Taskforce to reduce growth in participants and spending

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NDIS cost-cutting taskforce told to reduce growth in participants and spending

National Disability Insurance Agency quietly forms unit to avoid ‘cost overrun in 2021-22’

The agency that runs the national disability insurance scheme has quietly established a new taskforce aimed at cutting growth in funding packages and participant numbers.

Guardian Australia has obtained an internal document, published below, that shows the National Disability Insurance Agency has created a new unit to make “short term, immediate changes” to the scheme, citing a forecast “cost overrun in 2021-22”.

“The actions of the [Sustainability Action Taskforce] will make immediate changes to slow growth in participant numbers, slow growth in spend per participant and strengthen operational discipline, in accordance with the requirements of the NDIS Act and Rules,” the three-page document, marked “sensitive”, says.

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The establishment of a new unit aimed at slowing spending growth comes amid an already fierce fight between the government and disability groups over a planned overhaul of the NDIS Act and controversial introduction of independent assessments, both of which are viewed by advocates as attempts to gut the scheme.

The document claims the new taskforce is a separate to “scheme reform” initiatives such as moves to overhaul the NDIS Act and introduce independent assessments.

But it appears to consolidate increasingly alarmist warnings buried in the NDIA’s corporate plans about NDIS spending and will fuel concerns among the disability community about the agency’s plans.

Martin Hoffman, the NDIA’s chief executive, announced the establishment of the taskforce in an internal staff update last month, saying he had appointed a former McKinsey associate partner and existing NDIA general manager to lead the unit.

While Hoffman’s all staff update refers to a need to “moderate growth and spending” in the next six months, it’s not as explicit about the claimed need to slow “growth in spend per participant”. The internal document was designed for frontline planning staff and “strictly not for external distribution”.

Dated April 2021, it outlines “seven principles that should be applied every time staff create a participant’s plan”, and notes that these will “help ensure the scheme is financially sustainable”.

Notably, the first principle is “Fair for everyone, both today and for future generations”.

Others include “Fair funding to pursue your goals”, “Evidence-based best practice” and “Fair supports for your disability needs”.

The document includes talking points for staff, which include: “At the moment the costs of the scheme are increasing at a much higher rate than expected because we’ve been building budgets based on inconsistent information and decision-making.”

Labor’s NDIS spokesperson, Bill Shorten, said the “leaked secret plan” showed the “Morrison government is acting directly against the interests of Australians with disability”.

“It is a disgrace that they are instructing government staff to deliberately slow down getting people on the NDIS and reduce their funding,” he said.

“This is just the latest leak of a broader plan against the NDIS and participants that the government are hiding in the shadows because even they know it is shameful.”

Catherine McAlpine, chief executive of Inclusion Australia, said the organisation was “greatly concerned that a model of short-term cost-cutting will not make the investment needed for the social and economic participation of people with intellectual disability”.

“It’s a false economy to penny pinch, when it is investment that will keep costs down in the long term.

“The NDIS has told us for months that the proposed changes to the scheme are about fairness and consistency. The disability sector has expressed consistent concern that the real issue is cost-cutting. It seems that our concerns have been justified.”

The NDIA document says that the total budget for participant and scheme expenditure grew at 23% on average between the 2019-20 and 2021-22 financial years.

“This is almost six times the capped 4% per annum rate,” the document says.

“The Sustainability Action Taskforce (SAT) has been set up to identify and deliver the immediate actions we need to take to avoid this forecast overrun for the 2021-22 financial year.”

The NDIA’s corporate plan has previously identified supported independent living – where participants receive round-the-clock support to live in shared accommodation – as a driver of the growth in spending.

But the plan noted the agency would target “both SIL and non-SIL services” in reforms to drive “better outcomes for participants while ensuring financial sustainability”.

Advocates have argued that one of the reasons for the growth in spending is that participants are increasingly being empowered to utilise their plans. They say the scheme was never intended to place a cap on supports and have repeatedly criticised the agency’s focus on “suitability”.

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The NDIA’s last annual report, meanwhile, notes that there have “continued to be more children approaching the Scheme than expected”.

There are about 430,000 participants in the scheme, a figure expected to increase to 532,000 participants by 30 June 2023.

The 2019 budget revealed a $1.6bn underspend in the NDIS, which prompted an unlikely joint statement from the NSW Coalition and Victorian Labor governments accusing the government of short-changing people with a disability.

A spokesperson for the NDIS minister, Linda Reynolds, said the minister was “committed to working collaboratively with states and territories and the sector to ensure the NDIS achieves the coverage intended and supports quality outcomes for all NDIS participants in a way that is fair, equitable, consistent and affordable”.

“The government also acknowledges its responsibility to ensure that participants continue to receive the reasonable and necessary supports they need, and to ensure the long-term financial endurance of the scheme,” they said.

“She is currently receiving comprehensive briefings and is consulting with all state and territory disability ministers, the disability sector and NDIS participants.”

The NDIA was also approached for comment.

www.theguardian.com/australia-news/2021/apr/13/ndis-cost-cutting-taskforce-told-to-reduce-growth-in-participants-and-spending

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The restructuring of the NDIS

A secret taskforce set up to cut costs and reduce access to the NDIS is the tip of the iceberg in a suite of plans to dramatically reshape the scheme.

Controversial “robo-planning” reforms of the National Disability Insurance Scheme could lead to the loss of 1200 jobs within the agency and hugely limit the input of disabled people, according to a proposal prepared for the scheme’s board and executive leadership team.

