NDIA Accountability Project

Services to people with disabilities seeking review of decisions of the National Disability Insurance Agency (NDIA)

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National Legal Aid

30 June 2023

Joint Standing Committee on the National Disability Insurance Scheme PO Box 6100

Parliament House

Canberra ACT 2600

via email: ndis.joint@aph.gov.au

Dear Committee Members,

Joint Standing Committee on the National Disability Insurance Scheme - General Issues Inquiry

National Legal Aid (NLA) thanks the Joint Standing Committee on the National Disability Insurance Scheme for the opportunity to make a submission to the General Issues Inquiry.

NLA brings together the practice experience of eight Australian state and territory legal aid commissions (LACs). Each LAC provides a wide range of services to people with disabilities, including legal advice, task assistance, legal advocacy and representation for people with disabilities seeking review of decisions of the National Disability Insurance Agency (NDIA) through internal review processes and in the Administrative Appeals Tribunal (AAT), and services to people with disability through Your Story Disability Legal Support supporting the Disability Royal Commission.

Our enclosed submission builds on our previous collective advocacy in relation to NDIS issues, including to this Committee, to raise issues that we continue to see affecting participants and prospective participants in the NDIS and make suggestions for improvements to the implementation and administration of the Scheme.

Thank you for the opportunity to provide feedback to this review. We would welcome the opportunity to discuss this submission with you further.

Yours faithfully

John Boersig Chair, National Legal Aid

National Legal Aid Secretariat nla@legalaid.tas.gov.au | 0362363813 = GPO Box 1422 Hobart TAS 7001

NDIS General Issues Inquiry

Submission to the Joint Standing Committee on the NDIS

30 June 2023

National Legal Aid acknowledges Traditional Owners of Country throughout Australia and recognises the continuing connection to lands, waters and communities. We pay our respect to Aboriginal and Torres Strait Islander cultures; and to Elders past and present.

National Legal Aid Secretariat nla@legalaid.tas.gov.au | 0362363813 | GPO Box 1422 Hobart TAS 7001

Contents

Contents ……………………………………………………………………………………………………………………………… 3 Executive Summary ……………………………………………………………………………………………………………….. 4 Previous submissions on the operation of the NDIS …………………………………………………………………….. 5 Recommendations ………………………………………………………………………………………………………………… 6 Access to the NDIS ………………………………………………………………………………………………………………… 8 Improving access to the NDIS………………………………………………………………………………………………………… 8 Practical ways to improve access …………………………………………………………………………………………………… 8 Psychosocial disabilities ……………………………………………………………………………………………………………….. 9 Prospective participants in custody ……………………………………………………………………………………. 10 Improving the NDIS market …………………………………………………………………………………………………… 11 Market failure and thin markets ………………………………………………………………………………………………….. 11 Better consumer protections for NDIS participants ……………………………………………………………………….. 13 Improving decision making …………………………………………………………………………………………………..– 15 Clear, reasoned decisions……………………………………………………………………………………………………………. 15 Decisions and systems that reflect the law ……………………………………………………………………………………. 16 Providing support pending review of a negative decision ……………………………………………………………….. 17 Appropriate framework for debt waivers and write-offs ………………………………………………………………… 18 Participating fairly in reviews of NDIS decisions …………………………………………………………………………….. 18 Improving outcomes for participants with complex needs and improving transition supports ……………. 20 Transition supports ………………………………………………………………………………………………………………… 20 Gaps between systems ………………………………………………………………………………………………………………. 21 The health system …………………………………………………………………………………………………………………– 22 The mental health system ………………………………………………………………………………………………………. 22 The justice system………………………………………………………………………………………………………………..— 22 Integrated service response …………………………………………………………………………………………………..– 22 Increased regulation of supports linked to housing ………………………………………………………………………– 23 A National Framework for the oversight and use of restrictive practices ………………………………………….. 24 Conclusion ……………………………………………………………………………………… Error! Bookmark not defined.

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Executive Summary

National Legal Aid (NLA) welcomes the opportunity to make a submission to the Joint Standing Committee on the National Disability Insurance Scheme’s General Issues Inquiry for 2023.

Legal aid commissions (LACs) are collectively the largest provider of legal services to people with disability across Australia. LACs provide specialist legal advice and legal representation. LAC services are delivered at courts and tribunals and from head and branch offices across the nation, and by outreach including at correctional facilities, health facilities, community-based organisations and through health justice partnerships.

Legal Aid services are provided to the most disadvantaged people in Australia – of the 150,000 Grants of Legal Aid for ongoing legal representation in 2021/2022, 100% of clients were financially disadvantaged, 20% were Aboriginal or Torres Strait Islander (61% Northern Territory Legal Aid and 32% Legal Aid Western Australia) and a significant proportion of those accessing family and civil law services were women and children.1 25% of clients receiving intensive legal assistance self-identified as a person with a disability.2

LACs receive funding from the Department of Social Services to provide advice, minor assistance and representation to applicants in NDIS reviews in the Administrative Appeals Tribunal (AAT). Nationally, in 2021-2022, LACs provided over 1,500 legal advice sessions, over 1,200 instances of assistance and over 370 grants of legal aid for representation for NDIS reviews.

Our practice experience allows us to observe issues with the implementation, performance and administration of the NDIS and how those issue affect people with disability who are seeking to access disability supports for their independence, safety and wellbeing. Our recommendations are suggestions for improvement to the NDIS and to the process of seeking reviews of decisions of the NDIA.

1 National Legal Aid Statistics Reports. 2 NLA, Legal Aid Commissions’ Disability and Intersectional Service Data 2018-19 to 2020-21 (15 October 2021). The data is an underrepresentation due to limitations in data collection and reliance on self-reporting.

