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NATIONAL DISABILITY INSURANCE AGENCY

Quarterly Report to COAG Disability Reform Council31 December 2013

1Quarterly Report to Disability Reform Council31 December 2013

Note: Data extracted on 31 December, 2013 - 10pm AEST

Published: 31/01/2014

Contact: David BowenChief Executive Officer

Key definitions:

State Based on the jurisdiction administering participant case

Access request status

A Formal request by an individual for a determination of eligibility to access the Scheme. This includes all requests and is not unique to single participants.

Participant An individual whose Access Requests have been determined 'eligible'

Active Participant/ Plan Participants with a plan with approved funded supports

CALD Country of birth is not Australia, UK, USA, Canada or South Africa, or primary language spoken at home is not English

Indigenous (ATSI)

Response of:

- Aboriginal but not TSI; or

- Australian Aboriginal; or

- Torres Strait Islander

Approved Cost Calculated package cost, derived from all approved plan items. Costs are for duration of approved plan. Approved package cost = unit cost x quantity x number of frequency periods.

EI Early Interventions

Annualised Package Cost

Approved Package Cost, prorated over a 12 month period to allow like-for-like comparisons. This value does not represent the expected true cost of a package.


Introduction

This report to the COAG Disability Reform Council contains three sections:

Part 1: A report from the Scheme Actuary on the sustainability of the scheme for the first six months (1 July 2013 to 31 December 2013)

Part 2: A summary of progress against the Statement of Strategic Guidance

Part 3: A report under the Integrated NDIS Performance Reporting Framework

Parts 2 and 3 were included in the 30 September 2013 report and hence this report provides an update. Part 1 summarises the scheme experience to date.


PART 1

Report from the Scheme Actuary on the sustainability of the Scheme for the first six months

(1 July 2013 to 31 December 2013)


This report summarises the experience of the scheme for the first six months (1 July 2013 to 31 December 2013) and compares this experience with expected experience.

Before discussing the results a brief summary of the baseline assumptions and scheme dynamics is presented in order to provide context to the results.

1. Actuarial baseline model and bilateral agreements

The Productivity Commission report (released in August 2011) estimated that the number of participants in Tier 3 of the NDIS was 411,250 and the cost of providing care and support to these participants was $12.8 billion in 2011 values. Projecting the expected number of Tier 3 participants using population projections, and cost using inflation (including the increase in the SaCS award), results in an estimated 419,516 Tier 3 participants and full scheme cost of $14.7 billion in 2013/14 (which equates to an average cost of $35,000 per participant per annum). This cost includes an allowance for the cost of capital, but not for the expenses of administration.

In estimating costs for trial sites, the actuarial model starts with this full scheme estimate and uses 2011 Census data to estimate what proportion of participants and costs should be attributed to each trial site. Additional information on the participant profile of trial sites has also been added to the actuarial model in relation to the disproportionate number of residents of large institutions. There are some differences between the actuarial model and the bilateral agreements and this is particularly the case for South Australia (Table 1).

TABLE 1 SUMMARY OF BILATERAL AGREEMENTS AND ACTUARIAL BASELINE MODEL1

Bilateral agreements Actuarial baseline model Actuarial baseline model(adjusted for large residences)

Participants and cost 2013/14 2014/15 2015/16 2013/14 2014/15 2015/16 2013/14 2014/15 2015/16Participant numbers (cumulative) Hunter 3,000 5,030 10,111 3,000 5,030 9,902 3,000 5,030 9,902 Barwon 4,076 4,521 5,102 4,582 5,083 5,736 4,582 5,083 5,736 South Australia (0-14 years) 1,565 4,688 5,085 2,697 9,733 10,712 2,697 9,733 10,712 Tasmania (15-24 years) 792 960 969 801 971 980 801 971 980Expected annual cost of cohort Hunter $52.5 $147.6 $292.9 $52.3 $147.8 $289.9 $57.0 $183.0 $337.4 Barwon $71.3 $158.1 $186.1 $79.9 $177.8 $210.0 $79.9 $182.9 $216.6 South Australia (0-14 years) $8.2 $34.5 $56.7 $23.9 $116.0 $201.2 $23.9 $116.0 $201.2 Tasmania (15-24 years) $13.8 $32.2 $37.3 $14.0 $32.6 $37.9 $14.0 $32.6 $37.9

The large residences in the Hunter and Barwon trial sites are more costly on average and this has not been factored into the bilateral agreements. Including large residences in the actuarial baseline model adds a further $88 million in the Hunter trial site over the three years and $12 million in the Barwon trial site over three years (based on planned phasing arrangements).

This is only a pressure on trial sites and not on the full scheme cost.

1 Note: the cash flows in this table assume that there is no time lag between a participant receiving their approved plan, the participant receiving supports, and the service provider invoicing the NDIA for these supports. In the detailed actuarial modelling a time lag is included.


2. Scheme dynamics

These baseline estimates are highly uncertain – whilst based on the best population data available (the ABS Survey of Disability, Ageing and Carers), these data were not designed to directly estimate need for funded supports, and there is considerable uncertainty around estimates of small sub-populations (such as those eligible for the NDIS). Further, administrative data collected on people currently receiving disability services are poor - understanding exactly how many potential participants receiving existing services are in trial sites (and nationally) is difficult.

Hence, emerging scheme experience is vital in understanding short and long term costs. In order to monitor the emerging scheme experience, an understanding of scheme dynamics is required. Scheme dynamics include the following:

The number of participants found eligible

The length of time participants spend in the scheme. This is particularly relevant for participants who meet the early intervention requirements.

The amount of support approved for each participant – and importantly the overall distribution of participants and their approved supports.

The amount of support actually used by participants, noting that participants may not have to use all of the support approved in their plans. The amount of support approved is effectively the maximum amount of support a participant will receive.

The price of supports provided and the availability of the supports in the market

The total cost of the scheme (which is dependent on the number of participants found eligible, the amount of support approved, the amount of support utilised by participants and the price of supports).

Time lags between participants receiving their approved plan, utilising support, and providers claiming from the Scheme.

The extent to which early intervention supports reduce the need for funded supports over time (note: this report does not focus on long term projections and hence this scheme dynamic is not discussed further).

It is important to note that whilst average annualised package cost is a key factor in understanding scheme costs, considering it in isolation from all of the above dynamics it is misleading. For example, it may be that less participants than expected enter the Scheme at a higher than expected average cost, or more participants than expected enter the Scheme at a lower than expected average cost. In both scenarios the total cost may be in line with what is expected. Hence, it is important to consider total cost. This issue is further articulated in an example in Appendix A.


3. Results as at 31 December 2013

With these scheme dynamics in mind, the actual scheme experience for the first six months of the scheme is presented. It is important to note that scheme experience is limited. The participants who have entered the scheme to date will not be representative of all participants likely to enter the scheme or the respective trial sites. This is because of the bilateral phasing arrangements (that is, participants are being phased in by program and/or service provider). Hence extrapolating these results to make assumptions on full scheme costs is not possible at this stage.

The Scheme as at 31 December 2013 includes 2,586 participants with approved plans, and $90.0 million of support committed to these participants (Table 2). Of this $90 million it is estimated that $69.3 million (77%) will be paid in 2013/14. The funding envelope based on the bilateral agreements for 2013/14 is $145.8 million (including both cash and in-kind). At this stage the committed support for 2013/14 is just under half of the funding envelope. Individual trial sites are considered in more detail below.

Whilst committed support is a key scheme dynamic, the amount actually paid to service providers also needs to be considered against the funding envelope. At 31 December 2013, only $3.9 million had been paid to service providers (both cash and in-kind) which is well below the funding envelope.

Approved plans are for different lengths of time – annualising the $90 million of committed support, results in approximately $104.6 million.2 This annualised amount can also be compared with expected, noting that the supports will be provided and paid for over different financial years. The estimated annualised amount of $104.6 million compares with $135.2 million in the bilateral agreements and $164.4 million in the baseline actuarial model (Table 2). The dollar value of committed supports in approved plans is lower than expected across all trial sites. However, when plans are annualised, the amount exceeds the expected value in South Australia (compared with the bilateral agreements)3 and Tasmania (compared with both the bilateral agreements and the actuarial model)4.

It is worth noting that there are 1,466 participants eligible for the scheme at 31 December 2013 without approved plans. Whilst it is not possible to estimate the dollar value of these participants’ approved plans, this will impact on cash flow and will be monitored closely.

2 Note: annualising plan values adds uncertainty to estimates. It is not clear exactly which supports will continue into the future. The annualising approach taken is conservative, meaning the majority of supports were annualised.3 Note: annualising plan values in the South Australian trial site is very uncertain due to the high number of early intervention plans and the young age of participants.4 The Tasmanian bilateral agreement phasing saw people on the high needs register (that is, people not receiving any services or people not receiving enough services) enter in the first quarter, along with children exiting child protection, and people on Individual Support Packages. These participants are likely to be more costly than future participants phasing in from different programs.


