3.1
The COVID-19 pandemic has had extraordinary ramifications for virtually every element of society. This chapter reviews material raised in evidence during the committee's General Issues inquiry. It does not thoroughly examine all elements of the COVID‑19 pandemic and its effect on people with disability. The committee is also conscious that other major inquiries are considering these issues, including:
the Senate Select Committee on COVID‑19, which has taken evidence from the National Disability Insurance Agency (NDIA), the NDIS Quality and Safeguards Commission (the Commission), and representative disability organisations; and
the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (the Royal Commission), which in August 2020 explicitly considered 'experiences of people with disability during the ongoing COVID-19 pandemic'.
3.2
This chapter examines evidence regarding the effect of the pandemic, as follows:
Planning and preparation for the disability sector.
The effect of the pandemic on people with disability and their families.
The effect of the pandemic on disability support providers and the associated workforce.
Access to personal protective equipment (PPE).
The responses of the NDIA and the Commission to the pandemic, and comments from inquiry participants about these responses.
3.3
The chapter concludes with the committee's view and recommendations.
Planning and preparation
3.4
During the initial phase of the pandemic there was considerable concern that people with disability and the disability sector were not being adequately considered in the pandemic response.
3.5
On 18 February 2020 the Commonwealth Government published the Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID‑19) (the COVID-19 Plan). As Ms Kate Eastman SC, Senior Counsel Assisting, later told the Royal Commission in August 2020:
There was no mention or reference in the COVID-19 Plan for people with disability. The Royal Commission will hear this week that people with disability and their advocates watched and waited to hear the Commonwealth government's plan for people with disability.
3.6
On 26 March 2020 the Royal Commission issued a 'Statement of concern' regarding the response to the pandemic for people with disability. The Royal Commission said it 'is deeply concerned about the impact of the COVID-19 pandemic on people with disability' and called upon 'all governments to ensure that, in their responses, they include dedicated strategies to protect and support people with disability'.
3.7
The Royal Commission's statement was 'strongly' endorsed in an open letter released on 3 April 2020 and signed by over 70 disability organisations. The signatories called on the government to take ten 'urgent actions to protect the lives of Australians with disability in the context of COVID‑19', including in relation to continuity of supports for people with disability, the quality of public communications, and preventing discrimination against students with disability.
3.8
On 3 April 2020 the Australian Government established an advisory group 'to guide development and implementation of a response plan focusing on the unique health needs of people with disability during the coronavirus pandemic'. The group included 'experts from the disability sector, academia, clinical practice, nursing, Australian government officials, and state and territory government representatives'.
3.9
On 15 April 2020 relevant Commonwealth ministers wrote to the Royal Commission acknowledging the statement of concern and enclosing an outline of the government's actions in response to the pandemic in relation to people with disability. The following day, National Cabinet approved the Management and Operational Plan for COVID-19 for People with Disability. The Government said this plan 'forms part of the national response developed by the Government' and 'is aligned with' the COVID-19 Plan.
3.10
When asked why the initial COVID-19 Plan did not refer to people with disability, Ms Catherine Rule, Department of Social Services, acknowledged:
I think it's fair to say that, early in the pandemic, people with a disability were not specifically named in the high-level plans that existed around the response. It's not because thoughts weren't given to people with disability. Certainly, in the department, the commission and the agency, we had done a lot of work on planning what that operational response would look like. Subsequently, the [Australian Health Protection Principal Committee] agreed on a plan that was specifically about people with a disability.
Effect on people with disability and their families
3.11
A clear theme in evidence to the committee was that COVID-19 presented particularly difficult challenges for people with disability and their families. For instance, People with Disabilities Western Australia submitted:
The impact of [COVID‑19] for people with disability has been huge in terms of sometimes loss of services, anxiety, difficulty accessing vital services such as food and medicines, isolation, and essential supplies such as gloves and gowns being hard to source.
3.12
The Queensland Law Society stated that people with disability are at 'increased risk' during the pandemic, because in some cases 'their disability or health condition increases their vulnerability to illness', and because changes intended to reduce the spread of COVID‑19 mean that 'accessibility issues for persons reliant on the NDIS have become even more acute'.
