Submission to the Joint Standing Committee

Inquiry into the Integrity of the National Disability Insurance Scheme

Submitted by The Disability Trust Group 24 April 2026

The Disability Trust ermha365

OC Connections

Marriott Support Services embarc employment Bedford

a Disability TRUST embarc DCronnestions @& sumha mM Marfott ord

The Disability Trust Group represents a national network of not-for-profit organisations supporting people with disability, psychosocial disability and complex needs across Australia.

Employing 4,500-plus people, the Group operates across 115 sites across New South Wales, ACT, Victoria, Queensland, South Australia and the NT and is the second largest provider of supported employment in Australia.

We deliver the full extent of high intensity daily supports for cognitive, physical and complex psychosocial disability that require a high level of training, planning and risk management. All organisations within our group are registered NDIS providers.

The case studies in this submission have been de-identified. However, we would appreciate the opportunity to be consulted prior to the reproduction or publication of any content arising from such case studies.

Key message

Integrity, sustainability and participant safety cannot be separated. NDIS integrity is being undermined less by isolated fraud, and more by structural failure: persistent underfunding, misaligned planning decisions, and constant policy churn are creating unsafe conditions for participants while forcing registered providers to absorb escalating, unfunded safeguarding, workforce and clinical governance obligations.

Where fraud and sharp practices do occur, they flourish in the gaps created by these structural weaknesses, particularly in the unregistered market. We have seen participants enticed with inducements that were never delivered; plans stripped through misrepresented billing; and, in extreme cases, providers collapse overnight, abandoning dozens of people who must then rely on extraordinary, unfunded triage, coordination and risk management to stay safe.

Support coordination, frontline operational safeguarding and clinical oversight are the Scheme’s most effective but least recognised integrity safeguards, identifying fraud, challenging unsafe practice, managing complaints, and preventing crisis escalation, often at personal and organisational cost and with little response from the system.

Strengthening the NDIS must reform regulation, pricing and oversight to close the gaps that have embedded integrity failure by design.

Response to Terms of reference:

1. The nature and extent of non-compliance, including fraud and sharp practices

Across our services we have seen sharp practices including providers offering cash incentives, free iPads, free day program places, or cigarettes to induce participant sign- up or referrals. This is a particular issue in thin markets where there are few quality providers and scant NDIA oversight, and vulnerable participants can be preyed upon by bad-faith actors.

For example, since 2019, when ermha365 began its service in the Northern Territory, our team has experienced instances of highly complex and vulnerable participants exiting our services (often suddenly) for new and/or one-person operators.

One of these NDIS participants is Daniel* - an Aboriginal man who was supported by ermha365’s complex services team for many years. ermha365 provided 24/7, 2:1 SIL support for Daniel, who lives with complex needs, including an acquired brain injury, alcohol dependence and behaviours of concern. Daniel’s package was in excess of $1m.

ermha365 ceased supporting Daniel after another local provider employed sharp practices to sign him up to their services. This provider told Daniel it would directly fund and purchase his cigarettes and allow family and/or friends to stay overnight in the SIL property they provided. However, once Daniel signed with their service, he was told his family could not stay overnight. This is a clear example of inducements and misrepresentation by a competing provider where inappropriate promises to the participant were not delivered.

A SIL participant of The Disability Trust, Jerry*, was impacted by fraud when his plan was overcharged for six hours of community participation by a new provider that delivered only three hours. Due to Jerry’s complex psychosocial disability and behaviours of concern, Jerry had not participated in community activities for several years and it had taken him some time to build up the confidence to engage them. When the fraud was discovered, services had to be stopped, disrupting careful planning; the provider then went into liquidation, hindering cost recovery efforts and creating a material impact on Jerry’s NDIS budget.

In another example, our Support Coordination Lead at Marriott Support Services became aware of a small, unregistered provider fraudulently charging for services participants did not need and made numerous complaints to the NDIS Quality and Safeguards Commission.

