Way and National Disability Insurance Agency

[2018] AATA 983

Way and National Disability Insurance Agency [2018] AATA 983 (11 April 2018)

Administrative Appeals Tribunal

ADMINISTRATIVE APPEALS TRIBUNAL No: 2017/3534 National Disability Insurance Scheme Division Re: Fiona Way Applicant And: National Disability Insurance Agency Respondent DIRECTION TRIBUNAL: Professor R McCallum AO, Member DATE OF CORRIGENDUM: 6 June 2018 PLACE: Sydney Pursuant to subsection 43AA(1) of the Administrative Appeals Tribunal Act 1975, the Tribunal directs that the text of the decision in this application is to be altered such that the reference to “Ms Cameron Way” in paragraphs 27 and 32 of the decision is replaced with “Ms Fiona Way”. ................................[SGD]................................... Professor R McCallum AO, Member Administrative Appeals Tribunal ADMINISTRATIVE APPEALS TRIBUNAL No: 2017/3534 National Disability Insurance Scheme Division Re: Fiona Way Applicant And: National Disability Insurance Agency Respondent DIRECTION TRIBUNAL: Professor R McCallum AO, Member DATE OF CORRIGENDUM: 12 April 2018 PLACE: Sydney Pursuant to subsection 43AA(1) of the Administrative Appeals Tribunal Act 1975 , the Tribunal directs that the text of the decision in this application is to be altered such that the reference to “National Disability Insurance Act 2013” in paragraph 4 of the decision is replaced with “National Disability Insurance Scheme Act 2013”. .................................[SGD].................................. Professor R McCallum AO, Member Division: National Disability Insurance Scheme Division File Number(s): 2017/3534

Re:

Fiona Way APPLICANT And National Disability Insurance Agency RESPONDENT Decision Tribunal: Professor R McCallum AO, Member Date: 11 April 2018 Place: Sydney The decision under review is affirmed. ..................................[SGD]...................................... Professor R McCallum AO, Member CATCHWORDS NATIONAL DISABILITY INSURANCE SCHEME – acquired brain injury – high intensity classification – Applicant cared for in group home – reasonable and necessary supports – whether further funding to take applicant on outings is a reasonable and necessary support – underspent funding – decision under review affirmed LEGISLATION National Disability Insurance Act 2013 (Cth), ss 3, 4, 33, 34(1), 100(6)(a), 103 REASONS FOR DECISION Professor R McCallum AO, Member 11 April 2018 INTRODUCTION 1. The Applicant in this matter is Ms Fiona Way. As a result of a car accident in 1999, Ms Fiona Way has an acquired brain injury. 2. In mid-2016, Ms Fiona Way relocated from Sydney to Tamworth, New South Wales and she currently lives in shared accommodation at Tamworth Challenge Community Services (“Challenge”). 3. A client summary report from the NSW Department of Health New England Brain Injury Rehabilitation Service dated 2 August 2017 is before the Tribunal. I have taken into account this report in its entirety, however, for the purposes of this decision I reproduce the following extracts: Background - Fiona was referred to NEBIRS [New England Brain Injury Rehabilitation Service] to assist in her transition to community living in Tamworth. Fiona had her injury in 1999 and has had a number of care environments most of which have been in aged care facilities. Because of the limitations which Fiona's disabilities place upon her and the issues related to previous care environments, Fiona finds herself in a dependent and vulnerable position when placed in the care of others. The NEBIRS team agreed to work with Fiona to help her family with the transition to her Tamworth home and new care providers. Meetings with Fiona's direct care staff have been productive. Her care staff have displayed commitment, respect and care towards Fiona during the visits that NEBIRS have paid to the residence and day program. However, Fiona has quite individualised needs and will find it difficult to respond to a standardised model of care. Fiona shares the residence with a young man with often quite loud and intrusive behaviours. Staff do well to manage both individuals in the home but Fiona would find the environment at times frightening. The NEBIRS team has offered Challenge further support for staff education on working with people who have had a brain injury. Fiona attends a Day program at Greg Norman Drive. Fiona's personal care needs are high, therefore providing a program which caters for her cognitive, social and recreational needs can be challenging. Fiona would benefit from a more individualised program during the day rather than a traditional centre based model. Such a program will require considerable resources but if Fiona has opportunities for