Who will conduct assessments to determine access to the NDIS?
We recommend changes to the way people apply for access to the NDIS. We recommend a new Access Request and Supporting Evidence Form which would make clear what information is needed and why.
Supporting evidence and information could include functional capacity assessments by the applicant’s treating professional or developmental and behavioural evaluation assessments by a specialist for children. Any additional evidence required by the National Disability Insurance Agency would be arranged and paid for by the Agency.
Your local navigator would also help you get together the information to submit an NDIS Access Request (see navigation FAQs for more information).
What does streamlining access evidence requirements really mean?
Streamlining access evidence requirements means only essential information would be collected for all people seeking access to the NDIS. There would be a new Access Request and Supporting Evidence form, with guidance to explain what information is needed and why.
The Access Request and Supporting Evidence form should be a new, dynamic online form. It should update as details are entered and provide real-time advice where additional evidence is needed or there are issues with information entered.
This should make things simpler and easier for participants. It should allow for applicants to give evidence as experts in their own lives and needs, alongside evidence from treating professionals. It should also make decisions about eligibility more transparent and consistent.
In situations where a person applying for the NDIS does not have access to a computer or the necessary skills to complete the form themselves or with assistance from a family member or friend, they would be able to get help from a navigator.
Do I need to be re-assessed again so I can stay in the NDIS?
Participants should experience a smooth and fair transition to the new processes for access and budget setting and be given sufficient time to understand and adjust to the changes.
Very importantly, once a participant has met access requirements through the new approach, following a functional capacity assessment, they would not be required to be reassessed, unless there are exceptional circumstances.
Why are access lists to the NDIS being removed?
Access lists played an important role during the initial roll out of the NDIS. They did however lead to unintended consequences. Use of the lists has led to a focus on a person’s diagnosis, rather than on functional impairment and needs. The access lists are also unfair; some conditions are on the lists, while others are not.
We recommend removing the lists and automatic access to the NDIS. This would be replaced with streamlined evidence requirements to ensure only essential information is collected for all people seeking access. This would help make access to the NDIS fairer, more consistent and aligned with its original aim to be needs-based.
How will the recommendations reflect the needs of culturally and linguistically diverse communities?
We recognise that the concept of “disability” may be different for many culturally and linguistically diverse communities. Our disability support system is organised around Western concepts of disability and care that do not always translate well for people from diverse communities.
We want people who are culturally and linguistically diverse to have more say in the way they are supported and how the overall support system is designed and operated.
We also want all government services to support the unique needs of culturally and linguistically diverse communities.
So, we recommend targeted initiatives to invest in research, education materials and capacity building for government organisations, staff and service providers so they have the resources, skills and training to meet the needs of all people with disability and their families.
We have also thought about the skills and expertise that will be needed for many of the new roles we are recommending including navigators and foundational supports. These new workforces need to reflect the communities in which they work.
Are you kicking autistic children out of the NDIS?
No. In fact, they should get better support earlier in their lives than they do now. The Review is not singling out children or adults with any specific diagnosis.
This is consistent with our view that the NDIS should be based on functional impairments and support needs, not diagnosis.
The Review’s recommendations would expand the range of supports and early intervention for all children with developmental concerns, delay or disability. We want to ensure that all children get support matched to their need, when and where they need it.
The Review recommends:
- A new connected system of supports for children with developmental concerns, delay or disability and their families
- A new early intervention pathway in the NDIS
This connected system (or “continuum”) of supports should include:
- More inclusive and accessible mainstream services such as early childhood settings and schools
- Greater availability of foundational supports for children and families
- A new early intervention pathway in the NDIS for children with the highest level of support needs
There should also be better screening checks to pick up issues early and provide early intervention when it is most effective.
We also recommend changes to the way children and families access the NDIS. We want to make sure decisions are fair, clear and consistent.
Access to the NDIS should be based on a child’s support needs, not their diagnosis.
We think there has been too much focus on diagnosis and not enough focus on what support a child’s needs in their everyday life.
For that reason, we have recommended removing the Access Lists and automatic entry to the NDIS. Changes to the lists will affect new participants, not existing participants.
All children under the age of 9 years with disability or developmental concerns would have access to early intervention supports.
Children who have clear lifelong support needs would continue to be eligible for the NDIS beyond the age of 9.
