What does the new government mean for the NDIS, people with complex needs and those who support them?

Linda Hughes

While it is early days since the election, we know we have a new Labor government that has made promises to fix many of the troubles we have seen with the NDIS. 

Indeed, the NDIS played out as a key election issue with media reporting on:
  • Cuts to participants’ NDIS plans
  • Increasing number of appeals to the Administrative Appeals Tribunal (AAT)
  • People stuck in hospital due to extensive delays with NDIS funding decisions 

The #DownTo10Days Alliance and the Every Australian Counts #DefendOurNDIS ensured a focus on NDIS issues during the election campaign.
There are deep and complex problems facing the NDIS and no easy or quick fixes. Nonetheless, we can have some cautious optimism in the incoming government’s ability to address some of the problems the sector faces.

Bill Shorten is the new Minister for the NDIS. Mr Shorten is known for his long-term interest in disability support, so it will be good to have a well informed minister overseeing the NDIS.

So what can we expect to see with the new Labor government? And how long will it be before we see some changes?
Before the election Mr Shorten, as shadow disability minister, took time to discuss his plans for the NDIS with George Taleporos on the Reasonable and Necessary podcast. Mr Shorten said Labor’s key priority is to “restore trust”. Importantly this includes getting plans right. Mr Shorten said Labor would “stop the informal instructions” to ‘cut’ NDIS plans.

Addressing the Defend our NDIS Rally before the election, Mr Shorten said he would ensure cases going to the AAT were triaged and work on alternative dispute resolution.

Labor’s policy says it will “act urgently” to stop unfair cuts by establishing an “Expert Review”. The Expert Review will be an alternative dispute resolution mechanism that flags any decision to reduce a plan by more than 20%, allowing it to be referred to an expert reviewer.

While light on details we can interpret this as a good sign the current adversarial approach between the NDIA and participants will, at least, be softening.

With the crisis of approximately 1,100 people with disability stuck in hospital because they do not have the support or suitable housing to leave, Mr Shorten said he needed to “look under the hood” and see where the problems lie. He was not able to put a timeline on the process but indicated that quicker decisions on SDA and SIL could address these problems.

We can only hope “looking under the hood” includes greater cooperation between state hospital/health services and the NDIS. With a more conciliatory government approach there is potential that the gaps between the NDIS and mainstream interfaces might be stitched closer together resulting in a more holistic support for people with disability across systems.

The new Labor government wants to investigate the $500 million underspend in Specialist Disability Accommodation (SDA). Potentially this SDA underspend has been a barrier to people with disability stuck in hospital or aged care having access to appropriate housing. View the policy here.

Despite younger people in Residential Aged Care (RAC) being an identified priority group for SDA, there are still 3,436 younger residents living in aged care across Australia. After the Royal Commission into Aged Care there was a bipartisan commitment to stop young people with disability being forced to live in aged care because there was nowhere else for them.

Known as the Younger People in Residential Aged Care (YPIRAC) targets, this commitment acknowledges that aged care is ill-equipped to meet the needs of younger people with disability.  While there has been some progress, most younger people in aged care die or ‘age out’ of the YPIRAC targets. Far more work is needed to support YPIRAC to access housing, particularly SDA, that will meet their needs and preferences.  

To rebuild trust, Mr Shorten wants to create greater transparency in NDIS reporting and has highlighted putting people with disability at the centre of the NDIS. Importantly, he says, this includes the need for more people with disability working in the NDIS particularly at higher levels – on the board, executive and potentially CEO.

While the NDIA has employed higher than average numbers of people with disability, this has tended to be at lower levels within the agency, essentially without the clout to instigate changes.

Mr Shorten has expressed concerns about unregistered providers “ripping people off” and is supportive of more regulation and qualifications for support workers.

This has raised some concerns in the disability community with many noting the importance of choice and control, the challenges of thin markets and the diverse array of skills required by support workers. Many self-managing participants and plan managed participants appreciate the flexibility that tailoring of support can achieve beyond the traditional support approaches.

So while we wait and see what the future brings, if you are assisting a person whose funding has been radically cut, it is worth supporting them with a review of their plan. We might see these reviews resolved more quickly and with a more conciliatory approach.

Over the medium and longer term we should see fewer discharge delays from hospital. Ideally the NDIA will improve the timing and accuracy of decisions so participants will be getting the support and housing they need to leave hospital sooner. With long-term housing identified, accessing medium term accommodation (MTA)  and support could be a viable interim option to precipitate a timely discharge from hospital.

Importantly, younger people in RAC need to remain a focus with good housing options in the community available.  Investigation into the $500 million SDA underspend might result in increased market stewardship from the government. Enhancing confidence in the SDA market would be a welcome response.
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