Based on conversations with senior National Disability Insurance Agency figures, leaked memos and comments from agency staff, The Saturday Paper can reveal unprecedented detail about the mooted restructure within the government agency that oversees the NDIS.

Global management consulting firm McKinsey and Company led the high-level project on a $1.1 million, six-month contract. Internally it is known as the “Scheme Workforce of the Future” project, or SWOF, and agency staff have been briefed on its findings.

On Tuesday, The Saturday Paper revealed the existence of a secretive “sustainability action taskforce” within the NDIA, which has been given the ability to make “immediate changes to slow growth in participant numbers, slow growth in spend per participant and strengthen operational discipline”.

This SAT is run by Hassan Noura, a former McKinsey associate partner who joined the NDIA in March last year.

The taskforce has a goal over the next six months to dramatically reduce the NDIS budget.

Its objectives sit within a suite of reforms proposed by the agency, which will use computer-generated “robo” budgets to decide the level of care disabled people should receive. This care will be calculated on the basis of an automated “score”.

By stripping away elements of personalisation in the development of support budgets, which until now have involved close consultation with health workers and recipients, the NDIA predicts it will slash the hours it takes to “build” each participant plan. But the essential plank in that time-saving strategy is to remove almost all input from NDIS participants.

The time required to complete participants’ plans has been identified as a “pain point”, according to an internal message to agency staff, obtained by this newspaper.

Based on conversations with senior NDIA figures and leaked memos The Saturday Paper can reveal unprecedented detail about the mooted restructure within the government agency that oversees the NDIS.

The message notes that “this package of reforms will deliver a future state service delivery where information will be pre-populated into participants plans” in order to reduce the time taken on these plans by more than 90 per cent – from up to eight hours to just 45 minutes.

A spokesperson for the NDIA denied there were any plans to cut staff numbers but conceded that a “restructuring” is afoot.

“There are no plans to get rid of some 1200 planners as part of the future workforce changes and restructuring at the agency,” the spokesperson said. “The agency is currently hiring and looking at opportunities to expand the size of the planner workforce.”

This statement is at odds with an internal mission labelled “Planning 2.0” and the much-celebrated reduction in plan build times. Most planning jobs at a senior level will be pivoted to oversight of the independent assessment process and high-level approval of final budgets.

“It’s robo-planning. Pump them out, cut and paste,” a senior NDIA employee tells The Saturday Paper. “The update documents were pretty candid. They also spoke about massively shrinking the support co-ordination and plan manager sector and replacing them with local area co-ordinators.”

As it stands, the NDIA spends hundreds of millions of dollars contracting these local area co-ordinators (LACs) to deliver pre-planning services for participants in the NDIS.

Under the legislation, participants can then choose to have their support packages managed externally – and paid for by the agency – as well as support co-ordinators who help them find the services for which they are funded.

For the record, the agency stresses it is incorrect to say that plan management and support co-ordination functions will disappear altogether.

“There are no plans for this,” the spokesperson says.

Still, senior bureaucrats have commented on the draft legislation about new “provisions to restrict access to plan management”.

A new clause would allow the scheme chief executive to block plan management for participants “if the CEO is satisfied that the provider’s management of the funding for supports under the plan to any extent would present an unreasonable risk to the participant”. Although this power is largely aimed at unscrupulous providers, the agency wants the cost of plan management to be absorbed in participant budgets rather than come from the agency itself.

“The fact that other than in specified circumstances we are required to give effect to a participant’s plan management request … implies to me that the Agency will cover these costs separate to the funding identified as ‘the total amount of funding allocated for the purposes of a plan’,” a senior agency official says in comments on draft legislation.

“We are not currently planning for these services to be a bolt on outside of the PBT [personalised budget tool].”

On Thursday, the new NDIS minister, Linda Reynolds, was quoted in The Australian as saying the controversial rollout of independent assessments – for which contracts worth almost $400 million have already been signed – would be temporarily halted. She also conceded that legislation would be needed to enact these assessments – a claim the agency has previously made but which is contradicted by internal correspondence.

“There has been significant feedback already. And as a new minister, I’ll be consulting around the country with as many stakeholders as I can,” Reynolds told The Australian. “Once I’ve received that feedback and the trial has concluded and we can assess the feedback of the trial, it is then a matter of making sure we have the best process … one that is fair and equitable and has appeal mechanisms.”

The government and the agency has been under mounting pressure during the past month. Internally, at least, nothing has changed, and the agency bosses appear committed to the scheme reform program. These officials have been pushing updates and talking points to staff.

Morale among its employees is low, however, and NDIA chief executive Martin Hoffman was forced to issue a warning to staff that leaking to the media would be punished.

“Generally, the information being leaked is in draft or incomplete,” he said in the memo. “The consequence is that these articles create unnecessary concern for participants and their families and may cause people to lose confidence in the agency and the scheme.”

Hoffman added that there may be “severe penalties” for divulging sensitive agency information to the public and urged staff to report leaks or concerns about other employees internally.

He added that “sensitive information” should be disposed of in “secure bins or shredders” and that employees should only use NDIA email addresses for agency business.

Hoffman’s email warning staff not to leak to the media was immediately leaked to this newspaper.

This article was first published in the print edition of The Saturday Paper on Apr 17, 2021 as "Stripping the NDIS".

www.thesaturdaypaper.com.au/news/politics/2021/04/17/the-restructuring-the-ndis/161858160011479#hrd