TABLE 2 COMPARISON OF ACTUAL EXPERIENCE WITH THE BILATERAL AGREEMENTS AND THE ACTUARIAL MODEL

1 July 2013 to 31 December 2013 Hunter Barwon SA TAS TotalNumber of expected participants (bilateral agreements) - (a) 1,295 1,977 681 387 4,340Number of expected participants (actuarial model) - (b) 1,500 2,291 1,348 400 5,540

Number of eligible participants 1,111 1,721 712 508 4,052Percentage deemed eligible compared with expected - (a) 86% 87% 105% 131% 86%Percentage deemed eligible compared with expected - (b) 74% 75% 53% 127% 74%

Number of participants with approved plans 757 988 489 352 2,586Percentage with approved plans compared with expected - (a) 58% 50% 72% 91% 60%Percentage with approved plans compared with expected - (b) 50% 43% 36% 88% 47%

Expected annual value of plans ($m) (bilateral agreements) - (c) $45.3 $69.2 $7.2 $13.5 $135.2Expected annual value of plans ($m) (actuarial model) - (d) (e) $50.6 $77.2 $23.9 $12.8 $164.4

Value of committed supports in approved plans ($m) $28.6 $42.3 $6.0 $13.1 $90.0Value of committed supports in approved plans compared with expected (c) 63% 61% 83% 97% 67%Value of committed supports in approved plans compared with expected (d) 57% 55% 25% 102% 55%

Annualised value of committed supports in approved plans ($m) $32.0 $46.2 $9.9 $16.5 $104.6Annualised committed supports in approved plans compared with expected - (c) 71% 67% 138% 122% 77%Annualised committed supports in approved plans compared with expected - (d) 63% 60% 42% 129% 64%

Actual expenditure ($) $1,792,296 $1,171,367 $337,045 $639,200 $3,939,908Notes:(a) Number of expected particpants based on the bilateral agreements and comparison of this number w ith actual experience(b) Number of expected particpants based on the actuarial model and comparison of this number w ith actual experience(c) Expected annual value of plans based on the bilateral agreements and comparison w ith actual experience(d) Expected annual value of plans based on the actuarial model and comparison w ith actual experience(e) Excluding the cost of capital

In order to understand short term financial sustainability in more detail the following is compared by trial site and month (Figure 1):

The funding envelope (both cash and in-kind) based on the bilateral agreements. The amount included in the graph is funding envelope for all participants who enter during 2013/14 and not just the 2,586 participants who have approved plans at 31 December 2013. Note: cash was paid three months in advance to the NDIA - however, this is not included in the graph in order to better compare with actual experience.

Expected expenditure using the actuarial model. As discussed in Section 1, this differs from the bilateral agreements. Also, in practice a time lag between plans being approved and service providers claiming from the NDIA occurs – this is factored into more detailed cash flow projections but not included in this graph for comparison purposes with the bilateral agreements. As with the funding envelope, the amount included in the graph is funding for all participants who enter during 2013/14 and not just the 2,586 participants who have approved plans at 31 December 2013.

Committed support to participants with approved plans. Across the four trial sites, $90 million of committed support has been committed to 2,586 participants. The graph estimates when this committed support will be used on a monthly basis if all of this committed support is utilised by participants. This is not directly comparable with the funding envelope and actuarial model as more participants will enter the scheme in the second half of the financial year. Nonetheless, it provides some insight into how committed supports for current participants are tracking against the funding envelope and actuarial model.


Actual payments to service providers by month. This is comparable with the funding envelope as it is cash actually spent on supports provided and in-kind supports provided (as claimed by the service providers).

Both committed support and actual payments to service providers are important in understanding short term scheme financial sustainability.

Across all trial sites actual payments are less than income for each month and hence are well below the funding envelope for the first six months of the scheme. On this basis cash flow is likely to be sufficient for 2013/14.

As committed support is only for participants who have entered the scheme before 31 December 2013, comparison with the funding envelope and actuarial for the first six months of the scheme is more meaningful. Committed support is less than the funding envelope for the Hunter and Barwon trial sites for the first six months of the scheme. For the Tasmanian trial site, committed support is slightly higher than the funding envelope in most months until the end of 2013, and for South Australia, committed support exceeds the funding envelope in all months up until the end of 2013. This will be monitored closely.


FIGURE 1 COMPARISON OF EXPECTED CASH FLOWS WITH COMMITTED SUPPORTS AND ACTUAL PAYMENTS 2013/14HUNTER BARWON

SA TASMANIA

$0

$500,000

$1,000,000

$1,500,000

$2,000,000

$2,500,000

$3,000,000

$3,500,000

$4,000,000

$4,500,000

Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14

Funding envelope based on the bilateral agreements Expenditure based on the actuarial model

Committed supports Actual payments

$0

$500,000

$1,000,000

$1,500,000

$2,000,000

$2,500,000




$0

$2,000,000

$4,000,000

$6,000,000

$8,000,000

$10,000,000

$12,000,000




$0

$2,000,000

$4,000,000

$6,000,000

$8,000,000

$10,000,000

$12,000,000

$14,000,000





Some additional key findings from the actual versus expected analysis include:

The distribution of plans by age band was generally in line with expected - the Hunter trial site had a higher percentage of participants in the 0-14 year age band than expected, while Barwon had significantly fewer than expected participants in the older age bands (45-54 years and 55-64 years age bands). This variation between actual and expected could be explained by the bilateral phasing schedule.

Across all trial sites, there were more male participants than female. Hunter and Barwon trial sites had 57% male participants and the South Australian and Tasmanian trial sites had 64%. This is in line with what is expected.

Overall the distribution of participants with approved plans by primary condition group is largely in line with what is expected. The Hunter, Barwon and Tasmanian trial sites have fewer participants than expected with a Psychiatric and Neurological condition, offset by more participants than expected with an Intellectual/learning condition. In South Australia, the percentage of participants with an Intellectual/learning condition was less than expected, offset by more participants than expected in the Neurological and Sensory/Speech groups. As with the analysis by age band, the variation between actual and expected could be explained by the bilateral phasing schedule.

The length of plans in Hunter, Barwon and Tasmania are mostly annual whilst in South Australia the plan lengths are predominantly 6-9 months.

In the Hunter and Barwon trial sites, the most common support types are community participation, daily tasks/shared living, and assistance with personal activities. These activities represent just over 70% of approved supports. The next largest category is therapeutic support which represents around 5% of approved support.

In the Tasmanian trial site the most common approved support types are community participation (47%) and assistance with personal activities (27%). The next most common support types are assistance with accessing or maintaining employment (6%), and assistance with travel/transport (5%).

In the South Australian trial site the most common support type is early childhood supports (44%), followed by therapeutic supports (36%). The next most common support types are personal mobility equipment (6%), and assistance with personal activities (4%).

4. Trends

This section provides some information on monthly trends – in particular the number of participants and average annualised costs. As mentioned above, annualised average costs and scheme participant numbers should not be considered in isolation. These trends are presented to highlight the variations by month – most likely driven by the different participant cohorts entering the scheme each month.

Number of participants11

Quarterly Report to Disability Reform Council31 December 2013

Overall, the number of participants with approved plans in each month is increasing slightly (ignoring July). The trend differs by trial site with South Australia increasing more so in the last couple of months compared with the other trial sites (Figure 2).5

FIGURE 2 NUMBER OF APPROVED PLANS BY TRIAL SITE AND MONTH

0

50

100

150

200

250

July August September October November December

Number of approved plans

NSW VIC SA TAS

committed supports and annualised value of committed supports

The average annualised committed amount in approved plans is currently higher than the bilateral agreements and actuarial model. However, limited scheme experience is available, along with a lack of appropriate data, to understand this trend. The average annualised cost has decreased over the six month period for all trial sites (Figure 3).

Note: annualising plan values in order to compare with the bilateral agreements and actuarial model adds uncertainty to estimates. It is not clear exactly which supports will continue into the future. The annualising approach taken is conservative, meaning the majority of supports were annualised. Annualising plans is particularly uncertain in South Australia due to the age of participants.

Expected average annualised costs are different by age group – in particular, 0-14 year olds (children) have a lower expected annualised cost. As all participants in the Tasmanian trial site are aged 15-24 (adults), then expected costs may be higher. Hence, the adult average annualised cost is also included on the chart.

5 Note: from the middle of December, the date at which the plan was approved remains the same. For plans approved before this date, analysis was undertaken on daily extracts to estimate the approval date.


