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.
During recent Estimates, NDIS Integrity Chief, Mr. John Dardo, stated that 90% of plan managers showed significant signs of fraud, and 87% of service providers were unregistered and unmonitored, lacking adequate training for their responsibilities. Mr Dardo said, “we have no idea what they do when putting in their invoices.” This underscores the broken state of the NDIS, stemming from an ill-considered election promise devoid of data, reminiscent of the Gillard government’s hasty policy announcements without sufficient planning.
I proposed that an inquiry should evaluate the merits of returning responsibility for these services back to the states from which they originated. I pointed out that an unintended consequence has been a shortage of workers in the health and aged care sectors due to the excessively high pay NDIS service providers receive—often triple what they would earn in equivalent roles within these sectors.
Labor’s penchant for wasteful spending was exemplified by the squandering of $430 million on “the Voice,” funds that could have been more effectively allocated to NDIS services.
Ultimately, taxpayers foot the bill for this waste. I advocate for a shift away from the costly and ineffective centralised service model towards competitive federalism.
Transcript
At the recent Senate estimates hearings, the NDIS integrity chief, Mr John Dardo, admirably confirmed that 90 per cent of plan managers displayed significant indicators of fraud. The level of fraud it is now so high that there are dozens of examples of organised crime groups abusing the systems, with millions of dollars being rorted. The system is so out of control that 87 per cent of service providers are unregistered and unmonitored. I quote words that appeared in an article about Mr Dardo:
We have no idea of knowing what they do when they put in their invoices.
It’s taxpayers’ money, spent on something they have no idea of. He had the courage to admit that. He said that existing cases exceeded Australia’s judicial capacity, without finding more.
NDIS funds must not be used to pay for sex workers, expensive holidays or new cars that other taxpayers cannot afford. Projections are for a blowout of NDIS spending to $90 billion within a decade; it must be prevented. Using the system to peddle drugs is happening extensively. The name of this bill says what we already know about the NDIS. It’s broken and getting worse. It’s a licence for criminals and fraudsters to print money. It’s so far off track that the hope that this bill will get things back on track is a pigs-can-fly pipedream.
Since the Gillard Labor government’s NDIS inception, there has never been a track. It was hatched with no meaningful metrics or plan. It was simply an election slogan to desperately buy votes in an election that Prime Minister Gillard lost. It was hatched as a headline grabber and a vote harvester. Typical of ‘uniparty’ initiatives—and of policies and legislation in our parliament over recent decades—it lacks the discipline of a system based on hard data and a focus on customer needs. It was done to look good, not to do good. A hastily cobbled together election policy, it had holes in it a mile wide that clearly enabled fraudulent claims to be made with little chance of being picked up and stopped.
As servants to the people of Queensland and Australia, Senator Pauline Hanson and I have been calling out the NDIS fraud model since 2016. A significant effort is now needed to remove dodgy plan managers and service providers and to protect capable and honest plan managers and providers, using stricter laws to prevent participants from being defrauded, to prevent unscrupulous service providers from abusing vulnerable people and to save NDIS for genuinely disabled people with real needs. If we really care, we’ll clean up this mess. If we really care for disabled people, then we’ll have to get tough and sort out the criminals and the rorters. Providers, managers and recipients who commit fraud under this NDIS scheme must be heavily penalised and banned from any involvement in the scheme again. Wasted money through overspending has cost taxpayers well in excess of $8 billion already, and it’s essential to ensure that the current 150,000 unregistered care or service providers become registered and then are monitored for effective compliance.
The Gillard Labor government introduced the NDIS. In their election loss, they handed the incoming coalition government an illegitimate, loose and sloppy mishmash of slogans and empty titles, lacking discipline, coherence, focus and care, and lacking solid systems. If they’d cared, Labor would have put together a proper system, but they didn’t. They should have put together a system to provide effective care and to protect taxpayers’ hard-earned money. The Liberal and National parties tried to refine the monster, and now the NDIS is back in Labor hands for more mismanagement. The NDIS must be reconsidered and protections against mismanagement and abuse strengthened.
But who should be responsible for management? References to the non-constitutional National Cabinet are just a poor joke. National Cabinet is a mere grouping of state ministers responsible for similar portfolios, with no statutory authority or constitutional recognition of its existence or authority. It’s toothless—all mouth and no accountability. There’s no accountability in the current system. Right at the very top there’s the bogus unconstitutional National Cabinet. In such cabinets the state and federal government ministers just go, ‘They’re responsible.’ That means no-one is responsible. There is no accountability. It’s fundamentally structurally flawed.
I suggest an inquiry to consider the alternative model: putting the responsibility for providing for the needs of people living with a disability back to the states and territories, where it was stolen from. Clearly, each state is responsible. The states would work to ensure that services were monitored, reasonable and meeting client needs under a model reflecting the proven benefits of competitive federalism, the foundation under which our Constitution and government is made. This will provide the level of accountability that has been missing to date. Centralising doesn’t work; decentralising closer to the surface does. One of the unintended consequences of Labor’s mismanagement of NDIS funds is the shortage of aged-care and healthcare workers who migrated to work in the lucrative NDIS model. This is because NDIS wages are so overinflated that a worker can receive three times the rate of pay for the same work done in other sectors. This is not just hurting the NDIS. This rorting, mismanagement and waste of taxpayer funds is hurting aged-care and healthcare workers.
