This article first appeared on cpsn.org.au on January 20 2023.
It’s been ten years since the NDIS Act 2013 passed; since then, the NDIS, as well as the lives of the people who depend on it, have undergone a radical transformation which by far as been very positive.
Despite all the benefits created, it was only a matter of time before new providers would attempt to offer profit-driven cost-cutting alternatives to participants.
One growing example of this is Unregistered NDIS Providers; they offer many services the same as their registered counterparts but often promise lower hourly rates and more hours for the client without the safeguards and additional quality measures that registered providers offer.
It’s a tempting offer to any participant, mainly when there’s a growing concern about possible plan cuts. However, the suggested benefits, such as reduced hourly rates, cost savings on consumables, and a sense of choice and control, outweigh the risks that come with unsupervised and unregulated practices. Clients can access unregistered providers (for some services), either self-managed or plan-managed, and 40% of NDIS spending goes to unregistered providers. Over the coming months, CPSN will be doing a detailed exploration of some of the more significant risks associated with unregistered providers and workers. Here is an overview of the most significant risks of using unregistered providers or independent workers. Another type of unregistered service provision is when a support worker operates as an independent worker and is not employed by a provider. They operate with an individual ABN and are solely responsible for negotiating and working directly with NDIS participants/clients. Clients can be accountable for costs to do with public liability and superannuation. When you hire a support worker through a registered provider like CPSN, the agency or provider ensures that the support worker has provisions such as insurance and superannuation. Public liability is costly, and independent support workers may forgo including it with their services. The lack of coverage in these critical areas means that the client might be left with the cost of public liability if an incident occurs during a shift. In addition, while independent support workers might be attracted to negotiating better rates – they are not covered by WorkCover, they don’t receive any leave entitlements or benefits and they have to make their own superannuation contributions. to cover essential salary requirements such as organising superannuation. This means that a support worker with a busy schedule might be left without superannuation coverage. Unregistered providers and workers lack professional training and don’t have to follow quality standards. As part of their registration, the registered provider must adhere to NDIS Practice Standards, meaning that the provider must demonstrate that they practice vital principles such as person-centred approaches in their service of clients. The phrase ‘Person-centred approach’ may sound like a meaningless catchphrase, but it refers to upholding an individual’s legal and human rights and respecting their choice and control. There are specific practices that underpin the person-centred approach; it includes the following:
The client’s right to self-determination and freedom of expression (including their sexuality)
Provision of care in terms, languages, and modes of communication the client is likely to understand
The client’s chosen cultural identity and beliefs are acknowledged and respected
The client’s right to privacy and dignity is always upheld
While many participants feel like they may get this level of care from an unregistered provider or an independent worker, the issue for most is that there need to be safeguards to protect the participants. It leaves participants at increased risk of various forms of exploitation and risk. Clients are at an increased risk of abuse, neglect, and fraud. "Using an unregistered provider is something I'll never do again because they were very unreliable in terms of punctuality and actually helping me with my daily activities. When it came to paying for their services, they also charged me a much higher rate, which left me feeling ripped-off and undervalued." – anonymous. The lack of Practice Standards among unregistered providers has led to the most scathing and controversial aspects of unregistered services, which is the documented increased risk of abuse, neglect, and fraud. Fake invoices, padded fees from contractors and six-figure lawsuits have been heavily documented since NDIS’s inception. A recent hearing by the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability revealed several discrepancies between registered and unregistered providers. These discrepancies included that unregistered providers do not have to adhere to reportable incident requirements. While a police task force, in addition to the Royal Commission, has been established to crack down on fraud and abuse incidents, clients are still exposed to threats, intimidation, and violence. It’s impossible to highlight all unregistered providers’ issues. In particular, the disability sector needs more comprehensive regulation with universal screening for anyone providing NDIS-funded services. There is also a call for tiered registration standards as well as stronger demand for the NDIA and NDIS Commission to monitor, regulate and support the NDIS market. This will call for a funding boost for both agencies. In the coming months, we will focus on these issues in greater detail, bringing to light a greater focus on some of the specific individual risks that come with unregulated service providers.
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