3.13
Various submitters and witnesses reported that the pandemic increased stress and anxiety for people with disability and their families. Ms Chelsea McKinney of the Western Australian Association for Mental Health told the committee:
Some NDIS participants reported to us that the general anxiety around COVID, combined with issues of food insecurity, an inability to engage with remote options—not everybody has internet access or the data needed to engage with those supports—and the change in their supports, contributed to very significant heightened mental health issues for some consumers.
3.14
Ms Romola Hollywood of People with Disability Australia reported that:
…many people have told us that it's been quite scary through the COVID‑19 pandemic to have multiple workers potentially coming in and out of their home. Whilst there are measures that can be taken to reduce the risks, people feel that they would like to be able to build up a consistent, ongoing and long-term relationship with their support workers.
3.15
Mr Trevor Carroll stated that the advocates of his organisation, Disability Justice Australia, were unable to meet with any clients because 'disability advocates are not deemed to be essential workers'. This was particularly problematic because about 25 per cent of these clients are unable to use alternative means of communication without assistive technology and individual support.
3.16
One submitter advanced that COVID‑19 is likely to cause not only an economic recession, but also 'a so‑called "social recession"'. Observing that social isolation is associated with increased health risks, the submitter stated:
No one quite knows how the social isolation enforced by the COVID-19 will affect people with disabilities, but even those who avoid the worst consequences will likely see their quality of life degrade.
3.17
The Supportive Families and Friends Association emphasised the effect of the pandemic and associated restrictions on people in Supported Independent Living (SIL) settings, stating:
SIL changes are being introduced as group homes in Melbourne are currently in crisis. Day services have been closed since March and residents have been at home 24/7 for months. Their routines have been severely disrupted. The residents are at a high-risk of catching the coronavirus, as mask wearing, good hygiene and social distancing are difficult to implement. Many residents have not seen their family in months, and have no social contacts outside their home.
3.18
Ms El Gibbs of People with Disability Australia commissioned a report surveying over 200 people with disability about the pandemic. She discussed this report and shared her experience of four months 'on lockdown':
I'm also a person with disability and I'm one of those people who have been on lockdown since early March. I went for a walk recently, about two weeks ago, around my town very carefully. It was the first time I'd been outside since then. When I commissioned the report, I was reading the words of other people with disability who had had a very, very similar experience to my own. It was a time when it was really lonely and incredibly scary. I don't live in a particularly regional area, but I am about 100 kays outside of Sydney. It was an extremely difficult and stressful time. For me, all the systems that I used to live independently collapsed and disintegrated. It took me the first four, six or eight weeks to get systems back in place so that I could get groceries and I could get food. I have a huge advantage: I have a job; I have an income. I'm not living in poverty, so I could pay extra money to people so they could go and do things for me. I could pay extra money to rejig my disability supports. I could pay extra money to buy things from strange places on the internet, because I have the internet and I have money. I could do all of those things and I found it an incredibly difficult and stressful time. So, when I read in the survey where so many people with disability talked about having to make decisions between food and medication, feeling completely abandoned by everyone and feeling like they had no-one to turn to, it really broke my heart, but it made me feel that this experience was something that we shared across Australia.
3.19
Ms Mary Sayers of Children and Young People with Disability Australia emphasised that the pandemic has disrupted the education of young people with disability, and that '[o]ur members have reported a steep decline in mental health.' She advanced that the move to remote learning by schools for students with disability:
…reinforces the existing inequality and disadvantage they already face in their education. Outright discrimination, lack of reasonable adjustments and failing to include students with disability were prominent features.
3.20
Ms Liz Callaghan of Carers Australia emphasised that 'carers themselves have been under major stress'; she explained:
Large numbers of carers have needed to provide more intensive care in relation to a diversity of needs and to provide much longer hours of care, often without support from family and friends who are also in lockdown. Carers report high levels of financial stress, particularly in relation to the purchase of food and groceries, high costs of obtaining medicines and equipment, and higher transport costs, particularly for those previously reliant on public transport. To add to this stress, some carers have had to give up paid employment in order to provide full-time care during the lockdown.
Effect on disability support providers and the workforce
3.21
Like many elements of Australian society, disability support providers and their workers were seriously affected by COVID-19.
3.22
One mental health provider, the Mental Illness Fellowship of Western Australia, saw 100 of its 400 NDIS participants cancel their support 'overnight' when the pandemic emerged. Its Chief Executive Officer (CEO), Ms Monique Williamson, recounted that there was therefore:
…no work for their staff and no income revenue for us as an organisation. That was a real moral dilemma, because we knew that once COVID-19 settled down we would need those workers.
