NDIA Accountability Project

Concerns about NDIS reform sustainability and participant support

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Submission 33

CDSS

17 May 2024

Committee Secretary Senate Standing Committee on Community Affairs PO Box 6100 Parliament House Canberra ACT 2600

By email: community.affairs.sen@aph.gov.au

Dear Committee Members

National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024 [Provisions] (‘the Bill’)

Thank you for the opportunity to provide feedback in relation to the above.

About QCOSS

Queensland Council of Social Service (QCOSS) is Queensland’s peak body for the social service sector. Our vision is to achieve equality, opportunity, and wellbeing for all Queenslanders.

QCOSS’ position

QCOSS has concerns in relation to the Bill, which introduces significant changes in relation to the National Disability Insurance Scheme (‘the NDIS’).

QCOSS members in the Queensland community service sector include disability service providers and advocates. In the short timeframe available, QCOSS has drawn upon feedback from our members to inform this submission. Notwithstanding the shared values of our members who want to ensure ongoing, appropriately funded and rights respecting support is available to all people with disability, there is mixed feedback in relation to the Bill.

A commitment to human rights should guide reforms

As a signatory to the United Nations Convention on the Rights of People with Disability, it is critical to ensure the design and implementation of any changes are guided by a commitment to the human rights of people with disability. Opportunities must be taken to further embed human rights considerations and decision-making frameworks within legislation, systems and process. This includes ensuring that people with disability can actively participate in decisions that affect them.

QCOSS supports calls for a federal Human Rights Act. This reform process in relation to the NDIS presents an opportunity for the National Disability Insurance Agency (‘the NDIA’) to be on the front foot in expanding efforts to systemically embrace and embed human rights considerations into daily operations, resulting in powerful, rights respecting outcomes.

Consultation has been inadequate

Comprehensive processes supported widespread engagement with the NDIS Review and the Royal Commission into Violence, Abuse, Neglect, and Exploitation of People with Disability (‘the DRC’). Following on from those processes, it is disappointing that consultation on the Bill has been rushed. The Bill introduces major changes to the NDIS and lays the groundwork for future reform. The Bill should have been released publicly prior to its introduction to parliament. This would have enabled

greater participation of states and territory governments, service providers, advocates and people with disability to provide feedback on the details of the Bill.

QCOSS welcomes the Government’s commitment to ensure that key reforms are implemented in collaboration with people with disability and are supported with genuine consultation and collaboration with all key stakeholders.1 However, several QCOSS members are concerned that the Bill reflects a fundamental failure to do so. Member feedback has highlighted current feelings of anxiety among NDIS participants who are concerned about how the changes in the Bill will impact them. This is compounded in situations where participants have had negative experiences in navigating the NDIS previously, including experiences that felt overly adversarial.

Members have raised several specific areas where further consultation is required. This includes a need for information and consultation on what will or will not be considered an NDIS support, how those definitions can operate in a sufficiently flexible manner and how those definitions will support responsive rights respecting outcomes regarding eligible supports. Feedback has also highlighted a need for further information on the design and implementation of new assessment processes and assessment tools, including how the new approach to determining a ‘reasonable and necessary budget’ will be implemented. These definitions, systems and processes must be designed appropriately to ensure that the unique needs of an individual can be adequately met, including their need for choice and control.

Service providers and advocates have commented that some of the changes reflected in the Bill could deliver positive outcomes, depending on how those changes are designed and implemented. For example, proposals to assess participants’ needs more holistically, and to provide comprehensive early intervention support.

Sustainable and collaboratively planned supports are vital

Our members often reflect how transformative the NDIS has been for the lives of people with disability. Feedback consistently highlights the importance of ensuring the scheme remains sustainable and ensuring that all people with disability can receive the support they need.

Strategic planning must ensure that any change resulting from these reforms does not result in situations where people do not receive the support they need. Discussion with our members has illustrated confusion about who may or may not be able to receive support under the scheme going forward, whether that support will be sufficient to meet individual needs, what alternative supports will be available, and how the transition to relying further on foundational supports will be handled to ensure there are no gaps caused by the transition.

There is confusion and concern over whether people with psychosocial disabilities will be able to access NDIS support ongoing. Feedback has emphasised the importance of ensuring that people with psychosocial disability can access the support they need. It has been frequently raised that this reform process should also seek to address the kinds of circumstances where people with disability are currently not receiving any support or insufficient support. Feedback has also stressed a need to support service providers and participants in navigating the transition to different systems and processes.

Members have raised concerns about how the transition could impact all existing participants through this period. We have also received feedback outlining that disability service providers are experiencing considerable change fatigue and challenges to financial sustainability. There is a need for immediate price relief in parallel with the proposed transition, where the current cost model does not reflect the true cost of service delivery and compliance.

One regional service provider highlighted that the system must flexibly incorporate considerations on a person’s specific needs for support, along with the practicalities of accessing and delivering that support in different locations across Australia. They emphasized that a ’reasonable and

Additional Feedback on the Bill

QCOSS has received further member feedback outlining concerns on several proposed new powers and other aspects of the Bill. Broad feedback has expressed disappointment with some of the cost-cutting priorities reflected in the Bill, and over-emphasis on concerns relating to overspend in participant plans. While we are not in a position to engage exhaustively with the changes proposed by the Bill, we highlight the following:

  • There are concerns about suspension and revocation mechanisms where a participant fails to provide requested information. These mechanisms must incorporate strong safeguards, and adequate support to mitigate unintended negative consequences. Timeframes must be designed and communicated flexibly to accommodate the needs of participants, including those living in remote locations where access to services and specialists can be limited. Suspension and revocation processes should be approached with extreme caution, and decision makers should be cognisant of the impact these processes have on potentially vulnerable participants. The impacts of the RoboDebt scheme, for example, illustrate the grave consequences of poorly designed administrative processes that are not sufficiently empathetic or flexible.

  • Concerns have been raised in relation to mechanisms designed to respond to indicators that a participant may need additional support in managing their plan. Concerns include limits to participants’ choice and control, and the need to ensure that any decisions made in this context are the least rights limiting decisions available in the circumstances. Available options to be considered in this context should always include capacity building, guidance and support that empowers participants.

  • There is a need for clear guidelines and thresholds in relation to NDIA intervention, ensuring that any interventions are appropriate in the circumstances, and any processes or obligations can be easily understood.

  • Needs Assessments should constitute a reviewable decision, and participants should be actively included in each step along the assessment process.

  • Commitments to approach participant needs holistically must be genuinely realised and comprehensively reflected in the legislation, any guidance materials and assessment processes.

  • While many are supportive of longer-term plans with increased clarity and certainty, feedback has highlighted a need to ensure that avenues to adjust and review plans when

  • necessary are efficient and responsive, noting significant delays currently experienced in this respect.

  • One of our members who provide core supports as well as support coordination and plan management is concerned they will no longer be able to provide these combined services in light of changes proposed by the Bill. They acknowledge the importance of diligent conflict management in this context, although highlight that in delivering these services they are able to be highly responsive to the needs of their clients, which is particularly important when people are in crisis or experience complex life circumstances.

  • While many are supportive of commitments to ensure adequate safeguards and quality requirements with respect to service providers, feedback has outlined the need to consult further on how to ensure reforms in this respect are introduced and implemented appropriately. For example, acknowledging that some services naturally require higher standards of quality and compliance compared to others, and ensuring quality safeguards do not result in unintended negative consequences for participants.

Feedback has also urged careful consideration of mechanisms that authorise changes through delegated legislation, ensuring that major decisions, definitions and reforms are safeguarded through adequate oversight.