ACT Human Rights Commission submission on the implementation and governance of the NDIS in the ACT

Australian Capital Territory

INQUIRY INTO THE IMPLEMENTATION, PERFORMANCE AND GOVERNANCE OF THE NATIONAL DISABILITY INSURANCE SCHEME IN THE ACT

MARCH 2018

BACKGROUND

The Human Rights Act 2004 (ACT) (‘HRA’) protects the rights, interests and wellbeing of persons in the Australian Capital Territory (ACT). Most relevant to issues raised in this submission, the HRA provides for equality before the law and the right to non-discrimination (s8) — which includes discrimination on grounds of disability and/or mental health, and includes discrimination resulting from barriers to accessing services. Furthermore, there is an obligation under s40B of the HRA on public authorities and entities performing functions of a public nature, which includes provision of public health services, to act and make decisions consistently with human rights.

Within the ACT Human Rights Commission (ACT HRC), the Public Advocate and Children and Young People Commissioner (PACYPC) has legislative responsibility for protecting and promoting the rights and interests of people in the Australian Capital Territory (ACT) who are experiencing vulnerability, and for consulting with children and young people in ways that promote their participation in decision-making. The responsibilities of the PACYPC are underpinned by a range of functions including advocacy (individual and systemic), representation, investigation, and monitoring. Overarching these functions is a strong focus on ensuring that the PACYPC’s monitoring and oversight functions (and the recommendations we make to government and non-government agencies on legislation, policies, and practices) contribute to improvements in the accessibility, responsiveness and quality of supports and services that are available for persons experiencing vulnerability.

The Disability and Community Services Commissioner’s (DCSC) mandate is to consider complaints about the provision of services for people with disability (including mental illness), and/or for their carers. The Commissioner’s role is also to promote improvements in the provision of services for people with disability and their carers and to promote an awareness of the rights and responsibilities of consumers and providers. The Discrimination Commissioner’s role under the Discrimination Act 1991 (ACT) is to take complaints of unlawful discrimination under the Act. Unlawful discrimination occurs when someone is: treated unfavourably because of a protected attribute; and this occurs in public life.

The nature of contact the ACT HRC has with National Disability Insurance Scheme (NDIS) participants and their families is often related to issues of concern and complaints. While it is acknowledged that there are many people in the ACT who report strong outcomes from their participation in the NDIS, our submission will focus on the concerns and complaints raised by a wide range of participants and organisations representing people with disability.

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Australian Capital Territory

OVERARCHING COMMENTS

The National Disability Insurance Agency’s (NDIA) published information sets out “that the National Disability Insurance Scheme will provide all Australians under the age of 65 who have a permanent and significant disability with the reasonable and necessary supports they need to enjoy an ordinary life.”

The National Disability Insurance Scheme Act 2013 (‘NDIS Act’) sets out a number of objects including to:

support the independence and social and economic participation of people with disability
provide reasonable and necessary supports, including early intervention supports, for participants
promote the provision of high quality and innovative supports that enable people with disability to maximise independent lifestyles and full inclusion in the community
give effect to certain international human rights obligations. (NDIS Act s3 (1)(c)(d)(g))

At this time, the ACT HRC considers the intent of the scheme, as set out in the legislation, is yet to be fully realised in the ACT. The ACT HRC has identified a number of key factors that impact on the full achievement of these outcomes, as follows:

The current NDIS processes are complex, bureaucratic and not user-friendly;
There is a lack of accessible complaints management and resolution, particularly in relation to NDIA decisions;
There is a lack of assistance to access and navigate the system, which places an increased burden on informal supports and other service systems, and results in some vulnerable people not accessing the scheme;
The approach to plan approval appears to be to apply standardised or benchmark levels of support rather than consideration of the individual’s reasonable and necessary supports as required by the legislation;
Delays in processes, inaccessibility of NDIA staff and limited accountability of the NDIA impact on participants’ outcomes;
The developing disability services market in the ACT is not yet able to fully meet participant’s needs and deliver quality supports across the sector.

