Evolution of Disability Supports and NDIS Implementation
This informative content outlines the history of disability supports pre-NDIS, key reports leading to the NDIS, the NDIS legislation, and its principles for implementation. It discusses the shift in support systems towards independence, social participation, and individualized assistance in Australia.
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Presentation Transcript
National Disability Insurance Scheme Richard Madden Honorary Professor
Outline Outline Before the NDIS DIG & PC Report Bipartisan support / Legislation Pilots and the rollout since 2016 Finance Issues
Disability supports before the NDIS Disability supports before the NDIS Deinstitutionalisation: 1970s and 1980s Varying levels of State support, Commonwealth grants Disability Services Act 1986 Commonwealth-State Disability Agreement 1992 Various State initiatives (e.g., Stronger Together NSW 2006) WHO International Classification of Functioning, Disability and Health 2001 UN Convention on the Rights of People with a Disability 2006 Ratified by Australia in 2008
Reports: 2009 Reports: 2009- -2011 2011 Disability Investment Group Proposed / endorsed at Australia 2020 Summit 2008 (Bonyhady / Sykes) Established by new Labor Government (Bill Shorten Minister) John Walsh a member (later a Productivity Commissioner, see below) PwC supported the Group and its costings Productivity Commission 2011 Cost effectively minimise the impacts of disability Maximise social and economic participation Create community awareness Individually tailored, taxpayer funded support Separate National Injury Insurance Scheme
Legislation Legislation NDIS Act passed 2013 Bipartisan support Very unusual at that time All States and Territories signed agreements with the Australian Government (WA after a delay) States planned to withdraw from disability support State Government services have been devolved to NGO sector
NDIS principles and implementation NDIS principles and implementation Key principles Support independence and social and economic participation Provide reasonable and necessary supports Support achievement of goals and maximise independence Support living independently and inclusion as fully participating citizens Develop and support capacity to live in the community and be employed Enable choice and control Implementation Insurance based approach, informed by actuarial analysis Ensure financial stability Interact with mainstream services
Disability requirements Disability requirements Broad array of permanent impairments, including psycho-social Impairment results in substantially reduced functional capacity to undertake one or more of Communication, social interaction, learning, mobility, self care, self management AND Impairment affects capacity for social and economic participation
NDIS structure NDIS structure Age requirement for new applicants: up to age 65 Commonwealth/State agreements: complex Funding 50% Commonwealth, 50% State Commonwealth pays 100% of cost overruns Insurance scheme Not a funded scheme Lifetime approach Social insurance not an Australian model Model was injury compensation supports, especially NSW Administration National Disability Insurance Agency: Commonwealth
NDIS finances NDIS finances At maturity, estimated cost $22 billion per annum (2019-20) $21.7 billion in 2020-21 States contribute approximately 50%: what they were spending Medicare levy increase of 0.5%, from 1 July 2014 Offsets from existing Commonwealth programs Approx. $5 billion of new Commonwealth appropriation From 2020-21
National Injury Insurance Scheme National Injury Insurance Scheme People entitled to compensation were not eligible for the NDIS NDIS not a primary scheme National Injury Insurance Scheme was proposed States to develop, through Treasuries Array of medical indemnity, public indemnity schemes proposed, with separate funding sources No fault catastrophic road injury compensation has been achieved Common law actions remain
NDIS rollout NDIS rollout Pilots from 1 July 2013 Full rollout from 1 July 2016 2019-20 was target date for full rollout 532,000 participants now expected by mid 2023 (originally 470,000) 430,000 by end 2020; half are receiving support for the first time 6.7% Indigenous, 10.5% culturally and linguistically diverse (CALD) People under age 65 in nursing homes down 27% to 4,600 Cost pressures are concerning the NDIA: client numbers spending per package supported independent living (SIL)
Current issues Current issues Increasing client numbers Package size and spend per client increasing Packages bigger for high socio-economic groups Lack of transparency in decision making Service providers: pressures and disruption Controversies Independent assessments Rejection of some supports: sex services
Conclusion Conclusion NDIS a major social initiative in Australia Bi-partisan support from Australian, State and Territory Governments 430,000 participants Approx $10 billion in additional spending on supports for people with a disability Now
Some questions Some questions An insurance scheme: Implications Unfunded: social insurance How to limit expenditure growth Number of participants Package size Exclusion of injured people covered by compensation
Further reading Further reading 1. Productivity Commission report 2011 https://www.pc.gov.au/inquiries/completed/disability- support/report 2. NDIS Act 2013 3. National Disability Insurance Scheme (NDIS) Costs 2017 https://www.pc.gov.au/inquiries/completed/disability-support/report 4. Tune Review 2019 https://www.dss.gov.au/sites/default/files/documents/01_2020/ndis-act-review-final- accessibility-and-prepared-publishing1.pdf 5. NDIS Quarterly report Q2 2020-21 https://www.ndis.gov.au/about-us/publications/quarterly-reports
