The agency that oversees the National Disability Insurance Scheme (NDIS) has no idea how many of the workers it pays for to provide services are unregistered.
These workers, who are either employed by a company or are freelance, can provide services ranging from landscaping to personal care, chosen by NDIS participants. They’re governed only by a “code of conduct” comprising just seven dot points around respecting privacy, preventing and responding to sexual misconduct and providing quality care.
“There are more checks and balances when buying a beer than there is on the provisions of unregistered NDIS services,” Labor Senator Tony Sheldon told a Senate committee hearing yesterday. He pointed to the responsible service of alcohol (RSA) course those working in pubs and bars have to take to serve booze, versus the lack of certification disability workers have to have.
Allowing people with disabilities to pick and choose who provides their services is a crucial part of the NDIS model around choice and control. But with a toothless sector watchdog understaffed and overburdened with complaints, unregistered providers can not just be costly — but dangerous too.
Where’s the oversight?
Acting NDIS Quality and Safeguards Commissioner Tracy Mackey told estimates there were around 4000 unregistered providers — but couldn’t provide an exact figure. So how exactly are standards enforced?
While workers with a registered provide have to undergo a screening test before being hired, unregistered providers are subject to the code of conduct with little else governing how they work. Mackey pointed to the “half a million” downloads of the code of conduct as evidence workers were paying attention.
Disability staff are some of the lowest-paid workers in Australia and many have no disability-related qualifications. There’s high turnover too, with around a quarter of staff leaving their role in a given year.
As Crikey has revealed, this has led to several instances of abuse, neglect and theft for many people with disabilities.
The fact the NDIA can’t say how many unregistered providers or workers there are is extremely worrying, estimates heard. It also has no idea how many of those unregistered workers are vaccinated.
Social Services Minister Anne Ruston also said she has no idea how many Australians with disability have died from COVID-19. She said the government “wouldn’t necessarily know” if someone has a disability.
How are dodgy providers dealt with?
Mackey said people with a disability, their families or their advocate can make a complaint about a registered or unregistered provider with the NDIS Quality and Safeguards Commission.
But how realistic is this? As of June 2021, the commission employed just 124 staff across the country. In the past financial year the commission received:
- Over 1 million notifications of unauthorised use of restrictive practices, including using medication to restrain someone or locking them in a room, more than triple 2019-20 numbers
- 417 allegations of sexual misconduct, up from 350 the previous year
- 1179 notifications of death (unregistered providers don’t have to provide this data to the commission)
- 2030 allegations of unlawful physical or sexual contact, up from 1671 the previous year
- 3189 notifications of serious injury, up from 1854 the previous year
- 5971 allegations of abuse and neglect, up from 3637 the previous year
- 7231 complaints. More than half of those complaints were dismissed by the commission and just 2% of them were resolved through a resolution process
- 20,090 inquiries about behaviour support
Between July and December 2021, an extra 4134 complaints were submitted to the commission.
Crikey has heard instances of commission staff walking off the job in tears due to understaffing and under-resourcing. There were just 291 investigations launched into complaints in the past year, and just 46 providers have been banned since 2018 when the commission was formed.
The commission was recently granted broader powers to grant banning orders based on how suitable an organisation is to provide services and to approve or revoke quality auditors.
Are unregistered providers the issue?
Unregistered providers are an important part of allowing people with disabilities to chose who provides them with care — especially given the care is often personal in nature. But making sure that person is qualified, suitable, vaccinated and hasn’t been banned from providing certain reports largely rests on the person with disabilities.
“We do try really hard to encourage self-managing participants to require their disability support workers to be vaccinated,” Mackey said, while NDIA CEO Martin Hoffman said it was up to the states and territories to oversee vaccination status of disability workers.
Those working with a registered NDIS provider have to undergo a worker screening check, and if they’re found to have been involved with criminal activity that could impact a person with a disability, such as online scamming or abuse, they receive an exclusion from working with registered providers.
But this doesn’t exclude them from working with an unregistered provider or within the disability sector altogether.
A client of the service I work for just had $70 000 cut from his NDIS plan for supported independent living. He has no assets, no family, no friends, no one to advocate for him and as he is in a permanent amnesiac state as the result of an acquired brain injury, he can’t advocate for himself. He literally can’t remember what he said or did five minutes ago. Our service can’t advocate for him, either, being his supported independent living service – he has the “choice” to go shopping for a competitor who can house and support him for $70 000 less than we do.
Our service did query the cut and were told to “make it work” which our service will no doubt do by putting its hand in its own pocket to make up the shortfall as long as it possibly can, yet again.
No checks and balances for this sort of stuff, either. It sends a lot of services broke.
Welcome to the wonderful world of the Coalition’s destruction of the NDIS! All done to make the bloody budget look marginally better for Election Day- out of sight and out of mind of the Australian public who mostly wouldn’t care if they knew. All the Coalition need to do is start claiming there are welfare cheats among disability pensioners again (and they’re already implying it with lines about the NDIS never being intended as welfare for life) and the great Australian public will be screaming for greater cuts to the NDIS.
There are always “welfare cheats” in any system. However, they are a miniscule proportion of people needing adequate care.
My cynical view is -take as many disabled as possible for bus trip to some remote spot and lose them.
So disgusted with the LNP govt and its treatment of the needy in our society. LNP see welfare recipients as failures, ergo a drain on the economy.
How do they sleep at night?No nightmares?
Probably quite soundly, on large piles of taxpayer money.
SOP – understaff, then use the criticism to justify closing it down.
QED for the NeoCons.
Oh so true, pub before people seems to fit a certain leader with a frothy top.
The NDIS under LNP has done to people with disabilities what Howard did to the aged care sector. Super charged the profits of the unscrupulous and left the users and families of the system to rot. I began my career in disability a lifetime ago, when deinstitutionalisation commenced and the importance of educating and training the workforce was valued and we were working to build user choice. The NDIS could have been that, But of course the LNP don’t value the community sector so they have destroyed it ….. again and left it to the market forces, which always bodes well for the care of people [ sarcasm alert]
What a sad state of affairs. As someone with no exposure to the disability sector (ie am not coming from any expertise or lived experience) it sounds like the balance between enabling choice for people with disabilities in permitting them to appoint the people they want to work with – even if it means they haven’t gone through comprehensive checks – conflicts with the expectations that the disability workforce be appropriately regulated. But we know from pretty much every other aspect of life that systems do need to be appropriately regulated.