NIDA reportedly operating ‘above-the-law’ in the race to bring down NDIS budget 

In the drive to get the NDIS budget down, NDIA may have finally fallen foul of the law. Since the legislative reforms of October 2024, things have been difficult for NDIS’ severely disabled participants, who have been subjected to deep cuts– starting at 30% and ranging up to 75%.

These heavy reductions are being carried out in multiple ways, each more questionable than the last: from the sudden imposition of excessive requirements for frequent low-value consumable purchases, to large opportunistic cuts (30-40%) resulting from the purchase of Assistive Technologies (under the ‘zero-sum game’ prinicple)– NDIA have been nothing short of creative in their pursuit of reductions. However, the Agency may have now bottomed out in its quest for savings, with its latest innovation: the ‘unscheduled check-in/ unscheduled full plan review’.

The 'unscheduled check-in' is an unexpected casual drop-in and check-up by a NDIA employee which ends with a surprise axing – and in so doing, breaches NDIAs own internal processes as well as the due administrative procedures required of a government agency. 

Surprise!

Autistic participants (who lack social awareness and understanding), are now reportedly being blindsided with unscheduled check-ins by NDIA, which turn out to be full unscheduled plan reviews. Such blindsiding of participants, prevents them from organising the necessary allied-health and medical reports required to justify their funding. By not giving participants the opportunity to organise the necessary reports, NDIA can cut participant funding with ease and the decision cannot be successfully appealed as there is no evidence to justify the need for funding– required to challenge the decision.

This hit-and-run practice, does not appear to be the work of an isolated NDIA employee, as NDIA will no doubt be quick to claim. Similar strategies have been reported across the scheme in different chat forums online. Multiple reports have emerged of participants who have had their plans cut after an unexpected phone call from NDIA (see Reddit post below).

The widespread nature of the reporting suggests that the strategy of ambush is commonplace at NDIA and a frequent premeditated method employed by NDIA bureaucrats seeking to cut funding from participants earmarked for reductions– although this requires an independent (not internal) investigation to verify.

Taking advantage of an individual's mental disability is unacceptable at the best of times, but is morally reprehensible when carried out by a government agency charged with their care– can NDIA continue be trusted with the care of the severely disabled in light of the widespread use of exploitative approaches by its employees?

NDIS participants and families are so shocked by the underhandedness of 'unscheduled check-in', that they are now taking to Reddit to warn each other of NDIA's dirty tactics, see Reddit check-in post below.

NDIA acting 'above-the-law' 

Given NDIA's increasingly murky methods, it should come as no surprise that the Agency is now also refusing to comply with the FOI requests of plaintiff law firms, such as national law firm, Maurice Blackburn Cashman. This is unsurprising given the range of shady techniques employed by the Agency to get its budget's down any which way. Presently, should NDIA's questionable methods be scrutinized in the full light of day, liability may arise for the Agency.

In combination, NDIA's unscheduled plan reviews and lack of cooperation with FOI requests made by plantiff law firms suggests that they currently consider themselves ‘above-the-law’.

Why is this happening?

However before jumping to conlusions, it is important to understand why this is happening– as the answer is not as straightforward as it first appears. NDIS’ severely and permanently disabled participants are soft targets for cuts as they are generally unable to advocate for themselves– unlike the working parents of the autistic and developmentally delayed children who populate the scheme.

However, NDIS' severely and permanently disabled participants are not the cause of the scheme’s fast growing budget, which has rather been driven by the rapid intake of children under insurance-style automatic inclusions. While the recently proposed Federal-State Thriving Kids program will curb the rapid growth of NDIS from mid-next year by transferring the responsibility for the therapy of mild-to-moderately autistic and developmentally delayed children to the new Federal-State program, it excludes existing participants leaving NDIS budgets strained.

