Recommendations and actions

• Action 1.1: National Cabinet should agree to jointly design, fund and commission an expanded and coherent set of foundational disability supports outside individualised NDIS budgets.
• Action 1.2: The Department of Social Services, with state and territory governments, should develop and implement a Foundational Supports Strategy.
• Action 1.3: National Cabinet should agree to jointly invest in and redesign information and advice and capacity building supports.
• Action 1.4: National Cabinet should agree to jointly invest in navigation support for people with disability outside the NDIS.
• Action 1.5: National Cabinet should agree to jointly invest in achieving nationally consistent access to individual disability advocacy services.
• Action 1.6: All Australian governments should fund systemic advocacy of LGBTIQA+SB people with disability to strengthen representation at all levels.
• Action 1.7: The Department of Social Services and the National Disability Insurance Agency should improve linkages between the NDIS, Disability Employment Services and related initiatives targeting improved employment outcomes for all people with disability, including NDIS participants.
• Action 1.8: National Cabinet should agree to jointly invest in a capacity building program for families and caregivers of children with development concerns and disability.
• Action 1.9: National Cabinet should agree to jointly invest in state and territory home and community care support programs to provide additional support to people with disability outside the NDIS.
• Action 1.10: The Department of Social Services, with states and territories, should develop a nationally consistent approach for the delivery of aids and equipment outside the NDIS.
• Action 1.11: National Cabinet should agree to jointly invest in psychosocial supports outside the NDIS to assist people with severe and persistent mental ill-health currently unable to access supports.
• Action 1.12: National Cabinet should agree to jointly invest in early supports for children with emerging development concerns and disability.
• Action 1.13: National Cabinet should agree to jointly invest in programs and initiatives to support adolescents and young adults with disability aged 9 to 21 to prepare for and manage key life transition points such as secondary school, employment and living independently.

• Action 2.1: The Attorney General’s Department, with the Department of Social Services and the states and territories, should develop a unified and contemporary approach to disability rights, discrimination and inclusion legislation.
• Action 2.2: All Australian governments should improve the recognition and responsiveness of government services to culturally and linguistically diverse concepts of disability and care by investing in targeted research, education material and capability building for government organisations and staff, professionals and providers who deliver government services.
• Action 2.3: The Department of Social Services with relevant agencies should develop and trial a mechanism to publicly communicate the performance of current Disability Standards under the Disability Discrimination Act 1992.
• Action 2.4: All Australian governments should incorporate Disability Impact Assessments into new policy proposal assessment processes.
• Action 2.5: All Australian governments should take steps to protect the right to inclusive education for children with disability and developmental concerns in early childhood education and care and schools.
• Action 2.6: National Cabinet should agree to a multilateral schedule to a new Disability Intergovernmental Agreement that replaces the principles for determining the responsibilities of the NDIS and other service systems, including the Applied Principles and Tables of Supports to better clarify respective responsibilities.
• Action 2.7: The Department of Social Services, working with other Commonwealth agencies, state and territory disability agencies and the National Disability Insurance Agency, should implement a priority work program to improve coordination between complex mainstream settings and the NDIS.
• Action 2.8: The National Disability Insurance Agency and the Department of Education, with state and territory education and disability agencies, should develop a plan to better connect the NDIS and school education systems and improve educational outcomes for children with disability.
• Action 2.9: The Productivity Commission should develop an NDIS transport policy that better meets the mobility needs of participants.
• Action 2.10: The Australian Government should develop a national strategy to improve the quality of the disability ecosystem for First Nations people with disability.
• Action 2.11: The Australian Government should implement legislative change to allow participants once they turn 65 to receive supports in both the NDIS and the aged care system concurrently and clarify when aged care supports are reasonable and necessary.
• Action 2.12: The Australian Government should implement legislative or process change to allow access to the NDIS for Disability Support for Older Australians program participants.
• Action 2.13: All Australian governments should agree as a matter of priority to expand universally available child development checks, to ensure the early identification of children with developmental concerns and disability and enable early intervention.
• Action 2.14: State and territory governments should commit to and implement the general accidents stream of the National Injury Insurance Scheme.
• Action 2.15: The National Disability Insurance Agency and the Department of Social Services, working with state and territory governments and other relevant Commonwealth agencies, should update current arrangements governing the interaction between the NDIS and compensation schemes to reduce overlap and improve participant experiences.
• Action 2.16: The Disability Reform Ministerial Council should agree to cease the use of ‘in-kind’ arrangements in the NDIS.

