External Merits Review – Support Component
On 1 July 2013, the National Disability Insurance Scheme commenced in the Barwon area of Victoria, the Hunter area in New South Wales, Tasmania and South Australia, and from July 2014 in the Australian Capital Territory, the Barkly region of the Northern Territory and the Perth Hills area in Western Australia (the trial sites).
The National Disability Insurance Scheme provides long-term, high quality individualised care and support that is reasonable and necessary to meet the needs of people with permanent disability, where their disability significantly affects their communication, mobility, self-care or self-management. This may include an individual plan and an individually funded package.
The Australian Government has established the National Disability Insurance Agency to implement the first stage of the scheme. The National Disability Insurance Agency works closely with people with disability, governments, representative organisations, service providers and participating communities in trial sites to ensure the transition to the new arrangements take account of local needs and experience.
The National Disability Insurance Scheme Act 2013 creates the framework for the National Disability Insurance Scheme, including eligibility criteria, age requirements, and what constitutes reasonable and necessary support. The framework set up by the legislation is supported by detailed rules that keep it flexible and allow it to be adapted.
A person who is not satisfied with a decision made by the National Disability Insurance Agency can apply to have the decision reviewed internally by the Agency. If the participant is still dissatisfied with a decision following an internal review, they can then apply to the Administrative Appeals Tribunal (AAT) for a review. The AAT is the external merits review body for the National Disability Insurance Scheme.
An application for an AAT review must be made within 28 days, but extensions can be granted.
The aim of external merits review is to ensure National Disability Insurance Agency decisions are fair and robust. To ensure the external merits review process is accessible and as non-adversarial as possible for people with disability, a designated division of the AAT has been established, there is a fee waiver for applicants seeking a review of National Disability Insurance Agency decisions, and support services have been provided (the Support Component).
External Merits Review – Support Component Programme Guidelines
The Australian Government Department of Social Services (DSS) has developed a suite of Programme Guidelines which provides grants funding, and the suite of Activities that contribute to that Programme. The Programme Guidelines provide the key starting point for organisations who are considering whether to seek funding, and form a business relationship with DSS.
Information about the Disability and Carer Support Activity, which includes the External Merits Review – Support Component is available through the Disability, Mental Health and Carers Programme
External Merits Review – Support Component Operational Guidelines
Operational Guidelines are also available as an adjunct to the DSS’ Programme Guidelines, for the External Merits Review – Support Component (EMR). The EMR Operational Guidelines provide more specific information about the program, and should be viewed in conjuction with DSS Programme Guidelines.
Aims and objectives
The objective is to ensure that all people with disability and other affected persons have access to support when they are seeking review of National Disability Insurance Agency decisions in the AAT through:
• access to a support person; and
• access to legal services in limited circumstances - where a case raises complex or novel legal issues.
A person who is directly affected by a reviewable decision by the National Disability Insurance Agency may request review by the AAT under s103 of the National Disability Insurance Scheme Act 2013.
The primary participant group for the External Merits Review - Support Component is people with disability, but applicants may also be guardians and nominees of people with disability and carers and family members of people with disability. The External Merits Review - Support Component is not available to service providers.
Applicants can access the External Merits Review - Support Component once they have exhausted all avenues of review in the National Disability Insurance Agency and have made an application to the AAT. Upon application to the AAT, a participant is made aware of the availability of a support person.
The Support Component provides support persons to assist applicants in navigating the process of AAT review of National Disability Insurance Agency decisions. The support person’s role may involve attending AAT conferences and hearings with applicants, fostering self-advocacy for applicants to put their own cases before the AAT, or providing individual advocacy in cases where the person is unable to self-advocate.
Funding for the provision of support persons is directly provided to one National Disability Advocacy Program (NDAP) agency in each launch site. The agencies selected to provide this service are as follows:
Victoria (Barwon) - Regional Information and Advocacy Council Inc
New South Wales (Hunter) - Disability Advocacy NSW Inc
South Australia - Brain Injury Network of South Australia Inc (BINSA)
Tasmania - Advocacy Tasmania Incorporated
Western Australia (Perth Hills) - Midland Information Debt & Legal Advocacy Service
Northern Territory (Barkly) - Brain Injury Network of South Australia Inc (BINSA)
Australian Capital Territory - ACT Disability, Aged and Carer Advocacy Services
While the focus is on non-legalistic self-advocacy services, there may be some cases where complex or novel legal issues are raised. Recognising this, the Support Component also provides limited funding to the legal aid commissions in launch sites for complex or novel matters. Applications for assessment for eligibility against the Central Assessment Provider guidelines are undertaken through the Department of Social Services. Referrals for assessment are made through the support persons and through the legal aid commissions in the trial sites.
An External Merits Review pamphlet has been developed that briefly explains the process and includes contact details for each of the NDAP agencies providing support persons in the trial sites. There is also an EMR Fact Sheet available with more information.
The Department can be contacted about the External Merits Review – Support Component via:
Department of Social Services,
Disability and Carers Group
Tuggeranong Office Park, PO Box 7576
Canberra Mail Centre ACT 2610