NDIS review urged to expand access, redefine ‘reasonable supports’ and consider means testing

The National Disability Insurance Agency has been unreasonably pushing for all mental wellbeing issues to be treated through mental health plans rather than under the NDIS, GPs warn.

The NDIS review published nearly 800 submissions made during its 12-month long investigation into the scheme.

The National Disability Insurance Agency has been unreasonably pushing for all mental wellbeing issues, even for people with psychosocial disabilities, to be treated through mental health plans rather than under the NDIS, the nation’s general practitioners have warned.

And with 313,000 children now on the National Disability Insurance Scheme, early childhood professionals say the NDIA needs a specialist portfolio to handle issues including the growing numbers of scheme participants with autism and other psychosocial issues.

Ahead of the release of its final report – which the Coalition and Greens worry won’t be until December at the earliest – the NDIS review published nearly 800 submissions made during its 12-month long investigation into the scheme, with questions raised over who should be eligible for the NDIS, what should be considered reasonable and necessary supports, and how the scheme should be funded.

Leading researcher into disabilities, University of Sydney emeritus professor Stewart Einfeld, told the review it should consider using means testing for the NDIS in the same way as “many other government benefits” were applied.

“The NDIS should be for poor people with disabilities, not rich people with disabilities,” Professor Einfeld declared.

The idea was echoed in a submission by teal independent Kate Chaney, who outlined feedback received from constituents in Curtin that posed means testing, introducing small fees for services or setting up a disability levy as possible funding models.

The Australian reported this year on calls for the government to consider means testing in the NDIS by digital service provider Kismet, but NDIS Minister Bill Shorten shot down the proposal as a “lazy” way to make the scheme more sustainable.

In its submission to the NDIS review, the Royal Australian College of General Practitioners noted the difficulties faced by people with disability dealing with mental health issues, and how they were being supported and funded. “Increasingly, a narrative has been fostered by the NDIA that suggests that all issues related to mental wellbeing are ‘health related, not disability related’, particularly for those patients with psychosocial disabilities,” the RACGP said.

“It is unreasonable to expect a mental health professional funded under a Mental Health Treatment Plan to treat for functional deficits related to disabilities that have a negative impact on mental wellbeing. The NDIS is funded to provide supports for participants to overcome disability specific barriers to social and economic participation, whereas a MHTP is funded to treat a diagnosed mental health disorder with focused psychological strategies.”

The NDIS review comes as the government looks to find ways to ensure it is supporting Australians with the most profound disabilities, and is funding what are “reasonable and necessary” supports.

Physical Disability Australia said it was clear the government needed to “include a more robust definition of this term” in the NDIS Act.

“The broadness of these boundary conditions leave it open for participants, advocates and providers to claim ‘reasonable and necessary’ status for supports that PDA is sure the framers of the NDIS never envisioned,” PDA said.

While some advocates and providers were expecting the review to be published by the end of October, the government has signalled the final report will not be released until after it is considered by national cabinet. Many premiers and chief ministers are not expecting national cabinet to sit again until December.

National cabinet agreed earlier that the cost of the NDIS, which has been rising in recent years by 14 per cent annually, needed to be reined in. Part of the review’s remit is to deliver long-term financial sustainability.

Children have driven much of the growth in scheme numbers in recent years. One in nine boys aged five to seven are NDIS participants and one in 20 girls. Autism and psychosocial disorders are driving the increase.

In its submission to the review, advocacy group Professionals and Researchers in Early Childhood Intervention said the NDIS had been “developed for adults rather than designed with children in mind”.