FIGURE 3 AVERAGE ANNUALISED COST6

HUNTER BARWON

SA TASMANIA

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000


Average committed support ($)

Average annualised committed support ($)

Expected annualised average cost excluding capital ($)

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000




Expected annual ised average cost excluding capital ($)

0

5,000

10,000

15,000

20,000

25,000

30,000





0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

100,000





Expected annualised average cost excluding capital - adult rate ($)

6 Note: in previous estimates, approximately $3.5 million in accommodation support not funded by the NDIS was included in scheme costs (for the Tasmanian trial site). This has been removed from this analysis.


5. Summary

As experience emerges it will be possible to project these trends in experience and other scheme dynamics to understand the impacts on both short and long term cash flow. However, it is not possible to undertake projections as yet, because participants in the Scheme to date are not representative of all participants likely to enter the Scheme.

The Barwon trial site is expected to phase in all participants by the end of September 2014 and all of Newcastle in the Hunter trial site is also likely to be phased in by this time. This will allow some detailed analysis of a ‘complete’ cohort within a geographical area.

There is some evidence emerging that the number of participants will be lower than expected in Barwon. Considering this within broader scheme dynamics, it is likely that the participants who will not enter the Scheme are likely to be lower cost participants from the original Productivity Commission costings. Hence, if the number of participants was 25% lower than expected (compared with the actuarial model), than the average annualised cost could be as high as $46,700 and still be within the total funding assumed within the bilateral agreements.

Scheme processes also impact sustainability. A key risk with current processes is that there is a poor link from the outcome of the Support Needs Assessment to the reference packages (and hence individual resource allocation and reasonable and necessary support). The ABS frequency of support indicator used for this purpose was not adequate for this purpose. Further, sufficient and consistent data on a participant’s diagnoses and level of functional need was not captured. This affects not only reference packages, but also means that appropriate monitoring of scheme experience is not possible.

Work is underway to improve the link between assessment and reference packages, including trialling the World Health Organisation Disability Assessment Schedule II (WHODAS) self-reporting tool, and identifying severity indicators (such as level of lesion with spinal cord injury) for the more prevalent conditions in order to better monitor scheme experience.

Another risk to scheme sustainability is the current IT system. In order to monitor scheme experience, a longitudinal record of each participant is required. At present the IT system does not have this longitudinal capacity and hence an appropriate level of scheme monitoring will not be possible over time.

Section 24 and 25 of the NDIS legislation define who is eligible for Tier 3 supports – both people who meet the disability requirements and people who meet the early intervention requirements. Tier 2 supports a broader population, including those at risk of requiring Tier 3 supports. At present there has been little focus on Tier 2, which is likely to put pressure on scheme financial sustainability. This is because people who would be supported by Tier 2 may seek to enter Tier 3 in order to get supports.

It is also noted that operational reforms are underway, such as development of guidelines for typical volumes of travel, domestic assistance, community participation, therapy, and respite, along with


work on a national assistive technology strategy. Implementation of these reforms will impact trend analysis, and hence need to be considered when extrapolating trends.

Lastly, the Stockton large residence in the Hunter trial site begins to phase into the Scheme from 1 January 2014. This will impact scheme dynamics and will need to be monitored closely. It is worth noting that large residences are factored into full scheme costs. Hence, any extrapolation of the Hunter trial site to better predict full scheme costs will need to adjust for large residences.


Appendix AThe Productivity Commission report was released in August of 2011 and estimated that the number of participants in Tier 3 was 411,250 and the cost of providing care and support to these participants was $12.8 billion, including a margin for the cost of capital. Projecting the expected number of Tier 3 participants using population projections, and cost using inflation (including the increase in the SaCS award), results in an estimated 419,516 Tier 3 participants and full scheme cost of $14.7 billion in 2013/14 (resulting in an average cost of $35,000 per participant).

Underlying these estimates of the number of participants and the cost of participants is an expected distribution (Figure 4 and Table 3). Understanding this distribution is key to monitoring the Scheme and much more relevant than average annualised package cost. The estimated distribution indicates that Functional Group 1 and Functional Group 2 (participants with the highest support need) represent only 10% of participants (41,331). However, these groups represent 42% of costs ($6.1 billion). Similarly, Functional Support Group 9 (participants with the lowest support need) represents 29% of participants (122,510) but only 3% of costs ($0.5 billion).

FIGURE 4 EXPECTED NUMBER OF PARTICIPANTS AND TOTAL COST BY FUNCTIONAL SUPPORT GROUP

$6,104,797,105

$3,728,738,547

$3,074,715,596

$1,266,038,312

$459,446,182

41,331

58,093

88,609

108,973

122,510

$0

$1,000,000,000

$2,000,000,000

$3,000,000,000

$4,000,000,000

$5,000,000,000

$6,000,000,000

$7,000,000,000

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

FG1 & FG2 FG3 & FG4 FG5 & FG6 FG7 &FG8 FG9

Total - full scheme Number of particpants - full scheme


TABLE 3 EXPECTED NUMBER OF PARTICIPANTS AND TOTAL COST BY FUNCTIONAL SUPPORT GROUP

Functional support group

Expected participants

Distribution of participants Expected cost

Distribution of expected cost Average cost

FG1 & FG2 41,331 10% $6,104,797,105 42% $148,000FG3 & FG4 58,093 14% $3,728,738,547 25% $64,000FG5 & FG6 88,609 21% $3,074,715,596 21% $35,000FG7 &FG8 108,973 26% $1,266,038,312 9% $12,000FG9 122,510 29% $459,446,182 3% $4,000Total 419,516 100% $14,633,735,742 100% $35,000

It is possible that the number of Tier 3 participants will be lower than expected under the current eligibility rules – say by 100,000. If this is the case, it is most likely that these participants would be in the lowest functional support group (FG9). Overall, the number of participants in Tier 3 would decrease by 24%. However, the expected cost only decreases by 3%. On this basis, the average participant cost is $45,000 (Figure 5 and Table 4). This example highlights the risk of focusing on average annualised cost.

FIGURE 5 EXPECTED NUMBER OF PARTICIPANTS AND TOTAL COST BY FUNCTIONAL SUPPORT GROUP (REDUCTION OF 100,000 PARTICIPANTS)

$6,104,797,105

$3,728,738,547

$3,074,715,596

$1,266,038,312

$84,419,740

41,331

58,093

88,609

108,973

22,510

$0

$1,000,000,000

$2,000,000,000

$3,000,000,000

$4,000,000,000

$5,000,000,000

$6,000,000,000

$7,000,000,000

0

20,000

40,000

60,000

80,000

100,000

120,000

FG1 & FG2 FG3 & FG4 FG5 & FG6 FG7 &FG8 FG9

Total - full scheme Number of particpants - full scheme


TABLE 4 EXPECTED NUMBER OF PARTICIPANTS AND TOTAL COST BY FUNCTIONAL SUPPORT GROUP (REDUCTION OF 100,000 PARTICIPANTS)

Functional support group

Expected participants

Distribution of participants Expected cost

Distribution of expected cost Average cost

FG1 & FG2 41,331 13% $6,104,797,105 43% $148,000FG3 & FG4 58,093 18% $3,728,738,547 26% $64,000FG5 & FG6 88,609 28% $3,074,715,596 22% $35,000FG7 &FG8 108,973 34% $1,266,038,312 9% $12,000FG9 22,510 7% $84,419,740 1% $4,000Total 319,516 100% $14,258,709,300 100% $45,000Difference 100,000 $375,026,442Difference (%) 24% 3%


PART 2

Progress against Statement of Strategic Guidance


BackgroundOn 28 June 2013 the former Commonwealth Minister for Disability Reform issued the Statement of Strategic Guidance to the National Disability Agency (NDIA) Board. The statement was issued with the agreement of state and territory governments in accordance with section 125 of the National Disability Insurance Scheme Act 2013 (NDIS Act) and outlined government expectations of the Board and the NDIA for the duration of the trial phase of the NDIS and transition to full Scheme.

The statement specified key deliverables to be achieved by the Board both throughout the trial period and at specific intervals. The statement asked the Board to address progress in achieving the time-specific deliverables in its annual and quarterly reports under sections 172 and 174 of the NDIS Act.

This second quarterly report for 2013-14 includes below an update on progress against the time-specific deliverables for the first quarter of 2013-14, as well as an update on progress against the ongoing key deliverables.

September 2013 deliverables – Update on progress

Deliverable: Status:

1. Have an agreed corporate plan in place for 2013-16

The Board provided the corporate plan to the COAG Disability Reform Council (formerly the Standing Council on Disability Reform) at its 18 December 2013 meeting (NDIS Act, s 177).

