Disability Services Commission WA NDIS My Way · 2016. 2. 19. · Taylor Fry has previously conducted five Quarterly Actuarial Reviews as at the end of each quarter from September

Disability Services Commission

WA NDIS My Way

Quarterly Actuarial Review: December 2015

Issued: 17 February 2016

Alan Greenfield

Fellow of the Institute of Actuaries of Australia

Ash Evans

Fellow of the Institute of Actuaries of Australia

Chartered Enterprise Risk Actuary

WA NDIS My Way Quarterly Actuarial Review 31 December 2015

Sydney

Level 11, 55 Clarence Street Sydney NSW 2000

P 02 9249 2900 P 02 9249 2999

Melbourne

Level 6, 52 Collins Street Melbourne VIC 3000

P 03 9658 2333 P 03 9658 2344

ACN 087 047 809 ABN 29 087 047 809

www.taylorfry.com.au

Taylor Fry Pty Ltd – Consulting Actuaries & Analytics Professionals

http://www.taylorfry.com.au/


TABLE OF CONTENTS

1 Executive summary ....................................................................................................... 1

2 Introduction ................................................................................................................... 5

2.1 Background ......................................................................................................... 5

2.2 Previous reports ................................................................................................. 5

2.3 Adjusted baseline forecast and key cost drivers for the trial ............................ 5

3 Access ............................................................................................................................ 6

3.1 Eligibility requests ............................................................................................... 6

3.2 Participants ......................................................................................................... 7

4 Plans............................................................................................................................. 10

4.1 Approval ........................................................................................................... 10

4.2 Support needs .................................................................................................. 11

4.3 Committed costs ............................................................................................... 16

4.4 Strategies .......................................................................................................... 21

5 Delivery ........................................................................................................................ 24

5.1 Payments .......................................................................................................... 24

5.2 Provision of commitment ................................................................................. 24

5.3 Operating expenses .......................................................................................... 25

6 Reliances and limitations ............................................................................................. 26

Appendix A Glossary .............................................................................................. 27

Appendix B Background ........................................................................................ 28

B.1 Introduction ...................................................................................................... 28

B.2 The WA NDIS My Way model ........................................................................... 28

B.3 An actuarial approach ...................................................................................... 29

B.4 Baseline forecast and key cost drivers for the trial .......................................... 30

B.5 Access ............................................................................................................... 30

B.6 Planning and approval process ......................................................................... 31

B.7 Delivery ............................................................................................................. 32

Appendix C Reference package and Individual Support Rank .............................. 33

C.1 Introduction ...................................................................................................... 33

C.2 Support scores .................................................................................................. 33

C.3 Support scores to ISR ........................................................................................ 34


Appendix D Disability segment mapping ............................................................... 35

Appendix E Participants by age, sex and disability ............................................... 37

Appendix F Baseline Forecast Summary ............................................................... 40

Appendix G Access and plan timing....................................................................... 41

Page 1 WA NDIS My Way Quarterly Actuarial Review 31 December 2015

1 EXECUTIVE SUMMARY

The Western Australia Disability Services Commission (“DSC”) began the WA NDIS My Way trial (the “trial”) in the Lower South West (LSW) region on 1 July 2014 and in Cockburn-Kwinana (CK) region on 1 July 2015. Taylor Fry has been appointed to carry out an analysis of the trial’s performance on a quarterly basis. This quarterly actuarial report covers the quarter ending 31 December 2015.

Participants, plans and funding

Table 1.1 provides a summary of the experience of the trial as at 31 December 2015 compared to 30 September 2015. This is only the second quarter to include CK participants.

Table 1.1 Summary of experience

As at

31 Dec 2015 As at

30 Sep 20151

Change since previous quarter

Total annualised committed costs2 $60,111,399 $47,084,184 +28%

Total number of participants 2,058 1,838 +12%

Total number of active plans 1,724 1,559 +11%

Total number of funded plans3 1,568 1,362 +17%

Average annualised committed costs $34,867 $30,202 +15%

1. For comparability, the previous quarter’s numbers in this report are adjusted to reflect our current view of past experience. Changes from the previous report include an increase in retrospective plan changes related to meeting “the changing needs and emergency expenses” of participants.

2. Committed costs shown are for approved plans. These costs may be understated due to the under-reporting of in-kind committed costs.

3. Total number of funded plans includes only plans with positive committed cost.

As at 31 December 2015 there are 2,058 participants spread over the two trial sites: 26% fewer participants than the adjusted baseline forecasts1 which set a benchmark of 2,767. The average annualised committed cost increased by 15%. Of this increase:

9% is due to new commitments for accommodation and professional services provided by DSC

1 Adjusted baseline forecasts are revised versions of the original baseline forecasts made as part of the bilateral

agreement with the Commonwealth. These benchmarks are derived from forecasts presented in the “Financial Sustainability Summary Report” by Alan Greenfield, Ash Evans and Kari Wolanski dated 26 October 2015. See Appendix F.


6% is due to an increase in other funding committed, particularly for high-needs participants in CK.

The distribution of participants’ support needs is largely unchanged.

In our previous report, we reported an average annualised committed cost of $29,603. Our updated view of average annualised committed costs at 30 September 2015 is 2% higher ($30,202) due to retrospective increases in plan funding. My Way Coordinators make changes to plans in response to the changing needs of participants and emergency funding requirements. The increase in retrospective costs is particularly high in the December 2015 quarter because high demand in CK over the past six months has resulted in many short-term plans and delays of scheduled plan reviews. Consequently, once-off funding increases have been unusually high.

We expect that retrospective adjustment will be lower in future reviews as the initial surge of new plans in CK diminishes. Nevertheless, DSC and Taylor Fry will review recording practices in early 2016. We anticipate that this review will improve the transparency of plan modifications and the reliability of committed cost estimates.

The trial remains on track in terms of financial sustainability.

Plans: Scope, Volume and Price

The average committed cost of participants can be analysed by separately considering the support needs of participants’ first plans (including transferred plans at the beginning of the trial), archived plans, and their subsequent updated plans. In Figure 1.1, the average costs of these updated plans are shown in front of the average cost of the plans that they replaced (pink columns). The number of plans approved is shown at the foot of each column.


Figure 1.1 Average committed cost for first and updated plans1,2,3,4

1. Committed costs may be understated due to the under-reporting of in-kind committed costs 2. Approved in each quarter – viewed retrospectively using current data 3. Includes all approved plans – funded or unfunded 4. “Transferred plans” includes plans approved before 1 July 2014 in the LSW trial site, and before 1 July

2015 in the CK trial site.

Figure 1.1 shows that the 190 first plans approved in the December 2015 quarter have significantly higher average committed costs than previous quarters. This result is driven by the entry of new high-needs participants in CK. Similar to previous quarters, the average committed costs of subsequent plans is 35% higher than the average committed cost of the plans being archived.

Although updated plans are costlier than previous plans, the average committed cost of all approved and active plans is $34,867, which is 7% lower than the adjusted baseline forecast2 cost of $37,301. Figure 1.2 shows the distribution of approved and active plans by committed cost bands, for each disability segment.

2 See Appendix F.

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Average committed costs of plan archived

Average committed costs of plan approved


Figure 1.2 Number of participants by committed cost band and disability segment

Management

For the quarter ending 31 December 2015 the operating expense ratio has been estimated at 20%. This is slightly lower than the figure of 21% for the 2014/15 financial year.

