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Funding support for people with disability

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Parliamentary library briefing book: Key Issues for the 43rd Parliament Page | 22 Page | 23 reforming social services and institutions

in recent years, there have been increasing calls in australia for the introduction of a new, national, long-term mechanism for funding support for people with disability—national disability insurance. s uch calls have been made by a range of groups and individuals, from unions, disability advocacy groups, and medical associations, to carers’ representatives and people living with disability or in a caring role.

those arguing for a new approach have suggested there are a number of significant problems with the current system. t hese include:

the fragmented and complex nature of the • current disability services system continuing failure of funded services to meet • demand

the lack of an entitlement to disability care and • support services based on need, equivalent to the entitlement provisions present in a ustralia’s social security and universal health care

systems differential treatment between those who • acquire a disability through a workplace or motor vehicle accident and those who acquire

permanent disabilities in other ways (including at birth)—that is, while the former generally receive financial support, there is no automatic support for the latter projections of a significant increase in the •

number of people with a severe or profound disability—according to the a ustralian i nstitute of h ealth and Welfare, around 2.3 million australians will have a high level of disability by 2030 a likely shortfall in the numbers of people •

available to undertake caring responsibilities.

the current a ustralian disability support system separates the provision of income support from the provision of services. b oth the income support and services component of the disability support

system are funded from general revenue, rather than through a dedicated fund or insurance pool.

the Commonwealth provides income support primarily through the Disability s upport Pension (DsP) for those affected by disability. u ntil recently, the provision and funding of disability services by the Commonwealth, s tate and territory g overnments was dealt with under the Commonwealth s tate t erritory Disability agreement (C stDa). under the Council of australian g overnments (C oag) reforms to Commonwealth-state financial relations, announced in m arch 2008, the C stDa was replaced with the n ational Disability a greement (nDa). in the new agreement the areas of responsibility remain essentially the same.

under the n Da, open and supported employment services, as well as targeted employment support services, are administered by the Commonwealth government. s tate and territory governments administer accommodation support, community support and community access services for people with disability, along with respite care services that provide relief and support to families or carers of people with disability.

Funding support for people with disability Dr luke buckmaster and m ichael k lapdor, s ocial Policy s ection

1.2 million people in a ustralia with a severe or • profound limitation in 2003 estimated at 2.3 million by 2030 • 64 per cent of those with severe or profound •

limitations received income support ageing population will produce an increased • demand on services and welfare as well as a shortage of carers

aihW estimated unmet demand for • 23 800 people under the age of 65 for accommodation and respite, 3700 people for community access and 1700 people for disability employment services Cost $5.2 billion to meet unmet demand •

funding through the C stDa/nDa has been an area of dispute in recent years, with the states and territories and many in the disability sector claiming that funding provided by the Commonwealth is inadequate.

the Commonwealth, in partnership with the states and territories, is currently developing a n ational Disability s trategy ( nDs). the purpose of the n Ds will be to guide the development of disability policy across the jurisdictions.

following recommendations by the Disability investment g roup, the r udd-gillard g overnment directed the Productivity Commission to investigate the feasibility of new approaches. these included investigating a social insurance model, for funding and delivering long-term disability care and support for people with severe or profound disabilities however they are acquired. the Commission will report to the g overnment in July 2011.

therefore, the Parliament may be required to consider one or more proposals for the design of a new approach to funding support for the disabled.

key features of the scheme proposed by advocates of national disability insurance are: eligibility for those born with a disability or who acquire a permanent disability through an accident, injury or as a result of a medical condition, including mental illness

a ‘no fault’ model: provision of support and • care for people with disabilities would be separated from legal action for negligence/

culpable behaviour a lifetime approach to care, rather than simply • at times of crisis active case management •

universal (non means tested) access • funding possibly drawn from a special • supplement to the m edicare levy, private health insurance, third party car insurance and/or

workplace insurance national standards of assessment, care, • support and case management.

some expected benefits of national disability insurance are likely to be improved health and employment outcomes as a result of an increased focus on early intervention and more private investment opportunities in an expanded disability services sector. r educed expenditure on income support and medical care would be expected to offset some of the cost of the scheme. i f adopted, such a scheme would be about more than ensuring a funding base for disability services into the future. i t could enable the development of a more long-term, integrated and planned approach to disability services than is possible under current arrangements.

the introduction of a national disability insurance scheme would be a major reform. a s with Paid Parental l eave, australia’s most recent major social policy reform, there is likely to be significant debate about the design of any proposed disability scheme. k ey questions are likely to include what will it cost, how will it be funded, who will be eligible (or, perhaps more importantly, ineligible), and how the scheme would interact with existing supports and services (including D sP, medicare).

library publications and key documents

Disability i nvestment g roup, The Way Forward - A New Disability Policy Framework for Australia , Department of f amilies, h ousing, Community s ervices and i ndigenous a ffairs, n ovember 2009, sa/disability/pubs/policy/way_forward/Pages/default.asp x

Productivity Commission, Disability care and support , Productivity Commission i ssues Paper, 17 m ay 2010, viewed 2 s eptember 2010, s