Minutes of the Independent Advisory Council to the NDIS
Meeting 7 — 19 March 1.30pm to 4.30pm, hosted on MS Teams
Members
- Ms Robyn Kruk AO (Principal Member)
- Ms Leah van Poppel (Deputy Chair)
- Ms Kerry Allan-Zinner
- Ms Sharon Boyce
- Ms Jennifer Cullen
- Mrs Judy Huett
- Dr Leighton Jay
- Ms Sylvana Mahmic
- Ms Tricia Malowney OAM
- Mr James Manders
- Ms Sam Paior
- Ms Liz Reid AM
- Mr Mark Tonga
Expert Adviser
Dr Ben Gauntlett, Disability Discrimination Commissioner
NDIA Representatives
- Mr Martin Hoffman, Chief Executive Officer
- Mr Oliver Bladek, Deputy CEO, Design, Digital and Strategy
- Ms Sarah Johnson, Scheme Actuary
- Dr Sam — po ™* General Manager, Policy, Advice and Research
- Mr Trent” ™ Branch Manager, Agency Policy
- Ms Fiona” ~~ ™
1. Principal Member’s Welcome and Open
1.1. Principal Member’s welcome
The Principal Member opened the meeting at 1.33pm.
The Principal Member acknowledged the Traditional Owners of the lands on which Members, Expert Adviser and attendees were meeting.
The Principal Member thanked Ms Allan-Zinner for her recent report following participation as Council representative at the Participant Reference Group, noting this report and minutes from the previous Scheme Reform subgroup are available in the Resource Centre on Diligent.
The Principal Member said Scheme sustainability is a high priority for the Agency and that Members would benefit from further information on this topic. Members agreed with the Principal Member’s recommendation to include sustainability impact statements in all future formal advice.
The Principal Member advised Reference Group induction meetings were held in February, noting the wealth of members’ experience and diverse representation of people with disability, families, researchers and sector experts.
The Principal Member raised ongoing issues with accessibility of Agency consultations, communications and papers (particularly for members with intellectual disability). The Principal Member noted Ms van Poppel’s recommendation that all future Agency engagement with Members with intellectual disability should provide documentation in Plain English (at a minimum) and ideally Easy Read. Council endorsed this recommendation and it was agreed that the Agency would be advised.
1.2. Minutes, matters arising and declarations of interest
Council noted the updated register of conflicts of interest circulated in advance of the meeting.
Council approved the minutes from the meeting held on 4 February 2021 and noted the matters arising.
1.3. CEO Update
Mr Hoffman noted the value of the Minister’s attendance and thanked members for their presentations, noting the constructive solutions provided by Council members for Independent Assessments and broader Scheme Reforms.
Mr Hoffman noted that sector engagement and discussions about the proposed Scheme Reforms are ongoing.
Council queried the proposed release of funds system for participant plans, noting restricting available funds for some participants may impact choice and control over their plans. Members also requested further data on fraud in relation to exhausted plan reviews.
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Scheme Reform
Mr Hoffman responded to Members’ questions. He noted there is significant pressure on the Agency with regards to Specialist Disability Accommodation (SDA) as it is the only option available in each state and territory for social housing. Council acknowledged this as a State issue, although reaffirmed the importance of SDA for participants to live an ordinary life.
ACTION 1 Question on Notice: Members asked for the Agency to:
Provide data on fraud in relation to exhausted plan reviews (ie how many participants are overspending their plans due to fraud and not a crisis) and any data on participant vs provider fraud
2.1. Scheme Reform Consultation
The Principal Member advised Council of the name change of this standing agenda item from ‘Independent Assessments’ to Scheme Reform, noting the breadth of the consultations proposed and underway.
Dr provided Council with an update on the public consultation work of the Agency, including:
- 769 total unique submissions received.
- NDIS participants (including their families and carers) were the largest audience to submit feedback, followed by advocacy and peak organisations, providers, allied health service organisations
- 200 engagement sessions were run across Australia, with 50 of those open to the public and 20 held in regional and remote communities.
- Overall sentiment towards the consultations papers were mixed, there were many concerns and significant negative feedback. Although some supported the logic of IAs, many raised concerns about the practicalities of implementation and alignment to the participant pathway. This is consistent with views raised by Council.
Dr confirmed the Agency is working hard to ensure all feedback is collated and fed into policy development, noting feedback on legislation is provided to Department of Social Services (DSS) for their consideration.
Dr presented the main themes from the feedback received. He noted many people recognise and support the need for a fair and equitable approach to determining access and eligibility. He also acknowledged that many people continue to raise concerns and fears about the changes and are uncertain about the long term implications.
