1. National Disability Insurance Scheme - Australia
European Social Network Conference
Sarah Johnson – Scheme Actuary
Lisbon, Portugal
July 2015

2. An insurance-based approach
Agenda
An insurance-based approach
Journey to the NDIS
Scheme experience
Building a sustainable scheme

3. An insurance based approach

4. Strategic goals
People with disability are in control and have choices, based on the UN Convention on the Rights of Persons with Disabilities.
The National Disability Insurance Scheme is financially sustainable and is governed using insurance principles.
The community has ownership, confidence and pride in the National Disability Insurance Scheme and the National Disability Insurance Agency.

5. A disability insurance scheme
The NDIS is based on the principles of insurance
The risk of disability affects all Australians.
The NDIS is a way of pooling these risks.
Australians pay a premium (collectively) that is enough to cover the annual costs of the care and support needs of participants and the costs of running the scheme.

6. Insurance Principles
The aggregate annual funding requirement will be estimated by the Scheme Actuary
The NDIS will focus on lifetime value for scheme participants
The NDIS will invest in research and innovation
The NDIS will support the development of community capability and social capital

7. Expected future payments
Liability
Lifetime Cost of Participant
Past payments
Expected future payments
Once a participant is in the scheme, the NDIS is liable for their lifetime cost
Factors influencing lifetime liability: packages of support and changes to these packages, inflation (including wage rates), life expectancy
NDIS “average” participant: $35,000 average annual package and $1.2 million liability (lifetime liability 35 times the annual cost on average)

8. Monitoring and managing financial sustainability
Collect data on the number of participants, the characteristics of these participants , the outcomes for these participants, and the cost of supports provided to participants
Identify drivers of good and bad outcomes – benefits to participants, their families and the community

9. Journey to the NDIS
An insurance based approach

10. History
Heads of Agreement are now in place for full scheme in NSW, SA, ACT, Tas, Vic and Qld
2008: Government’s 2020 summit proposes a national disability scheme
2010: Productivity Commission conducts enquiry into long term disability care
October 2011: Council of Australian Governments agree to the need for reform – joint taskforce develops Scheme design
March 2013: NDIS Act 2013 establishing the NDIS and NDIA passed
2009: The Disability Investment Group released its findings in The Way Forward
July 2011: Productivity Commission submits report to government
December 2012: Council of Australian Governments sign an intergovernmental agreement to trial the Scheme
April 2013: Bilateral agreements with trial sites signed

11. Trial sites are established and expanding
Since 1 July 2013, the NDIS trial has been operating in:
South Australia (0-14 years)
Tasmania (15-24 years)
Hunter region, New South Wales
Barwon region, Victoria
On 1 July 2014, the NDIS trial commenced in:
Australia Capital Territory
Barkly region, Northern Territory
Perth Hills region, Western Australia
The Scheme now has 7 trial sites across Australia.
They are in the Hunter (NSW), Barwon (VIC), South Australia (for children under six years of age) and in Tasmania (for young people, aged 15 to 24 years).
As of 1 July 2014, we expanded the NDIS trial sites to include the ACT, Barkly in the NT and Perth Hills, in WA.
In addition, we are expanding our footprint with an office in Colac in the Barwon region, and an office in Newcastle in 2015.
In Queensland, important preparatory work by the NDIA and the Queensland Government is forging ahead under a Memorandum of Understanding. Queensland will transition in July 2016.

12. An insurance based approach Scheme experience to date
1 July 2013 – 31 March 2015

13. Profile of participants - Age
30-35% are children aged 0-14 years
The age distribution in the Australian Capital Territory and Western Australian trial sites reflects the phasing schedules of the trial sites.

14. Profile of participants - Gender
The proportion of males and females is consistent with the actuarial model for the New South Wales, South Australian, Tasmanian and Victorian trial sites.
The new trial sites have relatively more males than females due to the specific age groups currently in these trial sites.

15. Profile of participants – primary disability
Autism and related disorders and intellectual disability (including Down syndrome) are the largest primary disability groups in the New South Wales and Victorian trial sites.

16. Implementation issues
Transition from existing disability system to the NDIS
Legacy of existing systems evident in trial site experience to date
Move from block funding to invoicing
Support provided in kind

17. An insurance based approach
Building a sustainable scheme

18. Reference groups - background
419,500 people across Australia, at a total cost of $ billion (2013/14 figures)
Split into cohorts based on age, health condition, and level of functional support need
Reference packages:
provide an expected annual funding level for participants with similar support needs and characteristics
a link between resource allocation to individual participants and the overall funding envelope
a crucial role in scheme monitoring

19. Modelling of reference groups
Intellectual Disability $3 billion
Low Severity
$2 billion
Medium severity …
High Severity
0-14 year olds
$1 billion
14-24 year olds
$0.5
billion
Stroke
$0.5 billion
Low severity
$0.2 bn
Total Funding Envelope $14.7 billion

20. Outcomes framework - background
Legislation
support social and economic participation of people with disability
choice and control
maximise independence
facilitate greater community inclusion
Other documents:
Strategic plan
UN Convention on the Rights of People with a Disability
National Disability Strategy

21. Outcomes framework – life stages
Different goals may be relevant at different life stages. To allow for this changing focus, unique sets of questions have been developed for each age group:
Children from birth to school entry
Children from school entry to age 14
Young people aged 15 to 24
Adults aged 25 to 55
Older adults aged over 55.

22. Outcomes framework - adults
The adult frameworks consist of eight participant domains and five family domains.
The participant domains are:
Choice and control
Daily activities
Relationships
Home
Health and wellbeing
Lifelong learning
Work
Social, community and civic participation

23. Outcomes framework – families/carers
The family/carer domains are:
Families have the support they need to care
Families know their rights and advocate effectively for their family member with disability
Families are able to gain access to desired services, programs, and activities in their community
Families have succession plans
Families enjoy health and wellbeing

24. Transition to full scheme
Ongoing bilateral negotiations between states/territories and the Commonwealth government
Agreements likely in place in August 2015
Around 30,000 participants at the end of the trial, ramping up to 460,000 at full scheme
Focus on enduring data collections and reducing the need for frontline staff to collect data that may be available from other sources
Building a national footprint

25. Questions? Visit: www.ndis.gov.au