The 2019–20 Annual Report for the National Disability Insurance Agency (the Agency or NDIA) is prepared in accordance with legislative requirements. It summarises the Agency’s performance from 1 July 2019 until 30 June 2020. This includes how the Agency fulfilled the principles set out in the National Disability Insurance Scheme Act 2013 (NDIS Act).
We acknowledge and pay our respects to fellow Australians with disability and reconfirm our commitment to the mission of the NDIS to contribute to a just and inclusive Australia where all can reach their full potential and contribution. We support the objectives of the Convention on the Rights of Persons with Disabilities.
The Agency also acknowledges the Traditional Owners and Custodians of the country throughout Australia, and their continuing connection to land, sea and community. We pay our respects to their Elders, past, present and emerging.
1.2 Chairman's review
The National Disability Insurance Agency has a singular focus: to help participants improve their outcomes.
2020 was a landmark year for the National Disability Insurance Scheme.
Seven years after the launch of the Scheme, and four years after the move from Trial to Transition, the Scheme is now available to all eligible participants throughout Australia, with over 390,000 participants benefiting from the supports provided. But, from a participant perspective, the delivery of faster and improved services has also been significant. The time to deliver access decisions and first plans dramatically reduced; participant satisfaction rates climbed to over 80 per cent; the number of reviewable decisions declined; and the percentage of complaints fell to a record low. That reflects better service for participants.
This has not happened by chance. It has happened because of the ability to commit additional resources; through the energy and commitment of the Minister, the senior management team under the leadership of our new Chief Executive Officer (CEO), Martin Hoffman, and through the dedication of front line staff and partners. Simplified and streamlined processes have also been important.
Most importantly, the year saw improved outcomes for participants: participants exercising more choice and control in their decision-making; more carers joining the workforce; greater social inclusion for participants; and better health outcomes for some participants.
And, in the latter part of the year, those improvements occurred at the same time as participants faced the challenge of COVID-19. Participants were front and centre as we recognised that the challenges they faced were greater than most other groups in society.
In consultation with participants and providers, we learned together as events unfolded. We made it easier for participants to access supports; we made technology more accessible so they could get support without leaving home; we helped negotiate easier access to supermarket deliveries; and we made it possible for providers to access personal protective equipment so that participants and provider staff could be safe. Between March and June we made over 65,000 care calls to the Scheme’s most at-risk participants. And that has continued into the next stage of restrictions in Victoria. Through those calls, we have sought to let participants know we care about them as an individual and that they are not alone during this dark hour. Meeting the needs of participants in disability homes has also been a core focus as we work with providers and other state and federal agencies to keep participants as safe as possible. Nonetheless, a small number of participants have passed away. We offer our sincere condolences to their family and friends.
Our unrelenting focus on participants will continue and be amplified over the coming year, particularly through the early implementation of the Participant Service Guarantee. At the same time, we will respond to any challenges that COVID might bring, while striving to simplify and streamline the way we serve participants and those who provide supports to them.
The Board and management are equally focused on getting it right for participants. The CEO and his committed leadership team have made a real difference, as did Vicki Rundle, who was interim CEO before Martin joined.
So too have my dedicated colleagues on the Board. In particular, I wish to acknowledge and thank the Chairmen of the Board Committees, who bear a disproportionate workload: Estelle Pearson, Sandra Birkensleigh, Jim Minto, Paul O’Sullivan, and Robyn Kruk.
In addition, I pay a heartfelt tribute to John Walsh, who throughout the past year so ably led the Independent Advisory Council, through whose membership the voice of the participant resonates so profoundly with their frank, wise and fearless advice. Subsequent to the end of the financial year, John has advised of his intention to resign from the Board. The Board and all participants are in John’s debt for the legacy of the Scheme that he fought for and profoundly shaped. We know he will remain a passionate advocate for the Scheme.
We will also greatly miss another founding Director, Martin Laverty, with his background as a lawyer and his boundless passion for the Scheme. Andrea Staines also made a significant contribution through her first-hand knowledge of disability, as well as her insights into using technology to the benefit of participants. We also welcomed Jane Burns, who brings with her a wealth of knowledge of mental health and first-hand experience of disability.