activities that she both, enjoys and which she finds stimulating, then there is the prospect of a significant change with respect to behaviour. … Communication - Fiona responds showing understanding of what is said to her such as her expressing sympathy when told sad news about another person. She follows staff and family instructions. Fiona seems particularly responsive to visual items such as name badges and tattoos which appear to reassure her about the identity of people she is dealing with. At times Fiona resists what is asked of her. She conveys a sense of panic in some situations. At those times she may not understand all that is said, however her response could also be emotionally based rather than from any lack of language comprehension. To communicate distress she has been seen to arch up and back in her chair, turn her face, vocalise loudly and occasionally strike out to grab staff. Fiona also uses gestures to deter staff from actions that she does not want. Fiona speaks in single words and short phrases inconsistently to express herself to others. Her speech is sometimes unclear but more often clear in context to familiar listeners. Her family reported that she had greater speech clarity prior to the distortion of her lips in 2002 which occurred following failure in care following surgical intervention. There were no augmentative communication devices available to her when she was seen at Challenge or in her residence. … Swallowing/Mealtime Management - … Fiona's seated posture when eating and drinking was compromised with her feet hanging in the air and her seat not offering support to her upper body. A higher arm rest of one side was used to help her prop herself more upright. Fiona varied in her level of positive engagement during meals. She was seen opening her mouth and moving and chewing her food, as well as snatching at the spoon and turning away at other times. When given a break during meals by residential staff Fiona then later took more food. … Showering - Fiona is showered of an afternoon, on a moulded plastic shower commode. She is assisted by 2 staff for transfers, dressing and undressing, showering and drying. Fiona assists with 15% of these self-care tasks. Fiona and the staff lock themselves in the bathroom during showering tasks as her house mate has in the past opened the door during her self- care tasks. Her shower commode appears to be a custom made chair. The seat is set permanently at a 45 degree tilt, at a fixed height. This equipment is unsuitable for Fiona's use in a number of ways. The fixed position of the seat impedes her sit to stand transfers and stops her from placing herself correctly within the seat. The seat is wide and offers little support. The shower commode needs to be reviewed with possible replacement. Toileting - Fiona wears pads throughout the day and night with no toileting regime. Her current shower commode does not fit over the existing toilet. A consultation with a Continence Nurse was suggested. MS FIONA WAY JOINS THE NDIS 4. Ms Fiona Way became a participant in the National Disability Insurance Scheme (“NDIS”) with effect from 10 June 2016. The NDIS is established by the National Disability Insurance Act 2013 (Cth) (“ NDIS Act” ). The NDIS scheme is administered by the National Disability Insurance Agency (“NDIA”). 5. Ms Fiona Way’s first participant plan began on 16 August 2016. This was replaced by her second participant plan which commenced on 23 September 2016. 6. On 23 January 2017, the second participant plan commenced, and this is the plan which is under review in these proceedings and I shall refer to it as the “23 January plan”. 7. While the 23 January plan was being reviewed by the NDIA and the Tribunal, the NDIA, in effect, rolled over the plan under review for a further three months from 16 February 2018 to 18 May 2018. This third participant plan contains the same statement of supports as does the 23 January plan. MS FIONA WAY SEEKS REVIEW 4. 5. 6. 7. 8. Through her brother Mr Cameron Way who is one of her guardians, Ms Fiona Way sought an internal review of the decision which gave rise to the 23 January plan. 9. Ms Fiona Way sought extra funding as follows: 1. First, a further six hours of funding per week to enable two staff members to take Ms Fiona Way on outings twice a week; 2. Second, a further 14 hours of funding per week to assist her with showering and bed time. 10. On 5 May 2017, a delegate of the CEO decided to affirm the 23 January 2017 decision. In other words, the delegate decided not to increase the funding in the 23 January plan. 11. By her guardians, Ms Fiona Way has applied to the NDIS Division of the Administrative Appeals Tribunal to review the 5 May 2017 decision of the delegate. 