CEO Commentary – Many Lifeboats In the Ocean: Federal Budget 2023-24

CEO Commentary – Many Lifeboats In the Ocean: Federal Budget 2023-24 thumbnail.

The NDIS is here to stay.

In the Federal Budget 2023-24 delivered on Tuesday 9 May, many pleasing announcements were made across health, pensioners, single parents and of course – the NDIS.

Security and sustainability of the NDIS are a focus, as are outcomes and participant centric reforms underpinned by agency capability and capacity.

I was humbled to attend the House of Representatives Gallery last night to watch Treasurer Jim Chalmers deliver the Budget, announcing an overall surplus of $4.2bn. I also attended Question Time prior (always an interesting spectacle!) and had meetings with a number of key Ministers, Senators and Members of Parliament to discuss Down Syndrome NSW, the NDIS and the needs of people with disability and their families more broadly within the whole ecosystem of health, education, housing, transport, migration, justice and community.

I attended the National Press Club following the Budget, where Prime Minister Anthony Albanese spoke to the key investments being made. Here, my business card pile grew as I met with so many incredible advisors, business leaders, journalists and lobbyists. Let me tell you – politics is certainly a wild, weird, wonderful world and no better time than Budget night to experience this! I am so deeply grateful to very proudly represent our community.

NDIS in the Federal Budget 2023-24: Snapshot
Federal and state governments will spend $39.8 billion on the NDIS in 2023-24, which includes a combination of participant costs and additional expenses associated with the administration of the National Disability Insurance Agency (NDIA).

The Budget allocates $910 million to make the NDIS better, more efficient and ensure every dollar goes to the participant, supported by agency and sector capacity.

  • $732.9 million of this is targeted at improving the capacity and capability of the NDIA to achieve better outcomes for people by:
  • $429.5 million for the NDIS planners to have the capacity, capability and skills to better support participants
  • $73.4 million to on budget management support for participants and ensure better cohesion and oversight of plan managers, support coordinators and other providers.
  • $63.8 million to make plans clear and easy to change when life changes.
  • $56.4 million to strengthen supported independent accommodation and housing, with specialist planners and panel.
  • $29.3 million to improve services and develop a robust evidence base to improve quality and effectiveness.
  • $24.6 million to help services be creative, inject innovation and trial incentive and outcomes based payment systems.
  • $7.6 million for rural, remote and First Nations communities to pilot and access tailored and tethered support.
  • $48.3 million on improving IT systems and structures to better detect and prevent fraud, non compliant payments and ensure safety.

Protective measures include giving $142.6 million to the NDIS Commission; $14.1 million to a Covid Leave Grant to help stop COVID-19; $13 million for DSS to support systemic policy reforms and get the NDIS back on track; $7.3 million to help transition younger people out of residential aged care homes.

Growth moderation of the NDIS is a key component. National Cabinet has committed to an NDIS Financial Sustainability Framework. While the Scheme remains demand driven, the Framework will provide an annual growth target of total NDIS costs of no more than eight per cent by 1 July 2026.

See media realise by the Minister for the NDIS, the Hon. Bill Shorten here:

Not the Only Lifeboat in the (Vast) Ocean
Beyond the NDIS specifically, Budget announcements positively impacting our disability community:

  • $31.4 million to meet the remaining costs of establishing the National Disability Data Asset (NDDA) and its underlying infrastructure.
  • $41 million over three years to increase the capacity of the supported employment sector to support people with disability with high support needs. This is likely to be accessed via a structural adjustment fund. This is less than the previous allocation of $67 million earmarked for this purpose in previous budgets.
  • $11.7 million over four years to establish a disability employment advocacy and information program for supported employees, and their families and carers. This is part of the transition strategy and in line with the NDIS vision for supported employment.
  • $1.1 million dedicated for consultation and design of the Disability Employment Centre of Excellence, which will better support JobSeekers with disability, including supported employees, employers and employment service providers. The cost of medications will reduce from 1 January 2023 the maximum co-payment under the PBS gets cut to $30 from $42.50.
  • Increases to the base rate of working age and student payments by $40 per fortnight, including the Disability Support Pension (Youth) from 20 September 2023.
  • $15.2 million over two years from 2022–23 to support the establishment of the Y Careers Agency to provide young people with employment opportunities in the care economy, including the disability sector.
  • $17.7 million over four years from 2023–24 (and $4.7 million per year ongoing) in additional funding for the Higher Education Disability Support Program. This will enable providers to better support students with disability to access and succeed in higher education, including help to purchase equipment and modify teaching materials and delivery methods.
  • Additional funding of $3.2 million to extend the National Disability Abuse and Neglect Hotline and the Complaints Resolution and Referral Service
  • Tripling the incentive paid to GPs to bulk bill consultations for families with children under 16 years, pensioners and concession card holders.
  • $27.0 million to undertake additional pilots of early interventions for infants with signs of autism, and further progress the Government’s election commitment to deliver a National Autism Strategy.
  • $10.2 million to establish a Central Coordination of Disability Policy function in DSS.
  • 487 million over four years from 2023–24 (and $133.6 million ongoing) to continue and extend the Disability Support for Older Australians (DSOA) program.
  • $260.2 million over two years from 2023–24 to extend Commonwealth psychosocial supports for people with severe mental illness who are not in the National Disability Insurance Scheme. The National Housing Accord have a shared ambition to boost supply and build one million new homes from 2024.
  • Increase the National Housing Finance and Investment Corporation’s liability cap by $2 billion to a total of $7.5 billion, supporting lending to community housing providers for social and affordable housing projects.
  • $11.3 billion to support the Fair Work Commission’s decision to provide an interim increase of 15% to award wages for over 250,000 aged care workers.

