Australian Government

National Disability Department of Social Services Insurance Agency

Ref: MS21-000749

The Hon. Kevin Andrews MP Committee Chair Joint Standing Committee on the National Disability Insurance Scheme PO Box 6100 Parliament House CANBERRA ACT 2600

Dear Mr Andrews

Thank you for your letter of 25 October 2021 inviting a supplementary submission to the Joint Standing Committee on the National Disability Insurance Scheme (NDIS) inquiry into General issues around the implementation and performance of the NDIS.

The Department of Social Services (the department) and the National Disability Insurance Agency (NDIA) welcome the opportunity to provide an update to the committee further to the Government Response provided in May 2021.

Please find attached a supplementary submission for the committee’s consideration. Thank you for the opportunity to contribute to this inquiry.

Yours sincerely

Ray Griggs AO CSC Martin Hoffman Secretary CEO Department of Social Services National Disability Insurance Agency [Jrovember 2021 19 November 2021]

GPO Box 9820, Canberra ACT 2601 « Tel (02) 6146 0010 « Facsimile (02) 6204 4505 Internet www.dss.gov.au

Joint Standing Committee on the National Disability Insurance Scheme Inquiry into General Issues around the implementation and performance of the NDIS

Department of Social Services and the National Disability Insurance Agency Joint Supplementary Submission

The National Disability Insurance Scheme (NDIS) is a significant social reform that represents a unique opportunity to deliver life changing supports nation-wide for eligible people aged under 65 with permanent and significant disability, their families and carers. The Department of Social Services (DSS) and the National Disability Insurance Agency (NDIA) are committed to the ongoing improvement and performance of the NDIS.

This supplementary submission addresses the Committee’s request for an update on the following matters:

Vaccines for NDIS participants and people with disability and the disability support workforce
Changes to Operational Guidelines
Forthcoming amendments to the NDIS Act and Rules and the consultation period
Reforms to plan management
Reforms to Supported Disability Accommodation
The NDIA’s co-design process
Updates on the Government’s position on assessments following confirmation that the Government would not proceed with independent assessments in their form proposed
New national disability strategy
Advocacy funding
Culturally and linguistically diverse and refugee background participants
Review of the quality and safeguarding framework
NDIA pricing projects/reviews
ILC grants review
Younger People in Residential Aged Care Strategy 2020-2025 implementation

JOINT DSS - NDIA RESPONSE

Increased vaccination for NDIS participants and people with disability and the disability support workforce

NDIS participant (data as at 10 November) and Disability Support Pension recipient (data as at 8 November) vaccinations Since early June, there has been a substantial uplift in vaccination rates of NDIS participants with more than 195,776 additional participants having received at least one dose.

Nationally, 84.7 per cent of NDIS participants in shared disability accommodation have had at least one dose and 80.2 per cent are fully vaccinated. In jurisdictions that have had significant community transmission (NSW, Victoria and ACT), vaccination rates are higher, with over 84 per cent fully vaccinated and 88 per cent or higher having had at least one dose.

For NDIS participants aged 16 and older, 80.7 per cent have had at least one dose and 72.5 per cent are fully vaccinated. In NSW, Victoria and the ACT rates are again higher, with over 82 per cent fully vaccinated in NSW and the ACT and over 77 per cent fully vaccinated in Victoria.

For Disability Support Pension (DSP) recipients aged 15 years and 9 months and over, the vaccination rate is broadly similar to the NDIS participant group with over 68 per cent are fully vaccinated and more than 79 per cent having had at least one dose.

With a significant proportion of the NDIS and DSP population now fully vaccinated or awaiting their second dose appointment, the task is a more localised one. The Commonwealth is working actively with each state and territory and the sector to activate localised options for those who haven’t yet taken up opportunities to get vaccinated and to support those with complex requirements. This includes, for example, working through issues around availability of clinically-supported sedation during vaccination and re-offering opportunities to those in residential settings who declined an initial offer, including working with alternative decision makers.

On 18 October 2021, the Australian Government commenced sending DSP recipients or their nominee a text message advising them of support available, and if they need it, direct assistance to book a vaccination through the Disability Gateway. This initiative will continue until all DSP recipients and their nominees that have a valid mobile number available have been contacted. Over 280,000 text messages have been sent to date.