12. Under section 103 of the NDIS Act , the Tribunal has jurisdiction to review the decision of 5 May 2017 as it was made pursuant to section 100(6)(a) of the NDIS Act . THE RELEVANT LEGISLATION 13. Section 33 of the NDIS Act sets out the content of participant plans. It relevantly provides as follows: Matters that must be included in a participant’s plan (1) A participant’s plan must include a statement (the participant’s statement of goals and aspirations ) prepared by the participant that specifies: (a) the goals, objectives and aspirations of the participant; and (b) the environmental and personal context of the participant’s living, including the participant’s: (i) living arrangements; and (ii) informal community supports and other community supports; and (iii) social and economic participation. (2) A participant’s plan must include a statement (the statement of participant supports ), prepared with the participant and approved by the CEO, that specifies: (a) the general supports (if any) that will be provided to, or in relation to, the participant; and (b) the reasonable and necessary supports (if any) that will be funded under the National Disability Insurance Scheme; … 14. By her guardians, Ms Fiona Way asserts that an increase of funding to enable her to go on outings and to obtain added shower and bedtime care is a necessary and reasonable support which should be funded by the NDIA pursuant to subsection 33(2)(b) of the NDIS Act . 15. Section 34(1) of the NDIS Act sets out the criteria for the funding of necessary and reasonable supports as follows: Reasonable and necessary supports (1) For the purposes of specifying, in a statement of participant supports, the general supports that will be provided, and the reasonable and necessary supports that will be funded, the CEO must be satisfied of all of the following in relation to the funding or provision of each such support: (a) the support will assist the participant to pursue the goals, objectives and aspirations included in the participant’s statement of goals and aspirations; (b) the support will assist the participant to undertake activities, so as to facilitate the participant’s social and economic participation; (c) the support represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support; (d) the support will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice; (e) the funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks and the community to provide; (f) the support is most appropriately funded or provided through the National Disability Insurance Scheme, and is not more appropriately funded or provided through other general systems of service delivery or support services offered by a person, agency or body, or systems of service delivery or support services offered: (i) as part of a universal service obligation; or (ii) in accordance with reasonable adjustments required under a law dealing with discrimination on the basis of disability. 16. Of course, subsection 34(1) is only one provision in a detailed statute governing the NDIS. This provision must be interpreted having regard to the entire statute and subsection 34(1) must be read in conformity with the purposes and objects of the Act. The Parliament of Australia has expressly provided objects and general principles in the NDIS Act to give guidance on the interpretation of the statute and these apply to the interpretation of subsection 34(1). 17. It is not necessary to set out the objects and principles in their entirety, but for the purposes of this decision I reproduce the following objects and principles. 3 Objects of Act (1) The objects of this Act are to: (a) in conjunction with other laws, give effect to Australia’s obligations under the Convention on the Rights of Persons with Disabilities done at New York on 13 December 2006 ([2008] ATS 12); and … (d) provide reasonable and necessary supports, including early intervention supports, for participants in the National Disability Insurance Scheme launch; and (e) enable people with disability to exercise choice and control in the pursuit of their goals and the planning and delivery of their supports; and … (3) In giving effect to the objects of the Act, regard is to be had to: … (b) the need to ensure the financial sustainability of the National Disability Insurance Scheme; … 4 General principles guiding actions under this Act … (3) People with disability and their families and carers should have certainty that people with disability will receive the care and support they need over their lifetime. … (5) People with disability should be supported to receive reasonable and necessary supports, including early intervention supports. … (12) The role of families, carers and other significant persons in the lives of people with disability is to be acknowledged and respected. … (17) It is the intention of the Parliament that the Ministerial Council, the Minister, the Board, the CEO and any other person or body is to perform functions and exercise powers under this Act in accordance with these principles, having regard to: (a) the progressive implementation of the National Disability Insurance Scheme; and (b) the need to ensure the financial sustainability of the National Disability Insurance Scheme. THE HEARING 18. The date of the hearing was 28 March 2018. 