Playing Politics with Disability 

Most children of the 330,000 on NDIS are not severely disabled (mild-to-moderately affected only) and accessing the scheme for child therapy only. They have working parents who are capable of at least part-paying their therapy bills, however due to their high numbers and thus voting power– especially in Labor's electorates– it is not politically favorable for Labor to curtail their access to the scheme.

According to the Menzies Research Center, the rates of autistic NDIS participants is up to six times higher in Sydney Labor electorates, than in the more affluent Liberal Sydney suburbs. Most autistic participants accessing the scheme are children. These heavily populated suburbs just so happen to include Anthony Albanese's western Sydney electorate of Grayndler, as well as those of many of his party room colleagues– who were all standing for re-election, seeking a second term in office.

Prior to the last election, Labor PM Anthony Albanese, ruled out the possibility of means testing NDIS. At a casual glance 'no means testing', does not appear to be a controversial or harmful election promise. However when one considers the demographics of Labor held seats you can see how convenient this policy is for the Labor Party.

The other half of the scheme– the silent half– are severely disabled, and so in addition to being high-care, are unable to independently covered their basic care costs as they are too disabled to work (they suffer an 77% unemployment rate scheme-wide). This most disadvantaged half of the scheme, would not be affected by means testing, however the same cannot be said for the other half of the scheme, who as working parents (of 330,000 children on the scheme – 43% of all participants) would be heavily affected by means-testing and actively dislike it. So by ruling it out, Labor's Leader helped engineer second term in office– for both the Party and himself. It was a smart and winning move politically, however utterly devastating for the silent half of the scheme– the severely disabled and unemployed participants, who are unable to cover their own care costs out-of-pocket should there funding be cut.

Why the severely disabled don't count the at the ballot box

The severely disabled participants on NDIS do not pose a political threat to Labor. Firstly, a number of them lack the legal capacity to vote and are unable advocate for themselves and thus cause trouble. Of the remainder who do vote, where exactly would they swing to? The Liberal Party? The originators of the direct assessment and for whom the NDIS is nothing more than an incediary sink hole– the mere mention of which– causes them to lower their horns and hoof the ground. The best severely disabled participants can do electorally is to vote Greens– however then their preferences flow to Labor regardless, meaning their protest vote has no impact on Labor's election platform. In contrast, working parents of the mild-to-moderately disabled children on the scheme, are in a higher socioeconomic bracket and can potentially swing to Liberals, meaning they need to be kept on side politically.

So by refusing to means-test access to NDIS, Labor leader Anthony Albanese' guaranteed his Party's success at the polls, but threw the burden of NDIS’ weighty budget reduction onto NDIS' severely and permanently disabled participants, who are not only high-care so totally unable to care for themselves, but allxhave no means to pay their care costs out -of-pocket (due to a 77% unemployment rate scheme-wide). 

The profound and  widespread harm this election promise has caused, does not appear to bother Australia's 'social-reform party', whose decision to avoid means testing NDIS has very plainly focused NDIA’ aggressive cost cutting efforts on NDIS' most vulnerable participants with cuts of at least 30% and up to 75% over the past year to all funding streams– including essential care– using any means possible.

NDIA may wield the knife, but Labor hands it to them and directs where not to cut: the Party's election commitments are off-limits. The working parents– who populate their electorates and may swing–are not to be touched.

Harm and neglect on the scheme 

Such deep cuts to the most vulnerable on the scheme, has triggered the start of widespread neglect of NDIS’ severely disabled participants. Disabilitywatch's online research has found participants who– following deep cuts– are now unable to wash regularly or are suddenly developing bed sores from immobility– both clear signs of neglect. Disabilitywatch has also uncovered multiple reports of participants suffering emotional distress following large reductions to their care plan unable to cope – such as ‘crying all time’ or experiencing the onset of chronic anxiety post-cuts due to their now uncertain future.

Both of these behaviors suggest the onset of new mental health issues – where non existed before–  as a result of NDIA’s misguided actions, at the behest of the Labour Party. Despite that as the National Disability Insurance Agency, it is NDIA’s role to help– not harm its disabled charges.

