NDIA Accountability Project

Areas of relevance based on the Tasmanian Government's experience of the Quality and Safeguards Commission

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Tasmanian Government

Submission

Areas of relevance based on the Tasmanian Government’s experience of the

Quality and Safeguards Commission

September 2020

Table of Contents

I . Introduction

  1. Restrictive practices

  2. Market and workforce issues

  3. Residential aged care

  4. Responding to concerns, complaints and reportable incidents

  5. The NDIS Code of Conduct and the NDIS Practices

Standards

  1. Communication between the Commission and the

Tasmanian Government

2

I Introduction

The safety and wellbeing of Tasmanian National Disability Insurance Scheme (NDIS) participants is a key priority for the Tasmanian Government. An effective NDIS Quality and Safeguards Commission is critical in ensuring that Tasmanian NDIS participants feel safe and are able to access and receive quality supports, regardless of the type of services they need or where they live.

The following information highlights key areas ofrelevance for the Tasmanian Government based on our experience of the Commission in Tasmania.

2 Restrictive practices

  • Under the N DIS Quality and Safeguarding Framework jurisdictions are responsible for legislative and policy frameworks that authorise the use of restrictive practices.

  • The authorising frameworks differ across jurisdictions. This impacts on the ability to achieve a nationally consistent authorising environment for restrictive practices.

  • Tasmania’s restrictive practice regulatory framework does not include or define chemical restraint. This is a notable variance from the NDIS (Restrictive Practices and Behaviour Support) Rules 2018.

  • Since July 2019, when the Commission commenced operations in Tasmania, providers have indicated that there is some confusion in relation to the interface between national and state requirements, and that there has been an associated increase in, and duplication of, reporting requirements.

  • The increased reporting requirements can partially be attributed to Tasmania’s thin market in the supply of behaviour support practitioners and its capacity to meet the demand to develop behaviour support plans.

  • Tasmania has commenced preparatory work to enable a comprehensive review of the Tasmanian Disability Services Act 20 I I during 2021-22. This review will provide the mechanism to consider the alignment between Tasmanian legislative requirements and definitions with the NDIS as they relate to restrictive practices in Tasmania, including chemical restraint.

3 Market and workforce issues

3.1 Behaviour Support Practitioners

  • Tasmania’s limited supply of behaviour support practitioners and their capacity to meet the demand to develop behaviour support plans has resulted in significant waiting periods for NDIS participants and has contributed to the number of unauthorised restrictive practices required to be reported to the Commission.

  • Noting the range of experience and skill level of behaviour support practitioners in the Tasmanian market, further opportunities exist to improve the capacity to deliver quality behaviour support plans (e.g. increased access to training and resources).

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3.2 Audits and Registrations

  • Although the approved quality auditor market has increased, and most identify they provide services across Australia, there remains limited Tasmanian based auditors. This results in an additional financial impost associated with travel related expenses for Tasmanian based providers.

  • While there is a collaborative effort by providers and the sector peak body to minimise cost and coordinate audits, an opportunity exists to grow the capacity of locally based auditors.

  • The Tasmanian Government welcomes the Commission’s recognition that the capacity of NDIS providers to fully engage in registration renewal audits may be affected as they focus on continuity of support and services to participants during the COVID-I9 pandemic.

  • During the COVID-I9 pandemic, enabling the variation of conditions of registration where necessary (for example, allowing an extended period to complete the registration and/or audit process) has the Tasmanian Government’s support 4 Residential aged care

  • The Tasmanian Government supports the Commission’s decision to extend the NDIS residential aged care exemption from registration, from 30 June 2020 to 30 November 2020, in recognition of the significant pressure the COVID-19 pandemic has placed on the aged care sector.

  • Despite the extension, there is still a risk of increased regulatory burden for residential aged care providers if they are required to undertake certification for NDIS registration and meet and complete aged care certification.

  • The Tasmanian Government encourages strategies to be considered that, as far as possible, mutually recognise similar certification processes thereby minimising the need for providers to undertake multiple regulatory and administrative processes.

    5 Responding to concerns, complaints and reportable

incidents

  • A key function of the Commission is to respond to concerns, complaints and reportable incidents including those relating to abuse and neglect of NDIS participants.

  • The Tasmanian Government has been meeting regularly with representatives from the Tasmanian disability sector, including National Disability Services Tasmania. Based on feedback from the sector, the Government notes: o In regard to reportable incidents, providers have advised that the Commission is often reluctant to provide specific advice when requested (for example, a query around whether a particular event was a reportable incident) preferring to refer to generic information available on the Commission’s website.

o The lodging of notifications is, at times, cumbersome and time consuming and

providers have reported having to complete notifications at·weekends or during a ‘quieter’ period. o Providers have reported significant delays in receiving advice from the Commission about reportable incidents (an example was given where the Commission advised in May 2020 that a report lodged in July 2019 was not a reportable incident). o Where incidents occur outside of NDIS support hours, further clarity is required on the role of the provider and the Commission. 6 The NDIS Code of Conduct and the NDIS Practice

Standards

  • Tasmania considers the N DIS Code of Conduct and Practice Standards are generally adequate to regulate the NDIS workforce.

  • The Tasmanian Government supports recent amendments to the NDIS (Provider Registration and Practice Standards) Rules to address emerging issues on disproportionate regulatory burden for providers delivering lower risk supports.

  • In the context of disability related health supports, the Government considers the practice standards and accompanying skill descriptors could be augmented to ensure good clinical governance arrangements are embedded in the Commission’s regulatory framework Tasmania will continue to advocate for these improvements in the practice standards and skills descriptors through the relevant national working groups.

    7 Communication between the Commission and the

Tasmanian Government

  • The Tasmanian Government has established good working relationships with the Commission since its commencement in Tasmania on I July 2019. Information sharing protocols have been agreed and generally communication and engagement has been effective, achieving positive outcomes for NDIS participants and providers.

  • The Government welcomed the appointment of the Tasmanian State Director in 2019 and the recent appointment of Assistant Director for Behavioural Support. Tasmania looks forward to continued strong governance arrangements commensurate with other jurisdictions.

  • As a small jurisdiction, effective communication and sharing of information is particularly important for a range of reasons, including: the need to respond accurately and quickly to general or ministerial enquiries: and, in the case of NDIS providers who also deliver non-NDIS state-funded services (i.e. where a contract is in place with the Tasmanian Government), the Tasmanian Government needs to be aware of any interdependent governance or system arrangements that could impact service delivery.

  • At a national policy development level, progressing critical work with the Commission has presented some challenges, particularly in the areas of health and worker screening.

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  • An example in the health area is the Clinical Governance Working Group (CGWG). The CGWG was established following a Disability Reform Council decision to fund a range of disability related health supports through the NDIS from October 2019. While some issues have been progressed, further work remains outstanding on clarifying the clinical governance of delegated supports and developing guidance on the cost effective and safe delegation of disability related health supports. Tasmania understands the COVID-19 pandemic necessitated a shift in priorities for the Commission and jurisdictions which resulted in a pausing of the CGWG’s work Tasmania looks forward to the CGWG reconvening in the near future to ensure progress on the outstanding work

  • In regard to worker screening, the Tasmanian Government considers that communications could be improved, particularly those relating to providing information and technical detail for integrating with the Worker Screening National Clearance Database (NCO). For example, the later than expected delivery of NCO functional specifications continues to affect Tasmania’s capacity to build, test and implement integrated systems in a timely manner. This presents a high risk to data quality, functional integrity and system stability for all stakeholders.

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