Anonymous – 07/10/2021

My concerns relate to children/adults who are deaf participants.
A proposed change allows plans to be varied on the CEO’s own initiative, without request, consultation, or consent from the participant. To have a plan changed without their knowledge disrespects a participants right to control & input to their own plan. Perhaps this is an unintentional result of changes allowing plans to be amended or fixed where the amendments are not significant or perhaps allows for a change where the participant cannot be consulted within a reasonable time.
I understand Rule 10 of the new Plan Administration Rules sets out a non-exhaustive list of matters the CEO must consider when deciding to vary a plan on their own initiative & these matters do not limit the CEO’s power. This leaves it open for variations like changes to funding amounts or restrictions on how funding could be used. These variations could be made without consultation with participants again disrespectful & not in line with my understanding of how a plan is created for a participant.
I understand in Rule 8 of Becoming A Participant they must be undergoing or have undergone ‘appropriate treatment’ for the purposes of ‘managing’ their condition & the treatment has not led to a ‘substantial improvement’ in their functional capacity after a reasonable period of time. Or there must be no ‘appropriate treatment’ ‘reasonably available’ to the person. The terms in inverted commas are not defined & so in practice, it will be the CEO and delegate considering in each instance what these terms mean for a participant. Where is the guidance for the CEO or delegate for example what these terms mean for a participant with congenital deafness due to a gene mutation that no longer seems a specialist to manage a deafness that will not change.
Under changes to Rule 9(2)(b) if in the future genetic interventions could improve deafness does this mean they would no longer qualify for NDIS if a participant chose not to undergo gene intervention.
There are proposed changes to the way in supports are paid by the NDIA and are intended to make it easier for self-managing participants to make claims, by using a ‘tap and go’ system on smartphone apps with their service provider, rather than paying out of pocket first and seeking a reimbursement. These changes appear to be broadly sensible. However, we understand some people may be concerned by the inability for self-managed participants to opt out of this system and pay for their own supports first, or to mix-and-match their preferred payment method. The drafting of new section 45 states that payment is to be made ‘to the person determined by the CEO’. While the Government has clarified that this change is not intended to remove the ability for self-managed participants to continue their existing payment method, the drafting does not make this clear. Please consider making this clearer so there is that flexibility for the participant to pay and be reimbursed or provide an invoice to be reimbursed so you can pay the invoice.
Proposed additions to the Act s 100(1B) and (1C) allows participants to request reasons for decisions made by the NDIA which are subject to review. I can see this is a change that can empower individuals to understand decisions made about them at the initial stage – for example, a decision outlining why a plan has been approved as Plan Managed rather than the requested Self Managed. Although this could be improved in two ways. First, the provision of reasons should not be on request by the participant. It should be given automatically, as a matter of course, for all participants when a decision is made about them whether at the initial stage of application or on review. I think this also improves the review process because it makes it clear as to why a decision was made that was contrary to the submitted request. It should also use clear language without to quoting the Act or rules. Plain and simple language is important and always providing reasons enables a participant to receive reasons for decisions made about them, not just those who are willing or able to go through the further process of making a request.
Second, there is no requirement for providing reasons once a review of a reviewable decision is made under s100(6). In practice, reasons are often, but not always, provided in relation to internal reviews. Consider a provision be inserted to make this a legislated requirement. Every decision made by an NDIA reviewer should be accompanied by a statement of reasons. This is consistent with intentions of Tune recommendation, & good administrative decision-making principles
The Act amendment to provide more flexibility to fund EI support for children under 7 yrs outside a NDIS plan, in order to develop family capacity & ability to exercise informed choice & control. Families without a plan are being locked out of early EI.
I’m concerned about NDIS hearing + aids for mild/moderate 26+ yr olds.