RELATIONSHIP BETWEEN THE ACT GOVERNMENT AND AUSTRALIAN GOVERNMENT

Interactions between ACT Government and NDIS

The ACT HRC has been made aware of a number of areas of concern where the NDIS interacts with other systems such as health, education and corrections. We note that the ACT Health Directorate has identified a range of issues and examples where there is a lack of clarity or a dispute regarding the provision of services to ACT community members and whether services are appropriately provided by a health service or through the NDIS. The ACT HRC notes that these issues can lead to confusion and

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frustration on the part of the person with disability and their carers, family or advocates, where significant effort and negotiation has to be undertaken to navigate the various systems and processes.

With respect to the corrections environment, the ACT HRC is aware of a number of matters where there have been delays in assessing a person’s NDIS application because the person is detained in the Alexander Maconochie Centre (AMC) leading to delays in the provision of services to the person when they exit detention or leading to a person spending a longer time in detention because they cannot satisfy the parole board that they will have sufficient supports in the community. It is unclear why the NDIA has delayed assessing or reviewing a person’s application while they are detained in the AMC given the time at which a person is to be released can be uncertain due to remand or parole arrangements and there can be lengthy delays in NDIS processes. These issues cause significant distress and frustration for the person, their family or carers and advocates.

Disability Services Complaints

The ACT HRC has noted in the ACT Government’s submission that it considers there is a gap in relation to complaints resolution. At the moment, NDIS participants who have made complaints about the provision of services by the NDIA are unable to obtain a remedy through the Commission because the NDIA has asserted the ACT HRC does not have jurisdiction over the NDIA.

Despite the NDIS Quality and Safeguarding Framework stating that universal complaints and redress mechanisms will continue to be available to participants, this has not been the case in practice. The NDIA has consistently refused to engage with the ACT HRC in the exercise of its lawful complaint investigation functions in relation to disability services provided in the ACT. This leaves a gap in complaints resolution because the only redress mechanisms available at a federal level to individuals are the Commonwealth Ombudsman who is limited to investigating government administrative actions and the Australian Human Rights Commission, which is limited to receiving complaints of alleged discrimination including disability discrimination or an alleged breach of the Convention on the Rights of a Persons with Disabilities.

Unlike the ACT HRC, neither of these bodies is able to receive complaints about the provision of disability services more broadly and offer alternative dispute resolution as a way to resolve a complainant’s concerns. Further, the proposed NDIS Quality and Safeguards Commissioner (QASC) will not have the power to investigate complaints arising out of the provision of services by the NDIA. The ACT HRC complaint handling process therefore fills a gap that currently exists in the options that are available to NDIS participants, their families and advocates who wish to make a complaint about the services they have received from the NDIA, where there is otherwise limited means for redress. This is why the ACT HRC complaints handling process was specifically retained in the arrangements negotiated with the NDIA at the time when negotiations were undertaken with the ACT Government about the introduction of the NDIS into the ACT.

Alternative dispute resolution (ADR) processes offered by the ACT HRC have historically been able to provide a means of informal and accessible redress for people with disability in the ACT who have concerns about disability services provided in the ACT. ADR provided by the ACT HRC is an informal and flexible process that allows the parties to a complaint to resolve matters quickly and informally at a local

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level, with the help of a neutral and independent third party who is familiar with the local environment and trusted by the community.

The Commission has received numerous complaints from NDIS participants, their carers, their families, and their advocates. Some of the complaints related to not having sufficient funds approved, including a reduction of the amount previously approved, to cover all the supports needed by participants. Other complaints related to:

the provision of incorrect or conflicting information by the NDIA;
delays between old plans expiring and subsequent plans being approved resulting in service providers going into debt in an attempt to continue to provide the NDIS participant with the necessary supports or participants having to self-fund (if possible);
a lack of communication from the NDIA with participants, including emails and phone calls from participants going unanswered;
insufficient transport allowance resulting in a child participant not being able to access necessary occupational therapy sessions;
delays in requests for internal review being processed and reviews being conducted unsatisfactorily and not in accordance with applicable guidelines;
failure to consider all relevant information and paperwork provided by participants when making a decision about funding;
service providers not willing to take on NDIS clients due to increased administrative work required and also due to delays in payment by the NDIA; and
significant delays in obtaining approval for necessary home modifications.

While some of these issues are subject to the jurisdiction of the Administrative Appeals Tribunal it can be a costly and lengthy process for participants to use those appeal mechanisms when the ACT HRC’s complaint process can provide a timely, informal and accessible resolution through ADR.

