Compared with 2003, older people in 2018 comprise a greater proportion of all people with mild or moderate disability. This shows a shift in the age distribution of people with mild or moderate disability towards older age groups.
‘Life expectancy’ and ‘health expectancy’ provide an indication of the number of years a person can expect to live, or be in various health states (or in this case, the estimated years spent living with and without disability). For example, at age 65, males in 2018 could expect to live on average another 9 years without disability, plus another 11 years with some level of disability. Females aged 65 in 2018 could expect to live on average another 10 years without disability, plus another 12 years with some level of disability.
It is important to note that disability does not necessarily equate to poor health or illness. Also, expected years living with disability should not be considered as less value than years without disability (see People with disability in Australia for further detail).
Not all people with disability require or use formal specialist disability support services (provided by formal organisations, or other persons who are paid providers) or other informal assistance (such as family, friends or neighbours).
Analysis of the ABS SDAC showed that in 2018, around 60% of people with disability living in households (2.5 million people) need help with at least one of 10 activities of daily living. The most common are health care, property maintenance and cognitive or emotional tasks (AIHW 2020b).
In 2018, an estimated 40% of people with disability living in households identified as needing assistance from formal providers (36% for those under 65 and 45% for those 65 years and over).
Most (86%) people who needed formal assistance with at least one activity received some formal assistance (AIHW 2020b). The receipt of formal assistance was higher for those 65 years and over (89% compared with 82% for those under 65 years).
In 2018, 73% of people with disability, aged 15 and over (living in households), who needed formal assistance were satisfied with the range of services available to assist with at least one activity, while 82% of those who received formal assistance in the last 6 months were satisfied with the quality of services received with at least one activity (AIHW 2020b).
For those who do need support, specialist services are available to assist participation in all aspects of everyday life. These may supplement other supports that a person with disability receives, from say mainstream services, the community or informal carers. This page provides information about two specialist disability services available in Australia: the National Disability Insurance Scheme (NDIS) (that has largely replaced the disability services formerly provided by states and territories under the National Disability Agreement), and the Disability Employment Services (DES) program. It also outlines some of the other available support services for people with disability (specialised and mainstream), that exist outside of the NDIS and DES program.
Disability service provision has changed
In July 2013 the NDIS commenced in trial sites in some Australian states and territories. On 1 July 2020 Christmas Island and Cocos Island joined the Scheme, thus almost completing the National Disability Insurance Agency’s (NDIA) staged rollout of the NDIS (the NDIS is now available nationally, although some population sub-groups are still transitioning in Western Australia until 2022). The NDIS has largely replaced the provision of services under the National Disability Agreement, except for Disability Employment Services, and is jointly funded and governed by the Australian, and state and territory governments (NDIA 2020b).
In June 2023, the NDIS is projected to provide services to about 532,000 Australians, of which almost 508,000 are expected to be aged 0–64 (existing NDIS participants can choose to keep using the NDIS beyond 65) (NDIA 2020a).
National Disability Insurance Scheme
The NDIS provides reasonable and necessary supports to eligible Australians who enter the scheme under the age of 65 years, with a permanent (or likely to be permanent) and significant disability (intellectual, physical, sensory, cognitive and psychosocial disability). NDIS participants choose and pay for their supports and services out of an individually allocated budget based on their goals. Available supports fall into 15 categories, and include things like assistance with daily life, transport, assistance with social and community participation, and home modifications (see Supports and services funded by the NDIS) (NDIA 2021b). Early intervention supports are also provided under the NDIS to eligible children and adults. Participant choice and control are core features of the scheme’s design.
At 30 June 2021, around 467,000 people were active participants in the NDIS, and were in receipt of an individual support package. The number of participants has increased progressively each year with the roll out of the Scheme across Australia.
Of the active NDIS participants at 30 June 2021:
- the top 5 primary disability groups were:
- autism (32% or around 151,000 people; males accounted for around 73% of participants reported with autism)
- intellectual disability (20%, 91,300 people)
- psychosocial disability (10%, 48,500 people)
- developmental delay (8.1%, 37,700 people)
- hearing impairment (4.8%, 22,400 people)
- 6.9% of participants were Aboriginal or Torres Strait Islander people
- 9.5% of participants identified as culturally and linguistically diverse
- 49% (around 229,000) were aged 18 or under, 25% (around 119,000) were aged 19–44, and 26% (around 119,000) were aged 45 and over (only 3.6% were aged 65 and over)
- 62% (around 288,000) were male
- 68% were located in major cities (based on the Modified Monash Model of remoteness) (NDIA 2021a).
The NDIS supports children aged 0–6 who have a developmental delay or disability (and their families/carers) through the Early Childhood Early Intervention program (ECEI) (NDIA 2018). At 30 June 2021, there were around 11,800 children accessing the ECEI program, of which 11,400 were already receiving initial supports (NDIA 2021a).
