Reforming Queensland’s authorisation framework for the use of restrictive practices in NDIS and disability service settings

Why is it important?

If streamlining the authorisation process for restrictive practices involved the creation of a new role of Senior Practitioner (or a similar role), the requirement for the Senior Practitioner to publish information on the performance of their functions will make it is possible to focus on what the evidence shows in Queensland, and to use this to directly inform policy and practice and to drive system-wide improvements.

What do our current laws say?

The chief executive of Disability Services currently has the following prescribed functions under the DSA:

• (a) conducting multidisciplinary assessments for the proposed use of containment or seclusion;
• (b) the development of positive behaviour supports plans that include containment or seclusion; and
• (c) providing short-term approvals for the use of restrictive practices other than containment or seclusion.

The chief executive does not currently publish information on the performance of these functions.

One idea put forward by this paper is the establishment of the role of a Senior Practitioner (or similar role) in Queensland. A Senior Practitioner (or similar role) could perform many of the authorising functions currently performed by the chief executive, the Public Guardian and QCAT.

Other important information

NDIS (Restrictive Practices and Behaviour Support) Rules 2018 (Cth)

Under the NDIS Act, the NDIS Commissioner’s behaviour support functions include:

• overseeing the use of behaviour support and restrictive practices, including by collecting, analysing and disseminating data and other information relating to the use of behaviour supports and restrictive practices by NDIS providers, and
• undertaking and publishing research to inform the development and evaluation of the use of behaviour supports and to develop strategies to encourage the reduction and elimination of restrictive practices by NDIS providers.

Other jurisdictions

In Victoria, the Senior Practitioner role was established in 2006 through the enactment of the Disability Act 2006 (Vic).

Victoria has collected long-term population-level data on the use of restrictive interventions and behaviour support plans over 14 years.

This has enabled investigations into what has changed over time, and what factors have affected these changes. For example, in Victoria people with autism are more likely to be restrained over the long term (for periods over at least three years) with antipsychotic medication than people without autism.