Submission to the Joint Standing Committee

on General Issues around the Implementation and Performance of the NDIS.

A submission from NDIS Providers GL HRWOOD & SJ MARSTON Registered NDIS Providers 4-433C-2115 on expreinces with the issues, needs and implementation of the National Disability Insurance Scheme.

Acknowledgements:

We acknowledge the traditional owners of the lands on which we work and live and pay our respects to their Elders past, present and emerging, and to their care of country land and culture.

We also acknowledge the support of individuals, families, partners and our paid staff who continue to support the shared vision of demanding the need for increased integrity, transparency and positive engagement as essential elements in making the National Disability Insurance Scheme work.

Summary:

We seek to raise the issues with Committee especially around the ongoing issues with plan design, overuse of plan management, conflict of interest and ongoing concerns about the proper protections for vulnerable individuals in the NDIS against sharp practices and conflicts of interest.

The implementation of the NDIS is a vital element of social reform and creating accessibility and opportunity for citizens with a disability and the communities they live in. Far too much of the NDIS is now unregulated and subject to practices and behaviours of providers that are not subject to regulation and scrutiny.

The NDIS is in danger of not only costing more and delivering less value for money for the public investment, but also of having the funding not used to achieve the objectives and principles of the Act and its participants.

The Directors wish to have their submission published and for the wider concerns we have stated to be available to others who may have experienced these issues and behaviours, and who need to know there is still hope to review and revise the NDIS as it continues to develop and grow into the future.

General issues around the implementation and performance of the NDIS

Thursday 29th October 2021

The Hon. Kevin Andrews MP Committee Chairman of the Joint Standing Committee on the National Disability Insurance Scheme PO Box 6100 Parliament House Canberra ACT 2600 Phone: +61 2 6277 3083 Fax: +61 2 6277 5829 ndis.sen@aph.gov.au

deep Mr. Andrews

Submission to the General issues around the implementation and performance of the NDIS

We are a Registered NDIS provider of Support Coordination services providing services to NDIS participants in South-East Tasmania in a business that has been established since January 2018 and more recently in providing supported independent living and community access services.

Prior to establishing our NDIS services, we have had experience between us in the sector including working for the NDIA, ADHC in NSW, in all types of disability and mental health support services including residential, community, employment and community-based supports including and large national, state, regional and localised service providers and outlets in NSW, Victoria, Queensland and Tasmania.

We strongly support the key principles and intentions of the NDIS around providing capacity building, individualised plans and tailored supports; and the development of responsive and effective supports for individual participants, their informal supports and accessible communities for people to live in.

What we do not support and is the exponential growth of sharp practice and funding gouging which has emerged over the past four years and the misappropriation by elements in the provider sector of under the guise of “choice and control” that is effectively a means of trafficking in plans and people.

The explosion of plan management in the past two years and its promotion by the NDIA seem more of a mechanism to help address the failure in developing enough regulated (“registered”) providers in the market to meet the growth and needs of the Scheme- not as the Agency would have participants believe – away of providing flexibility in accessing services

What Is Particularly Galling About This So Called “Choice And Control” Arrangement

What is particularly galling about this so called “choice and control” arrangement is that a flood of unregulated, unmonitored providers of supports now receive exactly the same pricing rate as those who have to bear the cost of audit, review and the compliance with the “Standards”.

This is a significant failure of the structural market development over the past 8 years and has not delivered anything that looks like competitive pricing for end users and just adds another cost impost on the scheme to deliver service to the market – just with an additional $1500 premium or more added on for the middle person and an extra layer of administration for planners and the Scheme.

So lucrative has this market segment become, it is now managing on average more than 50% of non-SIL managed funds1, on excess of $8 billion annually- with little evidence from the NDIA or NDIS QSC of how this market is being monitored, regulated or tracked for compliance.

Perhaps it is time to go back to the Productivity Commission and the Auditor General to see if this burgeoning market really delivers value for money and investigate how many non-conforming purchases (not meeting Scheme requirements under section 32 reasonable and necessary criteria) are pushed past by Plan Managers who aren’t required to be very accountable? We have pushed a case through to the NDIA Fraud team of obvious misuse and overclaiming of funds in a plan with no tangible result or consequence for any party involved.

It would also be interesting and informative for the NDIA to report how many of their backlog of plan reviews are due to non-registered providers persuading participants to change their plans to plan managed from Agency managed so that those providers can take over the supports of that person? Alongside that (revealing) data, can the Agency also confirm how many providers hold conflicting registrations of both plan management, direct service delivery and support coordination alongside plan management- two areas the NDIA vowed would never cross over but now exist in abundance and without any regard to the Provider Code of Conduct “obligations”.

