The challenges and developments facing the sector now, and in the future
Since it first began, the National Insurance Disability Scheme (NDIS) has evolved, and we’ve seen changes both help and hinder people with disability. The good news? As of December 31, 2018, 244,653 Australians have been given access to the NDIS, including 73,956 receiving supports for the first time.
From January 2019, the NDIS is helping participants nationally, with the exception of the Northern Territory and Western Australia, where the rollout will continue.
From 2020, the NDIS is aiming to provide $22 billion in funding each year to around 460,000 people with disability. Approximately 90,000 jobs will have been created by this time to support the NDIS in Australia. This job creation represents strong disability sector growth. In this article, we discuss the state of the disability sector now and into the future once the NDIS rollout is complete.
How has the NDIS evolved since 2013?
The scheme’s rollout has not been without its teething problems. Inaugural board chairman of the NDIS, Bruce Bonhady, suggested more resources were needed to manage the growth and structural adjustment taking place for disability service providers. Responsibility for managing the adjustment had been blurred between the National Disability Insurance Agency (NDIA) and federal and state governments.
The NDIA did acknowledge that changes from the scheme presented the disability sector with challenges. What’s clear to us now is that some changes, especially those around funding for services and individuals, are going to take time to navigate.
Transformation of the sector around the NDIS relies on effective delivery of the reform from state and federal governments, and building knowledge for consumers, participants and people living with disability. Together, these factors will shape the nature of supports offered in the sector.
Despite these early issues, many have welcomed the NDIS as a significant improvement on the previous system. Australian Federation of Disability Organisations chief executive Ross Joyce is one of these supporters. He believes the previous system was patchy and tricky to navigate.
However, he acknowledged there was some confusion during the NDIS rollout process. Some supports were mistakenly withdrawn by certain governments, unaware that the NDIS does not take over every need in the sector.
What demands are being met and what gaps still need to be filled by service and support providers?
Transitioning to the NDIS is costing disability service providers. One in ten services considered closing their doors this past year. A survey by National Disability Services (NDS) also revealed that around 75% of disability service providers felt the NDIS was not delivering. According to NDS CEO Chris Tanti, the sector’s biggest challenges are unrealistic pricing limits, higher administrative costs and an increased demand for services.
What impact is the NDIS having on people with disability?
Let’s start with some high fives.
It’s providing genuine choice. There’s no doubting the NDIS is a significant social reform. It’s providing many Australians with a disability the chance to exercise genuine choice and control over their lives. “For the first time [people with disabilities] will have their needs met in a way that truly supports them to live with choice and dignity.” Julia Gillard, then-Prime Minister, introduced the NDIS bill in 2012 with these words.
Paul Fletcher, Minister for Families and Social Services, says we’re well on the way. “We have been driving hard to get the NDIS rolled out across Australia. Reaching this milestone means that a quarter of a million Australians with a disability are now being empowered to live their best life and achieve their goals.”
It delivers what people actually need. The fact that the scheme is driven by need means that participants with dual diagnoses can have their support adequately funded through the individualised, rights-based funding approach of the NDIS. The scheme also offers a good deal of flexibility, for both providers and participants, to develop and deliver services based upon what people genuinely need.
It’s also stimulating job growth. One in five jobs created in Australia over the next few years will be related to the NDIS. This will have a flow-on effect on decreasing unemployment, but also give participants, parents and carers the opportunity to establish themselves as service providers. And, importantly, there are many people, including vast numbers of school-aged children, who are receiving life-changing support for the first time.
And the drawbacks?
The tech is awkward. One significant challenge of the scheme is the technology associated with it, the portal, website and call centre. In December 2018, the Joint Standing Committee on the NDIS released a report looking at how IT for the NDIS was working. The findings revealed many user experience issues. Participants, families and carers were struggling to navigate the myplace portal, and the language was often confusing, not matching plan or phone information. Selecting a primary disability was a barrier for some participants with multiple interactive disabilities.
Not everyone is benefiting equally. As of September 2018, more than 6000 young people with a disability were living in residential aged care (RAC). The NDIS has the potential to offer young people different options than living in a nursing home. But there have been problems making this a reality, partly because most young people living in residential aged care are not yet participants.
A 2018 report from The Summer Foundation found that the NDIA was slow to get young people in aged care into the scheme and also that young people weren’t receiving funding for housing in their NDIS plans.
The NDIS can’t solve everything. Many young people in aged care don’t know about the NDIS or get the help they need to apply. Even if they are eligible, many face problems developing and implementing their plans, such as a lack of expertise among planners and support coordinators. There’s also a gap between what the health system provides and what the NDIS can deliver.
Regional areas are still lacking the supports and services they need. Every week we work with, and hear from participants in regional parts across the country who’ve been provided funding, but have no access to services. Often, their disabilities prevent them from travelling to larger cities and towns to find support providers – and these people don’t know how to bridge this gap. The NDIS Information Linkages and Capacity Building Framework is designed to give providers funding to supply much-needed supports and services, but far too often there are limited services in these areas for this growth to occur.
What does the independent support workforce look like now?
With the introduction of the NDIS, more than 90,000 Queenslanders will be provided with the reasonable and necessary disability supports they need for daily living. With demand growing, the current disability services workforce is expected to double before the full rollout of the scheme, an estimated 15,900 to 19,400 additional workers, in roles such as support workers, case managers and specialist practitioners.
To help prepare Queensland’s disability sector workforce for the NDIS, Workability Qld was developed, to make sure Queensland has the right people, with the right skills, in the right place at the right time to meet the demand of Queensland's NDIS participants.
What changes to the workforce need to be made?
When it comes to the workforce, what is the state of the disability sector? In June 2018, SEEK reported a 62 per cent rise in community and healthcare jobs in the five years since the introduction of the NDIS. This jump does represent sector growth, but it’s worth noting the mix of full-time and casual/part-time staff associated with this rise.
The second edition of NDS’s Australian Disability Workforce Report (ADWR), published in February 2018 had some significant findings. Compared to other sectors, the disability sector has a high proportion of casual and part-time workers. The employment gains we have seen since 2013 are coming mainly from an increase in casual employment.
If the sector continues to grow mainly through casual jobs, it may become less competitive in the labour market with job seekers more interested in permanent roles. There’s also a downward trend in average weekly work hours, which may put the sector at risk of not offering enough hours to attract and retain talent.
It’s hard to say what the disability sector future will look like, says NDS Victorian State Manager David Moody. One reason for this is that the consumer is in control, and NDIS participants have expectations about the supports they wish to access and the workforce they believe they’ll need to deliver these.
What are the challenges facing support and service providers?
According to the NDS State of the Disability Sector Report for 2018, disability service providers do remain committed to the NDIS. However, many (73 per cent) believe its systems and processes need urgent improvement. Key findings from the Annual Market Survey, which surveyed 626 disability service providers, revealed:
Half agreed that the NDIS policy reforms were heading in the right direction.
NDIS systems and processes continued to be a source of frustration.
63% found it difficult to recruit disability support workers.
What lies ahead for the sector?
Despite these concerns, there are many encouraging signs that current NDIS issues can be managed. We look forward to the best possible scheme moving forward, and a disability sector future that looks bright.
Over to you
What has your experience been with the rollout so far? And, what are your hopes for the future of the sector? We’d love to hear from you.