At MIFWA we drew around $50,000 out of our reserves and we continue to underwrite the salaries of our staff and try and redirect them into some COVID-19 supports for other people. But it really highlighted for us how insecure the NDIS workforce and job security are.
3.23
The Australian Orthotic Prosthetic Association submitted that the pandemic was having a 'substantial effect' on the orthotic/prosthetic workforce, and estimated that 'the majority of orthotic/prosthetic service providers will experience financial hardship with many services reducing service capacity'. As a consequence of reduced staffing levels, the association expected that it will be 'difficult for NDIS participants to access immediate and timely orthotic/prosthetic services'.
3.24
The Western Australian Department of Communities reported feedback from the disability sector that government support could be greater:
One thing that came up with the COVID pandemic and was repeatedly mentioned by people in the disability sector was disappointment that the incentives provided to the aged-care sector during the pandemic—incentive payments to retain staff and ready access to PPE—were not afforded to the disability sector.
3.25
Ms Lisa Kelly of Carers ACT observed differences in the 'level and degree of information' from the Department of Health regarding aged care compared to information that 'came through NDIS or disability service supports'. The latter:
…was confusing and not clear. It was mostly driven through the NDIS and didn't take into account the fact that there are people with a disability and carers of people with a disability who are not on the NDIS.
3.26
Ms Emeline Gaske of the Australian Services Union highlighted the particular difficulties facing support workers assisting a person with an intellectual disability who might have COVID-19:
Training someone to put the PPE itself on and take it off is one thing, but there's so much more work that goes into supporting a client who is suspected of COVID-19—even more so in a group home environment. There's cleaning. There's the management of the emotions and reactions of the client, and perhaps trying to support someone with an intellectual disability to understand the rules around social distancing and any number of associated things.
3.27
Some inquiry participants reflected on the higher unemployment rates caused by the pandemic and how this might interact with the disability sector. Ms Sayers of Children and Young People with Disability Australia asked:
When we look at how many workforce shortages we have, how can we shift the narrative to say that this work [in the disability sector] is really meaningful and valuable work that young people who have lost jobs in other sectors could be interested in entering? That requires a public campaign. It requires incentives, as I mentioned earlier, and the right environment.
3.28
Catholic Social Services Australia submitted that the NDIS workforce needed additional staff even before the pandemic. It stated:
Positioning the disability sector as an employer of choice needs to begin before the recovery of the rest of the economy. That is why CSSA is recommending that preparations for a strong awareness raising campaign to attract and retain employees in the disability sector should be done as matter of priority.
3.29
Mr David Moody of National Disability Services told the committee that:
COVID-19 has resulted in a substantial growth in unemployment, which is expected, unfortunately, to be sustained. This tragedy may deliver more disability support workers as people seeking work consider new career options.
3.30
Mr Tim Wilson of the Community Accommodation and Respite Agency (Cara) suggested that consideration should be given to the type of staff being engaged in the future NDIS workforce:
The level of unemployment due to the COVID-19 pandemic may lead some to conclude that there's an abundance of people looking for work which will lead to all our employment vacancies being filled. However, people are needed who align with customer needs, organisational values and NDIS worker requirements, and none of these should be weakened. So, despite an increasing unemployment rate, this is not a solution to the supply of workers to disability service providers.
3.31
The Victorian Public Advocate, Dr Colleen Pearce AM, expressed concern that the disability and social service workforces 'will face novel challenges in attracting and retaining workers in the aftermath of the pandemic'. She added:
Like others, I fear that that people with disability will be disproportionately affected, and that enduring issues affecting the under resourced, inadequately trained and poorly supported disability workforce will become even more critical.
3.32
Some inquiry participants advocated for the urgent implementation of paid pandemic leave in the disability sector. For instance, Ms Gaske of the Australian Services Union advanced that paid pandemic leave:
…is essential in the disability sector. We've seen the tragic situation in aged care, and that's driven by insecure work. This is a workforce that is precarious. It's one of the most casualised workforces in the country and they can't afford to miss a shift. Disability workers need the support of a safety net so they can isolate if they need to, without risking not being able to pay the rent or put food on the table.
