NDIS timetable for participant intake will be delayed, according to a Productivity Commission report. Governments must start planning now for a changed timetable, including working through the financial implications.
To reach the estimated 475,000 participants in the scheme by 2019-20 the National Disability Insurance Agency (NDIA) needs to approve more than 500 plans a day and review hundreds more. The current approval rate sits at around 165 a day. This “tsunami” of new participants must be processed into the scheme over the next two years. While the Commission recognised that implementing these recommendations will increase the NDIA’s workload, at least in the short term, without these changes the objectives of the scheme will not be achieved.
A significant challenge in the transition phase lies with developing disability services and growing the disability care workforce. It is estimated that one in five new jobs over the next few years will need to be in disability care, but workforce growth remains too slow. “Emerging shortages should be addressed by independent price monitoring and regulation, more effective coordination among governments to develop markets, a targeted approach to skilled migration, and equipping participants to exercise choice”, the report said.
Some disability supports are not being provided because of unclear boundaries about the responsibilities of the different levels of government. Governments must set clearer boundaries at the operational level around ‘who supplies what’ to people with disability, and only withdraw services when continuity of service is assured.
Concerns were also raised about the NDIA focus on participant numbers with little attention on planning processes. For the scheme to achieve its objectives, the NDIA must find a better balance between participant intake, quality of plans, participant outcomes, and financial sustainability. Greater emphasis is needed on pre-planning, in-depth planning conversations, plan quality reporting, and more specialised training for planners.
The Commission also heard from many stakeholders that the NDIA’s pricing methodology has, in some cases, led to poor participant outcomes and hindered market development, especially for those with more complex needs. According to the NDIA, existing providers who previously relied on block-funding were finding it difficult to adjust to the fee-for-service model. The NDIA report on its pricing approach will be completed by the end of 2017.
The report also found dissatisfaction with phone planning as it was not appropriate for some participants. The commission heard on numerous occasions that participants were called with no forewarning, or were not informed that the call was a planning conversation. Following on from this the NDIA has just released details of a new NDIS ‘pathway’ which includes face-to-face engagement for all plan development as well as a clearer focus on outcomes and goals during planning. (See following news story).
While some cost pressures are emerging, benefits of the NDIS are also becoming apparent. Early evidence suggests that many, but not all, NDIS participants are receiving more disability supports than previously, and have more choice and control.