Deafness Forum Australia analysed the Independent Review of the National Disability Insurance Scheme’s Final Report, examining and contemplating its extensive findings and recommendations.
By Hayley Stone, Director of National Disability Policy and Advocacy for Deafness Forum Australia.
The NDIS was established in 2013 as a collaborative funding effort by the Federal Government and state and territory governments. Its primary objective is to provide necessary and reasonable supports for eligible individuals with disability.
In 2022, the Government initiated an independent review with the express aim of realigning the NDIS with its core mission: placing individuals with disability at the forefront. The review aimed to rebuild trust, confidence, and pride in the NDIS.
The review’s final report was published in the weeks before Christmas. Titled “Working together to deliver the NDIS,” the report outlined 26 key recommendations and 139 specific actions to enhance the scheme over the next half-decade.
Like many organisations in the disability advocacy sector, Deafness Forum Australia was concerned about what the report might mean for the future of the NDIS and its participants – especially given ongoing public concerns around higher-than-predicted participants and the increasing costs associated with the Scheme.
While the review calls for significant readjustment to how the NDIS operates, there were no obvious red flags. The review’s 26 recommendations and 139 integrated actions provide a detailed blueprint for reducing cost projections, addressing many pain points of the Scheme while also expanding supports to cover people under 65 who currently fall through the cracks.
The recommendations go beyond the NDIS, calling for a well-coordinated, national effort towards designing, operating, and governing a new disability support ecosystem, and call for a massive investment in resources and services over the next five years, in addition to a shifting of responsibilities back to States and Territories for a new category of supports.
But nothing has been decided yet.
While states and territories have expressed commitment, in principle, to the reforms, we anticipate some pushback once planning gets underway. At the same time, the proposed five-year rollout would extend into the tenure of a new government, so it’s vitally important to have the solid commitment of the Opposition.
We’ve put together a summary of the review’s significant recommendations, with our initial thoughts.
- A new model for disability support.
The report has recommended replacing Tier 1 and 2 supports with an expanded range of foundational supports that would be available to people with disability under 65, irrespective of whether they are participants of the NDIS or not.
Targeted foundational supports would be for people with specific, but less intense, disability support needs, and would include things like aids and equipment, and home maintenance services.
General foundational supports would include services like peer support, information, and advice, as well as disability employment services.
What’s good about this model is that it will potentially expand the supports available to people with disability who are ineligible for the NDIS, but there’s limited information on precisely what supports would fit under the ‘foundational’ umbrella or whether this will mean that participants of the NDIS will have their supports split across foundational supports and their individualised plans, which could be challenging to navigate.
We also don’t know whether NDIS participants might be expected to transition off the Scheme if the supports they need can be accessed as foundational supports. It also doesn’t appear that foundational supports wi
ll be available for people aged 65 years and older – a missed opportunity for the review to address the inequity between the NDIS and Aged Care.
Another issue is that the proposed model transfers significant responsibility back onto states and territories to administer and provide funding for foundational supports. While this isn’t a new idea, we know that many state-funded services have been eroded over the past decade. Significant work will be required to rebuild those services to achieve the interconnected disability support ecosystem necessary for this recommendation to work in practice.
- The introduction of systems navigators.
Another recommendation is the introduction of navigators to support all people with disability under 65 years of age to access the support and services they need. The expectation is that navigators will have consistent training and national oversight but will be locally based to ensure they understand local communities. Systems navigators would be available to all people with disability under 65 years of age.
If a person with disability wanted to apply for the NDIS, the navigator would assist them in understanding the scheme and support them through the application process. Once a budget and plan have been set, the navigator could support the participant in accessing services in their local communities.
As we all know, the complexity of the disability support landscape is a significant barrier to people with disability getting access to the supports they need when they need them.
ators are used effectively in several other public service contexts, including healthcare and could significantly improve the experience of people with disability interacting across various elements of both the NDIS and the broader disability support ‘ecosystem’, but we need the right people for this vital role.
Navigators need to be unbiased and impartial. Service providers or entities affiliated with service providers should be excluded from providing navigation services to ensure that people with disability are appropriately referred, based on their preferences and requirements. We’ve also recommended that any navigator scheme be extended to support people with disability aged 65 years and older.
- A new system for determining NDIS eligibility, funding and supports.
The review has proposed that the NDIS place less emphasis on diagnosis and functional capacity as the mechanisms for determining eligibility, funding and supports.