There are now more than 10,000 vaccination sites available for people with disability and disability support workers to access across Australia, including 4,500 General Practitioners (GP), 3,600 community pharmacies, Aboriginal Community Controlled Health Organisations (ACCHOs), Commonwealth vaccination clinics, disability- specific vaccine hubs and 600 state and territory operated vaccination clinics.

There has also been considerable direct engagement effort by the NDIA. For example, in targeted locations where vaccination rates are low, the NDIA’s Partners in the Community organisations are reaching out to participants offering to coordinate and book vaccine appointments including transport and support, and using capacity building arrangements to address vaccine hesitancy and misinformation.

The NDIA has conducted an outbound call campaign to registered providers within the vicinity of the Commonwealth vaccination hubs to raise awareness of the hubs, confirm the supports available from the NDIS and identify any barriers providers may be experiencing.

To further encourage vaccinations, the NDIA is providing a temporary national support payment of $150 per participant for eligible NDIS providers to help participants book and attend an offsite vaccination location.

Disability support workers vaccinations (as at 10 November) Since the end of June, there has also been a substantial uplift in vaccination rates of NDIS screened workers with more than 165,228 additional workers having received at least one dose.

Over 84.7 per cent of NDIS screened workers have already received one dose of a COVID-19 vaccine and over 79.2 per cent are fully vaccinated. Rates are higher in those jurisdictions that have had outbreaks and rapidly increasing with the introduction of mandates.

All jurisdictions now mandate that workers delivering disability supports in person to NDIS participants must not enter or remain in a place of work unless they have had at least one dose of the vaccine, or have been issued a medical contraindication certificate. The commencement timing and specific parameters around the mandate are different for each jurisdiction. Additionally, on 5 November 2021, National Cabinet endorsed an Australian Health Protection Principal Committee recommendation of mandatory vaccinations for disability workers providing intensive supports to NDIS participants.

Eligible providers in all jurisdictions can also claim a one-off payment from the NDIA to cover costs for support workers to receive their COVID-19 vaccination. The payment of $100 per worker per dose, can be claimed retrospectively for any vaccinations that a worker has received since the date of announcement of mandatory vaccination.

To encourage uptake of COVID-19 vaccines, disability support workers have also been afforded priority for appointments.

COVID-19 vaccine booster dose The Australian Government announced on 28 October 2021 that a booster dose, commencing 8 November 2021, is now available for people aged 18 and over who have had their second dose of a COVID-19 vaccine more than six months ago.

For people with disability, the booster dose is available through several channels, including an in-reach program delivered in shared residential accommodation settings, dedicated disability hubs, GP clinics, pharmacies Commonwealth vaccination clinics, and state or territory vaccination clinics. The initial focus of the COVID-19 booster vaccinations is on residential aged care and disability facilities.

Further information on the booster dose for people with disability and disability providers has been added to the Department of Health’s web page at: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/disability-sector/service-providers

The Australian Technical Advisory Group on Immunisation (ATAGI) has also recommended a third dose of a COVID-19 for people aged 12 or older, who are severely immunocompromised. ATAGI are recommending this third dose be given between 2-6 months after the second dose. This is available through all of the same channels.

Improvements to NDIS Operational Guidelines

The NDIA is reviewing all operational guidelines to make them clearer and easier to understand. The guidelines, referred to as ‘Our Guidelines’, are now written in plain English and include more information about how the NDIA makes decisions. The new format and structure were designed based on feedback from participants, and set out the NDIA’s decision making processes in a simple, logical way for both participants and staff, as well as providing practical examples and explanations for supports the NDIS does and does not fund. As part of the agency’s commitment to transparency these guidelines, which the front-line staff use to assist with decision-making, are also published in the public domain.

The guidelines form part of the NDIA’s commitment to providing a quality experience and improved outcomes for participants, in line with the Corporate Plan 2021-25 and Participant Service Improvement Plan (PSIP), with all guidelines to be updated and rewritten into Plain English by mid-2022.

Since July 2020 the NDIA has published the following guidelines on the NDIS website:

Reasonable and necessary supports
Creating your plan
Your plan

Assistive technology
Supported independent living
Specialist disability accommodation
Short term accommodation or respite
Medium term accommodation
Independent living options
Younger people in residential aged care
Justice system
Social and recreation
Work and study
Early childhood
Plan reviews
Reviewing our decisions

Feedback from participants indicated they wanted more clarity around whether specific supports would be considered reasonable and necessary. In response to this feedback, the NDIA has published a ‘would we fund it’ guide. This guide provides examples of commonly requested supports indicating situations where these would be more likely, or less likely, to be supported.