Labor wastes money in other areas, too. Look at the wasted $430 million plus that the doomed referendum cost Australians—just like the Gillard government’s NDIS facade, which was based on slogans and empty promises lacking substance. Just think how that $430 million could have been spent directly to improve the lives of remote Australians living in need or spent on improving NDIS services and security for people who are disabled in some way. Then there are the follies of government cutbacks, such as when psychological services were cut from 20 appointments to a relatively useless 10 appointments for needy participants. Just think about what could have been supported with the wasted money—health, education and child protection are a few. Frontline staff are in short supply now, partly because of poor pay, inadequate training and lack of support and partly because of NDIS rorts and sloppiness. Many NDIS carers and support staff have little or no training in basic personal caring skills. Many recipients have physical health needs and their carers should have sound skills in lifting, mobility, feeding, toileting and showering. Expecting NDIS carers to do these things with no, or inadequate, training is unfair and dangerous for the recipient and the carer.
I have described a support system in crisis. This bill tinkers around the edges. As it is, this bill will not make significant positive differences, and who pays for all of this waste? Always, it’s we the people. Instead of tinkering around the edges of a broken system, do the work! I call on the government to do the work to define disabled people’s needs for service and taxpayers’ needs for protection. Instead of the ubiquitous fraud under low levels of accountability, consider returning to the original system of state governance. One Nation knows what history repeatedly proves: administration and services are of higher quality when services are closer to recipients. That enables understanding of needs, which is core to effective service. Replacing centralisation with competitive federalism provides a marketplace in governance. That’s what we all want. That’s what we need because improved governance provides accountability, effective service and better care.
At the recent estimates in June, the head of the Fraud Investigations Unit revealed that the volume of fraud cases reaching the courts is so high that the country’s judiciary is overwhelmed. This significant issue is driving up the cost of services.
I then enquired about the services provided to individuals with autism and was told that there are 200,000 people on the program with autism as their primary diagnosis.
No commitment was made to increase allowances for care providers.
Transcripts | Part 1
Senator ROBERTS: Thank you, Chair. Thank you to witnesses for being here today. We have been receiving a lot of phone calls and emails from constituents about the NDIA and the NDIS. What’s the fundamental need for having an NDIA and an NDIS as separate agencies? While they have different functions, the functions of NDIA and NDIS could be combined, doing away with a whole department and host of bureaucracies currently costing the taxpayer millions of dollars. It’s confusing to people. Could you please explain them?
Ms Falkingham: Yes, Senator. We have a scheme that’s set out under the act. There is only one agency, which is the National Disability Insurance Agency. We also have a commission. That might be what you’re referring to—the National Quality and Safeguards Commission. But the NDIS is not an agency, it’s not an entity of any type; it’s a scheme.
Senator ROBERTS: Why are people so confused about it?
Ms Falkingham: I think that over the course of the last 11 years we haven’t necessarily done the greatest job of explaining and communicating about the scheme—who it’s for, who it’s not for, what type of supports you can get on the NDIS and what supports you can get from outside the NDIS. Some of the confusion you might be speaking about goes to whether people have got an issue with their provider. If they have an issue with their provider, often it’s the National Quality and Safeguards Commission that they can make a complaint to, if it’s a registered provider. But, obviously, we also have things called local area coordinators. That’s a partnership we have with the community sector, which is often when people go in the first instance to speak to someone about getting onto the scheme. There are a lot of people involved in this scheme. One of the review’s recommendations is to really streamline that and have this concept of a navigator, and so we can start to have one person walk with a person with disability in an end-to-end kind of way along the planning process.
Senator ROBERTS: What’s being done in relation to auditing agency service providers who are sucking the scheme dry through fraudulent claims for services overcharged or not actually even provided?
Ms Falkingham: It’s an excellent question. I might ask John Dardo to come to the table. He can take you through all the work we’re doing on our crackdown on fraud.
Mr Dardo: I’m the deputy CEO and I look after contact centres and the integrity functions as well.
Senator ROBERTS: Sorry, what are the functions?
Mr Dardo: The Integrity functions—things like compliance, fraud and integrity checks.
Senator ROBERTS: Thank you.