The corporate plan, as well as the (former) Commonwealth Minister’s statement of strategic guidance (NDIS Act, s 125) and the Board’s statement of intent will be published on the NDIS website to promote public knowledge and awareness of the NDIS and the Agency.

The Board has also finalised a 2013-16 Strategic Plan after extensive consultation with shareholder governments, stakeholders and the public. The 2013-16 Strategic Plan will also be published on the NDIS website.

2. Ensure that the Agency is transitioning participants into the NDIS in accordance with the client phasing schedules agreed with all jurisdictions

Participants in 2013 trial sites are being brought into the NDIS progressively in accordance with the NDIS rules for phasing made under s 32A of the NDIS Act.

In the early months of the NDIS there were unexpected delays in completing participant plans. In response, the Agency has identified options for refinements to the planning and assessment process. A number of these improvements have already been implemented.

Some adjustments to phasing may be required in the Barwon launch site to ensure bilateral intake targets are met, as the actual number of participants in existing programs is 600




fewer than in the bilateral agreement according to data supplied to the Agency by providers pursuant to s 55 of the NDIS Act. The Victorian Government is currently validating this new data. If necessary, the adjustment would bring forward the in-take of some participants and would require an amendment to the NDIS rules.

The Agency is using its information gathering powers under s 55 of the NDIS Act in the Barwon, Hunter and South Australia launch sites to obtain identifiable data on participants from providers to support the phasing arrangements. This approach is being negotiated for the 2014 launch sites. Bilateral agreements for transition plans are progressing for jurisdictions commencing in July 2014 (Australian Capital Territory, Northern Territory and Western Australia).

Lessons from 2013 trial sites are being used to optimise approaches to participant phasing and program transition in 2014 trial sites.

3. Ensure the Agency is managing the utilisation of in-kind programs in a way that is consistent with the Intergovernmental Agreement (IGA) on the NDIS Launch and bilateral agreements

In-kind contributions are being managed consistent with the IGA and bilateral agreements.

In-kind data has been validated for Commonwealth programs (except for DSS mental health programs in Victoria).

Victoria has some outstanding in-kind data still to be validated. This has been escalated with DHS Victoria.

Some in-kind providers have not yet registered as providers, and a small number of outstanding issues are being followed up with jurisdictions.

The Agency, at both a National and trial site level, is actively working with program owners and providers to manage in-kind provision.

4. Support the implementation of national communications protocols (as set out in the IGA)

The Agency assumed direct control over communications and media activities for the NDIS on 1 October 2013 following the planned expiration of an MOU with the Commonwealth Department of Social Services.

The Agency’s external communications strategy was endorsed by the Board at its November 2013 meeting. The strategy is being used to inform the development and implementation of the Agency’s specific media, communications and engagement activities and supporting implementation plans.

Communications protocols have been agreed as part of the bilateral agreements with existing trial sites (NSW, Vic, Tas and




SA) and will be part of the bilateral agreements with new trial sites (NT, ACT and WA). The Agency ‘s implementation plans for media, communications and engagement activities support the communications protocols.

5. Ensure the Agency has effectively communicated with potential participants and providers to ensure that they understand how the roll-out of the NDIS will affect them

The Agency’s external communications strategy was approved by the Board at its November 2013 meeting.

All communications activity and related implementation plans are managed consistent with the strategy. The strategy identifies potential participants and providers as key target audiences, and provides for key messages to be tailored for those audiences and to suit local circumstances in each trial site.

The Agency has undertaken a wide range of activities to raise awareness of the NDIS both generally and specifically including amongst potential participants and providers. For example:

o 220 separate engagements during the December 2013 quarter) including community and provider information and discussion forums in the ACT and WA), regular (monthly and quarterly) community and provider forums in each 2013 trial sites.

o The monthly NDIS external newsletter, sent via email, to more than 18,900 people (>40% recipients open the online publication within 7 days of receipt, which exceeds the benchmark rate for such publications).

o The NDIS web site (www.ndis.gov.au), with more than 1,200,000 visits since its launch on 4 June 2013, and which has been rated highly for 'user-friendliness' and accessibility during external evaluation. New materials such as Operational Guidelines, fact sheets, etc are posted regularly, and there are between 2,000 and 3,000 unique visits each business day.

o Social media including the NDIS Facebook page (with an increase of more than 600 to its subscriber base of 40,650 individuals), and the NDIS Twitter account (with 86% of NDIS Tweets being re-Tweeted, indicating an active and involved subscriber base, which has increased in Followers by 50% since 1 October 2013).

o A series of monthly to bi-monthly webinars, with two on 'Choice & Control' and 'Breaking Down Barriers' taking place in late 2013.

o Promotional material in local and regional press linked 22


http://www.ndis.gov.au/



to stakeholder engagement opportunities exclusively in trial sites.

o The Agency has commenced re-branding NDIS products to reflect the name change in publicly facing materials and public domain platforms (Intranet site, Facebook page, domain name, and email signature blocks) on a low-cost, no frills approach (with the exception of the Agency’s Twitter handle, which involves a more complex name-change process peculiar to Twitter).

The Agency has developed a governance framework for continuous improvement, which includes a process for using feedback received from potential participants, current participants, providers and others to inform and improve the design and implementation of communication materials and strategies.

6. Ensure that any initial implementation risks have been identified to governments

The NDIA’s Audit and Risk Committee had their inaugural meeting on the 2nd December, 2013. The proposed Risk Management Strategy, as required by the NDIS Risk Rules, is to be considered at the February 2014 meeting.

KPMG has been engaged as the Agency risk adviser and to assist with development of the Risk Management Strategy. Workshops have been conducted with the Board and senior management to ensure maximum input has been obtained.

Risks associated to implementation have been identified to governments in this, and the previous, Quarterly Report to Standing Council. The Risk Management Strategy will be provided to the March meeting of the COAG Standing Council on Disability Reform.

Ongoing deliverables for period of trial – Update on progress


1. Provide regular information to governments, including through the quarterly report to the Ministerial Council, (as set out in section 174 of the

The Board provided its second quarterly report to the COAG Disability Reform Council (formerly the Standing Council on Disability Reform) (NDIS Act, s 174).

The Board provided the corporate plan to the COAG Disability Reform Council (formerly the Standing Council on Disability




NDIS Act and the Integrated NDIS Performance Reporting Framework in the IGA), to give all jurisdictions visibility of the Agency’s service delivery and fiscal outcomes and whether the Agency is meeting agreed performance targets, and keep government’s informed of implementation issues as they emerge

Reform) at its 18 December 2013 meeting (NDIS Act, s 177). The Board Chairman and the Agency’s CEO continue to meet

with stakeholder governments on a quarterly basis. The Board expects to finalise the 2013-16 Strategic Plan before

its February 2014 meeting, following an extensive consultation process including with shareholder governments and the public.

2. Maintain best practice standards of governance appropriate to the Agency, having regard to ANAO’s Public Sector Governance Better Practice Guides and ensuring Board members undertake their duties impartially with a high degree of diligence, care and skill and at all times act in a manner that promotes the highest level of corporate governance in Board operations

All Board meetings are run in accordance with the CAC Act and the ANAO Public Sector Governance Better Practice Guides.

All Board members have received training through the Australian Institute of Company Directors on their obligations and duties under relevant legislation.

The Board has established a Sustainability Committee and Audit and Risk Committee.

The Agency has established six internal governance committees for Customers and Performance, People and Culture, Work Health and Safety, Infrastructure (ICT and Property), Communications and Stakeholder Engagement, and Internal Audit Fraud Risk and Compliance. The Agency has written to the Commonwealth Department of Social Services (DSS) to request approval to utilise DSS’s Human Research Ethics Committee.

3. Operate in accordance with all relevant legislation including the NDIS Act, the CAC Act and IGA and comply with all responsibilities under these Acts, including those relating to the annual reports, significant events, financial accountability, conduct of directors and officers, director’s duty to disclose, compliance with General Policy Orders and Audit

The Board members are aware of their director’s duties to disclose material personal interests, as per the CAC Act, and a standing register of interests has been established to facilitate this.

The Audit and Risk Committee was established and met formally on 2 December 2013 and is in the process of finalising the NDIA Risk Management Framework and Risk Management Strategy to provide to COAG in March 2014. The Audit and Risk Committee is also finalising an Internal Audit Plan for 2014-2017 and the Agency Fraud Control Framework.

The Board has provided a statement of compliance with the CAC Act to the relevant Commonwealth Ministers.




Committee

4. Demonstrate evidence for how the Board has embedded a culture of decision making informed by actuarial advice throughout the Agency

The Scheme Actuary has been appointed and is in the process of establishing a permanent actuarial team.

The Scheme Actuary has attended all Board meetings since her appointment to provide advice and input into Board decision-making.

