Chapter 6Committee view and recommendations
6.1Participants have described the National Disability Insurance Scheme (NDIS) as positively life-changing, when they are able to access supports. However, many applicants and participants, their families, carers and advocates, have told the committee about their frustrations with the culture of the National Disability Insurance Agency (NDIA), and its capability to efficiently provide supports.
6.2The capability and culture of the NDIA has its roots in its governing legislation, Australia's international obligations including the United Nations Convention on the Rights of People with Disability, and the policy directions provided by successive governments and ministers.
6.3The committee considers that recent government initiatives, such as the Disability Royal Commission and the NDIS Review, have given the disability community hope for positive change. In particular, the committee anticipates that implementation of the Disability Royal Commission's recommendations will improve the capability and culture of the NDIA.
6.4The committee also believes that an additional $732.9 million in the 2023–24 Budget also indicates a willingness to invest in improving the capability and culture of the NDIA.
6.5However, the committee is concerned by evidence that the NDIA has not, in some instances, fulfilled the promises of the NDIS Act or Australia's international commitments.
6.6Evidence to the committee indicates that the government and the NDIA have significant work still to do, to improve the agency's capability and culture and ensure that the NDIA is built to serve the people it is for: people with disability.
6.7Participants are disappointed when the NDIA does not recognise them as individuals, or understand the totality of their disability. Participants want the agency to focus on their individual goals, aspirations and ambitions and to value their lived experience and the supporting evidence of the professionals they work with.
6.8For these reasons, the committee makes the following recommendations to improve the capability and culture of the NDIA.
Capability and Culture
Primary and secondary disabilities
6.9The committee has heard the frustrations of participants who have been denied access to reasonable and necessary supports for impairments that are not related to a defined 'primary disability'. These experiences and impacts are detailed in Chapter 2 of this report.
6.10According to the NDIS Act, a person meets the eligibility criteria for the NDIS if they have a permanent disability that is attributable to one or more intellectual, cognitive, neurological, sensory, physical or psychosocial impairments that result in substantially reduced functional capacity. The legislation thereby recognises that the totality of a person's disability may be the product of multiple impairments. It makes no mention of 'primary' or 'secondary' disability and does not specify how planning decisions should be made if a person has multiple impairments.
6.11The committee recommends that the National Disability Insurance Agency assess people according to the totality of their disabilities and no longer require participants to nominate a 'primary disability' and 'secondary disability'.
Invisible, episodic, rare and psychosocial disabilities
6.12People who have invisible, episodic or rare disabilities gave evidence of difficulties they experienced in having those disabilities recognised by the NDIA, and in accessing reasonable and necessary supports. These matters are considered in Chapter 2 of this report.
6.13In the NDIA's lists of disabilities, some invisible, rare and episodic disabilities are described on List A, as conditions that are likely to meet the disability requirements, or List B, conditions that are likely to result in a permanent impairment. Others are not listed and, according to submitters, therefore much more difficult to have recognised as causing permanent impairment and reducing functional capacity.
6.14The committee recommends that the National Disability Insurance Agency review, publish and implement changes to List A: Conditions that are likely to meet the disability requirements and List B: Conditions that are likely to result in a permanent impairment to improve inclusion of invisible, episodic, rare and psychosocial disabilities.
6.15It was put to the committee that a culture exists in the NDIA where invisible, episodic, rare and psychosocial disabilities are not considered as valid as visible disabilities. As explored in Chapter 2, submitters pointed out that this culture significantly disadvantages people with those disabilities.
6.16The committee received evidence where people with rare genetic conditions expressed that they are not being adequately supported in their interactions with the NDIA. NDIA coordinators and planners should be supported to have a general understanding that the support needs of people with genetic conditions fluctuate, often quite quickly.
6.17The committee recommends that the National Disability Insurance Agency develop, publish and implement a mechanism to improve staff knowledge and acceptance of invisible, episodic, rare, and psychosocial disabilities.
6.18The committee recommends that the National Disability Insurance Agency develop and implement a mechanism to recruit and retain staff with specialist knowledge and skills regarding invisible, episodic, rare, and psychosocial disabilities.
Fraud and the culture of mistrust
6.19The committee received substantial evidence that fraud against the NDIS is more likely to originate with service providers, rather than participants. The committee acknowledges the government's efforts to eliminate service provider fraud.
6.20There are concerns about the way in which the public narrative regarding fraud may negatively affect participants and the broader disability community.
6.21Submitters described a culture of mistrust of people with disability by the NDIA, which left them feeling that their integrity had been questioned and as though they were seeking to defraud the public.