What is a Lead Practitioner and can I choose the Lead Practitioner for my child?
We recommend Lead Practitioners be available for all NDIS participants as well as for some children who are not eligible for the NDIS, but who need this assistance.
A Lead Practitioner could be an allied health, developmental or early childhood educator, who is the main professional working with the family. Lead Practitioners would act as a key worker to help families find best practice supports to support their child and/or children.
The Lead Practitioner would coordinate a supportive team and provide early intervention to support children and families in their homes, early childhood settings and schools. This would help children to learn and practice skills in their everyday environment, built into daily routines.
We propose that NDIA set specific service delivery requirements for the Lead Practitioner in their contracts. This would ensure early intervention capacity building supports for children are based on best practice principles and evidence.
Families should have choice of their Lead Practitioner.
Will my child need to be reassessed as a result of these changes?
Yes - but not straight away. We recommend that families should have at least two years before they are asked to participate in any needs assessment or budget process.
Just like for adults, there should be a new, fair process to gather information about the child and family to set a NDIS budget, based on the child’s support needs.
The needs assessment should identify what support a child needs to do everyday activities. It should include information from families as well as any treating professionals. (You can read more about the assessment and budget setting in other FAQs).
We know these are big changes. We recommend that people with disability, their families and their representative organisations are involved in designing and testing the changes to make sure they work well.
We also recommend that they are introduced in stages to make sure everyone has time to understand and get ready.
Has this Review understood the needs of First Nations communities? What will change?
We recognise that “disability” is a Western concept that does not easily translate into First Nations communities and languages.
Our disability support system is also organised around Western concepts of disability and care. The NDIS focus on individual supports is often at odds with First Nations culture and values, which place family, community and inclusion first.
Our recommendations aim to give First Nations people with disability and their communities more say over how the disability support system would work for them.
This includes different ways for supports to be organised and delivered to First Nations communities by people they know and trust within their community.
We call this “alternative commissioning”. This means there should be more culturally safe services delivered by people and organisations that communities trust.
I am aged under 65 and not eligible for the NDIS. Will foundational supports be available to me?
Many people told us that there is not enough support for people with disability outside the NDIS.
So we recommend that governments improve support for all people with disability under the age of 65 and their families by investing more in what we call “foundational supports”.
Foundational supports is a new term we are introducing.
We recommend there should be two types of foundational supports:
General foundational supports would be available to all people with disability.
They would include programs and activities like information and advice, individual and family capacity building, peer support, self-advocacy, disability employment supports and capacity building to improve inclusion of mainstream and community services.
Targeted foundational supports would be available for people who have lower level disability support needs who are not eligible for the NDIS.
They would include home and community supports, aids and equipment, psychosocial support for adults to build their capacity, independence and daily living skills, early supports for families and children with emerging developmental concerns and transition supports to help young people prepare for employment and independent living.
We know this will not happen immediately. Foundational supports outside the NDIS will need to be built up over time.
We also recommend that people with disability, their families and their representative organisations are involved in designing and implementing a Foundational Supports Strategy to make sure the changes work well in practice.
How will NDIS Review recommendations make a difference?
We have made 26 recommendations. Underneath each recommendation there are supporting actions which outline the steps that need to be taken to implement the recommendations – there are 139 supporting actions in total.
Our Terms of Reference had three clear aims:
- Put people with disability back at the centre of the NDIS
- Restore trust, confidence and pride in the NDIS
- Ensure the sustainability of the NDIS for future generations.
All our recommendations and actions should be considered as a package to achieve these aims and help build a fairer and more inclusive Australia for all people with disability.
The recommendations aim to:
- Create a connected system of supports for all people with disability. This includes Foundational Supports and better access to mainstream services
- Ensure people with disability and their families have more help to navigate the new system of support
- Ensure NDIS processes, especially for access and budget setting, are simpler, fairer and easier to navigate
- Ensure NDIS processes focus on the whole person and their support needs – not just their diagnosis
- Provide more support for decision making so people can have genuine choice and control
- Better support for all children with developmental concerns, delay and disability, and their families
- Improve the availability, diversity and quality of services
- Improve quality of services and ensure appropriate safeguards through better and risk-proportionate regulation
- Secure the future sustainability of the NDIS by delivering better outcomes for people with disability with more responsive, efficient and cost-effective ways of providing support.
