QZHH and National Disability Insurance Agency

This matter concerned an application by the Applicant, a five-year-old girl with severe and complex medical conditions, for review of a decision by the National Disability Insurance Agency (NDIA). The dispute centred on the NDIA's refusal to approve certain supports within the Applicant's December 2016 NDIS plan, specifically carer support, top-up carer training support, back-up nursing support, and music therapy. The Applicant sought an increase in carer hours and the approval of the other supports, arguing they were reasonable and necessary.

The Tribunal was required to determine whether the proposed supports, or increased levels of supports, met the "reasonable and necessary supports" requirement under section 34 of the National Disability Insurance Scheme Act 2013 (Cth). A further consideration was whether any decision made by the Tribunal would have current effect, given that subsequent NDIS plans had replaced the December 2016 plan. This involved assessing whether a decision could enliven the earlier plan to allow the Applicant to access funding for approved supports during its currency.

The Tribunal reasoned that its review process should deliver a decision that has current effect and benefits the applicant, rather than being purely historical. It considered the Applicant's extensive medical conditions, including intractable epilepsy, global developmental delay, and significant physical and communication impairments, which necessitate constant monitoring and assistance. The Tribunal also took into account the Applicant's entire program of supports, including informal, community, and NDIS-funded supports, and the principles outlined in section 31 of the Act, which emphasise individualisation, participant direction, and the role of family and carers.

The Tribunal varied the NDIA's decision regarding music therapy, approving eight additional hours to the Capacity Building Daily Activities budget. However, the NDIA's decision to affirm the previous decision regarding carer support, top-up carer training support, and back-up nursing support was upheld. The Tribunal also addressed the jurisdictional issue, concluding that its decision could have current effect by enlivening the December 2016 plan for the period it was in force.