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Early intervention

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2 INTRODUCTION

2.1 Background

From 1 July 2013 the Commonwealth Government began the roll out of the National Disability Insurance Scheme (the “NDIS”) with the commencement of various trials around Australia. On 1 July 2014 the Western Australian Government commenced participation in the NDIS via a two-year trial. The WA State Government trial is based on its Local Area Coordinator model and is known as WA NDIS My Way (the “trial”). It is managed by the Western Australia Disability Services Commission (“DSC”).

The trial began in the Lower South West (“LSW”) region on 1 July 2014 and in Cockburn-Kwinana (“CK”) region on 1 July 2015. Further background on the trial, its performance framework, and key features of an actuarial approach is available in Appendix B. A glossary can be found in Appendix A.

This is the sixth quarterly actuarial report by Taylor Fry as appointed actuary to the trial. It complements DSC’s sixth quarterly report to the Commonwealth3.

2.2 Previous reports

Taylor Fry has previously conducted five Quarterly Actuarial Reviews as at the end of each quarter from September 2014 to September 20153. The last of these, as at 30 September 2015 is referred to as the “previous report”.

2.3 Adjusted baseline forecast and key cost drivers for the trial

Adjusted baseline forecasts of numbers of trial participants and average plan costs are sourced from the Financial Sustainability Summary Report by Alan Greenfield, Ash Evans and Kari Wolanski dated 26 October 2015. These “adjusted” baseline forecasts are modified from the “original” baseline forecasts by the Commonwealth for the purpose of funding the trial.

3 Both the quarterly DSC reports and the quarterly actuarial reports can be found here:

www.disability.wa.gov.au/wa-ndis-my-way/wa-ndis-my-way/quarterly-reports/


3 ACCESS

3.1 Eligibility requests

Figure 3.1 shows the breakdown of the status of eligibility requests (eligible, ineligible, outstanding). In addition, it shows the baseline forecast of new entrants to the trial for each month.

Figure 3.1 Status of eligibility requests made by consent month1

1. The CK trial site commenced on 1 July 2015, resulting in an increase in the baseline forecast of eligibility requests.

There were 176 eligibility requests in the December 2015 quarter. Of these 176 requests, 157 were accepted, 4 were deemed ineligible, 14 remain outstanding and 1 was withdrawn. A further 5 eligibility requests remain outstanding from previous quarters.

Figure 3.2 summarises the number of days from consent to decision (for those requests with decisions made):

The orange line indicates the average number of days from consent to decision

The boxes indicate the spread from the 25th percentile to the 75th percentile and the whiskers extend to the minimum and maximum observed

The white numbers in the bars give the number of consenting participants during that quarter.

0102030405060708090

100110120130140150

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Consent month

Ineligible

Outstanding

Accepted

Baseline


For example, it took an average of 15 days to an eligibility decision for the 161 participants that consented in the December 2015 quarter. In that quarter, half of the consenting participants were decided between 6 and 21 days and the longest time to decision was 83 days.

Figure 3.2 Days between consent and eligibility decision1

1. See Appendix G for more details.

Table 3.1 summarises the number of requests outstanding at the end of the December 2015 quarter.

Table 3.1 Number outstanding at 31 December 20151

Consent quarter

pre-Sep-15 Sep-15 Dec-15

Number outstanding 0 5 14 1. See Appendix G for more details.

3.2 Participants

We examine the characteristics of participants to understand demand and future support needs.

42100

73 82 174 161 632

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Consent quarter


Table 3.2 compares the number of new entrants and transfers versus the baseline forecast. We discuss each further below.

Table 3.2 Actual versus expected active participants as at 31 December 2015

Transfers New entrants Total

Number of participants 1,461 597 2,058

Adjusted baseline forecast 1,308 1,459 2,767

Comparison 112% 41% 74%

There were more transfers from the previous project than forecast and there have been fewer than forecast new entrants. The net result is 26% fewer participants in the trial than forecast. It is worth noting that many transfers from the previous project are receiving funding for the first time.

Table 3.3 shows the 2,058 participants by disability segment for each sex and each age group.

Table 3.3 Disability segment by sex and age as at 31 December 20151

Primary disability All

Sex Age M

ale

Fem

ale

0-1

4

15

-24

25

-44

45

-64

65

+

# %

Physical, intellectual and other disabilities

1838 89 1158 680 724 358 349 395 12

Psychosocial disorders 177 9 74 103 1 11 67 98 0

Early intervention 43 2 27 16 42 0 1 0 0

Total

# 2058 1259 799 767 369 417 493 12

% 100 61 39 37 18 20 24 1

1. Percentages may not add to 100 due to rounding

Viewing the demographic features by disability segment prompts the following observations:

Males make up 61% of all participants

Of the 1,838 participants in the physical or intellectual disability segment, 724 (39%) are under the age of 15.

Psychosocial disorders are more prevalent among females (58%) than males (42%).

All participants receiving early intervention support are receiving it in early childhood except one in the 25-44 year age band.

There are 12 participants aged 65 and over. Participants are afforded continuity of support when they turn age 65 if they were under age 65 at the beginning of the trial.


A breakdown by primary disability type can be found in Appendix E.

Table 3.4 shows the 2,058 participants by Aboriginal or Torres Strait Islander (“ATSI”) status and Culturally and Linguistically Diverse (“CALD”) status.

Table 3.4 Participants by ATSI and CALD as at 31 December 2015

Primary disability

ATSI CALD

Yes No Yes No

# % # % # % # %

Physical, intellectual and other disabilities

81 4 1757 96 118 6 1720 94

Psychosocial disorders 4 2 173 98 4 2 173 98

Early intervention 3 7 40 93 1 2 42 98

Total 88 4 1970 96 123 6 1935 94

To date, about 4% of participants identify themselves as ATSI and 6% of participants identify themselves as CALD. The composition of these groups by Primary disability segment as shown in the table above is broadly similar to the overall composition.


4 PLANS

4.1 Approval

Figure 4.1 and Table 4.1 show the number of days between participant eligibility and plan approval, and between plan endorsement and approval4, respectively. ‘Eligibility to approval’ only includes LSW participants that entered after 1 July 2014 and CK participants that entered after 1 July 2015. ‘Endorsement to approval’ includes all plans approved (new and transfers from the previous project), noting that participants may have multiple plan reviews (and thus approvals) over time.

Figure 4.1 summarises the number of days from when a particpant is deemed eligible to their first plan approval:

The orange line indicates the average number of days from eligibility to plan approval

The boxes indicate the spread from the 25th percentile to the 75th percentile and the whiskers extend to the minimum and maximum observed

The white numbers in the bars give the number of new entrants that had their first plan approved in each quarter.

Figure 4.1 Days from eligibility to plan approval for new entrants1

1. See Appendix G for more details.

4 If plan approval doesn’t require escalation, the plan can be endorsed and approved at the same time.

Otherwise, the plan is endorsed and escalated before being approved. See Appendix B for more details.

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Table 4.1 Days from endorsement to plan approval for all plans endorsed in trial

Endorsement Quarter

Number of

approved plans1

Average days

Median days

Minimum days

Maximum days

Number with same

day approval

Sep-14 68 4 0 0 23 38

Dec-14 218 2 0 0 27 150

Mar-15 177 3 1 0 19 83

Jun-15 257 3 1 0 45 112

Sep-15 443 2 0 0 34 238

Dec-15 605 2 1 0 27 299

Total 1,768 2 0 0 45 920 1. Endorsement to approval numbers includes first and updated plans (excluding plans approved before

trial commencement).

Figure 4.1 shows there have been 376 first plan approvals for new entrants up to 31 December 2015. The average time from eligibility to approval for these participants as at 31 December 2015 was 67 days, which has increased from 58 reported last quarter.

