NDISNDIS

The National Disability Insurance Scheme Scheme overview, implementation and transition management

David Bowen

CEO

National Disability Insurance Agency

September 2013

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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

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• 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.

Principles and objects of the NDIS Act 2013 underpin delivery

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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.

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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.

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The pathway is clear and simple

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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

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Structure of planning and assessment conversation

Training and procedures provide structured approach to planning building on participant statement

Draws on existing assessment information- If insufficient then

Assessment tool provides screening questions to identify whether person has limitations in:

Mobility

Self-care (includes Special Health Care Needs)

Domestic Life

Communication

General Tasks and Demands

Learning and Applying Knowledge

Interpersonal interactions and Relationships

Community, Social and Civic Life

Education

Employment PLUSSupport Needs for Sustaining Informal CareAssistive TechnologyRisk Assessment

Note – questions are prompts and are used to guide

conversation

If limitations ask further questions in relevant domainsIf limitations ask further questions in relevant domains

Consolidate information back into Participant record and resolve support needs with Participant

NDISDeveloping the Statement of Supports takes into account

Sustainable informal care • Records informal care that will be provided• Talk with the family about sustainable

arrangements into the future. • Reasonable expectations of care by family

Optimise mainstream supports• 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

NDISStatement of supports contains:

Fixed supportsEarly 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 Early childhood and early

interventions o Assistive technology to support

independence

Flexible Supports

• Flexibility allows the participant to

purchase more or less to best meet

their needs over life of plan.

• Flexibility is to beo within total $ value of flexible items in plan

o 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)

o less flexibility may be put on items that are

higher risk or for participants that are

vulnerable

Reassess risk or vulnerabilities –

ensure safeguards are in plan

Check reference packageCheck Life Time Cost EstimatorDelegations for approvals

Resolve plan management with

participant and include necessary assistance in plan

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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.

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.

Self management

(by participant or nominee)

Agency Management

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Plan Management

Provider

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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

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Individualised funding Choice and control Supports not programs

National Disability Insurance Agency

service delivery & payment

Plan & budget

payment

New

support

support

support

support

participant

funding & reporting

contracts

service delivery

program 1

program 2

program 3 participant

Government agencies

Capped funding Limited choice Limited control

Old

13

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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.

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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

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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

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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