NDIA Accountability Project

Exclusion of standard household appliances from NDIS funding

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Submission to

Senate Standing Committees on Community Affairs

National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024

May 2024

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Contents

Introduction ………………………………………………………

Recommendations ………………………………………..

General comment …………………………………..

s 32E Reasonable and necessary budget—entitlement to flexible funding or stated

supports ………………………………………………………

s 10 Definition of NDIS support ………………

Introduction

The Queensland Nurses and Midwives’ Union (QNMU) thanks the Senate Standing Committees on Community Affairs for the opportunity to provide feedback on the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024 (the Bill).

The QNMU is Queensland’s largest registered union for nurses and midwives, representing over 73,000 members. The QNMU is a state branch of the Australian Nursing and Midwifery Federation (ANMF) with the ANMF representing over 322,000 members.

Our members work in health and aged care including public and private hospitals and health services, residential and community aged care, mental health, general practice, and disability sectors across a wide variety of urban, regional, rural, and remote locations.

The QNMU is run by nurses and midwives, for nurses and midwives. We have a proud history of working with our members for over 100 years to promote and defend the professional, industrial, social, and political interests of our members. Our members direct the QNMU’s priorities and policies through our democratic processes.

The QNMU expresses our continued commitment to working in partnership with Aboriginal and Torres Strait Islander peoples to achieve health equity outcomes. The QNMU remains committed to the Uluru Statement from the Heart, including a pathway to truth telling and treaty. We acknowledge the lands on which we work and meet always was, and always will be, Aboriginal and Torres Strait Islander land.

This submission will first give a general comment regarding the matters currently being addressed by the NDIS Provider and Worker Registration Taskforce, to which the QNMU has also provided a written response. Then, we will address some of the items proposed in the Amendment bill.

Recommendations

The QNMU recommends:

  • That consideration is given in the NDIS rules to acknowledge the considerable and vital role of families, carers, people with an enduring power of attorney and/or people who otherwise support a person with disability during decision-making.

  • That the explanatory notes are reviewed to make clear that “standard household appliances and whitegoods” can be a necessary part of a person with disability’s everyday mobility and independence, and therefore should not be used as an example of items ineligible for NDIS funding.

General comment

As an organisation that represents nurses and midwives and assistants in nursing/personal care workers working across all sectors of health, aged care, disability and mental health, the QNMU welcomes the introduction of legislative reforms to the National Disability Insurance Scheme (NDIS) and its intention to support choice, inclusiveness, and flexibility for its participants.

In light of the findings and recommendations following the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, we believe the following principles must guide all structural, legislative, and regulatory changes:

  • The safety of its participants (and eligible participants) must come first.
  • Funding for the NDIS must adequately cover the level of care/services needed.
  • There must be appropriate regulatory oversight of NDIS providers.

The QNMU considers that the NDIS must be a system that recognises the personal autonomy of its participants and actively seeks to ensure that people with disability are able to make decisions on matters that affect their lives. We also acknowledge the significant cost of the NDIS in supporting people with disability to access the right care and services at the right time, in a manner that they choose.

However, the QNMU expresses concern that the current system has failed to build in safety measures to mitigate the risk of bad faith actors in this space. As identified in the Royal Commission, there is a concerning lack of regulation of NDIS providers and an absence of regulatory measures to ensure that participants are not placed at risk of exploitation and abuse at the hands of unscrupulous providers.

While we recognise that the tools, goods, and services necessary to live a meaningful life varies across individuals, and therefore self-determination will look different for all NDIS participants, there must be a baseline level of regulation and oversight to ensure that NDIS providers have the skills and/or qualifications required to provide appropriate care. The government must eliminate the risk of participants choosing (or being coerced into ‘choosing’, including through direct intimidation or through lack of alternative options) NDIS providers who are unable to demonstrate competency.

s 32E Reasonable and necessary budget—entitlement to flexible funding or stated supports

Flexible funding

(2) If the needs assessment report for the plan indicates that the participant needs at least some supports that are NDIS supports but not stated supports for the participant, the reasonable and necessary budget must provide:

(a) that certain funding (flexible funding), up to a specified amount (the total funding amount), will be provided under the plan to or in relation to the participant for those supports; and

(b) that the flexible funding may be spent on any NDIS supports for the participant and only on such supports, subject to any restrictions under subsection 32F(6) that require the funding to be spent on particular supports.

The QNMU asks that consideration is given in the NDIS rules to acknowledge the considerable and, at times, vital role of families, carers, people with an enduring power of attorney and/or people who otherwise support a person with disability during decision-making. People who are registered advocates should have far greater ability to be involved throughout the decision- making process, including being informed when a decision needs to be made or plans change.

We express concern that flexible funding and self-management of funding, under the auspices of increased financial autonomy, fails to recognise the inherent vulnerability of people with forms of disability that feature cognitive or decision-making impairment. There is a risk that flexible funding will open the doors for opportunists to target vulnerable people by creating an administrative barrier around families, carers, and other supports and preventing their involvement in decision-making around how the funding is allocated.

s 10 Definition of NDIS support

A support is an NDIS support for a person who is a participant or prospective particpant if:

(a) the support: (i) is necessary to support the person to live and be included in the community, and to prevent isolation or segregation of the person from the community; or (ii) will facilitate personal mobility of the person in the manner and at the time of the person’s choice; or (iii) is a mobility aid or device, or assistive technology, live assistance or intermediaries that will facilitate personal mobility of the person; or (iv) is a health service that the person needs because of the person’s impairment or because of the interaction of the person’s impairment with various barriers; or (v) is a habilitation or rehabilitation service; or (vi) is a service that will assist the person to access a support covered by subparagraph (iv) or (v); or (vii) will minimise the prospects of the person acquiring a further impairment or prevent the person from acquiring a further impairment; or (viii) is provided by way of sickness benefits; […]

The QNMU is concerned that the explanatory notes of the Bill are at odds with the new definition of NDIS supports, specifically, that “standard household appliances and whitegoods” are ineligible for NDIS funding. We would consider that standard household appliances and whitegoods are indeed “necessary to support the person to live and be included in the community, and to prevent isolation or segregation of the person from the community.” For example, a pull-drawer opening dishwasher would assist a wheelchair user, or a bottom-mount fridge freezer for someone with a spinal injury.

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The exclusion of standard household appliances and whitegoods from NDIS funding is indicative of a needlessly rigid and restrictive view of disability aids; it suggests that household appliances and whitegoods are not support items unless they are expressly marketed as having a disability-specific therapeutic use, while also suggesting that a person with disability either requires a disability aid all the time or does not. On the contrary, it is rarely the case that a single item or tool suffices to support independence to live and be included in the community, but rather, a collection of adjustments to a person’s everyday environment that that has the greater impact.

We therefore ask that the explanatory notes are reviewed to make clear that “standard household appliances and whitegoods” can be a necessary part of a person with disability’s day-to-day mobility and independence, and therefore should not be used as an example of items ineligible for NDIS funding.