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Previous submissions on the operation of the NDIS Our previous submissions about the NDIS include:

o Submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability - NLA submission to the Royal Commission, November 2022.

o Putting people first - Removing barriers for people with disability to access NDIS supports - NLA submission to the Review of the NDIS Act and the new NDIS Participant Service Guarantee, November 2019.

o Exposure Draft - National Disability Insurance Scheme Amendment (Participant Service Guarantee and Other Measures) Bill 2021 - NLA submission to the Department of Social Services, October 2021.

o Realising choice and control through supported decision-making - Victoria Legal Aid submission on the NDIS Support for Decision Making Consultation, September 2021.

o Protecting people with disability in the forensic and criminal justice systems - Victoria Legal Aid submission to the Inquiry into the National Disability Insurance Scheme Quality and Safeguards Commission, June 2021.

o NDIS Consultation Paper: Planning Policy for Personalised Budgets and Plan Flexibility - NLA submission to the National Disability Insurance Scheme, February 2021.

o NDIS Consultation Paper: Access and Eligibility Policy with independent assessments – NLA submission to the National Disability Insurance Scheme, February 2021.

o NDIS planning - NLA submission to Joint Standing Committee on the National Disability Insurance Scheme, September 2019.

o Inquiry into market readiness for provision of services under the NDIS - Legal Aid NSW submission to the Joint Standing Committee on the National Disability Insurance Scheme, March 2018.

o NDIS Thin Markets Project - Victoria Legal Aid submission to Department of Social Services and the National Disability Insurance Agency’s NDIS Thin Markets Project, June 2019.

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Recommendations

Our recommendations are:

  1. Improving access to the NDIS The National Disability Insurance Agency (NDIA) must better assist people to access the NDIS, particularly prospective participants in rural, regional and remote areas, from financially disadvantaged backgrounds, prospective participants from First Nations and culturally and linguistically diverse (CALD) backgrounds, prospective participants in custody and with psychosocial disabilities.

This should include:

  • Improving forms and guides provided to health and allied health professionals.
  • Providing greater assistance to health and allied health professionals about the requirements to access the NDIS.
  • Providing financial assistance to prospective participants to help them supply the evidence required, using the power in s 6 National Disability Insurance Scheme Act 2013 (NDIS Act).
  • Requesting further information from participants at an earlier stage, rather than refusing applications for insufficient evidence.
  • Providing practical assistance to prospective participants to help them supply the evidence required, including by facilitating video assessment of prospective participants in regional, rural and remote areas.
  • Promoting consistent, flexible decision making that reflects the substance of the information provided to support an access request and does not rely on rigid adherence to terminology.
  • Providing greater support to people in custody to apply for the NDIS, and to access the assessments required to establish eligibility for the NDIS.
  • Better supporting prospective participants from CALD backgrounds and First Nations applicants, including through increasing engagement with First Nations and CALD communities and representative organisations.
  1. Improving the NDIS market The NDIA should improve oversight of the NDIS market and strengthen mechanisms to address gaps between the NDIS and mainstream services.

This should include:

  • A service safety net that is responsive and accessible, and under which the NDIA intervenes if the unwillingness or unavailability of market providers leaves participants without supports.
  • Choice and control for people in rural and regional communities and access to culturally safe services, including training, engagement and capacity-building for local services.
  • Using pricing as a lever – ensuring pricing reflects the costs of delivering supports to people with high and complex needs, as well as the costs of delivering supports in regional, rural and remote areas.
  • Making decisions that reflect the market reality in a participant’s area.
  • Introducing better consumer protections for NDIS participants, including a purpose-built consumer dispute resolution body.

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  1. Improving decision making The NDIA should improve its decision making by:
  • Providing clear, reasoned decisions in plain language.
  • Providing draft plans and reasons for decision when making a section 33(2) NDIS Act decision.
  • Clearly indicating when an NDIS plan has been varied and when it has been replaced.
  • Updating its computer system to allow it to vary and backdate plans, consistent with the law.
  • Removing reference in systems, forms and decisions to a ‘primary disability’.
  • Continuing supports at the same level pending review of an adverse decision (including revocation, removal or reduction of a previously funded support).
  • Publishing clear guidance around debt waiver and debt-write off options and amending section 195 of the NDIS Act to allow consideration of the impact of a person’s disability when determining whether a debt should be waived.
  • Participating fairly, and in accordance with model litigant policy, in reviews of decisions, including adhering to orders, directions and decisions made by the AAT.
  • Updating operational guidelines and internal decision-making guides in response to decisions by the AAT as appropriate.
  1. Improving outcomes for participants with complex needs and improving transition supports The Commonwealth Government and the NDIA should:
  • Improve access to transition supports for people leaving custody.
  • Review the descriptions of the responsibilities of the NDIS and other service systems to ensure that relative responsibilities are clear and participants are not left in the gaps between systems.
  • Introduce greater protections for supports linked to housing.
  • Work with the Quality and Safeguards Commission and state and territory governments to introduce a national framework for the oversight and use of restrictive practices.

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Access to the NDIS

Improving access to the NDIS

There are now almost 600,000 participants on the NDIS.3

Although there have been improvements in the process of applying for access to the NDIS, our clients continue to experience barriers, technological, practical and financial, to accessing the NDIS. Those barriers are greater for prospective participants in rural, regional and remote areas, for First Nations people, for prospective participants from culturally and linguistically diverse backgrounds, for people from financially disadvantaged backgrounds and for prospective participants with psychosocial disabilities.

The NDIS Act, reflecting the Convention on the Rights of Persons with Disability (CRPD), creates a broad obligation on the NDIA to communicate in language and terms that are appropriate for those receiving the information.4 NLA supports the initiatives of the NDIA to improve its engagement with First Nations peoples and become more flexible, accessible, and culturally safe, including the creation of a First Nations advisory group and engagement with the First Peoples’ Disability Network.5

Establishing eligibility for the NDIS is often technical and often relies on prospective participants and their practitioners understanding NDIS terminology and having the resources to provide extensive information. It can be difficult for prospective participants to meet the NDIA’s requests for specialist reports, particularly in rural and regional areas.

The language of the NDIS Act, consistent with the CRPD, is of disability and impairment. We continue to see access applications refused where treating health professionals indicate that the prospective participant’s impairments are permanent and cause them substantially reduced functional capacity. Often, it’s clear the prospective participant meets the access requirements, but the issue is terminology or wording, or an incorrect application of the meaning of permanency.

It is important that decision makers have sufficient knowledge and training to appropriately assess applications for access. Requests for additional information should be limited to where information supplied is contradictory or ambiguous. The NDIA should actively assist prospective participants to demonstrate their eligibility for the NDIS.

