The National Disability Insurance Scheme (NDIS) is Australia's national disability insurance scheme that aims to provide insurance coverage for the costs of disability support. Key points of the NDIS include: 1) It pools the financial risks of disability so that no individual or family bears the full cost alone through contributions from all taxpayers. 2) It provides choice and control for participants over their disability supports and services. 3) While the NDIS funds disability supports, mainstream systems remain responsible for other services like healthcare, and the NDIS aims to coordinate with these other systems.

1. Scheme overview
National Disability Insurance
Scheme (NDIS)
Simon Guthrie
14 June 2017
Actuary

2. What is the NDIS?

3. Key insurance principles
• The risk of disability affects all Australians. Resulting financial costs may be
too much for any individual or family to bear
• The NDIS is a way of pooling these risks
• Each year, all tax payers pay a premium to cover the costs of running the
NDIS and providing care and support to participants
• We are all at risk of being affected by disability. We all share the risk and the
cost of disability. We are all covered if and when we need it

4. Economic benefits

5. Choice and Control

6. NDIS and mainstream systems
• The National Disability Strategy outlines a vision
where Australia is an inclusive society and
enables people with disability to fulfil their
potential as equal citizens.
• To achieve this vision, all Australian
governments, non-government organisations,
business and the wider community have a role to
play.
• The NDIS is not intended to replace the supports
or services provided by other mainstream
systems
• Wherever possible we assist participants to
access mainstream systems
• A participant’s plan may include a range of
supports provided by informal, mainstream and
community networks. Some of these may be
funded by the NDIS.

7. NDIS and the Healthcare system
NDIS will fund supports which help the participant manage ongoing functional
impairment that results from their disability.
– Supports that enable participants to undertake activities of daily living
– Non-clinical supports
– Aids and equipment
– Some exceptions – nursing care that is integrally linked to care and support
• The health system is responsible for assisting participants with clinical and
medical treatment.
• Diagnosis and clinical treatment of health conditions (including ongoing or
chronic)
• Supports directly related to maintaining or improving health status
• Rehabilitation and support after a medical or surgical event
• Medications and pharmaceuticals

8. Partners in the Community
Local Area Coordinators (LACs) and Early Childhood Early
Intervention (ECEI) partners will:
• support some participants and their families to join in and
contribute to the life of their community, and
• assist with the planning process, plan implementation and
community participation.

9. Market Opportunity
Assessing the range of opportunities
• Who are the customers, how do we find them and what are their
needs
• What is my best strategy to be sustainable
• What are my service costs and what price can I achieve
• What are the peripheral opportunities (not participant services)
Understanding the “rules of engagement”
• What are the compliance and reporting requirements
• How can we track and report on the outcomes Quality &
Safeguards requirements
• Are we confident in processes manage Conflicts of Interest
• What systems and processes do I need to work with the agency

10. The start of transition

11. Where we are now

12. For more information