FOI 24/25-1662
OFFICIAL For Internal Use Only
DOCUMENT 1
Case Management Guide Restrictive Practices
| Field | Category | Reference Documents |
|---|---|---|
| Title | Restrictive Practices | |
| Purpose | This document is part of a suite of guidance documents for Case Managers to use in formulating their approach to managing individual matters before the Administrative Review Tribunal (ART). | |
| Scope | This Guide applies nationally to the conduct of all matters within the External Review Branch. | |
| What are restrictive practices? | Restrictive practices refer to ‘any practice or intervention that has the effect of restricting the rights or freedom of movement of a person with disability;’ which includes chemical restraint, mechanical restraint, physical restraint, environmental restraint, and seclusion. Restrictive practices used by providers which are funded by the NDIA are subject to regulation and oversight by the National Disability Insurance Scheme Quality and Safeguards Commission (NQSC). |
Sections 9 and 181H of the National Disability Insurance Scheme Act 2013 National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 Behaviour support and restrictive practices |
| Policy statement | The ART process is often seen as stressful and adversarial by participants and prospective participants of the Scheme. The NDIA will adopt a participant-focused approach to resolving disputes before the ART, and will work directly with participants and prospective participants to provide better and earlier outcomes, where possible. The role of the NDIA is to assist the ART in reaching the correct and preferable decision, including by assisting participants and prospective participants in reaching the best possible resolution by agreement. Restrictive Practices The Agency will only fund supports which employ the use of restrictive practices within a behaviour support framework that includes proactive, person-centred, and evidence-informed interventions. |
NDIA Dispute Resolution Policy Appendix B to the Legal Services Directions 2017 NDIS QSC Policy Guidance: Developing Behaviour Support Plans Regulated Restrictive Practices Summary and Protocols Parts 2 and 3 of the National Disability Insurance Scheme (Restrictive Practices |
NDIA-ERB-GDE-013-FINAL OFFICIAL Page 1 of 5
FOI 24/25-1662
OFFICIAL For Internal Use Only
Case Management Guide Restrictive Practices
| Field | Category | Reference Documents |
|---|---|---|
| This means the Agency will fund supports that use restrictive practices in circumstances where they are: * clearly identified in a current behaviour support plan, which is subject to annual review to ensure the effectiveness and oversight of implemented restrictive practices; * compliant with State or Territory legislation regarding the use of restrictive practices, including compliance with authorisation processes and reporting obligations or the outright prohibition of restrictive practices. It is important to note that authorisation processes may differ in each state. Clarification can be gleamed through a desktop review of state authorisation processes; * a last resort in response to a risk of harm to a participant or others, after a provider has explored and applied alternative evidence-based, person-centred, and proactive/reactive strategies; * the least restrictive response available including least restrictive practice in the circumstances to ensure the safety of a participant or others; * effective in reducing the risk of harm to a participant or others; * proportionate to the potential negative consequence of the risk of harm; * used for the shortest possible time to ensure the safety of the participant or others; * clearly communicated to the applicant and their family in an accessible and culturally and linguistically inclusive format; * trauma-informed, recognising the high prevalence of, and mitigating future |
and Behaviour Support) Rules 2018 National Disability Insurance Scheme (Incident Management and Reportable Incidents) Rules 2018 National Framework for Reducing and Eliminating the Use of Restrictive Practices in the Disability Service Sector Conventions on the Rights of Persons with Disabilities (CRPD) 2515 UNTS 3 Restrictive Practices Authorisation (NSW) Restrictive practices and the law (ACT) Restrictive interventions (VIC) Restrictive practices (QLD) Restrictive Practices Authorisation Framework (NT) Restrictive Practices Authorisation scheme (SA) Authorisation of restrictive practices (WA) Restrictive Interventions TAS |
NDIA-ERB-GDE-013-FINAL OFFICIAL Page 2 of 5
FOI 24/25-1662
OFFICIAL For Internal Use Only
Case Management Guide Restrictive Practices
| Field | Category | Reference Documents |
|---|---|---|
| occurrence of, traumatic experiences in persons with lived experiences of disability; * clearly consider the participant and the participant’s context; * delivered by suitably trained staff; and * subject to regular monitoring and review. |
||
| Approach to ART matters | The Agency is committed to the reduction and elimination of restrictive practises where possible. The Agency is only likely to sanction the use of restrictive practices as a last report in response to a risk of harm, and for the shortest time possible. Advice from the Technical Advice and Practice Improvement Branch (TAPIB) is mandatory in matters concerning the use restrictive practices. In some circumstances it may be appropriate to deviate from the TAPIB advice. The use of restrictive practices must be clearly identified in an interim or comprehensive behaviour support plan, which requires a functional behaviour assessment. |