Practical ways to improve access

Some measures we recommend the NDIA take to improve access to the Scheme include:

  • Providing information booklets, including in a wide variety of languages, explaining the eligibility criteria to prospective participants and their treating health practitioners,
  • Supporting participants to complete the forms and obtain requested supporting information (including through additional funding for Local Area Coordinators),
  • Online and telephone support for people to speak to a representative of the NDIA throughout

3 National Disability Insurance Scheme website accessed 26/06/23 https://data.ndis.gov.au/ 4 National Disability Insurance Scheme Act 2013 (Cth) s 7. This is consistent with Articles 9 and 21 of the Convention on the Rights of Persons with Disabilities, opened for signature 30 March 2007, 2515 UNTS 3 (entered into force 3 May 2008). 5 First Nations Strategy | NDIS

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the access application process, and

  • Consulting with the prospective participant directly, or with their family members or treating practitioners (with consent), to better understand the impact of a person’s impairments.

The NDIA should use its powers in s 6 of the NDIS Act to provide support and assistance, including financial assistance, to prospective participants to assist them to obtain necessary reports in the early stages of assessing eligibility. It should also appropriately use its powers in s 26 of the NDIS Act to request that prospective participants provide further information to support their access request at an early stage.

In our work, we often see that in early stages of the decision-making process, the NDIA has been unwilling to fund reports for people who are unable to pay for reports themselves. In the AAT, the NDIA is more willing to fund reports, but this requires the prospective participant to have advanced through several stages of review. We have also seen the NDIA request the AAT issue summonses for information that it could have requested at a much earlier stage. This imposes an increased burden, including an administrative burden, on the resources of other agencies, such as state health services, therapists, disability advocates, the AAT, and legal aid commissions.

Applications for access should not be refused because a decision maker determines there is insufficient evidence about a person’s impairments, without first having exercised its powers to request further information, and support participants to provide information. Instead, decision makers should work with participants to use the powers in s 6 of the NDIS Act to supply the information needed so that an informed decision is made.

Psychosocial disabilities

Previous reviews of the NDIS, particularly the Tune Review, have highlighted the difficulties for people seeking access for psychosocial disabilities. One of the reasons for the difficulty is that best practice in psychosocial care emphasises a person’s strengths and abilities, and focuses on recovery and improved wellbeing,6 which does not always square well with the requirement that there are “no known, available and appropriate evidence-based clinical, medical or other treatments that would be likely to remedy the impairment”.7

In July 2022, some positive changes to the access requirements were introduced, including the replacement of the term “psychiatric condition” with “psychosocial disability” and the express recognition that some permanent impairments can fluctuate in severity, but still meet the access requirements.8

Unfortunately, we continue to see prospective participants with psychosocial disabilities having their access applications refused despite having long-standing, debilitating psychosocial impairments. This is often because decision makers don’t differentiate between ongoing consultation with a psychologist or psychiatrist, which can be essential to mental health recovery, and treatment likely to remedy an impairment.

6 David Tune AO PSM, Review of the National Disability Insurance Scheme Act 2013, Removing Red Tape and Implementing the Participant Service Guarantee, December 2019, page 74; NDIA, ‘Mental health and the NDIS | NDIS’ (Web Page, current at 18 May 2022 < https://www.ndis.gov.au/understanding/how-ndis-works/mental-health-and-ndis>. 7 National Disability Insurance Scheme Act 2013 s 24 and National Disability Insurance Scheme (Becoming a Participant) Rules 2016 r 5.4. 8 National Disability Insurance Scheme Amendment (Participant Service Guarantee and Other Measures) Act 2022 (Cth) Sch 2 clause 16-23.

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Participants with psychosocial disability can have difficulty engaging consistently with treatment because of the nature of their impairments. The NDIA continues to rely on this as a basis for finding that impairments are not permanent, rather than considering whether there are practical barriers affecting the availability of the treatment for the prospective participant in their personal circumstances.9

The NDIA has developed a number of resources to assist prospective participants with psychosocial disabilities and their doctors to present information about the impact of their disabilities. We consider that further support and training is needed to ensure that people with psychosocial disabilities can access the NDIS while pursuing mental health recovery. NDIA decision makers should not refuse access to prospective participants on the basis that they continue to consult a psychologist or psychiatrist, but should appropriately and thoroughly consider the information available about the prospective participant’s treatment history, the purpose of any recommended treatment and whether the prospective participant’s impairment is enduring.10

Prospective participants in custody

There is a high level of unmet need for disability support in prisons, and our clients face significant barriers accessing the NDIS while in custody. Advocacy and legal services are difficult to access, providers may be unwilling to assess a person in custody, and assessments are difficult to facilitate. It can be difficult to assess a person’s functional capacity while they are detained in prison, which can limit the information the NDIA has to make access decisions. These issues create difficulty and delays in accessing the NDIS. The effect is to impede transition planning and unnecessarily prolong the detention of people with disability.

There has been some positive feedback about the NDIA’s Justice Liaison Officer roles specifically assigned to youth justice, particularly with regard to the provision of additional resources, connection and facilitation of access to the NDIS that would otherwise be difficult to navigate. Additional resources to promote, enhance, and expand Justice Liaison Officer roles in youth justice settings could better support young people to access the NDIS and disability supports.

The NDIA should ensure that all eligible people have access to the NDIS while in custody, by supporting people in custody to access the NDIS, ideally at intake, and with an emphasis on ensuring that supports are in place prior to determination about parole and release. This would support rehabilitation and better address the needs of prisoners with disabilities, including children.

Dan’s story: limited access to Fetal Alcohol Spectrum Disorder (FASD) assessment while in custody11 Dan is a 16-year-old First Nations person with a mild cognitive disability who has had frequent interactions with the criminal justice system which has seen him in and out of custody. Dan’s support workers suspected that he has FASD. During the brief periods where Dan was out of custody, his supports were unable to contact him to arrange the FASD assessment. With Dan spending significant periods of time in custody, the support workers attempted to make use of the

9 See National Disability Insurance Agency v Davis [2022] FCA 1002 at [138]-[140]. 10 See National Disability Insurance Agency v Davis [2022] FCA 1002 at [76]-[100]. 11 Not his real name. This case study also appears in Submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability – National Legal Aid submission to the Royal Commission, November 2022.

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opportunity to arrange a FASD assessment to take place in juvenile detention. However, the assessment was unable to be facilitated. Without the assessment, Dan is unable to access NDIS supports necessary to break the cycle of further detention. An assessment and diagnosis would assist caregivers, educators and authorities better understand and respond to Dan’s behaviour and assist to provide better supports for Dan as he transitions to adulthood.