In the interests of balancing this submission, we also note that regulated providers also seem at times to have little to fear from the Regulator (NDIS Quality and Safeguards Commission) when it comes to accountability for their behaviour as we have witnessed here in Tasmania over the past 2 years. Reports of serious concerns about the misuse of funds, failure to meet Practice Standards and the Provider Code of Conduct and the theft and misuse of private information about participants, fraud etc pretty much seem to have gone nowhere and with no consequences for that behaviour.

We propose the NDIS is struggling - not only with the challenges of trying to reform the 100 years+ old welfare and support system in a very short space of time (with no public information campaign, no business plan to train planners or Allied Health in specialised areas (e.g., vehicle mods, home mods etc) and a transient and often under resourced planning and back of house workforce- but also with:

• Failure to critically assess and analyse the plan lifecycle needs of participants at Access to the scheme and invest in robust analysis of critical life stage transition needs for the first plans (15–18-year-old participants with significant or foreseeable post school needs are one example of constant failure). Many are falling back to a 9-3 school pattern for the long term of their plans.

  There is often a failure at the first plan stage with the NDIS “ecology” of using LACs for first plan when this is the most critical stage for ensuring success for the first and subsequent NDIS plans and should be done only by skilled planners and assessors. We receive multiple complaints from participants of poor experiences with LAC services and first plan that often must be reviewed within a few months of approval and are not fit for purpose.

• Failure to safeguard against sharp (or worse) practices by providers (the over and misuse of funds in plan, poor or intangible outcomes against goals and needs of people in service delivery, an apparent lack of intelligence sharing between NDIS and the NDISQSC to identify risks for vulnerable individuals around how plans, adequate checking and investigation of underlying reasons why fund management and services are being changed.

• Inherent problems with planners using default settings like inclusion of plan management in plans even when it isn’t needed or understood by participants, absolutely no risk assessment to see if the person is vulnerable to the influence of other interested parties and providers and no check in on any conflict of interests being exerted at reviews or reviews of reviewable decisions. There is active theft of plans by employees moving out to set their own business.

Case study: A long-established community not for profit had many of its participants plans taken by former employees - one of whom was running a NDIS business whilst employed by the service. The mechanism of changing participants plans to plan managed (to the business of the employee) were used to set up SIL services (unregistered) and to undermine and facilitate complaints about the provider.

One of the employees also wiped information from the providers records about a vulnerable person and acted as the nominee (with NDIS aware of this) to set the persons funding in a plan to suit their future purposes. The NDIS and NDISQSC were advised of these issues and no action taken. The community provider had to wind up services and the remaining participants were affected by changes to their accommodation.

An employee of the new provider then set up their own company (again through plan management) and then began persuading participants from her employer and the previous employer to move across to the company that they and their partner established (unregistered). The same tactics used on the first provider (creating disharmony and complaints against previous providers were used to create the business opportunity.

What is disturbing about this case study is that we have seen it occur repeatedly across the sector and for the past 4-5 years especially. There is no legal or legislative restraint on staff creating false or exaggerated claims against services about quality as means of persuading participants and families to move with them to their own company. In other circumstances this behaviour would probably be called grooming or coercive conduct.

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4. It is still common to find people and families who have no idea what their plan is for or their rights as consumers in service agreements (and few enforceable obligations on providers to disclose conflicts of interest etc).

We acknowledge to the Committee, Chair and Honourable Members that there are no simple, one off or easy fixes to the challenges of the continued implementation of the NDIS and those likely to be encountered ahead or some of the issues we have raised.

It is, however, our submission that many of the problems of the Scheme need to be addressed by a critical review and analysis of the integrity and monitoring measures in place for plans and greater efforts to ensure that the Agency and Commissions roles provide greater surveillance of players entering the sector. There also needs to be scrutiny of the issues of staff leaving services and taking plans and people with them — effectively the greatest conflict of interest of all and the misuse of privileged personal and financial information — effectively a breach of privacy and commercial theft.

We propose that the issues of conflict of interest and predatory behaviour by providers are rife in the sector; and there are few effective controls on the misuse of participant financial, personal and protected information by unscrupulous businesses by individuals who engage in the practice of taking plans and people from established services to set business for their own benefit.

Both the Agency and the Safeguards Commission seem unwilling, unable or incapable of identifying or dealing with this problem and oblivious to the impact it is having in the Scheme in terms of adding to the plan review workload and the additional problems that unscheduled reviews impose on the Scheme and its resources.

Yours faithfully,

G Harwood S Marston

28“ October 2021