6.22The committee recommends that the National Disability Insurance Agency focus its compliance activities on the activities of service providers and subcontractors, to prevent systematic fraud and to ensure that people with disability do not experience further discrimination in the wider society.
6.23The committee recommends that the NDIS Quality and Safeguards Commission make recommendations to the Fraud Fusion Taskforce for increasing investigation, detection and prosecution of systematic fraud against the scheme.
Early Childhood Early Intervention
6.24The committee understands the critical importance of early intervention in providing suitable supports for children with disability and developmental delays. Accessing timely and appropriate supports at the earliest opportunity has significant, life-long benefits for children with disability. Access to funds is, however, no guarantee of supports if local providers are unavailable. The committee therefore notes the requirement for state and territory governments to play a significant role in building services outside the NDIS.
6.25The committee recommends that the Australian Government work with state and territory government counterparts to ensure that children with a disability who need access to early childhood intervention services are able to do so, especially in rural, regional and remote areas.
Guardianship and financial administration
6.26The committee believes that the NDIA could better support and protect participants who are under guardianship or trustee orders if planners were required to meet, including an option of face-to-face meetings, with those participants to ensure that their will and preferences are respected when creating and agreeing to plans.
6.27The committee is concerned about the increasing number of NDIS participants who are subject to guardianship and financial administration and the ramifications for their ability to exercise choice and control in relation to their NDIS plans and funded supports.
6.28The committee recommends that the Australian Government work with state and territory governments to ensure that the rights and wishes of participants of the National Disability Insurance Scheme are upheld and respected when they are under guardianship and trustee orders.
6.29The committee recommends that the National Disability Insurance Agency keep and maintain accurate records of participants under guardianship and/or financial administration orders.
6.30The committee recommends that, where a participant is under a guardianship order, National Disability Insurance Agency delegates and planners are required to meet with the participant, including a face-to-face option, to ensure that plans reflect the wishes of the participant.
6.31The committee received evidence that participants living in supported accommodation are at risk of exploitation, coercion and abuse.
6.32The committee recommends that the Australian Government work with its state and territory counterparts to establish a joint task force with the powers necessary to investigate any instances where National Disability Insurance Scheme participants are exploited, coerced or abused while being supported by the state regulated Supported Residential Services sector.
6.33The committee has heard evidence that participants are particularly at risk of exploitation, coercion and fraud when their NDIS funded supports are provided by a single provider.
6.34The committee recommends that the Australian Government work with its state and territory counterparts to develop comprehensive guidance regarding the regulation of disability accommodation providers who are also National Disability Insurance Scheme providers.
6.35The committee recommends that the Australian Government develop, publish, and implement a mechanism to ensure that a participant's support coordinators, accommodation provider, and support providers do not have conflicts of interest that would impact the quality or safety of participant supports.
Information, Linkages and Capacity Building
6.36The committee heard criticisms of the current funding design of ILC grants, with a competitive model that discourages sharing learning and best practice. Small community-based volunteer organisations appear to be at a significant disadvantage when competing with well-resourced organisations that have the capacity to employ grant application writers. These issues are detailed in Chapter 4 of this report.
6.37The committee recommends that the Australian Government re-evaluate the design of grant funding under the Information, Linkages and Capacity Building program, giving consideration to the complexity and transparency of the application process, length of funding periods, and amount of funding available.
6.38Submitters suggested that essential activities being provided by organisations with strong track-records of effective service delivery should receive direct, recurrent funding without the need for a grant application. Advance notice of funding cycles might also allow smaller community organisations more time to prepare grant applications.
6.39The committee recommends the Australian Government promote secure, long-term investment in activities that support people with disability, including through Information, Linkages and Capacity Building funding.
6.40The committee received evidence that the 2020 transfer of the ILC program from the NDIA to the Department of Social Service resulted in a loss of connection and information sharing between the NDIA, to the detriment of participants and the NDIS. The committee urges the department to reestablish robust links between ILC providers and the NDIA.
6.41The committee recommends that the Information, Linkages and Capacity Building program be refocused to better meet the needs of people with disability through ongoing evaluation of outcomes and facilitation of information sharing and strategic development of services across jurisdictions.
6.42The committee is concerned by evidence that the application and reporting requirements for ILC grants place an onerous administrative burden on community organisations. Where grant funding periods are short and funding amounts are small, there appears to be little incentive for organisations to apply for grants.
6.43The committee recommends the Australian Government revise the administrative arrangements for Information, Linkages and Capacity Building grants, consistent with recommendation 5.6 of the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability for the Australian Government to establish new governance arrangements for disability policies and programs.