The NDIA’s refusal to engage in the legislated complaints resolution process of the ACT HRC does not appear to be in accordance with the Quality Assurance and Safeguards Working Arrangements for ACT NDIS Trial as agreed between the ACT Government and the NDIA (‘the Working Arrangements’) of May 2014, which is in force until the NDIS Quality and Safeguards Commission begins in the ACT on 1 July 2019. Those Arrangements state:

The ACT Disability and Community Services Commissioner will continue to have jurisdiction to deal with complaints about disability services (including complaints regarding NDIA functions that fall within the jurisdiction of the Disability & Community Services Commissioner). Services are obliged through law to inform consumers about their right to complain to the Disability and Community Services Commissioner. The Commissioner sits within the ACT Human Rights Commission, which can also deal with complaints about disability discrimination.

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The Working Arrangements further state:

Complaints raised with the Agency with respect to the providers of disability supports will be referred to the Health Services Commissioner or Disability and Community Services Commissioner. The Commissioner will advise the ACT Government or the NDIA when concerns arise that may require regulatory action by either organisation.

The Working Arrangements also state:

The NDIA will operate to ensure that there will be no diminution of the ACT Government’s quality assurance system and safeguards. The NDIA will work in close collaboration with the ACT NDIS Taskforce, relevant ACT Government Directorates and statutory authorities including:

ACT Disability & Community Services Commissioner

ACT Health Services Commissioner

ACT Human Rights and Discrimination Commissioner

Quality and Safeguards

The ACT HRC’s submissions made in relation to the QASC supported the implementation of a comprehensive regulatory framework for the NDIS. The ACT HRC noted that robust oversight and monitoring mechanisms are essential for safe and high quality standards of service provision.

The Royal Commission into Institutional Responses to Child Sexual Abuse (the Royal Commission) has undertaken significant research and analysis of the systems and processes necessary to protect children and young people (and by extension vulnerable adults) who are receiving care in institutional settings (such as respite care and residential care). The ACT HRC considers it essential for the NDIA and the QASC to align its operations with the recommendations of the Royal Commission.

The ACT HRC notes that supporting participant satisfaction and ensuring quality services will require more than registration and compliance activities. It will necessitate further education and appropriate supports to assist people with disability to understand and navigate the nature of their contractual arrangements with service providers, the relationship between personal expectation and the provider-participant agreement, and the remedial rights available to people. Active involvement by participants in consumer feedback processes, quality auditing and complaints management will also require education and support for participants. In particular, participants with cognitive impairment will need a significant investment in supports to help build their capacity to actively develop and maintain natural safeguards as well as participate actively in formal safeguard processes. While some of this support may come from within the person’s individual plan, a broader strategy of capacity building needs to be a key element of the NDIS quality and safeguard activities. This level of support has not yet been evident within the scheme.

Duplication of regulatory oversight of service providers

The ACT HRC is concerned about duplication and conflicting oversight of NDIS providers with the NDIS Code of Conduct under the Quality and Safeguarding Framework, to be overseen by the QASC. In its May 2017 Discussion paper on the NDIS Code of Conduct, the Department of Social Services noted the broader policy, legislative and regulatory environments that had been considered in developing the Code of Conduct. No mention was made of the National Code of Conduct for unregistered health care workers, nor of the Codes of Conduct for each of the fourteen National Boards.

The Code of Conduct for unregistered health care workers sets out, among other things, national standards against which disciplinary action can be taken and, if necessary, a prohibition order issued. It is not clear how the QASC and each relevant state or territory regulatory agency will manage compliance and enforcement actions such as civil penalties, enforceable undertakings and ban orders to determine who will investigate, and also to ensure that people are not punished twice for the same set of actions. It is also not clear whether service providers will be faced with separate registration costs and different compliance requirements or standards that may not be consistent.

PRACTICAL OUTCOMES IN RELATION TO IMPLEMENTATION

The Human Services Registrar

Currently in the ACT the Human Services Registrar (HSR) is able to monitor NDIS service providers for compliance with the ACT’s safeguard framework. As a regulator located in the ACT, the HSR has a good knowledge of the local environment in which it is operating. Once this function is transferred to the NDIS QASC that local knowledge and local connection will be lost and the ACT will simply be one jurisdiction out of many for which the QASC has oversight responsibility, with a likely increase in administrative delays for the ACT similar to other situations where local regulation has been lost to a national process.