Mr Dardo: Before I give a bit of a summary about the work that we’re doing, there are a couple of things that are really important to note. The No. 1 priority we have when we do integrity work is to make sure that participants’ safety is looked after. As we talk about the stuff today, it’ll be easy for some people to assume that participant safety is not the No. 1 thing we do, but participant safety is actually the most critical thing we do as we do our integrity work. As we do that integrity work, obviously we also look at things like sustainability of the scheme and making sure that the community can have confidence that people are getting the right services from the right providers. If we do it well, we get a level playing field for the providers, because the good providers can compete on a level playing field; they don’t have to compete against dodgy providers. The work we’re doing has lots of layers. There is a lot of work that we doing to identify, with intelligence, the providers or the things that are bad for the scheme. As we do that work, we’re working with other agencies to build layers of defence. That is because there is no silver bullet to getting integrity right within the scheme. One thing that we have is the Fraud Fusion Taskforce. It’s now 19 agencies.
Senator ROBERTS: The what taskforce?
Mr Dardo: It’s the Fraud Fusion Taskforce. There are 19 government agencies. It includes us, Services Australia—we co-chair it—the tax office, Attorney-General’s, the Australian Criminal Intelligence Commission, and a raft of other delivery agencies that do government payments and programs, such as Education, Employment and Workplace Relations, ASQA, who look after registered training organisations, professional standards that look after the quality of the medical professionals, Health and Ageing—there are a lot of agencies involved. The reason we partner with those agencies is that the people that are doing the worst things against the scheme and the worst things against participants don’t just work against the NDIS; they rort other systems as well. They rort the tax system, the Medicare system or the VET, vocational education and training, system. The patterns they use to defraud the scheme are similar across those systems. So, when we work with the other agencies, we’re more likely to detect those people, and we’re building a preventive architecture that doesn’t just stop fraud against the NDIS; it is also reusable to stop fraud against Medicare, vocational education and training, family day care or child care. So that taskforce is going brilliantly. It has a regular rhythm. We do a lot of work together to develop intelligence. We have intelligence alerts that come out to all the relevant agencies about providers or schemes that seek to defraud. We then act on those to stop payments or we work with the commission, who are also on the taskforce, to prevent bad players from being registered providers. In some cases, we do operations together. ASQA, the guys that look after registered training organisations, only came on board in the last month or so. Within a week or two of coming on board, we worked with them, and the tax office provided some support and the commission provided support, and warrants were executed on a provider that was problematic. So we work together really well.
Senator ROBERTS: How many service providers have been charged for falsely claiming fees for services not provided?
Mr Dardo: There are many, many dozens. Right now, there are approximately 20 prosecutions in progress, as in right in front of the courts right now.
Senator ROBERTS: That’s across Australia?
Mr Dardo: Yes. There are also several that are imminent. The affidavits have been produced. The work has been done with law enforcement. It’s been done with CDPP to result in either search warrants or charges. So there are more in the pipeline that are imminent. In addition to that, we’ve got to keep in mind that prosecution is the last resort. What we want to do is build a scheme where they can’t even get to the point of doing dodgy claims.
Senator ROBERTS: What I have seen and what I’ve concluded is that the NDIS was started as an election promise, it was cobbled together and flung out there—it wasn’t ready to go—and as a result there have been two things. Initially, there was a lot of corruption because the systems were loose, which is understandable, and then, as they tightened up, some people were missing out on services. Could you give me on notice, please, since the inception of the NDIS, the number of people charged for falsely claiming fees for services not provided, on an annual basis. I’d like to see if there’s a trend—if there’s a pick-up or a decrease. I mentioned the fact that, when you have a trend, it may be due to better enforcement or due to more—
Mr Dardo: Keep in mind the charges that are laid aren’t phrased exactly the way you described them, but certainly we can give you, on notice, the trend. What I will say is we are detecting now more than we could ever detect before, because the systems were not mature. They have been matured as we invest more in building more mature systems. For example, certainly in the last six to eight years, payments would be going out the door, and there were some periods through the day or through a weekend where payments were being processed with no NDIA eyes, or human eyes, looking at those payments. So payments were walking out the door without any system knowing that the payments were going out the door, because the systems were not mature enough or built in a way to prevent those payments.
Senator ROBERTS: We all know that the minister has been talking a lot about tightening up because ultimately the cost is getting out of control. What that means is that people who deserve good care don’t get it. So, by holding back the fraudsters, we’re protecting people to ensure they get their care in the future.
Mr Dardo: Absolutely. To give you examples, there are the prosecutions, but, even more important than that, in terms of the volume of the response that we’re implementing at the moment, there are the stoppers. There’s the stopping of payments where the providers are problematic or the claims are problematic.
Senator ROBERTS: So you’re making them jump through more hoops?
Mr Dardo: We’re stopping the claims, and we’re saying, ‘We’re not confident that this claim is legitimate; you need to provide evidence that it’s legitimate.’ In some of our stopper work, we’re hitting 50 to 87 per cent stop rates on claims. We have providers that have put claims in. We’re saying, ‘Sorry; that doesn’t look quite right,’ and they’re either withdrawing or cancelling their claims, or not responding at all—they’re walking away completely, and in some cases they’re shutting down their businesses and walking away because they’ve realised the game is up. And we’re not talking at the margins for these claims. Some of these claims are in the hundreds of thousands of dollars—
Senator ROBERTS: We’ve heard about them.
