austlii:cth/ARTA/2025/1821
General information, not legal advice.
ARTA
2025-09-17
Original judgment source is linked above.
Hart and Chief Executive Officer, National Disability Insurance Agency (NDIS) [2025] ARTA 1821 (17 September 2025)
Respondent: Chief Executive Officer, National Disability Insurance Agency
The Tribunal sets aside the decision under review pursuant to s105(c)(i) of the Administrative Review Tribunal Act 2024 (Cth). The matter is remitted to the Respondent for reconsideration with a direction that within 14 days of the date of this Decision the Respondent must facilitate the approval of a new Statement of Participant Supports (SOPS) for the Applicant, containing the following provisions:
(a) Supported Independent Living (SIL) for 1:1 support for 24 hours per day, 7 days per week including:
(i) Inactive overnight supports;
(ii) 21 hours per week of 1:1 support for assistance to access the community, social and recreational activities; and
(iii) 1,534 hours per year of 1:1 support to be provided by Alister French on the basis of 38 hours per week for six months, 24 hours per week for the following three months and 18 hours per week for the final three months but which can be utilised flexibly to provide support as required.
(b) Specialised Disability Accommodation as follows:
(i) House
(ii) Robust Build
(iii) 2 bedrooms
(iv) Breakout room
(v) Sole occupancy/single resident
(vi) Sunshine Coast Queensland.
(c) 10 hours per year for dietitian support.
(d) 12 hours per year for exercise physiology.
(e) 50 hours per year for occupational therapy.
(f) 4 hours per year for clinical nurse continence assessment.
(g) 26 hours per year for physiotherapy.
(h) 3 hours per year for podiatry.
(i) Level 2 transport support.
(j) 40 hours per year individual skills development.
(k) 90 hours per year specialist behavioural intervention support.
(l) 30 hours per year behaviour management plan including training in behaviour management strategies.
(m) 45 hours per year of level 3 support coordination.
(n) 55 hours per year of level 2 support coordination.
(o) Second skins in accordance with the quote of Second Skin Pty Ltd dated 12 February 2025 excluding the quote for consultations, provider travel (labour and non-labour costs) which are accounted for in the increased occupational therapy supports.
(p) Custom footwear, custom orthotics and modifications for Footwear 1 and Footwear 2 in accordance with the quote of Complete Custom Footwear dated 27 February 2025.
(q) Consumables and Assistive Technology in the current SOPS replicated for 12 months.
NATIONAL DISABILITY INSURANCE SCHEME - reasonable and necessary supports - consideration of s 34 National Disability Insurance Scheme Act 2013 (Cth) - overnight support - consideration of s 43(3) National Disability Insurance Scheme Act 2013(Cth) - whether SIL funding must be Agency-managed - restrictive practices - providers that are not registered NDIS providers - family member providing paid support - decision set aside.
National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Cth)
National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (Miscellaneous Provisions) Transitional Rules 2024 (Cth)
National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 (Cth)
National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 (Cth)
National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018 (Cth)
National Disability Insurance Scheme (Incident Management and Reportable Incidents)
National Disability Insurance Scheme (Specialist Disability Accommodation) Rules 2020 Disability Services Act 2006 (Qld)
Re Drake v Minister for Immigration and Ethnic Affairs (No 2) (1979) 2 ALD 60
National Disability Insurance Agency v WRMF [2020] FCAFC 79
VKKG and National Disability Insurance Agency [2025] ARTA 789
NDIS - Operational Guidelines - Reasonable and necessary supports
NDIS - Operational Guidelines - Supported Independent Living
(5) In deciding whether or not to approve a statement of participant supports under subsection (2), the CEO must:
(a) have regard to the participant's statement of goals and aspirations; and
(b) have regard to relevant assessments conducted in relation to the participant; and
(c) be satisfied as mentioned in section 34 in relation to the reasonable and necessary supports that will be funded and the general supports that will be provided; and
(d) apply the National Disability Insurance Scheme rules (if any) made for the purposes of section 35; and
(e) have regard to the principle that a participant should manage his or her plan to the extent that he or she wishes to do so; and
(f) have regard to the operation and effectiveness of any previous plans of the participant; and
(g) have regard to whether section 46 (acquittal of NDIS amounts) was complied with in relation to any previous plan for the participant.
(1) For the purposes of specifying, in a statement of participant supports, the general supports that will be provided, and the reasonable and necessary supports that will be funded, the CEO must be satisfied of all of the following in relation to the funding or provision of each such support:
(aa) the support is necessary to address needs of the participant arising from an impairment in relation to which the participant meets the disability requirements (see section 24) or the early intervention requirements (see section 25);
(a) the support will assist the participant to pursue the goals, objectives and aspirations included in the participant's statement of goals and aspirations;
(b) the support will assist the participant to undertake activities, so as to facilitate the participant's social and economic participation.
(c) the support represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support;
(d) the support will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice;
(e) the funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks, and the community to provide;
(f) the support is a NDIS support for the participant.