19. Mr Cameron Way attended the hearing and represented the Applicant, Ms Fiona Way who is his sister. The Respondent was represented by counsel. 20. As well as advocating on behalf of his sister, Mr Cameron Way also gave evidence by affirmation. 21. Mr Benjamin Noble gave evidence by affirmation over the telephone. Mr Noble is a supervisor at Challenge. He recounted that Ms Fiona Way lives in shared accommodation in a group home. Up until about two weeks before the hearing, she lived with another person who has now departed. Currently, Ms Fiona Way lives on her own. Mr Noble said that Ms Fiona Way’s needs were classified as high intensity. 22. Ms Wendy East also gave evidence by affirmation over the telephone. Ms East recounted that she is an Acting Director of the Technical Advisory Team, Operational Policy Guidance within the NDIA. Ms East prepared a written statement detailing the funding available to Ms Fiona Way and the amount of that funding which has been spent up until 16 March 2018. Annexure A to her statement is a spreadsheet which contains a summary of Ms Fiona Way’s NDIS funding. In her evidence, she confirmed the truth of her report. 23. Ms Deborah Frith gave sworn evidence. Ms Frith is the Managing Director of a provider called My Voice. Briefly put, My Voice provides services of self-management and support coordination to persons with disabilities and their families. In her evidence, Ms Frith said that she was appearing as a long-standing friend of the Way family whom she has known for 18 years. She said that she has not seen Ms Fiona Way for about two years. 24. Having regard to the evidence of Mr Cameron Way and of Ms Frith, I find that Mr Cameron Way loves and has deep empathy for his sister and has done his very best to assist her. I further find that over the years he has aided his sister with tenacity and steadfastness. THE ISSUES BEFORE THE TRIBUNAL 25. In his evidence, Mr Noble explained that when Ms Fiona Way was sharing accommodation with another person, three staff members attended when Ms Fiona Way was assisted to shower. Two of the staff would go into the bathroom and assist Ms Fiona Way to shower. The third staff member would remain in the group home with the other person. Ms Fiona Way would also be assisted at bedtime. 26. Mr Noble stated that as Ms Fiona Way is currently living on her own, meaning that only two staff members are now needed to assist her with showering and bedtime. 27. Given this evidence, I find that sufficient staff assists Ms Cameron Way with showering and bedtime. Therefore, Mr Cameron Way’s request for funding for a further 14 hours to enable staff to assist with showering and bedtime is no longer necessary. 28. The remaining issue before the Tribunal is whether Ms Fiona Way should receive a further six hours of funding per week to enable two staff members to take Ms Fiona Way on outings twice a week. BROAD AGREEMENT OF THE PARTIES 29. From the documentary and oral evidence before the Tribunal, I find there is broad agreement between the parties that enabling Ms Fiona Way to be taken out twice a week will be beneficial for her. 30. The Applicant’s statement of position relevantly provides as follows: 1.1. To our family view, Fiona's identified need to get out to places of interest for her as an urgent need and intervention on her emotional and psychological state was a minimal, reasonable, and valid request. 1.2. Fiona's need to get out in this way was recognised, agreed and accepted at our first NDIA planning meeting. Her original NDIA plan intended to meet this need in minimal form. 1.3. To our view, our request for funding for an additional 6 hours staff time per week to enable such outings was a reasonable request. Using existent provider staff was the viable solution given that from experience two people are needed to take Fiona out successfully in the community, those people need to have gained some degree of trust and acceptance by Fiona, and those people need to have had some period of experience with Fiona to be able read her signs and moods to manage her with some effective confidence. 