• Action 3.1: The National Disability Insurance Agency should introduce a more consistent and robust approach to determining eligibility for access to the NDIS based on transparent methods for assessing functional capacity.
• Action 3.2: The National Disability Insurance Agency should introduce a new Access Request and Supporting Evidence Form and accompanying guidance to make the process of applying for NDIS access more transparent and simple.
• Action 3.3: The National Disability Insurance Agency should change the basis for setting a budget to a whole-of-person level, rather than for individual support items.
• Action 3.4: The National Disability Insurance Agency should introduce new needs assessment processes to more consistently determine the level of need for each participant and set budgets on this basis.
• Action 3.5: The National Disability Insurance Agency should allow greater flexibility in how participants can spend their budget, with minimal exceptions.
• Action 3.6: The National Disability Insurance Agency should adopt a trust-based approach to oversight of how participants spend their budget, with a focus on providing guidance and support.
• Action 3.7: The National Disability Insurance Agency should reform the NDIS early intervention pathway to provide supports to individuals where there is good evidence the intervention is safe, cost effective and significantly improves outcomes.
• Action 3.8: The National Disability Insurance Agency should implement reforms to the participant pathway using an iterative, inclusive approach to design and testing, and ensure participants experience a smooth transition to the new arrangements.
• Action 3.9: The Australian Government should update and clarify legislation to support a more effective approach to determining access.

• Action 4.1: The National Disability Insurance Agency, through the joint commissioning process described in Action 4.3, should be the lead commissioner of a local navigation function to help people with disability find supports in their community and make the best use of their funding.
• Action 4.2: The National Disability Insurance Agency, through the joint commissioning process described in Action 4.3, should be the lead commissioner of a Specialist Navigation function for participants who have more complex or specific needs that cannot be reasonably met by general navigation support.
• Action 4.3: The National Disability Insurance Agency should ideally adopt a joint commissioning approach to deliver local navigation support within a nationally consistent framework, developed in partnership with other relevant Australian government and state and territory government agencies.
• Action 4.4: The National Disability Insurance Agency should design, test and implement the navigation function gradually, prioritising continuity of support for participants and their families and a smooth transition for the workforce and market.

• Action 5.1: The National Disability Insurance Agency should ensure participants receive accessible information and tailored advice to support informed decision-making.
• Action 5.2: The Department of Social Services and National Disability Insurance Agency should both ensure those with cognitive disability or complex communication support needs are connected with capacity building support and other lifelong opportunities to build decision-making skills and experience.
• Action 5.3: The National Disability Insurance Agency should include an assessment of participants’ need for independent decision-making support as part of budget setting and ensure participants can use their NDIS budgets to access independent decision-making supports.
• Action 5.4: The Department of Social Services, the new National Disability Supports Quality and Safeguards Commission and National Disability Insurance Agency should ensure decision-supporters have access to information, training and resources to assist them in providing best-practice support for decision-making.
• Action 5.5: The National Disability Insurance Agency should reform the approach to appointing nominees, provide improved training and information to nominees, and increase oversight of nominee decisions.

• Action 6.1: National Cabinet should agree to jointly invest in a continuum of mainstream, foundational and specialist supports to address the needs of all children with disability and developmental concerns.
• Action 6.2: The National Disability Insurance Agency should reform the pathway for all children under the age of 9 to enter the NDIS under early intervention requirements.
• Action 6.3: The National Disability Insurance Agency should introduce a more consistent and robust approach to assessing developmental delay.
• Action 6.4: The National Disability Insurance Agency should change the basis for setting a budget to a whole-of-person level, and introduce a new needs assessment process to more consistently determine the level of need for each child and set budgets on this basis.
• Action 6.5: The National Disability Insurance Agency, in partnership with the Department of Social Services, the National Disability Supports Quality and Safeguards Commission, should require early intervention capacity building supports for children be based on best practice principles and evidence.
• Action 6.6: The National Disability Insurance Agency should develop and implement an approach for ongoing monitoring and evaluation of the effectiveness of early intervention for children.
• Action 6.7: The National Disability Insurance Agency should implement reforms to support the continuum and pathway for children using an iterative, inclusive approach to design and testing, and ensure participants experience a smooth transition to the new arrangements. 