Will I be forced to share my home with others?
We want people to have more choice about where they live and who they live with. No one should be forced to share a home with others unless they want to.
We want to see more innovative options that enable people to live the way they want while still sharing support.
We also know that sometimes participants cannot share supports. They might have high support needs or complex circumstances where a higher level of funding is required.
We recommend creating a new role called a specialist Housing and Living Navigator.
This navigator would help participants to find options that will work for them, including trying housing options before committing.
Where participants live in a share-house with other people, they would also have access to a new shared support facilitator to help everyone in the house make decisions and have a say in how the house and support is organised.
Will I have to move out of my shared supported living house?
No. Participants should not have to move out of their current home (including their shared supported living house) if they do not wish to.
The Review wants to see a shift away from group home settings where participants have little or no choice about who they live with and how their support is arranged and delivered.
No one should be forced to live in a place or with people they don’t want to live with.
It is really important to remember that sharing supports does not have to mean sharing a home.
The Review wants to see more innovation in housing design, assistive technology and the development of more options that enable participants to share their housing supports in a way that suits their needs.
Participants who do want to move, should be supported to explore housing and living support arrangements with the help of a new Housing and Living Navigator.
They would also have the chance to try new options to make sure they work well for them.
How will intersectional needs be better understood and supported in the NDIS Review recommendations?
We acknowledge that previously people with disability have been treated as a homogenous group, without enough consideration for the different intersectional needs they might have. This includes needs of First Nations, culturally and linguistically diverse, and LGBTQIA+ people with disability. We have looked at intersectionality across the review, embedding the need to respond to diversity across all our recommendations.
While we have called out specific needs in many recommendations, we also recognise that responding to intersectionality must be an ongoing consideration in the way all of our recommended changes are designed and rolled out.
For example, we need to make sure capacity building programs and activities funded through foundational supports are culturally appropriate and able to respond to people with diverse needs.
The new roles we have recommended such as navigators must also have skills and expertise in working with diverse communities in a respectful and inclusive way.
That’s why we have recommended that people with disability, their families and organisations representing different communities should be involved in designing and testing the changes so they work well for everyone.
How will recommendations better include and meet the needs of LGBTQIA+ people with disability?
We know that LGBTQIA+ people with disability have difficulty accessing information, navigating the scheme and finding inclusive supports that meet their needs. The needs of LGBTQIA+ people with disability have been considered across all of our recommendations. In addition, we also recommend:
- More collaboration with LGBTQIA+ organisations
- Dedicated training and resources for improving the capacity of service providers
- Dedicated resources to better support self-advocacy
- A review of existing systemic disability advocacy funding to ensure appropriate resources are available to support sustained systemic advocacy.
What are you doing to make mainstream services more inclusive and accessible and work better with the NDIS?
All Australians benefit from more inclusive and accessible mainstream services and communities.
Our Review found that despite good intentions and commitments under Australia’s Disability Strategy, people with disability continue to face discrimination and barriers accessing mainstream services and participating in their communities.
This results in poor social and economic outcomes for people with disability and their families.
That’s why we recommend all governments – Australian, state and territory and local - work together to deliver genuinely inclusive and accessible services.
To make this happen, we suggest some specific changes we think would have the most impact:
- Introduce a new Disability Intergovernmental Agreement to govern the whole new disability eco-system, including the NDIS, foundational supports and mainstream service interfaces
- Strengthen accountability and transparency by measuring progress and outcomes and reporting this to National Cabinet, as well as Disability Reform Ministers Council
- Ensure that mainstream services and community supports are better connected with the NDIS, person-centred rather than system-centric and easier to navigate
- Change the agreements between the NDIA and other service systems like health and education so that they recognise shared responsibilities and people do not fall through gaps. This should be achieved through new comprehensive agreements between governments, which outline how these key service systems should work together to support all people with disability
- Ensure our laws must take a proactive and contemporary approach to inclusion
What is a navigator?
Navigator is a new term we are introducing.
The purpose of the navigator is to support people with disability under the age of 65 who are not eligible for the NDIS, as well as NDIS participants and their families.
The navigator will work for you. They will not be a NDIA employee.