Mr Dardo: or in the millions of dollars. Our ability to now detect it is allowing us to stop it before it goes out. If we can stop it before it goes out, we then don’t have to try and recover the money or raise a debt to recover the money. We need to get better at stopping it. Before they even exist to make the claim, we need to get better at bringing that further forward in the supply chain. As we look at many of these claims and many of these providers, what we’re seeing is that the behaviours have been going on for years. It’s just that we’re better now at seeing them and preventing or stopping them. It is generating some angst, and I’ll describe that in more detail. There are providers that have been really bad in setting up their business model to take funds out of the system, with an understanding with participants or nominees that they would provide a certain set of services which maybe should not have been provided by the NDIS, whether it be rent subsidies, alcohol or other lifestyle expenses, gift vouchers or gift cards. The participants or their nominees have grown accustomed to a standard of living—they may have signed leases on the understanding that that was the lifestyle they would enjoy—and we’re now identifying that those providers are problematic, and we’re saying, ‘Sorry; you can’t keep claiming that money to subsidise that type of spend.’ You can imagine that some of our participants are having their standard of living disrupted.
Senator ROBERTS: That is a recurring theme in some of the questions constituents put to us—that genuine care is not being considered but lifestyle choices are, and so money is going on that. This is another one that’s recurring: when will families or friends supporting a person with high-level needs be appropriately supported? They’re not adequately supported, but care providers are being overly supported.
Mr Dardo: There are certainly some really black-and-white spaces. There are providers that are just providers—they’re brilliant and they’re awesome, and what they do is fantastic. There are some providers that have a mixed business model—they do some good work, but they do a whole bunch of dodgy stuff to supplement their income, their lifestyle or their business. There are some providers that are really just fraudsters, criminals or criminal syndicates, and they’re using the NDIS for cash flow. There are some participants and providers that are the same thing. We have participants who have set up businesses to pay themselves to look after themselves, or nominees who have set up businesses to look after their kids. We have examples of cases where it’s not clear that it’s a provider or a participant or a nominee, because it’s all intermingled. The family group has set up three entities, and they’re paying each other to look after each other, or a mother has drawn down $100,000 a year as an income to pay herself for looking after her child with disability. There are some things there that are very intermingled between a provider and a participant. The conflicts of interest are pretty extreme. Then you have participants who have not understood what they can and can’t agree to with a provider, so they’re accepting things that they shouldn’t be. Examples just in the last week: a $20,000 holiday, a $10,000 holiday. There are participants who are claiming things that they shouldn’t and in the past would probably not have been detected. We had a participant that bought a car, brand new, for $73,000. The money was processed overnight. Fortunately, when we were able to approach them, they understood that they shouldn’t have done that and they were willing to repay the money. We have other participants who haven’t understood what they should be claiming and when we approach them they cease contact and refuse to engage. Then there are the vast majority of participants that are trying to do the right thing, and we have to figure out how we get the balance right so that we help the people who are trying to do the right thing get it right more often. For the providers that are doing an awesome job, we need to help them survive and flourish. For the ones that are running mixed businesses, we need to exit them from the scheme, and, for the providers that are dodgy, we need to exit them from all government services, not just the scheme—we need to exit them from Medicare, AHPRA and everything else that they’re involved with.
CHAIR: Senator, this will need to be the last question.
Senator ROBERTS: Can you give us the number of providers per year, for the last five years, who have been exited from the system please.
Mr Dardo: We can. There are some different metrics there, but we can see what we can get for you.
Senator ROBERTS: It sounds like the agency is waking up to what’s happening, so thank you.
Transcript | Part 2
Senator ROBERTS: Before I continue with my questions—I think they will be to Ms Falkingham—Mr Dardo, I want to say I appreciate your candid nature and your openness. I’ve rarely seen someone in your position who, when confronted with a senator telling them about a problem, says: ‘That’s not the end of it. It’s worse than that, actually.’ It’s only by us understanding it and what you’re doing that we can help you. Thank you. I appreciate that. Ms Falkingham, why have many persons with autism or on the spectrum had their services cut, often with little explanation provided?
Ms Falkingham: I am not aware of any evidence to support that claim. I will get the scheme actuary up and he can talk about the amount of money we invest in participants with autism.
Mr Gifford: I don’t have the precise figure with me but I believe it would be more than 200,000 participants in the scheme who have autism as their primary disability. There’s no data that would suggest that people with autism are having their services cut. The growth in plans of participants with autism is different to the scheme population more broadly.
Senator ROBERTS: What’s the plan to support older people currently receiving a support package that far exceeds the age pension yet their package will cease when they reach retirement age? Their needs will not diminish and may become more acute yet their support will be slashed.
Ms Falkingham: It might be a question for our colleagues in DSS. The NDIS review has made a number of recommendations in relation to the interface between aged care and NDIS, so we can absolutely do better for ensuring that people are receiving that continuity of support if they have been on the NDIS, which we do now for people under 65. The NDIS review has made a recommendation around the interface and how we can improve upon that, but I will check if my colleague wants to add to that.