1.4. To our view our communications to the NDIA has been adequate to explain the situation for it to have been reasonably recognised with merit. 31. The Respondent’s statement of position comments on outings for Ms Fiona Way as follows: 1. The respondent recognises that the applicant requires significant funding for reasonable and necessary supports, including the provision of personal care supports at all times in an appropriate mix of 1:1 and 1:2. It is also recognised that the applicant (taking into account the advice and support of her guardians, whose advocacy concerning the applicant’s needs are acknowledged and respected) should be supported to exercise choice and control in the pursuit of her goals. 2. The respondent accepts that, having regard to recent evidence outlining behaviours of concern, it is reasonable and necessary for the applicant to be provided with support (2:1) for showering, and support (1:1 or 2:1) for outings to places and activities aligned with the applicant’s goals. 32. However, the Respondent argues that at this point in time, further funding is not necessary as the available funding can be used flexibly to enable Ms Cameron Way to be taken on outings. In its statement of position, the respondent succinctly puts its position as follows: 3. However, the respondent’s position is that in the context of the applicant’s presently funded supports, an increase in funding would not be reasonable and necessary. The Tribunal should not be satisfied that the supports sought in this application could not be met by flexible use of the existing funding, which is underspent. On that footing the decision under review should be affirmed. MS FIONA WAY’S NDIS FUNDING 33. Ms East’s written statement is before the Tribunal. It provides in part as follows: 2. In the spreadsheet attached to this statement as Annexure A, I provide a summary of Ms Way’s funding as provided for under the NDIS scheme and as in fact spent to 16 th March 2018. I have compiled this summary by accessing on-line the details of Ms Way’s funding package. 3. The largest component in Ms Way’s funding is Core supports. I identify that Core supports have been budgeted in the applicant’s plan dated 25 January 2017 and 15 th February 2018 primarily for: a. Daily Activities- assistance in a shared living arrangement for 2 persons - complex needs (x 1) utilised by Ms Way’s supported independent living provider (approximately $274,000 per annum); b. Social, Community and Civic participation which appears to be utilised by Ms Way’s day program (approximately $37,500 per annum). 4. As at 16 March 2018, funding applied to Core supports component is underspent. Between 23 January 2017 and 15 February 2018, Ms Way’s Core supports were underutilised to the extent of $28,156.84. 5. Other than Transport funding which is made via an automated periodic payment, I have identified that Ms Way appears not to have utilised the funding made available in her plan for other supports, including: a. CB [capacity building] Daily Activity: $3,746.07, Nil utilised b. CB Relationships: $1,882.76, $219.46 utilised c. Support Coordination: $10,312.39 Nil utilised 34. From Ms East’s report, it also appears that $3,946.71 for assistive technology has not been used, and $10,119.70 for home modifications has also not been spent. 35. In his evidence, Mr Noble said that it is possible that two weeks of bills from Challenge are yet to be paid. However, it is clear that there is a significant amount of underspent moneys amounting at the very least to $20,000. Mr Way was asked why money for capacity building for daily living of $3,746.07 had not been spent. Furthermore, only $219.46 for capacity building relationships had been spent from the budgeted amount of $1,882.76. 36. As I understood Mr Cameron Way’s evidence, he thought that this spending was not necessary because the NSW Department of Health was providing assistance. However, Mr Cameron Way could point to no records detailing this type of assistance for Ms Fiona Way. 37. In his evidence, Mr Noble said that he believed there had been three visits by two physiotherapists in the past, but no follow up visits had occurred. 38. It was pointed out to Mr Cameron Way that in the client summary report from the NSW Department of Health New England Brain Injury Rehabilitation Service dated 2 August 2017, portion of which was quoted above, it was stated that Ms Fiona Way’s shower commode was unsuitable because its seat was set permanently at a 45 degree angle. Mr Cameron Way agreed that the shower commode has not been replaced. 