Castledine and National Disability Insurance Agency

This matter concerned an internal review of a decision by the National Disability Insurance Agency (NDIA) regarding the statement of participant supports for Mr Castledine, who has multiple serious and permanent medical conditions requiring intense and complex support needs. The review was undertaken by a reviewer appointed under section 100(5)(a) of the NDIS Act, following a deemed decision by the CEO not to review Mr Castledine's plan. An internal review meeting took place on 14 February 2017, and the reviewer's decision was recorded in a letter dated 9 May 2017.

The legal issues before the court involved the determination of the appropriate level of supports for Mr Castledine, specifically concerning the number of hours of speech therapy, occupational therapy, and practice coaching required. The dispute also extended to the provision of therapy assistants as an alternative support, the method for calculating transport supports, and the treatment of successive NDIS plans. The reviewer's decision, made on 27 April 2017, addressed changes to previous plan decisions, including increases to consumables funding and capacity building supports for daily activities and relationships, while declining to change decisions regarding short-term accommodation, respite, an intensive multidisciplinary team, a dietitian, and vehicle provision.

The reviewer's reasoning involved an assessment of Mr Castledine's support needs, leading to an increase in funding for a continence package and capacity building supports. This included a specific adjustment for a practice coach, previously charged at a therapy assistant rate, and the inclusion of hours for a continence nurse assessment. Additionally, support for capacity building in relationships was increased to address behaviours of concern and facilitate the development of a behaviour support plan. The reviewer also determined that no separate decision was required for program management and administration costs, as these were already incorporated into the pricing unit costs. The outcome of the internal review was the substitution of the previous decision with a new statement of participant supports, including an extension of the review date.