1.1
The Joint Standing Committee on the National Disability Insurance Scheme (the committee) was established by resolution by the House of Representatives on 4 July 2019 and the Senate on 22 July 2019. The committee is composed of five Members and five Senators, and is tasked with reviewing:
(a)
the implementation, performance and governance of the National Disability Insurance Scheme (NDIS);
(b)
the administration and expenditure of the NDIS;
(c)
such other matters in relation to the NDIS as may be referred to it by either House of the Parliament.
1.2
The committee is required to present an annual report to the Parliament on the activities of the committee during the year, in addition to reporting on any other matters it considers relevant.
1.3
The committee is also able to inquire into specific aspects of the Scheme. On
1 August 2019, the committee decided to undertake an inquiry into NDIS planning, with particular reference to:
(a)
the experience, expertise and qualifications of planners;
(b)
the ability of planners to understand and address complex needs;
(c)
the ongoing training and professional development of planners;
(d)
the overall number of planners relative to the demand for plans;
(e)
participant involvement in planning processes and the efficacy of introducing draft plans;
(f)
the incidence, severity and impact of plan gaps;
(g)
the reassessment process, including the incidence and impact of funding changes;
(h)
the review process and means to streamline it;
(i)
the incidence of appeals to the Administrative Appeals Tribunal (AAT) and possible measures to reduce the number;
(j)
the circumstances in which plans could be automatically rolled-over;
(k)
the circumstances in which longer plans could be introduced;
(l)
the adequacy of the planning process for rural and regional participants;
(m)
any other related matters.
Conduct of the inquiry
1.4
The committee published 157 submissions to the inquiry from individuals and organisations. Submissions are listed in Appendix 1.
1.5
The committee also held 14 public hearings in which matters related to planning were discussed:
8 October 2019 in Brisbane.
9 October 2019 in Sydney.
28 October 2019 in Hobart.
7 November 2019 in Melbourne.
19 November 2019 in Adelaide.
21 November 2019 in Canberra.
13 February 2020 in Canberra.
23 June 2020 via teleconference.
30 June 2020 via teleconference.
14 July 2020 via teleconference.
28 July 2020 via teleconference.
18 August 2020 via teleconference.
8 September 2020 via teleconference.
12 October 2020 via teleconference.
1.6
Besides hearing from witnesses during formal hearings, the committee heard evidence in town-hall sessions. Transcripts from hearings, with submissions and answers to questions on notice, are available on the committee’s website. Witnesses who appeared at the hearings are listed in Appendix 2.
Background to the NDIS
1.7
The NDIS, as the National Disability Insurance Agency (NDIA) informed the committee, is a social insurance scheme that takes a lifetime approach ‘by investing in people early to build their capacity to help them pursue their goals and aspirations resulting in greater outcomes later in life’.
1.8
The NDIS is a federal government initiative available in all Australian jurisdictions. It has replaced former state and territory government disability programs.
1.9
Planning is central to the NDIS. Besides access, planning is the primary point of contact between participants, the NDIA and partners in the community.
1.10
The National Disability Insurance Scheme Act 2013 (NDIS Act) establishes the NDIS and contains particular provisions concerning planning. The NDIS Act also establishes the NDIA, which is responsible for administering the scheme. The Commonwealth Department of Social Services is responsible for policy development in areas related to social services, including disability policy.
1.11
Another body relevant to planning is the NDIS Quality and Safeguards Commission, an independent agency established to improve the quality and safety of NDIS supports and services.
1.12
The NDIS began with the NDIS Act in 2013, and is now an Australia-wide program supporting more than 410,000 participants as of October 2020. In the 2019–20 financial year, the NDIS paid participants $17.2 billion in supports, with average payments per participant being $50,800.
Background to planning
1.13
Planning is central to the NDIS. Planning, along with access, is the primary point at which participants interact with the scheme. Every participant will—or should—receive a plan at some point after they have been granted access to the NDIS.
1.14
Planning can require a huge administrative effort for participants, families, support networks and others involved in the planning process, such as allied health professionals. The Victorian Office of the Public Advocate argued that ‘the bureaucracy of the planning process can lead to fatigue, be disempowering, and, in the worst of cases, can contribute to negative outcomes’. One participant outlined this in greater detail in a submission to the inquiry:
I want the Committee to get an understanding into how unimaginably stressful planning is – the stakes are too high. Planning determines so many things about my life and the NDIS has absolute control. This can never not be terrifying for anybody who is severely disabled.
If anything goes really wrong – like a gap in my plan – my worst nightmare is that I lose my remaining independence and in the worst case would have to move into a hospital or aged care facility…
Because everything is SO high stakes, the emotional toll planning takes on a person is enormous…
1.15
Planning is often the first time participants will interact with the NDIS after being deemed eligible. The success of the planning process shapes a participant’s overall experience with the NDIS and their ongoing quality of life. Once a participant has been deemed eligible for the NDIS, they will then develop a plan and have a plan meeting to discuss the content of that plan.
1.16
Planners help participants to develop plans. Planners include:
Local Area Coordinators (LACs), who are employed under contractual arrangements with the NDIA’s Partners in the Community;
Early Childhood Early Intervention (ECEI) partners, where a child under the age of seven becomes an NDIS participant; and
NDIA planners, including those who have the authority to approve plans as a delegate of the CEO of the NDIA.
