Caterson and National Disability Insurance Agency

This matter concerned an application by the Applicant, represented by their mother, for review of a decision by the National Disability Insurance Agency (NDIA) regarding the management of supports within the Applicant's National Disability Insurance Scheme (NDIS) plan. The core of the dispute revolved around whether certain supports, specifically Specialist Disability Accommodation (SDA) and high-intensity Supported Independent Living (SIL) funding, should be agency-managed or plan-managed. The Applicant's mother argued for plan management to ensure flexibility and independence in the utilisation and payment of supports, particularly as she was not a registered provider. The NDIA, conversely, proposed agency management for SDA and high-intensity SIL, while allowing plan management for other supports.

The Administrative Appeals Tribunal was required to determine the appropriate management method for the Applicant's NDIS supports, considering the provisions of the National Disability Insurance Scheme Act 2013 (Cth) and the National Disability Insurance Scheme (Supports for Participants) Rules 2013. Specifically, the Tribunal had to assess whether the NDIA's proposed agency management for SDA and high-intensity SIL was consistent with the principles of choice and control for participants, while also addressing the Respondent's concerns regarding the complexity and intensity of these particular supports.

The Tribunal reasoned that given the Applicant's extreme functional impairment and very high support needs, agency management was the appropriate approach for the Specialist Disability Accommodation and the high-intensity Supported Independent Living funding. This decision was made to ensure the effective and secure delivery of these critical supports. The Tribunal noted that while choice and control are important, the nature of the supports in question necessitated a more direct management by the agency.

Consequently, the decision under review was set aside and remitted to the NDIA for reconsideration. The Tribunal directed that the Specialist Disability Accommodation, specified as a new build, robust, one-occupant, two-bedroom house with high physical support, on-site overnight assistance, and fire sprinklers, and the funding for Supported Independent Living at a high intensity rate (comprising 1:1 support 24 hours per day, 7 days per week, including active overnight support) were to be agency-managed. All remaining supports in the Applicant's plan were to remain plan-managed.