A secret plan to restrict the access of autistic people to the $22 billion National Disability Insurance Scheme would prevent them from qualifying “automatically” for taxpayer-funded support as part of a sweeping overhaul to rein in costs.
The Weekend Australian has confirmed bureaucrats have been working on a strategy since late last year to pare back the number of people with autism receiving funding packages.
The agency running the NDIS accidentally published part of its plan to restrict access for autism cases on Monday when it updated a list of pre-qualifying conditions for the scheme. It later suggested it had “incorrectly” posted the wrong document.
A mid-ranking National Disability Insurance Agency staff member, without the knowledge of the deputy chief executive responsible, altered a list of conditions for autism spectrum disorders, which was not meant to be made public.
The update, which was taken down the next day and labelled “incorrect” by the NDIA, has been confirmed as genuine, making it the first clear sign the agency is attempting to restrict the number of people with autism qualifying for funding support.
Under the globally accepted Diagnostic and Statistical Manual of Mental Disorders, autism is broken into three levels of need with one being the lowest, level two requiring substantial support and level three requiring “very substantial support”.
The first list of conditions eligible for NDIS support — which is called “List A” and includes double amputees and people with brain injuries — has long contained autism levels two and three but level two was removed on Monday. The agency restored the original list the next day.
“We apologise for any inconvenience,” the NDIA posted.
Agency staff rang autism advocates and special interest groups to reassure them that the change was a mistake but The Weekend Australian has confirmed the organisation is working on a plan to restrict or remove automatic qualification for autism cases.
A spokeswoman for the NDIA said last night no changes had been made as yet.
“If and when any changes were to be made to List A and List B, they would be informed by research and evidence and only following consultation with stakeholders and with appropriate authorisation,” the spokeswoman said.
“Any person with autism who is eligible for the NDIS will receive the reasonable and necessary supports they need.”
About 30,000 children aged 14 and under have an NDIS plan.
Almost half of these are considered high functioning, meaning they have a “low level of disability”.
There are 142,000 participants in the disability scheme and 29 per cent of these have autism, the same proportion as those with intellectual disabilities. The proportion of those with autism has been increasing slightly — up from 28 per cent a year ago — while the incidence of intellectual disability has dropped sharply from 37 per cent. Among participants aged 25 and over, autism accounts for 5 per cent of clients.
“I think the agency has realised what a massive deal autism is for them with regard to the sustainability of the scheme,” said a source involved in the plans.
“They are strongly looking at the right way to solve this issue and I understand they are extremely keen to consult with the autism community.”
The source said there was a “very strong case the NDIS shot themselves in the foot” by including autism on the automatic qualification list. “It is a spectrum disorder — everyone has different needs,” the source said.
Removing autism from List A would not ban access to the scheme but it would require that every person be independently assessed before qualifying for support, according to their functional impairment.
In its submission to the Productivity Commission review of scheme costs last year, the NDIA conceded it had concerns about autism being included on List A.
“The NDIA has noted that autism spectrum disorders may represent a difficulty for List A, and there is evidence to suggest that use of the diagnosis process for autism may differ from the process’s intent, resulting in access to the scheme where eligibility requirements would not otherwise be met,” the NDIA submission says.
In its final report in October, the Productivity Commission said the condition lists were “a key entry pathway” to the NDIS and monitoring them was essential to ensure they worked as intended. “A process for quickly changing the lists as new information comes to light is necessary, as is transparency about what is on the lists and why changes are made,” the Productivity Commission report says.
NDIS executives splash out $180m on ‘strategic advice’
Chantelle Care-Wickham with her daughter Felicity, aged 5. Picture: Kelly Barnes
The executives in charge of running the National Disability Insurance Scheme spent more than $180 million on consultants and contractors in 16 months, $41.5m of which went to two top-tier private companies for “strategic advice”.
Leaked financial records from inside the National Disability Insurance Agency reveal the scale of outsourced expertise in the fledgling scheme, with the $180m figure from July last year to last month almost triple the $66m spent in 2015-16, taking the total to almost a quarter of a billion dollars.
The leading recipient of funding was global behemoth Boston Consulting Group, which raked in $21m after it was brought in to overhaul a Byzantine planning system that had become the scorn of people with disabilities who were often shunted onto support packages with little or no understanding of what had transpired.
In a bureaucratic twist, $10m was provided to Australian Healthcare Associates to conduct telephone planning and “information gathering” for the first support plans of NDIS clients, which was precisely the process abandoned under the new “participant pathway” that BCG helped design with its $21m payday.
The $22bn reform has been hit by growing pains and the speed of its delivery, which is enshrined in bilateral agreements signed between the federal government and states under Julia Gillard and has been heavily criticised by the Productivity Commission.
Consultants and contractors have been brought in to help fix a litany of rollout issues that spread after a near total IT meltdown in the middle of last year and included bungled client plans.
Adelaide mother of two Chantelle Care-Wickham said she was extremely frustrated after requesting an iPad and speech app in March for her five-year-old daughter Felicity, who has severe speech and language delays.
“Five months after making the request, our speech pathologist was sent a letter stating the NDIS had changed its forms and we had to reapply,” Ms Care-Wickham said.
Catch-up work is still a large part of the NDIA’s malaise. Documents show Deloitte Touche Tohmatsu, which holds an ongoing contract as the NDIA’s “ICT Services Strategic Partner” invoiced the agency for $20.5m.
The NDIS now has 120,000 people with disabilities on its books and must reach 460,000 by the middle of 2020. The cost of the NDIS in 2016-17 was about $5bn.
At a Senate estimates hearing last month, agency executives said the NDIA employed 2127 staff, 1012 contractors and 2203 local area co-ordinators, and was “about 500-ish” full-time equivalent positions below a public service cap of 2460 places.
Many of these contractors are in the outsourced local area coordinators system. The financial records obtained by The Australian show $18.5m was paid to the Brotherhood of St Laurence and $6m to LaTrobe Community Health Service for this work.
Social Services Minister Christian Porter told The Australian the amount spent on the scheme was “a matter of public record”.
“It was always envisaged that there would be high upfront costs, including the need to engage outside experts, in establishing the NDIS,” Mr Porter said. “The amount spent is a matter of public record and is entirely within the existing budget and is designed to put in place systems to restrain future costs. The Productivity Commission has confirmed that the NDIS is within budget.”
The NDIA handed over more than $4m to a company called Assessments Australia, which was acquired by Max Solutions in December 2015. Max Solutions is owned by US parent company Maximus which dominates human services delivery around the world, including in Saudi Arabia, and is the largest single employment services contract holder under Australia’s jobactive program for the unemployed.
“Assessments Australia were engaged to assist the NDIA primarily to back-capture client data and their contract expired in 2016,” a spokeswoman for the agency said.
The BCG contract for planning reform ended on October 30 but a “small team” continues to assist the agency. “The National Disability Insurance Scheme is a complex and highly valued national reform and the scale, pace and nature of the changes it is driving are unprecedented in Australia,” an agency spokeswoman said.
The agency has struggled to recruit experienced, full-time staff and spent tens of millions on recruitment services. The largest recipient in this area was with Hays Specialist Recruitment, at $15m, while $7.5m was paid to DFP Recruitment Services. The agency also spent $17m with Cushman & Wakefield, a commercial property specialist. By comparison, the Department of Social Services spent $15.5m on consultants in 2016-17.