By focusing NDIS’ budget reductions on the care plans of NDIS' severely disabled participants – rather than the mild-to-moderate ones with monied parents– causes physical and emotional harm to the most vulnerable participants on the scheme, rather than those who can weather it. For an example, of an NDIS user who has a spinal cord injury and is paralyzed from the armpits down recently received a 40% cut (following the purchase of a replacement hospital bed under the 'zero-sum gain' princple) and is now experiencing signs of physical neglect and emotional distress, see Reddit chat below (posted with permission).

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The Perfect Budget Storm for the Scheme's Most Severe 

The cuts to participants care plans have been unacceptably deep, because it has fallen on the scheme’s severely and permanently disabled participants to absorb three different budget pressures:

• Reducing NDIS’ annual budget growth of from 22% to 10-10.8% since Labor entered office, with the future aim of hitting the National Cabinet target of 8% annual growth by mid-next year;
• Offsetting the rapid budget growth resulting from the automatic inclusion of children who drive it up, which remains rampant at least 20% annually (this growth should end mid-next year but the existing participants will remain on NDIS);
• Setting aside $2 billion dollars over 5 years for the new Federal-State Thriving Kids program, which appears to be being cut out of the NDIS budget (in accordance with the Grattan Institute’s recommendations);

Layered on one another, these budget pressures are resulting in unacceptably deep cuts in the order of 30%-75% for NDIS’ severely disabled participants and driving NDIA to trial ever more inventive budget reduction approaches– such as spontaneous check-ins–in an effort to meet budget reduction targets imposed by Labor, which are too ambitious while mild-to-moderately affected kids continue to be accepted onto to the scheme in droves and are exempted. So not only are severely disabled participants required to offset the burgeoning numbers of minors with deep cuts to their plans– but the children themselves are untouchable: shielded under the wing of Labor's favour, who have been exempted them from being transferred to the proposed Thriving Kids to avoid rocking the boat. These children are– by enlarge– not severe, have working parents who are monied and are seeking therapy only.

This leaves the most vulnerable on the scheme to not only bear the brunt of the NDIS growth reduction targets, but also to offset the rapid growth in childhood admissions which is at least 20% per annum, as well as paying $2Billion for Thriving Kids) –resulting in a triple whammy of budget reductions.

The 'prequel' cartoon...

Making it Legal: Enter the I-CAN 

For NDIA, who are already operating outside the law in order to achieve ambitous budget targets set by Labor (while hemmed in by their election promises), the proposed I-CAN assessment would be a godsend– both administratively and legally. Why is that? Because by removing all existing safeguards and oversight for participants from the scheme, I-CAN allows NDIA to crush budgets unhindered.

The proposed I-CAN assessment, which would be conducted by NDIA bureaucrats using a proforma questionnaire, would remove all scrutiny and professional care and therapy recommendations by allied-health for severely disabled participants from the scheme. It would also remove the right for participants to appeal funding decisions made by the Agency to the Administrative Review Tribunal for review– 73% of which are overturned. The ability of the scheme’s severely disabled participants to appeal NDIA's decisions to the Administrative Review Tribunal, is the only recourse and safegaurd participants currently have against hardline cost cutting by the Agency. Which is precisely why NDIA want to remove it, the avenue for appeals poses an obstacle to NDIA meeting their budget reduction targets. 73% of ART appeals are overturned by the Tribunal due to human rights which causes endless headaches for the the Agency– now a fixture at the ART. Without an avenue by which NDIS decisions can be appealed, NDIA can cut much deeper and simply disregard human rights.

Which is what NDIA have planned: Under the I-CAN, professional recommendations by allied-health would be completely eliminated from the scheme, as would external oversight of NDIA’s decision-making, clearing the way for NDIA to ride roughshod over participants' rights and quietly crush participant care budgets behind closed doors undisturbed pursuit of the bottom line. 

