiry.

• Choice and inclusion for people living with disability

Original assumptions failed to account for significant unmet need

While not directly addressing the question of future Scheme costs, we believe it is important that the Committee acknowledge that the original assumptions underpinning the 2011 Productivity Commission report did not fully reflect the significant levels of unfunded and unmet need that existed across Australia at that time. As such, this modelling is a problematic benchmark against which to continue to compare current and future Scheme costs. Yet, those 2011 predictions are often cited in the context of evaluating how the Scheme is tracking.

We believe that there is value in the Committee revisiting the 2011 modelling and evaluating its ongoing usefulness as the regularly cited benchmark for Scheme costs. This evaluation could also help provide valuable insights into how costs have actually tracked compared to the estimates, and where gaps existed then – and may still exist today – in terms of estimating needs and providing people living with disability the supports they require. Importantly, we think there is a risk that the 2011 modelling may have used costings that are skewed in favour of the known costs of support at that time. The dominant service models that produced those known costs were shared supports, such as shared living and shared day programming. As such, this means the Scheme’s financial sustainability is only achievable if it can produce that cost profile, especially for people with higher support needs. Indeed, we are already seeing this play out, where participants with higher support needs are being directed into shared supports. For example, some participants are being approved for SDA on the basis that they will share a dwelling and the supports therein.

In this way, the context for ‘reasonable and necessary’ changes from the values of control and choice, and of social and community participation, to the value of Scheme affordability based on assumptions of shared consumption. This is not how the Scheme was meant to be calibrated.

Tier 2

To date, it seems that the overwhelming focus of the NDIS has been on individual plans and budgets while the proposed Tier 2 supports have not received the same attention. We believe that this has had implications for Scheme costs, particularly in relation to accessing mainstream services and building community connections. The role of Local Area Coordinators (LACs) has principally focused on planning around individualised funding. People living with disability have told us that LACs are often not based in their local communities and do not have adequate knowledge to help them access mainstream services or make community connections. We also note that the extent to which mainstream services are available depends on a person’s location. Accessibility, affordability, and a lack of information to clearly identify options are additional barriers.

There remains insufficient attention to how best to design and commission the LAC role so that Tier 2 people and Scheme participants can choose their LAC, and be confident that that person knows their community well and can find the entry points for welcome and belonging.

Oversight of providers

We share the widespread concerns about the prevalence of non-compliance or inaccurate charging by providers within the Scheme currently. Common examples that we are aware of include the overcharging of provider travel (including charging multiple participants full travel costs for a day of face-to-face appointments at a location), unrealistic charges for ‘active’ support work of up to 24 hours where a participant’s circumstances suggest it is more likely that the overnight portion of a shift was mainly ‘passive’, and therapists inflating quotes or invoices when becoming aware a person has an NDIS plan.

These provider behaviours, among others, result in an unnecessary increase in Scheme costs.

While we firmly believe that providers and workers should always be paid properly for their work, the NDIS plans of individuals should not be whittled down by unjustified charges. We urge the Committee to consider what further oversight and accountability measures might help address this issue.

• 2. How the overwhelming focus of the rollout of the Scheme has been on individual plans and budgets to the detriment of Tier 2 community supports and utilisation of mainstream services, with specific attention needing to be given to the current approach regarding Partners in the Community and the need for LACs to be truly local
• 3. How the ILC program has a critical role to play in facilitating Scheme outcomes, yet its future, and that of those user-led community agencies currently funded through it, is deeply uncertain
• 4. How increased oversight and accountability of provider charges can help address costs and provide greater assurance that the Scheme is well managed
• 5. How the lack of transparency of data, particularly during the early years of the Scheme rollout, continue to hamper the ability of stakeholders to assess the veracity of claims and counterclaims about sustainability
• 6. How the Committee’s Inquiry can help facilitate a rebuilding of trust in the disability community by ensuring that the voices and concerns of people living with disability are heard and that Scheme information and data is shared with them in a transparent manner