6.44The committee is troubled by evidence that Local Area Coordinators may have been diverted from their role in delivering referral, information and capacity building services. It appears that many Local Area Coordinators are instead having to prioritise urgent funding related activities such as planning and plan reviews.
6.45The committee recommends that the Department of Social Services revise the role of Local Area Coordinators to ensure sufficient resources are directed to the roles of capacity building, information sharing and community engagement, alongside coordinating NDIS supports.
Respite care and short-term accommodation
6.46The committee understands the importance of respite in maintaining ongoing care relationships. Regular respite offers numerous benefits, including giving carers a break from their caring responsibilities, helping prevent carer burnout, helping participants transition to supported independent living arrangements, and facilitating participant engagement with the broader community.
6.47The committee recommends that the National Disability Insurance Agency ensure that planners fully explore current and future accommodation and support needs with participants during pre-planning, planning and plan reviews.
6.48The committee understands the frustration felt by participants who have funds available in their plans, but are not able to use those funds for STA because they have been earmarked for other purposes. The committee believes that choice and control for participants could be improved if participants were able to decide how best to spend their funds.
6.49The committee recommends that the National Disability Insurance Agency allow participants to use plan budgets more flexibly, including in situations where short term or emergency accommodation is required.
6.50The committee acknowledges that the NDIS has a role in supporting people with disability, especially when their primary informal support circumstances change. The committee therefore calls on the NDIA to develop clearer pathways to supported independent living for participants.
6.51The committee recommends that the National Disability Insurance Agency develop and publish clear, comprehensive guidance material for participants who seek to transition into other forms of supported accommodation, including state disability housing, Supported Independent Living or Specialist Disability Accommodation.
Women
6.52The committee received evidence that women with disability face additional challenges in navigating the NDIS and accessing appropriate supports, including safe supported accommodation. Some women with disability felt forced to stay in bad or violent relationships because they were unable to access the NDIS support or accommodation that they would need to live independently.
6.53The committee recommends that the National Disability Insurance Agency implement mechanisms to support women with disability who are at risk of, or have experienced, domestic, family and sexual violence, including expedited approvals for Supported Independent Living, Specialist Disability Accommodation and Short Term Accommodation, where it is considered reasonable and necessary.
Aboriginal and Torres Strait Islander peoples
6.54The committee received evidence Aboriginal and Torres Strait Islander people with disability face additional barriers to accessing information about the NDIS, receiving culturally appropriate supports, and accessing legal information and representation.
6.55The committee recommends that the National Disability Insurance Agency improve connections with Aboriginal and Torres Strait Islander peak organisations with the goal of improving co-design, and access to culturally appropriate services.
Culturally and Linguistically Diverse people
6.56The committee received evidence that people with disability who are from Culturally and Linguistically Diverse backgrounds also face additional barriers to accessing information about the scheme, receiving culturally appropriate supports, and accessing legal information and representation.
6.57The committee recommends that the National Disability Insurance Agency improve connections with Culturally and Linguistically Diverse peak organisations with the goal of improving co-design, and access to culturally appropriate services.
LGBTQIA+
6.58The committee received evidence on the importance of co-design in developing and implementing policies related to sexuality. Submitters also emphasised the importance of the NDIA employing LGBTQIA+ staff, as well as signalling in other ways that LGBTQIA+ participants were welcome and that the agency understood their support needs.
6.59The committee recommends that the National Disability Insurance Agency invest in building staff capacity to drive an inclusive culture and appropriate support for LGBTQIA+ people with a disability.
Funding for advocacy groups
6.60The committee received substantial evidence on the need for effective and well‑resourced advocacy services to ensure people are appropriately supported to navigate the NDIS.
6.61The committee recommends that the Department of Social Services provide ongoing and adequate funding of advocacy organisations, including disability advocacy organisations.
Human rights
6.62The committee is concerned by evidence of exploitation, violence and abuse perpetrated against people with disability. The NDIA has a role to play in protecting people with disability, and ensuring their human rights are respected.
6.63The committee recommends that the Australian Government has regard to recommendations of the Disability Royal Commission 4.7 (right to live free from exploitation, violence, abuse), 6.41 (Legislative prohibition of non‑therapeutic sterilisation), 7.3 (Improve policies and procedures on the provision of reasonable adjustments to students with disability) and 10.1(Embedding human rights) in the implementation of the National Disability Insurance Scheme and throughout the participant planning pathway.
Ms Libby Coker MPSenator Hollie Hughes
ChairDeputy Chair