Submission: Inquiry into current

current scheme implementation and

forecasting for the NDIS

By Zoe Mithen

NDIS Participant (Autism and Psychosocial disability)

As part of the committee’s role to inquire into the implementation, performance and governance of the National Disability Insurance Scheme (NDIS), the committee has decided to conduct an inquiry into

current scheme implementation and forecasting for the NDIS, with a focus on how the NDIS is implemented and funded, and what supports are or should be available for people with disability in addition to the NDIS.

Forecasting for the NDS

The irregularity of 2011-2013

The Irregularity of 2017-2021

NDIS Implementation

Tony Abbott’s Staffing Cap

Functional and Support Assessments

Forecasting for the NDIS

Last year I began researching cost estimates for the NDIS due to my concerns about the Independent Assessments.

I have noticed two big irregularities in cost forecasts for the NDIS, in 2011-2013 and in 2017-2021.

Both of these times were when the Government of the day wanted to do legislation relating to the NDIS.

The irregularity of 2011-2013

In 2011 the Productivity Commission handed down their report on the NDIS, which stated the NDIS would cost $13.6 billion per yesr at full scheme (when fully rolled out across Australiia).

However in February 2012 the Fair Work Commission handed down its SCHADS decision. The NDIS was heavily exposed to the SCHADS decision due to the reliance on NGOs to provide disability services.

Following the SCHADS decision the Treasury asked the Australian Government Actuary to update the NDIS cost forecasts. We know the Actuary’s updated cost forecast was $22 billion at full scheme because the Centre For Independent Studies did a FOI to obtain the figures and published them later in 2012 in a work called The New Leviathan: A National Disability Insurance Scheme by Andrew Baker now of DSS.

The Productivity Commission released a report on NDIS Costs in late 2017 which stated that the SCHADS decision had added $6.38 billion per year to the cost of the NDIS at full scheme. All other contributions to cost increases only added up to $2.02 billion.

It was only around 5 months after the Productivity Report on NDIS Costs was released that in around March 2018 the then NDIA CEO Rob de

Operation Greenlight

Luca started “Operation Greenlight” which was the start of the Independent Assessments project.

However politics came into play as 2013 was an election year and the Labor Government probably didn’t want criticism of the Fair Work Act and the pay rises in the SCHADS decision (which Gillard publicly applauded), so the Labor Government misled Parliament about the cost forecasts by giving cost estimates based on the 2011 estimates by the Productivity Commission.

I personally do not know how Treasury disseminates cost estimates to the Parliament. My best guess is Treasury — then overseen by Treasurer Wayne Swann — gives the Prime Minister and Cabinet the cost estimates, then the Prime Minister and Cabinet are meant to tell the other Government MPs and Senators the cost estimates, and finally the Government is meant to tell Parliament the cost estimates.

Instead Gillard introduced the NDIS Bill on 29th November 2012, there was no debate that I could see and the matter was paused for the Christmas holidays, in 2013 there was the Second Reading Debate which is available to read on Hansard and I looked at every speech.

The February 2013 Bills Digest stated that the NDIS would cost “under $14 billion” referring to the outdated 2011 estimates.

I do not know how the Bills Digest authors get their information, but I presume from Department of Prime Minister and Cabinet.

Of the Cabinet only Gillard herself and Jenny Macklin spoke in support of the NDIS Act in Parliament. All of the other Cabinet Ministers refrained from speaking in support of the NDIS. LNP MP Paul Fletcher spoke in the Second Reading Debate and stated figures he had seen from Centre For Independent Studies said that the NDIS would cost $22 billion.

Immediately after Fletcher’s speech ALP MP Ed Husic spoke and stated the NDIS would cost only “$15 billion”, again referring to the outdated 2011 estimates.

• These were the only mentions of the cost of the NDIS at full scheme, other than Independent Andrew Wilkie who spoke and said that it didn’t matter what the NDIS cost it was a good idea.

-I do not know why the Opposition did not follow up the cost issues, other than because it was an election year, and they may have looked hard hearted and lost votes.

-I have reported this to the Committee of Privileges and Members Interests but they won’t keep me updated on the investigation and they would not update the staff from my local Federal MP Lisa Chester’s office either.

-The Irregulaity of 2017-2021

The NDIS cost estimates have been going up hugely the last couple of years as the NDIA and the Morrison Government have tried to impose Independent Assessments on us, and we are not being given enough information about the modelling to ask professionals if the modelling is good. would need more information to be able to analyse the cost estimates.

If we look at the Forward Estimates in the 2020-21 Budget and the 2021-22 Budget we see a substantial increase, and there is an even greater increase when we include cost estimates from the 2017 Productivity Commission Report into NDIS Costs, and the NDIA 2021 Financial Sustainability Report.

2017 Productivity Commission Report

Sustainability Report 2021

Year	NDIS Expenditure (in billions)
$2019-2020$	$$22.3 Billion$$
$2021-22$	$$25.448 billion$$: $$28.115 billion$$: $$29.223 billion$$
$2022-23$	$$25,615 billion$$: $$29.835 billion$$: $$33.886 billion$$
$2023-24$	$$25.706 billion$$: $$30.796billion$$: $$37,973 billion$$
$2024-25$	$$30.6 billion$$: $$33.320 billion$$: $$41.373 billion$$
$2029-30$	$$40.9 billion$$: : $$59.284 billion$$

As existing NDIS participants we are going to be affected by any attempts to reign in costs, or by the costs getting out of control, yet we are not being enagaged in discussions about the costs or given sufficient information to know if these models are correct.