We recommend creating different kinds of navigators to meet different needs:
General navigator – for all people with disability under the age of 65 and NDIS participants. General navigators would provide information, and help people to find and use mainstream services, foundational supports and NDIS services. They would also help people with an intellectual disability to connect with support for decision-making. They would support NDIS participants to develop a plan of action to use their budget, book and coordinate support where needed, and check-in frequently to see how things are going to ensure supports are meeting participant’s needs.
Specialist navigator – for NDIS participants with more complex support needs. Specialist navigators would help with similar activities to the general navigator, but would have more expertise and time to respond to the participant’s higher support needs or complex circumstances. Specialist navigators would help NDIS participants who frequently access and use multiple service systems, such as hospitals or the child protection system.
Psychosocial recovery navigator – forpeople with psychosocial disability. This navigator would provide support for participants with psychosocial disability who have higher support needs. They would have expertise and training in mental health to build capacity and capability of both young people and adults. They would help people understand and navigate the NDIS, as well as find mainstream and foundational supports that will work for them.
Housing and living navigator – for NDIS participants with housing and living budgets. The housing and living navigator would help participants think about and try housing and living options that fit within their budgets. Once participants make a choice, these navigators would help participants negotiate with housing and living providers.
Other specialist supports
Shared support facilitator – for participants who are sharing housing and living supports. These facilitators would make sure everyone who is sharing support can have a say about how their support is organised and delivered. Most importantly they would be independent of the support provider and property manager, so people have the chance to have a real say about their living arrangements.
Lead practitioner – for children and families. Lead practitioners would be available to all children who are NDIS participants and to some children who are not NDIS participants but who have higher support needs that cannot be met in other foundational supports and mainstream services.
Lead practitioners would support both the family and the child. They would identify needs, connect children and families to appropriate foundational supports and mainstream services, as well as provide information, advice and coaching to support the child’s development.
Lead practitioners who work with NDIS participants would do all these things as well as coordinate NDIS funded services to build a supportive team around the child and family.
We know these are big changes. That’s why we have recommended that all the different roles should be designed and tested with people with disability, families and their representative organisations.
Changes should be rolled out slowly and carefully so everyone has time to get ready.
How is a navigator different from a support coordinator?
At the moment support coordinators are only available to some NDIS participants. They only help them find and organise their NDIS funded services. The quality of support coordinators varies from very poor to excellent.
We want all people with disability to get more help.
The key difference between the Review’s proposed role of navigator and a support coordinator is that we recommend general navigators should be available to support all people with disability under the age of 65 and all NDIS participants.
General navigators should support people with disability to find and use mainstream services, find and participate in community activities they would like and use foundational supports.
For NDIS participants, the navigator would also support them to plan and use their NDIS budget effectively, with regular check-ins and help to manage risk.
There would also be specialist navigators for people with psychosocial disability, participants with complex needs and participants with a housing and living budget.
The role of a navigator is broader than a support coordinator.
Unlike support coordinators, navigators would be funded outside of individual NDIS budgets. This would ensure participants do not need to choose between a navigator and other supports.
For participants, this also means that the type and amount of help you get from your navigator could adjust as your needs and circumstances change.
Can I choose my navigator / what happens to my current support coordinator?
Yes, we expect there would be a range of navigators to choose from.
The Review also recommends that governments work with people with disability, their families and their representative organisations so they are closely involved in designing and testing the changes to make sure they work well.
We also recommend that changes are introduced in stages so everyone has time to get ready and adjust.
I am a support coordinator – will I no longer have a job?
The Review has recommended a set of connected reforms to governments, all with the goal of creating a more coordinated system of supports for people with disability in Australia.
This should include mainstream and community services, foundational supports, as well as NDIS supports.
The design, implementation and testing of our recommended reforms will take time. It must also be done with people with disability, their families, their representative organisations and providers to make sure the changes work well in practice.
We also recommend the reforms be introduced in stages so everyone understands what is changing and has time to adjust.
The Review expects that many of the functions of Local Area Coordinators, Support Coordinators and Plan Managers will be included in the new navigation role. This means there will be new opportunities for support coordinators and those in other roles to become navigators.
A staged and careful transition will allow the best features of these roles to be included in the new navigator role.
Who will be assessing my needs?
We recommend two different kinds of assessments. You may need to complete a functional capacity assessment as part of your application to the NDIS.