Recommendation One: Improving access to the NDIS The NDIA must better assist people to access the NDIS, particularly prospective participants in rural, regional and remote areas, from financially disadvantaged backgrounds, prospective participants from First Nations and/or CALD backgrounds, prospective participants in custody and with psychosocial disabilities.

This should include:

  • Improving forms and guides provided to health and allied health professionals.
  • Providing greater assistance to health and allied health professionals about the requirements to access the NDIS.
  • Providing financial assistance to prospective participants to help them supply the evidence required, using the power in s 6 National Disability Insurance Scheme Act 2013 (NDIS Act).
  • Requesting further information from participants at an earlier stage, rather than refusing applications for insufficient evidence.
  • Providing practical assistance to prospective participants to help them supply the evidence required, including by facilitating video assessment of prospective participants in regional, rural and remote areas.
  • Promoting consistent, flexible decision making that reflects the substance of the information provided to support an access request, and does not rely on rigid adherence to terminology.
  • Providing greater support to people in custody to apply for the NDIS, and to access the assessments required to establish eligibility for the NDIS.
  • Better supporting prospective participants from CALD backgrounds and First Nations applicants, including through increasing engagement with First Nations and CALD communities and representative organisations.

Improving the NDIS market

Market failure and thin markets

Market failure or ‘thin markets’ is a key reason that the NDIS is not yet living up to its purpose of giving choice and control to Australians with disability. We consider that the NDIA should do more to intervene in the market and ensure a safety net for participants who cannot access the supports they need.

LACs have seen service providers withdraw services from, or decline to consider providing services to, people with complex support needs and challenging behaviours, especially those involved in the criminal justice system. Where a person with complex support needs is in custody, it can be

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even more difficult for them to purchase the supports they need in a thin market. Some LACs have assisted clients with disability, who remain in custody because they have not been able to initiate assistance through the NDIS or access the support covered by their NDIS plans.12

People in regional, rural and remote areas experience significant market failures due to the limited availability of local services, particularly where specialist support is required. The Northern Territory Legal Aid Commission has assisted young people detained in the Alice Springs Youth Detention Centre and Don Dale Youth Detention Centre with their NDIS claims. Significant difficulties in gaining access to the necessary specialist assessment services while in custody caused lengthy delays in progressing their applications. The lack of available specialised support providers in the area made implementing plans practically impossible.

Urgent work is required to address the gaps between the NDIS and mainstream services. There is a need for a service safety net in urgent cases where market failure leads to people with complex needs entering the criminal justice system. There is also a need to ensure appropriate therapeutic disability supports are available while in custody and reduce delays in providing pathways out of custody for people with disability. Furthermore, there is a clear need for stronger NDIS market oversight, including by monitoring changes in the NDIS market which may indicate emerging risk, and monitoring and mitigating the risk of unplanned service withdrawal. We encourage the examination of all potential issues including, and beyond, geography and pricing in identifying why the market is not stepping in to meet the needs of all people with disability.

NDIA decision making must also take into account the markets in which participants are purchasing supports and fund a higher level of support if necessary to ensure that a participant gets the support they need. We have seen decisions where the NDIA has determined a particular support, or level of support, is reasonable and necessary for a participant even though the support is not available in the area where the participant lives. This is particularly an issue in the Specialist Disability Accommodation (SDA) market, where certain building types or design categories are not available, and in Supported Independent Living (SIL) markets, where supports are not available to the person at the ratio approved. In these cases, we consider that the NDIA should fund a higher level of support to ensure that the participant can actually access the support.

Jade’s Story: Absence of NDIS service providers contributes to entry to the justice system13 Jade is a young child who was assisted by NT Legal Aid in proceedings before the AAT. Jade lives in an extremely remote area in the Northern Territory and has significant disability support needs. Due to there being limited service providers in the region, the allocated funding in Jade’s first NDIS plan was not fully utilised. On this basis, the funding approved in Jade’s subsequent plans was reduced significantly, leading to the cessation of necessary behavioural supports. Without these supports, Jade had encounters with the criminal justice system. While NT Legal Aid’s advocacy led to an overall increase in funding for Jade, it was not to the level provided in Jade’s first plan, or to the level arguably required to provide adequate support. A thin (or in this case, absent) market had already led to poor legal outcomes for a child.

12 In a submission to the NDIS Thin Markets Project in June 2019, Victoria Legal Aid, Northern Territory Legal Aid and Legal Aid Queensland shared the stories of clients who spent protracted periods in jail or a mental health unit: Victoria Legal Aid, Ten Stories of NDIS ‘Thin Markets’: Reforming the NDIS to Meet People’s Needs, (Submission to the Department of Social Services and the National Disability Insurance Agency’s NDIS ‘Thin Markets’ Project, June 2019). 13 Not her real name. This case study also appears in National Legal Aid Submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, November 2022.

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Better consumer protections for NDIS participants

LACs provide assistance and representation to consumers under consumer laws. Through that work, we have seen an increasing number of NDIS participants and their carers being pursued personally by NDIS service providers for debts arising from insufficient funds in NDIS plans.

Plan managers, allied health professionals and support coordinators sometimes provide advice or recommendations to NDIS participants about engaging in services that are not included in a plan, or that cost more than the amount included in a plan.

We have seen NDIS participants and their carers receive letters from debt collectors on behalf of NDIS service providers and face litigation before tribunals and courts. In most cases these situations involve an issue with the plan funding as well as a consumer issue – that is, there is a support that is needed, but not funded, under the NDIS plan about which the participant can seek review. Courts and Tribunals in consumer matters cannot consider or order that the NDIA provide additional funding for amounts outstanding to a provider and can only order against a participant or carer personally.

Margaret’s Story: carer pursued for debts in court14 Margaret was a carer for her adult son who is a NDIS participant. She lived in social housing. Her son did not have capacity to make decisions for himself, and Margaret was his financial manager, guardian and NDIS nominee. Margaret engaged a NDIS provider, who was a sole trader providing essential services like dressing and showering her son. All agreements were oral. There was a dispute about payment rates, and the NDIS money ran out early. Margaret believes this happened because the provider over- charged. Margaret and the NDIS provider tried to get help from the plan manager and the NDIA but were not successful. Soon after, Margaret discovered that over $15,000 had been removed from her bank account under a garnishee order. The provider had served a statement of claim but had an incorrect address, so the provider was able to obtain a default judgment and garnishee order without Margaret knowing anything about the matter until her bank account was garnisheed. The money was her life savings and she needed it for another child with a disability.