These materials are the most popular set of webpages – over 319,000 views in financial year 2020-21, and receive 70 per cent “thumbs up” from website feedback.

Further information is available on the NDIS website: https://ourguidelines.ndis.gov.au/

Bill to amend the NDIS Act, associated Rules

Development of amendments to the NDIS Act The National Disability Insurance Scheme (Participant Service Guarantee and Other Measures) Bill 2021 (the Bill) was introduced into Parliament on 28 October 2021 and has been referred to the Senate Community Affairs Legislation Committee for inquiry and report.

To support the committee’s inquiry, DSS and the NDIA recently provided a joint submission to the committee on the Bill and appeared before the committee on 12 November 2021. The joint submission provides an explanation of the amendments to the NDIS Act and the NDIS Rules. A copy of that submission is attached to this submission (Attachment 1).

Improving the participant experience

Participant Service Charter The Participant Service Charter sets out what participants can expect from the NDIA. It provides overall principles for the way the NDIA interacts with participants and details clear service standards and timeframes. Service standards are defined in the Service Charter through five engagement principles. The Agency works to ensure that every interaction with a participant is transparent, responsive, respectful, empowering and connected.

Participant Service Improvement Plan The PSIP is the key to making real the NDIA’s promises in the Participant Service Charter and Participant Service Guarantee. It reflects the feedback participants have given the NDIA and sets out specific and tangible commitments the Agency will use to build a better NDIS. The NDIA is also focusing on making digital services easier and more efficient for participants, staff and service providers. Future improvements will include tracking an access request online and making payments easily through a new mobile app. In the past 12 months, the NDIA has fully implemented 16 commitments and started implementing another 23. A full list of the commitments and the Agency’s progress towards achieving each of them can be found on the NDIS website: www.ndis.gov.au/about-us/policies/service-charter/participant-service-improvement-plan

Reforms to plan management

The Bill and proposed changes to the National Disability Insurance Scheme (Plan Management) Rules contain amendments relating to plan management.

Details of these changes were provided in the recent joint submission by DSS and the NDIA on the Bill. Attachment 2 to this submision provides the explanatory memorandum to the Bill, which details the changes regarding plan management.

There has been a significant shift in plan management, with an increasing number of participants choosing to use a plan manager (51 per cent as at 30 September 2021) rather than have the NDIA manage their plan (18 per cent as at 30 September 2021, down from 43 per cent two years ago).

Self-Management To assist a growing proportion of some participants self-manage their plans, the NDIA has refocused on making it easier to self-manage plans, with appropriate data sharing, support and controls in place. the NDIA is currently reviewing its guidance, systems and processes to develop a Self-Management Policy. The Policy will promote a simple, effective and consistent approach to self-management that improves outcomes for participants and their experience with the NDIS. The NDIA is working closely with an External Reference Group that includes members of the Independent Advisory Council (IAC) and participants to develop the Self- Management Policy.

The NDIA has released a mobile app to allow self-managed participants, their nominee or child representative to make claims and better manage their NDIS budget. The app, known as, my ndis app, is designed to reduce the administrative burden on participants, making self-management a more viable option for more participants. The NDIA staggered the release of the app, starting with the public release of the Android version late August 2021, with the iOS version being launched late October 2021. Already, as at the start of November 2021 over 2,000 participants have used the app. Over 800 users have made 2 claims per week on average. Usage is growing by 15 per cent every week, and our app store feedback is greater than 4.5 out of 5.

The NDIA is also progressing work to develop a new point of support payments system as an additional claims method to provide participants increased choice and control over how they pay for supports funded by the NDIS. This option will provide another optional tool to reduce the administrative and financial burden on participants, and further support them to self-manage their plans if they choose to do so.

Plan Management In October 2020 the NDIA released the NDIS Guide to Plan Management (the Guide). The Guide gives clear information on how plan management supports a quality experience and improved outcomes for participants. Release of the Guide is a first step in a longer process of improving plan management services.

The NDIA is working closely with the sector to clarify expectations of plan managers when ensuring NDIS funds are spent in accordance with the participant’s plan.