Dr advised Members the next steps include:
- ‘You said, we heard’ reports will be available publicly by the end of March.
3. Minister for the NDIS
3.1. Discussion of Council and Ministerial priorities
Minister Robert joined the meeting at 1.38pm.
The Principal Member welcomed Minister Robert to the meeting and thanked him for taking the time to join the meeting. The Principal Member noted the concerns raised by and with Members in relation to the Minister’s commentary in recent radio interviews.
Minister Robert advised Council he is focused on Scheme Reforms to ensure future sustainability of the NDIS for all Australians. The Minister stressed that the NDIS is an Insurance Scheme, is underpinned by insurance principals and it is not a welfare system.
The following three items were presented to the Minister:
- Council’s formal advice on Local Area Coordination: The Minister supported Council’s advice, saying that he wants LACs to prioritise informal community supports for people with disability.
- Council’s draft formal advice on Participant Safety: The Minister said this advice is important for the NDIS, participants and the Disability Royal Commission. The Minister noted participant safety is a topic of discussion at the Disability Minister’s Meeting and would welcome Council’s draft advice in advance of receiving it formally. The Minister added work is currently underway on definitions of vulnerability and how to better connect with vulnerable participants.
- Council’s views on Scheme Reforms: The Minister recognised the issues raised on Scheme Reforms and appreciated that Council provided a number of practical ideas for solutions that could improve the perception and implementation of Scheme Reforms. The Minister requested a copy of these ideas.
Minister Robert thanked Council for its advice and ongoing support.
The Minister stated:
- that the Productivity Commission and Tune Review recommended these reforms to make the Scheme fairer and more equitable for all Australians, regardless of financial status.
- the NDIS has interface challenges with the criminal justice and child protection systems, and asked Council to keep him across any issues in these areas to work through solutions.
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Independent Advisory Council
mae nidis,
e the NDIS can be financially sustainable if the States and Territories also help all people with a disability get the mainstream supports they need.
The workforce continues to be an issue for the NDIS.
The Principal Member thanked the Council members who presented the reports to the Minister — Ms van Poppel, Dr Jay and Ms Paior and the support of Ms ™ 0° ==“ ™sees
ACTION 2: Council to provide to the Minister the following items:
- Speaker notes from each presentation
- Council’s draft advice on Participant Safety (prior to receiving the formal advice in June)
- Case studies on interface issues in relation to domestic violence, criminal justice, child protection services
4. Scheme Actuary
4.1. Quarterly Report Overview
Ms Johnson provided the Council with an overview of the recently released Quarterly Report for Q2.
Ms Johnson noted Scheme intake is not slowing down as projected. Substantial growth in average plan payments is putting significant pressure on the Agency and the sustainability of the Scheme. Members acknowledged the sustainability concerns and said they would be interested in receiving more advice on Scheme sustainability issues.
Council mentioned the increase in chronic health conditions and queried what the Agency is considering as a chronic health condition. Ms Johnson said there currently isn’t a specific definition, although generally high-prevalence lifestyle-associated conditions would be included.
Council raised a number of questions which Ms Johnson took on notice, including:
- Proportion of participants using less funding at plan review, and indication of outcomes if possible
- Break down of chronic health conditions gaining access to the NDIS
- Access decisions, reviews and outcomes by gender split (for adults)
- Any indication as to why the proportion of CALD participants in the Scheme increased in the last quarter
ACTION 3 Secretariat to arrange for Ms Johnson to present on Sustainability at a future meeting.
ACTION 4 Question on Notice - Members requested further detail on:
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5. Meeting close
5.1. Other Business
The Principal Member provided Members with an update on Council’s Roadshow to raise awareness of Council and their role within the NDIS and within the Agency. The Principal Member noted the Secretariat team aims to launch the Roadshow in late April and hopes it will:
- improve Agency staff understanding of Council’s role
- support the Agency to better engage with Council in any new policy or project work
The Principal Member noted Council became a partner of the Building Better Homes Campaign which aims to introduce a nation building code for all Australians. This aligns with Council’s submission to the National Disability Strategy Outcomes Frameworks which recommends increasing the supply of accessible housing.
5.2. Next Meeting
The next meeting is scheduled 21 April 2021 from 1.30pm-4.30pm.
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Attachments
6.1.ATTACHMENT A Sam
\speaker notes
Consultation closed 23 Feb
= What are we doing with the information? Service design / policy finalisation / leg = What happens next — exposure draft consult / publish papers you said we heard
Some of the stats:
- 769 total unique submission received. Of these 769, there were 450 responses to Access, 293 responses to Planning and 193 responses to ECEI.
- Some responses covered more than one of the papers, factoring this in there were 936 responses received altogether.
