Governments will need to invest an additional $25bn over the next five years if they are to achieve plans to rein in the NDIS’s growth by lifting disability services outside the scheme to a high enough level, a leading actuary has estimated.
It comes as disability organisations, particularly those advocating for the autism community, raise concerns about who will be able to access the scheme in the future, and whether those who can’t join the NDIS can still be well supported.
The figure of $5bn a year over the next five years in additional services, estimated by Anthony Lowe, chair of Actuaries Institute’s Public Policy Council Committee and former NDIS provider chief executive, could go towards establishing early intervention programs for those with developmental delays, he said.
It’s a key part of the independent review’s recommendations to fix the NDIS the Albanese government has deemed “unsustainable” on its cost trajectory. Estimates suggest it could tip past the $100bn mark a year in a decade’s time.
The review recommends the NDIS’s exponential growth can be reduced by adequately lifting services outside the scheme, called foundational supports, so that fewer people need to join.
If adopted, the changes would see the NDIS’s individualised funding packages form part of a spectrum of accessibility and inclusion measures, including “foundational supports” and mainstream services over a five-year period.
The federal government agreed to a 50-50 funding model with the states and territories for these additional services and is understood to have suggested a combined total of approximately $10bn over the next five years be agreed.
That figure would see foundational supports receive an additional $2bn a year across the country.
The review’s authors estimate about $2.67bn is already spent on foundational supports across the country, despite services being considered as nonexistent.
The funding is just one aspect. There’s also work to be done to get the workforce available and ready as the care sector faces continuing skills shortages, according to Lowe.
He said he wanted to see the federal government provide more clarity about its plan next year as work gets under way to overhaul the way disability support services are funded.
“It’s going to be very complicated and the risks of it not all working to plan, I think, are quite high,” Lowe said.
‘Too many people are falling through the cracks’
The precise nature of foundational supports is unclear but, at a high level, advocates understand them to include information and advice services, and less complex support services that will assist someone to live independently, such as cooking, cleaning and shopping support, as well as mobility aids and equipment – similarly to how My Aged Care currently functions for older Australians.
Foundational supports are also expected to include investment in early support programs for children with developmental concerns and disability to be delivered in schools and childcare centres.
Nick Avery, chief executive of South West Autism Network (Swan), said this recommendation could lead to fewer autistic people becoming NDIS participants.
“It would very much depend on what supports would be delivered through Foundational Supports, and what type of assessments are used to determine access to the NDIS,” Avery said.
Some foundational supports existed before the NDIS, including home and community care programs, and occasional state-funded therapy or early intervention programs. But these were patchy, limited and often difficult to access, especially for regional Australians.
“Most people had little or no support,” Avery said. In Western Australia, where Swan is based, there was also the community aids and equipment program, “which again was extremely difficult to access funding through. People often spent a lot of time fundraising or applied for grants [or] donations from charities.”
While foundational supports could see some people rolled off the NDIS, Avery said there was already a lot of unmet need in the community. She noted the long wait times to access a paediatrician or formal diagnostic testing.
“We are often contacted by undiagnosed autistic adults who are unable to afford the cost of the diagnostic assessment,” Avery said. “They are in need of supports, either Foundational Supports or NDIS, and currently have access to neither. Being undiagnosed, they are often unable to access Disability Employment Services or the Disability Support Pension, and are trapped on JobSeeker Payment, struggling (and often failing) to meet the mutual obligation requirements.
“Currently too many people are falling through the cracks.”
‘Creating a continuum of support’
The NDIS minister, Bill Shorten, last week at a Committee for Economic Development Australia event said the NDIS had “struggled under its own weight” and had become “the only lifeboat in the ocean as non-NDIS disability supports have eroded since the introduction of the scheme”.
But he cautioned changes were not about kicking people off it.
“This is not about moving hundreds of thousands of people out of the scheme at all. It’s about taking some of the pressure off whether or not you’re in or out, creating a continuum of support,” Shorten said.
The federal government announced it would invest an extra $511m in the NDIS to make it more sustainable over the next two years during the release of its mid-year economic and fiscal outlook last week.
It is expected details on what the extra foundational supports to be delivered over the next years, and how much funding will be allocated towards them, will be released in the first half of next year.
