The NDIS Review’s final report makes 26 recommendations to be implemented in a five-year transition. Many HACSU members’ longstanding concerns, from registration to pricing considerations, are addressed. However, the devil is in the details, requiring thorough consultation and implementation time. HACSU will be here every step of the way to ensure that workers remain a priority as the review is actioned.
Despite being named the “NDIS” review, the report shines a spotlight on the pivotal roles of supports outside the NDIS. Mainstream supports, crucial community services that serve both disabled and non-disabled people, largely vanished with the NDIS’s arrival. Foundational supports, encompassing both general and targeted supports, are designed specifically for disabled people. The Review’s aim is to build accessibility across the board, addressing the diverse requirements in the disability community.
Below, we’ve broken down some key recommendations members have asked about. For the full report and all 26 recommendations, visit the NDIS Review’s website, ndisreview.gov.au. Until we receive the government's response in 2024, we won't have clarity on the exact details or timeline for proposed changes.
The Review proposed a phased replacement of Support Coordinators and Local Area Coordinators with Navigators. Funded and commissioned by the NDIA, these Navigators would operate independently from other services, with local community presence but nationally consistent governance and training.
Four roles are proposed:
The current optional registration system leaves the NDIA without a list of all NDIS Providers. The Review recommends enhancing visibility and overnight by making provider registration mandatory, within a risk-proportionate framework. This involves different levels of registration (Advanced, General, Basic, and ‘enrolment’), ensuring a balancing regulatory approach. NDIS Practice Standards would apply to registered providers, and the Code of Conduct would apply to all providers.
Four categories are proposed:
Worker screening plays a crucial role in ensuring the safety of both participants and workers. As of June 2023, there were 154,000 unregistered NDIS providers, with less than 6,500 having workers with an NDIS Worker Screening Check. To address this, the Review proposes simplifying the current worker screening process, making it mandatory for workers at registered providers (and at enrolled providers with significant contact with people with disabilities). This would finally provide us with accurate information on the number of disability workers in Australia.
Addressing the high turnover of NDIS support workers (17–25%), recommendation 15 focuses on trialling strategies for attraction and retention, migration pathways, and an integrated approach to workforce development. The Review also focused on attracting more allied health and peer workers, incentivising supervision and training, and micro-credentials (short courses/qualifications). A recommendation to trial portable training—where workers would accrue credits as they work to take courses—is of interest, as it’s essential that this doesn’t take the onus off employers to provide training and support to workers. The review also recommends a portable personal leave scheme, so that leave balances would travel with workers as they move across the sector.
Alongside the new Navigators for individuals, the Review recommends Shared Support Facilitators be introduced where there are shared supports. These Facilitators would assist in determining how shared supports could be optimally used and monitor the delivery of these supports. Shared supports under this recommendation would not require participants live in the same home (e.g. neighbours), and would allow those sharing supports to pool their funds and exercise joint decision-making
Funding for 24/7 living supports would be based on an average shared support ratio of 1:3 (workers:participants) — recognising that complex needs may require a higher support ratio.
The Review suggests a reduction in the bedroom count for ageing SDA dwellings, to three. It emphasises, however, that no participant should be compelled to move, and if a tenant exits, funding will be adjusted to ensure adequate support for remaining residents. Additionally, the Review recommends that the NDIA collaborates with states and territories to commission SDA stock when the private market falls short. A strategy should also be developed to upgrade or repurpose publicly-owned ageing SDA stock.
The separation of SDA and living supports is recommended, addressing conflicts of interest prevalent in SRS (often called boarding houses). This move is geared towards mitigating and ultimately reducing exploitation within the private sector.
A new digital payments system is recommended to streamline processes and gradually eliminate the need for plan managers. Alongside this, pricing responsibilities would transition to the Department of Social Services (DSS) and the Independent Health and Aged Care Pricing Authority (IHACPA), creating independence from the NDIA. The Review recommends that pricing changes should consider the actual costs of supports, including non-face-to-face requirements, to more accurately reflect participants’ needs.
Enrolment payments are proposed to replace ROC-style funding for SIL, offering a bundled approach for more stability over longer periods. We’re hopeful these recommendations would break the cycle of endless roster reviews, allowing for rosters that focus on residents’ needs rather than funding. This would enhance the quality and flexibility of supports, while reducing casualisation and providing more stability.
The Review recommends urgent improvements in the quality of behaviour support plans (BSPs), aligning with the NDIS Commission's discovery that 80% of BSPs were rated as "underdeveloped" or "weak.". Further recommendations centre around the concentration of efforts on eliminating restrictive practices, moving away from the current focus on authorising and reporting these practices. In line with the emphasis on regulation, corrective action would be enforced against providers engaging in restrictive practices, and potentially harmful practices would be reviewed. This shift would be supported by information sharing, nationally consistent authorisation and banning prohibited practices.
The Review emphasises the wellbeing and rights of people with disability — something that is key to building a quality disability sector. As part of this, HACSU is committed to ensuring worker’s safety and wellbeing is also prioritised. Changes to restrictive practices require the disability workforce be well-trained, well-supported, and well-resourced to provide quality supports.
The review recommends ending the Disability Support for Older Australians (DSOA) Program, transitioning current clients to the NDIS. The DSOA served past Commonwealth Continuity of Support clients, and faced challenges due to funding and access to supports differing from the NDIS.
Looking ahead, the Review suggests NDIS participants turning 65 should have the option to receive funding concurrently from both aged care and the NDIS, not being locked into one.
The Review recommends increased non-complex psychosocial supports outside of the NDIS, through to mainstream and foundational supports, with a focus on personal recovery and independence. For those with psychosocial disabilities entering the NDIS, a specialised early intervention stream is proposed, facilitating a transition to "lifetime supports" if needed. Recognising the episodic nature of psychosocial disabilities, supports would be based on a “bad” day and offer more flexibility such as “step-up step-down" services. The Review aims for a more comprehensive approach to mental health, including increased coordination with public mental health services.
The success of these recommendations hinges on the commitment of the states and territories to adequately fund and implement mainstream and foundational supports. This includes sufficient funding for mental health services for people with complex needs accessing NDIS supports. HACSU backs the call for an overall increase in government support for those experiencing psychosocial disabilities and/or mental ill-health. Substantial investment in both specialist and mainstream services is imperative to prevent anyone in need from slipping through the cracks.
Overall, the NDIS Review’s report opens the door to some much-needed change in the disability sector. As we navigate the recommendations and await governments’ responses, HACSU stands committed to ensuring workers’ voices are represented. Many of the recommendations address longstanding concerns held by HACSU members, and we look forward to getting more detail on proposed changes impacted workforce issues. We'll continue to update members as we learn more.
To access the NDIS Review’s factsheets on the resources page (https://www.ndisreview.gov.au/resources), click the toggle next to ‘Factsheets’ in the left side menu.