During this Estimate session in November, I inquired about the potential streamlining of payments to care workers and received responses primarily related to care providers (agencies). It appears that not all care providers are registered, and the registered ones must meet minimum standards. I also asked about the possibility of family or friends providing care being properly compensated for their extensive services. I was informed that these individuals may receive allowances, but that these amounts would be small compared to fair remuneration for their services. The NDIS views these supports as beneficial, yet is not willing to pay unless they are provided on a professional basis by individuals trained to a specific standard.

It seems that the NDIS is not prepared to offer support to family members providing vital care; rather, they will only support workers affiliated with recognised care providers. They seem to overlook the fact that many families make significant sacrifices to care for a disabled relative in a home setting, yet are not entitled to fair remuneration for the many hours of unpaid work they contribute.

Transcript

Senator ROBERTS: Thank you, Chair. What is being done to streamline the payment system for care providers?

Ms C McKenzie: As Ms McKay was talking about before, we have a range of improvements underway through a significant program of work, particularly the crackdown on fraud program of work. That will include
progressive improvements to the provider platform and a range of other payment systems to improve and support the continued improvement of the payment system through to providers.

Senator ROBERTS: Does that mean the IT focus?

Ms C McKenzie: It is predominantly IT focused. Yes, that’s right. So it is upgrading systems that are at the end of their life or are approaching the end of their life. It is also developments in improving both the integrity of the data that we are able to capture and our ability to move more quickly and with more confidence in the payment to providers.

Senator ROBERTS: What is being done to set up a scheme to ensure that family members who provide constant care to a family member are compensated for the time and care put in to deal with high level basic care?
I understand that families like to take care of other family members; I’m not arguing against that. In one case, we had a pensioner on a low income looking after their 60-year-old son who is disabled. They were very concerned about him. There are some extenuating circumstances where families need to be compensated.

Mr McNaughton: There are a couple of components to that question. First of all, obviously through other portfolios, there are income support payments and carers payments and carer allowances in recognition of some of those activities. That is an important part of that. We also recognise that informal care is a really important part of the NDIS. Parents provide informal care for their children with disability. Ageing parents often do the same. There does come a time where that needs to be a paid care role. That is when the NDIS supports having paid, trained carers to come in and support that person with a disability. It is a combination of both. Who do you feel comfortable with providing that level of informal care and support and decision-making and assistance in your daily activities? There is the carer allowance and carer payments through the social security portfolio. The NDIS pays for the funded support workers to provide that trained specialist care for the person with disability as well. It is an ecosystem, a combination of all those things. It really does depend on the individual circumstance of the participant.

Senator ROBERTS: I presume, then, that a very formal assessment is required before moving from one to the other?

Mr McNaughton: Yes. But we know that participants like to have their families and informal supports around them. That is a really important thing. We don’t want to detract from that at all. Some participants also need
additional funded carers. There are regulations for being a qualified carer and a registered provider as part of the NDIS system. Those things need to work hand in glove to provide that support for the person with a disability.

Senator ROBERTS: Are all direct care providers to be registered if they wish to be paid under the NDIS?

Mr McNaughton: They don’t have to be.

Senator ROBERTS: What is registration? What does it involve?

Mr McNaughton: I might defer to the commission, who can talk through registration guidelines. There are differences in terms of pricing within the NDIS and registration criteria. I am not sure if the commission wants to respond about the registration of providers.

Ms Myers: The registration relates to providers. When it comes to workers, there is screening that occurs for workers.

Senator ROBERTS: So you’re looking at their capabilities and their skills?

Ms Myers: Worker screening is about suitability. Worker screening is for people who are in risk assessed roles. Worker screening checks are conducted by the state and territory worker screening units. The NDIS Quality and Safeguards Commission is responsible for maintaining the database. Registered providers can link their workers who have a worker screening check. That is another safeguarding measure so that participants can see which workers have a worker screening check. In fact, we’ve had record numbers of unregistered providers also seeking access to the worker screening database so that they can also link their workers.

Senator ROBERTS: So direct care providers don’t have to be registered, but for some circumstances they must be?

Ms Myers: For some circumstances, they need a worker screening check.

Senator ROBERTS: Are those reforms you both discussed complete?

Ms Glanville: I wonder whether, on the registration topic, Associate Commissioner Wade would like to speak on this, if she is there?

Ms Wade: Yes. Thank you, Commissioner Glanville. Registered providers are an important part of the disability care system. There is also provision for the regulator, which is the NDIS Commission, to regulate both
unregistered and registered providers. Registration status indicates compliance requirements of a provider, but that does not leave providers unregulated if they are not registered. All providers that receive funding from the NDIS are required to comply with a code of conduct. Failure to comply with that code of conduct can see regulatory action brought against the provider by the commission as the regulator.

Senator ROBERTS: Thank you. This is my final question. What monitoring is involved for both registered and unregistered providers?

Ms Myers: The Quality and Safeguards Commission is responsible for the monitoring of both registered and unregistered providers. Much of our work is conducted as a result of either complaints received to the commission or reportable incidents where we need to make further inquiries around the circumstances of particular incidents. Registered providers have obligations that they are required to report certain matters to us, including certain changes of circumstances. The commission utilises that information to determine what regulatory action it might take.

Senator ROBERTS: Are there audits of this? It’s not just self-reporting?

Ms Myers: We do some proactive compliance monitoring work. They also have audit processes tied to their registration. The audit process relates to the standards they must meet in order to maintain their registration.

Senator ROBERTS: Thank you, Chair.