Table 4.1 shows there have been 1,768 plans approved in total since the trial commenced, including plans that have since been updated. Approval time tends to be short, with 52% of plans being approved on the same day as endorsement. This is at least in part because plan funding arrangements are typically coming in below delegation thresholds.

4.2 Support needs

Figure 4.2 examines the level of support needs for all participants. That is, this graph divides the participants with current approved plans into ‘high needs’, ‘low needs’ and ‘no needs’ for each type of support.


Figure 4.2 Level of support needs of participants with approved plans as at 31 December 2015

We observe that education, community, domestic life and working are the categories of support needs in which participants require the highest levels of supervision (blue columns). The depth of support needs is better illustrated by examining support scores shown in the following figure.

Figure 4.3 shows the depth of support needs for all participants with active plans as at 31 December 2015. For example, the cluster of bars for mobility on the left shows the proportion of participants that require each different level of mobility support. For example, the chart shows that a high proportion of participants (27%) never require mobility support.

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Does not need helpDoes not need help or supervision but uses aids or equipmentSometimes needs help or supervisionUnable to do or always needs help or supervision


Figure 4.3 Depth of support needs of participants with approved plans at 31 December 2015

Support with general tasks is the most essential, with 87% of participants requiring at least daily assistance. Relatively few participants have daily mobility needs.

We have translated each depth of support needs into a numerical rank from 0 to 5. “Never” has been mapped to 0 and “More than six times a day” has been mapped to 5. Table 4.2 shows the average support needs rank by primary disability type.

The colouring illustrates the range of support needs for each Support Category – for example, a dark red value picks out the Primary Disability that has a high support need in that category. General tasks, learning and interpersonal support categories have the highest needs based on the average rank for all disability types.

These averages show:

Participants with developmental delay or intellectual disability have above average support needs in all support categories except mobility,

Participants with autism have above average support needs in the learning, interpersonal and communication categories,

Participants with multiple sclerosis, other neurological or spinal cord injury have above average support needs in mobility and general tasks,

Participants with cerebral palsy have above average support needs in mobility and self-care,

Participants with psychosocial disorders have below-average support needs across all categories.

0%

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Support score category

Never Less than weekly

Weekly (but not daily) 1-2 times a day

3-5 times a day More than six times a day


Table 4.2 The average support needs rank by primary disability for participants with approved plans as at 31 December 2015

We combine the support needs into a single individual support rank (ISR) between 0 and 9 for each participant (see Appendix C.3). The ISR allows a closer examination of variation in support needs between and within segments. Table 4.3 shows the number of participants

# approved plans Mobility Self-care General tasks Learning Interpersonal Communication

Physical & Intellectual disability

Acquired Brain Injury 38 3.0 2.6 3.6 3.0 2.7 2.2

Amputations (Single/Multiple) 8 3.0 2.4 3.1 0.3 1.1 0.1

Autism and Related Disorders 400 1.5 3.1 3.7 3.9 3.9 3.4

Cerebral Palsy 54 3.6 3.4 3.6 3.2 2.6 2.9

Corneal Disorders/Defects 1 5.0 3.0 3.0 1.0 1.0 0.0

Down Syndrome 4 3.0 4.3 4.5 4.8 4.5 4.8

Cornelia de Lange Syndrome 2 4.0 4.0 4.0 3.5 3.0 3.5

Deafblindness 5 3.2 2.2 3.6 3.0 3.0 3.0

Deafness/Hearing Loss 18 0.7 1.3 2.4 2.9 2.3 4.0

Dementia 1 5.0 5.0 5.0 5.0 5.0 5.0

Developmental Delay 74 2.4 4.0 4.1 4.2 3.8 4.1

Epilepsy 3 2.3 2.3 3.7 2.3 1.7 2.0

Fragile X Syndrome 1 4.0 4.0 5.0 4.0 3.0 3.0

Glaucoma 0

Global Developmental Delay 6 1.0 4.0 3.3 3.5 3.2 4.2

Hemiplegia 0

Huntington’s Chorea 2 2.5 2.5 4.0 3.0 2.5 2.5

Intellectual Disability 669 2.2 3.2 3.9 4.1 3.8 3.6

Meningitis/Encephalitis 2 1.5 2.0 3.5 2.5 3.0 2.5

Motor Neurone 6 3.5 4.2 4.5 2.2 1.2 3.0

Multiple Sclerosis 39 3.9 2.8 3.8 1.9 1.8 1.6

Muscular Dystrophy 8 3.6 3.5 3.9 1.9 2.1 2.0

Other Congenital Malformations or

Deformations1

5.0 5.0 3.0 0.0 0.0 0.0

Other Injury/Poison/External Cause 0

Other Neurological 56 3.3 3.0 3.9 2.6 2.4 2.2

Other Physical Disorders 100 3.5 2.9 3.4 1.7 1.7 1.3

Other Sight Loss 23 3.4 2.1 3.1 2.0 1.7 2.0

Parkinson's Disease 4 3.8 2.8 3.3 2.5 0.3 1.8

Retinal Disorders or Defects 12 3.8 2.1 3.2 1.9 1.3 1.8

Specific learning - other than

Intellectual/ADD4

1.8 3.3 4.0 4.3 4.0 4.0

Speech Impediment and Other

Speech Difficulties1

2.0 4.0 4.0 5.0 4.0 4.0

Spina Bifida 13 3.5 3.6 3.3 2.2 1.8 0.8

Spinal Cord Injury - Paraplegia 23 4.1 3.2 3.6 1.3 1.7 1.5

Spinal Cord Injury - Quadriplegia 3 5.0 4.3 5.0 0.3 0.7 1.3

Spinal Cord Injury - Tetraplegia 1 5.0 4.0 4.0 0.0 0.0 0.0

Stroke 4 3.8 2.8 3.3 2.0 1.5 1.3

Surgery/Medical Complications 3 3.0 1.7 2.7 1.7 1.3 1.3

Sub-total 1,590 2.4 3.1 3.8 3.5 3.4 3.1

Psychosocial Disorders

Bipolar Affective Disorder 21 1.3 1.7 2.9 1.5 3.0 1.7

Child/Adolescent Onset Psych

Disorder1

2.0 2.0 2.0 1.0 2.0 2.0

Obsessive Compulsive Disorder 1 2.0 3.0 2.0 2.0 2.0 2.0

Other Psychiatric Disorders 53 1.3 2.0 2.9 2.0 2.9 1.9

Schizophrenia 39 1.2 2.2 3.1 2.9 3.5 2.6

Sub-total 115 1.3 2.0 2.9 2.2 3.1 2.1

Early Intervention

Autism and Related Disorders 0

Developmental Delay 14 2.1 3.1 2.8 3.7 2.9 4.0

Global Developmental Delay 3 4.3 5.0 5.0 5.0 5.0 5.0

Intellectual disability 2 0.5 1.5 1.5 4.0 3.5 2.0

Other Sight Loss 0

Sub-total 19 2.3 3.2 3.0 3.9 3.3 3.9

Total 1,724 2.3 3.1 3.7 3.5 3.3 3.1

Support category

Primary Disability


with approved plans at 31 December 2015 for each ISR. Notably, the distribution has not changed since the previous report.

Table 4.3 ISR of participants with approved plans as at 31 December 2015

ISR Plans Observed

distribution

9 313 18%

8 332 19%

7 476 28%

6 104 6%

5 99 6%

4 175 10%

3 158 9%

2 36 2%

1 16 1%

0 15 1%

Total 1,724 100%

Figure 4.4 shows the distribution of these participants, split by new entrants and transferred participants.