Supporting improvements to Supported Disability Accommodation

Funding for Supported Disability Accommodation (SDA) housing is provided to NDIS participants who meet specific eligibility criteria. SDA funding is not for support and care services, but is instead for the homes in which these services are delivered.

Well-designed accommodation in the right location can allow for more independent living arrangements, increased community connection and access to informal supports. For those participants who are eligible for SDA, it is important that suitable properties are available in local communities across the country.

As at 30 September 2021 there were 6,561 enrolled SDA dwellings (excluding in-kind arrangements), an increase of 337 on the previous quarter. There were 16,347 active participants with SDA supports, with approximately $214 million in annualised SDA supports in their plans.

The NDIA is responsible for the stewardship of a market of NDIS providers who deliver SDA to eligible participants. Over recent years, the NDIA has implemented a number of initiatives to drive growth, innovation and sustainability in the SDA market, including:

SDA Design Standards
the SDA Limited Cost Assumption review and following changes to the SDA Rules in March 2020
refresh of the SDA Reference Group terms of reference and membership in March 2021
updates to NDIS Pricing Arrangements for Specialist Disability Accommodation 2021-22 on 1 July 2021 and as outlined in the SDA Pricing and Payments Framework, a review of SDA pricing will occur every five years starting in 2023 release of the SDA Market Statement in August 2021
introduction of the SDA Finder in August 2021
introduction of an SDA Quarterly data report in September 2021.

SDA Design Standards The SDA Design Standard mandatory application came into effect on 1 July 2021 and is required for all newly built SDA properties. Further information is available on the NDIS website: www.ndis.gov.au/providers/housing-and-living-supports-and-services/specialist-disability- accommodation/sda-design-standard

SDA Reference Group The SDA Reference Group terms of reference and membership has been refreshed and a new term commenced in March 2021. The first meeting for 2021 was held on 19 April with the second having taken place on 26 October 2021. The group will continue to advise the NDIA on SDA market development, with a strong focus on participant involvement.

SDA Roundtables The Minister for the NDIS, Senator the Hon Linda Reynolds CSC, hosted a number of SDA roundtables. The roundtables have provided a forum for housing providers, investors, peak bodies, and participants living in SDA properties on what is working well, and what issues the sector and participants are facing. This ongoing market engagement is helping inform a considered approach to address issues with SDA and housing for NDIS participants.

Changes to NDIS Pricing Arrangements On 1 July 2021 the NDIS Pricing Arrangements for Specialist Disability Accommodation 2021-22 (previously the Price Guide for Specialist Disability Accommodation) was updated to reflect changes in SDA indexation of price limits. Changes effective from 1 July 2021 were:

increase by 1.1% to price limits for SDA
increase by 1.1% to refurbishment thresholds
SDA price limits updated to reflect movement in the Consumer Price Index.

Changes also incorporated making the SDA Design Standard mandatory for New Builds and New Build (refurbished) dwellings from 1 July 2021. Since February 2021 SDA dwelling enrolments have been undertaken online which provides a better experience and greater visibility for SDA providers seeking enrolment.

SDA Market Statement The NDIA released the first SDA Market Information Statement in August 2021. The release of the Statement reflects the NDIA’s commitment to provide the SDA market with the information it needs to foster continued growth for a market that delivers quality, innovative SDA for participants and important national infrastructure. The 2021 Statement provides a high-level overview of SDA growth opportunities and risks. A copy of the market statement is available here: www.ndis.gov.au/media/3489/download?attachment

SDA Finder On 31 August 2021 the NDIA launched the SDA finder, an online tool for searching available vacancies, which provides better visibility of existing SDA supply and improves pathways for eligible participants to connect with SDA providers. SDA ‘demand’ and ‘supply’ data is now published in quarterly reports to disability ministers at the Statistical Area 3 (SA3) level, allowing more granularity to be viewed in the data. Further details are on the NDIS website at: www.ndis.gov.au/participants/home-and-living/specialist-disability- accommodation-explained/sda-finder

The NDIA will continue to engage with stakeholders through the SDA Reference Group to gather feedback on the market information being released and ways in which these can be further enhanced for the benefit of the market.