• Action 7.1: The National Disability Insurance Agency should introduce a new approach to psychosocial disability in the NDIS based on personal recovery and optimising independence.
• Action 7.2: The National Disability Insurance Agency should establish an early intervention pathway for the majority of new participants with psychosocial disability under section 25 of the National Disability Insurance Scheme Act 2013.
• Action 7.3: The National Disability Insurance Agency should establish an integrated complex care coordination approach with public mental health systems for participants with complex needs.
• Action 7.4: The new National Disability Supports Quality and Safeguards Commission should require providers delivering psychosocial supports to be registered, including demonstrating compliance with a new support-specific Practice Standard.
• Action 7.5: All Australian governments should prioritise supports for people with psychosocial disability as part of general foundational supports.
• Action 7.6: All Australian governments should improve access to mental health services for people with severe mental illness and strengthen the interface between mental health systems and NDIS.

• Action 8.1: The National Disability Insurance Agency should change the budget setting process to ensure that housing and living budgets are consistent and sustainable.
• Action 8.2: As part of the local navigation function (Action 4.1) the National Disability Insurance Agency should commission Housing and Living Navigators to provide advice on participants’ housing and living options.
• Action 8.3: The National Disability Insurance Agency should design, fund and implement a process for participants to try new living arrangements at key life stages, before they commit to them.
• Action 8.4: The National Disability Insurance Agency should commission a shared support facilitation function to empower participants sharing supports to exercise joint decision-making.

• Action 9.1: The National Disability Insurance Agency, in collaboration with the new National Disability Supports Quality and Safeguards Commission, should invest in the collection and dissemination of housing and living data and analysis.
• Action 9.2: The National Disability Insurance Agency should implement a new funding approach for participants sharing living supports to strengthen the focus on service quality and outcomes.
• Action 9.3: The National Disability Insurance Agency should release more detailed and frequent information on participant demand for 24/7 living supports and Specialist Disability Accommodation (both medium and longer term needs).
• Action 9.4: The National Disability Insurance Agency should remove the Improved Liveability category for new Specialist Disability Accommodation (SDA) developments, and review the remaining SDA categories and associated Design Standards to evaluate their effectiveness.
• Action 9.5: The Australian Government should transition responsibility for advising on Specialist Disability Accommodation pricing to the Independent Health and Aged Care Pricing Authority and introduce more flexibility to the way prices are set.
• Action 9.6: The National Disability Insurance Agency, in consultation with state and territory governments, should commission Specialist Disability Accommodation where needs are not adequately met by the private investor model.
• Action 9.7: The new National Disability Supports Quality and Safeguards Commission should strengthen Specialist Disability Accommodation (SDA) regulation to ensure dwellings are managed in accordance with the needs of participants and mandate the separation of SDA and living support providers.
• Action 9.8: All Australian governments should agree and implement an intergovernmental strategy for upgrading or repurposing ageing Specialist Disability Accommodation stock owned by states and territories.
• Action 9.9: The National Disability Insurance Agency should amend its change of circumstance and Specialist Disability Accommodation (SDA) policies to reduce the bedroom count of ageing SDA dwellings.
• Action 9.10: The National Disability Insurance Agency should introduce a new Specialist Disability Accommodation (SDA) category for participants funded for shared living supports but not eligible for existing categories of SDA.
• Action 9.11: All Australian governments should agree and publish a targeted action plan for housing under Australia’s Disability Strategy.

• Action 10.1: The Australian Government should develop and fund an easy-to-use centralised online platform that provides information on all locally available supports and services for participants and Navigators.
• Action 10.2: The National Disability Insurance Agency and the new National Disability Supports Quality and Safeguards Commission should enable better two-way information sharing with third party online platforms to encourage digital innovation that builds on the centralised online platform.
• Action 10.3: The National Disability Insurance Agency should transition to fully electronic payments and improve visibility of NDIS payments.
• Action 10.4: The Australian Government should invest in the underpinning digital infrastructure and capability needed to protect the integrity of the NDIS.
• Action 10.5: The Australian Government should develop and implement a clear transition path for existing Plan Managers.
• Action 10.6: The Australian Government should design and roll out an NDIS digital transformation strategy and roadmap to bring together and sequence all initiatives in the NDIS digital landscape.

• Action 11.1: The Department of Social Services should develop a new NDIS pricing and payments framework to be administered by the National Disability Insurance Agency and the Independent Health and Aged Care Pricing Authority, including better ways to pay providers to promote the delivery of efficient and quality supports and continuity of supply.
• Action 11.2: The National Disability Insurance Agency should progressively roll-out preferred provider arrangements for capital supports to better leverage its buying power and streamline access for participants.
• Action 11.3: The Australian Government should transition responsibility for advising on NDIS pricing to the Independent Health and Aged Care Pricing Authority to strengthen transparency, predictability and alignment.
• Action 11.4: The Australian Government should review and refine the pricing and payments framework once underpinning reforms have been implemented.