Mr Griggs: If you qualify before you’re 65, you don’t come off the scheme at 65.
Senator ROBERTS: What happens? When they go on the pension, don’t they come off the scheme?
Mr Griggs: No.
Senator ROBERTS: Not at all?
Mr Griggs: No, not if you qualified before 65.
Senator ROBERTS: Remember, these are coming from a lot of our constituents via emails and personal calls. Are you aware of clients who own their own home being pressured to sell their own home by the service providers to move to group care?
Ms Falkingham: I will check whether Deputy CEO Penelope McKay has any evidence. I do hear that anecdotally, but I’m not aware of whether we have any current cases. We can take that on notice for you.
Senator ROBERTS: Why is the focus seemingly moving away from providing support based on practical needs like assistance with cooking, cleaning, showering and hygiene to non-essential services that are routinely overcharged? We’ve heard stories of fishing and so on. Is there a switch there from genuine need to—
Ms Falkingham: Every decision we make is based on reasonable and necessary. The things you have outlined are absolutely the core of the scheme in terms of daily living and supporting daily living expenses, so I’m not sure. We can follow up for you, but some people will have goals in their plans that go to recreational goals and achievements, so obviously we will try to support a participant to achieve that goal by providing appropriate disability supports to enable them to do that. But things like building capacity, that’s what you’re speaking about in relation to cooking and cleaning and supporting people to live a good life. They are the core of our scheme and that’s predominantly what we fund now.
Senator ROBERTS: We’ve heard from constituents saying they have someone who will take them fishing but he comes in, does a quick look around—that’s a welfare check—and leaves. Is that the kind of thing some people are paying for?
Ms Falkingham: If you have evidence of that, I’m really happy to follow that up.
Senator ROBERTS: Why do agency service providers apparently get priority to receive payment over actual care givers who do massive amounts of unpaid work? In other words, personal care givers, family, do a massive amount of work and don’t get paid but agency service providers do.
Ms Falkingham: Obviously informal supports are a critical part of someone’s life and it is one of the things we discuss as part of the planning process. We fund paid supports under the scheme, but informal supports will always be a critical part of our community, and having family to be able to support loved ones is a really critical part of that. We obviously always provide respite services for families as well, who do provide a lot of informal supports, but that is the nature of our scheme. It is what we are funding under the NDIS.
Senator ROBERTS: Why is the carers allowance so pitifully small relative to paid agencies when many carers provide ongoing personal support 24 hours per day all year?
Ms Falkingham: I think that might be a question for DSS.
Mr Griggs: Carers allowance is part of the social security system. It’s not part of the NDIS. We can talk about that tomorrow in outcome 1 of DSS, when my team will be here, and they can take you through that.
Senator ROBERTS: When will care providers be remunerated appropriately because they put in more needed work hours than agency service providers? We’ll talk about that tomorrow.
https://img.youtube.com/vi/4iP2O7jiyyw/maxresdefault.jpg7201280Senator Malcolm Robertshttps://www.malcolmrobertsqld.com.au/wp-content/uploads/2020/04/One-Nation-Logo1-300x150.pngSenator Malcolm Roberts2024-06-28 17:37:042024-09-11 17:38:08Fraud is Overwhelming in the NDIS Sector
My questions to the NDIS Quality & Safeguards Commissioner was primarily about the quality and safety issues that render the system inefficient and hazardous.
It became evident that fraud was rampant, leading to significant financial waste and leaving many recipients’ needs unmet.
While some recipients received excessively extravagant packages with overvalued components, such as massages, fishing trips and cruises, others remained in dire need of basic assistance for eating, washing, toileting and dressing.
Initially, the system functioned fairly well, but it has now expanded excessively, resulting in waste, unmet needs, and dangerous conditions for vulnerable recipients.
During the recent Senate Estimates, I inquired with the NDIA about whether individuals with autism, often described as being on the spectrum, and their families are covered by the scheme to receive support? Constituents had informed me that support had been cut without explanation.
I was informed that there’s been no change and that individuals with autism will continue to be included in the National Disability Insurance Scheme (NDIS), with support determined on a case-by-case basis.
I also inquired about the plan for supporting older individuals nearing retirement who already receive assistance under the scheme, ensuring they continue to receive the higher level of support. I was informed that the government is still deliberating on this matter.
Transcript
Senator ROBERTS: Before moving on to my third question, I express my appreciation for the answers to the first two and for Mr Dardo’s concurrence that he’s going to put the details, in response to my first question, on notice—the financial figures. I don’t know who the appropriate person for this question is. Will families supporting a family member with autism be appropriately supported? Is autism covered?
Ms Falkingham: It is. Can I clarify what your question is about, though. Obviously we cover autism within the scheme.
Senator ROBERTS: You do?
Ms Falkingham: Yes, we do.
Senator ROBERTS: I’ve heard that many people with autism—or who are on the spectrum, as they say—had their services cut off, with little explanation provided. Is that true?