With help from Legal Aid NSW and a pro bono solicitor, Margaret was successful in getting the NDIA to review her son’s plan and include the funding needed to pay for the services and in getting the default judgment set aside.

Margaret’s situation was made more difficult because there was no one forum where she could go to resolve her dispute. The NDIS Quality and Safeguards Commission can investigate complaints against providers, state courts and tribunals can adjudicate and enforce outcomes in consumer disputes and issues with NDIS funding are reviewed through the AAT.

We recommend that there be a specific dispute resolution forum created with powers to determine consumer disputes that arise in the course of providing NDIS supports.15 The forum,

14 Not her real name. This case study also appears in National Legal Aid Submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, November 2022. 15 Legal Aid Queensland does not support this recommendation.

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which could be overseen by the NDIS Quality and Safeguards Commission, should be able to convene dispute resolution processes that involve the participant, their carers, the provider, any support coordinator or plan manager involved and the NDIA.

We recommend that the forum work similarly to the Australian Financial Complaints Authority (AFCA). AFCA provides free, independent dispute resolution for financial complaints. When a consumer lodges a complaint with AFCA prior to a judgment being entered, court proceedings are stayed to facilitate the dispute resolution process. Decisions of AFCA are binding on lenders.

A specialised NDIS consumer body could work similarly by providing a robust and binding mediation process involving all affected parties and staying court action until a result is reached. An agreement to participate in the body and accept its recommendations could be part of the NDIS Code of Conduct which sets out the expectations for conduct of NDIS providers.

The NDIA should be required to be present in dispute resolution. This would allow for decisions to be made immediately to increase supports to cover shortfalls and avoid costly and time- consuming court processes for pursuing debt. While it may not always be that the NDIA considers it appropriate to increase funding in these circumstances, a body able to adjudicate over NDIS funding related disputes would:

  • Allow for disputes that involve NDIS funding related issues and consumer issues to be resolved in one forum,
  • Decrease the administrative burden on participants, the NDIA and providers, and
  • Reduce the likelihood that participants and their families are unfairly pursued for debts.

Recommendation 2: Improving the NDIS market The NDIA should improve oversight of the NDIS market and strengthen mechanisms to address gaps between the NDIS and mainstream services.

This should include:

  • A service safety net that is responsive and accessible, and under which the NDIA intervenes if the unwillingness or unavailability of market providers leaves participants without supports.
  • Choice and control for people in rural and regional communities and access to culturally safe services, including training, engagement and capacity-building for local services.
  • Using pricing as a lever – ensuring pricing reflects the costs of delivering supports to people with high and complex needs, as well as the costs of delivering supports in regional, rural and remote areas.
  • Making decisions that reflect the market reality in a participant’s area.
  • Introducing better consumer protections for NDIS participants, including a purpose-built consumer dispute resolution body.

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Improving decision making

Clear, reasoned decisions

Much of our work with NDIS participants involves providing advice and assistance to participants and prospective participants in relation to NDIS decisions. There are still significant issues with the decisions the NDIA makes, including:

  • Review decisions that are standard form, with reasons that do not engage with the individual participant’s circumstances or evidence.
  • No reasons provided when the NDIA approves a statement of participant supports for a participant, leaving no way to discern why certain supports have been excluded, or in some cases, no clear way to know what has been funded. Plans themselves providing very limited detail about what is included and how participants are permitted to use their funds.
  • Limited use of draft plans, which were proposed to allow participants to see a proposed plan and raise any issues before the plan is approved.
  • When a participant receives a plan, no way to establish whether it’s a variation to a plan or a new decision to approve a statement of participant supports.
  • Review decisions that exclude certain supports on the basis of a general exclusion,16 and which do not set out whether the reasonable and necessary criteria are met.

Clearer, well explained decisions help participants to understand what has been funded for them and why and help to reduce unnecessary reviews. Clear decisions about what is funded are especially important considering that the NDIA has a power to recover NDIS amounts from a participant not spent in accordance with a plan.

Review decisions could be improved by:

  • Requiring a reviewer to communicate with the participant prior to completing the review,
  • Making it mandatory for a reviewer to consider the powers available under the NDIS Act, including s 6 NDIS Act, to provide support and assistance to participants in relation to doing things under the Act, and s 36 NDIS Act, to request information at an earlier stage, and
  • More clearly directing reviewers to consider the effectiveness and operation of previous plans (including any market reasons why supports might not have been used) when making planning decisions.

If the reviewer is not satisfied that there is sufficient evidence for a support, they should support the participant, including financially, to obtain the required evidence.

Case study: The need for strengthened internal review process for NDIS matters17 A recent client of Legal Aid Western Australia had asked for new supports to be funded for their daughter, who has a disability that requires a number of different supports, during a planning review. The resulting plan remained at almost exactly the same level, so they applied for internal review and provided further evidence about why they needed the requested new supports.

16 National Disability Insurance Scheme (Supports for Participants) Rules 2013, r 5.1. 17 Name withheld. This case study also appears in NLA’s submission Administrative Review Reform: Designing a new federal administrative review body that is user focused, efficient, accessible, independent and fair, 12 May 2023.

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When they received the internal review decision, it stated that they were already funded for many of the supports they were requesting in the review. At the AAT, they learned that the plan funding remained at a similar level because, although the new supports had been funded, the participant’s support worker funding had been cut to a lower support ratio. This information was not communicated to Legal Aid WA’s client at any point in the internal review process, and the NDIA had never requested or considered evidence about the appropriate ratio of support until the matter was already in external review at the AAT.

Decisions and systems that reflect the law

NDIA decisions are governed by the NDIS Act, which sets out broadly the principles and considerations for decisions under the Scheme. The NDIS Act is supplemented by Operational Guidelines and policy documents which assist the NDIA to make decisions. Guidelines are to be followed to the extent that they are consistent with the law.

Unfortunately, LACs see practices and decisions of the NDIA that do not reflect the law.

a) Backdating plans

A review of the decision to approve the statement of a participant supports, particularly if it advances to external review by the AAT, can take months, or years.

It is not uncommon for participants, out of necessity, to pay for supports themselves during the process, or to accrue debts to providers for providing the support they need.