Figure 4.4 ISR for participants with approved plans as at 31 December 2015

ISR 7 has the largest share of participants for both new entrants and transfers. Figure 4.4 supports our expectation that transferred participants are weighted towards high ISRs because most participants transferred from the previous project, which typically had a

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higher entry level of support for eligibility due to resource constraints. For new entrants, 59% of participants have ISRs below 7 compared with 29% for transferred participants.

4.3 Committed costs

Table 4.4 shows committed costs for participants with active and approved plans. These figures include unfunded plans. We have calculated that the average annualised committed cost is $34,867.

Table 4.4 Committed costs for active plans1,2

As at

31 Dec 2015

As at 30 Sep 2015

As at 30 Jun 2015

As at 31 Mar

2015

As at 31 Dec 2014

As at 30 Sep 2014

Total annualised committed costs ($’000)

60,111 47,084 17,805 16,410 14,887 11,293

Observed average annualised committed costs ($)

34,867 30,202 26,146 26,297 25,319 25,492

Adjusted baseline average annualised committed costs ($)

37,301 37,715 36,023 36,365 36,854 37,614

Comparison: Observed / Expected

93% 80% 73% 72% 69% 68%

1. Committed costs may be understated due to the under-reporting of in-kind committed costs 2. For comparability, previous quarters’ numbers in this report are adjusted to reflect our current view of

past experience. Changes from the previous report include an increase in retrospective plan changes related to meeting “the changing needs and emergency expenses” of participants.

Average annualised committed costs are 7% below the baseline forecast of $37,301. The average annualised committed cost increased by 15% since 30 September 2015:

9% is due to new commitments for accommodation and professional services provided by DSC

6% is due to an increase in other funding committed, particularly for high-needs participants in CK.

The distribution of participants’ support needs is largely unchanged.


In our previous report, we reported an average annualised committed cost of $29,603. Our updated view of average annualised committed costs at 30 September 2015 is 2% higher due to retrospective increases in plan funding. My Way Coordinators make changes to plans in response to the changing needs of participants and emergency funding requirements. The retrospective increase in costs is particularly high in the December 2015 quarter because high demand in CK over the past six months has resulted in many short-term plans and delays of scheduled plan reviews. Consequently, once-off funding increases have been unusually high.

We expect that retrospective adjustments will be lower in future reviews as the initial surge of new plans in CK diminishes. Nevertheless, DSC and Taylor Fry will review recording practices in early 2016. We anticipate that this review will improve the transparency of plan modifications and the reliability of committed cost estimates.

Table 4.5 shows the allocation of committed costs between strategy types. In this review, we have separately identified accommodation and professional services provided by DSC. We refer to these under the “DSC managed” strategy type. Other strategy types include service provider, self-managed and in-kind. In-kind committed costs remain slightly understated.

Table 4.5 Allocation of annualised committed costs by strategy types for approved plans as at 31 December 2015

Service

provider Self-

managed In-kind

DSC managed

Total

Committed costs ($’000) 43,519 8,315 3,652 4,626 60,111

Committed costs (%) 72 14 6 8 100

Table 4.6 shows the total funding, number of plans and the average annualised committed costs for active plans by approval quarter. The 616 plans approved in the December 2015 quarter have an average annualised committed cost of $45,254. This increase in average committed costs is attributable to the high number of first plans and first reviews of high-needs participants in CK.


Table 4.6 Funding and average annualised committed costs of approved plans active as at 31 December 20151,2

Approval quarter

Annualised committed

costs

Numbers Average annualised

committed costs

All Funded Percentage

funded All Funded

$’000 $ $

Pre-trial 10,162 332 268 81% 30,608 37,918

Sep-14 2 1 1 100% 1,813 1,813

Dec-14 449 11 11 100% 40,780 40,780

Mar-15 3,624 135 127 94% 26,841 28,532

Jun-15 5,543 229 211 92% 24,206 26,271

Sep-15 12,456 400 367 92% 31,140 33,940

Dec-15 27,876 616 583 95% 45,254 47,815

All 60,111 1,724 1,568 91% 34,867 38,336

1. Committed costs may be understated due to the under-reporting of in-kind committed costs 2. Using current data - dates of approval may change retrospectively over time.

Table 4.7 shows the evolution of committed cost for the trial to date, split into three disability segments: physical and intellectual disability, psychosocial disorder, and early intervention. The amount shown is the annualised committed funding to active plans at each review date. The large increases at 30 September and 31 December 2015 are due to the commencement of the trial in CK.

Table 4.7 Total active annualised committed cost split by disability segment

Disability segment

30 Sep 2014

31 Dec 2014

31 Mar 2015

30 June 2015

30 Sep 2015

31 Dec 2015

$’000 $’000 $’000 $’000 $’000 $’000

Physical, intellectual and other disability

11,293 14,505 15,728 16,537 45,506 57,922

Psychosocial disorder

0 379 667 1,237 1,527 2,005

Early intervention

0 3 15 31 51 185

Total annualised committed cost

11,293 14,887 16,410 17,805 47,084 60,111

The vast majority of committed costs relate to physical, intellectual and other disabilities (96% at 31 December 2015), with the remainder related almost entirely with psychosocial disorders. There have been very few early intervention entrants to date.

Figure 4.5 and Figure 4.6 show the number of active participants and total committed cost in each committed cost band by disability segment. Participants with committed costs less


than $30,000 make up 74% of the population but contribute only 25% of the total committed cost, while participants with committed costs above $100,000 make up only 8% of the population but contribute 47% of the total committed cost. We will continue to monitor this metric as an indicator of the financial significance of large plans.

Figure 4.5 Number of participants by committed cost band and disability segment as at 31 December 2015

Figure 4.6 Active total annualised committed cost by committed cost band and disability segment as at 31 December 2015

0

100

200

300

400

500

600

700

Nu

mb

er o

f p

arti

cip

ants

Committed cost band

Early intervention

Psychosocial


0.0

2.0

4.0

6.0

8.0

10.0

12.0

Act

ive

to

tal c

om

mit

ted

co

st (

$'M

)

Committed cost band

Early intervention

Psychosocial



Figure 4.7 shows the average committed costs of first plans and of updated plans (i.e. not the first plan) in each quarter that these plans were approved. The average costs of these updated plans are shown in front of the average cost of the previous plans (pink columns). The number of plans approved is shown at the foot of each column.

The figure shows that the 190 first plans approved in the December 2015 quarter have significantly higher average committed costs than previous quarters. This result is driven by the entry of new high-needs participants in CK. Comparable to previous quarters, the average committed costs of subsequent plans is 35% higher than the average committed cost of the plans being archived.

Figure 4.7 Average annualised committed cost for first and updated plans1,2,3,4

1. Committed costs may be understated due to the under-reporting of in-kind committed costs 2. Approved in each quarter – viewed retrospectively using current data 3. Includes all approved plans – funded or unfunded 4. “Transferred plans” includes plans approved before 1 July 2014 in the LSW trial site, and before 1 July

2015 in the CK trial site.

Table 4.8 uses the ISR to compare the average committed costs over time (see Appendix C.3).

We observe that the average committed cost generally decreases as ISR decreases, indicating that ISR is broadly consistent with committed cost as a measure of support needs. The increase in average annualised committed cost since the previous report is concentrated at ISR4 and above.

