Down Syndrome Australia Submission
NDIS Provider and Worker Registration
May 2024
About Down Syndrome Australia
Down Syndrome Australia was established in 2011 as the peak body for people with Down syndrome in Australia. Our purpose is to influence social and policy change and provide a national profile and voice for people living with Down syndrome. Our vision is an Australia where people living with Down syndrome are valued, reach their potential, and enjoy social and economic inclusion.
Down Syndrome Australia and its members and partners work together to provide support for people with Down syndrome and to make Australian society inclusive for people with Down syndrome. We work in partnership to maximise the opportunities and support for people with Down syndrome and their families and support networks.
Our vision is an Australia where people living with Down syndrome are valued, reach their potential, and enjoy social and economic inclusion. In line with the Convention on the Rights of Persons with Disabilities (CRPD) and Australia’s Disability Strategy (the Strategy) we work towards a community where all people with disability are included, and their rights respected and protected.
Down syndrome is a genetic condition in which the person has an extra copy of some or all of chromosome 21. This additional chromosome results in a number of physical and developmental characteristics and some level of intellectual disability. There are more than 13,000 Australians who have Down syndrome and approximately 1 in every 1,100 babies in Australia are born with Down syndrome.1
For more information contact:
Darryl Steff
Chief Executive Officer
Down Syndrome Australia
Email: Darryl.Steff@downsyndrome.org.au
Website: www.downsyndrome.org.au
1 Down Syndrome Australia (2020). Down Syndrome Population Statistics. Retrieved from https://www.downsyndrome.org.au/about-down syndrome/statistics/
Submission: NDIS Provider and Worker Registration
Down Syndrome Australia (DSA) welcomes the opportunity to provide input to the NDIS Provider and Worker Registration Taskforce (the Taskforce).
Providers play a critical role in delivering effective supports to participants. Effective oversight of providers is critical to ensure a well-functioning NDIS with appropriate, safe and high quality supports for participants.
DSA supports the introduction of a risk proportionate graduated approach to Provider and Worker Registration in line with Recommendation 17 of the NDIS Review Report.
This submission includes our reasons for support, as well as recommendations for effective design and implementation. These include:
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Capacity of the NDIS Quality and Safeguards Commission;
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Consideration of Foundational supports;
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Consideration of the balance of increased regulation with maintaining choice and control;
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The need for support and education for people with intellectual disability to effectively navigate these changes;
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Ensuring support for providers to transition;
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Lessening the burden on providers by considering existing complementary or professional registrations; and
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Ensuring a continued commitment to co-design NDIS reform alongside people with disability. Support for a new model of NDIS Provider and Worker registration We are supportive of the need to change the current NDIS Provider and Worker registration model as the current system is putting participants, in particular those with Down syndrome and other intellectual disabilities, at increased risk of harm. As the Review Report highlighted “The current registration system is not fit for purpose, does not stop violence and abuse of people with disability, does not prevent conflicts of interest or provider exploitation of people with disability.”
DSA recognises that the Review Report has identified that significant supports are being provided by unregistered providers. This is in part due to the significant regulatory burdens currently required for registration. However, registration also manages some of the risk presented to NDIS participants by requiring registered providers to meet minimum safeguarding requirements. At present, unregistered providers and unregistered workers are not subject to basic screening processes and this can provide an avenue for violence, abuse, neglect and exploitation.
DSA is also supportive of a registration system for all providers which would provide further fraud prevention measures, as well as the potential for creating better data for NDIA about the supply and demand of different goods and services.
Although DSA supports the need to change the Provider and Worker Registration models, we have some comments on the proposed changes that we hope will aid the Taskforce in their recommendations to Government on how such a model should be designed and implemented.
A new model cannot safeguard participants on its own: systemic changes must be reinforced through NDIS Quality and Safeguards Commission and Foundational supports. The model proposed in the Review Report is not the only change required to address the potential for high risk of harm that participants with Down syndrome are currently exposed to. Whilst registration does ensure visibility and compliance to a minimum standard of performance, it can only operate effectively if the mechanism to hold providers to account is also reformed in line with the new approach.
DSA would like to see that the NDIS Quality and Safeguards Commission is reformed in tandem with changes to the registration process. Such reforms should include increasing the capacity of the Commission to manage the increase in registrations, as well as to ensure that complaint and reporting mechanisms, and scrutiny of providers can operate in an effective way to proactively prevent harm to participants. Reform should also include the audit process for providers so that it operates effectively in terms of not only enforcement but also administration and clear expectations. There must be a strong and effective workforce attached to the Commission to deliver these outcomes.
DSA would also like the Taskforce to recommend that the new provider and worker registration model be applied to supports outside of the NDIS such as the Foundational Supports recommended by the NDIS Review which are currently being designed. It is critical that people with disability who receive supports outside of individual plans are also protected by a robust provider and worker registration system.
Increased regulation must be balanced with maintaining choice and control through considering participant experience People with disability must have choice and control over the supports they use, both inside and outside the NDIS. Whilst DSA supports a new approach to provider and worker registration, there is also some concern about the potential impact on choice and control of people with disability to choose what providers are used.
The Taskforce must ensure that in the design of the risk proportionate graduated approach, choice and control is not adversely impacted by increased regulation leading providers to leave the market or change the supports they provide.
DSA believes that in the design of the risk proportionate, graduated approach, the Taskforce should consider whether the proposed model with the four tiers of registration, and associated obligations, provide sufficient flexibility to accommodate an appropriate balance of regulation and choice and control. It may be that an additional tier, or differing obligations under tiers need to be included. Key areas that DSA would like the Taskforce to consider in this regard include:
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“Services for 1” models where staff are employed directly to support a person with disability;
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Sole traders/University students who often perform tasks such as support work part time and for a short period of time and therefore may be less willing to go through a registration process;
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Regional and remote communities where there is often already a limited supply of providers; and
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Workforces where supply is limited (such as some therapies and decision-making supports); Support and Education is needed for people with intellectual disability People with disability need to be able to access information and supports to engage with providers and understand the characteristics of a good quality service as well as their rights in respect of that service. The Taskforce should consider the provision of independent, peer led, accessible information and support as part of the transition to a new model.
DSA would also like to see a new approach also consider the ways in which people with intellectual disability are supported to ensure that the risk of influence or coercive control is reduced by providing support for complaints, assessments or consultation independently of the participants regular support providers.
Support is needed for providers to transition DSA would like to see the Taskforce include in its recommendations that there needs to be support for service providers to transition to the new model of registration. This support should include both financial support for the costs to transition to the new model, as well as training and information on the new model, why it is needed, and how it operates.
Existing systems and processes need to be leveraged to lessen burden of registration One of the key criticisms of the current registration process is the regulatory and administrative burden it puts on providers that is not proportionate to the complexity and risk of supports provided. DSA encourages the Taskforce to review and leverage complementary registration systems such as aged care or, in some cases, professional regulation, that could be recognised as part of this process to reduce duplication of compliance for providers.
Changes must be co-designed to build the trust of people with disability DSA welcomes the commitment of the Taskforce to co-design NDIS Reforms and emphasises the importance of involving people with intellectual disability in the co-design of the new registration system. People with disability need to know that a new system will result in a workable outcome, and there needs to be a development of trust in the NDIS and the Government, as both effective regulatory and administrative operators.