3.33
Mr Lloyd Williams of the Health Services Union referred to unions' industrial relations proposals in March 2020, which included paid pandemic leave:
Disappointingly, the proposals received no support from the Commonwealth, and many employer groups devoted considerable resources to stopping these changes from happening. As a consequence, our members report feeling very much forgotten during the pandemic and describe feeling dangerously underprepared and unsupported throughout the pandemic.
Access to personal protective equipment
3.34
The onset of the COVID-19 pandemic placed considerable strain on the availability of PPE such as masks, gloves, goggles and gowns. While it seems that this issue has largely been addressed, it attracted significant public attention and concern during the initial phase of the pandemic.
3.35
A key finding of a University of New South Wales (UNSW) Social Policy Research Centre survey of 2,341 disability workers, conducted in March 2020, was as follows:
There is an urgent lack of personal protective equipment (PPE) being supplied to staff and clients, and many workers feel their organisation's safety protocols have been inadequate in the context of COVID-19.
3.36
The survey provided a range of comments by disability workers about the difficulty accessing PPE during initial phase of the pandemic, including:
Dangerously unprepared with lack of PPE. We had to ask other houses for hand sanitiser. No face masks or protective eye wear for personal care procedures. Made me feel very unsafe working with children and I don't want to go back to work and be put at risk.
…
Since the arrival of COVID19...every time I head to work it feels like Russian Roulette. Knowing that we have not been supplied with basic safety equipment e.g. hand sanitizer, anti-bacterial hand wash, masks, shoe covers etc, does not make me feel safe. Knowing that there are no guidelines re: an outbreak of the disease in the houses, and knowing how vulnerable some of the clients (and staff are) is terrifying…
3.37
Ms Claire Hewat of Allied Health Professions Australia referred to 'critical shortages' of PPE during the initial phase of the pandemic; stating in July:
The initial response to pandemic revealed significant issues in relation to provisions for people with disability and the allied health providers delivering support to them. At a time of critical shortages of personal protective equipment, the national stockpile was limited, with no access for allied health. Whilst that has actually improved a little bit, there are still significant issues in Victoria where allied health professionals working with people with disability in environments of very close contact still have to source their own supplies of PPE if they can.
3.38
Mr David Moody, CEO of National Disability Services, advised that from mid- to late-March until about June, his organisation was 'getting complaints from providers about their inability to access PPE from the National Medical Stockpile'. These complaints particularly arose where PPE was sought for the purpose of 'ensuring a belt-and-braces approach to worker and participant safety'; Mr Moody said that it 'was particularly difficult for providers doing the right thing to get access to PPE'. He explained that National Disability Services decided to set up its own hub to support supply:
These were issues that, at least in part, might have been resolved when the commissioner was able to get an email address inserted on the National Medical Stockpile website specifically for disability service providers. It is fair to say that the hoped-for outcome wasn't immediately delivered, because providers using that email address were still confronted with the reality that the criteria for accessing the National Medical Stockpile essentially limited access to PPE to those working in the health and aged‑care sectors. That actually saw [National Disability Services] working with a number of providers of PPE to establish our own [National Disability Services] PPE hub, to ensure that our members at least were able to access PPE on a full cost-recovery basis during the pandemic, certainly during stage 1 of the pandemic.
3.39
In August 2020 Dr Emma Campbell of the ACT Council of Social Service reported that the availability of PPE had improved over previous months, but nonetheless referred to a prior 'situation of crisis':
[W]e're not in a situation of crisis in the ACT, and I would suggest that the situation with PPE was resolved only after the situation of crisis had passed. So I think some of that frustration still remains, but, because we have no community transmission and also because the advice has changed to encourage people to wear masks, which was not the case previously, even though many people who were providing disability care or receiving disability care felt safer having proper PPE, I think there is a bit more certainty and confidence in the disability service sector at the moment.
Government response regarding access to personal protective equipment
3.40
In September 2020 a representative of the Department of Social Services, Ms Catherine Rule, acknowledged initial issues relating to PPE but said 'feedback from providers and participants is that those issues that existed early in the pandemic have been resolved and they have access to the equipment they need'. She also clarified:
When it became clear early on that there were supply issues nationally—not just for disability but nationally around PPE—we worked quickly with the National Medical Stockpile to make sure there was a specific process in place and allocations available for the disability sector.