The recommendations propose scrapping the Access List in preference of a uniform assessment process to determine eligibility based on applicants’ needs. The assessment would be based on self-reporting and strength-based interviews. The same assessor who conducts the assessment would support a successful applicant to plan their budget and supports.
It’s clear that the proposed assessment model is not a rebranding of the independent assessment model that was fiercely opposed in 2021. The proposed model doesn’t work to an algorithm, it doesn’t use the same diagnostic tools and looks to have scope for assessors to seek supporting information from an applicant’s treating professionals.
If the new assessment model is adopted and implemented well, we anticipate that it should address current inequities around evidence requirements for people with different types of disabilities, while ensuring people continue to receive customised supports.
If the new assessment model is confirmed, we will need to be assured that the tools are evidence-based, that the assessors have the skills and training necessary to administer the assessments, and that people with disability have the time and supports necessary to fully articulate their needs.
- A continuum of supports for children and young people with disabilities.
Addressing the needs of children and young people with disabilities and their families was a key priority in the review. The report recommends additional screening processes to identify children with disabilities and developmental delays as soon as possible through general community screening, and a continuum of supports for children and young people with disability, irrespective of whether they are NDIS participants or not, to the age of 21,
Changes would include expanding the early intervention program to age 9, new supports and services for children and young people aged 9-21 to prepare for key life transition points, including secondary school and employment, and targeted funding for a capacity-building program for parents and caregivers.
Children would be assessed via a whole-of-person needs-based assessment and monitored to track how well supports were working.
While we welcome these changes in principle, we’ve requested more details. We want to know how the impacts of supports would be assessed in practice and whether there is scope to optimise the universally available child development check for screening. We also need to be confident that needs-based assessments are evidence-based, age-appropriate, and conducted by people with the right skills and expertise.
Any capacity building programs for parents and caregivers, must be developed in co-design with people with disability and be identity affirming. We’d also recommend the development of a national database to track lifetime progress against measured outcomes, with scope for interventions as needed, to ensure that all Australian children with disability can reach their full potential.
- Enhanced access to assistive technology supports.
The review noted that access to assistive technology for people outside the NDIS is underfunded, fragmented, and complex, with an estimated 108 different schemes to access assistive technology outside the NDIS.
The review has called for the Department of Social Services, with States and Territories, to develop a nationally consistent approach for delivering aids and equipment outside the NDIS with a focus on improved planning and coordination of aids and equipment between the NDIS, Health, and Aged Care.
While we would welcome a centralised, national program to link people with disability to the aids and technology they need, further detail is necessary to understand how such a scheme would be funded and coordinated.
- A digitalised market with increased quality and safeguarding mechanisms to protect consumers.
The report proposes significant changes across the market, including introducing a new pricing and payments framework, a complete transition to electronic payments, and developing a centralised online platform to help participants find service providers in their local area.
The review panel also recommends that the National Disability Supports Quality and Safeguards Commission actively monitor the market to identify and respond to poor service delivery and introduce a new graduated risk-proportionate regulatory framework.
Under the proposed framework, all disability service providers must be enrolled or registered with the National Disability Supports Quality and Safeguards Commission. Providers would have graduated regulatory obligations increasing depending on the risk associated with the services the provider is delivering. There would be minimal ‘red tape’ for service providers who provide low-risk services.
These recommendations represent a good balance between providing regulatory safeguards for consumers and facilitating their choice and control by encouraging a robust, diverse marketplace. We can anticipate that these reforms would reduce fraud, price gouging, and over-servicing.
So, what comes next?
It’s now a matter of wait and see how many recommendations are picked up and the response from the Australian Government, States, and Territories to the five-year implementation target. Until then, we’ve been told by the NDIA that participants should expect things to be business as usual.
Our key priorities across the implementation of the reforms will be making sure Governments and the NDIA commit to genuine co-design with people who require hearing and speech supports and people whose first language is Auslan. We’re aiming to influence and and inform decision-making around the practical implementation of the changes and will continue to advocate for increased supports for those who are deaf or hard of hearing who are over 65 years of age.
We’ll keep you informed as we learn more about changes and will be reaching out for your thoughts and input over the next few months once we know the plan for the NDIS moving forward. In the meantime, there are some resources on the recommendations, including fact sheets on key topics and an easy-read version of the final report, on the NDIS Review website.