Ms Falkingham: It’s not true that there has been any change in relation to autism. Autism will always remain part of our scheme. But, if there are any individuals that have got particular cases that you would like me to look at, I’m really happy to do that.
Senator ROBERTS: Thank you. I have two more questions. What’s planned to support older people currently receiving a disability support package that’s far in excess of an age pension? What’s the plan for them when they reach retirement age?
Ms Falkingham: That might be a question for our colleagues in DSS as well, because the NDIS review has made some recommendations in relation to making sure that people continue to receive disability supports after 65, but government is currently deliberating on that recommendation.
Senator ROBERTS: Thank you.
Mr Griggs: Senator, we can come to that.
Senator ROBERTS: Sorry?
Mr Griggs: We can come to that when we get to outcome 1 in DSS tonight. That would be the place to discuss that.
https://img.youtube.com/vi/CitVY0OCZw0/maxresdefault.jpg7201280Senator Malcolm Robertshttps://www.malcolmrobertsqld.com.au/wp-content/uploads/2020/04/One-Nation-Logo1-300x150.pngSenator Malcolm Roberts2024-03-18 17:07:182024-03-18 17:07:21NDIA Coverage of Autism and Supporting the Elderly
At the February Senate Estimates I asked the National Disability Insurance Agency (NDIA) how much money has the NDIA been able to claw back through identified National Disability Insurance Scheme (NDIS) fraud? Funding across 16 agencies, including the NDIA, of $140 million over four years was provided in 2022 to tackle fraud. Those agencies are working together. It seems reasonable that we should know what return on this investment we’re getting since we’re paying for it.
There are major concerns with the NDIS. It was hastily brought to life and hastily implemented. There are concerns with both over and under-servicing. That’s not necessarily a reflection on the people in the NDIA, but that’s the reality.
I also asked what is being done in relation to auditing service providers who are sucking the scheme dry through fraudulent claims for services that are overcharged or actually not even provided? My questions regarding the amount actually clawed back was taken on notice, however John Dardo, Deputy CEO of Integrity Transformation and Fraud Fusion Taskforce, freely admits to having layers of concern about NDIS fraud. There are over 600,000 participants in the scheme and Mr Dardo says the system is extraordinarily immature for a scheme paying out over $100 million each day, with 400,000 claims a day. Among the risks they’re managing is whether they can be confident that a participant is a real human being, is in the scheme knowingly and actually exists.
Transcript
Senator ROBERTS: Thank you for appearing today. On the topic of fraud, how much money has the NDIA been able to claw back through identified NDI fraud?
Ms Falkingham: I’ll ask Deputy CEO John Dardo, who leads that program, to come forward to the table.
Mr Dardo: Thanks for the question. There are different ways to measure that. One of the ways to measure it is to think about how much we’ve prevented from going out the door by implementing systems or detecting the integrity leak before the money has left the door. Another way to measure it is to look at whether we’ve asked the participant or provider to pay the money back. Another way to measure it is by the amount of money that is subject to a prosecution activity—so where it has gone to the courts. Not all of that is recoverable, because unless there’s criminal asset confiscation, or unless there are penalties being charged, that money may not be recoverable. So there are lots of different ways to measure it.
What I would say is that, as my colleague mentioned earlier in relation to detecting the anomalies, there are a range of things that we’ve been building up over the last 18 months to allow us to identify where there are integrity leaks, and what I would emphasise is that integrity leaks are very, very strongly correlated to participant risk. The safety of participants is put at risk when money is leaking to the wrong places. It’s because the participants aren’t receiving the services they need, or because we’ve got providers that are dodgy and are actually growing their businesses at the expense of good providers—so they’re wiping out the good providers—or because that money is actually funding activity for participants that is putting them at further risk, whether it be drug abuse, alcohol abuse, risky behaviours or other behaviours. So the money’s important, but the reason we look at the money is the participant safety impact that it has.
What I would also say is that there’s a level of detail that I can’t share in this forum—I’m happy to do it in a private setting—because we do not want to run a 101 session on how to commit fraud against the NDIA. But I’m on the public record in previous hearings talking about the layers of concern that we have. We have, in round figures, over 600,000 participants in the scheme. The system is extraordinary immature for a system that pays out over $100 million a day, with 400,000 claims a day. It is an extraordinarily immature system. Certainly it’s one of the most immature I’ve seen. If I think about the sorts of risks that we’re managing and investing in, being confident that a participant is a real human being, is in the scheme knowingly and—
Senator ROBERTS: Actually exists.
Mr Dardo: actually exists is an area of risk that we’re certainly unpacking and understanding, and we’re identifying things that need to be addressed.
Senator ROBERTS: Excuse me. Out of respect for the chair wanting to conclude pretty soon, could you take it on notice to provide the figures around the categories of fraud that you mentioned earlier on, please? What money has been saved?
Mr Dardo: We can do that.