The Board has formed a Sustainability Committee comprising all Board members, the CEO, the Scheme Actuary and the Reviewing Actuary to provide advice to the Board and Agency on the financial sustainability of the NDIS.

The first quarterly actuarial report was provided to the CEO and Board documenting results to 30 September 2013.

5. Carefully monitor the use of discretionary powers set out in the legislation and the Rules, to ensure that these powers are subject to effective controls and operate consistently to support scheme sustainability and transparency in access to supports

A quality assurance package has been implemented in trial sites whereby a review occurs of 10% of access and funding decisions across all sites to confirm and improve consistency in process and decision making. This work is undertaken by each site’s quality assurance team and senior planners and includes providing feedback to delegates. These processes are also informed by the outcomes of the satisfaction survey of participants that have occurred from day one.

Internal review decisions and applications to the Administrative Appeals Tribunal are commencing. The outcomes from these reviews will increasingly provide feedback on these issues to primary decision-makers


PART 3

Report under the Integrated NDIS Performance Reporting Framework

Index of Tables

1. Participant Outcomes1.1.1. Information about participants (total active participants) ………………………. 281.1.2. Support needs for participants ………………………. 291.1.3. Plans requiring early review (%) ………………………. 301.2.1. Delivery of agreed supports as planned ………………………. 311.2.2. Proportion of participants with support packages within expected ranges ………………………. 321.2.3. Support funded by type (Tier 2 and Tier 3) ………………………. 331.2.4. Average days from access request to first plan start date ………………………. 341.2.5. Agreed support received / not received by support type ………………………. 351.2.6. Service provider characteristics and market profile ………………………. 36

1.3.1. Trends in proportion of participants using each or a combination of plan management options ………………………. 371.3.2. Access requests made ………………………. 38


1.3.3. Access requests accepted for funding ………………………. 391.3.4. Reviews of decisions ………………………. 401.3.5. Total appeals by outcome and average processing time ………………………. 411.3.6. Appeals by Category ………………………. 421.3.7. Complaints by outcome and average resolution time ………………………. 431.3.8. Complaint type ………………………. 441.3.9. Participant/Carer satisfaction with the Agency and the experience ………………………. 45

2. Financial Sustainability2.1.1. Total payments ($, in kind) ………………………. 462.1.2. Operating Expenses Ratio (% total costs) ………………………. 472.1.3. Average length of time from application to commencement of services ………………………. 482.1.4. Cash payments to providers and participants, split by support type ………………………. 492.1.5. Value of and number of approved packages by client group ………………………. 50

2.1.6. Number of participants receiving cash payments and/or in-kind supports by client group ………………………. 512.1.7. Ratio of cash to in-kind services by client group ………………………. 522.1.8. Number of plans with single supports ………………………. 532.1.9. Real, average and median costs of individual support packages ………………………. 542.1.10. Client numbers (Tier 2 and Tier 3) ………………………. 552.1.11. Total cost of supports funded – Tier 2, Tier 3 ………………………. 562.1.12. Total number of Tier 3 plans developed ………………………. 572.2.1. Proportion of participants with early intervention supports ………………………. 582.2.2. Total and average cost of Investment in research and innovation ………………………. 59

3. Community Inclusion3.1.1. Proportion of participants accessing mainstream services ………………………. 60

3.2.1. Community capacity building activities undertaken by funded NGOs within the period ………………………. 61

Appendix 2: Measures documented in Level 2 Performance Reporting Framework not included in this report ………………………. 62

Appendix 3: Definition of measures reported in Quarterly Report to Standing Council ………………………. 64


Detailed Performance Indicators1. Participant Outcomes

1.1. People with disability achieve their goals for independence, social and economic participation

1.1.1. Information about participants (total active participants) , split by gender, age and primary disability

State Total ATSI CALD Male Female XAge =

0-4

Age =

5-14

Age =

15-24

Age =

25-44

Age =

45-64

Age =

65+

PhysicalDisability

Intellectual/LearningDisability

NeurologicalDisability

PsychiatricDisability

Sensory/Speech

Disability

Unclassifi-ed

Disability

NSW 757 2% # 57% 43% 0% 9% 25% 13% # 30% # 5% 58% 24% 6% 8% 0%

SA 489 2% # 64% 36% 0% 92% 8% 0% # 0% # 3% 64% 15% 0% 18% 0%

TAS 352 2% # 64% 36% 0% 0% 0% 98% # 0% # 3% 80% 13% 2% 3% 0%

VIC 988 1% # 57% 43% 0% 13% 19% 22% # 18% # 4% 70% 23% 1% 2% 0%

Total 2586 2% 1% 59% 41% 0% 25% 16% 26% 17% 16% 0% 4% 67% 20% 2% 7% 0%

# = This cell is not populated as there is a risk of disclosure of personal information about one or more individuals and a resulting interference with privacy.

Table 1.1.1 shows the demographic information of active participants with an approved plan. The overall distribution shows that 67% of active participants have an Intellectual/learning disability and a further 20% have a neurological disability.


1.1.2. Support needs for participants by life domain

State Total Independence Economic Education Health + Wellbeing

Living Arrangements Social No domain

identifiedNSW 757 500 159 148 499 # 479 #SA 489 407 0 141 330 # 358 #

TAS 352 204 117 91 144 # 226 #

VIC 988 798 252 232 672 # 742 #

Total 2586 1909 528 612 1645 608 1805 48


Table 1.1.2 shows the distribution of funded support by aggregated life domain. Committed funding may address more than one life domain. Across each of the trial sites, the most commonly funded life domains are Independence, Social and Health & Well-being.


1.1.3. Plans requiring early review (%)

State Proportion

NSW 12.45%

SA 60.78%

TAS 13.14%VIC 13.59%

Total 22.11%

Table 1.1.3 shows the proportion of plans requiring review less than 12 months after the plan commenced. Over time a definition of what constitutes “early” will be developed. The proportion of plans requiring review less than 12 months after the plan commenced is significantly higher in South Australia compared to the other trial sites as more than half their plans are for six months. This is expected as current participants are very young.


1.2 Increased mix of support options and innovative approaches to provision of support in response to assessed need

1.2.1. Delivery of agreed supports as planned

Total Claimed in Plans Prorated plan amount %

NSW $1,792,296 $8,210,585 21.83%SA $337,045 $1,962,173 17.18%TAS $639,200 $4,556,045 14.03%VIC $1,171,367 $9,770,153 11.99%

Total $3,939,908 $24,498,955 16.08%

Table 1.2.1 shows the total dollar amount claimed to date compared to the funds committed for supports delivered to date. Insufficient time has elapsed for this development to be meaningful.


1.2.2. Proportion of participants with support packages within expected ranges (reference +/- x %)

State Planner Senior Planner Director State Manager

NSW 64% 22% 11% 3%

SA 83% 15% 2% 0%TAS 51% 35% 10% 5%VIC 54% 35% 9% 2%

Total 62% 27% 8% 2%Expected 38% 40% 16% 6%Variance +24% -13% -8% -4%

Table 1.2.2 shows the distribution of participants with an approved plan by delegation level. The expected distribution is from the delegation instrument . The percentage of plans approved by Planners is much higher than expected across all trial sites, in particular South Australia.


1.2.3. Support funded by type of funded support (Tier 2 and Tier 3)

Tier 3

State Total Plans Communication Community -

Social and CivicDomestic

life Education EmploymentGeneral

Tasks and Demands

Interpersonal Relationships

Learning and Knowledge Mobility Self-

care

NSW 757 526 350 180 13 90 255 128 36 253 442SA 489 438 104 13 8 0 67 30 116 189 183TAS 352 178 223 74 18 65 152 28 34 98 175VIC 988 592 616 307 57 117 426 203 135 418 667

Total 2586 1734 1293 574 96 272 900 389 321 958 1467

Table 1.2.3 shows the distribution of funded support. Committed funding may address more than one support cluster. Across each of the trial sites, the most commonly funded supports are Communication, Self-care and Community participation. Note: there has been no Tier 2 funding for individuals at this stage.


1.2.4. Average days from access request to plan approval

State Av days access request to plan approval

NSW 61

SA 59TAS 43VIC 65Total 63

Table 1.2.4 shows the average number of days between when an access request is made and support is approved. The average number of days is similar for the New South Wales, South Australian and Victorian trial sites, between 59 to 65 days. The Tasmanian trial site is lower, at an average of 43 days.


