In response to the NDIS Review: Final Report’s proposed risk-proportionate model for the regulation of providers and workers
Australia’s track record for keeping people with disability safe is shameful. According to the Australian Institute of Health and Welfare, people with disability may experience higher rates of violence, abuse and neglect than people without disability.
In Australia, it is estimated that:
- more than one-third (37%) of adults who have experienced at least one incident of violence after the age of 15 have disability
- close to half (46%) who have experienced abuse before the age of 15 have disability (ABS 2017b).
In addition, our society’s utilisation of the medical model of disability (in which having a disability is equated with being broken, damaged, and even less than human) means low expectations of people with disability abound, and these low expectations directly influence their safety. Our existing support systems (regulated or not) widely assume that settings like special schools, ADEs, hospitals, and group homes offer best-practice support and care. We would argue that these settings are currently where people with disability may be most at risk, even when the provider is registered and observes existing codes of conduct and other regulatory requirements.
We believe that far more than regulations, it’s people who keep people safe.
People with disability are safer when they
- Are known in their neighbourhood and are missed when they’re not around
- Have a meaningful job embedded in the community with workmates who notice when something isn’t right
- Have a choice over who will be supporting them and when and how the support will be provided, especially if the individual has goals to access the good things in life
- Are supported to build respectful relationships with the people who support them.
What the Independent Review of the National Disability Insurance Scheme recommends when safeguarding people with disability
The NDIS Review addressed safeguarding under several of their recommendations.
The section on Recommendation 17 begins,
There are gaps in oversight of providers, particularly when delivering high-risk supports. In the NDIS, the registration process aims to ensure that providers and their workers are reputable and have the skills and knowledge to deliver supports. While registration is not a guarantee of either safety or quality, it ensures visibility and does indicate a provider has taken steps to deliver supports professionally and competently, and is an important way of holding providers to account.
– From page 206 of the NDIS Review
We agree that provider registration alone is unlikely to safeguard NDIS participants. However, we strongly believe that the stated “improved visibility via registration” won’t necessarily hold providers to account and may make self-managing funding and employing staff directly more difficult for individuals and families.
What does recommendation 17 say?
Recommendation 17 of the report is to
Develop and deliver a risk-proportionate model for the visibility and regulation of all providers and workers, and strengthen the regulatory response to long-standing and emerging quality and safeguards issues.
Recommended actions include:
Action 17.1
The Department of Social Services and the new National Disability Supports Quality and Safeguards Commission should design and implement a graduated risk-proportionate regulatory model for the whole provider market.
Action 17.2
The Department of Social Services and the new National Disability Supports Quality and Safeguards Commission should develop a staged implementation approach to transition to the new graduated risk-proportionate regulatory model.
Action 17.3
The Australian Government should amend the National Disability Insurance Scheme Act 2013 to remove the link between a participant’s financial management of their plan and the regulatory status of their support providers.
Action 17.4
The Department of Social Services, working with the new National Disability Supports Quality and Safeguards Commission and state and territory agencies, should expand the coverage of worker screening requirements.
Action 17.5
The Department of Finance and the Department of Social Services, working with the new National Disability Supports Quality and Safeguards Commission and state and territory agencies, should improve, streamline and harmonise worker screening processes for care and support workers.
Action 17.6
The new National Disability Supports Quality and Safeguards Commission should be resourced to strengthen compliance activities and communications to respond to emerging and longstanding quality and safeguards issues, and market developments and innovation.
Our concerns about Recommendation 17
We worry about what this regulatory model will mean for families that are self-managing and already doing a great job in keeping their family members with disability safe while building their capacity to navigate the world and access the good things in life.
We wonder if an increased focus on regulation will more firmly cast people into the role of human service clients when many of us are doing our best to help people with disability be seen as contributing members of our community.
We wonder what will happen to people who are self-managing their funding and directly employing staff. Will this add another layer of paperwork? If so, will there be support for people with disability and families in completing all the auditing?
While action 17.6 recommends that the Quality and Safeguards Commission be responsive to market developments and innovation, we wonder what this means for self-managing individuals and families who currently have the flexibility to be truly innovative on a one-person-at-a-time basis. Will self-managers be able to continue to have the flexibility that is currently serving people with disability so well?
We wonder what will happen to the housemate model, where a person with disability lives with one or two housemates without a disability. Will housemates need to be registered? Will share house occupants need to undergo regular audits? What will the ‘practice standards’ be for housemates? Will housemates need an ABN or another ‘provider identification’ document? Currently, families are going to great lengths to keep the housemate model as typical a living arrangement as possible. We worry that the proposed recommendations won’t allow this flexibility and will make this typical arrangement into something odd and onerous.
We wonder if a capacity-building approach would be better than a compliance approach.
What you can do now to influence the proposed changes
I strongly recommend that you take some time to read pages 207-217 of the NDIS review and think about how the recommendation will likely affect your family member with disability.
If you’d like to comment on the proposed actions, there is a process for doing so.
In February 2024, the NDIS Provider and Worker Registration Taskforce (the Taskforce) was established to provide advice on the design and implementation of the new graduated risk-proportionate regulatory model.
Specifically, the Taskforce is providing advice on key design elements related to Recommendation 17 of the Report. To do so, it will consult with people with disability, their families and advocates, the NDIS provider market, workforce representatives, and other relevant stakeholders. The Taskforce will consider this feedback when informing the Government of its advice.
To have your say, please visit DSS Engage to review the guidance materials and focus questions that will assist you with your submission. The online consultation closes at 11:59 p.m. on 28 April 2024.
You can also visit the department’s website for more information on the Taskforce’s work, membership, and Terms of Reference.
I strongly encourage everyone, especially those who are self-managing an NDIS plan, to make a submission.
What you can do about safeguarding a person with disability
In May 2024, we’re holding a two-day national conference in Canberra called Safeguarding the Future. Join us to hear from individuals, families, and industry leaders as we explore the many different ways people with disability can be kept safe, both now and in the future.
If this is a topic that interests you, please plan to come along. We offer flexible pricing for people with disability and their family members.
You can register for the three pre-conference webinars if you can’t attend in person.
Visit this page to learn more about the Safeguarding the Future conference.