The support worker would take four or five NDIS participants to concerts and events on weekends in small groups yet invoiced at a 1:2 support ratio. In addition, overnight stays occurred at their private home and charged at a 1:1 sleepover rate.

Complaints to the provider were ignored, concerns remained regarding the provider conduct and safety of the participants, and, despite significant time spent providing reports to the NDIS regarding the fraudulent practices, these appear to have gone unaddressed.

These are three of many individual examples that have an immeasurable impact on scheme integrity, participants, and other providers, creating extra, unfunded and often psychologically distressing work. We see little action after fraud reporting to the NDIS, and this is a persistent, endemic issue in the Scheme. Any action we do see takes too long and is not nimble enough to have a safeguarding effect on the participant before their funding has been stripped and they are entangled in complex unsafe arrangements.

As registration requirements change and market movements accelerate, there is a growing expectation that quality providers will assume market stewardship by default: an approach that is neither prudent nor acceptable.

For example, in April 2026, The Disability Trust’s Support Coordination team provided an extraordinary amount of unfunded work to participants who were left without supports following the collapse of a local provider, leaving many in temporary accommodation and requiring emergency support.

Despite serious concerns about this provider being raised to the NDIS and Quality Safeguards Commission, no apparent interventions were evident, and the local provider networks were left to step in to provide the solutions to ensure vulnerable people could continue to be provided with essential supports. This is becoming an additional workload and pressure for remaining providers – work that is not funded.

(*names changed for privacy)

2. Impacts of non-compliance on participants and families

In our experience non-compliance can include financial misuse (misaligned billing, supports to drain plans); quality and safeguarding failures (restrictive practices without authorisation, support gaps); and structural non-compliance driven by policy/pricing (registered providers unable to meet legal duties within funded plans).

When quality service provision is financially unsustainable, participants and families experience:

Market failure for people with the highest needs, including service refusal, delayed discharge from hospital or custody, or repeated placement breakdown. Hospitalisation has now become a default system workaround that is actively recommended to trigger NDIA funding reviews or crisis responses. Our Plan Managers and support coordinators report being directly told to “leave the person in hospital”. As providers this becomes our only option – our attempts to resolve issues and flag issues through other channels are largely met with inaction.
The impacts of unequal risk distribution between registered and unregistered providers, where registration increases cost and scrutiny without commensurate pricing recognition. Participants who engage unregistered providers are accepting a level of risk they may not fully understand, and the registered providers who deliver other services to the same participant are – in many cases – required to regulate other providers as the “implementing provider”. In one example, it cost several thousand dollars for our organisation in legal advice to defend the role of our support coordination service to support the participant to change service providers, because their unregistered support provider did not understand their obligations around complaint management and the participant’s choice and control.
Increased risk of harm for participants, where plans are funded for sleepovers, shared ratios or reduced staffing despite clear evidence that active nights or higher ratios are required. The provision of services at the funded ratio only works if you can match the right number of people with the right funding ratios – there are no market mechanisms to enable this.

Case Study

Gemma* is a woman in her late thirties who has an intellectual disability and lived with her elderly mother.

Gemma’s NDS plan included some daily living and community access support.

The unregistered provider of personal care services didn’t use a slip mat for Gemma while showering her; consequently, Gemma fell in the shower. The seriousness of the fall resulted in Gemma spending four months in hospital, and she now lives with a complete spinal injury.

No incident report was made by the unregistered provider, who under the scheme’s rules, aren’t obligated to do so, nor are they required to maintain an incident management system. The incident was reported by The Disability Trust Support Coordination service; however, the complaint was closed by the QSC with nil action.

When this incident occurred, Gemma was in the process of transitioning to Supported Independent Living (SIL) with a registered provider. Due to her life- altering injuries, Gemma now requires much more care, including 2:1 home support.

In the meantime, the unregistered provider who caused the injury was extremely insistent with the family to try and secure 24-hour in-home support services for Gemma once she was discharged, despite not being able to provide the appropriate level of care.

