XXWC by his mother and National Disability Insurance Agency

This matter came before Deputy S A Forgie P of the Administrative Appeals Tribunal concerning a dispute between XXWC, represented by his mother, and the National Disability Insurance Agency (the Agency). XXWC's parents sought reimbursement of $47,922.38 for expenses incurred in providing Capacity Building supports under XXWC's NDIS Plan. This amount represented the difference between the total expenditure of $91,234 on Capacity Building supports, the $39,196.62 funded by the Agency, and $4,115.00 recovered through Medicare.

The Tribunal was required to determine the appropriate funding for Early Intensive Behavioural Intervention (EIBI) supports for XXWC, who has been diagnosed with Autism Spectrum Disorder (ASD). Specifically, the court needed to consider the costing of these supports, including the hourly rates and the inclusion of travel time, as presented by XXWC's parents and the Agency. The dispute also involved assessing the validity of recommendations made in reports by Irabina Autism Services regarding the quantum of EIBI support required.

The Tribunal considered costing models for EIBI provided by Dr Briggs, which were based on the 2018/2019 NDIS Price Guide and calculated on three-hour blocks of time. The Agency, in contrast, re-costed these services according to the NDIS Price Guides applicable to the relevant period and included travel time. The Agency had proposed varying XXWC's statement of participant supports to approve an additional 18 hours of EIBI per week, based on recommendations from Irabina Autism Services. The Tribunal noted that the hourly rate recommended by Irabina was a blended rate reflecting various components of the support.