If the 2017 Productivity Commission Report is almost $20 billion wrong in its estimate for 2030 then how do we know that the NDIA Actuary’s 2021 esimate for 2030 is right?

Why are the Forward Estimates in the 2020-21 Budget and the 2021-22 Budget significantly different when less than a year had passed between these Budgets?

When we look at the NDIS website they repeat the word “could” — “could grow”, “could be”, “could reach”.

NDIS expenditure could grow to $40.7 billion in 2024-25 which is $8.8 billion above the current Portfolio Budget Statement estimates

NDIS expenditure could be $22.6 billion higher than the Portfolio Budget Statement estimates over the four years from 2021-22 to 2024-25.

Participant numbers could reach 682,760 at 30 June 2025 and 870,761 at June 2030, compared to the Productivity Commission estimates of 582,860 at 30 June 2030.

How much certainty is there in these models?

Concerns Regarding Participant Projections for Autism

I am also concerned about the participant projections, particularly the ones for autism as a primary disability.

I have autism level 2 and schizoaffective disorder and delusional disorder, my primary disability for NDIS is psychosocial, with autism being my secondary disability.

The Actuary is saying that in 2021 there are 146,412 participants with autism as a primary disability, but that in 2030 (less than 10 years away) there will be 339,035 participants with autism as a primary disability.

This does not make a lot of sense considering the autism prevalence.

WHO estimates 1 in 160 children worldwide has autism.

estimates 1 in 70 Australians have autism.

The CDC estimate 1 in 54 children in the US have autism.

Australia has a population of 25.69 million.

If the autism prevalence is 1 in 160 that’s 160,562.5 Australians who have autism.

If the prevalence is 1 in 70 367,000 Australians have autism.

If the prevalence is 1 in 54 475,740 Australians have autism.

So the idea that there will be 339,035 NDIS participants with autism as a primary disability in 2030 only makes sense if the highest prevalence of autism is right, 1 in 54.

If its 1 in 70 it would mean almost 100% of Australians with autism become NDIS participants.

But we know that most adults with autism are not in the NDIS, and in fact many adults with autism are still undiagnosed because the diagnostic criteria was different when they were growing up.

• So does the Actuary expect most adults with autism will get a diagnosis and apply for the NDIS in the next 8 years?

• Or where is this figure coming from?

NDIS implementation

tony abbott’s staffing cap

Tony Abbott’s staffing cap has totally distorted the design of the NDIS by the Productivity Commission in 2011. We were meant to see an NDIA delegate to do our planning meeting and assessment. The LAC’s were not meant to do our planning meetings, the LACs were meant to improve the community’s accessibility for all disabled people, including NDIS participants, but also disabled people who are not NDIS participants. Due to the NDIA staffing caps the LACs are almost entirely focused on planning meetings, and are not making our communities more accessible hardly at all. Because of this we have lost Tier 2 of the NDIS, which was for disabled people who are not eligible for the NDIS, and now they have hardly any help. This has also caused a cost issue because we need more funding if our communities are not accessible. Some things I like using my funding on are yoga and art classes in my community. I live in a small town and it has been good for several NDIS participants here to use their funding to do local mainstream classes with a range of other people. LACs could try and promote this sort of thing, but they don’t.

Functional and Support Assessments

I think the NDIA needs to fund university researchers to develop a psychosocial disability functional assessment, as this doesn’t exist anywhere in the world.

There are tools like LSP and WHODAS but they are hopeless for mental illnesses like mine with a huge range of symptoms, medication side effects, fluctuations.

I feel like the NDIS has been very unfair for me since I was incredibly non-functional when I got NDIS in 2017 because I had Delusional Disorder from 2013-August 2018 but my NDIS plan was only $40,000 and they didn’t give me support coordination even though I was totally crazy, I couldn’t spend hardly any of my funding and the next year they cut my funding to $25,000 which is all I had when I was trying to recover from my 5 years of Delusional Disorder and they still didn’t give me support coordination so for the first 6 months I was too fragile to spend hardly anything and had to spent it in the last 6 months, then I got support coordination but they only put my plan up to about $33,000 per year for 2 years, and then we got Covid. I was finally able to have the energy and concentration to get OT reports, and first the NDIS said the first OT report wasn’t good enough, and then with the second OT report they didn’t take hardly any notice of it and increased my funding to only $55,000 per year for 2 years without meal deliveries or personal training which I need for my medication associated weight gain. It is so unfair because I have incredibly serious mental illnesses and have been hospitalised a lot over the years, plus autism level 2 as well, and I know people with less severe mental illnesses who get much more funding than me.

I think because there is no psychosocial functional assessment the funding you get just depends on which LAC and delegate you get, and if they happen to feel sympathetic to you or not. They shouldn’t just ignore the OT reports, but they do.

It is so unfair.

Now I have to go to the AAT and see if they will increase my funding and give me meal delieveries (which I only use occassionally for around

$1000 per year when I have symptoms or exhaustion), and personal training because my medication makes me morbidly obese and my life expectancy is 53 due to my mental illness and medications and I am 43 now already.

So those are some of my personal comments about my NDIS funding.

Overall I am grateful to have NDIS though because it is better than what I had under the mental health system before, because they hardly provide anything.

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