The National Disability Insurance Scheme (NDIS) has been under intense scrutiny due to widespread reports of fraud involving both participants and providers.
While authorities work to crack down on those who exploit the system, many legitimate service providers with the best intentions continue to face an uphill battle when navigating the complex bureaucracy of the NDIS.
A support coordinator for a highly regarded disability service provider – who wished to remain anonymous – sat down with HelloCare and highlighted a long list of issues that providers face when dealing with the NDIS.
From inefficiencies in document transfers to difficulties in obtaining consent, these providers struggle daily to secure the support their clients desperately need.
Issues with Consent and Communication
One of the most immediate hurdles is obtaining consent to speak on behalf of participants. The support coordinator described this process as a “nightmare,” particularly for clients who have transitioned to the NDIS’s new system, PACE.
She explained that PACE often fails to transfer essential documents, which means consent records are lost, forcing providers to repeatedly go through the verification process.
“The first thing when you call is they check if you have consent to talk on behalf of the participant. They lose it, especially if the client has moved to PACE. They do not transfer all documents over,” she said.
“I don’t even know how anyone could write software that selectively fails to transfer certain documents – it would be harder to be as terrible as it currently is.”
Without the necessary documentation, providers must either seek new consent from clients – an impossible task for non-verbal individuals without a nominee – or spend significant time waiting on hold for NDIS representatives to manually retrieve records.
“If the client is non-verbal, and they don’t have a nominee or a Public Guardian, you are pretty much stuck,” she said.
Another major frustration is the outsourcing of NDIS call centre services to a private company. This means providers are often speaking to representatives who are not NDIS employees and have only limited access to relevant information.
“You’re not even talking to an NDIS staff member. Their knowledge is just whatever is on their screen,” she explained. More concerningly, she revealed that call centre staff are paid based on the number of files they open.
“You have to quote a participant’s name and NDIS number before they will answer a question.”
“They cannot answer a general question unless they access a file. You have to have an NDIS participant before they can even speak to you.” This creates inefficiencies, as providers are unable to obtain general guidance without unnecessarily involving a participant’s file.
Our source also revealed that the lack of NDIS knowledge from call centre staff often results in being put on hold for lengthy periods of time as they scramble for answers to very basic questions and requests.
“Imagine being put on hold for 15-minutes three times during one conversation with a client and their family sitting next to you. That’s the kind of thing that we deal with.”
The support coordinator also described the confusion caused by sudden case closures. Providers receive emails stating that a case has been closed but with no details on which participant or issue the closure pertains to.
“We have letters telling us that a client is no longer under our care, but we don’t know who it is or why,” she said. “Imagine managing 300 clients and suddenly receiving a generic case closure email – how are you supposed to know which case it refers to?”
This lack of transparency means crucial funding applications, such as those for essential mobility aids, may be denied without any clear explanation or opportunity for follow-up.
Perhaps the most frustrating issue providers face is the process for securing additional funding when a participant’s needs change.
Previously, when a participant’s plan was due for renewal, a face-to-face meeting would be held with the family to discuss their evolving needs. However, the NDIS has moved away from this approach, instead opting for automatic plan rollovers unless a “change in situation” request is submitted.
“In the past, we had a meeting where we could explain what was needed. Now, you have to prove a change in circumstances, and the burden of proof is extreme,” she said.
“For example, I had a client who went blind due to a neurological condition. We applied for additional funding, but NDIS denied it, saying we had to prove the blindness was ‘permanent and significant.’”
This shift has placed undue stress on families, many of whom may lack the necessary literacy, advocacy skills, or knowledge of NDIS processes to navigate these complex requirements.
“Not every participant is funded with a support coordinator. What are they supposed to do?”
This article just touches a few of the never ending issues participants and their supports face. The NDIS Service Guarantee means nothing anymore. The constant requirement for participant to lodge s100 Internal Reviews simply because they either didn’t get a fair opportunity to explain their circumstances or needs, results in numerous planning errors, then the onus is on the participant or their supports and nominees to lodge requests for internal reviews or change of circumstances. All of which are often very stressful and time consuming not only impacting the participant but an obvious waste of NDIS budgetary funds. There is no accountability within the NDIS systems for anyone other than the participants, families or nominees. There is focus in the media on sensational fraud cases but no articles address what’s happening regarding the utter wastage of tax payers money by the NDIS or NDIA themselves. It’s generally the actual participants screaming out for help to address such matters, and it seems both main government parties just want to blame the other and not have a true internal audit of wastage. Just try ringing the NDIS and see if you can get the same answer twice to what should be standard inquiries.