All in all – pretty good!

All the usual things are there thanks to pre-Budget announcements and the openness of Minister Shorten about where we are heading, why and most importantly – how.

Of course much discussion is being had about the 8% growth target for the NDIS by 1 July 2026 ala the NDIS Financial Sustainability Framework. I have observed commentary with interest and enjoy the diverse views and wealth of expertise around us. To be clear, this is a target not a cap. The NDIS will remain demand driven. This target does not affect that nor will it affect access to timely, quality services or take away the NDIS from participants needing supports. What the target does do though is enable us to approach the NDIS with a business lens of sustainability, drawing on the already uncovered inefficiencies, fraud and the need for mainstream and community services to do their part – something I am deeply passionate about.

As you’ll note from my earlier CEO Commentary on Minister Shorten’s National Press Club speech where he noted that the “NDIS can’t be the only lifeboat in the ocean”, in my view and personal experience seems that somewhere along the way the inclusion agenda tripped over itself and became exclusive. It seems across a number of areas of health, education, transport, housing, community supports that an invisible triage system has evolved whereby people with disability are sent down the NDIS path and those without disability are sent down the mainstream services path.

So, what’s missing in the Budget?

I’ll need some time to do a deeper dive but some of what I’ve not seen announced in line with what we know people with Down syndrome (and disability more broadly) and their families are needing includes:

  • Inclusive education. Earth to education, hello are you there, can you see us, helllooooo? Despite the investment in higher education (which we of course welcome), significant work needs to be done around inclusive education that I’m yet to see in this Budget. Yes, education is primarily a state issue though it would be great to see national leadership, drawing on the instruments of the UNCRPD and the national Disability Standards for Education. We know this is a paramount issue for our members and that education lays a critical foundation for us all.
  • Access to specialist health professionals and therapy which in some way will be looked at in the NDIS review and we warmly welcome the investment into Medicare bulk billing and medication costs, however I’m keen to look at how long wait times, thin markets and outcomes based specialist can be more readily accessed by our community. We know the earlier, the better.
  • Investment into innovation lead by people with disability and their families, as well as organisations like Down Syndrome NSW. We have ideas, we want to pilot new ways of doing things – particularly in the housing and accommodation space, as well as employment. Down Syndrome NSW has great models scoped up ready to test that just need funding, the learnings from which can be extrapolated across all disability types. Further, I know our members have great ideas that deserve to be incentivised. I’m not seeing much in the Budget for this but I’ll do a deeper dive.
  • Upskilling mainstream services on disability: The investment into the NDIA is very much needed and welcomed, but I’m keen to understand what upskilling is slated to ensure that all services – education, health, justice, transport, housing etc – have knowledge of disability, have up to date disability action plans that are co-designed and translated into practice and are committed to genuine inclusion.
  • Support for carers and siblings is an area I am personally passionate about, particularly as we now have the first generation of people with Down syndrome (and disability more broadly) who en masse will outlive their carers. Investments to bring down cost of living and increase housing supply help, certainly, however carer burnout, future planning, wills and estates, the aged care interface and certainty of quality care and residence are key priorities I need to look at further in the Budget. Siblings need to be at the table – for working groups, policy reviews, advisory councils. We have unique experiences to add. Count us in.

A quick note on media coverage, as I’ve seen many an article in recent weeks. One last night from the AFR read, “NDIS blows out by $32m a day”.

These headlines are not helpful to our community. I remember what life was like before the NDIS and I don’t want to go back there, nor does my sister or my parents. Does it need reform? Yes. Is it utterly frustrating at times? Yes. Is my sister living a better life now than she did 10 years ago thanks to the NDIS? Absolutely yes.

My asks of you:
We need to keep sharing the good with the areas to improve. Keep sending us your incredible photos, updates, milestones, stories, fill in our surveys, engage in the consultations and submissions. Just yesterday, the Chair of the Joint Parliamentary Standing Committee into the NDIS commented to me that in the Inquiry submissions and hearings, they generally only hear from those having issues, as those who are doing well under the NDIS don’t tend to engage. Let’s work together to change that.

We need to respond strongly when people outside our sector, no matter how well meaning, state all to often to me, “Oh that NDIS of yours is a worry, isn’t it?” (which at times I read as: those people with a disability a really expensive, aren’t they?).

We need to zoom out and look at the whole ecosystem, reminding mainstream and community services of their important role. Supporting people with disability isn’t just the right thing to do ethically, economically it is too.

Another year, another Budget, one that is securing our NDIS not just now but forever. One that has glimmers of mainstream capacity investment. One that brings down some costs of living for our families.

There are many lifeboats in the ocean – some big, some small, some slowly deflating, some way off course, some national, some state. Down Syndrome NSW will continue to work tirelessly to raft them up for our members to ensure a cohesive, efficient and effective ecosystem at every life stage.

Budget night is over, now let’s get back to work – together.

You can download a pdf version of this article here. An ‘In Brief’ overview of the Federal Budget is also available to download here.

Emily Caska
Down Syndrome NSW