Interim findings
5.1
This chapter comprises the committee's interim report for its current inquiry into current scheme implementation and forecasting for the NDIS.
5.2
The chapter provides background information on the inquiry, discusses key evidence received in the initial tranche of submissions received, and sets out the committee's interim observations and one recommendation in relation to this evidence.
Background
5.3
During the committee's inquiry into independent assessments, the committee heard a range of views in relation to the projected scheme costs of the NDIS. These included concerns raised by federal NDIS ministers and the NDIA that projected scheme costs posed risks to the long-term sustainability of the scheme. Other submitters, however, expressed scepticism about the actuarial data used to argue that there are issues with scheme sustainability, and noted a range of other factors influencing scheme projections.
5.4
In consideration of the evidence already presented to the inquiry on independent assessments, the committee decided to conclude that inquiry and initiate a new inquiry with focused terms of reference to examine some of these broader questions concerning the implementation of the NDIS to date and projections about its future.
5.5
In October 2021, the committee announced it would conduct an inquiry into current scheme implementation and forecasting for the NDIS, with particular reference to:
(a)
The impact of boundaries of NDIS and non-NDIS service provision on the demand for NDIS funding, including:
(i)
the availability of support outside the NDIS for people with disability (e.g. community-based or ‘Tier 2’ supports), and
(ii)
the future of the Information, Linkages and Capacity Building grants program;
(b)
The interfaces of NDIS service provision with other non-NDIS services provided by the States, Territories and the Commonwealth, particularly aged care, health, education and justice services;
(c)
The reasons for variations in plan funding between NDIS participants with similar needs, including:
(i)
the drivers of inequity between NDIS participants living in different parts of Australia,
(iii)
whether inconsistent decision-making by the NDIA is leading to inequitable variations in plan funding, and
(iv)
measures that could address any inequitable variation in plan funding;
(d)
How the NDIS is funded, including:
(i)
the current and future funding sources for the NDIS,
(ii)
the division of funding between the Commonwealth, States and Territories, and
(iii)
the need for a pool of reserve funding;
(e)
Financial and actuarial modelling and forecasting of the scheme, including:
(i)
the role of insurance-based principles in scheme modelling, and
(ii)
assumptions, measures, and methodologies used to forecast and make projections about the scheme, participants, and long-term financial modelling;
(f)
The measures intended to ensure the financial sustainability of the NDIS (e.g. governance, oversight and administrative measures), including:
(i)
the role of state and territory governments, and the Disability Reform Ministers Meetings,
(ii)
the arrangements for providing actuarial and prudential advice about the scheme,
(iii)
the way data, modelling, and forecasting is presented in public documents about the NDIS, (e.g. NDIS Quarterly Reports and Reports by the Scheme Actuary), and
(iv)
measures to ensure transparency of data and information about the NDIS;
(g)
The ongoing measures to reform the scheme including:
(i)
the new early childhood approach, including whether or how early intervention and other supports intended to improve a participant’s functional capacity could reduce their need for NDIS funding, and
(ii)
planning policy for personalised budgets and plan flexibility; and
(h)
Any other related matters.
Conduct of the inquiry
5.6
The committee set two closing dates for submissions: 29 October 2021 for consideration in an interim report, and a second submission closing date of 28 February 2022 for consideration in a final report. The committee received a number of submissions to the inquiry by the initial closing date. These submissions are available on the committee website.
5.7
The committee intends to hold public hearings to receive evidence from individuals and organisations prior to presenting a final report to Parliament.
Key issues raised in initial evidence
5.8
Submitters raised a range of issues in response to the committee's terms of reference, including providing suggestions for areas for further inquiry by the committee. Key issues identified included:
supports for people with disability outside the NDIS
the adequacy of the Information, Linkages and Capacity Program
interfaces between the NDIS and mainstream services
decision making in relation to access and planning decisions
actuarial and other data related to the NDIS, and
trust between the NDIA and people with disability.
Availability of supports outside the NDIS
5.9
The committee heard that there are inadequate supports available to people with disability outside of the NDIS. Further, many people with disability face barriers to accessing the community supports that are available, including because of costs, or because they are not accessible for people with disability.
5.10
Submitters also commented that the systems and range of services are complex, and that further capacity building is needed to assist people with a disability to access community supports.
5.11
Some submitters made the point that supports previously funded by the Commonwealth were withdrawn when the NDIS was introduced, particularly mental health supports. This had led to a 'missing middle' for the broader scheme, where people not eligible for individual funding packages under the NDIS struggle to obtain support for their disability.
5.12
The committee further heard that access to disability support outside the NDIS is even more difficult for people in regional, rural and remote areas. Further, more support is needed for people with disability from culturally and linguistically diverse backgrounds, for people aged over 65 with disabilities, and for people with psychosocial disabilities.
Information, Linkages and Capacity Building Program
5.13
The Information Linkages and Capacity Building (ILC) program is intended to provide funding to organisations to deliver community-based projects that can be accessed by any Australian with a disability, as well as their carers and families. Projects funded by the program are intended to create and build connections between people with disability and their communities, build confidence and capacity of people with disability, and improve access to community and mainstream services.
5.14
Submitters emphasised the importance of the Information, Linkages and Capacity Building Grants Program to address gaps in community-based supports but maintained that the projects are not yet providing the supports needed to address these gaps. Factors that were considered to contribute to the perceived inadequacy of the program included:
low awareness of the program
short-term funding of projects
projects are 'piecemeal', and
inconsistency in services available in different parts of the country.
