NDIS
The National Disability Insurance Scheme
Scheme overview, implementation and transition management
David Bowen
CEO
National Disability Insurance Agency
September 2013
NDIS
The NDIS is a new way of delivering
disability support
•
Supports tailored to individual needs
•
Insurance approach for more stable long term
costs and better outcomes
•
Choice and control is central
•
Demand-driven rather than rationed funding
•
Delivered in local community
•
Working towards national coverage
NDIS
Principles and objects of the NDIS Act 2013 underpin
delivery
• Give effect to the obligations under the CRPD and certain obligations in other
conventions
• Support independence and social and economic participation – not passive
• Provide reasonable and necessary supports, including early intervention
• Enable people to exercise choice and control in pursuit of their goals, and in
the planning and delivery of their supports
• Facilitate a nationally consistent approach to the access, planning and funding
of supports
• Promote the provision of high quality and innovative supports to maximise
independent lifestyles and full inclusion in the community
• Raise community awareness of the issues that affect social inclusion
• Evidence base is critical
Principles expand on the objects for implementation and to guide administration.
NDIS
Taking an insurance approach provides benefits
Risks are pooled and recognise the
unpredictable nature of disability – new
Levy refers
Supports relate to the individual
Risk approach that allows higher short term
costs given longer term benefits
Prudential governance approach focusing
management on cost trends
Enables planning to encompass positive
outcomes for the individual – such as early
intervention, outcome planning, links to
community
Strong and transparent accountability
Section 180 of the legislation goes to
the appointment and duties of the
Scheme Actuary including:
• Assessing the sustainability of the
Scheme
• Risks of the Scheme and causes
• Any trends in the provision of
supports and drivers
• Estimate future expenditure and
provide a report on the consideration
and estimation
Estimates must be done at least once
per quarter.
The actuary provides advice to Board or
CEO as requested and bring matters of
concern to the Board.
NDIS
The scheme was launched on 1 July
On 1 July 2013, the first stage of the NDIS
commenced
•
For cohorts in South Australia, Tasmania
•
The Hunter in NSW and
•
The Barwon area in Victoria
From July 2014
The whole of the ACT, the Barkly area of NT and
Midland, Kalamunda and Mundaring in WA. Plus two
My Way sites also in WA.
NDIS
The pathway is clear and simple
NDIS
Determining Access to the Scheme
• People with disability who meet the access
requirements will become participants in the
Scheme
• The Scheme has a wide gateway to introduce
people through multiple channels and touch points
• People can use MyAccess Checker to get an
indication about whether they will be able to access
assistance from the Scheme
• Gradual intake of participants into the scheme,
starting with people in launch locations
Age
Residency
Disability
Early intervention
NDIS
Structure of planning and assessment conversation
Training and
procedures
provide structured
approach to
planning building
on participant
statement
Assessment tool provides
screening questions to identify
whether person has limitations in:
Mobility
Self-care (includes Special Health
Care Needs)
If limitations ask further
questions in relevant domains
Domestic Life
Communication
General Tasks and Demands
Learning and Applying Knowledge
Draws on
existing
assessment
information
- If insufficient
then
Note – questions are prompts
and are used to guide
conversation
Interpersonal interactions and
Relationships
Consolidate information
back into Participant
record and resolve support
needs with Participant
Community, Social and Civic Life
Education
Employment PLUS
Support Needs for Sustaining
Informal Care
Assistive Technology
Risk Assessment
NDIS
Developing the Statement of Supports takes into account
Sustainable informal care
Optimise mainstream supports
•
•
•
•
•
Records informal care that will be provided
Talk with the family about sustainable
arrangements into the future.
Reasonable expectations of care by family
•
Not funded by NDIS
Plan records nature, referral and support to
access to be provided
NDIS will not provide supports that should be
provided in mainstream
Are general supports needed
Are services to be provided by the Agency
e.g.
