Disability Care and Support

Inquiry report

This inquiry report was released on 10 August 2011. An Errata has been issued with this report.

See also

Download summaries of the report

The overview booklet contains the key points, an extensive summary of the Commission's analysis and recommendations.

If you want to see the detailed supporting material, please download the full report below.

The Commission has also prepared an Executive Summary of the Proposed Scheme, together with Easy English and Plain English versions of this. These can be downloaded below. The Easy English version is written in an easy-to-read way, and uses pictures to explain some ideas.

Contents

  • Preliminaries
    • Cover, Copyright, Letter of transmittal, Terms of reference, Contents, Acknowledgments and Abbreviations
  • Overview - including key points
  • Recommendations
  • Chapter 1 Introduction
    • 1.1 What has the Commission been asked to do?
    • 1.2 Definitions and some key facts
    • 1.3 Ways of thinking about disability
    • 1.4 Rationales and objectives
    • 1.5 Some design elements for a new scheme
    • 1.6 Inquiry processes
    • 1.7 Structure of the report
  • Chapter 2 Why real change is needed
    • 2.1 Introduction
    • 2.2 Disadvantage and disability
    • 2.3 Insufficient support provision
    • 2.4 Underfunding in the current system
    • 2.5 The need for structural change
    • 2.6 Conclusions
  • Chapter 3 Who is the NDIS for?
    • 3.1 Introduction
    • 3.2 A tiered approach to providing supports
    • 3.3 Tier 1 - minimising the impacts of disability
    • 3.4 Tier 2 - ensuring appropriate support from any system
    • 3.5 Tier 3 - individually tailored funded supports
    • 3.6 Taking account of the broader context of service delivery
    • 3.7 How many people are likely to receive individualised supports
    • 3.8 Implementation issues
  • Chapter 4 The role of the community and the NDIS
    • 4.1 Introduction
    • 4.2 The importance of community participation and inclusion of people with disabilities
    • 4.3 Engaging the community
    • 4.4 NDIS issues
  • Chapter 5 What individualised supports will the NDIS fund?
    • 5.1 Introduction
    • 5.2 Specialist disability supports
    • 5.3 The role of 'mainstream' services
    • 5.4 Income support
    • 5.5 The basis for providing specialist disability supports
    • 5.6 Means testing, front-end deductibles and co-payments
  • Chapter 6 Aligning the Disability Support Pension with goals of the NDIS
    • 6.1 Reform strategies
    • 6.2 Altering expectations
    • 6.3 The incentives to work are often blunted by current arrangements
    • 6.4 Work bonuses and other approaches to address the fixed costs of working
    • 6.5 Social impact bonds and other innovative approaches
    • 6.6 Engaging employers
    • 6.7 An anomaly: the treatment of the blind
    • 6.8 Using data for optimal interventions
    • 6.9 Some other presumptions should be re-assessed
    • 6.10 Some caveats
    • 6.11 More scrutiny of the DSP is needed
    • 6.12 What about the Youth Disability Supplement?
  • Chapter 7 Assessing care and support needs
    • 7.1 Introduction
    • 7.2 What is being assessed?
    • 7.3 What is the purpose of the assessment process?
    • 7.4 Desirable features of assessment tools
    • 7.5 The current suite of assessment tools
    • 7.6 A single tool or a 'toolbox'?
    • 7.7 Who should conduct assessments?
    • 7.8 When should assessments occur?
    • 7.9 Should carers have their own assessment
    • 7.10 How assessment might work in practice
    • 7.11 Diligent use of the assessment tool
    • 7.12 The transition to a fully-fledged assessment toolbox
  • Chapter 8 Who has the decision-making power?
    • 8.1 Person-centred approaches
    • 8.2 Defining 'self-directed funding' in more detail
    • 8.3 Reasons for self-directed funding
    • 8.4 Impacts, benefits and costs
    • 8.5 Design of self-directed funding
    • 8.6 Exercising power at the family level
    • 8.7 What services should be covered?
    • 8.8 Self-directed funding needs to be structured carefully
    • 8.9 What about spending options in regional and remote Australia?
    • 8.10 Employing people directly
    • 8.11 Paying relatives for care
    • 8.12 Take-up of self-directed funding and the need for support
    • 8.13 What about the general risks of self-directed funding?
    • 8.14 Implementing individualised funding
  • Chapter 9 Governance of the NDIS
    • 9.1 Introduction
    • 9.2 Defining the scope of governance in the NDIS
    • 9.3 The role of the NDIA and others within the NDIS
    • 9.4 Creating a National Disability Insurance Agency
    • 9.5 Measures to encourage high performance