Decisions made by the AAT are by default to have effect from the day on which the decision under review has or had effect.18 In practice, decisions made by the AAT are implemented by the NDIA prospectively. For NDIS supports decisions, this means that supports found reasonable and necessary for a past period are not available for a participant to claim but must be sought by reimbursement. Claims for reimbursement can take months to pursue.

NDIA systems should be updated to allow for backdating of plans, which would reflect the law and allow participants more timely access to supports they have been found to need.

b) Variations to plans

In July 2022, key amendments to the NDIS Act by the National Disability Insurance Scheme Amendment (Participant Service Guarantee and Other Measures) Bill 2022 came into force. The amendments removed the prohibition on varying NDIS plans and created new ways for plans to be changed to reflect a participant’s changing circumstances.

The considerations about whether, when and how to vary a plan are different to and more limited than those for approving a statement of participant supports under s 33(2) NDIS Act. However, because a participant often only receives a copy of a plan when a variation or decision to approve a new statement of participant supports is made, there is often no practical way to determine which has occurred.

Because the considerations for variation and approving a new statement of participant supports are different, it is important for a participant’s review rights to know which one has occurred.

18 Administrative Appeals Tribunal Act 1975 (Cth) s 43(6).

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NDIA systems should be updated to clearly differentiate between the two and participants should be clearly informed which one has occurred.

c) ‘Primary disability’

Decisions of the NDIA continue to refer to and rely on factors that have no legislative basis, for example the concept of ‘primary disability’. The NDIS Act does not contemplate a participant having to identify the disability that affects them the most, nor does it contemplate that supports must relate to the disability that affects a participant the most. Reliance on this concept has led to several participants seeking to apply to the NDIS when they are already participants in an effort to have their disability needs recognised.19 Systems and decision-making tools used by the NDIA should remove reference to this term. Published forms that invite prospective participants or their health practitioners to nominate a ‘primary disability’ and secondary disabilities should also be amended to remove reference to those terms.

Providing support pending review of a negative decision

Decisions to revoke a participant’s status, to remove a previously funded support or to reduce the level of support a person receives can not only risk a participant’s health, safety and independence, but can also make it difficult for a participant to pursue their review rights. Currently, when these decisions are made, they are of immediate effect. A person seeking to review a decision to revoke their status as a participant or reduce their supports must do so without having access to the support they once had.

We recommend that before a decision is made, a participant should be advised of the intention:

  • To revoke their participation in the NDIS under s 30 of the NDIS Act,
  • To make funding in the plan agency-managed (which can affect a participant’s ability to use their chosen providers),
  • To remove a previously funded support, or
  • To reduce the level of support in a plan.

A participant should be able to have the decision reviewed before any reduction or revocation takes place.

Under the Social Security (Administration) Act 1999, people who apply for review of adverse Centrelink decisions can continue to be paid income support payments pending the outcome of the review.20 This is to mitigate against severe financial hardship, ensure the person can continue to support dependent children, access medical treatment and remain housed.

Losing access to supports under the NDIS can also cause severe financial hardship and affect a participant’s ability to maintain their health and housing. Giving notice of the intention to make an adverse decision and continuing supports until a review is completed would support participants and allow them to participate effectively in the review process. Even if the participant does not wish to challenge the decision made, a transition period would allow participants the time to put an appropriate transition plan in place.

19 For example, Goodliff and National Disability Insurance Agency [2021] AATA 5022. 20 See Social Security (Administration) Act 1999 (Cth) subsection 131(1).

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Bernadette’s story: a year to reinstate NDIS supports21 Bernadette is a participant in the NDIS. She has a bowel disease, which had led to part of her bowel and intestines being removed and left her with problems with fatigue, mobility, temperature regulation and a limited ability to work. She has a small amount of part time work through an Australian Disability Enterprise (ADE) (an organisation assisting people with disability to engage in work tasks). The ADE placement was supported through NDIS funding. Bernadette’s status as a participant was revoked on the basis that her impairment “was not deemed as a disability” and “was not covered by the NDIS”. It took over a year for the decision to be reversed, during which time Bernadette had no access to supports.

Appropriate framework for debt waivers and write-offs

LACs are seeing increasing numbers of participants seeking assistance in relation to debts raised by the NDIA. This might be due to expenditure the participant, or someone on their behalf, has authorised and is typically money that has been paid to a third party.

It is imperative that participants have clear guidance about their options in the event that a debt is raised. There is no publicly available guidance as to how to seek a waiver or write-off of such debts under s 190 or s 195 of the NDIS Act, nor is there any advice to participants that these are reviewable decisions reviewable by the AAT. We are not aware of any criteria the NDIA uses to make such decisions.

In addition, s 195 as currently drafted expressly precludes consideration of financial hardship or the impact of a person’s disability when determining whether to waive a debt. We consider that these two factors should be relevant to determining whether it is appropriate to pursue a debt. A person’s disability should be a crucial consideration in understanding how a debt came about and the appropriateness of pursuing it.

Section 1237AAD(b) of the Social Security Act 1999 (Cth), a provision drafted in similar terms in relation to social security debts, states that a debt may be waived where “there are special circumstances (other than financial hardship alone) that make it desirable to waive” the debt. We consider this is a more appropriate basis for special circumstances waiver, particularly given that NDIS debts will frequently arise where funds were never received by the participant themselves.

Section 195 should be amended to remove reference to the exclusion of a person’s disability as a relevant factor and should make financial hardship a factor that can be considered (albeit not on its own), as per the equivalent sections of the Social Security Act 1999.

Participating fairly in reviews of NDIS decisions

The number of NDIS cases being reviewed by the AAT grew significantly in 2021/2022. According to the AAT’s latest Annual Report, the number of applications lodged in the NDIS Division of the AAT increased from 2,160 applications in 2020/21 to 5,918 in 2021/22, an increase of 174%.22 In 2022/2023 we understand that application numbers have remained high.

21 Not her real name. This case study also appears in National Legal Aid submission to the NDIS Consultation Paper: Access and Eligibility Policy with independent assessments, February 2021. 22 AAT Annual Report 2021-22, page 62.

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We recognise that there have been a number of initiatives recently introduced to address the significant increase in NDIS review applications to the AAT and that a significant proportion of applications are resolving in favour of applicants.

However, it is still important to recognise that a significant number of applicants are self- represented, where the NDIA is represented in every matter by a solicitor, and in many cases, also a barrister. The environment is generally adversarial, and the requirements can be technical. It can be intimidating for unrepresented applicants and non-legally trained advocates. A fair process requires balanced representation for both applicants and respondents.