SDA Quarterly Data Report A new report, the Specialist Disability Accommodation Quarterly data report was released on 30 September 2021 to help providers gain valuable insights into the current market and assist to steward market growth opportunities in the housing sector. This report shows that since the March 2021 quarter, there has been a 23 per cent increase in New Build SDA. The report also highlights that over the past 18 months there has been a significant growth in SDA designed for high physical support. The SDA Quarterly Data Report is available on the NDIS data and insights website: https://data.ndis.gov.au/reports-and-analyses/market-monitoring#specialist-disability-accommodation-sda-quarterly-report.

The NDIA’s co-design process

The NDIA is working closely with stakeholders to embed co-design in the NDIA’s engagement approach. The IAC, along with 27 Disability Representative and Carer Organisations (DRCO), participated in two virtual co- design workshops in September 2021. The workshops were held following a decision by disability ministers in July 2021 to not proceed with the proposal for independent assessments.

The NDIA acted on advice from the IAC to strengthen relationships and build trust with the disability sector, and respond to the Terms of Engagement provided by the disability sector to Minister Reynolds in June 2021.

The workshops were an opportunity to develop a constructive working relationship between the NDIA, the IAC and DRCOs and to begin co-design and prioritise topics for co-design. Specifically, the workshops brought together the IAC, 27 DRCOs, DSS, NDIA board members and senior executives.

Former Disability Discrimination Commissioner Graeme Innes facilitated both workshops, supported by facilitators from the disability community.

Workshop discussion topics Workshop attendees discussed how to build mutual trust, how to strengthen the relationships between the disability community and the NDIA, and a range of priorities for changes and improvements to the NDIS.

This included the topics the NDIA, the IAC and the disability sector have been asked to work on by disability ministers, and how the NDIA could start working towards co-design. Workshop attendees discussed how the NDIA could establish a co-design framework based on a “learn by doing” approach, agree on key principles of co-design and terms of engagement. The NDIA committed to learn from the past and engage constructively with the disability community in future.

Outcomes of co-design workshops Workshop attendees acknowledged:

the need to improve relationships and build trust between the NDIA and the disability community
the shared commitment to work towards better outcomes for people with disability and to improve Scheme processes
the need to better understand interactions among the range of issues faced by people with disability, sector organisations and the Scheme, and how they can be jointly resolved

the need to work together to better understand the issues the Scheme is facing, including financial sustainability, from all stakeholder perspectives
the shared commitment to immediately work on priorities which would benefit from co-designed solutions such as a new person-centred assessment model as well as ending segregation for people with disability and strengthening community inclusion
the focus on a range of improvements to the operations of the NDIS
the need to recognise and respect the importance of diverse views, experience and contributions made by the Scheme, DSS, the IAC and disability and carer representative organisations; acknowledging:
- DRCOs as legitimate representatives of participants and families/caregivers
- the IAC’s statutory role to advise the NDIA Board as outlined in the NDIS Act, including their appointed experts among which are people with disability, families/carers and service providers
- the NDIA as the statutory authority responsible for delivering the NDIS in accordance with the Act
- DSS as responsible for the NDIS legislation, for the Information Linkages and Capacity Building program, and the broader Australian Disability Strategy.
the importance of regular and accessible communication with participants, families and carers as well as state, territory and local community groups and networks and provider networks, to inform and enable involvement
the importance of agreement about the governance of the relationships and the processes used in any joint work between the sector and the NDIA
that these co-design workshops were a first step in developing better ways of working together to benefit participants and the Scheme. There is more to do.

Next steps

Co-design advisory group Leaders from the IAC and the DRCOs selected representatives to form the co-design advisory group. The advisory group started to meet on 15 October 2021 and are meeting fortnightly to provide strategic advice on the implementation and topics which should be prioritised for co-design.
Confirm co-design priority work NDIA representatives will work with a co-design advisory group to establish initial co-design priority work, for consideration by the broader disability sector. An Engagement Framework and roadmap of activities is expected to be share with the disability sector for feedback and published by the end of 2021.
Information updates The NDIA, the IAC and DRCOs will agree on a regular schedule to inform the disability community of co-design topics and progress, and advise any key issues requiring wider consultation.