    • 9.6 Why have just one agency?
    • 9.7 Managing the funding pool
    • 9.8 Complaints and dispute resolution
    • 9.9 Other functions
  • Chapter 10 Delivering disability services
    • 10.1 Disability support services
    • 10.2 Navigating the disability system
    • 10.3 Safeguarding quality
    • 10.4 The implications of consumer choice for block funding, government-run services and rural areas
  • Chapter 11 Disability within the Indigenous community
    • 11.1 A snapshot of Indigenous disability
    • 11.2 Challenges to supporting Indigenous Australians with a disability
    • 11.3 Addressing the high rate of Indigenous disability
    • 11.4 Improving support to Indigenous people with a disability
    • 11.5 Conclusions
  • Chapter 12 Collecting and using data under the NDIS
    • 12.1 Introduction
    • 12.2 Deficiencies in the existing evidence base
    • 12.3 Why an effective evidence base under the NDIS is needed?
    • 12.4 Data systems
    • 12.5 Research
    • 12.6 Methods of analysis
    • 12.7 Other features of the evidence base under the NDIS
    • 12.8 Implementation
  • Chapter 13 Early intervention
    • 13.1 Introduction
    • 13.2 Nature and scope of early intervention
    • 13.3 The benefits of early intervention
    • 13.4 Targeting beneficial early interventions under the NDIS
    • 13.5 Interventions outside the NDIS
  • Chapter 14 Where should the money come from? Financing the NDIS
    • 14.1 The money can only come from several sources
    • 14.2 Tax design criteria
    • 14.3 Tax and revenue options
    • 14.4 Ensuring sustainable returns
    • 14.5 Fully-funded, pay-as-you-go or a hybrid?
    • 14.6 Federal or Australian Government financing of the NDIS?
    • 14.7 The Australian Government as the exclusive financier for the NDIS
    • 14.8 A pooled funding approach is a weaker alternative
    • 14.9 Achieving a fair effort by all jurisdictions
    • 14.10 The funding of the scheme is feasible and manageable
  • Chapter 15 Workforce issues
    • 15.1 A snapshot of the disability workforce
    • 15.2 Are there, and will there be, labour shortages?
    • 15.3 Attracting more workers to the disability services industry
    • 15.4 Alternatives to increasing the formal workforce
    • 15.5 Are labour supply concerns surmountable?
    • 15.6 Qualifications, working knowledge and career paths
  • Chapter 16 The cost of the NDIS
    • 16.1 Introduction
    • 16.2 Data
    • 16.3 Estimated number of people in tier 3
    • 16.4 Costs of the scheme in 2018-19
    • 16.5 Scenarios
    • 16.6 Cost of the NDIS - 2011-12 to 2018-19
  • Chapter 17 Insurance arrangements for injury
    • 17.1 Introduction
    • 17.2 What is catastrophic injury?
    • 17.3 Criteria to assess injury insurance arrangements
    • 17.4 Certainty, timeliness and quality of lifetime care and support
    • 17.5 Coverage of people acquiring a disability through a catastrophic injury
    • 17.6 Impacts on recovery and health outcomes
    • 17.7 People's freedom
    • 17.8 The value of 'justice'
    • 17.9 Providing incentives for people to avoid injuries
    • 17.10 Efficiency and costs
    • 17.11 The performance of common law systems of fault-based compensation
  • Chapter 18 A national injury insurance scheme
    • 18.1 A national injury insurance scheme is needed
    • 18.2 Implementing a no-fault approach for lifetime care and support of all catastrophic injuries
    • 18.3 How should NIIS claims be financed?
    • 18.4 What might the costs be?
    • 18.5 The scope of the NIIS beyond 2020
    • 18.6 Some other matters
  • Chapter 19 Implementation
    • 19.1 Implementation in outline
    • 19.2 Implementation of the NIIS
    • 19.3 Implementation of the NDIS
    • 19.4 Interaction between the two schemes
  • Chapter 20 The benefits of reform
    • 20.1 What are economic benefits?
    • 20.2 The potential economic gains from the NDIS are large
    • 20.3 But how much would the NDIS make a difference?
    • 20.4 A basic plausibility test
    • 20.5 The employment impacts on people with disabilities of the NDIS, DSP and employment service reforms
    • 20.6 How many carers could potentially re-enter the workforce?
    • 20.7 A more complex analysis of 're-distributive' effects of the NDIS
    • 20.8 A wrinkle or two
    • 20.9 The NDIS as an insurance product
    • 20.10 The bottom line
  • Appendix A Consultations
  • References

Please note: The following appendices are only available online and are not in the printed copy.

Just briefly...

Printed copies

Volumes 1 and 2 are only available online.

Printed copies of the overview can be purchased from Canprint Communications.

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