James Stormon

Social Policy Implementation Unit

Government Relations Branch, NSW Health

NSW Health

Implementation of the National Disability Insurance

Scheme

National Disability Insurance Scheme

Most significant social reform since the introduction of Medicare

Delivered in concert with other disability reforms – National Disability Strategy

(Disability Inclusion Action Plan1) and the National Carers Strategy (NSW

Carers Strategy2)

Social insurance scheme providing a package of supports for people with

disability found eligible, with funding in part from a dedicated income tax levy

Aims to support, independence, social and economic participation and

enable choice and control

NSW and the Commonwealth agreed to support 140,000 people, including

50,000 currently not receiving NSW disability supports

NSW full scheme roll out planned by July 2018

1 http://www.health.nsw.gov.au/disability/Publications/disability-action-

plan-16-19.PDF 2https://www.adhc.nsw.gov.au/__data/assets/file/0017/300077/NSW_C

arers_Strategy_2014-19.pdf

W

Where have we come from?

Disability Care and Support

Productivity Commission

report proposes the NDIS

2011

2013

Bilateral Agreement between

Commonwealth & NSW,

Transition to NDIS 2015

NDIS Act and NSW enabling

Act 2013

July 2013 NDIS trial commences in the

Hunter region

Applied Principles and Tables of

Supports (APToS) – delineates

the responsibility of mainstream

services and the NDIA

2015

Early Launch commences in

Nepean Blue Mountains LHD –

children and young people 2015

2016 Full scheme commences

with the roll out of Year 1

districts / networks

2016 Operational Guidance for NSW Mainstream

Services on the Interface with the NDIS

(Mainstream Interface)

2017 Year 2

districts

transition to

the NDIS

NDIS history

Projected NDIS expenditure (2019–20)

Adapted from the Department of Parliamentary Services, Parliamentary Library, Research Paper,

The National Disability Insurance Scheme: a quick guide, 1 September 2016

James Stormon

Social Policy Implementation Unit

Government Relations Branch, NSW Health

NSW Health

Implementation of the National Disability Insurance

Scheme

Health Executive Management Group (Meet as required)

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Working Group

NDIS Reform Group

(DPC/TSY)

Government Relations

Branch

MoH Governance

NSW Governance

Dis

abili

ty P

olic

y

NDIS Steering Committee (Deputy Secretary)

NDIS Transition Board

(Secretary)

Local Governance (LHD/SHN SteerCo)

Implementation Steering Committee

(NNISC)

ROWG - Central

ROWG - North

Senior Officers’ Group

Alli

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ROWG - Sydney

ROWG – South & ACT

PMO

Bilateral Steering Committee (BSC)

Health

Implementation Governance

Regional Operational Working Groups

• Seek to resolve

operational

issues

• Escalate

issues / risks

• Report to the

NSW NDIS

Implementation

Steering

Committee

(NNISC)

NSW Bilateral Agreement - Applied Principles

and Tables of Support (APTOS3)

3 Schedule I (pg 47) http://ndis.nsw.gov.au/wp-

content/uploads/2015/07/Bilateral-Agreement-between-the-Commonwealth-

and-New-South-Wales-2.pdf

Health is responsible for:

Diagnosis and clinical treatment

of health conditions (including

ongoing or chronic)

All supports directly related to

maintaining or improving health

status

Rehabilitation and support after a

medical or surgical event

Medications and pharmaceuticals

The NDIS will fund supports that help

a participant to manage ongoing

functional impairment that results from

their disability, which includes:

Supports that enable participants

to undertake activities of daily

living

Aids and equipment

Therapy supports that enhance

function for children

Other therapy directly related to

maintaining functional capacity

Role of the NSW Ministry of Health

Achieve our objectives by:

Working collaboratively with NDIA and others to ensure effective

implementation of the NDIS

Maximising opportunities and minimising impacts on health services

Communicating with staff across NSW Health on the changes that are needed

to get the best outcome for individuals under the NDIS

Guiding transition planning – consulting with LHDs/SHNs, creating transition

deliverables, providing support and advice

Creating a range of formal tools e.g. Implementation Toolkit, Provider Tool

Monitoring, evaluating and modelling the impacts on the health system

Monitoring of service provision market development

Operational Guidance for NSW Mainstream

Services on the interface with the NDIS1

Working arrangements between the NDIS and other mainstream service

systems is crucial for the success of the NDIS.