3.41
The NDIA advised that requests from the disability sector for PPE are assessed by the Department of Health using criteria that 'take into account disability sector specific issues' but also reflect the criteria applied to aged care, so that 'access to the stockpile is consistent'. Where a registered NDIS provider is approved for supply from the national medical stockpile, that supply is provided through the NDIA.
3.42
Mr Graeme Head AO, the NDIS Quality and Safeguards Commissioner, stated that the Commission gave 'extensive advice to providers and participants about access to PPE', and there was also a dedicated 'hotline-style' email address established for providers or self‑managing participants to contact the National Medical Stockpile. He explained:
The advice to people with disability is, in the first instance, to attempt to source PPE through their usual arrangements. But where there's a clinical basis—based on Health's advice—for a person to continue using PPE, they contact the National Medical Stockpile.
3.43
Mr Head also advised that the Commission gave providers access to 'the Commonwealth Health training on infection control and COVID-19 related issues', and this training was 'used extensively by disability workers along with our own training'.
3.44
As at the week commencing 27 July 2020, the NDIA had distributed 58,580 surgical masks from the stockpile to 'organisations delivering support to NDIS participants'. By 7 September 2020 this figure was 193,000 masks.
Government response in the disability sector
3.45
This section reviews evidence regarding the responses of the NDIA and the Commission to the pandemic. Government representatives have indicated that it was largely the role of the NDIA to communicate with participants, and the role of the Commission to communicate with providers.
3.46
While not the focus of this section, the government's response in the disability sector was not limited to the actions of the NDIA and the Commission.
The National Disability Insurance Agency's response
3.47
The NDIA submitted that the pandemic 'highlighted the need for the NDIA to be agile and responsive to rapidly changing situations'. It assured the committee that it had:
…acted swiftly to address the potential impact of the COVID-19 pandemic on NDIS participants, families, carers and providers. The NDIA's absolute priority during the COVID-19 pandemic is participant health, safety, and ensuring participants can continue to access their essential supports.
3.48
The CEO of the NDIA, Mr Martin Hoffman, advised that even during the initial phase of the pandemic, 'the volume of services and supports provided has continued to increase'. Mr Hoffman explained:
In the June quarter, over $5 billion worth of services and supports for people with disability in the scheme were provided, which was the biggest quarter ever. What we saw was a number of providers increasingly changing their delivery to make use of teledelivery of services, and that enabled a number of people to continue accessing services even during heavy lockdown times. I think that change in technology and approach is particularly important in rural and remote areas.
3.49
However, in late April 2020 Mr Hoffman also reported that physical distancing restrictions caused an overall decline in the amount of psychosocial supports being delivered, though some group supports had moved to one-on-one or telehealth.
3.50
Several of the NDIA's policy responses to the pandemic—discussed below—were announced by the Minister for the NDIS, the Hon Stuart Robert MP, on 21 March 2020.
Support for NDIS participants
3.51
The NDIA submitted that it implemented 'a number of changes and improvements to support participants during the COVID-19 pandemic'. This section discusses some of these changes.
3.52
To ensure that participants had access to funding, the NDIA automatically extended some plans beyond their expiry date. It explained:
Where a participant has an NDIS plan that is working for them, the NDIA is extending current plans by up to 12 months automatically where a plan is due to end, and approving new plans of up to 24 months upon review to make sure participants have the funding they need.
3.53
Between 27 March and 30 April 2020, 12,930 plans were 'auto extended'. The NDIA stated that it will 'explore options' to retain the capability for automatic 12 month extensions beyond the pandemic.
3.54
Other changes that relate to NDIS participants include the following:
The NDIA 'proactively' contacted 'vulnerable participants to ensure they were continuing to receive and access their key NDIS supports'. Between the minister's announcement of this measure on 21 March and 1 July 2020, the NDIA made 62,188 outbound calls of which approximately five per cent were by email or letter. The NDIA submitted that, as a result of these calls, 2,212 plan amendments (including light touch reviews) were made prior to 30 June 2020.
The NDIA provided greater flexibility for participants by allowing them:
…to use their funding across the four categories of their core supports budget. Participants can decide how to use this funding for day-to-day assistance, to pay support workers to help with everyday tasks like grocery shopping or daily living tasks.