Further details on the NDIA’s work towards co-design is available on the NDIS website: www.ndis.gov.au/community/working-towards-co-design

Updates on the Government’s position on assessments following confirmation that the Government would not proceed with independent assessments in their form proposed

Future co-design of a new person-centred assessment model At the 9 July 2021 Disability Reform Ministers Meeting (DRMM), disability ministers agreed independent assessments would not proceed, and agreed to work in partnership with people with disability on the co- design of a new person-centred assessment model.

As outlined above, the NDIA is working with DRCOs, and the IAC to explore and establish an approach to co-design with people with disability, for example drawing on approaches taken for the new national disability strategy. The

department also supports this work. Specific work on the new person-centred assessment model will begin after the outcomes of more general discsussions on how co-design should be undertaken have been agreed with the sector.

New national disability strategy

The new strategy,The, to be called Australia’s Disability Strategy 2021-2031 (the Strategy), is currently with state and territory first ministers for endorsement, having already been endorsed by disability reform ministers, the Australian Government and the Australian Local Government Association. Subject to this endorsement, the Strategy is expected to be launched later in 2021. The Strategy was developed by Australian, state, territory and local governments, through more than two years of engagement with people with disability, their families, carers and representatives.

The Strategy is Australia’s national disability policy framework. It builds on the National Disability Strategy 2010-2020 and sets out a plan for continuing to improve the lives of people with disability in Australia over the next ten years.

Advocacy funding

Currently the Commonwealth and states and territories all fund disability advocacy.

In 2020 South Australia committed funding for disability advocacy for the first time since 2007. South Australia described this as a short term measure to continue the role of their Disability Advocate and to fund community legal centres to support vulnerable people with the risks presented by COVID-19. The current Commonwealth annual commitment for 2021-22 is approximately $56 million.

At the 13 December 2019 meeting of the former Disability Reform Council, all states and territories, with the exception of South Australia, agreed funding of independent disability advocacy is a joint responsibility of the Commonwealth and states and territories.

The Commonwealth led a demand and gap analysis of independent disability advocacy and decision-making supports supported by all states and territories. The outcomes of the project were reported to Disability Ministers in February 2021.

The Commonwealth is working with states and territories to address the following recommendations in the report:

develop a national approach to the funding of disability advocacy and an advocacy outcomes framework
address identified gaps impacting the delivery of independent disability advocacy through action plans, aligned with the Strategy
articulate governments’ shared commitment to disability advocacy within the framework of the Strategy, to ensure independent advocacy is recognised as a mechanism to promote rights, participation and system improvement for people with disability.

National Disability Advocacy Program The Commonwealth’s National Disability Advocacy Program (NDAP) provides people with disability with access to effective disability advocacy that promotes, protects and ensures their full and equal enjoyment of all human rights enabling community participation. Under the NDAP program 59 advocacy organisations across Australia are funded. In 2021-22, funding for the NDAP program was $24.2 million.

NDIS Appeals The purpose of NDIS Appeals is to ensure all people with disability, and others (such as parents and carers) affected by reviewable decisions of the NDIA, have access to support when they are seeking review of those decisions in the Administrative Appeals Tribunal.

There are two main types of assistance available via NDIS Appeals:

access to a skilled advocate who acts as a support person
access to legal services - where there is wider community benefit and/or disadvantage that would substantially benefit from legal representation

These supports are delivered by 42 advocacy organisations and eight Legal Aid Commissions across Australia and are free for those who call on them.

Disability Representative Organisations The Disability Representative Organisations (DROs) program provides the capacity for all people, and their representative organisations, to have their views communicated to the Government, regardless of type of disability, gender, cultural background, age or membership.

DRO’s undertake valuable systemic advocacy work as they provide advice to the Government on breaking down barriers and improving social and economic participation and engage with a range of ministers and portfolios. In 2021-22 DSS provided $1.85 million in funding to six DROs:

Children and Young People with Disability Australia
Disability Australia Consortium, which is made up of:
- Australian Federation of Disability Organisations
- Autism Aspergers Advocacy Australia
- Blind Citizens Australia
- Brain Injury Australia
- Deaf Australia
- Deafblind Australia
- Deafness Forum of Australia
- Disability Advocacy Network Australia
- Down Syndrome Australia
- The National Mental Health Consumer and Carer Forum
- Physical Disability Australia
First Peoples Disability Network Australia
National Ethnic Disability Alliance
People with Disability Australia
Women with Disabilities Australia.

