Who we are:

We are three community health nurses who have worked in the homeless and disability sector over the last three decades.

William Brennan Anne Bolzonello Julie Fry

We have a wealth of experience and knowledge working as nurses with the most vulnerable and marginalised members of our community.

In 2022 we commenced work on a project funded by the federal government specifically looking at the links between residents in Supported Residential Services and the NDIS. We identified this cohort as being vulnerable to abuse and control by the most unscrupulous and corrupt providers of NDIS care.

The multi-agency project report People Need People is attached.

Our focus is on this most vulnerable group. The group includes people living with disability in Supported Residential Services, insecure housing settings, and with minimal social supports or advocates.

Our submission quotes the attached report and the relevant page numbers.

Please note that all case studies have anonymised and are factual.

1. Fraud in this sector :

When the NDIS was being introduced, we could already see that “for-profit” accommodation services for the at-risk-homeless sector was ripe for exploitation and fraud. Many of the proprietors of these forms of accommodation where already providing substandard care. They could see opportunities to exploit business opportunities offered by the new NDIS. Within the first 12 months of the NDIS roll-out, SRS providers were starting to open their own NDIS businesses. In doing so, they were double-dipping for services they were already funded to provide.

SRS, SILs and other forms of housing for people living with psycho-social disability are places of high risk for all forms of abuse.

What follows is an example of bribery and coercion of an ex-SRS owner who moved to operating SILs and thrived due to limited oversight. This person was considered so unsuitable as an SRS owner that his business was closed by the Department. And yet, here are the details of his acceptance as an NDIS registered provider :

Practitioner Concerns

practitioner became concerned and began the process of applying for a Guardianship order to protect him. Clive is not the only ex-resident that Nigel has managed to track down and ‘entice and bribe’ to change accommodation (See page 57).

The proprietors of SRSs who now also own SILs know how to rort the system. (See another example on page 92.)

Predatory Business Practices within the NDIS

We identified many of these (See report page 44)

The abuse of people living with psycho-social disability in a range of supported accommodation environments is pervasive and persistent. All the specific details of the risks and concerns were provided by our team to the relevant authorities to investigate and take action.

These risks and concerns included examples of:

• kidnap
• coercion & bullying
• manipulation
• harassment
• neglect
• bribery
• grooming,
• collusion between businesses
• financial abuse and exploitation,
• fraudulent billing practices,
• NDIS package drainage

Additional sector concerns included (see page 63):

• Increased use of unregulated ‘pop-up’ SILs
• Developments in NDIS market and the growth in “charlatans”
• Predatory business practices
• Use of workers that were insufficiently skilled/lacked experience
• Lack of screening workers
• Unmonitored use of restrictive practices
• Insufficient safeguards
• Loose regulatory framework
• Weak enforcement

Regarding SILs and fraud (see page 83):

As of June 2023, the average plan for a participant without SIL funding in Victoria is $55,400. The current annual spend for a SIL participant is $418,700. As a predatory business this means that if you manage to ‘house’ and ‘control the packages’ of just 3 participants, you are looking at an accessible income of $1,256,000 per year. Quicker if you drain their packages. That’s a ‘healthy turnover’ for an

Impacts on Participants

ordinary 4-bedroom house in Werribee, The annual payment to participants in SIL has now increased to $11.5 bn. This is a growth industry. Adverts pop up on news feeds. Business are being attracted into the sector with the promise of significant return on investment.

Currently SILs fall outside any specific regulatory framework or registration requirements and are therefore unregulated environments. SILs do not have register their location, presenting issues of clients being housed in hidden locations increasing participants risk of exploitation and abuse.

The impacts on NDIS participants

In our report there were various case studies that highlighted the impacts on the participants. Here are a few:

• Robert (page 84)

Robert was removed from an SRS and taken to a SIL where he is the only tenant, and he is often left alone. A worker from his NDIS provider drops by to administer medications (an unregistered nurse). Robert has no phone and no access to any other supports. NDIS providers were contacting his previous support coordinator demanding they release payments. Robert’s perspectives highlight the challenges of coercive control. Despite lack of supports and inappropriate level of service Robert describes his providers as his ‘friends’. Robert has an intellectual disability and an extensive and complex forensic history. Despite a 2:1 package for 12 hours a day, Robert receives very few services.

• Paul (page 87)

Paul had been happily engaged with NDIS providers and receiving supports from his community health nurse. One day, an independent support worker, Bob, was booked to transport Paul to an appointment. Bob and another man later approached Paul and asked him to sign some paperwork. Paul signed but was unsure what the paperwork was about. A few days later, a couple of workers turned up at Paul’s and said they were from his new NDIS provider. They told Paul they could get him some new furniture (which never appeared) and started visiting him to ‘provide supports’. The new workers then deleted key contacts, including his old NDIS providers numbers out of his mobile phone. Paul’s community health nurse called him to see how he was doing. Paul was distressed and couldn’t work out how to get his old supports back. The nurse contacted his previous providers who made a complaint to the NDIS. His new provider began increasing their contact in person and by the phone. They contacted Paul’s brother Dave, who has a history of bullying and standing over Paul. The NDIS company took Dave and Paul into NDIS office trying to pressure Paul into signing a package. The NDIS workers became very aggressive towards Paul’s community health nurse and tried to prevent them visiting Paul. Eventually the nurse reported their behaviour to the police. Even though this situation has since been resolved, the impacts on Paul have been enduring. Paul’s stutter has worsened to point of being hardly able to speak. Paul said he ‘felt like a prisoner in his own home’ and had anxiety from the NDIS workers’ presence. He told us he ‘wished he had never heard of the NDIS’.