Recognising that many services were being delivered online, the NDIA temporarily allowed participants to 'access low cost [assistive technology] items, such as smart devices and fitness equipment, in consultation with their existing support providers'. In practice, this enabled participants to spend up to $1,500 on 'low cost [assistive technology] items from their existing Core - Consumables budgets' (although participants were not to spend more than $750 on electronic devices needed for existing services).
The NDIA broadened the eligibility criteria for specialist disability accommodation to allow certain additional participants to access it upon discharge from hospital when required.
Certain forms were made available online so that it was not necessary to visit an NDIA office. Between 27 April and 5 May 2020, the Access Request Form was downloaded 4,985 times.
The NDIA 'worked with' supermarkets so that, from 6 April 2020, participants were able to request priority when buying groceries online for delivery to their home.
The NDIA 'prioritised the use of phone-based planning', but NDIA offices remained open for those who wished to visit an office in person.
Support for NDIS providers
3.55
In response to the pandemic, the NDIA also made a number of changes relating to providers, including the following:
The NDIA provided financial assistance to NDIS providers:
From 30 March 2020 the NDIA offered an advance payment to 7,846 eligible providers. This payment was 'to support them with immediate cash flow to retain their staff and deliver supports to participants through the COVID‑19 pandemic'. The NDIA is recovering these advance payments from 1 October 2020 over a period of six months.
From 25 March to 30 June 2020, a 10 per cent 'loading' was added to the price limits for core NDIS supports. This applied only to price controlled support items in certain categories and not to quotable supports.
From 30 March to 1 July 2020 participants cancelling a service were required to give 10 business days' notice in order to avoid paying the full fee for the cancelled service. This was an increase from requiring two business days' notice to avoid paying 90 per cent of the service fee. The cancellation period has now reverted to two business days, but the amount providers can charge for a cancelled service will continue to be 100 per cent.
The NDIA implemented several measures to support continuity of service, including:
clarifying arrangements for the time critical exchange of information between the NDIA and the NDIS Commission; and
tracking payments to service providers each day to identify any emerging service gaps.
In collaboration with the Department of Social Services and the NDIS Commission, the NDIA launched 'a dedicated webpage…to help providers and participants find additional support workers during the pandemic'.
Effect on the work of the NDIA
3.56
Like many other organisations, some of the work planned by the NDIA was affected by COVID-19. This includes the following:
The transition to independent assessments was delayed.
The National Community Connector Program was 'originally designed on a face‑to‑face basis', but the NDIA said that due to the pandemic:
…it is not possible to provide these services using an assertive outreach approach. The National Community Connector Program commenced roll out from 1 July 2020, utilising innovative delivery methods in the COVID‑19 environment.
The timeline for delivering Disability Reform Council initiatives relating to participants with psychosocial disability 'will extend into 2021 as a result of the impact of COVID-19 on operational priorities for all Australian governments'.
Work by the NDIA to rollout a 'streamlined process' for the approval of assistive technology 'has been impacted by COVID‑19'.
In December 2019 the NDIA released a preliminary discussion paper in relation to a Digital Partnership Program that 'will manage controlled and secure access to some of the NDIA's data and systems'. Due to COVID‑19, the period for responses to the discussion paper was extended from March to 14 April 2020.
Work by the NDIA to reduce market gaps in certain locations has been affected by the pandemic; the NDIA submitted:
The COVID-19 pandemic has limited the face to face work that can be done to address market challenges in the NDIS, however 'thin markets' work continues.
The NDIS Quality and Safeguards Commission's response
3.57
This section briefly discusses the Commission's response to COVID-19, recognising that the committee is currently conducting another inquiry that is specifically focussed on the Commission.
3.58
The Commission advised the committee that it 'is, of course, heavily involved in responding to COVID-19'. The Commission stated that its '[r]egulatory priorities for the current year are being adjusted to take account of the specific issues that have arisen through the management of the COVID-19 pandemic'.
3.59
Regarding the Commission's work during the pandemic Mr Graeme Head AO, Commissioner, stated that:
…a very significant part of our work during the pandemic has been communicating regularly and clearly about issues of concern to participants and also things that providers needed to know.
3.60
The first Provider Alert relating to COVID-19 was issued to registered providers by the Commission on 7 February 2020. In August 2020 the Commission reported that it had issued 23 provider alerts and four fact sheets 'dealing with issues such as infection control training, access to and use of Personal Protective Equipment, and the use of restrictive practices'.
