The National Disability Insurance Scheme

1. The National Disability Insurance Scheme Scheme overview, implementation and transition management David Bowen CEO National Disability Insurance Agency September 2013

2. 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

3. 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.

4. 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.

5. 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.

6. The pathway is clear and simple

7. DeterminingAccess to the Scheme Age Residency • People with disability who meet the access requirements will becomeparticipants 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 Disability Early intervention

8. Structure of planning and assessment conversation Training and procedures provide structured approach to planning building on participant statement Note – questions are prompts and are used to guide conversation • 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 • EmploymentPLUS If limitations ask further questions in relevant domains If limitations ask further questions in relevant domains Consolidate information back into Participant record and resolve support needs with Participant Draws on existing assessment information - If insufficient then • Support Needs for Sustaining Informal Care • Assistive Technology • Risk Assessment

9. Developing 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

10. Statement of supports contains: Fixed 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: Early childhood and early interventions 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 be • 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 Check reference package Check Life Time Cost Estimator Delegations for approvals Resolve plan management with participant and include necessary assistance in plan Reassess risk or vulnerabilities – ensure safeguards are in plan

11. 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.

12. 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

13. Old program 1 Government agencies contracts program 2 funding & reporting program 3 participant service delivery Capped funding Limited choice Limited control New service delivery & payment support National Disability Insurance Agency Plan & budget support support support participant payment 13 Individualised funding Choice and control Supports not programs

14. 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 • Requires an agreed Bilateral approach covering identified areas by November 2013. • Staff will commence in November with community engagement.

15. 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

16. 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

17. 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