Once you become a participant, you would also do a support needs assessment. This is because assessing your support needs is not the same as assessing functional capacity.
The support needs assessment would be completed by a new Needs Assessor. The Assessor would be skilled, qualified and have disability expertise. They might be a trained allied health practitioner or social worker/youth worker or similar.
They would also have enough time to complete a thorough assessment of your support needs. The needs assessment might take many hours, perhaps over several days. The Needs Assessor would really get to know you and your needs.
The needs assessment would consider what kind of supports you need in your daily life and to achieve your goals.
The needs assessment should include information from you, your family (where appropriate) and any medical or clinical professionals you may have.
The results of the support needs assessment would be translated into a reasonable and necessary budget.
Why can’t people over the age of 65 access the NDIS?
The NDIS was not designed to replace the aged care system. The two systems were meant to work together so that people with disability could receive appropriate support as they age.
We have heard clearly through our Review however that this does not happen consistently. We think that both the NDIS and the aged care system should uphold human rights as their core values and align with the UNCRPD.
We also think the NDIS should remain designed for disability acquired earlier in life (before the age of 65), and the aged care system should assist Australians with age-related needs and associated disability acquired later in life (after the age of 65).
But we also think the two systems should work together much more effectively so NDIS participants have good support as they age.
At the moment, NDIS participants aged 65 and over have to choose between the NDIS and aged care. If they choose aged care, they cannot, for example, continue to receive assistive technology such as customised wheelchairs through the NDIS.
Our recommendations would help ensure:
- NDIS participants aged 65 and over would be provided with the information and support they need to make informed choices about which supports and service system are most appropriate for their needs.
- The NDIS and the aged care system would work together more closely to enable NDIS participants to access the most appropriate, sustainable, and seamless mix of NDIS and aged care supports and services when they are aged 65 and older and aged 50 and older for First Nations Australians and those who are homeless or at risk of homelessness.
Are you kicking people with psychosocial disability out of the NDIS?
No. The NDIS should support people with significant psychosocial disability.
The NDIS has increased funding for disability supports for people with severe mental ill-health and has made a positive difference for many people.
But we have also heard that the NDIS has not always supported participants with a psychosocial disability well.
Access and planning processes have not responded well to the changing or episodic needs of people with psychosocial disability, and support has not always been focused on personal recovery.
As a result, participants with psychosocial disability continue to experience lower community participation, employment and carer employment than other participants in the NDIS.
We want to make sure there is a new dedicated approach to psychosocial disability that better meets people’s episodic needs and focuses on recovery.
We recommend a new specialist three-year early intervention pathway into the NDIS for most new participants with psychosocial disability, to support personal recovery as soon as possible.
We also recommend creating a new role called a psychosocial recovery navigator.
This specialist navigator would have experience and training in psychosocial disability, to help find and organise support in a way that works best for participants.
This would include support to access mainstream services such as community mental health services, employment and education.
Participants with psychosocial disability who will likely need lifetime support from the scheme after the three-year early intervention period should continue to be funded by the NDIS under the permanent disability pathway.
This new early intervention pathway would be for new NDIS participants only.
Will I have a say about what is in my budget?
Budgets will be set based on all the information gathered from you including your individual support needs assessment.
The needs assessment will take a person-centred approach to understand what support you need in your daily life and to meet your goals.
It will be a more structured and fair way to build a complete picture of your needs. This more consistent way of collecting information will mean the budget is no longer set by including single items of disability support. It will, instead, be a total budget based on all of your support needs.
There would only be separate categories for housing (SDA or home modifications), living (24/7 supports) and major assistive technology, but these would be all part of your support needs assessment.
Once the budget is set you would have more flexibility in how to spend it to meet your needs. You would also have more help from a navigator (see Navigation FAQs).
I live in rural / remote area where there are few disability supports available. How will these recommendations change my situation?
We have recommended a number of ways to ensure all people with disability across Australia have better access to the supports they need.
One of our recommendations includes progressively rolling out provider panel arrangements to address persistent supply gaps, starting with allied health supports in small and medium rural towns.
Provider panels involve organising providers to commit to delivering services in a particular area – rather than letting the market just develop.
This means participants should be able to access therapy services closer to where they live. It also means they should not have to spend as much of their NDIS budget on travel, as providers would be required to work more collaboratively with each other to deliver services (including coordinating travel).