- Largest audience who submitted feedback was NDIS participants, their families and carers (230 submissions)
- Next largest audience: advocacy and peak organisations (198), providers (142), allied health service organisations (123).
- Other audiences included government and mainstream support.
= Engagement sessions to promote submissions to the papers:
- NDlAran over 200 specific sessions across Australia, 50 of which were open to the public. Over 1030 people attended these sessions.
- 20 specific session were held for regional and remote communities.
- 112 discussions were held with sector representatives and state and territory governments.
- 14 targeted focus groups and workshops were held over a 3 month period.
= Overall sentiment towards the papers:
- Very mixed — a lot of concerns and significant negative feedback
- Some supported the logic of IAs but had uncertainties about practicalities of implementation and alignment to participant pathway. Planning paper had support for plan flexibility, with concerns regarding reviews and appeals processes.
Consultation themes
e While many people recognise and support the need for a more equitable approach to determining access and edibility to the NDIS, we also heard concerns as well as uncertainty that these changes raise.
e Respondents indicated concerns about the following topics: On Access:
e Participant experience
o IA process will trigger additional stress and anxiety for people applying or already in the Scheme. o Preference to do assessments in a variety of ways — home, telehealth, clinic/office.
Independent Advisory Council
Other parties should be involved in the assessment if requested by the person with disability — family and friends, providers and other professionals known to the family.
Need for informed consent — participants understand the process, consents to their information being used, and knows what the information will be used for and who will have access to it.
Assessment tools
Time allowed to complete IAs won’t provide a true picture of a person’s disability or complexity of an individual situation.
Reliability of assessment tools in assessing disability, including in culturally diverse communities.
Potential for inaccurate reports on functional capacity from people who have paid for practitioner advice/reports and received appropriate plans and budgets
Assessors
Adequate training for assessors to ensure appropriate expertise and experience to conduct assessments, including knowledge disability types.
Strong preference for treating health professionals to complete assessments instead of an unfamiliar, independent assessor.
Cultural competency of assessors and cultural appropriateness of assessments for people from diverse communities.
And concerns regarding the impact of these measures on the allied health provider market, where participants and prospective participants already face difficulties in finding treating health professionals with experience and skills to work with people with disability.
Availability of assessors in rural and remote communities.
Exemptions, reviews and appeals
Questions about what happens when someone disagrees with the assessment or outcome.
Preference for results of IAs to be a reviewable decision, need for clear appeals and/or complaints process and transparency about how decisions on exemptions to IAs will be made.
Need for strong safeguards.
Loss of support and funding
Potential reduction in the number of people supported by the NDIS.
Potential reduction in the amount of funding people receive.
Suspicion around reasons behind introduction of IAs
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On planning:
We heard clearly that people want the NDIS to be easier, they can see the inequity and inconsistency in our current practices, and want their experiences with the NDIS to be improved. But the perceived impact of these changes on people with disability, NDIS participants, their families and carers has caused concern.
Personalised budgets
- Support for IAs in access process — less so in planning
- Lack of support/understanding for how IAs can be used to deliver individualised planning — further information required to help understand.
- Although assessors will not make recommendations on supports or services, concern and question of appropriateness of using IAs to inform funding amounts.
- IAs will not accurately capture a full picture of a person’s life, aspirations and support needs, which could result in insufficient plan funding.
- Ability to ensure IA results are accurate before they are used to develop plans.
- A possible loss of choice and control in receiving a pre-determined budget without the ability to change funding allocations.
Planning experience
- Uncertainty about the function of a planning meeting when plan budgets have been informed by IA results.
- Ability to discuss individual circumstances and needs before a plan is drafted, and impacts on the adequacy of plan funding and ability to exercise choice and control.
- Role of goals in a participant’s budget and plan, the ability for plans to be tailored to support individual goals and aspirations, and the cultural appropriateness and relevance of goal setting.
Plan implementation
- Support for flexible budgets, plan flexibility and simpler budget categories
- Comfortable with some budgets being fixed, as long as participants could ‘top up’ fixed budgets with flexible funds if required.
- Suggestions and recommendations for what types of funding should fall into a fixed budget (high cost assistive technology and home mods)
- Longer term plans welcomed but concerns about implementation of personalised plans.
- Concern proposed approach to the release of funds will limit choice and control on spending and limit ability to save for planned or unexpected events — counterproductive to flexibility. Seen as backwards step
- Need for participants to be supported to use and get the most out of flexible budgets, as it is a significant change.
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So next steps:
- Publish reports
- Continue to work with the Council and IA Ref Group on specific topics, including those that have been identified by Council for discussion
- Specific further work planned with Sarah on the PBT build
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