“Is The NDIA Acting In The Best Interests Of Participants?”

"There is no greater disability in society than the inability to see a person as more." - Robert M. Hensel

Many participants and their families report feeling overwhelmed, confused and disempowered by the planning process as a result of too little time to build their understanding of the NDIS, the inability to view a draft plan, and the lack of communication and transparency regarding decision making. A 2016 audit by the Australian National Audit Office on the management of the transition to the NDIS found that the rate of unscheduled plan reviews and appeals to the Administrative Appeals Tribunal has far surpassed expectations, placing significant pressure on the NDIA and creating additional stress and frustration for participants.

Many Participants find the planning process disempowering , with very little communication or transparency between the NDIA, LAC/ECEI staff and participants and families.

NDIA planners often base decisions about the inclusion or exclusion of funded supports on TSPs (rather than the circumstances of the participant, resulting in participants receiving plans that do not match what they discussed with their LAC staff member. This creates significant confusion and distrust between LAC staff and participants, undermining the relationships that are critical to good planning outcomes.

Allowing participants to view a draft plan is critical to empowering them with choice and control—as consistently stated by advocates, participants, families and many others—and should be implemented immediately. Doing so would help reduce the incidence of issues , such as plan gaps and unscheduled reviews. However, draft plans need to be complemented by more opportunity for communication and collaboration between participants and their families, the LAC/ECEI staff member working with them, and the NDIA delegate approving their plan.

Planning needs to recognise not only any functional impairment experienced as a result of disability, but also the person’s context – their family, friends and carers; the community they live in; and their strengths and interests, as well as any other challenges they may be facing.

Critically, plans are often too narrowly focused on the funded support needs of the individual alone, to the exclusion of what families need to build resilience and continue to support their loved ones. Given that the NDIS is predicated on families continuing to provide up to 60 per cent of care, family-centred planning is critical for not only good participant outcomes, but for scheme sustainability.

Understanding a participant’s context as part of the planning process requires adequate time to build trust and relationships between participants (and their families), LAC/ECEI staff and planners. However, contractual KPIs for LAC/ECEI providers work against the development of these relationships. KPIs relate to the number of days elapsed between steps in the planning process, driving efficient throughput rather than quality planning. This is compounded by the overreliance on TSPs by NDIA planners to decide the components of participant plans, rather than an understanding of the participants.

Serious concerns have been raised within relation to exploitative actions by service providers in relation to provision of SIL arrangements. This includes examples where a service provider will allocate multiple people into independent living accommodation, but continue to charge each participant for private accommodation when it is a shared living arrangement.

Other processes relied on by service providers are presumably designed with a focus on service provider administrative convenience, rather than on facilitating the best living arrangement for the individual. For example, a participant is unable to seek a review or make changes to their accommodation arrangement without undergoing a full review of their plan.

Applications for an NDIA internal review of a SIL package are only permitted within the first months of the participant entering the accommodation, meaning that a participant is often ‘locked in’ to a SIL package that may not be suitable, for an extended period of time. Appeal pathways to the Administrative Appeals Tribunal are restrained to the limited jurisdiction of the Tribunal to make decisions on these issues.

There is some concern over the lack of monitoring and oversight the Quality and Safeguards Commission has shown to date with NDIS service providers. One particular concern which has been highlighted to the National Disability Insurance Agency and the Commission, is the lack of oversight, monitoring and investigation of service providers who provide ‘wrap around services’, such as accommodation, support workers, support coordinators and even their own therapist’s or medical professionals.

These service models are especially prevalent in Supported Independent Living (SIL), arrangements, hostels and other group home settings. Many participants living in SILs, hostels or group homes did so prior to the NDIS roll out. These participants have not been provided the opportunity to explore different housing options, different service providers or even different support coordinators outside of the service provider who provides both accommodation and support workers.

On occasion where a participant may voice their concern or request that an outside organisation provide support (such as support coordination), the participant is threatened with eviction, termination of support services and in some cases ‘reprimanded’. This results in participants staying quiet to ensure they have somewhere to live.

The processes involved in accessing the NDIS present many barriers for people experiencing disadvantage. From getting the form itself to through to completing each step, our members report the process is often inaccessible, intensive, invasive and long.

When people are in crisis or experiencing multiple layers of disadvantage, there is no dedicated avenue for their access request to be escalated or addressed with sensitivity. While the complex needs pathway has been established for the planning phase of the scheme, it has been reported that there is no equivalent specialised support available on the ground before or during the access stage.

This intensive support is usually provided by service providers, who are not funded to provide this kind of assistance, and advocates, who are equally stretched and underfunded. As providers complete the full transition of their business into the scheme, this unfunded work will not be sustained. Additional pressure will be placed on families, carers and advocates, who will not be able to sustain their efforts either.

Making the form easier to access, in a range of online and offline accessible formats, would provide greater opportunities for staff in intersecting services to support people through the NDIS access process.

There is a burning platform for change. Confidence and trust in the scheme – from the perspective of participants, families and carers, advocates, service providers, and the broader community – has been substantially eroded. Understanding, accessing and navigating the NDIS has become so complicated that the scheme is inaccessible for some of the very people who need it most.

All Participants should be granted support coordination funding within their first NDIS plan, to assist them to learn how to navigate the system that is the NDIS. It also should not automatically assumed that a participant’s support coordination funding can be decreased over time and there should not be a blanket ruling as such. In detemining a Participant’s eligibility for support coordination, their individual circumstances should be taken into account, as some Participants are more vulnerable than others.