NDIS Quality and Safeguards Commission — Regulated Restrictive Practices Guide National Framework for Reducing and Eliminating the Use of Restrictive Practices in the Disability Service Sector |
| Recommended evidence | Interim behaviour support plans should be implemented no later than 1 month after a service agreement. Within the interim plan, a Behaviour Support Practitioner is required to perform an assessment to identify the use of Restrictive Practices. The Behaviour Support Practitioner has approximately 6-months after the interim behaviour support plan to develop a comprehensive behaviour support plan with relevant authorisation for Restrictive Practices contained in the plan. The use of restrictive practices should be informed by a collaborative approach involving health care and allied health care providers, occupational therapists, speech pathologists and physiotherapists, with respect to a participant’s context and background, as well as the systems and environment in which restrictive practices will be used. |
NDIS Quality and Safeguards Commission — Regulated Restrictive Practices Guide Administrative Review Tribunal Guideline on Persons Giving Expert Opinion Evidence |
NDIA-ERB-GDE-013-FINAL OFFICIAL Page 3 of 5
FOI 24/25-1662
OFFICIAL For Internal Use Only
Case Management Guide Restrictive Practices
| Field | Category | Reference Documents |
|---|---|---|
| A comprehensive risk assessment should be conducted prior to the use of restrictive practices, taking account of any underlying physical health-related concerns and psychological risks and the risk of injury to a participant. | ||
| Other considerations | As a condition of registration, all NDIS providers must ensure that: * restrictive practices do not occur where the relevant State or Territory prohibits such use; * restrictive practices are used in accordance with State or Territory authorisation processes and a behaviour support plan; and * restrictive practices are recorded by the provider and reported to the NDIS QSC Commissioner, so that the use of restrictive practises can be effectively monitored and regulated by the NDIS QSC. * The oversight role of the NDIS Commission extends to registered NDIS providers only. Therefore, family implementing Restrictive practices may not hold reporting obligations to the NDIS QS8c- * The use of unauthorised restrictive practices requires a Participant Critical Incident (PCI) report. Please liaise with line manager to discuss options to lodge a PCI outside of the tribunal. The penalties imposed on providers who are found to have breached the conditions of registration relating to the use of restrictive practices include civil penalties and the revocation of their registration. The use of chemical constraints (including medication prescriptions) must be included in an BSP, even when prescribed by a physician. Intensive person-to-person support models, such as a support ratio of 3:1 or 4:1, may constitute a containment model. |
Core, Capacity Building and Mainstream Interface Supports NDIS Quality and Safeguards Commission — Regulated Restrictive Practices Guide Rules 7A, 20(4) and 20(5) of the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018 Behaviour support and restrictive practices |
NDIA-ERB-GDE-013-FINAL OFFICIAL Page 4 of 5
FOI 24/25-1662
OFFICIAL For Internal Use Only
Case Management Guide Restrictive Practices
| Document Control | Responsible Person | Date |
|---|---|---|
| Document author | Continuous Improvement | March 2025 |
| Document approver | Assistant Director, Policy, Continuous Improvement | 20 March 2025 |
NDIA-ERB-GDE-013-FINAL OFFICIAL Page 5 of 5
FOI 24/25-1662
DOCUMENT 2
AAT Case Management Guide Restrictive Practices
OFFICIAL For Internal Use Only
| Field | Content | Reference Documents |
|---|---|---|
| Title | Restrictive Practices | |
| Purpose | This document is intended to establish the Agency’s policy position regarding the use of restrictive practices. | |
| Scope | Restrictive practices refer to ‘any practice or intervention that has the effect of restricting the rights or freedom of movement of a person with disability;’ which includes chemical restraint, mechanical restraint, physical restraint, environmental restraint, and seclusion. Restrictive practices used by providers which are funded by the NDIA are subject to regulation and oversight by the National Disability Insurance Scheme Quality and Safeguards Commission (NQSC). |
Sections 9 and 181H of the National Disability Insurance Scheme Act 2013 National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 Understanding behaviour support and restrictive practices |
| Escalation to Hearing Oversight Committee (HOC) | If a matter is within the parameters of this document, the AAT Case Management Branch Manager may approve proceeding to hearing. Where there is substantial risk or the matter is outside the parameters of this document, the matter should be referred to HOC. | |
| Current National Disability Insurance Agency (NDIA) policy on the subject | The AAT process is often seen as stressful and adversarial by the participants and our focus should be on resolving issues as practicably and quickly as possible. The role of the NDIA is to assist the AAT and the participant in reaching the best possible resolution for the participant by agreement. The Agency will only fund supports which employ the use of restrictive practices within a behaviour support framework that includes proactive, person-centred, and evidence-informed interventions. This means the Agency will fund supports that use restrictive practices in circumstances where they are: * clearly identified in a behaviour support plan; |
