The NDIS Provider and Worker Registration Taskforce was tasked with providing advice on a single recommendation of the NDIS Review. Their report is 117 pages long. For providers, their recommendations raise almost as many questions as they answer. Here’s what you need to know.
Some supports will be affected more than others. Some sooner than others. We discuss recommended changes to:
- NDIS provider registration requirements
- Audit and compliance processes
- Worker registration and training obligations.
And the questions that remain.
NDIS Provider Registration Categories
The vast majority of providers would need to be registered. The Taskforce recommends increasing the number of registration levels — five in all, proportionate to the level of risk involved. To make that work, they’ve had to tweak two definitions.
Firstly, the Report redefines the term ‘provider’, just a little, to include self-managed participants (see Self-Directed Registration, below).
Secondly, the risk levels currently associated with supports had to change to fit the expanded registration categories. The Taskforce hasn’t clearly defined which supports fall into each category but has provided examples — SIL is high-risk; high-intensity supports are medium-risk. Some of the examples seem to require an assessment mechanism — e.g., community participation appears among medium- and low-risk supports (see Questions remaining below).
- Advanced Registration — Providers of high-risk supports including supports delivered in high-risk, ‘closed’ environments. The Taskforce identifies the following as high-risk supports:
- Behaviour support and restrictive practices
- Specialist Disability Accommodations (SDA)
- Plan management
- Support coordination (including specialist support coordination)
- Early childhood supports and therapies
- Supported Independent Living (SIL, STA and ILO)
- Supported employment.
In-depth registration for high-risk supports would include:
- audits conducted by auditors from within the NDIS Commission.
- in-depth observational audit of compliance with relevant practice standards.
- unannounced visits for group homes, possibly all high-risk supports (requires the government to develop a statute).
- General Registration — Graduated registration for medium-risk supports, which would include most support services delivered in-home or in the community, including high-intensity supports (e.g., high intensity daily personal activities, complex bowel care or sub-cutaneous injections), and supports involving “significant 1:1 contact” with people with a disability (e.g., personal care, community access, disability-specific transport services and therapy).
This category requires regular audits as per current requirements:- against the NDIS Practice Standards and any other relevant module.
- by NDIS-approved Quality auditors.
- Self-Directed Registration — This category would apply where both the following apply:
- The participant, their guardian or legal representative contract all their supports directly, including through direct employment, independent contractors, or Services for One.
- The supports DO NOT fall into the Advanced Registration category (e.g. behaviour support, restrictive practices, or a group home) — these supports would be subject to Advanced Registration, regardless of self-direction.
Self-directed providers would not require audits but would have a “check in” with the NDIS Commission as a requirement of registration. People supplying supports to self-directed providers DO NOT need to be registered as providers but must satisfy the proposed Worker Registration Scheme requirements (see below). So, there will remain unregistered providers in the system — according to the current, but not the proposed, definitions.
People with a disability should be involved in the co-design of the self-directed registration process. There should also be investment in peer support and capacity building programs for self-directed providers.
- Basic Registration — supports involving “more-limited 1:1 contact with participants”. The Taskforce’s example, social and community participation, appears under both Basic and General Registration (see Questions remaining below). It will depend on the amount of risk involved (i.e., the amount of contact and the environment in which it takes place).
This category does not require audits, but registration will include a self-assessment and attestation of compliance with the NDIS Practice Standards. - Purchase Visibility only — no registration required. Applies to products bought off the shelf from mainstream providers. This category allows the use of NDIS funds to be tracked through receipts.
Changes to NDIS audits and compliance
There are some significant changes recommended for the audit process.
- Advanced Registration audits: Auditors from within the NDIS Commission would assess providers in the proposed high-risk category.
- Appointment of auditors: Auditors should be appointed by the NDIS Commission, not chosen by the provider.
- Proportionate audits: Theoretically, the current audit model is proportionate to support-related risks and size of service. So, this might imply any, or all, of the following:
- creation of guidelines for implementing risk-proportionate audits.
- pressure on auditing bodies to apply the principle in practice.
- Recognition of compliance: Providers could gain ‘earned autonomy’ by consistently demonstrating compliance with audited obligations could win. This, too, would require specific guidelines for implementation.
- Subsidised Travel: The NDIS Commission should subsidise audit travel costs for providers in rural and remote areas where auditors cannot be sourced locally.
- Verification of key personnel Identity to be provided when applying for provider registration.
- Unannounced visits for high-risk services should be introduced — requires legislative change.
- Community Visitor Scheme —a nationally consistent scheme to be developed and implemented in each state and territory.
- SIL and Home and Living supports — All providers of these supports should be registered within 12 months, under the existing registration framework. The NDIS Commission is likely to accept this recommendation.
