RE: Current Scheme Implementation and Forecasting for the NDIS

Dr Gareth Beal Proprietor, 3D Support

To Whom It May Concern:

RE: Current Scheme Implementation and Forecasting for the NDIS

3D Support is a sole-trading disability support provider in the NSW Central Coast area. I’ve worked in the sector since 2017, and currently serve as a member of the Central Coast Council’s Access and Inclusion Reference Group, which advises council on the design and implementation of its Disability Inclusion Action Plan. Having previously lodged a submission to the Joint Standing Committee’s Inquiry into Independent Assessments, I’m pleased to have been invited to do so again in relation to the current inquiry.

To keep this submission as brief as possible, I’d offer four suggestions that I believe are constructive, achievable, and relevant to C, E and F of the Terms of Reference. With regards to G, I’d only observe that most of my younger clients receive little to no funding for day-to-day supports, and/or respite for their parents/carers. The idea that such care is an ‘ordinary’ parental responsibility could itself be made the subject of an inquiry, because the resilience of carers is a valuable, under-appreciated resource that helps to ensure a financially sustainable NDIS.

Beyond that, my four suggestions are as follows:

• Dissolve the NDIA Board. From a Sydney Morning Herald article in July of this year: ’[…] one of the biggest ever Australian government programs is controlled by an agency that administers itself, designs much of its own policy, sets its own budget without serious central agency oversight, spends more money than the army, and operates with an extraordinary level of independence from the elected government and responsible minister.’1 Surely this situation is untenable? That the NDIA sets its own budget is an undeniable conflict of interest, as noted in the

• Productivity Commission’s Report of 2017. It may also explain how a projected NDIS budget blowout that same year, in reality turned out to be an underspend. This was followed by a $1.6 billion underspend in 2019. Is it unreasonable to ask whether the current, dire forecasts are any more reliable, when they aren’t even produced by Treasury?

2. Pursue and eliminate service-provider price gouging. Arguably, this begins by not encouraging such practices in the first place. Why, for example, is the rate for car expenses set at $0.72 per kilometre by the Australian Tax Office, but up to $0.85 per kilometre in the NDIS Pricing Arrangements and Price Limits 2021-22? Why does the NDIS offer a Temporary Transformation Payment (TTP), a provider surcharge set at 4.5% over current price limits, even to services that didn’t exist prior to the roll-out of the scheme? What precisely are such services transitioning from? Why is it that in August this year, The Saturday Paper reported that a cleaning company had charged an NDIS participant nearly $9000 for what would otherwise be an approx. $750 ‘deep-clean’ of their 150-square-metre home? Surely these sorts of expenditures should be considered and addressed before any cuts are made to participant support packages?

3. Scrap NDIS Provider Registration. In September 2020 the Sydney Morning Herald reported that, in the previous two years, the NDIS Quality and Safeguards Commission received some 8000 complaints, in response to which it banned one provider and 22 individuals, and issued a single fine. This from a $35 million-a-year agency, $1.5 million of which gets spent on travel expenses, and $2 million on executive salaries. Based on those numbers, it seems redundant to point out that this doesn’t represent a financially sustainable, or effective, resource.

Having made such a complaint against an NDIS registered provider, and having been drafted in by a previous employer to help them prepare for their Third Party Verification (TPV) Audit, I know that these measures don’t hold providers to a meaningfully higher standard. However, the very existence of NDIS registration

creates the impression of this. False assurances are dangerous. It might be that the point of NDIS registration is to generate money to help pay for the scheme, but this is at least partly offset by the higher prices such services charge, resulting in participants getting less for their money and requiring more funding to access basic levels of support. It also creates a two-tiered system within the scheme itself, and a schism between disability and mainstream services who might otherwise offer similar, less costly supports.

Most alarmingly, agency managed participants can only access NDIS registered providers. Where is their choice and control in this, and how is it supposed to drive market competition or mainstream participation? As a support worker, I’m often asked to help my clients research and price assistive technology related to their disability; for agency managed participants, there’s often one choice of supplier, which can have only one result. Going through my records, I found three items for which I obtained a quote from both mainstream and NDIS registered suppliers (prices rounded up to the nearest dollar):

                                 Recommended NDIS Registered  Mark-Up    Item                                                 Retail Price    Supplier Price    %
Empatica Embrace 2 Epilepsy Smart Watch   $334.00       $562.00         68%
Cobolt Speechmaster Talking Induction Hob  $150.00       $436.00         190%
 eSight 4 Low-Vision Digital Glasses         $7972.00      $10,000.00       25%

Again, these numbers speak for themselves.

4. Repeal s34(2) and adhere solely to s34(1) of the National Disability Insurance Scheme Act 2013. Having worked in legal publishing many years ago, I still have an appreciation for considered, well-drafted legislation. Section 34(1) of the NDIS Act, which defines a ‘reasonable and necessary’ support, is precisely this: comprehensive, challenging but fair. If a participant manages to address each of its six criteria with supporting evidence, no one needs to doubt that their requested funding is reasonable and necessary. This all goes out the window with s34(2), with its cloudy reference to other, overriding ‘matters’ that the CEO may apply to such decisions. Funding is refused for ‘ordinary living expenses’ for example, another amorphous idea, especially when such an exception could only be applied after s34(1) has been satisfied, i.e. the support is both reasonable and necessary, and unable to be supplied through other means. But something as ordinary as a gym membership, having been proven to be otherwise unattainable under s34(1), might save tax payers the greater cost of a participant’s ongoing

physiotherapy.

Likewise, according to a recent study, 1.3 million (predominantly low-income) Australian households aren’t connected to the internet, and 1 in 10 Australians don’t own a mobile phone.8 These things aren’t part of an ordinary life for them. But as an affordable source of assistive technology, smartphone apps have the potential to allow some NDIS participants to access the community without having to hire a support worker like me. Ten hours (or less) of my time would buy them such a phone, and from there it’s all savings.

Repealing s34(2) would also be a cost saver in that it would discourage the NDIA from entering into frivolous, agenda-driven arbitration. I’m reminded specifically of the case in May 2020, when the Federal Court of Australia ruled that an NDIS participant’s request for sex therapy was ‘reasonable and necessary’ as defined in S34(1).9 But as reported in The Guardian Australia, of the 3891 cases brought before the Australian Appeals Tribunal in 2019-2020, the NDIA hired private law firms to represent them in 1294 or one-third of these cases, for a total cost of $13.4 million. Of these, ’only 2% proceeded to a contested hearing and published decision.’10 That’s a lot of wasted money.

If funding decisions are made strictly on the basis of s34(1), and participants are provided with resources and other supports to allow them equal opportunity to make ‘reasonable and necessary’ requests, such decisions will be more consistent, fair, transparent and financially sustainable.

Thank you for taking the time to read and consider this submission.

Sincerely,