The NDIA’s performance audit report card

In a month of big government reports dropping every other day, you’d be forgiven if you missed an absolute pearler: the Australian National Audit Office (ANAO) Performance Audit Report on the Effectiveness of the NDIA’s Management of Assistance with Daily Life Supports. If you think the name of the report deserves its own TLDR, don’t fret. I’ve made enough coffee-stained rings on this 100-pager to pop out a two pager for ya.

 So, who are the ANAO and why are they interested in the NDIS? The ANAO is an independent body that audits Commonwealth agencies, requests documents otherwise hidden from public eyes, and tables a report for all to see. Put crudely, the process keeps the b******s honest…(*bureaucrats*).

Recommendations

 Here’s the condensed recommendations for the NDIA:

•  Rec 1: the NDIA and Services Australia should document how, when, who and why data is accessed from other departments involved in running the NDIS. The government need to set out if/how the law allows this data sharing and improve reporting/data governance
• Rec 2-5: improve planning. Evaluate functional assessments and the impact they have on plan values. Improve controls on planning, release clear operational guidelines, and learn from and publish appeals data
• Rec 6-7: manage conflicts of interest. ANAO want relevant Agency staff and its contractors to declare conflicts of interest and establish processes to do so on the regular. The ANAO also want the NDIA to crack down on Support Coordinators involved in delivering other NDIS services to the same people
• Rec 8-11: improve risk assessments and document risks that are outside the NDIA board’s risk tolerance
• Rec 12-15: understand where fraud is occurring, improve fraud detection and reporting, and develop performance measures for detection

Typical Support Packages (TSP)

We learnt that the Typical Support Package (TSP) will have an important role going forward, according to both the ANAO’s and NDIA’s vision. To rehash, the TSP is a calculator built into the NDIA’s IT system. The calculator eats a participant’s data, including their primary disability, functional scores from tools like the WHODAS, their region, and several ‘reference packages’. The calculator coughs up a dollar figure based on averages from participants with similar features and function. This figure acts as a target for the planner. If plan value is a certain percentage higher than the TSP (this was 10%) the plan and the reasons for the larger-than-TSP plan used to have to be submitted to NDIA bosses for approval.

The ANAO found that the NDIA needs to improve TSP and stick to it more. Data from September 2022 showed that only 14% of plans approved in the two years prior fell within the 10% range of TSP. The NDIA told ANAO it has since completely removed the requirement for planners to send higher-than-TSP plans to management for review, because it was not considered efficient. Presently, a single planner can build/approve plans up to the value of $385,000, without their bosses getting up in their business.

Don’t worry, the NDIA responded in the ANAO report, because we’ve built an even better TSP 2.0 calculator into our swanky new Salesforce system called PACE. PACE is the new IT business management system that will impact the internal and external experience of the NDIS. It will change everything from provider payments, how participants upload documents, individual claiming, all the way to how the Agency builds and benchmarks plans. It’s due for rollout in September this year.

 Exactly how the ANAO in their push for greater use of this TSP consistency proposes the NDIA will deliver individualised plans, with tailored supports, remains mysterious. And if the Agency wants participants – let alone their own planners – to take the planning controls like the TSP seriously, giving the public a squiz at PACE’s proposed TSP and its assumptions might be a good place to start.

Coordination of Supports and Conflict of Interest

Safeguarding against provider conflicts was already high on the Agency’s agenda – the Tune review cautioned against some shonky practices where providers were referring clients to themselves. The ANAO zoomed in on Support Coordinator organisations that deliver other services to the same participant.

This practice – though not exclusive to Support Coordinators – has been described as ‘client capture’ and can cause serious harm. The tricky thing for the Agency here is thin markets, particularly in rural and remote areas, where it may be necessary for some participants to access multiple services from the same provider. The Agency will also need to deal with the thorny issues before doing anything that limits participant choice.

The Agency told ANAO their computers are already looking for patterns in how providers are doing this and will use this data to crack down on specific providers that are all-too-frequently engaged in this practice. The Agency said it’s getting legal advice on whether they can prohibit the practice by law (with thin market exceptions).

Many staff + sensitive information = risky business

The ANAO’s discussion of data sharing safeguards could not come at a more important time, with the Robodebt Royal Commission last week recommending significant reform to data governance. Currently, the NDIA uses Centrelink’s mainframe to confirm participants details and records. There’s also an undisclosed amount of data shared across agencies like ACIC, ATO and AFP for the “work of the NDIS Fraud Taskforce and the NDIA’s compliance Branch”. ANAO told us, between February 2022 and 2023, 255 NDIA staff had accessed the Centrelink mainframe.

The ANAO recommended establishing a protocol between the agencies and keeping records of decisions by Services Australia that allow/deny cross-departmental access. ANAO also asked the NDIA and Services Australia to set out “the legislative basis, terms and conditions for use and applicable governance arrangements” for this extraordinary amount of data sharing. The NDIA agreed with this ANAO recommendation. Services Australia did not, on the basis it felt the arrangements were satisfactory and lawful. The ANAO doubled down.  

NDIA’s reason for decisions

For a long time, participants, reformers, and advocates have been begging the Agency to provide ‘reasons’ for decisions not to fund an NDIS support. Of the plans audited, the NDIA had only documented reasons in 57% of cases. The Agency explained that it hasn’t developed mandatory fields for ‘reasons’ in its current IT system. Instead, the NDIA is holding out for the PACE IT system which, at this rate, is also on track to solve climate change.

The NDIA stopped short of saying they would automatically provide reasons as the default in the planning process. They said, “The PACE system is designed to ensure all planning decisions are recorded along with valid justification and evidence to support reasonable and necessary decisions. This will be recorded in such a way that these decisions can be easily retrieved and referenced in the future.”

Clearly a step forward. But NDIA, bae, you are why we have commitment issues.

Appeals

The NDIA revealed they’ll develop a “formal mechanism” to release yearly reports with learnings from Administrative Appeals Tribunal, Independent Expert Reviews, and Federal Court cases. This mechanism will inform policy changes and operational guidance. Advocates and participants have been pushing for greater appeals transparency for some time, so this is a welcomed “announcement".

TTP

The ANAO was concerned about the lack of safeguards against providers claiming for things for which they were not eligible. The Temporary Transformation Payment – a payment to maintain supply while providers developed efficiencies – was one example of a payment providers could claim without the Agency being certain the provider had satisfied the eligibility criteria. NDIA agreed and revealed they are piloting stronger controls for providers claiming the Temporary Transformation Payment.

And that concludes the ANAO summary. Read the full report here.