NDIS Review Outlines 10 Major Reform Areas

On Wednesday, NDIS Review co-chair Professor Bruce Bonyhady gave his second teaser speech, this time in Geelong—NDIA heartland. Following on from the speech given at townhall in late August, Professor Bonyhady outlined the 10 major reform areas the Review will recommend in its highly anticipated report.

Bonyhady said the ‘detailed design and implementation’ work will need to be done by the NDIA, governments, people with disability and their representative organisations, not the Review team. It seems as much as we want the Review team to have all the answers down to the minutest details, they are the big picture people.

Addressing the fear and anxiety that hangs over all conversations about changing the NDIS, Bonyhady emphasised that the NDIS isn’t going anywhere. But that doesn’t mean the job is done. The onus is on each of us to reach the ‘full, transformational potential of the NDIS.’

 Without further ado, let’s take a look at what he said: 

From an individual to community-wide stage

The initial rollout of the NDIS focused on getting large numbers of people into the Scheme. This was, Bonyhady says, the ‘individualised stage.’

But NDIS 2.0 will need to re-focus on the ‘community-wide’ stage. Particularly, this means building an inclusive society for all Australians with a disability, regardless of whether they have an individualised funding. Bonyhady said that if attitudes change and mainstream services are more inclusive, many of these people will never need an NDIS plan.

Broader community supports have been given many jargony names over the years- from Tier 2 to ILC. But Professor Bonyhady said the Panel’s perspective is that they should be called foundational supports. As discussed two weeks ago, foundational supports will include things like peer support, information and, for some adults - help with cooking, cleaning and shopping. It will also include more support for children with developmental delays.

Bonyhady wasn’t mincing words about how seriously the Review team takes this:

‘The Review strongly believes that the fairness, trust, and sustainability of the NDIS depends on the delivery of community-wide foundational supports to the one-in-five Australians with disability.

In other words, the sustainability of the NDIS depends on foundational supports.’

Sustainability is a human rights issue

Understandably, conversations about the sustainability of the NDIS are anxiety inducing for many people with disability (myself included). Because for us the NDIS isn’t just something which is nice to have, it is the tool that enables us to live our lives. To get out of bed in the morning. To have a job. To make sense of the world around us. In other words- it is a human right.

In this speech, Bonyhady agreed with the DANA report from last week, which argued that Scheme sustainability is essential to the rights of people with disability. Because ‘a human right that cannot be sustained is a human right that, in effect, has been denied.’

Eligibility to the NDIS

Bonyhady argued that eligibility for NDIS supports needs to be clarified. He said that the Panel believes that eligibility ‘should be based first and foremost on significant functional impairment and need – and only secondly on medical diagnosis.’ This would allow the NDIA to consider the interconnected impact of multiple disabilities, rather than assess eligibility against each diagnosis.

Moving away from diagnosis-based eligibility is a step in the right direction in my opinion. This was the original intention of the NDIS Act. But it’s just one of the many things that seems to have been lost in the churning wheels of the government bureaucracy.

Reasonable & Necessary and “Planning”

In his August speech, Bonyhady triggered a bit of alarm by suggesting the Panel would recommend moving the planning meeting until after the participant’s budget has been developed. What followed was a statement from People with Disability Australia and more than a little LinkedIn controversy. People worried this would be Independent Assessments (IAs) in all but name.

In response Bonyhady outlined what the Review Panel sees as the 3 stages of the plan development cycle.

Stage 1 is information gathering. Information would come from participants, the professionals in their lives and assessments. I know what you’re thinking- there’s that dreaded A-word again. BUT Bonyhady said that unlike IAs there would be ‘no shortcuts’ and the process would be transparent and designed with the disability community. 

Stage 2 is combining all that information through ‘consistent and transparent processes’ to develop an individualised plan budget. People will be given a budget which they can use flexibly. Plans will not be painstakingly developed line-by-line, with the exception of big ticket items like Assistive Technology,  Specialist Disability Accommodation and Supported Independent Living.

Stage 3 is the fun part- implementation! With participants getting greater support to use their plans.

10 Big Reforms

 In this speech, Professor Bonyhady gave us a little taster of what we can expect in the Review’s final report at the end of October.

 He outlined the 10 big reforms the report will focus on: 

1. Foundational supports of all Australians with a disability, including negotiating new inter-governmental agreements to ensure better mainstream services.
2. The NDIS to become more person-centred and respond better to intersectional identities, including better outcomes for First Nations people and culturally and linguistically diverse communities. Also, paying more attention to the role of gender and supporting people with complex support needs.
3. Determining eligibility based on functional impairment, not medical diagnosis.
4. Developing a clear, consistent and fair definition of reasonable and necessary supports.
5. Identifying developmental concerns in children early and providing evidence-based supports.
6. Improving home and living supports, including through more consistent decision making and a greater focus on individualised solutions.
7. Removing some of the confusion about the roles of intermediaries like Support Coordinators, Plan Managers, Local Area Coordinators, etc. and who they work for. There weren’t many details here, unfortunately!
8. The government stepping in to steward the market, and giving participants a greater say in the direction of the market. Again, a bit light on details.
9. Growing a skilled workforce. At the risk of sounding like a broken record, there weren’t many details provided here either. 
10. Develop a proportionate regulation systems and better quality and safeguards framework.

It's a little frustrating that some of these reform areas are more fleshed out than others. But to be fair, this is a speech, not the final report. Curiosity officially piqued. October can’t come fast enough if you ask me- and not just because I have a trip to Bali booked.

You can read Professor Bruce Bonyhady’s full speech here.