• Action 12.1: The Australian Government should establish and appropriately resource a quality function within the new National Disability Supports Quality and Safeguards Commission led by a dedicated Deputy Commissioner for Quality.
• Action 12.2: The new National Disability Supports Quality and Safeguards Commission should make quality improvement a priority in capacity-building initiatives and audit processes.
• Action 12.3: The new National Disability Supports Quality and Safeguards Commission, working with the Department of Social Services, should design, test and implement an approach to measure and publish metrics of registered provider performance.

• Action 13.1: The Australian Government should undertake more active, evidence driven market monitoring to identify issues with access to quality supports early and take more timely and appropriate action.
• Action 13.2: The National Disability Insurance Agency should progressively roll-out provider panel arrangements for allied health supports in small and medium rural towns or where participants face persistent supply gaps.
• Action 13.3: The National Disability Insurance Agency should develop matching tools to support participants and Navigators to pool demand for supports.
• Action 13.4: All Australian governments through the Disability Reform Ministerial Council should agree and publish a provider of last resort policy to ensure participants have continued access to supports where markets fail.

• Action 14.1: The National Disability Insurance Agency, in partnership with First Nations representatives, communities, participants and relevant government agencies should progressively roll-out alternative commissioning arrangements for both First Nations communities and remote communities, starting as soon as possible.

• Action 15.1: The Australian Government should design and trial workforce attraction and retention initiatives.
• Action 15.2: The Australian Government should develop targeted and flexible migration pathways for care and support workers.
• Action 15.3: The Australian Government should develop an integrated approach to workforce development for the care and support sector.

• Action 16.1: The Disability Reform Ministerial Council should agree a Disability Support Ecosystem Safeguarding Strategy to coordinate activities to support the safeguarding of people with disability.
• Action 16.2: The National Disability Insurance Agency should design, pilot and implement a new individual risk assessment and safeguard building process.
• Action 16.3: The Department of Social Services, working with the National Disability Insurance Agency, the new National Disability Supports Quality and Safeguards Commission and other agencies where relevant, should ensure participants can consider and access a wider range of safeguarding supports.
• Action 16.4: State and territory governments, with support from the Department of Social Services, should ensure participants can access high-quality, nationally consistent Community Visitor Scheme offerings that interface with the NDIS.
• Action 16.5: State and territory governments should establish or improve adult safeguarding agencies to deliver a universal service offering for the safeguarding of all people at risk of harm, including people with disability.

Legislative change required

• Action 17.1: The Department of Social Services and the new National Disability Supports Quality and Safeguards Commission should design and implement a graduated risk-proportionate regulatory model for the whole provider market.
• Action 17.2: The Department of Social Services and the new National Disability Supports Quality and Safeguards Commission should develop a staged implementation approach to transition to the new graduated risk-proportionate regulatory model.
• Action 17.3: The Australian Government should amend the National Disability Insurance Scheme Act 2013 to remove the link between a participant’s financial management of their plan and the regulatory status of their support providers.
• Action 17.4: The Department of Social Services, working with the new National Disability Supports Quality and Safeguards Commission and state and territory agencies, should expand the coverage of worker screening requirements.
• Action 17.5: The Department of Finance and the Department of Social Services, working with the new National Disability Supports Quality and Safeguards Commission and state and territory agencies, should improve, streamline and harmonise worker screening processes for care and support workers.
• Action 17.6: The new National Disability Supports Quality and Safeguards Commission should be resourced to strengthen compliance activities and communications to respond to emerging and longstanding quality and safeguards issues, and market developments and innovation.

• Action 18.1: All Australian governments should agree a joint action plan for meaningful collaboration and a stronger focus on corrective actions against providers to reduce and eliminate restrictive practices, and review interventions and practices that may be harmful.
• Action 18.2: The new National Disability Supports Quality and Safeguards Commission, working with other agencies as relevant, should work with behaviour support practitioners and providers to urgently improve the quality of behaviour support plans, enhance quality of life for participants and eliminate poor provider practices.
• Action 18.3: The new National Disability Supports Quality and Safeguards Commission, working with state and territory agencies, should better support providers to deliver on their role in reducing and eliminating restrictive practices.

