Roger Cook has warned that the States will not bear all the costs of federal cuts to the NDIS as Health Minister Mark Butler eyes tighter regulation and a reset of eligibility to rein in the runaway program.
The Federal Government is looking for billions in savings from the NDIS by halving its growth rate, and will announce plans to spend some of that money on aged care.
It has been looking at ways to constrain the number of people on the scheme or constrain the growth in costs for services, or a combination of the two.
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The WA Premier – who currently leads the grouping of all State and Territory leaders – said he understood the Commonwealth’s desire to get the “galloping costs” associated with the NDIS under control.
“The Commonwealth should be looking, I’m sure, at a reform process which minimises the escalation in cost to the NDIS, but they shouldn’t expect the states to pay for all of that,” he said after a briefing from Treasurer Jim Chalmers to his State colleagues on the broad direction of the plans.
NSW Treasurer Daniel Mookhey was tight-lipped about what he described as a “high-level briefing”, saying he’d leave it to the Commonwealth to make its announcements, but underscored Mr Cook’s point about who pays.
“We made it clear that when it comes to challenges that they are facing in the NDIS, as well, that the states are prepared to play a role, but they are equal to the resources that we have,” he said.
“I think any effort the Commonwealth Government does to stamp out fraud and criminal behaviour in NDIS is most welcome.”
But that act alone won’t be enough to cover the savings Dr Chalmers has in mind as he prepares to hand down his fifth Federal budget next month.
At least some of the savings from the NDIS will be redirected to aged care services, including changes to the new Support at Home program to reclassify showering, dressing and toilet help as clinical services.
There were widespread concerns when the new system came into place in November that people would now be out of pocket for such services after they weren’t classed among “essential” care.
“Showering, dressing, continence care – these aren’t optional extras. They’re the basics of ageing with dignity, and no older Australian should miss out because of cost,’ Aged Care Minister Sam Rae said.
It’s understood the change will cost roughly $1 billion.
The high level of uncertainty and weeks of discussion about cuts had scared the disability community.
“They don’t know what it means for their everyday lives, for their ability to keep a job, be able to engage in the community, to be able to access the basic supports that they need, so that they don’t have to put pressure on other systems, like the health system and spaces like that,” People With Disability Australia’s acting chief executive Megan Spindler-Smith said.
They recognise that a sustainable scheme is extremely important, but are concerned about changes that could push people off the scheme or send smaller and family-run providers out of business.
Greens spokesperson Jordon Steele-John accused the Government of “spending their days before the budget trying to pick which group is least deserving of having the support they need to live a decent life”.
He was also hearing from the community that people were on edge and scared, with little clarity about the future.
One of the NDIS’s architects Martin Laverty, who served as the scheme’s inaugural director, points to five key ways to getting it back on track.
These include “resetting” eligibility to bring it back in line with the original intention of supporting people with significant, permanent disabilities; streamlining the three layers of intermediaries currently “each clipping the ticket of a participant’s plan”; better coordination of disability accommodation; and establishing an independent price-setting body.
But the most important announcement he’s looking out for is a timetable for mandatory registration of all providers who receive taxpayer funds.
At the moment, just 7 per cent of providers are registered, although changes come into effect in July to require all supported independent living and service platform providers to be registered.
“You could not imagine in other parts of the human service economy, 93 per cent of providers being invisible to government,” Dr Laverty, now the CEO of non-profit disability service provider Aruma, said.
He believed shifting the NDIS regulatory and pricing systems closer to those used for hospitals and aged care was a “long overdue” move that would ultimately give better outcomes for participants and save taxpayers money.
WA Treasurer Rita Saffioti indicated that provider registration was one of the key issues raised during Tuesday’s briefing.
As well, there were further discussions to be had “in relation to who’s in and out”.
“I would say that the NDIS was something that was created by the federal government. We’ve seen some of that management not as effective as we’d like to, but look, the issue of making sure people with disabilities have care is something that … we care for,” she said.
And, with her own budget set to be handed down days before the Federal Government’s one, Ms Saffioti said there had so far been no clarity over how the changes would affect the States’ bottom lines.
Disability services ministers will received a more detailed briefing after Mr Butler’s speech on Wednesday.
When the NDIS was set up, it was estimated to have about 400,000 participants and cost around $13 billion a year.
It currently has 760,000 participants, and this year costs $52 billion – more than is spent on aged care or Medicare and three times the bill for childcare subsidies.
The government has more than halved the growth rate from the 22 per cent it was at in 2022, but wants to claw it back further to 5-6 per cent.
It would still be one of the fastest-growing programs in the budget.
Dr Chalmers said this week the scheme was vital but “growing too fast for Australians to afford” and it would form the largest part of the savings package in May’s Budget.