In conclusion, I wish to acknowledge the many participants, providers and representatives of the sector with whom I have had the privilege of interacting over the past year, COVID-19 notwithstanding. I gain insight, wisdom and strength from each of you and I thank you for your ongoing commitment to the Scheme.
Dr Helen Nugent AO Chairman
1.3 Chief Executive Officer's review
I joined the Agency as CEO on 4 November 2019. I’m proud to be leading the Agency at this critical time as we make the transition from establishing a world-first Scheme, to improving the experience and outcomes our participants achieve with the Scheme.
This Annual Report sets out the significant achievements we made this year on that journey, culminating in the Scheme being fully available throughout Australia on 30 June 2020, and serving almost 400,000 participants with over a third of those receiving supports from government for the first time.
Most importantly, the Report highlights the positive impact the Scheme is having on the lives of participants. Participants are making more of their own decisions, are much more involved in the community and are better positioned to undertake activities that interest them.
We also made significant improvements in the operating efficiency of the Agency. Getting the operational detail right means we have a better chance of having the Scheme deliver on its real purpose—a different life trajectory for people with disability.
In the June quarter, we had the lowest absolute number of complaints since June 2018, and that was when the Scheme had less than half the number of participants we do now.
Our Satisfaction Survey results in the June quarter (based on a random sample of over 5,500 participants with ongoing oversight and input from the Independent Advisory Council) recorded our highest scores, averaging over 83 per cent satisfaction across access, pre-planning, first-plans and plan reviews.
We are getting more than 90 per cent of reviews of reviewable decisions done in less than 60 days, with more than 95 per cent of any resulting plan changes being implemented in less than 28 days.
In September 2019 we had 8,400 review cases open; at June 2020 it was down to 2,100.
Our focus on Participant Requested Plan Reviews is working too, in June 2019 we had 7,300 open reviews; at June 2020 it was down to 2,200.
In June 2020, access decisions on average took 10 days, four times faster than 12 months ago. The average number of days to receive a first plan is 67 days, 50 per cent lower than 12 months ago.
And all this has been done through a year when we also added 106,000 new participants and were dealing with a pandemic and all that has meant for Australia.
These are all just operating statistics—but we never forget each one represents an interaction with a real person, a participant and their family.
The Annual Report also gives a sense of the future direction of our journey, which of course is set out in more detail in the 2020–24 Corporate Plan.
I want to focus also on the intangibles how the Agency will act and feel both internally and, even more importantly, externally: how we will make real our culture and values. Again, this Report sets out the progress we have already made on this front.
We will have a renewed focus on our participants, constantly asking ourselves: if I was a participant or my child was, how would I want things to happen? And of course many of our staff are just that: participants or close family members of participants.
We will have a greater sense of urgency and pace in everything we do; decision velocity matters, just as decision quality does.
We will be resisting the tendency towards the bureaucratic inward focus on process and form for its own sake, and instead take an outward focus on the participant experience and outcomes.
We will continue to improve how we engage about the Agency, our guidelines and decision making. Co-design and consultation will be real and meaningful. We’ll show a willingness to genuinely listen even if we don’t always agree, and willingness to say directly where we don’t agree and not skirt around it.
We’ll also be working more closely with the other service systems—such as health, education, justice—across all jurisdictions that interact with our participants to reduce complexity.
We will continue to focus on maintaining a high performing, high engagement, flexible and fast-moving culture.
In my time with the Agency, I have been impressed by the passion and commitment of our workforce. Our staff and Partners in the Community teams have demonstrated the Agency’s resilience throughout the recent challenging times of severe bushfires and the COVID-19 pandemic. I thank them all for their incredible efforts over the last year.
I must recognise Vicki Rundle, who acted as CEO before my appointment and then continued as a Deputy providing tremendous support and guidance. Vicki left for a senior leadership role at the Department of Veterans’ Affairs at the end of the year, leaving a lasting contribution to the Scheme.
I also want to sincerely thank the many individual participants, families and carers, representative organisations, providers and peak bodies with whom we engage in many different ways for their expert assistance, support and encouragement, and for holding us to account too.
I should also acknowledge our colleagues at the NDIS Quality and Safeguards Commission and the Department of Social Services, with whom we work closely to deliver the Scheme.