• Action 19.1: The Disability Reform Ministerial Council should agree a Disability Supports Quality and Safeguarding Framework.
• Action 19.2: All Australian governments should prioritise greater collaboration, consistency and timely exchange of data and information to ensure effective quality and safeguarding, including expanding the coverage of the NDIS Quality and Safeguards Commission to become the National Disability Supports Quality and Safeguards Commission.
• Action 19.3: The Australian Government should ensure the new National Disability Supports Quality and Safeguards Commission has the resources, powers and approach to proactively and effectively regulate the disability supports market.

• Action 20.1: National Cabinet should agree a new Disability Intergovernmental Agreement to underpin delivery of a comprehensive and unified disability support ecosystem.
• Action 20.2: National Cabinet should agree new funding arrangements to align incentives and share costs in the disability support ecosystem.
• Action 20.3: National Cabinet should establish a new permanent Disability Advisory Council reflective of the diversity of people with lived experience of disability to advise Disability Reform Ministers.
• Action 20.4: National Cabinet should develop a dedicated First Nations Schedule under the new Disability Intergovernmental Agreement to embed a First Nations Disability Forum and an independent sector-specific accountability mechanism.
• Action 20.5: National Cabinet should establish a Disability Outcomes Council to monitor and publicly report on the performance of all governments in meeting the outcomes, commitments and benchmarks outlined in the Disability Intergovernmental Agreement.

• Action 21.1: National Cabinet should be accountable for the sustainability of the unified disability ecosystem, including the NDIS.
• Action 21.2: The Department of Social Services, in consultation with state and territory governments, should review existing National Disability Insurance Agency operational guidelines to identify and prioritise opportunities to strengthen the National Disability Insurance Scheme Act 2013 and Rules.
• Action 21.3: The Australian Government should ensure that the Minister responsible for the NDIS remains a Cabinet Minister.
• Action 21.4: The Australian Government should clarify roles of relevant agencies for administration market stewardship, pricing, policy, regulation, commissioning and legislation.

• Action 22.1: When undertaking capability reviews, the Australian Public Service Commission should have regard to the capacity, capability and culture of the National Disability Insurance Agency, National Disability Supports Quality and Safeguards Commission, and Department of Social Services to deliver relevant reforms.
• Action 22.2: The National Disability Insurance Agency and the new National Disability Supports Quality and Safeguards Commission should publish biennial culture and capability plans, supported by independent audits and staff, participant and stakeholder surveys.
• Action 22.3: The Australian Government should re-design the Participant Service Guarantee to prioritise high quality, transparent and efficient decisions and improved participant experience.
• Action 22.4: The Disability Reform Ministerial Council should agree measurable culture and capability outcomes as part of new funding arrangements.

• Action 23.1: National Cabinet should agree to replace the current NDIS Outcomes Framework with a new Disability Support Outcomes Framework.
• Action 23.2: The Department of Social Services, in consultation with the National Disability Insurance Agency, the new National Disability Supports Quality and Safeguards Commission and the Independent Health and Aged Care Pricing Authority, should establish and manage an NDIS Evidence Committee to provide guidance on reasonable and necessary disability supports.
• Action 23.3: The Department of Social Services should establish a new Disability Research and Evaluation Fund to coordinate and fund research and independent evaluation activities.
• Action 23.4: All Australian governments should agree to jointly invest in actions to improve disability data quality and sharing.
• Action 23.5: The Australian Government should ensure that all disability reporting mechanisms facilitate the collection, analysis and publication of intersectional indicators.

• Action 24.1: The Disability Reform Ministerial Council should agree architecture to support implementation and delivery of the NDIS reform agenda.
• Action 24.2: The new NDIS Review Implementation Advisory Committee should report to the Disability Reform Ministerial Council every six months or as needed.
• Action 24.3: The new NDIS Experience Design Office should commission agile projects to design and test reforms to the participant pathway.

• Action 25.1: The Department of Social Services, with input from the National Disability Insurance Agency and NDIS Quality and Safeguards Commission, should review the recommendations from this Review and develop a proposed package of legislative reforms.

• Action 26.1: National Cabinet should agree and publish an implementation roadmap.
• Action 26.2: The National Disability Insurance Agency should ensure existing participants experience a smooth and fair transition to the new participant pathway.
• Action 26.3: The new NDIS Review Implementation Working Group should coordinate communications across relevant agencies to regularly update and inform stakeholders on implementation progress.