1.2.5. Agreed support received / not received by support type

State Total Plans Communication

Community - Social and

Civic

Domestic life Education Employment

General Tasks and Demands

Interpersonal Relationships

Learning and Knowledge Mobility Self-

care

NSW 21% 29% 20% 23% 0% 12% 16% 17% 14% 22% 19%

SA 21% 28% 14% 8% 13% 0% 28% 20% 7% 24% 14%TAS 13% 11% 13% 8% 6% 5% 11% 11% 6% 11% 24%VIC 13% 19% 12% 13% 5% 2% 9% 9% 10% 10% 19%

Total 17% 24% 15% 16% 5% 6% 13% 13% 9% 16% 19%

Table 1.2.5 shows the proportion of participants with funded supports that have had at least one claim for payment, by support type.


1.2.6. Service provider characteristics and market profile

Disability care Allied health Disability equipment

Plan management providers Other Total

Total 713 719 717 173 18 998

Local 0 0 0 0 0 0State 678 683 685 155 15 950

National 35 36 32 18 3 48NGO 247 244 139 114 9 279SME 438 448 545 51 8 675

Other private 8 8 18 0 1 20Public 20 19 15 8 0 24

Previously providing Department of Social Services

252

Not previously providing Department of Social Services

746

Table 1.2.6 shows the market profile and characteristics of registered service providers.


1.3 People with disability are able and supported to exercise choice

1.3.1. Trends in proportion of participants using each or a combination of plan management options

Agency Managed Combination Plan Management Provider Self-Managed

NSW 67.37% 29.99% # #SA 86.30% 10.02% # #TAS 70.45% 26.42% # #VIC 68.32% 30.77% # #Total 71.73% 26.02% 0.12% 2.13%


Table 1.3.1 shows the distribution of plan management options being used by active participants. Across the trial sites, the majority of plans are agency managed. Only a small proportion of plans are solely self-managed.


1.3.2. Access requests made

Total numbers

Total Closed Eligible In Progress Ineligible Revoked Withdrawn

NSW 1623 # 1111 186 236 13 #

SA 967 # 712 155 54 0 #

TAS 578 # 508 49 13 0 #

VIC 2166 # 1721 196 132 0 #

Total 5334 9 4052 586 435 13 239

Total proportions

Total Closed Eligible In Progress Ineligible Revoked Withdrawn

NSW 1623 # 68.5% 11.5% 14.5% 0.8% #

SA 967 # 73.6% 16.0% 5.6% 0.0% #

TAS 578 # 87.9% 8.5% 2.2% 0.0% #


VIC 2166 # 79.5% 9.0% 6.1% 0.0% #

Total 5334 0.2% 76.0% 11.0% 8.2% 0.2% 4.5%


Table 1.3.2 shows the number and distribution of access requests made by the current status of the request. To date, 76% of access requests have been found to be eligible, and a further 11% are in progress. Around 8% of access requests have been deemed ineligible.

1.3.3. Access requests accepted for funding

State Accepted

NSW 757

SA 489TAS 352VIC 988

Total 2586


Table 1.3.3 shows the total number of access requests that have an approved plan for funding by trial site.


1.3.4. Reviews of decisions

Total Number Average Days to resolutionOpen 9 -Affirmed 1 50Revised 1 44

Total 11 47

NSW Number Average Days to resolution SA Number Average Days to resolution

Open 3 - Open 1 -Affirmed 0 - Affirmed 0 -Revised 0 - Revised 0 -

Total 3 - Total 1 -

TAS Number Average Days to resolution VIC Number Average Days to resolution

Open 0 - Open 5 -Affirmed 0 - Affirmed 1 50Revised 0 - Revised 1 44

Total 0 - Total 7 47

Table 1.3.4 shows the number of decisions that participants, providers, or their agents, have formally requested to be reviewed. To date, there have been 11 requests, with the majority from Victoria (5) and New South Wales (3).


1.3.5. Total appeals by outcome and average processing time

Total Number Average Days to resolution

Approved 0 -

Denied 0 -

Grand Total 0 -

NSW Number Average Days to resolution SA Number Average Days to resolution

Approved 0 - Approved 0 -

Denied 0 - Denied 0 -

Total 0 - Total 0 -

TAS Number Average Days to resolution VIC Number Average Days to resolution

Approved 0 - Approved 0 -


Denied 0 - Denied 0 -

Total 0 - Total 0 -

Table 1.3.5 shows that there have been no appeals lodged.

1.3.6. Appeals by Category

Total Category 1 Category 2 Category

3Category

4Category

5Category

6Category

7Category

8

NSW 0 - - - - - - - -

SA 0 - - - - - - - -TAS 0 - - - - - - - -VIC 0 - - - - - - - -

Total 0 - - - - - - - -

Table 1.3.6 shows that there have been no appeals lodged.


1.3.7. Complaints by outcome and average resolution time

NSW Number Average Days to resolution* VIC Number Average Days to resolution*

Closed - referred to another agency 0 - Closed - referred to another agency 1 0.0

Closed - resolved 7 14.4 Closed - resolved 31 13.2

Closed - unresolved 1 0.0 Closed - unresolved 5 -

Open 8 - Open 16 -

Total 16 Total 53 12.3

SA Number Average Days to resolution* National Office Number Average Days to resolution*



Closed - unresolved 0 - Closed - unresolved 1 0.0

Open 7 - Open 4 -

Total 12 7.2 Total 13 3.8

TAS Number Average Days to resolution* Total Number Average Days to resolution*




Closed - unresolved 0 - Closed - unresolved 7 0.0

Open 1 - Open 36 -

Total 4 0.4 Total 98 8.6

* Note: Currently the system does not require a closure date for the complaint to be closed. A fix has been requested.50% of resolved complaints closed do not have a closure date recorded. Average days are based on only those complaints with a closure date.

Table 1.3.7 shows the number of complaints submitted by outcome and average resolution time. In total, there have been 98 complaints, of which 62 have been closed (63%).


1.3.8. Complaint type

State Provider AgencyReasonable and Necessary

SupportsHarm, Abuse,

Neglect Other TotalNational office 1 5 0 1 6 13

NSW0 12 3 0 1 16

SA 0 7 5 0 0 12TAS 0 3 0 0 1 4VIC 1 38 10 0 4 53Total 2 65 18 1 12 98

Table 1.3.8 shows the distribution of the total complaints to date by complaint type. The majority (66%) of complaints are agency related, with a further 18% classified due to the amount of reasonable and necessary supports in participant plans.


1.3.9. Participant/Carer satisfaction with the Agency and the experience

(Note: Satisfaction is reported on a scale of -2 extremely dissatisfied to +2 extremely satisfied, with 0 = neutral)

Participant Satisfaction Experience satisfaction

State Avg Score Avg ScoreNSW 1.85 0.10SA 1.80 0.30TAS 1.82 0.32VIC 1.80 0.28

Total 1.83 0.24

Participant satisfaction measures satisfaction of the Agency, and in particular, the planning process. Experience satisfaction measures participants overall satisfaction with their current life experience and outcomes.

Career satisfaction is currently not measured. This is being addressed for future reporting.


2. Financial Sustainability

2.1. Effective estimation and management of short-term and long term costs

2.1.1. Total payments ($, in kind)

State CASH IN-KIND TotalNSW $1,788,507 $3,789 $1,792,296SA $337,045 $0 $337,045TAS $557,523 $81,677 $639,200VIC $785,528 $385,840 $1,171,367Total payments $3,468,602 $471,306 $3,939,908

Table 2.1.1 shows total payments to date by trial site. Almost half of all payments are from the New South Wales trial site (45%).


2.1.2. Operating Expenses Ratio (% total costs)

%

Operating90.8%

expenses ratio


2.1.3. Average length of time from application to commencement of services

State Average Days After Access Request

NSW 65

SA 71TAS 57VIC 77Total 70

Table 2.1.3 shows the average length of time from when an access request is submitted before an invoice for support is received. Only participant plans that have had at least one claim are included in this measure. Many plans are yet to have their first claim, and as such this measure is underdeveloped. At this stage, the average number of days range between 65 and 77 across the trial sites, with the exception of Tasmania, which has an average of 57 days.


