Email to: NDISConsultations@dss.gov.au
Australian Music Therapy Association
Consultation response: NDIS legislative changes and Participant Service Guarantee 2021
About the Australian Music Therapy Association
The Australian Music Therapy Association (AMTA) is the peak body for music therapy in Australia. AMTA represents Registered Music Therapists (RMTs), music therapy students and advocates for access to music therapy on behalf of the community. Our mission is to enable, advance and advocate for excellence in music therapy.
AMTA is the regulating body responsible for registering music therapists, accrediting music therapy courses, and maintaining professional standards and ethics. A member organisation of Allied Health Professions Australia (AHPA) and National Alliance for Self-Regulating Professions (NASRHP), AMTA supports Registered Music Therapists (RMTs) to use research-based practice that actively promotes the health, wellbeing and functioning of Australians.
RMTs work in private practice and in allied health teams in hospitals, residential facilities, community services and schools. They use evidence-based music therapy techniques to promote better health outcomes for vulnerable and unwell Australians.
There are currently 626 registered music therapists in Australia, with 152 registered NDIS providers of music therapy services. Music therapy is listed as a reasonable and necessary support to address NDIS participants’ needs in the capacity building budget. Registered music therapists use evidence-informed music-based interventions to deliver successful outcomes for NDIS participants.
AMTA welcomes the opportunity to provide feedback on the proposed NDIS legislative changes.
Summary
- AMTA strongly supports the increased focus on NDIS governance, reporting and accountability for participants and the public.
- AMTA welcomes the inclusion of people with lived experience with disability on the Board. We believe this is overdue and a welcome improvement to NDIS governance.
- AMTA welcomes changes to improve access to information and supports for current participants, their support people, and applicants.
- AMTA is seriously concerned by changes that allow the CEO to change participant plans without engagement with the participant.
- AMTA is concerned by the nature of ‘market intervention’ outlined in the Rules.
- While this response focuses on proposed legislative changes, AMTA notes that everyday practice dictates how the NDIS works and is experienced by participants. NDIS participants and our members continue to highlight that decision-makers may not have sufficient knowledge or training to make valid decisions about participant goals and plans, or the most suitable providers for support. This is an ongoing issue that requires immediate attention.
- AMTA notes the timeframe for consultation was four weeks only. This is insufficient time for stakeholders to review information of this depth and importance. AMTA is deeply concerned that this undermines the ability of NDIS participants, their advocates and the public to review these documents and meaningfully engage with and respond to their content and this consultation.
Strengthening governance and accountability
AMTA welcomes strengthening NDIA governance and accountability within the Guarantee:
- We strongly support increasing clarity and rights for participants and applicants to receive timely information about decisions about their eligibility and plans.
- AMTA strongly supports participants’ increasing rights to internal and external review.
- AMTA recommends timeline targets placed from time of access at NDIA to plan preparation and approval. We would also recommend ‘as soon as is practicable or within X days’ to encourage the NDIA to act sooner, rather than waiting for the nominated timeframe to lapse.
- We strongly support the role of the Commonwealth Ombudsman clarified within the Guarantee. We note the inclusion of performance reporting requirements of the NDIA. AMTA recommends reporting items include outcome and experience measures as reported by applicants, participants and providers.
AMTA strongly endorses the increasing role of people with disabilities in the planning, design, policy decisions and governance structures of the NDIS. We welcome the removal of qualifications for Board membership by people with disabilities, acknowledging the value and importance of lived experience of disability. We note the changes to reinforce the inclusion of people with disabilities in a co-design capacity. We would welcome more explicit definition of what is meant by co-design in this context. We challenge the NDIA to progress this thinking and further reinforce inclusion of people with disabilities in both co-design and leadership capacities.
We support the principles behind 100(1B) and (1C) of the Act that allows requests to the CEO for reasons for decisions made by the NDIA. However, AMTA believes the NDIA could improve this further. NDIS participants, together with AMTA’s registered NDIS providers, frequently report misunderstandings, miscommunication about, and rejections of music therapy as a funded support. We strongly recommend that communicating reasons for decisions becomes a routine process for the NDIA when making all access, planning and plan review decisions (consistent with the Tune Review). This process as a standard operational procedure would vastly improve transparency and enable more informed decision making for applicants, participants and providers.
Improving plan flexibility
AMTA supports changes to the Guarantee that further enable participants to exercise choice and control without negotiating excessive ‘red tape’. We welcome Section 47A that allows participants to initiate a plan change without requiring a plan reassessment or new plan.
However, AMTA is deeply concerned by the use of 47A to allow the CEO to change a participant’s plan when the CEO initiates the variation and without consultation with the participant. AMTA is strongly opposed to variations to plans without request, consultation or consent by the participant, which seem to conflict with the NDIS’ central principles of choice and control, and other changes to accountability and governance responded to above.
Becoming a participant
AMTA is deeply concerned by new requirements governing applicant admission to the NDIS (Rule 8). NDIA must consult with people with lived experience and their advocates to develop appropriate definitions for terms used such as ‘permanence’, ‘appropriate treatment’, ‘substantial improvement’. Issues already arise around the definition of ‘permanence’ for people with psychosocial disabilities, degenerative conditions or fluctuating impairments. AMTA recommends the NDIA give this Rule more consideration and provide greater detail. AMTA also questions the need for people with disabilities to have already undertaken every therapy or treatment available before accessing the NDIS.
Market intervention and Plan Management Rules
AMTA is deeply concerned by Sections 6-8 in the Plan Management Rules, particularly those related to market intervention. Principally, AMTA believes these rules could shift NDIS further from choice and control and participant empowerment. Importantly, this level of control and decision making requires a certain (high) level of understanding of possible supports, potential providers, local service availability and the available evidence base, by those in the NDIA. Registered music therapists repeatedly recount experiences of NDIA staff misunderstanding, discounting or actively devaluing music therapy to participants and NDIS providers. Our members question the ability of NDIA to specify supports and providers on a participant’s behalf.
We are also concerned by the final point in section 8(2), which states the CEO can make such changes due to “any other matter the CEO considers relevant”.
Language of reassessment, variation, review
AMTA has heard from participants and providers that there is ongoing confusion about the various terms used within the NDIS. We understand this round of terminology changes attempts to clarify language. This terminology (particularly the differences between a variation and a reassessment) will need to be clear to participants and their families, carers and support people. Due to the level of concern about ‘independent assessments’ (which we are pleased to see no mention of in these legislation changes), changes to terminology will need to acknowledge any concerns and potential mistrust by participants.
Inclusion of families, carers and support people
AMTA welcomes the clear inclusion and respect for families and carers within these legislative changes. We draw the NDIA’s attention to the National Mental Health Commission, which also
refers to ‘support people’ or ‘supporters’. Support people may not be family members or carers, but provide people with living experience of mental health with significant support in decision making and living independently.
Translating legislative changes into practice
AMTA is available to work with the NDIA to support the practical changes associated with implementing this legislation. We would welcome the opportunity to work with the NDIA to develop resources and processes to support decision making by participants, providers and agency staff.
For further information, please contact:
Bridgit Hogan
Chief Executive Officer
Australian Music Therapy Association Inc
m. +61 438 444 439
e. ceo@austmta.org.au