•
•
Provision of information
Local area co-ordination to assist person to
access mainstream or other community services
Identify the Reasonable and Necessary Supports
•
•
•
Provides funding for support reasonable and necessary to achieve goals in participant statement
Assist independence, social and economic participation
Are effective or beneficial for the participant, having regard to current good practice
NDIS
Statement of supports contains:
Fixed supports
Flexible Supports
Early intervention and investment
supports are fixed in the plan, as are
“in-kind’ supports
These items aim to ensure over long
term, the desired outcomes for
participants are maximised.
Funding for these items cannot be
used for other items.
Examples include:
•
o
o
Early childhood and early
interventions
Assistive technology to support
independence
Reassess risk or
vulnerabilities –
ensure safeguards
are in plan
•
Flexibility allows the participant to
purchase more or less to best meet
their needs over life of plan.
Flexibility is to be
o
o
o
Check reference package
Check Life Time Cost Estimator
Delegations for approvals
within total $ value of flexible items in
plan
within limits set for each item (all items
have a default level of flexibility but this
may be altered to suit each
participant’s need)
less flexibility may be put on items that
are higher risk or for participants that
are vulnerable
Resolve plan
management with
participant and
include necessary
assistance in plan
NDIS
Management of funding for supports to be resolved with
Participant
The type of funds management that the
participant chooses can vary depending on
their circumstances.
Self management
(by participant or
nominee)
Different options can be chosen for
different supports.
Plans may have a combination of the
options as shown.
Agency can limit self management where
financial or personal risk.
Plan
Management
Provider
Agency
Management
NDIA
NDIS
Request to self-manage the funding for supports
•
•
The participant should be able to manage his or her plan to the
extent he or she wishes to do so unless there are grounds for the
participant not to self-manage.
Grounds to refuse a self-management request
 Participant or nominee is insolvent under administration
 The support is prescribed by the NDIS Rules as being matters
not managed by a participant
 Where delegate (of CEO) is satisfied management of the plan
presents an unreasonable risk to the participant
NDIS
Old
program
1
Government
agencies
Capped funding
contracts
funding &
reporting
program
3
Limited choice
New
National
Disability
Insurance
Agency
program
2
Plan &
budget
service delivery
participant
Limited control
service delivery
& payment
support
support
support
support
participant
payment
Individualised funding
Choice and control
13
Supports not programs
NDIS
Logical next steps for Scheme implementation in WA
• WA and Commonwealth continue progress with NDA (2012) reforms.
• Jurisdictions to work with community and providers to raise awareness
and readiness.
• Build individual capacity for engagement on goals and choice and
control
• Draw on better practice resources as they become available form
Scheme
• Agency has commenced WA readiness
o Requires an agreed Bilateral approach covering identified areas
by November 2013.
o Staff will commence in November with community engagement.
NDIS
What the NDIA brings to the partnership
• National capability with local decision making and responsiveness
• Systems and processes that have been tested in launch with strategic
investment plan for full scheme enhancements
• Existing capability that now underwrites future growth
• Strong community engagement approach
• Strong engagement with sector
• Growing research capability
NDIS
Engagement activity has helped prepare people and
communities
•
From January 2013 over 800 events were attended/organised by Agency
•
Included public forums, formal presentations, smaller targeted sessions for
people with disability and providers
•
Engagement activity focused on preparing people and providers for launch
•
Additional engagement conducted by Alliance (Carers Australia, National
Disability Services and AFDO) to inform design and improve readiness
•
“Your Say” online forum used extensively on design, legislation and rules
•
DisabilityCare Australia website activated on 4 June ahead of national
advertising campaign
•
Facebook and Twitter live
NDIS
Strategic Issues for Agency to progress in 2013/14
• Operationalising choice and control in restricted environments – such
as institutions.
• National strategy for aids and appliances
• Housing strategy
• Refinement of approach to mental health for those that need a funded
package
• National framework for quality and safeguards
• Industry workforce – projected need for 65,000 FTE or 130,000
individuals when fully implemented
• Developing effective interfaces with mainstream such as employment