39. From the evidence of Mr Noble and Mr Cameron Way, it was unclear to me why Ms Fiona Way’s moneys could not be used flexibly to enable her to go on a number of outings. For example, Ms Fiona way attends a Day program at Greg Norman Drive for six hours a day, five days a week. This program is run by Challenge. The social, Community and Civic participation money in her budget of approximately $37,500 appears to be used to pay for this day program. I appreciate that staffing the day program and the shared accommodation is complex and may on occasions be difficult. However, given the underspent money in her core funding of at least $20,000, some outings for Ms Fiona Way could have been arranged. MS FIONA WAY’S BEHAVIOUR 40. A difficulty in arranging outings for Ms Fiona Way may have been owing to some of her behaviour. In his evidence, Mr Noble noted several occasions on which Ms Fiona Way engaged in difficult behaviour. A series of incident reports compiled by Challenge staff are before the Tribunal. Of course, these incident reports only note difficult behaviour and do not comment on occasions when Ms Fiona Way’s behaviour is excellent. From reading all of these incident reports, disruptive behaviour only occurs when Ms Fiona Way is unsettled or upset. 41. For the purposes of this decision, I note two occasions when Ms Fiona Ways’ behaviour was difficult. Mr Noble mentioned these two occasions in his evidence and they are written up in the incident reports by Challenge staff members. 42. On 5 February 2017, Ms Fiona Way was driven to a takeaway shop. She was agitated in the car and the driver had to pull over to ensure that Ms Fiona Way was sitting in a safe position. When they arrived at the shop, a staff member went inside to order the food. Ms Fiona Way then scratched the other staff member and drew blood. 43. On 6 March 2017, Ms Fiona Way attended Peel Health for her podiatrist appointment. The incident report reads in part as follows: Fiona was very unsettled at the podiatrist's on several occasions trying to attack staff and other people in the waiting room… staff asked a lady if her and her son could move whilst they were coming through as staff didn't want them to get hurt, as they went to move (sic) Fiona latched onto the little kids arm digging her nails in and causing it to bleed. the lady was very understanding when staff apologized profusely… A SUPPORT COORDINATOR 44. Ms Fiona Way’s NDIS budget in the 23 January plan has approximately $10,000 to be used to hire a support coordinator. 45. The NDIA has published a fact sheet which details the activities which should be undertaken by support coordinators. It provides in part as follows: What is support coordination? Support coordination is a capacity building support to implement all supports in a participant’s plan, including informal, mainstream, community and funded supports. What activities does a support coordinator usually undertake? Support coordinators work creatively and resourcefully with participants in how they utilise their support budgets to achieve their goals. This is likely to include supporting the participant to: • assess a number of mainstream, community, informal and provider options • choose preferred options or providers • negotiate services to be provided and their prices, develop service agreements and create service bookings with preferred providers • negotiate services and prices as part of any quotable supports • arrange any assessments required to determine the nature and type of funding required (eg assessment to determine the type of complex home modifications required) • decide the budget for each support type and advise any relevant plan manager of the breakdown of funds • liaise with any plan manager to establish the appropriate claim categories and attribute the correct amount of funds … 46. In his evidence, Mr Way said that he did not need the services of a support coordinator. In her evidence, Ms Frith agreed that Mr Cameron Way did not require assistance from a support coordinator. 47. Having regard to the oral and documentary evidence before the Tribunal, I proffer the view that Mr Cameron Way could have been usefully assisted by a support coordinator. I appreciate that in rural NSW, there are fewer providers and available services than in Sydney. However, assistance could have been given in negotiating with Challenge over Ms Fiona Way’s program and the use of funding for outings. Further assistance could have been given in arranging assessments. Perhaps assistance from a support coordinator could have enabled Ms Fiona Way’s shower commode chair to be replaced by a more appropriate shower commode. At the very least, a support coordinator could have assisted Mr Cameron Way in maintaining records concerning his sister’s interactions with doctors, physiotherapists, occupational therapists etc. 48. In my