Thousands of children with autism or developmental delay who should not be on the $42bn National Disability Insurance Scheme are still getting taxpayer support because public servants are failing to reassess their cases.
The NDIS caseload of young children surged last year, as the number of 0 to 6-year-olds who joined the scheme skyrocketed 400 per cent more than expected.
In the latest NDIS annual financial sustainability report, scheme actuary David Gifford notes greater numbers of children with developmental delay joining the scheme in 2022-23 pushed numbers significantly higher than anticipated.
More than 16,500 0 to 6-year-olds joined the NDIS last financial year, 415 per cent greater than the 3211 expected. An additional 23,766 people across all age groups joined the scheme in 2022-23 with developmental delay as their primary disability, when just 5440 were anticipated.
Despite the National Disability Insurance Agency’s inability to predict the recent massive increases, the scheme actuary still projects between five and six per cent of the 300,000 children aged 0-14 on the NDIS are likely to be removed each year for the next three years as staffing resources ramp up. The revelations came as NDIS executives fronted parliament on Wednesday and conceded $60bn in projected savings would likely disappear altogether if Labor’s efficiency measures fail. Former NDIS minister Linda Reynolds led a united front of Coalition and Greens senators attacking the Albanese Government’s secrecy over its plans to contain the scheme’s growth over the next decade.
Senator Reynolds grilled officials on whether the scheme was still running “above expectations”, to which she was told the cost of the NDIS was 0.9 per cent above expectations as of last September.
The WA senator also asked the NDIS executives what would happen if Labor’s $720m in budgeted “efficiency measures” – which the government says will get the scheme’s growth down to 8 per cent a year – was not successful.
“It will result in $60bn in savings not being realised? In us being $60bn … in the black?” Senator Reynolds said.
Mr Gifford replied “based on quick calculations, yes, it would be something like that”.
Despite admitting that the NDIS’s third quarter report was available and in the hands of commonwealth and state governments, the officials refused to table the documents or provide budget data over the past four months.
Greens senator Jordon Steele-John criticised the agency for setting a “dangerous precedent” while Senator Reynolds blasted what she called an “unprecedented” lack of transparency.
“It is outrageous and unprecedented for any agency or department to come to Senate estimates and refuse to provide current budget estimates data,” she said.
The boom in child and adolescent cases saw an overall increase in NDIS participant numbers in 2022-23 of 75,847, 32 per cent more than the 57,639 the actuary had expected.
“New entrants with developmental delay and autism accounted for 70 per cent of total new entrants in 2022-23,” the actuary’s paper says.
About 12 per cent of all boys aged 5-7 are on the NDIS.
Total scheme numbers sat at 610,500 at the end of 2022-23 and are projected to increase to over a million by 2033, with scheme costs anticipated to run to $92bn.
A critical factor in overall scheme numbers being higher than expected was that fewer children than anticipated left.
“(This) reflects a short-term shift in focus of the National Access and Reassessment Branch in 2022-23, with priority given to initial access decisions which limited activity in regard to eligibility reassessments for people in the scheme,” the financial sustainability report says.
“Recruitment of new staff and a recommencement of reassessments in 2023-24 is expected to increase future rates of participants leaving the scheme.”
Those additional staffing numbers, part of a $730m commitment in the 2023 federal budget to “support participant outcomes and the effective and sustainable operation of the scheme”, are expected to rapidly bolster the exit of children from the NDIS.
Sam Bennett, Director of the Grattan Institute's Disability Program.
After about 1.5 per cent participants aged 0-14 left the scheme in 2022-23, the actuary projects significantly higher exits in the next four years as the number of scheme participants in that age bracket approaches 300,000.
“The rate of children leaving the scheme is expected to increase from 4.5 per cent in 2023-24 to a peak of almost 6.0 per cent over the three years ending 30 June 2026, driven by the impact of initiatives related to early childhood,” the report says.
Mr Gifford’s report said the unexpectedly high developmental delay numbers were due to “waiting times to obtain an autism diagnosis for children, increased awareness of developmental delay, lack of capacity within mainstream services to support children with developmental delay and Covid-19 related impacts.”
Grattan Institute disability director Sam Bennett agreed Mr Gifford’s reasons were part of the story, but said a factor not mentioned was “just how low the bar for access under the developmental delay criteria actually is”.
Dr Bennett said the NDIS defined developmental delay as a mental or physical impairment that substantially reduces functional capacity and requires specialist services for an extended duration.
“But it is subjective and open to wide interpretation, particularly the lack of definition around what constitutes substantially reduced functional capacity,” he said.
Work commenced by the NDIA in 2021 which would have clarified assessment thresholds for developmental delay was abandoned by the previous government, Dr Bennett said.
“It seems that access under the developmental delay criteria has actually become easier as a result,” he said. “In practice, there is virtually no barrier at all to entry, it all hinges on a clinician’s Judgement which the NDIA has no objective means of interpreting.”
While the actuarial report takes into account 2023 NDIS budget measures, it doesn’t consider any of the recommendations of the NDIS review, which reported to federal and state governments in December.