1,0

10

34 13

6

44 70 17

0

19

0

27 81 13

2

18

2

25

5

43

20

5

10

15

20

25

30

35

40

45

50

Tran

sfer

red

Sep

-14

Qtr

Dec

-14

Qtr

Mar

-15

Qtr

Jun

-15

Qtr

Sep

-15

Qtr

Dec

-15

Qtr

Sep

-14

Qtr

Dec

-14

Qtr

Mar

-15

Qtr

Jun

-15

Qtr

Sep

-15

Qtr

Dec

-15

Qtr

First plans Subsequent plans

Ave

rage

co

mm

itte

d c

ost

($

'00

0)

Average committed costs of plan archived

Average committed costs of plan approved


Table 4.8 Average committed costs by ISR1

ISR Number of

plans

Average annualised

committed costs

Average committed costs for plans active at 30 Sep 20152

Comparison

$ $ %

9 313 86,000 73,552 117

8 332 43,705 39,245 111

7 476 25,285 20,288 125

6 104 19,062 19,509 98

5 99 12,586 10,528 120

4 175 11,898 11,341 105

3 158 7,184 7,664 94

2 36 4,281 7,861 54

1 16 2,018 22,4343 9

0 15 1,069 1,503 71

Total 1,724 34,867 30,202 115

1. Committed costs may be understated due to the under-reporting of in-kind committed costs 2. Active as at end of quarter – viewed retrospectively using current data. These numbers may differ from

the previous report due to retrospective changes in the underlying data. 3. The support needs of 3 new participants were incorrectly understated as at 30 September 2015. This

has since been resolved.

4.4 Strategies

This section provides analysis of the types of strategies that are being funded to assist participants in achieving their plan goals, and the nature of the outcomes those strategies are intended to achieve. A plan can have multiple strategies. The strategies for any given plan belong to support ‘clusters’, although many strategies can belong to one ‘cluster’. Consequently, there are 7,517 funded strategies.

Table 4.9 is a matrix of the number of funded strategies by WA NDIS My Way support cluster and outcome. We do not include unfunded strategies, even if the plan is funded.


Table 4.9 Number of funded strategies by Support Cluster and Outcome for approved plans as at 31 December 2015

Support Cluster

Outcome

Total1

Wel

lbei

ng

Co

mm

un

ity

par

tici

pat

ion

Lear

nin

g n

ew s

kills

Ch

oic

e an

d c

on

tro

l o

ver

life

Sup

po

rtin

g fa

mily

fr

ien

ds

and

car

ers

Safe

ty a

nd

sec

uri

ty

Fam

ily a

nd

rela

tio

nsh

ips

# %

Accommodation 34 3 4 36 4 62 5 148 2

Behaviour Support and Specialist Care

37 2 21 8 14 20 4 106 1

Communication 2 2 4 7 4 2 0 21 0

Daily Living 412 288 381 362 205 162 65 1875 25

Episodic Coordination of Support

13 0 0 5 3 2 0 23 0

Equipment 537 50 163 208 9 312 1 1280 17

Family and Carer Support 60 10 18 14 296 6 96 500 7

Other 0 2 0 1 7 1 2 13 0

Self-management 0 0 0 0 0 0 0 0 0

Therapy and specialist support 765 41 474 96 8 76 38 1498 20

Wellbeing 406 947 373 155 35 27 110 2053 27

Total

# 2266 1345 1438 892 585 670 321 7517 100

% 30 18 19 12 8 9 4 100 1. These totals include all funded strategies for funded plans. This differs from the comparable measure

used in DSC publications where all strategies (funded and non-funded) are included for funded plans.

We observe that, as was the case in the previous reports, the majority of strategies are related to wellbeing and daily living support clusters. There are also significant numbers of strategies related to equipment, and therapy and specialist support clusters. The remaining clusters have relatively few strategies. The most prevalent outcomes related to these support clusters are wellbeing, community participation and learning new skills.

Table 4.10 and Table 4.11 show an average annualised committed cost by outcome and WA NDIS My Way support cluster. These are average committed cost per funded strategy rather than for whole plans. They are intended to provide an illustration of the costs that are being included in plans and an indication of component price. In this review, we have separately identified accommodation and professional services provided by DSC. These are referred to as “DSC managed” strategies. As they relate primarily to accommodation, these DSC strategies are large in cost but few in number.


Table 4.10 Average committed cost per funded strategy by Outcome for approved plans as at 31 December 2015

Outcome

Management type

In-kind DSC

managed All Service

provider Self-

managed

$ $ $ $ $

Choice and control over life 22,579 3,738 2,098 73,643 11,612

Community participation 13,603 3,869 2,564 108,973 8,687

Family and relationships 7,818 2,783 963 9,078 4,766

Learning new skills 8,389 2,404 1,850 7,086 5,184

Safety and security 32,706 2,633 3,025 163,869 17,248

Supporting family friends and carers

11,360 3,136 1,518 6,600 5,812

Wellbeing 13,635 3,061 1,660 6,377 6,235

All 14,401 3,091 2,101 69,049 7,997

Average number of strategies per plan

1.8 1.6 1.0 0.0 4.4

Table 4.11 Average committed cost per funded strategy by Support Cluster for approved plans as at 31 December 2015

Support cluster

Management type

In-kind DSC

managed All Service

provider Self-

managed

$ $ $ $ $

Accommodation 122,993 25,321 59,840 211,400 114,328

Behaviour Support and Specialist Care

10,780 2,578 6,076 13,873 8,151

Communication 13,465 2,905 510 8,094

Daily Living 14,887 2,576 3,408 7,656

Episodic Coordination of Support

10,628 2,630 320 5,899

Equipment 2,892 1,096 472 746

Family and Carer Support 11,100 4,775 2,244 7,421

Other 6,726 626 2,503

Therapy and specialist support

5,738 2,378 2,721 6,409 4,052

Wellbeing 11,618 3,657 4,892 8,231

All 14,401 3,091 2,101 69,049 7,997

Average number of strategies per plan

1.8 1.6 1.0 0.0 4.4


5 DELIVERY

5.1 Payments

Table 5.1 shows the payments made to service providers and self-managed participants in each quarter of the trial.

Table 5.1 Total payments

Payment quarter

Payments to2:

Total1

Service providers

Self-managed participant

$ $ $

Sep-14 1,641,034 436,036 2,077,069

Dec-14 2,349,041 601,780 2,950,821

Mar-15 2,817,701 532,822 3,350,522

Jun-15 3,098,337 630,513 3,728,850

Sep-15 8,295,237 1,118,769 9,414,005

Dec-15 8,882,813 2,077,650 10,960,464

Total2 27,084,162 5,397,570 32,481,732 1. Total does not include in-kind or DSC managed committed costs or strategies. 2. The totals differ from the DSC Quarterly Report due to different criteria for inclusion.

Self-managed payments make up approximately 17% of total payments. This is broadly consistent with the proportion of committed costs that are self-managed (14%). At present, it is not possible to consider in-kind and DSC managed strategy payments in detail because these are not presently captured by the system.

5.2 Provision of commitment

We examine how much of the committed costs approved during planning are paid over the course of the plan. Table 5.2 shows the plan fulfilment statistics. ‘Total committed prorate’ is the amount that was expected to be paid up to 31 December 2015 for all plans, assuming funding is paid evenly over the plan year.

There were 2,161 plans up to 31 December 2015 with either a service provider or self-managed commitment or combination of both. Of the $32.9m committed cost expected to be paid during the trial period so far, $32.5m (99%) has been paid. This percentage is slightly higher than the previous report.


Table 5.2 Plan fulfilment statistics for all plans

Service providers Self-managed All1

Number of completed plans 1,565 1,354 2,161

Total paid $27,084,162 $5,397,570 $32,481,732

Total committed prorate2 $26,439,341 $6,437,492 $32,876,833

Plan fulfilment 102% 84% 99% 1. “All” does not include in-kind or DSC managed committed costs or payments 2. Total committed prorate is the amount of committed costs expected to be paid to date assuming that

the payment of commitments occur uniformly over each plan.