• Louise (page 90)

Louise was unhappy with her NDIS provider, who were providing support coordination and core supports, as she felt there was poor communication and inconsistent attendance of support workers. Louise asked for assistance from a trusted health practitioner to change providers. Louise’s current provider became obstructive, tried to request her application to join another provider was cancelled and staff visited trying to convince her to stay with them. Louise insisted she wanted a clean break, however her account was still locked in the portal to the provider. Louise became quite distressed.

• Only way to resolve this matter was for Louise to attend a local NDIS office with the support of her trusted health practitioner.
• The NDIA planner was not surprised by the concerns related to Louise’s current providers.
• This is not the first time they have come to their attention for unethical behaviours.
• A formal complaint was made.
• Louise then felt like she was being harassed when different members of the team from the previous provider, including a psychiatric nurse, began visiting and phoning to see if they could change her mind.
• Louise began to feel quite anxious and stressed that somehow the company she didn’t want would start providing supports again.

3. The effectiveness of government agencies in safeguarding NDIS participants.

Some of our conclusions in 2023 about complaints and safeguarding clients are written below:

Page 117:

Lodging a complaint is challenging and has been for many of the practitioners that spoke with us. Trying to report concerns about predatory practices of NDIS providers for example, is not that simple. Complainants are expected to provide sufficient evidence that the Code of Conduct has been breached. The word of the resident isn’t ever any proof.

Lodging complaints to any authority is particularly challenging for a person living with psycho-social disability. The NDIS complaints system is complex and ineffective for vulnerable adults. The complainant is encouraged to complain to their provider in the first instance. When the complaint is related to mistreatment, neglect, coercion, manipulation or financial abuse there is a risk that a complaint aggrieves the service provider. This places vulnerable adults at increased risk of harm.

Pg 120:

Weak enforcement / Repercussions: There is a natural assumption that the types of practices that we discovered, reported and provided evidence regarding would be investigated. And then if (when) substantiated, significant penalties and repercussions would follow. These sanctions would not only prevent the specific perpetrator, they would act as a deterrent to other providers engaging in similar predatory business practices and perpetrating abuse. We tried to find the possible ways to use the law to bring about justice. We wanted the regulators to throw the book at people making money out of abusing vulnerable people. Shut places down. Arrest people. Put some perpetrators in prison. Seize their flashy cars and nice houses bought from the money made from kidnapping people or leaving them in squalor. Realistic outcomes we thought. That was the difference we wanted to achieve. We were disappointed. The legal instruments that currently exist seem deficient for the task. If the task is providing protections for people living with a psycho-social disability. or to hold perpetrators to account for their actions. or to prevent them from having opportunities to cause harm to other vulnerable people in the future. We seem to start by issuing compliance notices and ‘please explains’. There appears to be a very high bar to providing evidence that a breach of the law or the codes or the regulations has occurred. even when these ‘practices of concern’ (abuses) have been identified, reported, evidenced and proven, the sanctions which are placed on a person or a company do not seem to reflect the impact of their inappropriate actions. there are very few examples of prosecuting business people for the exploitation, abuse or neglect of people living with disability.

4. Reforms and recommendations

In our 2023 report there were forty seven recommendations regarding SRS and NDIS (Pages 142-145). The following are the most pertinent for this submission:

 -   Establish a national safeguarding authority for vulnerable adults.
 -   Establish a national reporting system for reporting risks to vulnerable adults.
 -   Establish public accountability for reducing abuse with public reporting on reports received,
   responded to and resolved.
 -   Require every person employed to work with vulnerable adults to undergo a screening
    process.
 -   Establish local health and wellbeing multi-disciplinary response teams at all Community
   Health Centres to support the health outcomes of local vulnerable adults.
 -   Urgent action is required to ensure SILs are the legal responsibility of an appropriate
    regulatory authority.
 -   Improve NDIA and NDIS risk assessments to ensure they appropriately identify vulnerable
     adults.
 -   Review (and improve) current standards and codes related to accommodation of vulnerable
     adults.
 -   Develop universal accreditation standards that apply to all services that provide
   accommodation for vulnerable adults.
 -   Conduct desk-top reviews and cross-reference all information given to all regulators (ASIC,
  ATO, NDIA, DFFH) by businesses using tax-payers money (DSP, NDIS) to provide services
    to vulnerable adults.

Conclusion :

This is a short synopsis of the issues facing the most marginalised and vulnerable members of our community. They typically have limited supports and are highly susceptible to exploitation.

As the three members of the health team from the report “People Need People”, we heard firsthand how poorly the NDIS was working for this cohort and the harm that it was doing. Our interviews also highlighted the extent to which both registered and unregistered NDIS businesses were using exploitative practices to extort money from the government. We identified widespread neglect and abuse of the most vulnerable members of society. We had great hopes that change would come. We’re still waiting.

Link to the report : People Need People.pdf