The NDIS Plan

E&OE

Introduction

Good afternoon. It is a pleasure to be with you here today. Can I start by sincerely welcoming the NDIS participants, their families and carers here with us today.

I would also like to welcome the many advocates, providers and departmental and NDIA staff, including Secretary of the Department of Social Services, Kathryn Campbell AO CSC, and the CEO of the NDIA Mr Martin Hoffman.

The National Disability Insurance Scheme was envisaged almost ten years ago. People with disability, advocates, carers and many Australians recognised we couldn’t continue with the status quo in terms of how the nation supported people with disability, on a state by state basis.

The idea was to see people with disability live life to their full potential through a national scheme that would allow them to participate in the community to get a job if able, and have greater independence.

There was also recognition that state, territory and federal investment at the time was disparate and there was a significant level of unmet need.

To their credit, the former Government recognised these issues and asked the Productivity Commission to develop a report into how we, as a country, can do better.

And so the NDIS was born for Australians with permanent and significant disability. A scheme based on insurance principles and participant choice and control that would help people with disability realise their social and economic potential.

A world first, a truly national endeavour, that is changing lives.

But the Government is under no illusions.

The journey of rolling out this national endeavour has not and will not always be easy.

The image of a plane taking off while still being built remains an apt description.

I have frequently said we are about 80 per cent there, with 20 per cent left to go. And the last 20 per cent is often the hardest.

The plan I am announcing today is about delivering the last 20 per cent and putting the NDIS onto a business as usual even keel for the long term.

Developing the Plan

This plan has been developed with advice from the NDIA and the Department of Social Services. I have spoken with my state and territory colleagues.

I listened to members of parliament about what they were hearing from their constituents right across the country.

I held roundtables with peak disability organisations, advocates and service providers to hear firsthand their experience of the NDIS.

But most importantly I have been meeting directly with people with disability, their families and carers.

The Prime Minister and I have held roundtables in places such as Penrith, Launceston, Adelaide, Caboolture, North Sydney and Kalgoorlie.

We heard from people such as Shoan, an NDIS participant and advocate in Adelaide who has a vision impairment and who one day wants to represent Australia at blind tennis.

Shoan told the PM and me about how there was a need for greater flexibility in the NDIS to empower participants to reach their goals.

We met Zoe, an NDIS participant in Launceston, who together with her family are dealing with their own challenges but are confident the NDIS is getting Zoe off to the best start in life.

In all of my discussions, what is clear is that the NDIS is already having a profound impact on the lives of people with disability.

The choice and control they and their families are experiencing is unprecedented.

Unfortunately, I have also heard the NDIS is not always living up to high expectations.

Based on this feedback, and building on our election commitments to people with disability, this plan will deliver the final 20 per cent of the NDIS and set it up for future long term success.

As I will outline today, the development and release of this plan has not stopped us from acting. In the 169 days since my appointment we have already achieved significant progress.

The first NDIS Quarterly Report for 2019-20, which I am releasing today, shows real progress is being made.

We now have over 310,000 participants with an NDIS plan – including more than 114,000 participants who are receiving specialist disability supports for the very first time.

The number of NDIS participants has grown by 930 % since the commencement of transition on 1 July 2016 – from approximately 30,000 to over 310,000 Australians with disability—all with an individual plan of support.

This is a significant accomplishment and sets the runway to deliver a world leading NDIS to an estimated 500,000 participants over the next five years.

The Government’s NDIS plan has six core swim lanes:

1. 1. Quicker access and quality decision making
2. 2. Increased engagement and collaboration
3. 3. Market innovation and improved technology
4. 4. A financially sustainable scheme
5. 5. Equitable and consistent decisions; and
6. 6. Improve long term outcomes.

Lane 1 – Quicker access and quality decision making

One of the key concerns is the long wait times being experienced by some participants and their families when accessing the NDIS, getting a plan or accessing assistive technology or having their plan reviewed.

That is why at the 2019 election, the Morrison Government committed to introducing a new NDIS Participant Service Guarantee, which will set new service timeframes for NDIA service delivery.

To inform the development of the Participant Service Guarantee, Mr David Tune is reviewing the NDIS Act to consider ways we can streamline NDIS processes and cut red tape for participants and providers.

Consultations have occurred all over the country and we remain committed to finalising the review and legislating changes for the commencement of the NDIS Participant Service Guarantee from 1 July 2020.

One important change that is likely to come out of the review is the implementation of a simple, agile plan adjustment processes – to ensure participants who only require a small adjustment to their plan due to a change in circumstances, is able to so without a full plan review.

