Bill Shorten will struggle to rein in cost growth in the NDIS to 8 per cent if he can’t slow the high numbers of children with autism entering the scheme and address the high costs of Supported Independent Living.
The $730m over four years designated in the budget to flatten the NDIS cost trajectory from the current 14 per cent to 8 per cent by 2026, a target agreed by national cabinet a fortnight ago, seeks to address a range of critical issues such as the capacity of the National Disability Insurance Agency (NDIA) to cater to 600,000 participants and growing.
Detail is still thin given the scale of the proposed savings – $15.3bn over the next four years and $74bn over the decade, but Shorten is looking to co-design the changes with the disability community.
Shorten is all in, insisting the new measures will do the job of curtailing spending to meet the target. It is understood he is ruling out any legislative change to limit NDIS eligibility, even as the scheme heads to $56bn by 2027.
With more than a third of scheme participants having autism as their primary diagnosis, ensuring those coming into the scheme have a permanent and significant disability warranting NDIS support is vital.
Scheme eligibility is supposed to be based on a person’s functional capacity, not a particular diagnosis. At present a diagnosis of level 2 and 3 autism is on a list, List A, of conditions likely to meet the disability requirements for entrance to the scheme.
Concerns have been raised about clinicians diagnosing children with levels of autism to secure NDIS funding, even if their functional characteristics don’t warrant it. Shorten says he is concerned that diagnosis has been “following the money”, a problem inherited from his predecessors.
Any intervention will be politically difficult given the sensitivities involved with families facing a dearth of services outside the scheme.
Shorten is looking at early intervention programs for children with developmental delay to divert them from the path of the NDIS. It will be interesting to watch what the government’s independent review of the NDIS, due to report in October, recommends. A tough call may be needed.
Shorten also needs the states to get back in the game on Supported Independent Living, where packages average about $400,000 annually. They vacated the field when the NDIS was created. It would be a start if they returned to being a “provider of last resort” for people with the most profound support needs.
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