NDIA Dispute Resolution Policy Appendix B to the Legal Services Directions 2017 NDIS QSC Policy Guidance: Developing Behaviour Support Plans Regulated Restrictive Practices Summary and Protocols |
AAT CM Guide Restrictive Practices November 2022 3
FOI 24/25-1662
AAT Case Management Guide Restrictive Practices
OFFICIAL For Internal Use Only
| Field | Content | Reference Documents |
|---|---|---|
| * compliant with State or Territory legislation regarding the use of restrictive practices, including compliance with authorisation processes and reporting obligations or the outright prohibition of restrictive practices; * a last resort in response to a risk of harm to a participant or others, after a provider has explored and applied alternative evidence-based, person-centred, and proactive strategies; * the least restrictive response possible in the circumstances to ensure the safety of a participant or others; * effective in reducing the risk of harm to a participant or others; * proportionate to the potential negative consequence of the risk of harm; * used for the shortest possible time to ensure the safety of the participant or others; * clearly communicated to the applicant and their family in an accessible and culturally and linguistically inclusive format; * trauma-informed, recognising the high prevalence of, and mitigating future occurrence of, traumatic experiences in persons with lived experiences of disability; * clearly consider the participant and the participant’s context; * delivered by suitably trained staff; and * subject to regular monitoring and review. |
Parts 2 and 3 of the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 National Disability Insurance Scheme (Incident Management and Reportable Incidents) Rules 2018 National Framework for Reducing and Eliminating the Use of Restrictive Practices in the Disability Service Sector Conventions on the Rights of Persons with Disabilities (CRPD) 2515 UNTS 3 Refer also to relevant State and Territory legislation |
|
| NDIA Posture in relation to this subject | The Agency is committed to the reduction and elimination of restrictive practises where possible. The Agency is only likely to sanction the use of restrictive practices as a last report in response to a risk of harm, and for the shortest time possible. Advice from the Technical and Advisory Branch (TAB) is mandatory in matters concerning the use restrictive practices. In some circumstances it may be appropriate to deviate from the TAB advice. Note: In all cases where a proposed resolution deviates from the TAB advice, the case must be |
NDIS Quality and Safeguards Commission — Regulated Restrictive Practices Guide National Framework for Reducing and Eliminating the Use of Restrictive Practices in the Disability Service Sector |
AAT CM Guide Restrictive Practices November 2022 3
FOI 24/25-1662
AAT Case Management Guide Restrictive Practices
OFFICIAL For Internal Use Only
| Field | Content | Reference Documents |
|---|---|---|
| escalated to a Case Management Director, Administrative Appeals Branch. | ||
| Evidence recommended to inform NDIA position in a specific matter before the Administrative Appeals Tribunal (AAT) | The use of restrictive practices must be clearly identified in a comprehensive behaviour support plan, which requires a functional behaviour assessment. The use of restrictive practices should be informed by a collaborative approach involving health care and allied health care providers, occupational therapists, speech pathologists and physiotherapists, with respect to a participant’s context and background, as well as the systems and environment in which restrictive practices will be used. A comprehensive risk assessment should be conducted prior to the use of restrictive practices, taking account of any underlying physical health-related concerns and psychological risks and the risk of injury to a participant. |
Rule 20 of the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 NDIS Quality and Safeguards Commission — Regulated Restrictive Practices Guide Persons Giving Expert and Opinion Evidence Guideline Administrative Appeals Tribunal |
| Other considerations | As a condition of registration, all National Disability Insurance Scheme (NDIS) providers must ensure that: * restrictive practices do not occur where the relevant State or Territory prohibits such use; * restrictive practices are used in accordance with State or Territory authorisation processes and a behaviour support plan; and * restrictive practices are recorded by the provider and reported to the NQSC Commissioner, so that the use of restrictive practises can be effectively monitored and regulated by the NQSC. The penalties imposed on providers who are found to have breached the conditions of registration relating to the use of restrictive practices include civil penalties and the revocation of their registration. |
Core, Capacity Building and Mainstream Interface Supports NDIS Quality and Safeguards Commission — Regulated Restrictive Practices Guide Rules 7A, 20(4) and 20(5) of the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018 Understanding behaviour support and restrictive practices - for providers |
AAT CM Guide Restrictive Practices November 2022 3
FOI 24/25-1662
AAT Case Management Guide Restrictive Practices
OFFICIAL For Internal Use Only
| Field | Content | Reference Documents |
|---|---|---|
| Previous matters that may advise the NDIA position | ||
| Document admin | Quality, Strategy and Training | 4 January 2023 |
| Approved | redacted: s47F Matthew Swainson, Chief Counsel |
redacted
AAT CM Guide Restrictive Practices November 2022 3