(a) the time at which the disability requirements or the early intervention requirements need to be met is the time the CEO decides to approve the statement of participant supports; and
(b) a participant's disability support needs arising from an impairment in relation to which the participant meets the disability requirements or the early intervention requirements may be affected by a variety of factors, including environmental factors or the impact of another impairment in relation to which the participant does not meet either of those requirements.
Circumstances where funds must be Agency-managed
(b) the CEO is satisfied that the participant's management of the funding for supports under the plan to a particular extent would:
(i) present an unreasonable risk to the participant; or
(ii) permit the participant to manage matters that are prescribed by the National Disability Insurance Scheme rules as being matters that must not be managed by a participant.
Considerations for whether self-management presents an unreasonable risk
Matters to which the CEO must have regard - participant
(2) The following are matters to which the CEO must have regard in considering, for the purposes of subsection 44(1) of the Act, whether a participant's management of the funding for supports under a plan to a particular extent would present an unreasonable risk to the participant:
(a) whether, and the extent to which, any identified risk could be mitigated by:
(i) particular supports, safeguards or strategies that are, or will be, included in the participant's statement of participant supports to which the plan management request relates;
(ii) any informal, community or mainstream supports that the participant has in place;
(b) whether, and the extent to which, any identified risk has been mitigated in the past by:
(i) particular supports, safeguards or strategies that were included in the participant's statement of participant supports;
(ii) any informal, community or mainstream supports that the participant had in place;
(c) the nature of the supports that are, or will be, included in the participant's statement of participant supports to which the plan management request relates;
(d) whether, and the extent to which, the participant is at risk of experiencing:
(e) the participant's ability or capacity to make decisions or to appropriately manage finances, taking into account any support or assistance the participant is likely to receive to do so;
(f) whether a court or tribunal has ordered another person to manage, wholly or partly, the property or finances of the participant;
(g) any matters raised by the participant that the CEO considers relevant;
Harm arising from poor quality or unsafe supports
Using restrictive practices when providing supports
(d) physical restraint, which is the use of physical force to prevent, restrict or subdue movement of a person's body, or part of the person's body, for the primary purpose of influencing the person's behaviour but does not include the use of a hands-on technique in a reflexive way to guide or redirect a person away from potential harm or injury, consistent with what could reasonably be considered the exercise of care towards a person.'
Incidents between 1 January 2024 to 2 February 2025
hitting Lisa and support workers with open hand and closed fist (hitting body, face, head, etc.), attempted hitting, kicking pinching and biting, throwing objects at SWs, grabbed SW's hair, charging at SW and Lisa, took knife and tried to throw at SW.
throwing items onto the floor (majority of the time smashing items like glass bowls and plates, crockery, picture frames, wall clock, windows, furniture, appliances, knives, pot plants, etc.), threw iPad onto ground and smashed, throwing furniture at café setting.
Sophie then went into the lounge room and picked up a pot plant and through it across the room toward me, she then looked at the TV and before I could get to it launched it across the room, it was at this point Sophie was trying to access the kitchen where the stove was on and there where sharp utensils, I stood between Sophie and the kitchen, this is where Sophie started to frantically kick, punch and try to bite me. This went on for about 15 minutes before I was able to get to my phone and call (M). While waiting for (M) I maintained space between Sophie, myself, and anything I could see that might be launched, broken or harmful to Sophie or myself.
(M) then asked her to walk to the car, Sophie said no and when (M) moved close to her she hit him in the nose. (M) held her hands by her side and explained she must walk safely to the car. Once we got to the car Sophie tried to hit (M) again. (M) assisted Sophie into the back seat, (M) and myself assisted each other to put her belt on, (M) sat in the back with Sophie but she was still behaving violently towards (M), so he placed a child safety seat between them to ensure his safety. (sic)
As her mother I am not going to leave her standing there going absolutely troppo off her head throwing plates and having the risk of her cutting her feet so I have stepped in on those occasions to stop her from cutting her feet, holding her hand because she wants to smack you and hit you or she wants to try and throw more plates or just come after you. So obviously the best way to stop Sophie is to actually hold her hands and talk to her kindly which has been done and that way she is safe.'
Lisa was consulted about the use of unauthorised physical restraint restrictive practices observed within review of Sophie's recorded incident reports in the past 12 months and it was recommended a family implemented physical restraint protocol be included in this CBSP to reduce risk of harm for all involved. Lisa declined this recommendation, and it was discussed that all uses of unauthorised physical restraint must be recorded and submitted via incident reports and will be reported to the NDIS immediately.
Sophie is highly sensory-sensitive during the evenings. She prefers total silence and is often disturbed by the slightest noises, which significantly affects her unusual and delicate sleep patterns. An active overnight support person in the home would be detrimental to her well-being and would increase her anxiety.
Sophie develops structured expectations of how her environment should operate.
Having a support person awake throughout the night would contradict the quiet, low-stimulation routine we have carefully developed over time. For example, when her dog sleeps inside and moves around at night, Sophie can be disrupted. We have found the most effective solution is for me to go to bed and then quietly get up only when Sophie requires assistance. I change her bedding without communicating and return to bed immediately. This process reduces stimulation and helps Sophie return to sleep on her own terms.