The Mainstream Interface is informed by the Applied Principles and

Tables of Support (APToS). It outlines the agreed funding and service

delivery responsibilities of the NDIS and mainstream services.

Mainstream systems need to adjust to work with the NDIS – referral,

access, planning and service delivery for people accessing mainstream

services and the NDIS.

If the condition has not been identified as a permanent impairment/

functional capacity by the NDIS, evidence of impact is required. Allied

health professionals can complete part F of the Access Request Form or

the NDIS Supporting Evidence Form.

1. http://internal.health.nsw.gov.au/communications/ndis/

Hunter New England key learning

Local protocols to identify clients who require prioritisation by

the NDIA.

Detail and language of supporting documentation can reduce

the impact of process delays.

Clinical staff need to consider those people who may have

reduced capacity to advocate for themselves (children and

mental health clients).

The transfer of services from ADHC to NDIS will imply some

challenges (e.g. in-home supports for children deemed

ineligible for the NDIS; post-operative care to children;

continence aids and equipment, home enteral nutrition).

Rural markets may be at risk of market failure.

James Stormon

Social Policy Implementation Unit

Government Relations Branch, NSW Health

NSW Health

Implementation of the National Disability Insurance

Scheme

Early Childhood Early Intervention

• The type of supports

offered will be different

for every child and

their family according

to their individual

needs.

• Children aged 0-6 do

not need to have a

diagnosed disability to

access Early

Childhood Early

Intervention under the

NDIS.

• Providers are listed

here: https://ndis.gov.au/ecei/NSWe

ceiproviders.html

https://www.ndis.gov.au/html/sites/default/files/Early-childhood-Early-

Intervention.pdf

Mainstream Interface and the ECEI

Early childhood health professional can provide advice to the

parent/carer on possible impairments requiring professional

assessment or which could be addressed through ECEI.

Early childhood care providers to encourage families of children

with delay or disability to contact health services for an

assessment.

Early childhood partners may provide initial supports. If the child

needs more intensive supports, they will be referred to the

NDIS.

Children that are currently ADHC funded do not have to lodge an

application for the NDIS.

James Stormon

Social Policy Implementation Unit

Government Relations Branch, NSW Health

NSW Health

Implementation of the National Disability Insurance

Scheme

NDIS transition schedule

The start of transition

https://www.ndis.gov.au/medias/documents/hc6/h8e/8800064339998/Qtr-2-

Poster-NDIS-2016-17-V0.6-accessible.pdf

https://www.ndis.gov.au/medias/documents/h01/hea/8800417775646/National-Dashboard.pdf

Potential risks and challenges

Timeframes to process urgent and prioritised clients

Operationalising ‘Continuity of Supports’

Local Health staff may not have clarity on supporting information needed

for the Access Request Form

Number of external factors can affect the outcome of the NDIS plan

Information sharing

Operational issues during transition

Market development

Capability of workforce in the private market

Potential for market failure in rural and remote areas

Health and disability interface

Clarification around services that will continue to be provided by NSW

Health and services provided by the NDIS

Identification of service gaps

o barriers including Intellectual Disability, Mental Health, Justice

and ADHC disinvestment

Potential risks and challenges (cont.)

What we’ve learnt so far

Trial experience – overall positive, some issues identified, particularly system

interface, new client scheme entry and market development

Scale and complexity of the NDIS transition

All of the answers not in place – we are building new practice

Local relationships and governance mechanisms are critical to resolve issues

Good understanding of the Applied Principles and Tables of Support (APToS) at

the local level translates into effective service responses for clients and good

client outcomes

Changes to operational practices and cultures are needed to ensure the success

of the scheme