Proceedings for review of decisions of the NDIA can be long and complex, requiring multiple expert reports, multiple days of hearing, multiple witnesses and written submissions, even when a participant’s support needs are self-evident. The NDIA should be limiting the complexity of matters wherever possible and should not be relying on technicalities.

In participating in reviews, the NDIA must ensure it meets its model litigant obligations, including:

  • Ensuring that it assists the decision-making body to come to the correct and preferable decision, by limiting the issues in dispute, participating fully in alternative dispute resolution, by avoiding delay and by correctly characterising the decision under review.
  • Acting consistently in the handling of reviews.
  • Limiting reliance on summonses, including limiting the scope of any summonses requested.
  • Implementing decisions as quickly as possible.

Finally, it is important that participants understand what they are accepting when they enter final terms of agreement for supports matters in the AAT or agreeing to withdraw their proceedings. Terms of agreement can use technical legal language, and it is often difficult to understand how they will translate into a statement of participant supports. The NDIA should provide draft plans to participants for feedback prior to entering final terms of agreement, to ensure that participants understand the effect of any agreement, and to ensure the terms reflect the agreement of the parties. The NDIA should also ensure that participants understand the consequences of withdrawing a matter from the AAT, and only do so when it is in their interests.

Recommendation 3: Improving decision making The NDIA should improve its decision making by:

  • Providing clear, reasoned decisions in plain language.
  • Providing draft plans and reasons for decision when making a section 33(2) NDIS Act decision.
  • Clearly indicating when an NDIS plan has been varied and when it has been replaced.
  • Updating its computer system to allow it to vary and backdate plans, consistent with the law.
  • Removing reference in systems, forms and decisions to a ‘primary disability’.
  • Continuing supports at the same level pending review of an adverse decision (including revocation, removal or reduction of a previously funded support).
  • Publishing clear guidance around debt waiver and debt-write off options and amending

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  • section 195 of the NDIS Act to allow consideration of the impact of a person’s disability when determining whether a debt should be waived.
  • Participating fairly, and in accordance with model litigant policy, in reviews of decisions.
  • Updating operational guidelines and internal decision-making guides in response to decisions of the AAT as appropriate.

Improving outcomes for participants with complex needs and improving

transition supports

Transition supports

LACs represent many clients with disability awaiting discharge or release from prisons or inpatient units.

In our experience, there is:

  • inadequate transition planning, especially for people on short or fixed term sentences,
  • limited coordination and planning between systems (e.g., fragmented health information systems inhibit information-sharing between custodial and community health providers, creating gaps in service provision when people leave custody),
  • difficulty arranging NDIS plans, and a lack of clear processes, accountability and responsibility for NDIS plans, and
  • a lack of support for people making applications for parole.

These issues can delay discharge or release from prison or inpatient units. They also increase the risk of a person being released into homelessness or inappropriate accommodation without supports, putting them at risk of breaching any conditions of their release, further offending, and readmission to some form of custody.

For forensic patients without a fixed or clear release date, it can be particularly difficult to arrange a NDIS plan to support transition to the community. In particular, the NDIS disability/justice support gaps have significantly restricted forensic patients, who only have a cognitive disability, from accessing less restrictive care in the community. For example, even where the Mental Health Review Tribunal agrees a person is ready for conditional release, that person will not be released without appropriate support.

We also see the NDIS refuse supports or give lower priority to cases where the individual is already “supported” in custody or detention. This has resulted in delayed release into the community of NDIS participants in long-term detention (as forensic patients or prisoners).

We recommend that the NDIA assist people with disability to transition to the community by:

  • urgently identifying people with disability who remain in custodial, forensic or mental health settings due to a failure to secure disability services,
  • developing integrated teams with specialised, trained planners to assist people with disability to access NDIS supports,
  • adopting clear processes for obtaining access to NDIS supports and planning for a person’s

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  • release before their sentence is complete or discharge is imminent, and
  • funding supports for transition prior to release, so that supports are in place to facilitate successful discharge or release and reduce their risk of reoffending or readmission.

Bob’s story: insufficient release planning23 Bob is a young First Nations person diagnosed with moderate to severe intellectual disability. He has been repeatedly in and out of youth detention. When Bob was accepted on to the NDIS, he waited nearly two months after his planning meeting for his NDIS plan to be developed. When he returned to custody, the NDIA advised that they were “unable to commence a plan build until a release date is finalised and set in stone”. With legal assistance, a plan was finally prepared, but provided no funding for the 50 hours per week of core supports recommended for Bob by allied health professionals. Bob was released from custody and his coordinator of supports made a change of circumstances application. Had Bob’s planning process been conducted efficiently and with a longer-term view of his needs, he would not have been released from custody with uncertainty about his supports.

Additionally, we recommend that policies around medium-term accommodation are revised to increase access to the support for people transitioning from custody. The NDIA’s Operational Guidelines have been updated to simplify the eligibility for medium term accommodation for people leaving the justice system, but they still require the person to show they are eligible for Specialist Disability Accommodation (SDA).24

Medium term accommodation is an essential support for people with disability transitioning from custody. It can help to overcome the difficulties of performing functional assessments for people in custody by providing an environment where a person with disability’s functional independence can be assessed. Assessments can help determine what accommodation model will work best, whether it is Supported Independent Living, Specialist Disability Accommodation or social or private housing with drop-in support. If medium term accommodation is restricted only to those who already have demonstrated they are eligible for SDA, its use to help establish needs and facilitate the transition back into the community for people with disability in custody is limited. We recommend that the medium-term accommodation policy is amended to remove the requirement to have already established eligibility for SDA.

Gaps between systems

To work effectively and to ensure that people with disabilities are adequately supported, the NDIS must work with other systems such as the health and mental health systems, the justice system, education and housing.

The Supports Rules Schedule 1 governs when the NDIS and when another system will be responsible for providing a support to a person with disability. These rules were developed by the Council of Australian Governments,25 and most recently revised on 27 November 2015.

23 Not his real name. This case study also appears in National Legal Aid Submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, November 2022. 24 Operational Guideline – Medium Term Accommodation – 30 January 2023: Medium term accommodation | NDIS. 25 National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Cth), note to rule 7.3; and see Department of Social Services, The Applied Principles and Tables of Support to Determine Responsibilities NDIS and other service | Department of Social Services, Australian Government (dss.gov.au), 27 November 2015.