Disability Workforce strategies

As the first state to fully transition to the NDIS, the impact of limited workforce is now being experienced in the ACT and this provides a unique opportunity to review, develop and trial strategies to address workforce shortage. The exit of Disability ACT as a major provider of disability supports has meant that there has been a need for significant development of the workforce within the non-government sector. A proportion of government disability support staff and professional staff have not transitioned to the non-government sector resulting in a reduced pool of existing workers. This, combined with growth in the numbers of people supported, impacts on workforce availability. There is an ongoing need for access to externally-funded training and skill development for workers to promote and encourage workers to enter or remain in this workforce. The activities undertaken by the ACT Government during the trial period assisted supported workers to gain qualifications but this needs to be ongoing especially for the length of full-scheme roll-out.

Non-government organisations have identified there is increasing difficulty in recruiting staff, particularly for the provision of supports for people with high and complex needs. The training, skills and experience

required to provide individual and group supports for people with complex needs is higher than for other consumer groups, but the sector reports this is not sufficiently reflected in the prices set by the NDIS and subsequently in wages able to be paid to staff with specialised experience and skills.

There is also a reported lack of stability and security for disability support workers with ongoing high rates of casual workers and lack of long-term employment certainty. This is impacted by time-limited (usually under 12 months) service agreements between providers and participants and the significant reductions of supports in plans over the past 12 months. This has a flow-on effect to a lack of consistency in support workers for participants particularly in supported living situations.

Availability of services

In the ACT, there is still a developing market with areas of market failure in relation to supports for people with high and complex needs and therapeutic supports. Carers and family members have reported significant waitlists for necessary therapeutic supports.

There are limited supports available for people with high and complex needs and family members report often being advised by providers that they are unable to meet their needs. The specialised training, skills and experience required to provide individual and group supports for people with complex needs is higher than for other consumer groups. However, it is reported the costs are not sufficiently reflected in both the prices set by the NDIS and the amount of support included in plans. This creates significant disincentive for both organisations and workers to provide these supports.

There have been many reports that ACT participants have had their level of support decreased in their recent plans despite their level of need not having changed or sometimes having increased. People report that following plan reviews, sought because of changes in their circumstances due to increased need or reduced availability of informal support, the outcome of the review resulted in reductions in the level of support putting them at significant risk. People have also reported that NDIA staff have told them that their plan will be reduced at the next review. The language used by the NDIA to explain these decisions is not consistent with the application of ‘reasonable and necessary’ as set out in the legislation.

Case example: A parent called the ACT HRC to raise concerns about their child’s NDIS plan. They had previously been classified as ‘complex needs’ and were receiving in-house care from redacted to 9pm. In September 2016, they were re-assessed as ‘standard needs’ and lost funding for the caring arrangements. Their service provider has tried to seek an explanation from the NDIA, as has the family. They have been told the child’s funding was over the benchmark.

Further the reduced level of supports in the plans significantly impacts on the ability of the person to maintain their independence, social and economic participation, and full inclusion in their community. It also places additional burden on informal carers. Non-government organisations report concerns with the transition of carer support services into NDIS and the resulting decrease in the availability of these services. This includes services that support the person with disability while providing respite to the carer. Although many of these supports can be included in plans, in practice they are not included if the NDIS participant says they do not want them, even though they are considered essential to carers. This is of

particular concern to carers of people who do not have insight into their care needs and the impact on their carers. This has resulted in a significant increased burden to carers.

Another common factor limiting people’s access to supports are the delays resulting from NDIS processes. These delays occur for people seeking eligibility to the scheme, getting their first plan, approval for assistive technology and home modifications and in plan reviews due to changed circumstances. These delays place significant ongoing burden on the participant, their family and carers, and the providers supporting them, and are a significant impediment to the effective operation of the NDIS.

Implementation of local area coordination

Feros Care’s involvement was not part of the trial so the subsequent change of process whereby Feros Care is the local area coordinator but also undertaking planning activities has been confusing. The respective roles of NDIA and Feros Care is confusing for participants and their family. Further this role appears to be primarily focussed on planning rather than actually undertaking the broader functions of local area coordination.