The plan fulfilment of service provider strategies is 102%. We expect some deviation from 100% because funding is not paid evenly over the plan year. The plan fulfilment of self-managed strategies is 84%. That is, 16% of self-managed funding has not been spent relative to the average amount of time passed for all plans. It is likely that inevitably some committed costs may not be spent by those self-managing their plans. However, there may also be a rush to spend committed costs towards the end of each plan period, in which case the assumption of uniform payments over the life of a plan may be invalid.

These statistics require careful monitoring moving forward. If the plan fulfilment consistently lies above 100% (i.e., more is paid than is expected based on the committed amount), then participants are using their funding faster than anticipated and reviewing their plan to renew their funding earlier than anticipated.

5.3 Operating expenses

Table 5.3 shows the trial operating expense ratio for the financial year to date. The operating expense ratio is 20% for the 2015/16 financial year to date. This is slightly lower than the figure of 21% for the 2014/15 financial year.

Table 5.3 Operating expense ratio (financial year to date)

2015/16 2014/151

Total payments made2 (including administration costs) 28,129,299 17,220,736

Administration costs:

Direct costs of WA NDIS My Way coordination 3,668,913 2,446,056

Indirect costs including operations and funding 1,041,499 671,995

Corporate overheads 829,739 524,084

Total 5,540,151 3,642,135

Operating expense ratio3 20% 21%

1. For comparability, the 2014/15 results are adjusted to reflect our current view of past experience. 2. Total payments made includes the approximate discharge of in-kind and DSC managed payments

based on a prorate allocation of each participant’s in-kind committed costs, $1,471,339 for 2014/15 and $2,214,679 for 2015/16.

3. Administration costs divided by total payments made. This may differ slightly from the DSC report due to differences in the approximation of in-kind and DSC managed payments.


6 RELIANCES AND LIMITATIONS

In developing this report Taylor Fry has relied upon historical data and other quantitative and qualitative information supplied by DSC, without audit or independent verification. We have, however, reviewed this information for reasonableness and internal consistency. The accuracy of our results is dependent upon the accuracy and completeness of these underlying data; therefore, any material discrepancies discovered in this data by DSC should be reported to us and the report amended accordingly.

This is the sixth quarterly review carried out for the DSC in relation to the trial. While there has been significant effort expended by both Taylor Fry and DSC to produce and understand the data extracts, there remains a chance that we have misunderstood some aspect or other of the data.

This review relies on forecasts for comparison with experience. Original baseline forecasts were made as part of the bilateral agreement with the Commonwealth prior to implementation of the NDIS My Way Trial. Adjusted baseline forecasts are presented in the “Financial Sustainability Summary Report” by Alan Greenfield, Ash Evans and Kari Wolanski dated 26 October 2015.

These adjusted forecasts relied on the estimations within the Productivity Commission report, and the accuracy of Census 2011 and migration statistics. We cannot assess the accuracy and completeness of the analysis within the Productivity Commission report. Conclusions may differ materially if the analysis underlying the Productivity Commission report is shown to be inaccurate. In any case, all forecasts should be considered highly uncertain at this early stage of scheme development. Furthermore, these forecasts (the adjusted baselines) should not be considered actuarial projections of expected performance – they are not necessarily central estimates. No attempt has been made to provide central estimates of future experience based on the limited experience to date from LSW. The adjusted baselines are an update of the original baselines allowing for known impacts. They provide a baseline for monitoring the evolving experience only.

Over time, as the trial matures, the analysis and review of experience will become more reliable.

Detailed judgements about the analyses, assumptions and results from this actuarial report should be made only after considering the report in its entirety.

This report has been prepared for the DSC for the specific purpose of monitoring the performance of the trial. No reliance should be placed on this report for any other purpose without confirming with us that such a purpose is appropriate.


APPENDIX A GLOSSARY

Table A.1 provides a glossary of acronyms and terms used in this report.

Table A.1 Glossary

Term Definition

Approval date Date at which a plan is approved

ATSI Aboriginal or Torres Strait Islander

CALD Culturally and Linguistically Diverse

Consent date Date at which an participant provided consent to perform an eligibility assessment

CK Cockburn-Kwinana

DSC Western Australia Disability Services Commission

Endorsement date Date at which a plan was submitted by a My Way Coordinator for approval. Note: Endorsement also equals approval for unfunded plans and plans less than $10,000

“Expected” or “forecast” numbers of participants and amounts of payments

These are forecasts provided to DSC by the Commonwealth Government, adapted by Taylor Fry for comparing against experience of the trial. See Appendix B

In-kind Provision by mainstream services not funded directly through WA NDIS My Way trial

ISR Individual support rank

LSW Lower South West

NDIA National Disability Insurance Agency

NDIS National Disability Insurance Scheme

New entrant Participants that have been assessed as eligible on or after the start of the trial; Lower South West on or after 1 July 2014, Cockburn-Kwinana on or after 1 July 2015.

New plan Plans that are approved and endorsed after 1 July 2014. Includes participants who transferred from the previous project that have had their plan updated.

NPA National Partnership Agreement

The previous project My Way project (June 2012 to 30 June 2014 in LSW and to 30 June 2015 in CK)

Trial WA NDIS My Way trial


APPENDIX B BACKGROUND

B.1 Introduction

From 1 July 2013 the Commonwealth Government began the roll out of the National Disability Insurance Scheme (“NDIS”) with the commencement of various trials around Australia. The agency charged with operating the Scheme is the National Disability Insurance Agency (“NDIA”). On 1 July 2014 the Western Australian Government commenced participation in the NDIS via a two-year trial. The WA NDIS My Way trial (the “trial”) is based on its Local Area Coordinator model. It is managed by the Western Australia Disability Services Commission (“DSC”).

The trial began in the Lower South West (LSW) region on 1 July 2014 and the Cockburn- Kwinana (CK) region on 1 July 2015.

A concurrent trial is also underway in the Perth Hills, based on the Commonwealth NDIS model.

The National Partnership Agreement on Trial of My Way Sites (“NPA”) sets out the terms of the trial and objectives for performance:

People with disability lead lives of their choice

NDIS is a financially sustainable, insurance-based scheme

Greater community inclusion of people with disability.

Through the NPA, DSC has committed to report quarterly in line with the Integrated NDIS Performance Reporting Framework, and to introduce an actuarial approach to ensure that:

Performance is consistent with the expectations used to determine the financial envelope

Meaningful performance reporting and actuarial analysis contributes to a continuous feedback loop that informs decision making throughout the DSC; and

Decision-making is a based on a long-term view.

Taylor Fry has been appointed actuary to the trial. A key requirement of the role as actuary is to carry out an analysis of performance on a quarterly basis.

B.2 The WA NDIS My Way model

The trial builds on the well-established Local Area Coordination model, and will further existing knowledge about how best to support people with disability to:

Exercise more choice and control over their supports and services

Achieve a good life in their local community

Build on natural supports such as friendships, neighbours and local community groups.

New features of the trial include:

http://www.disability.wa.gov.au/wa-ndis-my-way/wa-ndis-my-way/the-trial/governance/


Increased focus on early planning

Inclusion of new cohorts, such as participants with psychosocial disorders

Changes to the funding approach (localised decision making and flexible, non-programmatic funding)

Actuarial monitoring of financial sustainability.