This provider continues to operate, working with vulnerable people. Many unskilled people have taken advantage of the NDIS’s lack of regulation.

(*name changed for privacy)

3. Effectiveness and adequacy of government policies to improve scheme integrity

Current integrity measures focus heavily on compliance enforcement, audits and payment recovery, while failing to address the cost of delivering safe, high-quality support. Major reforms such as pricing and funding periods are released with insufficient notice, and providers do not have the systems that are flexible enough to implement this at scale and quickly. We are simply underfunded to keep pace with the way the Scheme is operating.

Government policy inconsistency is evident in the direct conflict between providers’ obligations under industrial relations and work health and safety legislation, and the narrower client-safety focus of the NDIS Quality and Safeguards Commission. Providers are legally required to ensure the safety of both participants and workers, particularly in remote, isolated or high-risk settings. However, NDIS plans are routinely funded for one-to-one or single-staff models in circumstances where WHS regulators would reasonably expect two staff, for example, where there is a risk associated with lone work, emergency evacuation, or overnight supervision. Providers are therefore forced into an untenable position: either breach state safety laws by operating unsafe staffing models or absorb unfunded costs to meet non-negotiable legal requirements. This misalignment exposes organisations to enforcement action by state safety regulators, increases workforce risk and turnover, and demonstrates how current funding and regulatory settings actively undermine scheme integrity rather than strengthen it.

Across SIL, Home and Living reform, independent assessments, support coordination and the NDIS Supports Lists, The Disability Trust Group consistently observes:

Systemic underfunding of plans and escalating regulatory and safeguarding expectations without aligned pricing. We provide detailed information outlining a person’s support needs and how we can support them safely, which is costed and fed into the planning process. Increasingly, plans are renewed with inadequate funding for the person’s needs. Services are required to deliver services at the funded ratio, though this may involve greater risk to the person (potential for injury or incident) or increased restrictive practices. This consequently increases the requirement to report to the Quality and Safeguarding Commission.
Significant plan inflexibility and administrative burden following the introduction of funding periods, to the detriment of participant supports. Funding periods require constant invoice policing by plan managers; lock down funds during periods of highest need (initial assessments); and push providers into “manual claims” and emergency requests, increasing NDIA workload rather than reducing it. Examples like these are now a regular occurrence across our services:

A participant who needed hoist equipment purchased for a new SIL property was refused and the support coordinator was told by the NDIA they would need to go to hospital instead.
A supported employee was not able to attend their employment for three weeks because they had run out of support funding.
Participants have had speech pathology limited to two hours per month for mealtime management.
Some high-risk participants have had to reduce or cease day program attendance each quarter to “stretch” funding, with follow-on impacts in other settings, for example increased time spent in SIL services.
Under-recognition of support coordination as a core integrity mechanism that prevents misuse of funds, service breakdown and crisis escalation. Providers still have no direction on where support coordination is headed and there has been a freeze on pricing for more than five years. There is insufficient detail on how the “Navigator” function will work, and removing support coordination without an adequate replacement will create extreme risk for participants and the market. Yet when there is a crisis, specialist support coordinators are frequently called upon by agencies like the NSW Public Guardian to sort out issues with unscrupulous providers who are working with some of the most vulnerable people.
Independent assessment and planning reforms that increase expectations on providers and assume providers can perpetually absorb escalating and extensive preparatory, coordination and risk-mitigation work without an increase in funding.
Government’s fixed position on conflicts of interest that in some instances, runs contrary to participant choice, control and best interests, and disrupts continuity of care. For example, a participant was recently forced to change to provider due to a conflict-of-interest determination, leaving them without clinical supports and with a gap in support that delayed both the implementation of their behaviour support plan and oversight of restrictive practices. There certainly are cases where a robust approach to conflict of interest is required, however there are also cases where provision of multiple services from the same provider facilitates benefits to the participant and cannot be achieved otherwise. For example, the NSW Public Guardian does not allow clinical supports and support coordination from the same provider, which is to prevent sharp practices exploitation. However, this blanket rule does not provide any consideration for ethical providers, whereby advantage may be gained by using accessing services from the same provider.