Interface issues
5.15
Concerns about managing the interfaces between the NDIS and 'mainstream' services offered by states and territories were raised by numerous submitters. These services include health, mental health and aged care, transport, criminal justice, and education. Submitters called for more cross-sector coordination and integration between the NDIS and these services, for example, by including healthcare professionals in planning processes and supporting people to access the scheme.
5.16
The committee also heard that there is a lack of clarity and consistency regarding responsibilities for service provision at these interfaces, with some submitters calling for a review of the Applied Principles and Tables of Support to Determine Responsibilities NDIS and other service which are used by the Commonwealth and state governments to determine the funding and delivery responsibilities of the NDIS, and the obligations of other service delivery systems.
Decision making by the NDIA and its partners
5.17
Several submitters indicated that the inconsistent decision making by the NDIA and partners is contributing to inequitable outcomes for NDIS participants and people seeking to become NDIS participants. Some submitters saw this inequity as being correlated with a person being in a regional or remote as compared to metropolitan area, while others noted the importance of having access to support through the NDIS access and planning processes.
5.18
Submitters suggested that planners and local area coordinators need to have a better understanding of different disability types, especially psychosocial disabilities, rare and genetic conditions, and communication disabilities.
5.19
The committee also received submissions from the Commonwealth Ombudsman and the Australian National Audit Office regarding the quality of decision making by the NDIA.
Data about the NDIS
5.20
Submitters were pleased that the NDIA Actuary had released a full Annual Financial Sustainability Report (AFSR) in 2021. However, most submitters also expressed the view that further transparency is required in relation to NDIS data, including actuarial data, and that broader research and analysis of NDIS data should be undertaken by independent bodies.
5.21
Submitters also suggested additional measures including:
providing more data about NDIS performance at regional levels and in relation to different cohorts, especially Aboriginal and Torres Strait Islander people with disability and people with disability from culturally and linguistically diverse backgrounds
ensuring data is provided in various accessible formats, for a broad range of audiences
that actuarial modelling builds in understanding of NDIS participants and requirements of quality care
that the AFSR should include assessment of trends in provision of supports to people with disability otherwise than through the NDIS.
Trust and co-design
5.22
Submitters stressed the importance of trust between the NDIA and the disability community to ensure that the vision of the NDIS can be achieved. Submitters emphasised that trust needed to be rebuilt between the NDIA and people with disability following the distress caused by the government's attempts to introduce independent assessments.
5.23
Submitters also highlighted the importance of ensuring that any reforms to the scheme are developed using genuine co-design with people with disability, their families, and advocates.
Other issues raised
5.24
A range of other matters were put forward by submitters, including:
that NDIS pricing assumptions should be reviewed;
more research is needed into best practice early intervention, and support required for people to transition out of individual funding with the NDIS;
specific concerns related to hearing services;
concerns regarding accommodation for people with disabilities;
support for people with psychosocial disabilities, and an understanding of psychosocial disabilities and recovery-oriented care;
supporting Aboriginal and Torres Strait Islander people with disabilities;
access to assistive technology;
use of algorithms in NDIA decision-making; and
the role of community pharmacies.
Relevant Government initiatives
5.25
The committee also received initial evidence from the Department of Social Services and NDIA which identified current and planned government initiatives that were relevant to the terms of reference to this inquiry. These included:
release of the full Annual Financial Sustainability Report (AFSR) in October 2021
the NDIS Annual Pricing Review 2020-21, released May 2020
regular review of the operation of NDIS bilateral agreements and scheme costs and funding under the National Disability Insurance Scheme Act 2013
work by Commonwealth and state and territory disability ministers to understand cost drivers underpinning assumptions in AFSR (initial work by senior officials is expected to be provided to disability ministers in December 2021)
proposed legislative amendments, including the National Disability Insurance Scheme Amendment (Participant Service Guarantee and Other Measures) Bill 2021, introduced into Parliament in October 2021
co-design workshops held in September 2021
development of an engagement approach to building disability community understanding of cost drivers and underpinning assumptions of the AFSR
changes to the early childhood intervention approach, with a progress update on these changes released in October 2021
work on a new disability strategy, 'Australia's Disability Strategy 2021-2031', which is expected to be launched late 2021; and
Department of Health initiatives to work with disability support systems under the National Health Reform Agreement 2020-2025.
Committee view
5.26
The terms of reference for this inquiry cover a wide range of important matters affecting the NDIS. The committee acknowledges that the inquiry has been initiated late in the 46th Parliament, and that there is limited time for submitters and witnesses to provide evidence on these consequential issues, and for the committee to consider this evidence, before the dissolution of this committee in its current form, in the first half of 2022.
5.27
The committee has nevertheless already received useful evidence in the submissions provided, which identify areas of concern, and make thoughtful suggestions for further inquiry. Several submitters also indicated that they will provide supplementary submissions for consideration in the final report for this inquiry. The committee thanks all those who have contributed to the inquiry by lodging submissions to date and looks forward to receiving additional evidence over the coming months.
5.28
The committee will continue to progress work on this inquiry for the remainder of the Parliament, informed by submissions it has received to date, as well as submissions received by the second closing date in February 2022. Noting the weight and consequence of the issues already raised, the committee recommends that the Joint Standing Committee on the NDIS of the 47th Parliament continue the work of this committee in relation to these matters by re-initiating this inquiry in the next Parliament.
5.29
The committee recommends that the Joint Standing Committee on the National Disability Insurance Scheme of the 47th Parliament of Australia reinitiate this committee's inquiry into Current Scheme Implementation and Forecasting for the National Disability Insurance Scheme and continue to consider evidence received by the committee in the 46th Parliament.
Hon Kevin Andrews MPSenator Carol Brown
ChairDeputy Chair