B.3 An actuarial approach

In social insurance and insurance schemes – such as workers’ and accident compensation schemes – it is a requirement for actuaries to periodically quantify long-term costs. Understanding the future cost of a scheme and identifying emerging risks ensures that schemes are adequately funded so that they remain solvent. These same tools can also be used to provide insight into client behaviour, outcomes, key drivers of cost, and changing trends that tell a performance story about the scheme, and assist in managing its financial sustainability.

The key features of an actuarial approach are:

Analysis of differences between participants in the scheme and the distribution of support needs and related costs

A long-term view of participants’ behaviour and related costs

An actuarial control cycle that compares actual scheme experience to what was forecast, in order to understand performance.

The first two points are illustrated above. The third point is illustrated in the figure below. An actuarial control cycle begins by valuing scheme costs to set a baseline based on the mix of participants involved with the scheme, and forecasting how scheme costs are expected to evolve over the long term. Periodic monitoring identifies how experience differs from forecast, giving insight into emerging changes to the scheme and their implications for its financial sustainability. The forecasts are periodically updated to reflect the changing realities of the scheme.

Very high functional support needs

High functional support needs

Med functional support needs

Med-low functional support needs

Low functional support needs


B.4 Baseline forecast and key cost drivers for the trial

Baseline forecasts of numbers of participants and average plan costs were initially produced by the Commonwealth for the purpose of funding the trial, and were updated as part of the “Financial Sustainability Summary Report” by Alan Greenfield, Ash Evans and Kari Wolanski dated 26 October 2015.

Key drivers of scheme costs identified by NDIA are:

Access,

Scope,

Volume,

Price,

Delivery,

Distribution.

Quarterly reports focus on performance in relation to each of these key cost drivers, with a particular focus on participants accessing the trial, their support needs, and how committed plan cost compares to expected cost, based on the distribution of support needs.

B.5 Access

The pathway to participation is shown in Figure B.1. Access to the trial is a key driver of cost. Eligibility has been broadened relative to the previous project. Monitoring changes to the distribution of participants within the trial gives insight into changing needs and future costs.


Figure B.1 Pathways to participation

B.6 Planning and approval process

Figure B.2 displays the plan design, approval and review process. The scope and volume of funded plans for participants who access the trial, as well as the price of these supports are key drivers of the trial cost. Monitoring the breadth and depth of support needs, and changes in these needs over time provides insight that can be helpful in managing the trial outcomes and financial sustainability. It is also instructive to benchmark plan costs relative to these needs, and to understand how costs themselves are evolving to identify emerging cost pressures.

Ineligible

Eligibility assessment

New

Eligibility appeal

Participant

Found eligible

Existing

Ineligible without appeal

Ineligible with appeal

Ineligibility upheld

Ineligibility overturned


Figure B.2 Plan design, approval and review process

B.7 Delivery

Service delivery is also a key driver of the trial costs, and an important dimension of performance. Delivery of plans can include regular care, temporary help or irregular intervention.

Figure B.3 displays the service delivery process.

Figure B.3 Delivery process

Delegated approval

Approved Plans

Endorsed and

approved

Endorsed and

escalated

Strategy and plan design

Participants

Replanning

MWC assigned

Approved

Review

Organisation

Approved Plans

Service delivery

Self-management

Funds acquittal

Service receipt

Funds acquittal


APPENDIX C REFERENCE PACKAGE AND INDIVIDUAL SUPPORT RANK

C.1 Introduction

The Reference Package (v1.1) is a tool supplied by NDIA that includes a mapping between support needs and expected committed cost.

We adapt the Reference Package to provide the Individual Support Rank (ISR). The ISR disentangles a participant’s support needs from their expected committed cost. This will help comparisons over time: while participants’ expected committed costs will vary due to external factors such as inflation and funding arrangements, ISR will only vary if the participant’s support needs change. This consistent ISR is particularly useful in the early years of the trial while expectations regarding funding are still developing.

While the reference package tool provided by the NDIA is of questionable validity and is no longer used by the NDIA, Taylor Fry continues to use the support scores in the reference package to determine the ISR. Taylor Fry no longer uses the reference package for expectations. When NDIA provide DSC and Taylor Fry with the updated reference package tool this will be considered for future reports and will enable a better comparison with NDIA data.

C.2 Support scores

The support scores are numerical translations of the support needs discussed in the previous section. The support score categories differ slightly from the support needs matrix in line with the reference package tool supplied by NDIA. These categories may be reviewed when NDIA provide access to the new package reference tool which has been developed.

Currently, the six support score categories are:

Mobility,

Self-care,

General tasks,

Learning,

Interpersonal,

Communication.

This ranking allows simple analysis of depth of support needs by disability. Those with no support score are excluded from this analysis.


Table C.1 Support scores


Mobility

Self-care

Communication

General tasks

Learning

Interpersonal

Table C.2 Frequency of need

Frequency of need Reference package

support score

Never 0

Less than weekly 1

Weekly (but not daily) 2

1-2 times a day 3

3-5 times a day 4

More than six times a day 5

C.3 Support scores to ISR

The six support scores are rationalised to four for determining the ISR (and average committed cost). That is, the maximum if the general tasks, learning and interpersonal scores becomes a single cognition score.

Table C.3 Mapping support score categories into ISR

Reference package group ISR

At least six times a day for three or more support score categories 9

At least three times a day for three or more support score categories 8

At least daily for three or more support score categories (including Self-care) 7

At least daily for three or more support score categories (excluding Self-care) 6

At least six times a day for two or more support score categories 6

At least three times a day for two or more support score categories 6

At least daily for two or more support score categories (including Self-care) 5

At least daily for two or more support score categories (excluding Self-care) 4

Self-care once a day 4

Mobility, communication or cognition daily 3

Weekly for two or more support score categories 2

Weekly for one support score category 1


APPENDIX D DISABILITY SEGMENT MAPPING

Table D.1 Disability segment mapping

Disability segment Disabilities

Physical, Intellectual and Other Disability

Acquired Brain Injury

Amputations (Single/Multiple)

