It’s been a long journey for disability advocates and while its inception looks to be driven by brutal Federal political opportunism the National Disability Insurance Scheme (NDIS) will still be greeted with relief by many.
As befitting its many political and financial dimensions, a limited roll out of the program is underway for 20,000 people with significant disabilities in five locations, South Australia, Tasmania, the ACT, the Hunter region in NSW and the Barwon region in Victoria.
What is the NDIS?
The tragic reality is that every 30 minutes, someone in Australia is diagnosed with a significant disability. Be it through accident, illness, injury or other means, Australia has more than 410,000 people who have a permanent disability that significantly affects their communication, mobility and ability to care for themselves.
Up until the NDIS, where you live determined what support was available for people with disabilities, their families and carers. It’s been likened to a lottery. If you were unfortunate enough to live in an area where services were limited, you had very few options.
Plus, the previous support systems in place were designed to help in the immediate post-diagnosis phase, in the acute phase. The services and support systems tended to peter out over time.
Disabilities are for life, and the services and support networks that will be provided to Australians with disabilities, and their carers under NDIS will be designed to provide life long solutions.
The NDIS will be a structured organisation that will work with those in need on an individual basis. Its services will be national, and dispersed where and when people need them.
The full roll out of the NDIS is expected to be in place by 2018/19.
Who is eligible?
The NDIS program, if established and if rolled out nationally, will be available for any Australian who has, or acquires, a permanent disability.
Think of the NDIS as a safety net for you, and every other Australian, if they are born with, develop or acquire a permanent disability.
What support is now available?
The program aims to ensure that they get the support that is reasonable and necessary to meet their individual needs. This may be in the form of an individual plan or a funded package.
Some people will get individual support where there is evidence that early intervention will provide significant help. This may apply for people with autism, an acquired brain injury, cerebral palsy, sensory impairments, multiple sclerosis and Parkinson’s disease.
Other people will have access to get information about community support, government support and education programs.
The fundamental change the NDIS brings is that support will no longer rationed, and a wider range of services will be available regardless of where they live.
How will this help people with disabilities and their carers?
For the first time the needs of someone with a disability will be assessed beyond their immediate needs. Families and carers will have peace of mind that individualised care and support will be available as the needs of the person with the disability change.
There will also be a choice about how, when and where the support is provided. All of this means that people with disabilities, with even limited means, will now be able to have meaningful lives within their communities and reach their potential.
How will it be funded?
Each state government will contribute to a national fund that will form the basis of the NDIS. It is anticipated that by its launch in 2018/19, the NDIS will have an annual cost of around $15 billion.
The states combined funding on disability services is currently around $8 billion, so, there is a funding shortfall of about $7 billion. This funding shortfall has been the cause of much dispute between the federal and state governments. Additional taxes or replacement taxes, along with federal government funding are expected to fill the funding shortfall.
It is probably an understatement to say that the funding of the NDIS is expected to continue to be an issue that will be disputed in any upcoming state and federal elections.
The Centre for Independent Studies, under freedom of information laws, requested and reviewed the Productivity Commission NDIS feasibility study costings. These costings, conducted by the Australian Government Actuary, indicated that the NDIS would not cover 411,000 at a cost of $15 billion but in fact cover 441,000 at a cost of approximately $22 billion by the time the scheme was fully operational.
With an estimated growth rate of 6 per cent a year by 2023-24 the NDIS may potentially covering 500,000 people at a cost of nearly $30 billion a year. The CIS also estimated that over 8,000 public servants would be required to administer the scheme.
This is particularly relevant, as while the planned trial program is expected to cost $1 billion, funding for the full program has been pushed beyond the the standard four year budget estimates. A budgetary slight of hand that does not bode well for the long term integrity of the program.
What happened before the NDIS existed?
Basically, people with disabilities and without means of their own, or their families, have tended to slip through the system.
If a child needed a wheelchair, the previous systems often took up to two years to provide it. Plus, the previous systems had rigid rules. Motorised wheelchairs were not available to children under five, even if their mobility and ability to learn and play required it. Now, under the NDIS, the individuals needs will be assessed to provide the right support, equipment and education.
If you are young, disabled and need full-time care, the only place to receive it has been in aged care homes. YoungCare, a charity that is dedicated to helping get young people with high-care needs out of aged care, has some startling statistics:
In 2012, there are 7,600 Australians aged under 65, with full-time needs living in aged care simply because there have been no other options.
There are 700,000 others under 65 who were being cared for at home by family and friends.
No matter which way you look at it, there are services available but arguably they are not meeting the real life needs of those with disabilities, their families and carers. The NDIS is designed to change that.
What were the previous options?
Prior to the NDIS, each state government offered an array of support services. These supplemented different charity and non-profit groups that also work to provide support services.
The federal government also provides some payments for people with disabilities and their carers, and it’s confusing. Carers can receive an allowance each fortnight, plus an additional payment if they are caring for children under the age of 16.
Some people who acquire disabilities may have personal insurance that will provide a lump sum payment upon diagnosis. Total Permanent Disability (TPD) Cover, Critical Illness and other personal insurance covers can assist with financial survival after diagnosis. But many do not have this cover, and for many who do, they are underinsured. This means they have some cover, but it is inadequate to cover the costs of medical treatment, devices, rehabilitation and daily care for the rest of their lives. If you have or want to have your own insurance for this type of cover, speak to your insurer or a financial planner.
Health care cards, reduced medicine costs under the Pharmaceutical Benefits Scheme (PBS) and other payment programs exist to help with the purchase of essential equipment such as electric wheelchairs, home ventilators, heart pumps, home dialysis machines and feeding devices.
However, not all devices and medical treatments were covered under this scheme.
Under the NDIS, families should have more choice about how to use the available funding to care for those with disabilities. It’s about bringing equality of services and support to those who need it.
Like many of the more important things in life, what happens next will come down to a combination of funding availability and brutal politics.
The NDIS will require at least an extra $7 billion, every year, from an already straining tax system. And as it stands today, where this money will come from is anybody's guess. A particularly vexing question when our nation is already living beyond it's means.
Expect to hear a lot more about the NDIS over the coming weeks, as establishing legislation is to be introduced to parliament by mid to late November. How Labor, the Greens and the nominal independents play this out against the Coalition and the major State governments is anyone's guess. But it is sure to be loud and furious.
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The views in article are those of the author, and are not necessarily those of Telstra BigPond.