Culturally and linguistically diverse and refugee background participants

Advocacy representing people with disability from a CALD background The department has provided $300,000 in funding to the National Ethnic Disability Alliance in 2021-22 to provide systemic advocacy representing people with disability from a culturally and linguistically diverse (CALD) background. In addition, three NDAP providers who receive funding specialise in providing advocacy to CALD clients, Multicultural Disability Advocacy Association of NSW Inc., Action on Disability within Ethnic Communities Inc. (VIC), and Kin Advocacy (WA).

NDIS Cultural and Linguistic Diversity Strategy The Cultural and Linguistic Diversity Strategy 2018 (the CALD Strategy) is the NDIA’s public statement of commitment to working alongside people with disability from CALD backgrounds to achieve access to, and outcomes from, their NDIS Plan on an equal basis with the broader population.

The CALD Strategy sets priority areas for action focussed on building connections and positive relationships with CALD communities, broadening choice and control, and increasing cultural competency within the NDIA and its Partners. As at 30 September 2021 the NDIS was funding supports for 44,485 people with disability who identify as having a CALD background (which is 9.2% of all participants compared with an expected percentage of 18.9 per cent. Work was undertaken to better understand the reason for this difference – specifically, whether a number of CALD people are yet to join the NDIS, or whether the NDIS is under- reporting the number of CALD participants in the Scheme based on the data collected on country of birth and

main language spoken at home.). NDIA analysis implies that it is likely that CALD participants are joining the Scheme but have not been identified as CALD in the data collected.

With the introduction of the NDIA’s new ICT system, the opportunity to collect improved data on participants should allow better identification of CALD participants. Further details are in the Quarterly report to disability ministers for the period 1 July 2021 to 30 September 2021 available on the NDIS website: www.ndis.gov.au/about-us/publications/quarterly-reports

On 30 July 2021 the NDIA released a progress update on the NDIS website on the CALD Strategy, detailing progress against the priorities identified in the strategies and actions to further drive the implementation of the strategy over the next 18 months.

The NDIA will commence engagement in late 2021 with CALD stakeholders, including participants, families, carers and the sector to develop refreshed Strategies, which will be completed in 2022. This engagement will help to drive improved outcomes for cohorts that may experience difficulty accessing the NDIS and utilising supports, and will contribute to the NDIA’s broader engagement with the disability community, including through the co-design process.

NDIA pricing projects/reviews

Annual NDIS Price Review The NDIA is currently conducting the Annual Pricing Review 2021-22. This annual review identifies the need for possible changes to price limits and pricing arrangements for NDIS supports based on market trends, provider costs and other market factors.

The NDIA is currently consulting with participants, providers, community and other sector representatives – a public consultation paper has been released at: www.ndis.gov.au/providers/pricing-arrangements/making- pricing-decisions/annual-pricing-review. Submissions are due by 28 November 2021.

Pricing and Payment project The Australian Government committed to undertake a pricing project to consider approaches to improve the effective operation of the NDIS market as part of the full scheme bilateral agreements with Victoria and Queensland. The department is planning to release a consultation paper to seek views of the sector (participants, providers and peak bodies) and the community on ways to improve the pricing and payment approach for the NDIS over the longer term. Timing for this consultation process is yet to be determined.

Review of the quality and safeguarding framework A review of the NDIS Quality and Safeguarding Framework is scheduled to commence in 2021-22. The review will examine the early implementation of the Framework and its effectiveness in order to identify any further areas for adjustment.

ILC grants review DSS has been reviewing the Information, Linkages and Capacity Building (ILC) program since it transferred from the NDIA in 2020. The purpose of the review is for DSS to better understand the program, including the role of local area coordination and build the evidence about progress and outcomes achieved under the ILC.

A review report of early findings was provided to disability ministers in April 2021. The review included consultations with states and territories, the NDIA and key sector representatives to identify issues and high- level themes. Based on stakeholder feedback, early findings identified areas for improvement, including:

the need for the intent of the ILC to be clarified
better targeting of funding to locations of need
longer funding agreements
simplifying and streamlining the funding application process
clearer communication about funding opportunities.

DSS is working to address these issues in future funding rounds.

DSS has engaged Swinburne University of Technology to conduct research to assist in understanding where there are gaps and unmet needs within the ILC grant program. This work includes analysis of data on current ILC grants and targeted consultations with the sector, current ILC grant recipients and state and territory governments. Input is gathered through a combination of surveys and interviews.

