After 12 years of confusion, cost blowouts and an explosion in provider numbers, the National Disability Insurance Scheme is undergoing significant reforms to return the scheme to its original intent and ensure its sustainability.
The NDIS was lauded in 2013 as one of the most significant steps in the history of Australian public policy, but it quickly became apparent the system was difficult to navigate and susceptible to fraud and misconduct.
Since 2019, Corowa-based, Amaranth Foundation has provided comprehensive NDIS services in southern NSW and northern Victoria.
Chief executive, Julianne Whyte, OAM said the changes being implemented were necessary to ensure equity, accessibility and sustainability of the program and to bring the scheme into line with other insurance models in Australia.
She said there was currently no requirement for an NDIS service provider to be registered, and anyone with an ABN could set up an independent business.
“Many people are setting themselves up as support workers without an understanding of the system and promising things they can’t deliver,” Ms Whyte said.
“The NDIS review and the changes have been made to stop nonregistered organisations taking advantage of the NDIS.
“Things have changed since 2013; in the early days, participants could do or buy much more than you can now, and often things that didn’t support their disability - ‘wants’ rather than ‘needs’.
“If you had $50,000 for example, there’s organisations that would take you out fishing all day and have a support worker with you the whole time.
“That might cost $500 a day out of a participant’s plan; these changes will mean it is less likely to happen now.”
Changes to eligibility assessment and funding periods, reforms to ensure the focus is on support for participants with permanent and significant disability, and a new framework to improve quality and safety standards are being implemented, to provide a more wholistic approach to support.
The government is cracking down on fraud and rorts in the system with an increase in investigations and prosecutions.
From July 1, changes to NDIS pricing will ensure participants are charged fairly and include a new clause mandating fair pricing for all providers.
By 2027, all providers, whether a sole provider or business, will need to be registered and qualified with the appropriate checks, correct policies and procedures, and will be audited.
According to the NDIS Quality and Safeguards Commission, as of December 2024, there were 661,267 NDIS participants, 21,387 registered providers - an increase of 7 per cent, compared with the previous year - and more than 154,000 unregistered providers in the market.
“The government wanted to break down the monopolies, so they opened the market up,” Ms Whyte said.
“They just put it all out there to see who entered the market.”
She likened the situation to the Wild West and said people needed to be aware when choosing an NDIS provider.
“The first question people should ask is ‘are you registered?’,” she said.
“Do you have qualifications; established policies and procedures; and how will you help me to set and achieve my goals, and use my money wisely and within budget?”
“Do you have qualifications; established policies and procedures; and how will you help me to set and achieve my goals, and use my money wisely and within budget?”
“The new rules mean the supports provided need to align with participants’ goals, which are set in the planning meetings.
“That could be to get into volunteering, to live a healthy life, learn how to speak properly, or join a group to make more friends.
“But there must be meaning and purpose. and these goals need to be achievable.
“That could still be to go out and have coffee if it is part of a goal to learn to socialise, to go places you haven’t been before or learn to order a coffee.
“You can do that with a support worker and that’s legitimate; it’s not just having coffee and cake because we don’t know what else to do.
“There are support workers who will just put people in cars and drive them around for three hours without achieving anything or meeting any goal.
“They’re being paid $65 an hour of taxpayers money to sit in a car, plus $1 a kilometre to drive around with no goal.”
Ms Whyte said these kinds of supports were all coming out of the participants’ plans where the providers should be held accountable for the spending of the funds.
Now changes to the system mean every support needs to be justified within reasonable and necessary means.
Impact on rural and remote clients
National Rural Health Alliance chief executive Susi Tegen said the changes to NDIS rules will effectively discriminate against people based on their location or mobility challenges.
“Clinicians will have no choice but to reduce or cease services to rural areas due to the financial disincentives created by these new pricing arrangements,” Ms Tegan said.
“Rural, regional and remote communities already face persistent healthcare access challenges, where service access is well and truly below the urban average, especially in regions or towns, which have between 100 to 50,000 people.”
The maximum allowable rate a physiotherapist or occupational therapist can charge under new rules decreased by $10 an hour to $183.99 and travel rates reduced by half to $91.99 per hour.
Allied health professionals say they have not been properly consulted on the changes with smaller providers likely to be most impacted.
“This is not just a health issue. It’s a social and economic one too,” Ms Tegen said.
“Removing or reducing viable services from rural towns has ripple effects far beyond healthcare, affecting employment, community resilience, and quality of life.”