In the meantime, we continue to improve the timeliness of NDIS service delivery and reduce any backlogs that have built up during transition.

In June I announced a number of initiatives to reduce waiting times for children aged 0 to 6 in accessing the NDIS and having their plan approved through the Early Childhood Early Intervention – or ECEI – pathway.

We committed to setting a timeframe of 50 days for children aged 0 to 6 from being deemed eligible and having their plan approved, by surging resources and offering an interim $10,000 plan should a full plan not be developed until after 50 days.

As outlined in the latest Quarterly Report, I am pleased to announce that the number of children currently waiting more than 50 days for a plan after receiving access has reduced from 3,314 to 1,686 over the September quarter.

During the same period the average wait time for children currently waiting for a plan after receiving access has reduced from 104 to 54 days. By mid-October, this average wait time has fallen to 48 days. The KPI is 50 days.

We are on track to resolve any backlogs and delays in the ECEI pathway by the end of the year, and will continue to monitor it closely into next year to ensure it continues to deliver appropriate service timeframes for Australian families.

The Quarterly Report also highlights some significant achievements in resolving other backlogs and delays.

As at 30 September 2019, all access decisions currently with the NDIA for decision have been in progress for an average of 12 days, compared with 38 days at 30 June 2019.

This means that access decisions are being made within the legislated timeframe of 21 days and there are currently no backlogs or delays in getting access into the NDIS.

Similar to access decisions, I can announce today that first plans are being approved more quickly after an access decision has been made – 88 days on average in September compared to 133 days in June. A key focus over the coming months will be to reduce this even further.

It is also a key priority to tackle the time it is taking to approve assistive technology and home modifications for participants— whether it be a motorised wheelchair, a prosthetic or a bathroom renovation.

Improvements implemented earlier this year are already having a significant impact, including:

• the inclusion of low-cost, low-risk items under $1,500 in a participant’s plan without further assessment, quote or approval;
• reducing the number of quotes required to no more than two for items above $1,500;
• only requiring one quote for the replacement of an item valued between $1,500 and $15,000; and
• the inclusion of appropriate repairs and maintenance funding in all plans.

Between the end of May 2019 and the end of September 2019, the number of outstanding assistive technology and home modification quotations awaiting approval has reduced from approximately 14,500 to approximately 5,000.

Further enhancements, including a redesigned process for complex and non-standard assistive technology and home modification requests; assistive outreach to assist participants in getting quotes; and new complex home modification guidelines for providers, are currently on track for release and implementation during the remainder of this financial year.

New standard operating procedures that incorporate streamlined processes commenced rollout in October, and are expected to address the remaining backlog for assistive technology by the end of December 2019 and home modifications by the end of March 2020.

The Government has also committed to providing a single point of contact for NDIS participants and encouraging longer duration plans. Almost 300,000 participants already have a single point of contact in the NDIS, and we are on track for all participants to be covered by the end of March 2020.

Further, the number of participants with plans longer than 12 months continues to grow.

As at 30 September 2019, around 13 per cent of participants aged 18 years and older had plans longer than 12 months, and this is expected to increase with approximately 17 per cent of plan reviews completed each week resulting in a plan duration greater than 12 months.  

Of course, several groups of participants require a plan less than 12 months due to their disability or changing life stages, including children aged 0 to 17 years old.

In order to reduce requests for plan reviews the NDIA will also commence the national rollout of joint planning meetings and the provision of draft plan summaries from April 2020.

Providing a draft plan summary—so often asked for by participants—will enable them to review and amend their personal details, goals, living arrangements, informal community supports and other community supports, and social and economic participation prior to a plan being developed.

Similarly, joint planning will allow a participant, Local Area Coordinator and NDIA Planner to collectively discuss a working version of the plan and included support funding before it is approved.

Joint planning will lead to a greater understanding for participants about their plan, how it was developed and how to use it.

We will continue to focus on resolving these existing pressure points and implementing service changes to ensure we have quicker access and quality decision making for participants and their families in the lead up to the introduction of the Participant Service Guarantee.

Lane 2 – Increased engagement and collaboration

I have heard first hand that a person’s experience of the NDIS is often determined by where they live, their education, socio-economic status and/or support networks.

No more is this clearly evident than in rural and remote areas, for indigenous Australians, people from culturally and linguistically diverse – or CALD – communities, and those with mental health challenges.

As a result of tailored service delivery pathways and engagement strategies, including indigenous and remote community connectors, we are beginning to see an increase in the diversity of participants entering the NDIS.