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In practice, in many areas the divide between the responsibility of the NDIS and of other systems has been unclear. This results in participants not getting the support they need when no system considers a support is its responsibility.

The health system

In relation to the health system, there were many improvements when the NDIA introduced a policy on disability related health supports, recognising that it was responsible for health supports related to the functional impact of a participant’s disability. However, it is not uncommon for decision makers to refuse support to a participant such as psychological support, physiotherapy or occupational therapy, because a limited number of sessions are available under a chronic disease management plan or mental health care plan, even when the need for the support is disability related and is not related to the time-limited, goal-orientated treatment of a condition.

The mental health system

For the mental health system, the Supports Rules say that support will be available under the NDIS if it is not ‘clinical in nature’: r 7.6. Because ‘clinical’ relates to treatment, the rule is out of step with the recovery model of mental health, under which a person might continue to have treatment with a psychologist or psychiatrist after it is recognised that they have a permanent and significant disability. We frequently see participants with psychosocial disabilities denied the mental health support they need to participate in the community on the basis that the support is delivered by a psychologist. We consider that the wording of the rule needs revision, consistent with changes that have already been made to the access criteria, to align the rule with best practice in mental health treatment and management.

The justice system

A further area where the Support Rules are unclear and are applied to deny participants disability supports is the justice system. Under Support Rules 7.23-7.25, the NDIA is not responsible for funding day-to-day supports while a person is detained in prison or a mental health facility and is only responsible for other supports “to the extent appropriate in the circumstances of the person’s custody”. This lack of clarity makes it difficult to establish responsibility for supports. For forensic patients it can be difficult to establish what supports a person can receive under the NDIS where the provision of supports will result in a reduction in the patient’s risk to self or others. Without funding for disability supports, decision makers may be less likely to approve a forensic patient’s release, due to concerns about the level of support the patient will have in the community and how this may relate to the patient’s risk of harm to self and others.

Integrated service response

In a complex landscape that now spans across NDIS and state-funded service providers, as well as disability and mainstream services such as housing, justice and education, the lack of a coordinated multi-agency response to provide wraparound support for people with disability and complex support needs is a significant concern.

E.g. In the past, there were initiatives to bring together different services to coordinate services for people with disability, including the integrated service response in NSW. The multi-agency and coordinated response provided a critical role in consistent service delivery and a forum to access that collaborative response. The ISR was disbanded without any replacement or access to referral contact points.

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More approaches to establish coordinated and multi-agency responses should be prioritised to ensure that people with disability and complex needs are appropriately and adequately supported.

Increased regulation of supports linked to housing

LACs frequently assist NDIS participants with complex support needs who have faced unreasonable evictions from SDA and other supported living arrangements. We see accommodation providers terminate client services at short notice in response to challenging behaviour, with insufficient consideration about whether less restrictive alternatives were possible, or of the potential homelessness of the participant.

Although a participant is responsible for meeting their own housing costs, including rent, a participant’s ability to remain in certain forms of accommodation is often linked to ongoing NDIS funding at a certain level. If a participant’s support level is reduced or a housing-related support is removed, it can lead to complete withdrawal of services and homelessness.

We welcome the introduction of new initiatives for supported independent living introduced in April 2022 which provide for a transition period of 12 weeks at the previous funding level to support the transition to new support arrangements.

We also welcome the Quality and Safeguards Commission’s Inquiry into Aspects of Supported Accommodation.26 We agree, based on our experience of advocating for clients, that specific regulation of group home settings is needed, and that participants need more support to make changes to their living arrangements.

We recommend that:

  • As submitted above, where the NDIA intends to reduce support or remove a previously funded support, funding at the previous level be maintained until the participant has exhausted their review rights.
  • The obligation on providers to work with participants to find alternative arrangements be strengthened, with an obligation for a provider to notify the Quality and Safeguards Commission if a support change is likely to lead to homelessness within 90 days, with notification to lead to mediation of any dispute.
  • Policy should require suitable and long-term alternative accommodation be available before a service provider can ask a participant to leave.27
  • There be an obligation on all providers of Supported Independent Living which let housing to participants to provide a written housing agreement to a participant (as is required for SDA providers), separate from any agreement for NDIS services.
  • The NDIA develop best-practice contract clauses around the termination, variation and commencement of housing agreements connected to support arrangements.

26 NDIS Quality and Safeguards Commission, Inquiry Report: Own Motion Inquiry into Aspects of Supported Accommodation, January 2023, https://www.ndiscommission.gov.au/resources/reports-policies-and-frameworks/inquiries-and-reviews/own-motion-inquiry-aspects. 27 This obligation is imposed on residential aged care services in the aged care context – see s 6 of the User Rights Principles 2014.

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A National Framework for the oversight and use of restrictive practices

LACs support efforts to reduce the use of restrictive practices and compulsory treatments for people with disabilities. We continue to see the use of restrictive practices not in accordance with the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018, including:

Restriction of the lives of people with disability in residential services and group homes, such as restricted access to visitors and phone calls, whether and what they can watch on television, and when and in what circumstances they may access the community under staff supervision.

  • The use of environmental restriction to protect from risk, due to a lack of staff and other resources to monitor risk. This can include locked doors and/or refusal to provide support to exercise freedom of movement.

It is highly likely that cases of restrictive practices are underreported. These practices are largely hidden from external sight, and some people subjected to restrictive practices in disability-specific settings may be unable to seek the advice and assistance that they need.

There is a lack of consistency and robustness in federal, state and territory legislation regarding a formal authorisation process for the use of restrictive practices including by NDIS providers on NDIS participants. We recommend that the NDIA, the Quality and Safeguards Commission and state and territory governments should adopt a national framework for the regulation and oversight of the use of restrictive practices that applies to all settings.

Recommendation 4: Improving outcomes for participants with complex needs and improving transition supports The Commonwealth Government and the NDIA should:

  • Improve access to transition supports for people leaving custody.
  • Review the descriptions of the responsibilities of the NDIS and other service systems to ensure that relative responsibilities are clear and participants are not left in the gaps between systems.
  • Introduce greater protections for supports linked to housing.
  • Work with the Quality and Safeguards Commission and state and territory governments to introduce a national framework for the oversight and use of restrictive practices.

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