Senator ROBERTS: There are concerns with the NDIS. It was hastily brought to life. It was hastily implemented. There are concerns with overservicing, as you know. There are concerns with underservicing and there are concerns with fraud. That’s not necessarily a reflection on the people in the NDIA at the moment, but that’s the reality. Please also take it on notice to answer: what is being done in relation to auditing service providers who are sucking the scheme dry through fraudulent claims for services that are overcharged or actually not even provided?
Mr Dardo: An enormous amount of activity. Some of that activity is some randomised integrity checks. We’ve done tens of thousands of those to try and understand, at a randomised level, what we’re seeing. The sorts of common things we’re seeing include overclaiming, duplicate claims, claiming for services that were never provided and claiming for services that are not consistent with the plan. If I think about some other risk points, we have some particular cohorts where we have very significant concerns about the behaviour of the cohorts, and, when we cross-reference our data with other data such as tax data, for example, we see that some of our providers are non-compliant with basic obligations to the Commonwealth. If they’re non-compliant with their basic obligations to the Commonwealth but they’re managing money on behalf of participants or managing services on behalf of participants, we’ve got concerns. We have several hundred providers where they’re managing money or services on behalf of participants or managing other providers on behalf of participants and yet they’re not compliant with their most basic tax obligations. We’re cross-referencing data with other agencies.
A taskforce commenced in November 2022. At the most egregious end of the offending, that taskforce has 16 Commonwealth agencies working together to identify networks of providers or syndicates that are targeting the scheme. You may have seen some media coverage about the search warrants being executed, the prosecutions being conducted and passports being seized or surrendered as part of bail conditions. That work is continuing to ramp up. We have over 100 investigations in the pipeline, and some of those cases are very significant both in dollar value and participant numbers being affected and also in the egregious behaviour of those providers.
Senator ROBERTS: There are a lot of costs involved. Some of the costs are from the 16 agencies that are working with you and they’ll be hidden from the total cost.
Mr Dardo: No, those agencies were funded as part of that announcement. That funding was $140 million over four years. Those agencies, as well as the NDIA, were funded as part of that Fraud Fusion Taskforce and they’re working in partnership with us.
The government’s spending on NDIS threatens to bankrupt Australia.
The NDIS is a runaway spending rocket which is failing to serve the disabled and getting worse. The service was never set up correctly in the first place and continues to waste billions and let down those who need it because of endemic bureaucratic bungling. There’s zero accountability within this agency. It is letting some abuse the system and as taxpayers we’re footing an exorbitant bill. The NDIS is not fit for purpose, yet a disability service is desperately needed and not reaching many of those it was meant to assist.
In questioning Minister Gallagher about what Labor is doing to fix this problem her answers were unhelpful and it seems she is being deliberately obstructive. Creating another level of bureaucracy won’t address the problem. It’ll only add another burden for taxpayers and extra layers of complexity for those needing help to try and navigate. If Labor is hoping that by ignoring the NDIS problem it will go away, they will be disappointment.
The NDIS needs addressing now before it’s too late.
Transcript
In serving the people of Queensland and Australia, I have four questions. I’ll do a little bit of explaining to get to the point. One Nation simply cannot support a bill that establishes an entirely new disability bureaucracy when the bill does not even define ‘disability’. I wonder: is this an admission that the NDIS has failed or that the government is letting it run completely out of control? I’ll come back to that.
I remind everyone of the hasty and ill-thought-out concoction of the NDIS. Prime Minister Gillard hastily introduced it for election purposes before an election. Then she was voted out, and the Liberals and the National Party inherited a complete mess. They tightened it up, but it’s still sloppy. In tightening it, we got mixed signals going about services that are being provided to the disabled. That leaves them in a totally inadequate situation. I’m concerned about taxpayers and the disabled in these remarks and questions. If the NDIS continues in its current form, it will send the entire country broke and continue to provide inadequate services to the disabled.
This bill does not deal with the NDIS. It establishes an entirely new bureaucracy in an entirely new agency. If the Disability Services and Inclusion Bill 2023 and the associated consequential bill pass into law, the Minister for Social Services will be given legislative authority for new spending programs to cover the 88 per cent of Australians living with a disability who cannot access support under the National Disability Insurance Scheme at the moment.
I want to talk about the NDIS now because it provides financial support to just 610,000 participants, or 12 per cent of Australia’s estimated population living with a disability, while being the second-most expensive social program after the age pension. The annual running costs in the year ending 30 June 2023 were $38.8 billion. That is 26 per cent higher than Medicare, $30.8 billion; 40 per cent higher than aged care, $27.7 billion; and 40 per cent higher than the support for state government hospitals, $27.3 billion. Minister Bill Shorten expects the annual running cost in 2026 to be $50 billion, making it almost double what is spent on state government hospitals. The NDIS is unsustainable at these levels and will not be able to properly provide services for the disabled.