4. Legislative and other reforms required to strengthen scheme integrity

1. Recognise and fund the true cost of quality

A tiered approach to independently set pricing must recognise registered, quality providers and restore equity in the Scheme.

Pricing and planning must also explicitly recognise unavoidable unbillable work required for:

SIL and Home and Living assessment, transition and pathway planning;
clinical governance, restrictive practice compliance and reporting;
workforce supervision, training and debriefing;
support coordination for complex, multi-system participants.

2. Strengthen registration as an integrity safeguard

Registered, mission-driven providers deliver the Scheme’s strongest protections. Registration should be incentivised and protected, not rendered financially unviable through policy and pricing design.

Although registered providers are expected to meet high standards of quality and safeguarding, the NDIA does not fund the associated governance or compliance work. Consequently, registered, quality providers like The Disability Trust Group bear the full cost of mandatory reporting for restrictive practices and reportable incidents.

In addition, The Disability Trust has one of the best Disability Support Worker training programs in the industry, which is delivered at a significant cost to the organisation. However, frequently individuals are employed as support workers, access the training program, but never accept shifts. Instead, these individuals go into business as unregistered sole-trader providers for themselves, with a clear difference in the hourly amount they can earn. It has been reported that labourers decline $40/hr construction roles because they can earn $70+ per hour as disability workers with no training. This illustrates why the Scheme attracts unqualified entrants while registered providers lose staff.

It is fundamentally problematic that organisations with strong governance, training and safeguarding obligations are paid the same as people with no experience or qualifications. However, if properly incentivised through the right pricing structures, a top-tier quality registered providers could contribute to capacity-building of other providers who do not have access to this level of training and support.

3. Align planning decisions with safeguarding and legal obligations

There is an urgent need to align planning decisions with other safeguarding and legal obligations that providers must adhere to.

NDIA decisions must reflect:

duty of care and work health and safety requirements;
fluctuating and episodic needs;
justice orders, guardianship and restrictive practice obligations.

Integrity cannot exist where providers are funded to deliver less than the law requires.

4. Reinforce support coordination as a preventative control

Support coordination for complex participants is not optional. It:

prevents overspend through plan literacy and active monitoring;
reduces crisis-driven plan failure; and
enables early intervention and coordinated decision-making.

Weakening or underfunding coordination increases downstream non-compliance and system cost.

5. Reform Home and Living policy for complex participants

Home and Living policy reform must support financially viable and successful shared living, adding shared service funding to the individual funding component to make the service model work. In addition:

transition funding must extend beyond 90 days;
rental cost subsidies and housing interface supports must be permitted where SDA is unavailable; and
innovative congregate living and therapeutic housing models should be piloted to improve outcomes and reduce long-term costs.

It is our collective experience that when supporting NDIS participants with complex psychosocial disability, providers absorb all housing-related costs such as rent, property damage, and utilities unless SDA is funded. For example, in Victoria, it is the experience of ermha365 that the complex participants we support experience significant package shortfalls – up to eight weeks per year unfunded.

Providers also absorb higher WorkCover and agency costs due to staff burnout and injury.

Conclusion

The integrity of the NDIS depends on its capacity to sustain safe, high-quality supports, delivered by registered, mission-driven providers operating within the rules.

Persistent underfunding of essential, unbillable supports, inconsistent planning and erosion of the regulated provider market are systemic integrity risks. Addressing these issues through pricing reform, policy alignment and recognition of the real cost of quality is essential to protect participants, families and the Scheme itself.

Submitted by: The Disability Trust Group

Date: 24 April 2026

Contact: Hayley Watson, Public Relations and Communications Manager

redacted