We also know that won’t be enough to address the lack of services in remote communities. We think governments need to be much more active in working with First Nations communities to organise and purchase services.
We call this “alternative commissioning”.
These arrangements should be designed by the community (or ‘community-driven’) and based on the strengths and needs of the local community (or ‘place-based’).
Over time, people in remote communities would access more supports where they live, from people who are part of their community.
Will these reforms stop the risk of abuse, neglect and exploitation of people with disability highlighted by the Disability Royal Commission?
Evidence shows that the most effective way to try to keep people with disability safe and to try and prevent abuse is through natural safeguards – increasing people’s capacity and increasing their connections to community.
Formal safeguards should be more targeted and more intensive for people in circumstances that place them at particular risk of harm or who have limited natural safeguards available.
To make this happen, we need a joined-up and coordinated approach to safeguarding across all levels of government.
To deliver these effective safeguards, we recommend:
- A Disability Support System Safeguarding Strategy that outlines responsibilities, coordination and information sharing across government agencies, as well as connections with broader safeguarding arrangements
- A new individual risk-assessment to support participants to identify, respond to and monitor risk in their lives
- Tailored safeguards including education, advocacy, support for decision making and outreach
- More consistent safeguarding of people with disability through Community Visitor Schemes and adult safeguarding agencies.
Will provider registration reduce my choice and control?
We know choice and control is incredibly important and you will still be able to exercise choice and control.
Choice and control and the safety of participants are both important for people with disability to get good outcomes and achieve their goals.
But the existing system does not balance those two things well. High risk supports are often delivered with little or no oversight.
People are confused about whether there are safeguards in place and who is covered by them. It is not fair to expect people with disability to take all the responsibility for whether providers deliver safe supports.
We want you to have access to quality services that meet your needs. We also want you to be confident both in providers and the services they deliver.
We want you to know the government is chasing down fraudulent and unsafe providers. But that is hard when the government can’t see who is providing services.
No NDIS providers should be allowed to fly below the radar. We need a system of proportional regulation.
So, we recommend all providers be enrolled or registered to be eligible to deliver supports to participants.
The requirements of registration would vary based on the risk of the services provided. Enrolment or registration would be simple and easy where the services provided are relatively straightforward and low risk.
Registration for more personal or higher risk services would have more requirements.
Registration and enrolment would also allow you to pay providers through a new simple and easy electronic payments system. This will also assist with scheme integrity.
Our approach would mean providers of basic services such as lower risk supports in the community and specialist transport would have to commit to meeting relevant Practice Standards but not have to undergo audits.
We have recommended these changes because we believe it is important that everyone delivering supports and services should be aware of their obligations and requirements, and be accountable, no matter what supports they are delivering.
These changes are also necessary to help prevent harm, instead of responding after things have gone wrong.
Most importantly you would still have choice and control in the supports and services you purchase.
We understand that this is a big change. So, we recommend that people with disability, their families and their representative organisations are involved in designing and testing the changes so they work well in practice.
How are you going to fix the culture of organisations involved in the delivery of the NDIS?
We have heard that the organisations that deliver the NDIS – including the National Disability Insurance Agency, the NDIS Quality and Safeguards Commission and Local Area Coordinators – have not always worked with you well.
We have heard that they are not always responsive, reliable or empathetic – leaving you stressed, anxious and sometimes traumatised.
We have also heard that interactions with the NDIA and its partners are often adversarial, particularly around what is funded in NDIS plans.
People do not feel trusted by the NDIA and they in turn do not trust the NDIA.
We have also heard that the NDIS Quality and Safeguards Commission does not respond quickly or get back to you when you are concerned about safety or report concerns about provider behaviours.
All of this must change. Urgently.
We think any organisations involved with participants must be capable, well trained, resourced and accountable for the work they do.
We have made recommendations about the way that could be achieved – including capability and culture audits, making sure that people with disability and their families have a say about how they think the scheme is working and that the Participant Service Guarantee should include quality measures not just timeframes.
We have also recommended the NDIA adopt a trust-based approach to oversight of how participants spend their budget, with a focus on guidance and support from navigators.
The NDIA should also ensure adequate training and practice standards are in place for navigators. This would also involve nationally consistent guidance to help participants find quality services and comply with rules around how to flexibly use their funding.