Of the 26,688 participants joining the NDIS during the last quarter:

• 6.5 per cent of participants who received a plan in the quarter identified as Aboriginal and/or Torres Strait Islanders, compared with 5.8 per cent in previous quarters combined.
• 11.5 per cent of participants who received a plan in the quarter identified as CALD, compared with 8.4 per cent in previous quarters combined.
• 10 per cent of participants who entered the NDIS in the quarter had a psychosocial disability compared with 9 per cent in previous quarters combined.

The Government will continue to support the NDIA in rolling out strategies to engage these groups of people.

We have committed an additional $20 million over two years to further expand the community connectors program to help those Australians requiring more tailored support to access and engage with the NDIS.

Existing community connectors in remote settings will be expanded, new community connectors for CALD and Aboriginal and Torres Strait Islanders in urban and rural settings will be established and a virtual community connector support service and referral pathway – known as NDIS Carer Connect – for ageing parents of people with disability will be established via the existing Carer Gateway.

We will also continue to implement the NDIS Information, Linkages and Capacity Building – or ILC – Strategy.

Under this strategy, organisations will be funded to assist all people with disability, their families and carers, regardless of whether they are eligible for the NDIS, by providing information and individual capacity building support, as well as assisting to promote accessible and inclusive communities.

We have already announced over $65 million under the ILC National Information Program for 37 organisations to assist Australians with disability, their families and carers to more easily access high-quality and up to date information about living with disability.

For example, more than $9 million was provided to Amaze to implement Autism Connect, a one-stop-shop providing independent evidence-based information, advice and assistance to all people with autism, their families, professionals and the NDIA.

Over $160 million in further ILC grants that will build the individual, social and economic capacity of people with disability, and increase the inclusiveness of the health system are also currently under assessment and will be announced soon.

Lane 3 – Market innovation and improved technology

Earlier this year the Government released the ‘Growing the NDIS Market and Workforce’ Strategy.

It recognised the primary role of the Government in the long term is to ensure appropriate market settings and to provide market oversight.

Given the scale and pace of reforms to the disability support sector, it also recognised a need to support business and workforce development while the market transitions and matures.

The Government has already invested heavily to assist market transition, including:

• The $45 million Jobs and Market Fund and $33 million Boosting the Local Care Workforce Program that are funding projects designed to assist individual providers to transition or build sector wide business and workforce capability.
• The implementation of NDIS pricing increases by the NDIA from 1 July 2019 totalling approximately $1.6 billion per annum.
• The rollout of nationally consistent regulation via the NDIS Quality and Safeguards Commission.

But there is more work to be done. We will be working to trial and assess different initiatives that respond to thin markets.

In line with the Government’s commitments to improve service delivery for all Australians, the NDIA will also support the development of new and innovative models of support by reducing the administrative burden NDIS participants and providers face when interacting with NDIA technology.

As a first step, the NDIA is currently developing Application Programming Interfaces – or APIs – to enable seamless and secure integration with the NDIA Business System in real-time.

Building on this initiative, the NDIA is also working to enable a new Digital Market Service from early next year that will facilitate, encourage and support the development of a vibrant digital market.

This initiative will make it easier for providers to enter the market and grow, providing participants greater access to a broader range of providers, improving the transparency of the market and driving greater competition.

Of course, no market will exist without building the capability and size of the NDIS workforce. It is expected that the NDIS will require an additional 90,000 workers over the next five years, almost doubling the current estimated workforce of 100,000.

This represents one of the largest job creation opportunities in Australia’s history.

Approximately 71 per cent of newly created jobs are expected to be support worker roles, 12 per cent allied health service roles, 11 per cent case and social worker roles and 6 per cent managerial roles. As such, most NDIS roles require the right capabilities and experience rather than formal qualifications.

To further support the development of the NDIS Workforce, the Government will be working with state and territory governments to finalise a national NDIS Workforce Strategy by the middle of next year.

Lane 4 – A financially sustainable scheme

The NDIS is a massive undertaking and it is imperative that we ensure the NDIS remains financially sustainable both now and into the future.

To ensure the NDIS remains sustainable into the future it cannot exist as an oasis in the middle of a desert. Implementation of the ILC Strategy and the broader National Disability Strategy are key in delivering this outcome.

So too is ensuring the NDIS operates effectively with other mainstream service systems. I have therefore committed the COAG Disability Reform Council – or DRC – to meeting every 90 days to sort out all remaining issues that cross over federal, state and territory jurisdictions.