I’m not going to sign a blank cheque for any government. I won’t be giving the government more spending power until I know how taxpayer money goes to those to whom it is intended, and many of the disabled are not getting the services necessary. Like many Australians, I’ve worked hard to bring up my children and to pay my taxes. Every tax dollar that the NDIA wastes is a dollar that is not spent on health, education and keeping us safe. NDIS participants using their plan money to holiday in exotic places and paying excessively for ordinary items like transit wheelchairs and aluminium shower chairs diminishes support for the program and prevents services to other disabled people who deserve support. Until I’m satisfied the Labor government can manage their departments, I’m not going to give them any more spending power.
The Auditor-General investigated decision-making in the NDIA, the agency, between 1 July 2016 and 31 March 2017 as part of his report Decision-making controls for sustainability—National Disability Insurance Scheme access. In one group of 150 cases that were reviewed, the decision-maker’s name was not recorded in 42 cases. In another 18 of the 150 cases, there was no record of the reasons for the decision. That’s not accountability for taxpayers’ money. In a review of another 1,339 cases, 13 per cent—that’s almost one in seven—did not have sufficient evidence to support decisions to give lifetime support under the NDIS Act 2013.
These findings in 2017 led to the Auditor-General making a number of recommendations. Seven of the nine recommendations made in relation to improving decision-making controls and fraud controls were not fully implemented by the time the Auditor-General investigated the NDIA again last year. Despite a history of approving access to the NDIS without lawful authority, senior bureaucrats in the NDIA will not make sure all delegates are trained. Of the 1,147 NDIA planners employed by the NDIA on 30 June 2020, only 73 per cent—under three-quarters—of them had been trained to spend billions of hard-earned taxpayer money. No wonder the NDIA costs cannot be controlled! Not only does the government need to show me it can manage the NDIA in accordance with the law passed in this chamber, but it also needs to deal with the demand shock created by the introduction of the NDIS. The sudden high demand created by the tsunami of money in NDIS participant plans has caused the cost of seeing an occupational therapist, a speech therapist or a psychologist—as well as others—to skyrocket. NDIS is more generous than the Department of Veterans’ Affairs or aged care, and that leads to inequality. That should not be the case. It’s a mess. It’s time the government aligned the price it pays for the same service across different government programs.
Anyone can apply for a participant package under the National Disability Insurance Scheme Act 2013, but only people with a disability who meet the age, residency and disability requirements and can demonstrate that support is reasonable and necessary are intended to get support for a lifetime. As I’ve already said, it’s a lottery at the moment because decision-making is so poor in the National Disability Insurance Agency due to its messy and improper formation and its lack of foundation at its birth.
While public servants sit in air-conditioned offices, an army of poorly paid disability workers provide the core supports needed by people with a disability. Disability workers are poorly paid, trapped in a system with little job security or prospects. They’re often working with questionable service agencies. Their employers are small businesses which often have no relevant experience and are unable to provide training or support in what can be confronting and stressful situations. No wonder there’s a shortage of disability workers right now.
I want to see all National Disability Insurance Agency plans de-identified and made public. Australians need to know what is being funded. They’re the ultimate payers for this service. Employing a qualified chef to teach someone how to cook at home is a luxury that we cannot afford. Prior to NDIS, it was estimated that families provided 80 per cent of the support for a person with a disability and the government provided 20 per cent. The introduction of the NDIS was to shift some, but not all, responsibility to government, with families providing 60 per cent of the support and the government providing the remaining 40 per cent. We don’t know much about the level of family support provided today, but we do know only 30 per cent of all plans are managed fully or partially by the participant or their family, which suggests that government is taking on far more responsibility than was ever planned. Participant managed plans account for 30 per cent of the number of plans but just 12 per cent of the NDIS budget. These budgets are spent, but not overspent. Another 60 per cent of plans are managed by someone other than the participant or their family. These managed plans account for 46 per cent of the NDIS, four times as much. The remaining 10 per cent of NDIS plans are NDIA managed, and they account for 42 per cent of the NDIS budget. The NDIA consistently underspends these plans. Why?
Until I see lawful, responsible and effective by the National Disability Insurance Agency, I will not be supporting any new spending power by government. One Nation supports disability services, yet they have to be sustainable for the Australian taxpayer or there will be no services in the future, and those services that there are won’t be fit for the disabled. Spending on the NDIS will outstrip all Medicare services. There is billions of dollars of fraud currently happening in the NDIS that the government has done next to nothing to stop. We’ll be opposing this bill until the government can prove it is running the NDIS in a way that isn’t going to send the country broke.
I’ll go back to my opening question from my first question: is this new legislation an admission that the NDIS has failed or that the government is letting it run completely out of control?
https://i0.wp.com/www.malcolmrobertsqld.com.au/wp-content/uploads/2023/05/180523-Capture-1.jpg?fit=896%2C1121&ssl=11121896Sheenagh Langdonhttps://www.malcolmrobertsqld.com.au/wp-content/uploads/2020/04/One-Nation-Logo1-300x150.pngSheenagh Langdon2023-05-18 14:45:022023-05-18 14:45:08NDIS needs a hell of a good look at
