HHRQ and National Disability Insurance Agency

This matter concerned an application by HHRQ for review of a decision by the National Disability Insurance Agency (NDIA) to refuse funding for an Early Intensive Behaviour Intervention (EIBI) program and an intensive feeding program. The NDIA had refused funding on the basis that these supports did not represent value for money, pursuant to section 34(1)(c) of the *National Disability Insurance Scheme Act 2013* (Cth). HHRQ, who has diagnoses of Autism Spectrum Disorder (ASD) level 3, global developmental delay, and severe expressive and receptive speech delay, sought funding for 28 hours per week of EIBI and an intensive feeding program.

The court was required to determine whether the EIBI program and the intensive feeding program constituted reasonable and necessary supports for HHRQ under the National Disability Insurance Scheme Act. This involved considering the evidence presented regarding HHRQ's needs, the nature and intensity of the proposed therapies, and whether these supports represented value for money in achieving HHRQ's stated goals of increasing her physical, cognitive, language, communication, social, and self-care skills. The court also had to consider the relevance of the Operational Guidelines and evidence-based practice frameworks, such as the 2022 Autism CRC draft guidelines, in assessing the reasonableness and necessity of the requested supports.

The court reasoned that while the NDIA had conceded that some supports, such as occupational therapy and support coordination, were reasonable and necessary, the refusal of the EIBI and intensive feeding programs required further consideration. The court noted the importance of evidence-based approaches and the scarcity of data regarding the optimal intensity and duration of interventions for children with autism. It referred to the 2022 Autism CRC draft guidelines, which emphasise tailoring support to individual needs and caution against the assumption that greater amounts of support consistently lead to better outcomes. The court found that the NDIA's decision to refuse funding for the EIBI and intensive feeding programs was not adequately supported by the evidence and reasoning, particularly in light of the potential benefits of these intensive therapies for HHRQ's development.

Accordingly, the court set aside the NDIA's decision and remitted the matter back to the NDIA for reconsideration. The NDIA was directed to undertake a fresh assessment of HHRQ's request for funding for the EIBI and intensive feeding programs, taking into account all relevant evidence and the principles of reasonable and necessary supports.