TRCH and National Disability Insurance Agency

This matter concerned an application for review of a decision by the National Disability Insurance Agency (NDIA) regarding the statement of participant supports (SOPS) for a child participant, TRCH, who has autism (level 3), severe intellectual disability, sensory processing disorder, and attention deficit hyperactivity disorder. The applicant, Ms TRCH, sought additional funding for allied health interventions, support worker assistance, a feeding program, and travel expenses. The core dispute revolved around whether the requested supports met the criteria of being "reasonable and necessary" under section 34(1) of the *National Disability Insurance Scheme Act 2013* (Cth).

The Tribunal was required to determine whether the supports requested by Ms TRCH, including extensive allied health services, behaviour intervention, and support worker assistance, satisfied the "reasonable and necessary" criteria as defined by the NDIS Act. Specifically, the Tribunal had to assess if these supports were value for money and effective and beneficial for TRCH, considering his complex disability profile and the stated aim of enhancing his opportunities and assisting with daily activities.

The Tribunal found that some of the requested supports did indeed meet the "reasonable and necessary" criteria and should be included in TRCH's SOPS. The Tribunal's reasoning led to the setting aside of the NDIA's Decision Under Review and a remittal with directions to facilitate the approval of a new SOPS for TRCH. Subsequent NDIS plans, approved on 19 April 2024 and 18 July 2024 following remittal, incorporated some of the changes sought by Ms TRCH, reflecting an increase in funding for core supports, social, community and civic participation, capacity building through allied health, and specialist behaviour management.