2021- 22 NDIS Q4 Report – Highlights
The NDIA has released the latest NDIS Quarterly Report for disability ministers Q4 2021-2022 which provides a data focused snapshot of the NDIS. DIA recently held an online information session that touched on the high-level metrics of the report a format we will look to continue to deliver in the future. In preparation for the online session DIA poured over the 2021-22 NDIS Q4 Report picking out the “highlights” so you can get all the necessary detailed information without having to trudge through many, many pages of NDIA reporting.
The report is a summary of how the Scheme performed from 1 April 2022 to 30 June 2022.
Key Scheme Numbers Include:
- 534,655 people with a disability are being supported by the NDIS
- 19,291 people with a disability joined the scheme in Q4 (an increase of 3%)
- 44% of new participants in Q4 were aged 0-6 (8,419)
- Participation costs in Q4 was $7.542bln, up from $6.810bln in Q3.
The continuing value Intermediaries bring to both participants and the NDIS is clearly demonstrated by the increasing numbers of participants engaging Registered Plan Management and Support Coordination Providers across Australia.
On the data published by the NDIA, DIA’s CEO, Mr Jess Harper said:
“We welcome the release of the NDIS Q4 – Quarterly Report, the data in the report shows a continuing trend in participants requesting all or part of their funds to be managed by a Registered Plan Management Provider. The ongoing increase in the number of participants being funded with Support Coordination within their plan is also encouraging. We continue to call for a measure of adequacy to be included in the data”.
The Q4 2021 – 2022 quarterly report is, like its previous editions, an ever growing excruciatingly long document at 858 pages (up from 810 pages) if you are, like DIA, are interested in reading through the many pages of Appendices. Essentially, this report takes the same format as the previous quarters of 2021-2022 and is therefore an update of “more of the same” rather than providing any new or valuable information. As noted in the previous 2021-2022 DIA summaries, the NDIA made some significant changes from the Q4 2020- 2021 report following repeated questioning of the information presented. As a reminder DIA noted that:
- The much discussed “Functionality” measures have been left out; and
- Graphs highlighting participants issues with “Choice and Control” has also been left out.
These have not re-appeared in any of the 2021-2022 reports.
The narrative of engagement and working with the disability community from the NDIA is again “front and centre” in the early pages of the report, however considering how certain aspects of the COVID-19 response were implemented (or weren’t at all) and the widespread loss of trust between the disability community and the NDIA, this could be brought into question. From an Intermediary sector viewpoint, the Annual Pricing Review was far from a genuine consultative process resulting in a price freeze that has placed participants and providers at significant risk.
Functionality Remains Out – Community and Social Activities In
As highlighted in DIA’s review of the 2020-2021 Q4 Report, the reporting from the NDIA showing apparent declines in participant functionality as participants spent time in the Scheme showed either;
- A Scheme that was failing its participants;
- A Scheme that promoted participants to “under report” functionality improvements; or
- Inaccurate data via collection or interpretation.
DIA would expect that the exclusion of this reporting set in the past three quarterly reports isn’t the NDIA putting “functionality” in the too hard basket, rather taking the time to assess and more accurately report the level of functional improvement being experienced by participants.
The NDIA have again provided a series of graphs highlighting the increased participation in community and social activities over a 5- year period which on face value we will take as a positive (noting our comments above of course).
Improved Employment Strategies Need to be Implemented
In 2019 the NDIA released its Participant Employment Strategy that sets out the commitment and strategy from the NDIA to participants in finding and keeping meaningful employment. Subsequently, the NDIA have released two research papers on employment; Employment Outcomes and Exploring Participant Experiences which have been used to formulate the NDIA’s Participant Employment Strategy 2021-22 Action Plan that aims to have 30% of employment age participants in meaningful work by June 2023. The NDIA notes that the current environment continues to be challenging but this important commitment needs to be a high priority for the NDIA given the significant benefits employment generates for participants and secondly, the often neglected benefits that the Scheme generates for society and the economy as a whole.
As shown below, when the age cohorts are combined there is significant improvement required in order for the 30% target to be met by 2023.
The SIP Continues to Slip….
Following the Tune Review, the NDIA implemented the Participant Service Guarantee (PSG) and the Participant Service Improvement Plan (SIP). The NDIA have been reporting on the progress of the SIP and over the past 2 years there have been a number of extended time frames noticed by DIA. Below is a snapshot of the delays from the original published completion date, the completion date in the 2020-21 Q4 report, the completion date published in the 2021-2022 Q2 and Q3 reports and the updated completion dates published in the 2021-22 Q4 report:
SIP – Face-to-face meeting with the person making decisions on plans and funding.
June 2021 to December 2021 to June 23 still June 2023 (24 months behind).
SIP – Manage your plan via a new NDIA mobile app.
June 2021 to December 2021 to March 2022 and Completed June 2022 (12 Months Behind).
SIP – The website and portal will be clearer and easier to use.
December 2021 to December 2021 to September 2022 still September 2023 (18 Months Behind).
SIP – Promote children and young people’s voice in their own plans.
June 2021 to December 2022 to June 2022 still June 2022 (12 Months Behind).
SIP – Apply to the NDIS in your way including an online access form.
December 2021 to December 2022 to June 2023 still June 2023 (18 Months Behind).
SIP – Support more video-conference plan meetings.
June 2021 to December 2021 to September 2022 to June 2023 (24 Months Behind).
SIP – Clearer about Support Coordination services and what to expect from them.
June 2021 to September 2021 to June 2022 to December 2023 (30 Months Behind)
SIP – We will have clearer guidelines and procedures so there is consistency in how we make decision and we will make more of these public.
