Support for decision making in the NDIS

This report gives advice to the National Disability Insurance Agency (NDIA) Board about support for decision making in the NDIS.

The Independent Advisory Council (IAC) wrote this report. When we say ‘we’ we mean the IAC.

Our recommendations

We recommend that the NDIA develops an approach to support for decision making.

We use the term ‘supported decision making’ to describe providing support to people to make decisions and remain in control of their lives.

We recommend the NDIA Board supports a framework for supported decision making which:

Has strategies to improve decision making support.
Describes good practice for participants with intellectual, cognitive, or psychosocial disability.
Gives options to support decision making in the NDIS.
Gives information about current practice, best practice, and limitations.
Will guide the NDIA to develop a support for decision making approach. This will support the Scheme’s goal to enable real choice for people with disabilities.

We recommend the NDIA put the framework into action by:

Improving the NDIA systems, knowledge and risk assessment processes.
Funding services to build awareness and capability for supporters.
Developing standards for support coordinators to use when working with participants to support decision making.
Changing the description and price of the line-item ‘Assistance with decision making, daily planning and budgeting’ in the NDIS Pricing Arrangements and Price Limits.

We recommend the NDIA monitors the framework, with a focus on continuing to improve processes and measure outcomes.

Plan nominees can be appointed where it is not possible to support or build the decision making ability of participants. A plan nominee is a person who can make decisions about a participant’s NDIS supports.
The current practice to appoint nominees lacks clarity and guidance.
There are 2 parts to support for decision making:

A supporter is a term used to describe family, friends, support workers or advocates.
The ability of some participants to make decisions may go up and down, depending on their health and wellbeing. For example, people experiencing psychosocial disability.
Those who support participants in decision making should assess risk early. Noting, there is a level of healthy risk which can help people build their decision making capacity.