1.17
According to the 2019 Review of the NDIS Act led by David Tune AO PSM (Tune Review), around 30 per cent of participants are assigned an employee of the NDIA to develop a plan, while 70 per cent are assigned an LAC or ECEI partner who then sends the plan to an NDIA delegate for approval. These figures were current at the beginning of the national roll-out of joint planning in early 2020, in which a participant meets face-to-face with an NDIA delegate, as well as their LAC or ECEI Partner. The national roll-out of joint planning has been paused because of the COVID-19 pandemic.
1.18
The steps involved in a planning cycle are as follows:
(1)
Pre-planning, in which participants prepare for a planning meeting by thinking about their goals and the supports needed to achieve those goals, including, if relevant, by consulting with family members and allied health professionals.
(2)
The participant meets in a formal planning meeting with an NDIA planner, a LAC or an ECEI partner to develop goals and discuss supports.
(3)
The NDIA allocates funding for a package of supports in a plan for a particular period of time.
(4)
The plan is provided to the participant for implementation.
(5)
Towards the end of the plan, the cycle begins again with an evaluation of how the plan has been working combined with pre-planning for the next plan.
(6)
Following a plan review, the NDIA issues the participant a new plan.
(7)
If a participant is unhappy with NDIA decisions, they may ask for an internal review of these decisions.
(8)
If a participant is unhappy with the outcome of the internal review, they may apply, in certain circumstances, to the AAT for an external review.
1.19
The NDIS Act specifies that the following must be included in a plan:
A statement of goals and aspirations prepared by the participant, which includes their goals, objectives and aspirations, and the environmental and personal context of the participant’s living; and
A statement of participant supports, prepared with the participant and approved by the CEO, which outlines general supports, reasonable and necessary supports, the date by which the NDIA must review the plan, and the management of the funding for supports under the plan.
1.20
Participants can ask someone else to manage their plan (a plan nominee), self-manage their plan, be plan managed (use a registered plan manager to manage their plan) or be agency-managed (have the NDIA be responsible for purchasing and managing the supports in their plan).
1.21
Participants who are agency-managed can only use service providers who are registered with the NDIS Quality and Safeguards Commission. Participants who self-manage or are agency-managed may use supports from non-registered providers, except for specialist disability accommodation, specialist behaviour support services and supports that involve using a regulated restrictive practice. Plan managers must also be registered NDIS providers.
1.22
Plans are of varying length. Generally, plans will last for one year. However, some plan are as short as three months and others—more recently—have been as long as three years.
1.23
Planning is a broad exercise crossing many different areas, including other government systems like health and the criminal justice, allied health supports, access to community programs and, in some instances, the AAT.
Interim report by this committee
1.24
The committee tabled its interim report into planning in December 2019. The committee’s recommendations covered the following areas:
Standardising terminology.
Plan flexibility and funding for transport.
Draft plans and joint planning.
First plan approvals and complex support needs.
Children with acquired injuries and complex care needs.
1.25
The Government tabled its response to the interim report in March 2020. More detail about the interim report and the Government’s response is provided in Chapter 2.
Supported Independent Living inquiry
1.26
The committee tabled its report into Supported Independent Living (SIL) in May 2020. This report examined issues for participants receiving SIL, including the role of planners and the content of plans. The report is available on the committee’s website.
Review of the NDIS Act and the new NDIS Participant Service Guarantee (Tune Review)
1.27
The Tune Review was commissioned in June 2019 to look at ways that NDIS participants’ experiences could be improved, including ways that the NDIS Act could be amended to achieve these improvements. The review also considered a Participant Service Guarantee, to ‘set standards and timeframes for NDIA decision-making as it affects NDIS participants, their families and carers’.
1.28
The NDIS Participant Service Guarantee was a campaign promise by the Morrison Government in the 2019 federal election to set ‘new standards for shorter timeframes for people with disability to get an NDIS plan and to have their plan reviewed’, with a focus on children, and participants needing specialist disability accommodation and assistive technology.
1.29
This report refers to the recommendations of the Tune Review and the Government’s response where there is cross-over between this inquiry and the content of the Tune Review.
Structure of this report
1.30
This report is divided into twelve chapters:
Chapter 1 (this chapter), which introduces the inquiry and provides a brief overview of the planning process.
Chapter 2, which outlines the recommendations made in the committee’s interim report and the Australian Government’s response.
Chapter 3, which presents issues concerning plan funding.
Chapter 4, which presents concerns about informal supports and the role of families in the planning process.
Chapter 5, which examines the overlap between NDIS planning and other government systems.
Chapter 6, which discusses the role of experts in the planning process.
Chapter 7, which looks at concerns about planner training and expertise.
Chapter 8, which examines planning for particular groups of participants.
Chapter 9, which presents issues about planning in rural and remote areas.
Chapter 10, which outlines concerns about the AAT process.
Chapter 11, which discusses issues relating to communication with the NDIA.
Chapter 12, which details further issues concerning planning.
Note on evidence provided to this inquiry
1.31
The submission closing date for this inquiry was September 2019. As a result, a number of the issues outlined in evidence may have been superseded by reforms the NDIA has commenced since then.
Note on terminology and references
1.32
Abbreviations are outlined in full at the beginning of this report. Those that are most commonly used throughout the report include the NDIS Act (National Disability Insurance Scheme Act 2013), the NDIA (National Disability Insurance Agency), LACs (Local Area Coordinators), ECEI (Early Childhood Early Intervention) and the Tune Review (2019 Review of the NDIS Act and the new NDIS Participant Service Guarantee).
Acknowledgements
1.33
The committee thanks all those who contributed to the inquiry by lodging submissions, providing additional information or expressing their views through correspondence. In particular, the committee thanks participants, their family members and advocates who gave the inquiry first-hand information about their experiences of the planning process.