Attention Deficit (hyperactive) Disorder

Autism and Related Disorders

Birth Trauma/Injury

Cerebral Palsy

CHARGE Syndrome

Corneal Disorders/Defects

Cornelia de Lange Syndrome

Deafblindness

Deafness/Hearing Loss

Dementia

Developmental Delay

Down Syndrome

Epilepsy

Fragile X Syndrome

Glaucoma

Global Developmental Delay

Hemiplegia

Huntington’s Chorea

Intellectual Disability

Meningitis/Encephalitis

Microcephaly

Motor Neurone

Multiple Sclerosis

Muscular Dystrophy

Other Chromosomal Abnormalities

Other Congenital Malformations or Deformations

Other Injury/Poison/External Cause

Other Neurological

Other Physical Disorders

Other Sensory/Speech Disorders

Other Sight Loss

Parkinson's Disease

Prader-Willi Syndrome

Retinal Disorders or Defects


Disability segment Disabilities

Specific learning - other than Intellectual/ADD

Speech Impediment and Other Speech Difficulties

Spina Bifida

Spinal Cord Injury - Paraplegia

Spinal Cord Injury - Quadriplegia

Spinal Cord Injury - Tetraplegia

Stroke

Surgery/Medical Complications

Williams Syndrome

Psychosocial disorder

Bipolar Affective Disorder

Child/Adolescent Onset Psych Disorder

Obsessive Compulsive Disorder

Other Psychiatric Disorders

Schizophrenia

Early intervention New entrants classified as Early Intervention


APPENDIX E PARTICIPANTS BY AGE, SEX AND DISABILITY

Table E.1 Participants by age group

Disability type (primary) Number of participants

Total 2058

0-14 767

15-24 369

25-44 417

45-64 493

65+ 12

Table E.2 Participants by disability type

Disability type (primary) Number of participants

Total 2058

Autism and related disorders 480

Intellectual disability 727

Neurological 153

Global developmental delay 14

Cerebral palsy 58

Sensory/speech 89

Physical 234

Other 303


Table E.3 Primary disability by sex and age as at 31 December 20151


Sex Age

Mal

e

Fem

ale

0-1

4

15

-24

25

-44

45

-64

65

+

# %

Physical, Intellectual and Other Disabilities

Acquired Brain Injury 48 2 31 17 2 2 10 31 3

Amputations (Single/Multiple) 17 1 8 9 0 1 3 13 0

Autism and Related Disorders 479 23 381 98 346 107 21 4 1

Cerebral Palsy 58 3 40 18 30 13 10 5 0

Corneal Disorders/Defects 1 0 1 0 0 0 1 0 0

Down Syndrome 4 0 4 0 2 1 1 0 0

Cornelia de Lange Syndrome 2 0 0 2 2 0 0 0 0

Deafblindness 8 0 2 6 3 0 2 3 0

Deafness/Hearing Loss 31 2 20 11 15 0 3 13 0

Dementia 1 0 0 1 0 0 0 1 0

Developmental Delay 77 4 56 21 77 0 0 0 0

Epilepsy 4 0 1 3 1 0 1 2 0

Fragile X Syndrome 1 0 0 1 1 0 0 0 0

Glaucoma 2 0 1 1 1 0 0 1 0

Global Developmental Delay 10 0 7 3 10 0 0 0 0

Hemiplegia 2 0 1 1 1 0 0 1 0

Huntington’s Chorea 2 0 0 2 0 0 0 2 0

Intellectual Disability 718 35 428 290 175 210 224 108 1

Meningitis/Encephalitis 2 0 0 2 1 0 0 1 0

Motor Neurone 6 0 3 3 0 0 1 5 0

Multiple Sclerosis 56 3 13 43 0 0 13 43 0

Muscular Dystrophy 8 0 8 0 1 2 3 2 0

Other Congenital Malformations or Deformations

1 0 1 0 1 0 0 0 0

Other Injury/Poison/External Cause 1 0 0 1 0 0 0 1 0

Other Neurological 65 3 32 33 10 6 15 33 1

Other Physical Disorders 119 6 52 67 19 8 15 73 4

Other Sight Loss 29 1 12 17 11 0 3 15 0

Parkinson's Disease 5 0 4 1 0 0 0 5 0

Retinal Disorders or Defects 16 1 9 7 3 0 3 10 0

Specific learning - other than Intellectual/ADD

4 0 3 1 3 0 1 0 0

Speech Impediment and Other Speech 1 0 1 0 1 0 0 0 0



Sex Age

Mal

e

Fem

ale

0-1

4

15

-24

25

-44

45

-64

65

+

# %

Difficulties

Spina Bifida 15 1 7 8 5 4 5 1 0

Spinal Cord Injury - Paraplegia 26 1 20 6 0 4 11 10 1

Spinal Cord Injury - Quadriplegia 5 0 5 0 0 0 3 2 0

Spinal Cord Injury - Tetraplegia 1 0 0 1 0 0 0 1 0

Stroke 7 0 4 3 0 0 0 6 1

Surgery/Medical Complications 3 0 1 2 0 0 0 3 0

Sub-total 1835 89 1156 679 721 358 349 395 12

Psychosocial Disorders

Bipolar Affective Disorder 31 2 11 20 0 1 12 18 0

Child/Adolescent Onset Psych Disorder 3 0 2 1 1 2 0 0 0

Obsessive Compulsive Disorder 1 0 0 1 0 0 0 1 0

Other Psychiatric Disorders 82 4 23 59 0 6 21 55 0

Schizophrenia 60 3 38 22 0 2 34 24 0

Sub-total 177 9 74 103 1 11 67 98 0

Early Intervention

Autism and Related Disorders 1 0 1 0 1 0 0 0 0

Developmental Delay 38 2 23 15 38 0 0 0 0

Global Developmental Delay 4 0 2 2 4 0 0 0 0

Intellectual Disability 2 0 2 0 2 0 0 0 0

Other Sight Loss 1 0 1 0 0 0 1 0 0

Sub-total 46 2 29 17 45 0 1 0 0

Total

# 2058 1259 799 767 369 417 493 12

% 100 61 39 37 18 20 24 1

1. Percentages may not add to 100 due to rounding


APPENDIX F BASELINE FORECAST SUMMARY

Table F.1 Baseline forecasts

Month ending

Total

Participants Total

committed cost

Average committed

costs Payments

Jul-14 461 17,686,072 38,404 1,400,313

Aug-14 512 19,450,713 37,969 1,547,366

Sep-14 564 21,215,355 37,614 1,694,420

Oct-14 616 22,979,996 37,318 1,841,473

Nov-14 668 24,744,637 37,068 1,988,526

Dec-14 719 26,509,279 36,854 2,135,580

Jan-15 771 28,273,920 36,669 2,282,633

Feb-15 823 30,038,561 36,507 2,429,687

Mar-15 875 31,803,203 36,365 2,576,740

Apr-15 926 33,567,844 36,238 2,723,794

May-15 978 35,332,485 36,125 2,870,847

Jun-15 1,030 37,097,127 36,023 3,017,901

Jul-15 2,069 78,789,829 38,084 6,362,300

Aug-15 2,208 83,674,297 37,888 6,769,339

Sep-15 2,348 88,558,766 37,715 7,176,378

Oct-15 2,488 93,443,235 37,561 7,583,417

Nov-15 2,627 98,327,703 37,424 7,990,456

Dec-15 2,767 103,212,172 37,301 8,397,495

Jan-16 2,907 108,096,641 37,189 8,804,534

Feb-16 3,046 112,981,109 37,088 9,211,573

Mar-16 3,186 117,865,578 36,995 9,618,612

Apr-16 3,326 122,750,047 36,911 10,025,651

May-16 3,465 127,634,515 36,833 10,432,690

Jun-16 3,605 132,518,984 36,761 10,839,729


APPENDIX G ACCESS AND PLAN TIMING

Table G.1 Time elapsed between consent and eligibility decision

Consent quarter

Eligibility requests

Average days

Median days

Minimum days

Maximum days

Sep-14 Decision made 42 39 19 2 287

Outstanding 0 0 0

Dec-14 Decision made 100 27 16 0 116

Outstanding 0 0 0

Mar-15 Decision made 73 30 12 0 259

Outstanding 0 0 0

Jun-15 Decision made 82 33 19 0 187

Outstanding 0 0 0

Sep-15 Decision made 174 30 18 0 163

Outstanding 5 127 120 98 170

Dec-15 Decision made 161 15 10 0 83

Outstanding 14 41 39 13 90

Total Decision made 632 27 15 0 287

Outstanding 19 63 50 13 170

Table G.2 Time from eligibility to plan approval for new entrants

Eligibility Quarter

Number of first plans for new entrants

Average days

Median days

Minimum days

Maximum days

Sep-14 25 79 77 33 168

Dec-14 94 34 14 0 183

Mar-15 75 80 68 10 269

Jun-15 64 85 87 11 201

Sep-15 98 78 83 4 161

Dec-15 20 51 57 6 84

Total 376 67 68 0 269

Documents

Disability Services Commission WA NDIS My Way · 2016. 2. 19. · Taylor Fry has previously conducted five Quarterly Actuarial Reviews as at the end of each quarter from September