The original model of local area coordination as implemented in Western Australia and subsequently in Queensland is substantially different to what is being implemented under the NDIS. This was a highly successful model but the key functions of developing community inclusion and informal support appear not to be replicated under the NDIS model.

As individuals attend for plan reviews, supports coordination is being reduced or removed entirely. Some of the messages from the NDIA are that the local area coordination agency will undertake this function. However for people with complex needs, coordinators undertake a wide range of complex coordination activities essential to the participant maximising their NDIS plan, achievement of their goals and increasing their social and economic participation. The reduction or cessation of hours of supports coordination is counter-productive to the effectiveness and efficiency of the NDIS.

In addition, Feros Care has advised that it is bound by the NDIA’s Operational Guidelines and the NDIA’s funding agreements, that all information relating to participants is held in the NDIA’s central information technology platform, and that it has no legal authority to disclose or use that information except for the limited purposes authorised under its funding agreements and any other applicable provider obligations. The practical effect of this is that Feros Care has not participated in the ACT HRC’s complaints resolution process in relation to complaints specifically about the provision of services by Feros Care to NDIS participants.

While the ACT Government’s disability and mental health services are providing the required information for access determination for the people they are working with, this does not extend to all people with psychosocial disability. In situations where there are no existing assessment reports that are suitable, access to the NDIS may require prospective participants to arrange and fund assessments to provide to the NDIA. When this is needed, the cost of obtaining these reports is a significant barrier to accessing the NDIS.

The NDIS planning process has changed and evolved during the trial period, and since July 2016 has dramatically changed with full scheme implementation. The new process presents difficulty for many people with disability but in particular for people with severe psychosocial disability. The level of complexity of their situations and the need for plans that are very different from people with other types of disability is best managed through planning conversations that are undertaken in person by staff skilled in working with people with mental illness. It has been reported that the level of skills demonstrated by staff undertaking planning activities varies greatly.

Over the past 18 months there have been reports of a number of situations where the NDIS have advised they will no longer fund supports they determined to be the responsibility of other sectors. This is a critical issue for people with psychosocial disability who usually have an ongoing level of engagement with mental health services.

It is acknowledged that the NDIS sits alongside a range of other service systems however close partnerships between systems do not appear to have been established at an individual level. There appears to still be significant gaps between service systems and particularly complex mainstream systems like health. The need for close connections between mental health services and NDIS funded supports is essential for a holistic approach. However, for many people, mental health case management and NDIS supports coordination (or connection) is not well connected and does not deliver effective communication and integration.

The transition of significant portions of the community-based mental health programs into the NDIS is resulting in a change to the range and scope of supports provided. Organisations supporting consumers report that many low intensity community groups that promote social inclusion are not viable under the NDIS funding model resulting in a loss of this type of activity and support. This reduces the choice available to people with psychosocial disability as these groups require both block funding for people not eligible for the NDIS and funding from NDIS participants purchasing group activities.

The impact of psychosocial disability is often episodic in nature requiring different levels of support at different times. Effective NDIS plans need to be able to respond to this variable pattern of need without frequent reviews. NDIS plans can include higher level of supports for estimated time periods based on past patterns of need. However in practice, the focus on plan funding levels not exceeding benchmarks means that the level of funding for reasonable and necessary supports may not be achieved for people with episodic high support needs.

The NDIA advises that if a person’s need increases a review of the plan can be instigated. However the NDIA also advises using the available funding fully before seeking a review. Many people are concerned that if they use the funding as needed for periods of high support they may be denied additional supports in a subsequent review.

Further, in practice there have been significant delays in plan reviews and participants and their families frequently report reviews result in decreased levels of funding. For people and their supports coordinators, the uncertainty of getting additional funding leads to using a lower level of supports throughout the plan in order to retain capacity to respond to high need times. This is counter-intuitive to

the focus on maximising social and economic participation. The lack of adequate NDIS ongoing supports is also likely to impact on other support systems, particularly mental health services, as people may find themselves in crisis due to not having been able to access the supports they need at the time they need them.