- Support Coordination and Plan Management — Will enter the Advanced Registration category until further notice.
- Sole Traders — The Report recognises sole traders’ contribution to the NDIS and aims to avoids discouraging it. Business structure, however, is not a factor in determining registration level. Sole traders will be audited at the level of the services they provide. While it is “anticipated that many sole traders will fall within the Basic Registration category”, higher-risk supports would require General or Advanced Registration. However, if the size of the organisation were factored into the graduated risk-proportionate system, it seems possible that sole traders’ obligations might be somewhat reduced.
- Platform providers (such as Mable, Hireup) should be registered at a level commensurate with the supports they provide.
- NDIS Practice Standards: Specific changes weren’t recommended, and they don’t appear necessary to implement the Taskforce’s proposals. Where the report recommends ‘simplified general standards for all support types’, the Verification Module would fit the bill for use at the Basic Registration level. Changes to the NDIS Practice Standards and audit process should be co-designed with the disability community.
- NDIS Code of Conduct will need to be changed (via legislation) to operate with relevance to the five registration levels.
Worker Registration Scheme and training requirements
The Taskforce proposes the establishment of a Worker Registration Scheme. Additional training requirements for workers were also recommended. This would create greater workforce visibility, skill standardisation, and accreditation.
- The Worker Registration process should be simple.
- All workers would be required to:
- register with the Scheme.
- undertake 10 hours per year of ongoing professional development training.
- NDIS providers in the Advanced and General Registration categories with 5 or more workers would be required to establish documented training plans for each worker. The training, skills enhancement and accreditation plan should be updated annually.
- Development of a Worker Training and Qualifications Framework, including minimum training and qualification requirements to apply to the disability sector.
Questions remaining.
The Taskforce’s recommendations raise their own questions. The creation of Self-Directed Registration requires extensive co-design prior to implementation. Purchase Visibility can’t work unless the Code of Conduct is rewritten and operationalised across all registration levels. Advanced Registration provides oversight for high-risk supports but requires an extraordinary expansion of the NDIS Commission.
- Verification audits? — The Report recommends that Verification audits “should be more than a desktop review and involve at least one face to face exercise.” However, they are not assigned to any of the five registration levels. So, where do they fit in? The Taskforce probably imagines them as part of the graduated, risk-proportionate audits, applicable to lower-risk supports within General Registration.
- Definitions of ‘significant’ and ‘more-limited’ 1:1 contact? Basic and General Registrations are differentiated by the degree of close contact between workers and participants. The Taskforce leaves the terms ‘significant’ and ‘more limited’ undefined. The NDIS Commission might impose a self-assessment mechanism as with Role Risk Assessments, where ‘more than incidental contact’ is reinforced with more robust categories. Until that mechanism has been formulated, the cut-off between Basic and General Registration will remain a bit unclear.
- Recognition of AHPRA registration? — The Taskforce recommends that AHPRA registration should be recognised as NDIS provider registration — with the important caveat: “where this can be achieved”. This could be achieved only where the NDIS and AHPRA overlap:
“(W)here there is a difference between the professional registration and the NDIS Provider and Worker Registration Scheme, the practitioner will need to meet those outstanding obligations to provide NDIS supports.” (Recommendation 11)
There is little overlap between the NDIS and AHPRA standards, especially at the General Registration level. So, no significant reduction in the regulatory burden. The Commission is unlikely compromise on Quality and Safeguarding. The Taskforce seems to recognise this. It does suggest including self-regulating allied health professionals (such as dietitians, audiologists and speech pathologists) — but it doesn’t sound confident.
As for NDIS Worker Screening checks — AHPRA criminal checks simply aren’t enough. Therapists would need NDIS Worker Screening checks. - Purchase Visibility only? — Will this apply only to mainstream services or will it extend to purchasing disability-specific equipment?
- Self-directed Registration? — Lots of questions, here. To be co-designed.
- Funding and NDIS Commission capacity? — Can the government find the funds to expand the NDIS Commission as recommended? Can the NDIS Commission build the required capacity?
Conclusion and advice
Despite raising problems, the Report has moments of hard-nosed practicality. Rather than waiting for Advanced Registration category to be established and funded, high-risk supports (SIL, STA, ILO) will be immediately included in the existing framework at the Certification level.
As a result, providers of nominated high-risk supports have more clarity. And, if the proposal is implemented, it might indicate how further phases of implementation will likely occur.
For now, our previous advice hasn’t substantively changed (even though the details are a little different). When planning strategies, just remember that your best way forward will depend on:
- your current situation
- the registration level proposed for the supports you provide
- what you’d like to provide in the future
- NDIS Commission capacity to implement proposed system.
And if you’d like to discuss your options and how we can help, get in touch for your free 15-minute consultation.