I want to thank Helen Nugent as Chairman and the whole Board for its unstinting support and commitment to me and the whole Agency, in the interests of the Scheme and its participants. And the Independent Advisory Council for its significant and expert contribution over the year.
Let me close by stating simply that the whole Agency team and I are committed to bringing the Scheme ever closer to fulfilling the promise made to Australians living with disability. 2019–20 saw the Agency improve in delivering on that promise, with further progress to come.
Martin Hoffman Chief Executive Officer
1.4 The National Disability Insurance Scheme
The National Disability Insurance Scheme (NDIS or the Scheme) is a fundamental shift in the way Australians with a significant and permanent disability access supports. It ensures that all eligible Australians under the age of 65 years who have a permanent and significant disability can get the reasonable and necessary supports they need.
Under the Scheme, eligible people, known as participants, are given a plan of supports that is developed and tailored to their individual needs. A plan may include informal supports that a person receives through family or friends and from mainstream or other community services. If required, the Scheme will also fund reasonable and necessary supports that help participants achieve their goals.
Participant choice and control are core features of the Scheme’s design. In this market-based system, participants work closely with planners and Local Area Coordinators (LACs) to determine a plan that focuses on their individual goals. Participants can choose their providers and move between them, rather than having providers selected for them.
On 1 July 2020 Christmas Island and Cocos Island joined the Scheme, completing the staged national geographical rollout of the NDIS.
The Scheme provides specialist disability supports that complement mainstream services provided by the Australian Government and state and territory governments. It is founded on insurance principles, making evidence-based decisions on individuals’ access to the Scheme.
This insurance approach is underpinned by four key principles:
1. Develop actuarial estimates of the reasonable and necessary support needs of the targeted population
The Scheme Actuary estimates the aggregate annual funding requirements through analysis of reasonable and necessary support needs. The Agency continually tests the aggregate funding requirement against emerging experience.
2. Focus on lifetime value for Scheme participants
The Agency focuses on lifetime value for Scheme participants by funding competitively priced, best-practice supports that deliver benefits and outcomes for participants. This includes the allocation of resources through early investment in capacity building.
3. Invest in research and innovation
The Agency invests in research and innovation aligned to the Scheme’s goals of improving social and economic participation, and independence for participants.
4. Support the development of community capability and social capital
In addition to providing individual supports, the Agency invests at a systemic level. For example, the Agency encourages the use of mainstream services, building community capacity and social capital. These activities are designed to benefit all people with disability, including people with disability who are not participants in the Scheme.
These four insurance principles are governed by the Board, which assesses, monitors, reports and manages Scheme sustainability within a prudential framework and in line with the Portfolio Budget Statements. This means that decisions are informed by:
a person’s level of functional capacity
the reasonable and necessary supports required to enable a person to reach their goals, live and enjoy their life
the overall context of Scheme financial sustainability.
This approach considers financial support over the lifetime of the participant and is a move away from a traditional welfare model. The Scheme also has greater capacity for cost management as it maintains sustainability by calculating the total future cost of support for all eligible participants.
The Scheme is ultimately designed to support participants to reach their individual goals and ensure they have the opportunity to participate in the community, get a job if they are able, and live more independent and full lives.
The Scheme forms an important part of the Australian Government’s National Disability Strategy 2010–2020, a 10–year policy framework for improving the lives of Australians with disability, their families and carers. Governments and communities across Australia are working together to develop a new strategy beyond 2020. The current and future strategy will be the key way Australia implements the United Nations Convention on the Rights of Persons with Disabilities, making sure people with disability can participate in all areas of Australian life and fulfil their potential as equal citizens.
1.5 The National Disability Insurance Agency
The Agency is a corporate Commonwealth entity under the PGPA Act with statutory authority under the NDIS Act. Funding and governance of the Scheme is shared among the federal and state and territory governments. All Australian governments are involved in decisions on NDIS policy, funding and governance.
The Agency is overseen by the NDIA Board, which has responsibility for ensuring the proper, efficient and effective performance of the Agency’s functions and for setting our strategic direction. The Agency’s governance structure also includes an Independent Advisory Council (IAC) that provides advice to the Board on how effectively the Agency is delivering the Scheme.
The NDIS Act, in conjunction with other laws, gives effect to Australia’s obligations under the United Nations Convention on the Rights of Persons with Disabilities.