It is noted that NDIA has implemented significant reform to the processes for people with psycho-social disability and has identified that more work is required in the ACT. The NDIS recently held a workshop with providers on 21 March 2018 to assist in improving future practice.

UNIQUE FACTORS IN THE ACT

By the end of two year trial period in the ACT, the NDIA had responded to a wide range of concerns with planning, reviews, and needs for supports coordination in plans. However at the commencement of full scheme implementation in July 2016, a wide range of changes to the NDIS processes were made including new IT systems and payments as well as new planning and review processes. These changes have resulted in ongoing dissatisfaction from participants, carers, family members and providers. ACT participants have also reported significant reductions in the amount of supports provided in their plans, with the continuity of supports appearing to have been significantly eroded over time.

While it is understandable that changes would occur during and following the trial period in the ACT, the level of change has been significant and costly for people with disability and providers in the ACT. ACT NDIS participants, family members supporting them, and organisations alike, report a high level of change fatigue.

The ongoing non-payment or late payments to providers has had a major impact on the financial viability of ACT providers who do not work in other service systems with block funding. In addition, the cost of changing business systems repeatedly in response to the NDIS system changes has placed significant burdens on NDIS providers in the ACT. As a whole-of-jurisdiction trial site, this burden has been disproportionate for ACT providers compared to their interstate counterparts.

In the ACT, a number of roles and functions previously undertaken by Disability ACT are not adequately replicated under the NDIS. There is no provider of last resort and this is very concerning given the market failure for people with complex needs. Disability ACT also provided case manager type functions particularly for people with complex needs, and people with limited or no social or family support. Within the NDIS, this role may be undertaken through supports coordination, however there remain significant gaps in both the quantity of this support in plans, and in the availability of experienced and skilled staff to undertake this critical role.

Another particular area of concern is that the NDIS does not consider and put into plans the supports that are needed to enable an individual to comply with requirements imposed through the criminal justice system. For a small number of people, this lack of compliance is a direct result of their disability and during the trial period resulted in some people spending relatively long periods of time in detention. In the past, Disability ACT has funded this community-based support to enable them to live an ordinary life.

This has left a shortfall in current funding as the NDIS does not match the level that was previously provided. When this support is not in place, the participant is at significant risk of harm to themselves either directly or a result of further criminal convictions or detentions. At this time, the ACT Government is providing additional funding for these situations.

The recent changes to requirements for Occupational Therapists and Psychologists registered specifically for particular roles (such as home modifications and behaviour support) will disadvantage ACT participants due to the very small numbers of professionals in the ACT. Targeted and funded professional development activities for ACT professionals as well as funding to enable access to interstate professionals is likely to be required to enable equitable access for ACT participants.

The ACT is a transient city, and accommodation is also expensive; this impacts on the level of voluntary and community support available to those with support needs from the family and community.

RECOMMENDATION

The ACT HRC recognises that while the Scheme is still in a development phase, this is a critical time to address issues with the ongoing design and implementation of the Scheme that have a negative impact on ACT participants. The ACT HRC will continue to make ongoing active representations for change. The ACT HRC recommends that key ACT Government agencies continue to address priority areas for development with the NDIA and Commonwealth Government.

Jodie Griffiths-Cook Public Advocate and Children and Young People Commissioner

Karen Toohey Disability and Community Services Commissioner Discrimination Commissioner