At its June meeting, DRC resolved the key interface issues between the NDIS and the health system. Since 1 October, NDIS participants have been able to receive funding for their disability-related health supports via their NDIS plans.

We also agreed to an Action Plan to reduce delays in hospital discharge processes for NDIS participants, as well as roles and responsibilities for children with disability living in accommodation outside of the family home.

At its October meeting, DRC agreed to:

• an approach to improve the access and experience for participants with psychosocial disability in the NDIS and to address interface issues between the NDIS and mainstream mental health systems; and
• the introduction of Justice Liaison Officers in each state and territory to work across their justice systems, to provide a single point of contact for state and territory justice workers and a coordinated approach to supporting NDIS participants in youth and adult justice systems.

DRC also endorsed an approach to improve the provision of transport supports under the NDIS.

This includes interim measures to increase transport funding for NDIS participants who are significant users of taxi subsidy schemes, and the full reimbursement of states and territories for the continuation of their taxi subsidy schemes for NDIS participants until longer-term transport support policy and funding is resolved.

I will continue to work with my state and territory colleagues to monitor the implementation of these decisions to ensure they provide clarity and good outcomes for NDIS participants.

We will also work through DRC to establish an NDIS Reserve Fund from accumulated cash currently in the NDIS.

Essentially this will act as a fund to improve participant outcomes and manage scheme sustainability on insurance principles.

Lane 5 – Equitable and consistent decisions

The diagnosis and assessment of disability is influenced by a range of factors, including the assessment tools used to assess the impact of a person’s disability on their daily life.

Current inconsistent assessment processes have resulted in inconsistent decisions and a large number of participants requesting reviews of access and funding decisions.

It has also led to anxiety and fear.

In response to feedback from participants, the NDIA has been looking at how it can improve the consistency and reliability of access and plan funding decisions, to help deliver high quality, appropriate supports.

As far back as 2011, the Productivity Commission recommended the NDIA engage independent health professionals to undertake the assessments of those wanting to receive support under the NDIS.

In late 2018, the NDIA undertook an Independent Assessment Pilot to better understand and assess the impact of disability for people seeking support from the NDIS.

Participants of this voluntary pilot completed a functional impact assessment with an independent assessor using standardised assessment tools.

The Independent Assessment Pilot was well received by participants and their representatives.

It experienced a 70 per cent voluntary opt-in rate, with over 500 functional assessments conducted by an independent assessor completed for participants aged over 7 with a primary disability of autism, intellectual disability and psychosocial disability.

Participant satisfaction after completing assessments was very high, with 91 per cent either very satisfied or satisfied.

The evaluation of the pilot determined that the use of consistent functional assessments resulted in improved decision-making and more equitable plan outcomes for participants with similar characteristics.

NDIA staff and partners reported that information contained in the assessments informed their conversations with participants, which in turn increased their levels of confidence in developing plans.

The NDIA will re-commence the independent assessment pilot in the Nepean Blue Mountains from later this month.

The pilot will test the use of independent functional assessments across the full range of disability types, ages, cultural backgrounds and circumstances.

Following the completion of the pilot to Government’s satisfaction, we intend to fully implement the use of independent functional assessments – fully paid for by the NDIA – in the access and planning pathways from 1 July 2020.

Improving the assessment process will help make the NDIS more reliable, consistent and equitable for everyone, ensuring it provides the right levels of support for the people it was intended to support.

The use of independent functional assessments will form one element of a broader program of work to imbed the insurance principles of the NDIS.

This includes providing greater flexibility to participants in utilising their plan budgets.

From 1 July 2020, and in line with functional assessments, we will aim to remove the distinction between core and capacity building so that participants and their families can use plan funding more flexibly on those supports that best meet their needs.

We will also look to extend plan duration even further so that wherever possible and appropriate plan reviews are only initiated in line with significant life milestones, such as starting school and finishing school, getting a job, moving house or other changes in support needs.

As we move to develop this program of work we will continue to engage and consult with people with disability, their families, carers and other stakeholders to ensure that we get it right.

The insurance program will shift the conversation between NDIS planners, local area coordinators, participants and their families from what is in and out of a plan, to a conversation about how best to utilise a plan budget to achieve a participant’s goals.

It is therefore important that we provide participants with better information on what supports are likely to result in the best outcomes for participants.

To assist in this endeavour, we need to start making better use of the NDIA’s data on NDIS participants that has built up over the six years of rolling out the NDIS.