December 2021 to December 2021 to June 2022 to September 2023 (21 months behind).
SIP – We will improve the way we provide you support for independent decision-making.
June 2022 to June 2022 to December 2023 still December 2023 (18 months behind).
SIP – Our guidelines will come in plain English descriptions and more examples.
December 2021 to December 2021 to June 2022 to June 2023 to September 2023 (21 months behind).
SIP – We will be clearer on what reasonable and necessary supports means, with case studies and examples.
December 2021 to December 2021 to March 2022 to June 2022 to September 2023 (21 months behind).
DIA will continue to monitor the progress of the deliverables of the SIP.
Section 5 Financial Sustainability
Once again the projections included in the quarterly report are one dimensional with no clarification of any underlying assumptions.
DIA would again call for a more transparent multi scenario forecast path to be presented rather than the repetition of the “one scenario” forecasting of the future costs of the Scheme:
DIA is again pleased to see that the Median values of Payments have been included rather than just presenting the Average values. This provides an extra layer of context that has been sorely missing from much of the financial sustainability commentary from the NDIA. DIA would like to see this extended to the Plan Budget data which is still only presented as Averages.
Complaints and AAT Cases Remain High
Unfortunately, the last 2 years under the previous leadership will not be recorded as a great success for the NDIA. Given the numerous missteps the NDIA made it is not surprising, even to the casual observer, that both complaints and AAT cases had risen from Scheme lows just over 2 years ago. DIA, and the broader disability community, are hoping that the commitments made by Minister Shorten, and the new leadership appointments, reverse the trend in complaints and AAT cases in the last quarter of 2022 and into 2023.
The above graph showing the number of AAT cases only has one explanation; there has been a significant increase in a short space of time which is a stark metric of the gap between the NDIA and many participants.
Plan Deflation Is Occurring
Over the 3 years to June 2022 there has been a consistent number of plans being reviewed that have more than 5% reduction in value in the mid to high 20% range. Conversely, the number of plans that have had an increase of more than 5% has decreased significantly from 53% in 2019 /2020 to 39% in 2021 / 2022.
Anecdotally, DIA continues to hear that plan deflation has increased significantly during 2021 and 2022 (possibly a major cause of the jump in complaints and AAT cases) and that the practice of keeping the value constant but extending the length of plans has also been prevalent. DIA would again question if the data presented by the NDIA accounts for this plan extension deflation effect.
It is increasingly difficult to get a clear picture of where the Scheme is actually headed as the messaging from the NDIA becomes more and more scrambled. More data isn’t necessarily better in this instance. It would be far more beneficial if clear, transparent and consistent data was provided giving participants and stakeholders the information required so that informed and constructive conversations can be had to make the NDIS all it can and should be.
Before we look specifically at Plan Management and Support Coordination, a few closing thoughts on the 2021 – 2022 Q4 Quarterly Report. In summary essentially more of the same (with a few adjustments from the NDIA). As a quick (if you can call 858 pages quick) snapshot of how the Scheme looks at the end of June 2022 it ticks the boxes but as per previous editions falls well short of providing the underlying transparency being called for from a growing number of parties. What is concerning is seeing the number of AAT cases remaining high, a sure sign that the NDIA has much work to do to regain the trust of the disability community.
PLAN MANAGEMENT AND SUPPORT COORDINATION DATA
Intermediaries continue to increase in popularity with Participants, who see the undeniable value and importance Plan Management and Support Coordination brings to the Scheme.
PLAN MANAGEMENT NATIONALLY
- In the last quarter 61% of participants elected to plan manage all or part of their plan nation-wide, an increase of 7% from prior quarters.
- In the last quarter 54% of plan budgets were plan managed, an increase of 14% from prior quarters.
- The NDIA have published data on the top ten Plan Management providers by dollar value and percentage of claims by registration status with the overwhelming majority being members of DIA.
- Claims by Plan Managers has been further broken down to show payments to registered, unregistered and to plan management providers.
- Although the number of Plan Mangers has grown, the rate of growth (2.8%) over the past 2 years is well below the growth rate of participants requestion Plan Management (8.3%) and below the growth in the overall Provider market.
NEW SOUTH WALES - PLAN MANAGEMENT
VICTORIA - PLAN MANAGEMENT
QUEENSLAND - PLAN MANAGEMENT
WESTERN AUSTRALIA - PLAN MANAGEMENT
SOUTH AUSTRALIA - PLAN MANAGEMENT
TASMANIA - PLAN MANAGEMENT
AUSTRALIAN CAPITAL TERRITORY - PLAN MANAGEMENT
NORTHERN TERRITORY - PLAN MANAGEMENT
SUPPORT COORDINATION NATIONALLY
- 51% of plans last quarter included support coordination, an increase of 10% from previous quarters.
- Support coordination accounts for approximatly 3% of the total annualised committed support funding.
- The total percentage of participants with Support Coordination funding is reported at 44%. DIA has noticed that despite numerous quarters of above 50% of plans having support coordination funding included, the total percentage has not moved up from 44%. DIA will question the NDIA on the reported numbers.
- Over time, the percentage of participants with support coordination funding in plans has had four distinct waves.
- The total number of participants with support coordination funding is over 248,00 as at June 2022.
- A comparison of support coordination funding between 2020 and 2022 by Primary Disability shows:
- 72% of support coordination payments in Q4 2021-22 where agency maanged participants with 26% being plan managed participants.
- Of those payments made by a plan manager, 64% where to registered providers with the remaining 36% to unregistered providers.