Mueller and National Disability Insurance Agency

The Administrative Appeals Tribunal considered a dispute between Mr Ralph Mueller, the applicant, and the National Disability Insurance Agency (NDIA) concerning the provision of Specialist Disability Accommodation (SDA) funding. The applicant, who has cerebral palsy and associated impairments including behaviours of concern, sought 24/7 one-to-one (1:1) Supported Independent Living (SIL) funding for a period of twelve months. The NDIA had proposed a reduction in this funding, suggesting 1:1 SIL for seven months, followed by a period of shared accommodation with a 1:2 support ratio for the remaining time.

The primary legal issue before the Tribunal was to determine the appropriate duration for which 1:1 SIL funding constituted a "reasonable and necessary" support for the applicant, in accordance with the National Disability Insurance Scheme (NDIS) legislation. This involved assessing the applicant's functional capacity, the impact of his behaviours of concern, the effectiveness of past capacity-building supports, and the risks associated with shared accommodation, particularly in light of a failed trial. The Tribunal was required to balance the applicant's need for independence and safety against the NDIS's requirement for value for money and the potential for harm to the participant or others.

The Tribunal's reasoning focused on the applicant's significant and ongoing behaviours of concern, including faecal and urination practices, aggression, and self-harm threats, which had previously led to a failed trial of shared accommodation. Evidence indicated a decline in the applicant's functional capacity and a history of resistance to capacity-building supports. Considering these factors, the Tribunal concluded that 1:1 SIL support was reasonable and necessary for the full duration of the plan, with a review of his capacity to live with a co-resident to occur after seven months. The Tribunal also ordered reimbursement to the applicant's SIL provider for the difference between the 1:1 and 1:2 SIL funding provided during a specified period.