With appropriate protections, the NDIA has and will continue to release new and updated data on a quarterly basis to build a clear and accurate picture of what is working in the NDIS and what challenges we need to overcome to ensure long term outcomes for participants. This builds on the DRC’s transparency agenda.

We hope the release of data will stimulate conversations about the disability sector and market. We want to encourage people with disability, community groups, research institutions and others to use this data to undertake research into what supports and initiatives provide the best outcomes for NDIS participants.

The DRC is developing a National Disability Data and Research Policy, with the Commonwealth already committing $15 million for the development of the National Disability Data Asset and providing $2.5 million to the Melbourne Disability Institute at Melbourne University to further develop a National Disability Research Partnership with other interested research and community organisations.

Lane 6 – Improve long term outcomes

As the latest Quarterly Report shows, we are already beginning to see some improved outcomes for NDIS participants and their families.

We now have longitudinal analysis of a sample of participants who have been in the NDIS for three years.

For participants who entered the NDIS between 1 July 2016 and 30 September 2016, community and social participation continues to increase – from 35 per cent when participants entered the NDIS, to 38 per cent after one year, 46 per cent after two years, and 50 per cent after three years.

Unfortunately, however, participation in work remains at similar levels, with 25 per cent of participants in employment after two years in the NDIS compared to 24 per cent at entry.

To ensure that employment remains a key priority for the NDIS, just last week I released the NDIS Participant Employment Strategy.

At the launch, I met Jonathon – a 19 year old Tasmanian who has already secured three days a week at a local green grocer and is well on his way of achieving his goal of full time employment.

Jonathon told me that through the support of the NDIS he secured a 10-week placement at Bunnings, which helped build his confidence and develop the life skills to get a job.

The strategy is all about emulating stories like Jonathan and the excitement he has in getting a job.

It is the culmination of work by the NDIS Participant Employment Taskforce established by the Government late last year.

The strategy will guide the activities of the NDIA over the next three years and help it achieve its goal of 30 per cent of participants in paid work by 2023.

Similarly, the Government has continued to implement the DRC response to a review of the Specialist Disability Accommodation – or SDA – Pricing and Payments Framework.

Just recently I released the new SDA Design Standards, the outcomes of the SDA limited cost assumptions review, and a new SDA Innovation Plan.

Together these initiatives will assist in building market confidence and ensuring that only the best and most innovative SDA is developed for NDIS participants.

For example Shania, an 18-year-old wheelchair user from Melbourne has recently moved into SDA housing fitted with a range of assistive technology with two other females and an NDIS-funded support worker who provides around-the-clock care.

Shania now has safe, accessible and age-appropriate accommodation which her family say will open up doors to her future that were previously not an option.

Shortly I will be writing to my state and territory counterparts to implement further recommendations to allow SDA eligible participants to be able to live in shared housing arrangements with family or friends that are not SDA eligible.

This is an important change and will increase choice and control for SDA eligible NDIS participants from 1 January 2020.

These reforms are already seeing a significant increase in SDA. The number of participants with SDA in their plan has increased by more than 120% over the past two years – from 6,068 in September 2017 to 13,581 as at 30 September 2019.

Over the same period the number of dwellings enrolled as SDA has increased by more than 350% – from 764 dwellings to 3,489.

Already we are starting to see the impact the NDIS and SDA is having for people with disability, including those living in residential aged care.

Between March 2017 and June 2019, the number of younger people in residential aged care has decreased from 6,287 to 5,606. This is a decrease of 11%, the first noticeable decrease in 12 years.

The number of younger people entering residential aged care has also decreased by 22%, from 536 new entries in the June quarter of 2017 to 416 in the June quarter of 2019.

This number is of course still too high.

Earlier this year the Government released a Younger People in Residential Aged Care Action Plan. Implementing this plan in consultation with states and territories, including our ongoing reforms to the SDA market and fixing the interface between the NDIS and the health system will help contribute to bringing this down further.

However, the Government remains open to any recommendations that will be made by the Aged Care Royal Commission on this issue.

We are actively seeking to do more and exceed the targets set in the Action Plan.

Conclusion

This plan will guide us over the next 12 to 24 months and beyond.

We will take a flexible yet determined approach to implementation, guided always by people with disability, their families, carers and other stakeholders along the way.

As I said at the outset, this is a truly national endeavour – a world-first, once in a generation reform, the largest social reform this country has seen since the introduction of Medicare.

It will take the hard work and dedication of all Australians working together to ensure the NDIS delivers for people with disability, their families and carers.

We all have a role to play and I thank all Australians in advance for their support and dedication in the task ahead.

Thank you.