2.1.4. Cash payments to providers and participants, split by support cluster

Support Cluster Provider Participant Agency TotalAssess-Skill, Ability, Needs $75,163 $4,916 $0 $80,079Assist Access/Maintain Employ $35,382 $0 $0 $35,382Assist Prod-Pers Care/Safety $54,957 $27,125 $3,560 $85,642Assist-Integrate School/Ed $5,613 $5,175 $0 $10,788Assist-Life Stage, Transition $40,207 $628 $0 $40,836Assist-Personal Activities $585,804 $86,832 $1,054 $673,690Assist-Travel/Transport $12,650 $41,257 $565 $54,472Assistive Equip-Recreation $0 $25,039 $2,852 $27,891Comms & Info Equipment $0 $23,902 $9,507 $33,409Daily Tasks/Shared Living $981,377 $1,536 $0 $982,914Development-Life Skills $59,831 $8,451 $0 $68,282Early Childhood Supports $130,995 $2,502 $0 $133,497Hearing Equipment $0 $10,690 $0 $10,690Home Modification $4,413 $23,417 $1,860 $29,690Household Tasks $16,755 $5,776 $0 $22,531Other $23,432 $4,871 $1,320 $29,623Other Innovative Supports $515 $6,817 $864 $8,196Participate Community $571,155 $25,940 $463 $597,557Personal Mobility Equipment $53,080 $29,857 $22,266 $105,203Physical Wellbeing $6,823 $11,762 $3,532 $22,117Therapeutic Supports $364,491 $27,749 $165 $392,405Vehicle modifications $0 $10,199 $5,957 $16,155Vision Equipment $5,931 $1,364 $262 $7,556Total $3,028,573 $385,803 $54,226 $3,468,602

Table 2.1.4 shows total cash expenditure split by support type and payee. The majority of payments are made to providers (87%).52


2.1.5. Value of and number of approved packages by client group

Primary Disability Number Total committed costs Average annualised cost

Physical 100 $3,068,824 $35,151

Intellectual/Learning 1726 $56,700,266 $38,331

Neurological 528 $25,497,789 $55,237

Psychiatric 57 $2,418,848 $53,044

Sensory/Speech 175 $2,340,070 $15,903

Unclassified 0 $0 -

Total 2586 $90,025,797 $40,466

Table 2.1.5 shows the number of participants who have approved plans, the total cost committed in these plans and the average annualised cost of the plans, split by primary condition group. Note: annualising plan values adds uncertainty to estimates. It is not clear exactly which supports will continue into the future. The annualising approach taken is conservative, meaning the majority of supports were annualised. Further, annualising plan values in the South Australian launch site is very uncertain due to the high number of early intervention plans and the young age of participants.


The majority of participants have an Intellectual/learning condition, which has an average annualised plan amount of $38,331. Participants with a neurological condition have a higher average annualised plan amount at $55,237.

The overall average annualised plan amount is $40,466.


2.1.6. Number of participants receiving cash payments and/or in-kind supports by client group

State Cash In-kind Cash and in-kind Total

NSW 349 0 2 351SA 181 0 0 181TAS 85 5 19 109VIC 288 31 37 356

Total 903 36 58 997

Table 2.1.6: Almost all claims against plans are for cash payments (91%) or a combination of cash payments and in-kind supports (6%).


2.1.7. Ratio of cash to in-kind services by client group

State Cash services In-kind services

NSW 99.8% 0.2%SA 100.0% 0.0%TAS 87.2% 12.8%Vic 67.1% 32.9%

Total 88.0% 12.0%

Table 2.1.7 shows the distribution of cash payments and in-kind supports by trial site. Victoria has the highest percentage of in-kind supports at 32.9%.

Since the September Quarterly Report, an agreement was reached between the Commonwealth and the South Australian State Government that three specific providers would be fully cashed out providers, with no in-kind period. This arrangement was backdated to 1st July 2013. This meant that all previous in-kind claims by these providers had to be cancelled and re-entered as cash claims.


2.1.8. Number of plans with single supports

State Single supports Ratio

NSW 49 6.5%

SA 54 11.1%TAS 27 8.0%VIC 72 7.4%Total 202 7.8%

Table 2.1.8 shows the number of approved plans that only contain a single type of support. South Australia has the highest percentage of these plans, at 11.1%.


2.1.9. Real, average and median costs of individual support packages

State Actual expenditure total Average annualised committed Median annualised committed

NSW $1,792,296 $42,319 $21,596

SA $337,045 $20,261 $16,012TAS $639,200 $46,957 $28,679VIC $1,171,367 $46,735 $31,947

Total $3,939,908 $40,466 $22,780

Table 2.1.9 shows the actual expenditure, the average annualised plan amount and the median annualised plan amount, by trial site.

Tasmania and Victoria have the highest average annualised plan amounts, at $46,957 and $46,735 respectively. South Australia has the lowest average annualised plan amount at $20,261. Note: annualising plan values adds uncertainty to estimates. It is not clear exactly which supports will continue into the future. The annualising approach taken is conservative, meaning the majority of supports were annualised. Further, annualising plan values in the South Australian launch site is very uncertain due to the high number of early intervention plans and the young age of participants.


2.1.10. Client numbers (Tier 2 and Tier 3), split by gender, age and primary disability

Tier 3

State Total ATSI CALD Male Female X

Age =

0-4

Age =5-14

Age =

15-24

Age =

25-44

Age =

45-64

Age =

65+

PhysicalDisability

Intellectual/LearningDisability

NeurologicalDisability

PsychiatricDisability

Sensory/Speech

Disability

UnclassifiedDisability

NSW 757 16 # 429 328 0 65 193 100 # 229 # 37 436 184 43 57 0SA 489 9 # 311 178 0 449 39 0 # 0 # 15 315 73 0 86 0TAS 352 6 # 225 127 0 0 0 346 # 0 # 9 281 46 7 9 0VIC 988 8 # 565 423 0 128 185 216 # 181 # 39 694 225 7 23 0

Total 2586 39 17 1530 1056 0 642 417 662 444 410 11 100 1726 528 57 175 0

# = This cell is not populated as there is a risk of disclosure of personal information about one or more individuals and a resulting interference with privacy.Table 2.1.10 shows the number of people accessing Tier 3 supports.

There is insufficient data available to produce meaningful reporting for Tier 2 supports.For Tier 3 supports, the corresponding distribution of Tier 3 participants is shown in Table 1.1.1.


2.1.11. Total cost of supports funded – Tier 2, Tier 3

State Committed funds

NSW $28,596,180

SA $6,003,286TAS $13,123,917VIC $42,302,415

Total $90,025,797

Table 2.1.11 shows the total cost of committed supports for Tier 3 only. There is insufficient data available to produce meaningful reporting for Tier 2 supports.


2.1.12. Total number of Tier 3 plans developed

State Tier 3 plans

NSW 761

SA 491TAS 354VIC 990

Total 2596

Table 2.1.12 shows the total number of Tier 3 plans developed. This includes some plans which have since been superseded.


2.2 Benefits are realised from targeted investment strategies in enhanced disability support

2.2.1. Proportion of participants with early intervention supports

State Ratio

NSW 61%SA 85%TAS 56%VIC 68%

Total 68%

Table 2.2.1 shows the proportion of participants receiving early intervention supports by trial site. South Australia has the highest proportion at 85%, reflecting the lower age of participants targeted in this trial site.


2.2.2. Total and average cost of Investment in research and innovation

State Total # Total $ Average investment

NSW 0 $0 $0

SA 0 $0 $0TAS 0 $0 $0VIC 0 $0 $0

Total 0 $0 $0

As at December 31 2013, there has been no expenditure on investment in research and innovation


3. Community Inclusion

3.1 People with disability are able to access support from mainstream services

3.1.1. Proportion of participants accessing mainstream services

Participants accessing mainstream services

Proportion accessing mainstream services

NSW 528 70%SA 439 90%TAS 263 75%VIC 889 90%TOTAL 2119 82%

Table 3.1.1 shows that the majority of participants with approved plans are also accessing mainstream supports (82%).


3.2 Effectiveness of LAC community capacity building activities

3.2.1. Community capacity building activities undertaken by funded NGOs within the period

Activities undertaken Funding $TOTAL 5 $3,955,067


APPENDIX 2

Measures documented in Level 2 Performance Reporting Framework not included in this report


For reasons detailed in Appendix 2, not all measures documented in the Intergovernmental Agreement were able to be reported on for 2013/14 Q2. These are listed below:

1. People with disability lead lives of their choicePeople with disability achieve their goals for independence, social and economic participationProportion of participants achieving their life goals as specified in their planProportion of participants achieving their plan goals (total)Proportion of participants achieving their plan goals in one or more specific domains:

oEconomicoSocialoEducationoHealth and well-beingoLiving arrangements

Planning and goal setting completed on time (%)Trends in proportion of participants using different approaches to decision supportsCarer satisfaction with agency

2. NDIS is a financially sustainable, insurance-based scheme


Growth in future commitmentsAverage support package growth rate (%)Management of prudential riskProvision of supportsAverage cost of supports per assessorCurrent and future funding resourcesCurrent expenditure compared to projectionsProjected expenditure compared to projected revenueLong term cost trends (population, price and wage growth)Average client lifetime cost of supportNumber of Tier 2 supports with LAC funding and purpose of fundingAverage cost of internal reviewsAverage cost of appealsProportion of participants with reduced needs after intervention supports

3. Greater community inclusion of people with disabilityPeople with disability are able to access support from mainstream servicesSuccessful referrals to mainstream / generic disability services (Tier 2 and Tier 3)Community awareness activities undertaken within the periodCommunity capacity building activities undertaken by LACs within the period


APPENDIX 3

Definition of measures reported in Quarterly Report to the COAG Disability Reform Council

Measure Title Page Brief Description Included in 2013-14 Q2

report?