Following this analysis and as outcomes of existing grants are realised, DSS will consult with people with disability, the disability sector and states and territory governments on future directions for the ILC.

Younger People in Residential Aged Care Strategy 2020-2025 implementation

The Younger People in Residential Aged Care (YPIRAC) Strategy 2020-25 (the YPIRAC Strategy) was released on 30 September 2020, and builds on the 2019 YPIRAC Action Plan, extending and improving upon previous initiatives. It covers all younger people under the age of 65 living in, or at risk of entering residential aged care, including Aboriginal and/or Torres Strait Islander people between 50 and 64 years of age who are eligible for aged care services.

Since the launch of the Government’s YPIRAC Action Plan in March Quarter 2019, there has been:

a 62 per cent reduction in younger people entering residential aged care down from 407 in the March 2019 quarter to 156 in the June 2021 quarter
a 40 per cent reduction in people under the age of 45 living in residential aged care, down from 167 in March 2019 to 100 in June 2021
a 32 per cent reduction in people under the age of 65 living in residential aged care, down from 5,715 in March 2019 to 3,900 in June 2021.

Activities that are being progressed by the Government, in collaboration with state and territory governments, sector stakeholders and younger people themselves, are contributing to reductions in the number of younger people entering, and living in, residential aged care.

Achievement against priority areas include:

Priority Area 1 - Understanding Younger People and Systems

Ipsos Report - Commissioned by Health as part of the Government’s investment in data and research included work undertaken by Ipsos Public Affairs Pty Ltd to complete a detailed analysis of younger people living in residential aged care. This project was unique as it merged Health and NDIA data, and looked at different groups within the data to understand their characteristics.
Australian Institute of Health and Welfare (AIHW) quarterly public reporting - To build an understanding of the YPIRAC cohort and those at risk of entry to residential aged care, Health established an agreement with the AIHW for public facing quarterly reporting until 2025 against the YPIRAC targets, as well as investigating data linkages to identify key pathways and outcomes for younger people. The first data report against the YPIRAC targets was released on the AIHW Gen website in April 2021. Ongoing quarterly releases over the life of the Government’s YPIRAC targets will be made publicly available.

Priority Area 2 - Improving the System

The Government is working across systems with the states and territories to ensure there are appropriate and effective pathways to accommodation and supports including assessments, planning, coordination and assistance.
The Aged Care Assessment Supplementary Guidelines for Younger People were released by Health in January 2020. The Guidelines include processes that Aged Care Assessment Teams must go through before the assessment and approval of any younger person for residential aged care, including consideration of the NDIS.
System Coordinator Initiative - The YPIRAC System Coordinator Program was announced as part of the 2020-21 Budget to support the goals of the Strategy. The priority focus will be to assist

younger people who are not NDIS participants to navigate Commonwealth and state and territory health, housing and disability systems to access age-appropriate accommodation and support services.

Dedicated NDIA YPIRAC planners - The NDIA has expanded its team of dedicated NDIA YPIRAC planners to around 80 planners.

Priority Area 3 - Creating Options

The Government is working to ensure alternative options to residential aged care are available for younger people who are at risk of entering, and for those who are currently living in residential aged care options to transition to living arrangements of their choice.
The NDIA is working to give participants more options for how they can be supported at home. NDIA planners work with participants to understand which NDIS-funded support option is most appropriate to help the participant achieve their home and living goals.
On 30 April 2021, Commonwealth, state and territory Building Ministers agreed met to consider next steps on options to increase Australia’s stock of accessible housing. A majority of Ministers agreed to include minimum accessibility provisions for residential housing and apartments in the National Construction Code 2022 based on the Liveable Housing Design Guidelines silver standards.

Priority Area 4 - Supporting Change

A multi-agency Communications Strategy and associated communication plans have been developed to ensure younger people, their families, carers, health, aged care, and the disability sector understand there is support available to access age-appropriate alternatives to residential aged care if they choose to do so.

Attachments

Attachment 1: Submission to the Senate Community Affairs Legislation Committee Inquiry into the NDIS Amendment (Participant Service Guarantee and Other Measures) Bill 2021

Attachment 2: Explanatory Memorandum NDIS Amendment (Participant Service Guarantee and Other Measures) Bill 2021