The NDIA also publishes data relating to key baseline indicators for participants, with respect to lifelong learning, work, home, and health and wellbeing. The baseline questionnaires collected between July 2016 and June 2021 show:
- of those children at school (up until the age of 14), 70% were attending school in a mainstream class
- for those aged 15–24, 67% rated their health as good, very good or excellent, (42% in the 25 and over age group)
- for those aged 15–24, 18% have a paid job, while for those aged 25 and over 22% have a job (NDIA 2021a).
Disability Employment Services
Unlike other former NDA services, open employment services (Disability Employment Services, or DES) will not be rolled into the NDIS. Between May 2016 and May 2021, the number of DES participants rose steadily from 182,000 to 313,000 (DESE 2021).
While improvements were recorded in the number of DES participants with 26-week employment outcomes (see below) from 2018–19 to 2019–20 (from around 28,800 to 32,100, or around 12%), the Department of Social Services (DSS) notes that:
… from early March 2020 the COVID-19 pandemic impacted on the number of DES participants being placed into employment and a number of DES participants who were in employment lost their jobs as a result of the COVID-19 pandemic and subsequent economic downturn. Both these factors directly affected the number of DES participants who would have achieved at least a 26-week employment (DSS 2020a).
Disability Employment Services
Employment assistance provided under DES focuses on addressing participants’ barriers to employment, in order to place them into jobs as soon as is practicable (DSS 2021b). DES outcomes data provides an indication of the number of participants who have maintained sustainable employment or education for a specific period of time. The participant must meet their required employment benchmark (number of hours a participant must work each week, on average, to achieve a full outcome), as assessed through an Employment Services Assessment or Job Capacity Assessment.
Other specialised and mainstream service supports
In Australia, governments also provide other services (specialised and mainstream) that support people with disability outside both the NDIS and the DES program including:
- the National Disability Advocacy Program that provides people with disability with access to effective disability advocacy that promotes, protects and ensures their full and equal enjoyment of all human rights enabling community participation
- the Information, Linkages and Capacity Building program provides funding to deliver community projects that benefit all people with disability, their carers and families
- the Australian Disability Parking Scheme that helps eligible people park nearest their destination
- Community Mental Health programs that provide assistance to people with mental illness and their families and carers to manage the impacts of mental illness on their lives and improve their overall wellbeing
- for those people aged over 65 the My Aged Care website and contact centre provides access to a range of government-funded services that are designed to help people live independently (e.g. home modifications and aids)
- the Continuity of Support Programme provides support to older people with disability who are currently receiving state-managed specialist disability services but who are not eligible for the NDIS
- some remaining state and territory disability or disability-related services.
Australia’s social security system, administered by the DSS, aims to support people who cannot, or cannot fully, support themselves. The DSP is the primary income support payment for working age people aged 16 and over with a disability who have a reduced capacity to work because of their impairment (see Disability Support Pension and Carer Payment).
As at March 2021, 752,000 adults aged 16 and over received DSP (DSS 2021a).
Where individuals have a reduced capacity to work less than 30 hours per week due to an impairment but are not eligible for the DSP, they may have reduced mutual obligation requirements of other payments, that is to be looking for work or being engaged in activities which will help them find work in the future (such as volunteering or training). This affects payments such as the JobSeeker Payment, Parenting Payment Single and Youth Allowance (Other) Payment.
In March 2021, 32% (or 374,000) of JobSeeker recipients had a partial capacity to work. This is a large decline from the same period in 2020 (41%), reflecting short-term policy measures to the Jobseeker payment (such as suspending mutual obligation requirements) during the COVID-19 pandemic (see ' Chapter 4, The impacts of COVID-19 on employment and income support in Australia’ in Australia’s welfare 2021: data insights).
The staged national rollout of the NDIS is now almost complete. During the rollout of the NDIS, former users of NDA disability support services (NDA service users) transitioned to the new scheme (where eligible) in a staged manner. As noted above, the DES program will not transition to the new scheme.
During this staged transition a decline in the proportion of NDA service users who used non-open employment services is apparent in the data for the years prior to 2018–19.
In 2014–15 about 334,000 people used NDA disability support services. Those who only used open employment services accounted for 35% of users (117,000 people), while those who used at least one non-open employment service accounted for 65% of users (217,000 people). In comparison, in 2018–19, the last year for which NDA data were available, 230,000 people used NDA disability support services. Around 67% of this population, or around 153,000 people, only used open employment services, while those who used at least one non-open employment service accounted for 33% (76,700 people) (AIHW 2021).
From 2014–15, for those NDA service users who used at least one non-open employment service, the proportion of the total services used by different primary disability groups, remained broadly consistent through till 2018–19 (see Figure 2). The primary disability group of a NDA service user was the one that most clearly reflected their experience of disability, and caused them the most difficulty in everyday life (AIHW 2021).