1 Participant Outcomes 25

1.1.1.Information about participants (total active participants)

25

Summary of demographics for active participants, defined as people eligible for funding as per the Act, who have an approved plan for funding in place.

Yes

1.1.2. Support needs for participants 26

For active participants, identifies the life domains which supports are being funded to address identified need. Note: Approved funding may address more than one life domain.

Yes


n/aProportion of participants achieving their life goals as specified in their plan

-

The outcome of a review of a participant's goals. Goals refer to the overarching, personal goals of participants.

No - insufficient scheme development for any plan reviews. Reporting to commence in 2014/15.

n/aProportion of participants achieving their plan goals (total)

-

The outcome of a review of a participant's plan objectives (plan goals). Plan objectives refer to the identified aims within a plan, for which funding is allocated to support the achievement.


n/a

Proportion of participants achieving their plan goals in one or more specific domains

-

The outcome of review of a participant's plan objectives (plan goals), with identification of the aggregated life domain the objective was related to.


n/a Planning and goal setting completed on time (%) -

Reports the proportion of plan reviews that are completed on or before the previous plan's scheduled end date.


1.1.3. Plans requiring early review (%) 27

Reports the proportion of plans that were, or are due to be, reviewed less than 12 months after the plan commenced

Yes


report?

n/a Active Participants (Tier 2 and Tier 3) -

On plan review, number of participants who change the way funding is utilised to support their needs.


n/a Availability of provider services (%) -

Proportion of identified support needs that have at least one registered provider servicing the residential area of the participant.

No. Data is not currently available for this measure.

1.2.1. Delivery of agreed supports as planned 28

Proportion of funds committed for supports delivered to date that have been claimed.

Yes - insufficient time for meaningful development


1.2.2.

Proportion of participants with support packages within expected ranges (reference +/- x %)

29

Delegations are determined by the instrument of Delegation. This measure reports the delegation required to approve committed plans

Yes

1.2.3. Support funded by type (Tier 2 and Tier 3) 30

Support types for which supports have been funded. Note: A single plan can contain funding in multiple support types

Yes

1.2.4. Average days from access request to support approval 31

Days taken from when Access Request is received until initial funded plan is approved.

Yes

1.2.5. Agreed support received / not received by support type 32

Proportion of participants with funded supports in support type that have had at least one claim for payment.

Yes

1.2.6.Service provider characteristics and market profile

33 Market profile of registered providers Yes

n/a

Trends in proportion of participants using different approaches to decision supports

-

At plan review, proportion of participants who choose to change the way their plan is managed



report?

1.3.1.

Trends in proportion of participants using each or a combination of plan management options

34Split of plan management options being used by active participants.

Yes

1.3.2. Access requests made 35Number of formal requests for access, with status of request.

Yes

1.3.3. Access requests accepted for funding 36

Number of eligible access requests that have established plans for funding.

Yes


1.3.4. Reviews of decisions 37

Number of decisions that have been formally requested to be reviewed by participants, providers or their agents.

Yes

1.3.5. Total appeals by outcome and average processing time 38 Number of appeals

submitted. Yes

1.3.6. Appeals by Category 39 Number of appeals submitted. Yes

1.3.7. Complaints by outcome and average resolution time 40

Number of complaints submitted by participants, providers, staff, and/or the general community.

Yes

1.3.8. Complaint type 41

Number of complaints submitted by participants, providers, staff, and/or the general community.

Yes

1.3.9.Participant/Carer satisfaction with the Agency and the experience

42

On a scale of -2 extremely dissatisfied to +2 extremely satisfied, with 0 = neutral, self reported satisfaction of participants and their carers. "Participant Satisfaction" reports satisfaction of participants with the Agency, and in particular, the planning process."Experience Satisfaction" reports the overall satisfaction of a participant with their current life experience and outcomes.

Partial - Data is not available at this time to report Carer Satisfaction


report?2 Financial Sustainability

n/a Growth in future commitments -

Reports growth in projected liabilities, as per actuarial modelling

No - insufficient scheme experience for informed adjustment to actuarial model

2.1.1. Total payments ($, in kind) 43

Total claims against plans, split by cash and in-kind. Note: This does not represent total expenditure (reported in Measure 2.1.17)

Yes


2.1.2. Operating Expenses Ratio (% total costs) 44

Operating Expenses as a proportion of total scheme costs

Yes

n/a Average support package growth rate (%) -

Growth from previous quarter in average committed annualised costs

No - insufficient scheme development time to report growth

2.1.3.Average length of time from application to commencement of services

45

Average time from when access request is submitted, to first invoice for support is received by NDIA

Yes

n/a Management of prudential risk - Reports liabilities and assets

of the Agency


2.1.4.Cash payments to providers and participants, split by support type

46

Cash payments against plans, split by support type and payee. This does not represent total expenditure (See measure 2.1.17)

yes

2.1.5.Value of and number of approved packages by client group

47

Number of plans with approved funding, the total costs committed in those plans, and the average annualised cost of the plans.

Yes

2.1.6.

Number of participants receiving cash payments and/or in-kind supports by client group

48

Number of participants who have had claims against plans. This does not represent total expenditure

Yes

2.1.7. Ratio of cash to in-kind services by client group 49

Ratio supports claimed paid through cash or in-kind arrangements

Yes


report?

n/a Average cost of supports per assessor -

Average value of funds committed in plans per planner


2.1.8. Number of plans with single supports 50

Number of plans approved that only contain a single type of support

Yes

n/a Current and future funding resources -

Current annualised costs of approved plans, and the unannualised committed value of plans

No - insufficient scheme experience to compare expenditure to projections


n/a Current expenditure compared to projections -

Actual expenditure compared to actuarial projections

No - insufficient scheme experience to compare expenditure to projections

n/aProjected expenditure compared to projected revenue

-Comparison of projected expenditure to projected revenue


n/aLong term cost trends (population, price and wage growth)

- Monitors long term economic assumptions


2.1.9.Real, average and median costs of individual support packages

51

Reports total expenditure, compared with average and median annualised committed funds

Yes

n/a Average client lifetime cost of support -

Average actuarial estimate of individual participants' future cost liabilities.


2.1.10. Client numbers (Tier 2 and Tier 3) 52

Reports number of people accessing Tier 2 or Tier 3 Supports

Partial - system for capturing Tier 2 activities was not implemented for 2013-14 Q2

2.1.11. Total cost of supports funded – Tier 2, Tier 3 53

Reports annualised costs of supports committed to be funded for Tier 3 participants and for Tier 2 supports

Partial - system for capturing Tier 2 activities was not implemented for 2013-14 Q2

n/aNumber of Tier 2 supports with LAC funding and purpose of funding

-

Number of supports with Tier 2 funding. Note: This is not the same as number of clients - supports are not necessarily attached to individuals

No - system for capturing Tier 2 activities was not implemented for 2013-14 Q2


report?

2.1.12. Total number of Tier 3 plans developed 54

Total number of plans that have been developed and approved. This measure includes plans that have now been superseded.

Yes

n/a Average cost of internal reviews -

Average cost of administering internal reviews)

No - system is not in place for capturing internal review costs for 2013-14 Q2 (No reviews to report)


n/a Average cost of appeals - Average cost of administering appeals

No - system is not in place for capturing appeal costs for 2013-14 Q2 (No appeals to report)

n/aProportion of participants with reduced needs after intervention supports

-

Reports growth in annual committed costs for participants who have had early intervention supports as part of the previous plans.


2.2.1.Proportion of participants with early intervention supports

55

Proportion of currently approved plans that have supports identified as early intervention supports - included to reduce long term need for lifetime supports

Yes

2.2.2.Total and average cost of Investment in research and innovation

56 Costs for investment into research and innovation Yes


report?3 Community Inclusion

3.1.1Proportion of participants accessing mainstream services

57

Proportion of participants with approved funded supports who are also accessing mainstream supports

Yes


n/a

Successful referrals to mainstream / generic disability services (Tier 2 and Tier 3)

-Reports successful referral to mainstream supports by Local Area Coordinators

No - system not in place for recording Local Area Coordinator at 2013-14 Q2

n/aCommunity awareness activities undertaken within the period

-Reports community awareness activities undertaken by LACs


n/a

Community capacity building activities undertaken by LACs within the period

-Reports community capacity building activities undertaken by LACs


3.2.1.

Community capacity building activities undertaken by funded NGOs within the period

58

Reports funding provided to Non-Government Organisations to undertake community capacity building activities.

Yes


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