Healthcare | Social Policy

When funding is withdrawn | An NDIS case study

16 May 2018, by Amy Sarcevic

In 2013, the National Disability Insurance Scheme (NDIS) began its mission to optimize social and economic independence and full participation for people living with disability in Australia.

The scheme promised to give people with disability control and choice; to be a financial sustainable system that the community could take pride and confidence in, with its personalized approach to providing support.

While undoubtedly delivering many success stories, the NDIS scheme has experienced a number of ‘teething problems’ over the years; and there is now a significant subset of people who have had their entitlements removed, leaving them in worse circumstances than before the NDIS was introduced.

Nick Mann of Polaris Lawyers highlights the case of his client ‘John’, who lives with multiple disabilities following a stroke, including severe cognitive and mobility issues that prevent him from undertaking everyday activities without the support of a Carer.

Based in regional Australia, John lives a significant distance from rehabilitation facilities, his family and the general community. Under the NDIS scheme, he was initially receiving approximately $11,000 per year funding to cover transport costs for four weekly medical, rehabilitation and social trips.

But in 2016, there was a reduction of John’s funding under a new NDIS plan, and he was left with just $2,592 per year, on the basis of an NDIS intrinsic policy which ‘caps transport funding’. The amount was subsequently increased to $3,456 following an internal review, but remains short of the full cost of the treatment John reasonably requires.

This is despite the NDIS’ legal mandate to provide support which is reasonable and necessary for people living with disability.

As John’s two-year legal bid to reclaim his funding continues, the National Disability Summit – 20-21 August in Melbourne – takes a candid look at NDIS case studies and some of the legal and ethical inconsistencies that are implicit in the scheme – with a view to improving the system for everyone involved.

Nick Mann who is due to reveal further details of John’s case study at the Summit says, “It is critically important that a robust plan is created from the outset in consultation with the participant and with family and carers”.

“It is costing the agency more to defend appeals than it is to provide reasonable funding in many cases. Considering that decisions to remove, reduce or restrict funding are said to be based on the financial viability of the scheme, this is a bit of a farce.”

“We also have to remember that there are people at the end of all of these plans, not just a bunch of policies stitched together. My client has suffered significantly since his funding was withdrawn two years ago. The cuts to his transport funding mean that he can’t get the rehabilitation he needs which is causing physical decline; and the stress of the appeal is further taking its toll on his emotional well-being. While the NDIA [National Disability Insurance Agency] defends its policy, it ignores that John is left sitting on the couch staring at the walls”.

“In the last week, the Agency has refused to continue his funding, on the basis that his previous plan is being appealed. There is no legal or other justification for this.”

The case study will yield practical tips regarding the formulation and appeal of plans for the benefit of NDIS participants.

The National Disability Summit will offer a balanced set of perspectives from Government, industry and beneficiaries; and ignite debate on how the sector should best move forward.

Learn more and register here.

 

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