Anonymous – 07/10/2021
- Support for DIA
We supports the feedback provided by Disability Intermediaries Australia (DIA) in their submission paper, Changes to the NDIS Act.
- Essential intermediary function
Plan Management is a critical support under the NDIS and is used by participants and their families to fulfil a number of needs within the Scheme. The availability of ongoing financial intermediary, provider connection and plan management support is needed not just to build capacity but to maintain arrangements.
- Independent intermediaries
Intermediary services can facilitate the best participant and Scheme outcomes when they are impartial and free from potential conflicts of interest. We support the proposal to impose separation between intermediary (Plan Management and Support Coordination) and direct service delivery supports except in circumstances which may be detrimental to participants such as thin markets.
- Plan Management and the execution of choice and control
We note the proposed introduction of a risk assessment when participants exercise their choice to have part or all of their plan funds managed by a Registered Plan Management Provider (RPMP). While Leap in! acknowledges and respects the need to ensure appropriate safeguarding is in place, the exposure draft in its current format raises two issues of concern:
- There is no definition of ‘unreasonable risk’ or what circumstances or behaviors would meet this risk assessment threshold. Without this detail it is not possible to assess the level of impact this proposed change will have on participants ability to exercise choice and control, and if that impact is reasonable. In addition, without a clear definition, it is unlikely to be operationalised with consistent and objective decision making by delegated National Disability Insurance Agency (NDIA) staff, leaving participants in the hands of subjective planning decisions; and
- There is no clear right to appeal. In the current format, the exposure draft indicates that a participants only path to appeal a decision on plan management is via the Administrative and Appeals Tribunal (AAT). This is costly, time consuming and unfair. We recommend that decision made under section 9 of the Rules must be a Reviewable Decision.
- Intermediaries as enablers not as accountable entities
The proposed Plan Management Rules have potentially significant implications for RPMP. The scope of impact is unclear given the limited information about how the NDIA and the NDIS Quality and Safeguards Commission (NDIS Commission) will interpret and operationalise the proposed changes. For example: we note the changes proposed in Section 6 of the Plan Management Rules which delegates authority to restrict participant choice of providers and/or specify use of specific providers.
- What are the accountabilities for RPMP to enforce these decisions?
- What is the process for informing the NDIA if non-conformities are identified or suspected?
- With increased authority of the NDIA to override participant choice in the procurement of services and selection of providers, who will be accountable for claim payments that are retrospectively reviewed by a delegate as unsuitable when processed through an RPMP?
- What changes to the payment structure of Plan Management will be made to compensate for any additional duties or responsibility?
A robust intermediary market is a key success factor for a market-based social insurance scheme. It is critical that these services remain independent, and enablement focused, working with a participant to undertake functions which assist them to build capacity and execute the free will and decision making. It is equally important that individuals take accountability for the decisions they make – this is also a critical foundation of Choice and Control principles and the human rights principles underpinning the Scheme intent.
We recognise the right of the NDIA as the ultimate ‘assessor’ of claims for products and services delivered via the Scheme. This includes the Agency’s right to retrospectively review decisions. However, with consideration to the legislation and any definition of financial intermediary responsibility, it is equally important to recognise that the role of the financial intermediary and RPMP is not in any respect, a decision-maker or assessor of claims. At most, an RPMP could be considered an advisor to participants to assist them to make informed decisions and exercise the foundational Scheme rites. To that end it is not reasonable to pass any accountability and financial liability for participant decisions onto the RPMP. We are strongly opposed to any legislative or operational changes that will result in this change.