3.61
Mr Head also confirmed that all registered providers have a general obligation to notify the Commission of matters that may affect the provision of supports. In mid-March 2020, Mr Head issued a notice to providers:
…reinforcing that obligation but also requiring specific notifications related to COVID-19. Those notifications relate to both things that will affect the provision of supports and the extent to which there are known infections of workers or clients.
3.62
The Commission submitted that its budget was revised in recognition of the pandemic:
In the July 2020 Economic and Fiscal update, the NDIS Commission received $2.6 million for 2019-20 and $3.6 million for 2020-21 to recognise the NDIS Commission's additional support to individuals and service providers impacted by COVID-19.
3.63
The Commission's planned work was disrupted to an extent by the pandemic; it would have held another national advocacy workshop earlier in 2020 if the pandemic had not arisen.
Comments about the government's response in the disability sector
3.64
Some inquiry participants supported the continuation of certain changes enacted by the NDIA and the Commission in response to COVID-19. For instance, measures supported by People with Disabilities Western Australia include:
the ability to use 'the core flexible budget to purchase support coordination if needed';
the ability for participants whose core budgets are plan or agency managed to spend their core funding flexibly across all four core categories;
increased flexibility in the use of core funds for transport and low cost assistive technology; and
the process by which plans could be extended by up to 24 months.
3.65
Evidence also indicated support for the continued availability of telehealth. For instance, Ms Callaghan of Carers Australia suggested:
Some of the adjustments and innovations made to support carers during COVID have had positive impacts and should be continued into the future. These include access to affordable telehealth.
3.66
Ms Samantha Jenkinson of People with Disabilities Western Australia told the committee that plan reviews were processed more quickly during the pandemic:
During the main part of COVID, we were seeing that, if people were requesting reviews for things which were quite small, they were actually getting through very quickly. It was much better. There was a much clearer understanding of the need to be flexible about those things, which we hadn't seen previously.
3.67
More broadly, Mr Harry Lovelock of Mental Health Australia submitted that lessons learned during the pandemic about supporting people with psychosocial disability should be recorded so that they can be called upon in future.
3.68
The NDIA has recognised the potential benefits of continuing certain changes that were introduced in response to the pandemic. The NDIA advised that it will 'continue to monitor and review its response to the COVID-19 pandemic to ensure the safety and well-being of participants is placed at the centre of all decisions'. As Mr Hoffman told the committee:
The COVID-19 pandemic has fundamentally changed how the agency interacts with participants and the way participants use their plans. Feedback indicates that some short-term initiatives put in place during the pandemic may provide ongoing benefit, such as participant check-ins, plan extensions and rollovers, and light-touch reviews. Based on this feedback, we've taken the opportunity to further develop the way we interact with participants beyond COVID and in our approach to planning.
3.69
Notwithstanding these positive comments, the committee also heard concerns about the response of the NDIA and the Commission.
3.70
Mr Damian Griffis, CEO of the First Peoples Disability Network, recounted his organisation's decision to independently distribute care packages to First Peoples with disability:
We were frustrated by the bureaucratic way in which care packs appeared to be administered—for example, by such measures as online registration processes. We know such a process is largely inaccessible to many First Peoples with disability and their families. We felt we couldn't wait, so, when an opportunity to partner with the Al-Ihsan charity arose, we gratefully accepted the opportunity to partner with them. I'm very proud to say that, as of today, we've delivered, in partnership with the Al-Ihsan charity, a total of 1,458 care packages throughout New South Wales and the ACT. It is our understanding that this far exceeds the delivery numbers of any other mechanism currently being employed to distribute care packages to Aboriginal people.
3.71
People with Disabilities Western Australia expressed concern about the 10 per cent loading allowed for providers, submitting that it:
…is being absorbed by services rather than going to our employees and yet it comes from our plans. This 10% increase is not being automatically reimbursed to our plans, and this creates a situation where we are being sacrificed for the sake of the service providers.
3.72
Mr Hoffman sought to provide assurance that '[t]he money is coming from the scheme within the plan budget framework', and stated:
Utilisation rates of plans are running—it varies—at 60 to 70 per cent, so there is scope within the funded plan that the scheme provides to cover this time limited additional payment. Where there is not, or where in a particular case a plan may hit the limits, we have been very quick to make plan adjustments as required for a particular participant.