Human Rights Commission
Phone: (02) 62052222
L2/11 Moore Street, Civic 2601 ACT

APPENDIX 1

Case examples of complaints received by the HRC

Funding: A person complained that they were being evicted from their accommodation provided by a disability service provider (a NDIS partner). One of the reasons for the eviction was that the person’s medical condition had deteriorated and they now required two people to transfer them from the bed to bathroom but the NDIA refused to provide funding for two carers. The provider said that keeping the complainant at their property put the safety of their staff and the complainant at risk.
Funding: A person complained about the management of their NDIS plan, including providing incorrect advice resulting in them running out of core funds, not paying invoices from service providers, and a debt of $6000-8000 due to poor plan management. A review of NDIS funding and outstanding bills resulted in a new plan the person was satisfied with and a payment plan for outstanding amounts. They also noted improvement in communication from the NDIA.
Offering services that are unavailable: A parent made a complaint on behalf of their child against a disability service provider. They stated the provider assured them they would have a therapist available for their child, so they changed their child’s NDIS plan to switch providers. The parent alleged they waited 6 months for a therapist, and had been told there may be a wait of up to 12 months. They also alleged they were billed twice for services their child did not receive.
Management of funding: A person told the Commission the NDIA changed their funding from plan management (by a community organisation) to an agency managed plan. This meant they were not able to get access to their regular cleaning service as they were not registered with the NDIA. This caused significant issues with their housing provider and they were at risk of eviction and homelessness as a result. The NDIA resolved the concern directly with the person prior to the Commission becoming involved. They are now on a plan that can be managed by a community organisation, and the cleaning service was able to recommence.
Delays: A parent complained that their 2 year old child was originally denied an NDIS package in 2015 despite providing medical evidence the child required the assistance. The parent requested a review of the decision by the NDIA in October 2016, and was told their child was eligible for funding 4 months later in January 2017. They required a planning meeting to allocate the child’s funding, and the parent stated this meeting had not been scheduled at time of the complaint in June 2017. The parent reported their child had been receiving a service for their hearing loss from a service provider as it believes the child was eligible for funding.
Service refusal: A person made a complaint that a physiotherapist clinic told them they would not take them on because they have a policy against taking on further NDIS clients. The person requires regular physiotherapy, and said that the clinic told them that their books are still open to

private patients but NDIS clients are “too much work and that it amounts to 8 hours unbilled per client”.

Delays: A person with a disability complained about the delays in obtaining an occupational therapist assessment for the NDIA. They were advised to obtain a plan under the NDIS so that they could continue to access support and care they needed. They stated they had a plan developed and it was agreed that their home bathroom required modification. They were subsequently advised that an assessment must be performed by an NDIS credentialed occupational therapist and there was a six month wait in the ACT. They had also been advised that if the modification costs more than $20,000 the matter would be referred to a newly established task force for their consideration which may take 12 to 18 months.
Reduction of funding: A parent complained that their two adult children had their NDIS packages reviewed and reduced. The parent was particularly concerned that the funding to enable their adult children to leave the house for community access dropped to 25% of the original funding, which significantly curtailed their ability to engage in activities that they enjoy, and was concerned it may result in one adult child being left at home unsupervised for periods of time. The two plans were reviewed by the NDIS several months after the parent first submitted their complaint to the HRC. Funding was increased, including in relation to community access hours.
Service provider not paying staff: It was brought to the attention of the Commission that a disability service provider had been reported to the Fair Work Ombudsman for not paying staff and using staff inappropriately. The NDIA had two participants that they have found new service providers for and are concerned that there may be other people with disabilities who may be affected.
Funding: A person complained that they had sought a review of their NDIS plan to be brought forward three months as their needs had changed and they did not have sufficient funds remaining in their plan which was meant to cover the next three months.
Inadequate transport allowance: A parent complained about a disability service provider who was providing their child with occupational therapy and speech therapy under their NDIS plan. Due to the service provider moving locations, the child’s transport allowance limited the number of sessions they were able to access from fortnightly to 8 times per year as the transport allowance was not adjusted to accommodate the additional distance.
Funding: A parent complained on her child’s behalf about a disability service who are providing NDIS service coordination for their child. They said a recent review of the child’s plan did not follow guidelines, including planning meetings, assessing their child’s needs, and obtaining required paperwork. They stated this resulted in a significant and unsustainable reduction in the child’s NDIS funding.

Delay: A parent complained that their 8 year old child’s NDIS funding lapsed after their plan was reviewed in April 2017 with no final outcome. The plan expired on 13 June 2017. The parent stated they were currently self-funding the disability support in place for their child at great personal cost. They also complained that their other child, who is 12 years of age, required one on one disability support, however had only been funded for group support despite multiple reports from a clinical psychologist.
Funding and lack of communication: A parent complained about their child’s NDIS plan. They had previously been classified as ‘complex needs’ and were receiving in-house care from 7am to 9pm. In September 2016, they were re-assessed as ‘standard needs’ and lost funding for the caring arrangements. Their service provider had tried to seek an explanation from the NDIA, as had the family, and no response had been received at the time of submitting their complaint in March 2017.