It is this precise lack of oversight, as well as a complete absence checks-and-balances on their administrative power that the I-CAN offers which makes it so appealing for NDIA as an administrative tool. The Agency– desperate to reduce its budgets undisturbed and unfettered– is now seeking to crush budgets easily and legally– without any fuss.

Were the I-CAN to be introduced in its current form, a humanitarian disaster would quietly unfold: with the scheme's straightjacketed participants unable to appeal or amend NDIA's draconian decisions.

A national disability scheme which has no safeguards, external oversight or avenues for appeal is not only unsuitable for the disabled– but actively dangerous.

In summary, the proposed I-CAN doesn't pass the sniff test.

Keeping Up Appearances

All this harm is happening so that Labor can keep its reputation and not upset its voting base, nor appeared to have failed policywise.

Publicly, NDIA is now successfully bringing NDIS’ budget growth down– in-line with taxpayer expectations– however, behind closed doors the most vulnerable are being harmed on a daily basis. NDIA's severely disabled participants cannot complain publicly, so are not a political liability and therefore not a concern.

They suffer in silence; they suffer in pain. 

Co-payments: a safer way forward

While access to NDIS does not need to be means tested, a means tested co-payment for working parents of children accessing NDIS therapy only, needs to be introduced post haste.

It is the job of the government to intervene where the market has failed, not to duplicate it. It is unclear why working parents, who are able to part-pay their child's therapy bills are fully subsidized by the NDIS, while severely disabled participants who lack the resources to privately cover their own care costs, are weathering such deep cuts and suffering neglect as a result.

Medicare only partly subsidizes citizen’s medical bills, on the understanding that individuals who have the means to part-pay should. Why is NDIS any different? Especially considering that the allied-health therapy sessions which NDIS fully reimburse,  are lower priority than the medical appointments which Medicare only part-pay.

Children make up 43% of participants on the scheme– at least 330,000 participants. Most are not severe, have working parents and are seeking only therapy and rather than care support), so a shift to only partly subsidising their therapy (by households who are able to do so) would significantly relieve pressure on NDIS' strained budget.

Not only could the co-payment be means-tested to make it fair, but the size of the reimbursement could be tiered depending on the level of household earnings to ensure that access to therapy is not impeded. Additionally, co-payments disincentivize unnecessary therapy appointments thus minimise expediture– a feature bound to please Treasury. Such a policy shift is actually necessary, as the current rebate system is wasteful as it actively encourages participants to book unnecessary therapy sessions, as any unspent funding is automatically and permanently cut at the end of their plan under NDIA's 'use-it-or-lose-it' rule. A means tested co-payment for therapy sessions would curb this wasteful practice as no one will waste their own money.

Introducing a co-payment for child therapy only, would be a more challenging policy for Labor, as it would affect large numbers of their voting base, but it is a necessary move given the widespread mistreatment, neglect and harm currently being meted out by Government to the most vulnerable on the scheme– 'use-it-or-lose-it' and indeed in the country. Labor's current path is highly unethical and needs to change.

It will not be possible to rein in the NDIS budget safely, if the policies that the NDIA design for continually waste money by encouraging unnecessary spending. The severely disabled on the scheme cannot absorb more cuts– they are disadvantaged and cannot cover the short-fall, they just deterioirate and neglected. Too much harm has been done to them already.

NDIS can be steered into financially sustainable waters, however a fresh approach is needed. The current NDIS funding model is broken and cannot be window dressed: it was designed for a cohort with a far more elastic capacity than the severe cases NDIA now select for– which results in the frequent missallocation of funding. Along with the introduction of co-payments, NDIS' funding model requires urgent revision to prevent its vulnerable participants from being harmed in the race to make NDIS financial sustainable.

The ‘Party of Social Justice’, cannot continue down it's current path of crushing care budgets of the most severely disabled on the scheme in the name of political expediency; blind to the sea of human suffering they leave in their wake.

Yes, NDIA need to rein in spending– but safely– not by any means possible.

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