3.73
Ms Sayers, Children and Young People with Disability Australia, referred to a report by her organisation titled Not even remotely fair: Experiences of students with disability during COVID-19. She stated:
Whilst half of our respondents said that their NDIS needs changed with the onset of COVID-19, not many families, only five per cent, actually were able to secure changes. As one parent explained: 'I don't have capacity for that battle.'
3.74
Despite the need for some participants to amend their plan due to COVID-19, Victoria Legal Aid submitted that the NDIA 'has been reluctant and indeed has refused in several cases' to vary plans where the participant has an appeal on foot with the Administrative Appeals Tribunal (AAT). Victoria Legal Aid submitted that this issue relates to uncertainty about the AAT's jurisdiction and provided examples of affected participants, including:
In May 2020, a [Victoria Legal Aid] lawyer acting for an NDIS client received a call from the NDIA to do a "COVID welfare check" in relation to the client and to see whether the client needed any changes to his plan, but was then told that because there was an AAT appeal outstanding, no changes could actually be made to the plan.
3.75
Ms Kirsten Deane of Every Australian Counts acknowledged that the Commission published various fact sheets for participants about COVID-19, but expressed concern many participants might not be aware that information was available. She also raised concern that the Commission's advice to participants was delayed, recalling that her daughter (an NDIS participant) received advice in September 2020 about what to do in the face of a COVID-19 outbreak. By that time, her family had been in self-isolation since March and 'because we live in Melbourne we had been in stage 4 lockdown for about five weeks before we received that letter'.
3.76
Ms Hollywood of People with Disability Australia expressed concern about the way that the Commission oversaw providers during the pandemic:
During the COVID-19 pandemic, people with disability told us of NDIS service providers that ceased support, breaching their obligations to provide continuity of support. However, rather than launching its own motion investigations into these claims and reports, the commission generally encouraged individuals to make complaints.
Committee view
3.77
It is clear that the COVID-19 pandemic has had an extraordinary and disruptive effect on Australian society. This effect was particularly acute for people with disability and their families. As discussed in this chapter, people with disability may be particularly vulnerable to the health effects of COVID‑19 or to the closures implemented to reduce physical contact.
3.78
The committee recognises the serious difficulties presented by the pandemic for people with disability, their families, providers, workers, and others in the disability sector. Many people put in a great deal of effort to support people with disability and themselves during the pandemic, and the committee is grateful for these endeavours.
3.79
During March and April 2020, when many in the community were very concerned about the consequences of COVID-19 for people with disability, including access to PPE, the committee sought and received confidential briefings from the Department of Social Services, the NDIA, and the Commission. Government representatives assured the committee that the government was endeavouring to resolve these issues as quickly as possible.
3.80
The evidence presented in this chapter shows that the government adopted a wide range of measures to support NDIS participants and providers during the pandemic. However, it would have been beneficial if relevant planning and preparation had been in place earlier. This is reflected, for example, in the problems with access to PPE during the initial outbreak of COVID-19—even though these problems were later addressed. Planning and preparation for future pandemics should reflect consultation with people with disability, NDIS participants, disability support providers, disability support workers, and other affected groups.
3.81
The committee is pleased that the NDIA and the Commission implemented various changes with particular regard to the challenges of COVID-19. It appears that several of these changes were beneficial and may continue to be beneficial beyond the pandemic. Serious consideration should be given to maintaining these changes, including access to telehealth, increased flexibility in budgets, and increased flexibility regarding plans. However, other elements of the response, discussed in the chapter above, could be improved.
3.82
The events of the COVID‑19 pandemic, and the responses of the NDIA and the Commission, should be closely reviewed and assessed to improve the NDIS and support for people with disability in future emergencies. This process should be undertaken in consultation with people with disability and other relevant groups to ensure that the lessons learned from the pandemic are well‑informed.
3.83
The committee recommends that the National Disability Insurance Agency and the NDIS Quality and Safeguards Commission:
review and assess their responses to the COVID‑19 pandemic to better understand how to respond to future emergencies, including pandemics; and
in connection with the Commonwealth Government, ensure that appropriate preparations and plans are in place to support people with disability during future emergencies, including pandemics.
3.84
The committee recommends that the National Disability Insurance Agency and the NDIS Quality and Safeguards Commission maintain, beyond the COVID‑19 pandemic, beneficial changes that were implemented in response to the pandemic.