Due to her disability - Diabetes Insipidus - Sophie requires multiple bed changes throughout the night. However, this routine allows her to gain more rest and experience less anxiety. In the mornings, she enjoys quiet alone time, often watching TV or using her Wii Fit before requesting support. This has helped us build better sleep patterns and support Sophie's independence.
Providing a fully awake support person would risk undoing the consistent progress we've made. It would introduce unfamiliar behaviours and disrupt Sophie's sense of control and calm, likely increasing her anxiety and worsening her insomnia and behaviours.
Is 24/7 1:1 support with active overnight support reasonable and necessary?
Should the funding be described as SIL funding?
Supported independent living is paid personal support. It includes things like having someone to help with personal care or cooking meals. It's one type of help or supervision with daily tasks to help you live as independently as possible and build your skills. Supported independent living is best suited to people with a disability who have higher support needs. This means you need a significant amount of help throughout the day, 7 days a week. This includes overnight support
The risk that Ms French's management of SIL funding presents to Ms Hart
The Tribunal sets aside the decision under review pursuant to s105(c)(i) of the Administrative Review Tribunal Act 2024 (Cth). The matter is remitted to the Respondent for reconsideration with a direction that within 14 days of the date of this Decision the Respondent must facilitate the approval of a new Statement of Participant Supports (SOPS) for the Applicant, containing the following provisions:
(a) Supported Independent Living (SIL) for 1:1 support for 24 hours per day, 7 days per week including:
(i) Inactive overnight supports;
(ii) 21 hours per week of 1:1 support for assistance to access the community, social and recreational activities; and
(iii) 1,534 hours per year of 1:1 support to be provided by Alister French on the basis of 38 hours per week for six months, 24 hours per week for the following three months and 18 hours per week for the final three months but which can be utilised flexibly to provide support as required.
(b) Specialised Disability Accommodation as follows:
(i) House
(ii) Robust Build
(iii) 2 bedrooms
(iv) Breakout room
(v) Sole occupancy/single resident
(vi) Sunshine Coast Queensland
(c) 10 hours per year for dietitian support.
(d) 12 hours per year for exercise physiology.
(e) 50 hours per year for occupational therapy.
(f) 4 hours per year for clinical nurse continence assessment.
(g) 26 hours per year for physiotherapy.
(h) 3 hours per year for podiatry.
(i) Level 2 transport support.
(j) 40 hours per year individual skills development.
(k) 90 hours per year specialist behavioural intervention support.
(l) 30 hours per year behaviour management plan including training in behaviour management strategies.
(m) 45 hours per year of level 3 support coordination.
(n) 55 hours per year of level 2 support coordination.
(o) Second skins in accordance with the quote of Second Skin Pty Ltd dated 12 February 2025 excluding the quote for consultations, provider travel (labour and non-labour costs) which are accounted for in the increased occupational therapy supports.
(p) Custom footwear, custom orthotics and modifications for Footwear 1 and Footwear 2 in accordance with the quote of Complete Custom Footwear dated 27 February 2025.
(q) Consumables and Assistive Technology in the current SOPS replicated for 12 months.
Solicitor for the Respondent: Ms S Dole, Sparke Helmore
[2] From 14 October 2024, the AAT became the Administrative Review Tribunal (Tribunal). Applications for review to the AAT that were not finalised before 14 October 2024 are taken to be an application for review to the Tribunal, and the Tribunal has authority to continue and finalise any aspect of the review not already completed by the AAT: Transitional provisions in the Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024.
[3]The statement of the law that follows in part adopts in the summary in VKKG and National Disability Insurance Agency (NDIS) [2025] ARTA 789.
[4] Re Drake v Minister for Immigration and Ethnic Affairs (No 2) (1979) 2 ALD 634.
[5] Webpage: ourguidelines.ndis.gov.au
[6] Paragraphs 33(2)(b) and (d) of the NDIS Act.
[7] National Disability Insurance Agency v WRMF [2020] FCAFC 79 at 201.
[9] Item 129(1), part 3, schedule 1 of the Amending Act.
[13] For new framework plans, see subsection 32D(7), and for old framework plans, see subsection 33(6) NDIS Act.
[16] Parts 2 and 3 of the Incident Management Rules.
[20] NDIS Quality and Safeguards Commission October 2020.
[22] Defined in a way that is similar to the definition in the Provider Registration Rules.
[23] Part 2 Restrictive Practices Rules.
[26]The Tribunal takes this to be a reference to what is now an NDIS clearance for workers obtained in accordance with the process in the Disability Services Act 2006 (Qld).
[30] T9 and A3. The proceedings regarding the order were adjourned during 2023 and 2024.
[48] Paragraph 44(1)(b) for management by Ms Hart
[49] Paragraph 44(1)(b) for management by Ms Hart
[50] Subsection 44(3) for management by Ms Hart