view, the use of a support coordinator would not in any way have lessened Mr Way’s highly commendable and loving advocacy on behalf of his sister. CONSIDERATION 49. The criteria for the funding of necessary and reasonable supports are set forth in section 34(1) of the NDIS Act which has been set out above. In the circumstances of Ms Fiona Way, the only relevant paragraph is section 34(1)(c). This paragraph requires me to determine whether “ … the support represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support ”. Therefore, I must determine whether a further six hours of funding per week to enable Ms Fiona Way to go on outings twice a week, represents value for money within the meaning of section 34(1)(c) of the NDIS Act . 50. After careful consideration, I have come to the view that the provision of further funding of six hours per week to take Ms Fiona Way out does not represent value for money. I have come to this view for the two following reasons. 51. My first reason is that Ms Fiona Way’s core supports funding is underspent by at least $20,000. Furthermore, the social, community and civic participation money in Ms Fiona Way’s budget of approximately $37,500 can be used flexibly. At present, this money is paying for her day program. 52. I find that the underspent money from Ms Fiona Way’s core supports budget, coupled with the flexible use of some of her social, community and civic participation money could fund outings for Ms Fiona Way without the need for further funding. 53. My second reason is that there is no evidence before the Tribunal that capacity building programs have been utilised to lessen Ms Fiona Way’s behavioural difficulties. An individualised skill building program is likely to make it easier for staff to take Ms Fiona Way out to places of interest to her. 54. Ms Fiona Way’s capacity building money is underspent. Her daily activity funding of $3,746.07 has not been utilised. I further note that only $219.46 for capacity building relationships has been spent from the budgeted amount of $1,882.76. 55. In her written statement, Ms East writes that: 12. The items CB Daily Activity and CB Relationships as described above are intended to provide individual therapy assessment and development of skill building programs to be implemented by the participant, support workers and informal supports and behaviour management assessment and development of an individualised plan to be implemented by the participant, support workers and informal supports. 56. In these circumstances, the expenditure of further funds does not represent value for money. THE SUPPORTED INDEPENDENT LIVING REVIEW 57. Ms Fiona Way’s participation plan is being reviewed by the NDIA under the Supported Independent Living (“SIL”) program. In his evidence, Mr Noble said that Challenge has already provided the SIL review with a quotation for services. This review will continue once these Tribunal proceedings have been finalised. 58. In her written statement, Ms East writes as follows: SUPPORTED INDEPENDENT LIVING (SIL) REVIEW 17. Supported Independent Living (SIL) is assistance with tasks of daily life to develop the skills of individuals to live as autonomously as possible. From 1 July 2017 the NDIA adopted a new way of processing SIL quotes for plans and plan reviews. 18. I am aware Ms Way’s SIL provider will be required to provide a new quote in accordance with the newly-adopted process at the time her current plan is reviewed, pending the outcome of this AAT matter. This SIL quote will be reviewed along with any evidence provided to justify any requests to fund above SIL benchmarks. Evidence required must be up to date and can include clinical assessments and reports, behavioural assessments/plan, incident reports individual routines, police reports, risk assessments, statements from pervious/other providers, standardised assessments (examples provided on SIL Quote document available on NDIS website). 19. As part of this process, I am aware that the NDIA will meet with Ms Way and her family in person to understand Ms Way’s aspirations and needs, including but beyond those the subject of the application in the Tribunal. 59. It is my hope that this SIL review which will involve Ms Fiona Way’s family may better align her NDIS funding with her needs and aspirations.

DECISION

1. The decision under review is affirmed.

I certify that the preceding 60 (sixty) paragraphs are a true copy of the reasons for the decision herein of Professor Ron McCallum AO, Member

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Associate

Dated: 11 April 2018

Date(s) of hearing:	28 March 2018
Applicant:	In person
Solicitors for the Respondent:	Tony Giugni, Australian Government Solicitor