Assistive Technology Parliamentary Enquiry Submission — Western Australia Occupational Therapy Association (WAOTA)

The Western Australian Occupational Therapy Association (WAOTA) is the peak body representing occupational therapists in WA since 1952.

Members of WAOTA are health professionals who work, or have worked, within many sectors where occupational therapy provides valuable contributions. Many occupational therapists operate in settings involving clients engaged with, or eligible for, the National Disability Insurance Scheme (NDIS). Members interact with WAOTA via affiliated interest groups as well as direct communication that raises awareness about issues affecting our profession.

a. The transition to the NDIS and how this has impacted speed of equipment provision;

Feedback from members indicates significant slowing down of equipment provisions following the rollout of the NDIS. Previously available services could supply items quickly often having stock ready for immediate issue enabling more flexible responses addressing risks impacting client safety promptly delivering interventions when needed timely fashion. Concerns exist regarding current processes being time-consuming while lacking flexibility necessary for handling high-risk situations efficiently within desired timelines.

Additionally under previous pathways refurbished equipment represented value-for-money appropriately utilizing existing resources currently there’s no option reissue unused gear creating potential risk people buying unsuitable devices through second-hand markets thus not fully realizing investment made by NDIS if suitable reusable equipment remains unavailable.

Participants report accessing NDIS involves lengthy arduous procedures requiring battles convincing planners understand functional implications disabilities require specific assistive technologies included plans sometimes participants aren’t aware what they need leading difficulties acquiring required assistance later due limitations imposed during review periods.

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a. whether market based issues impact the accessibility, timeliness, diversity and availability of assistive technology;

Rural and remote NDIS participants are at a disadvantage with difficulties that are exponentially greater in WA given the vast size of the state and distances between towns where, and indeed if, services are located. The additional travel allowance for these areas often does not reflect the time requirements of the travel undertaken and there is the potential that service providers are unable to provide services, or alternatively are having to provide this service ‘in kind’ impacting their economic viability, which in turn influences their longevity in service provision to these areas. The risk is that there is no incentive for service providers to establish and maintain services to these regions which further disadvantages NDIS participants who live in regional and remote areas.

Trialling of equipment can present issues in metropolitan areas, with the NDIS AT process to demonstrate a number of alternatives have been considered and trialled. Undertaking this process can be time consuming when there is the potential to visit a number of suppliers, and/or make repeated visits to a participant’s home in order to make the most appropriate selection. Often the hours for health professionals allocated in participants plans do not adequately accommodate the hours required for trials. The issue of trialling assistive technology is further problematic in regional areas. Suppliers have a reluctance to meet the cost of freight to provide the equipment, in addition to the additional time that their equipment is not available to trial with others. There can also be difficulties with coordinating equipment availability to coincide with health professional and participant availability, necessitating additional visits and hours to complete trials.

There is also concern that suppliers who have taken the time to provide equipment and expertise to support participants AT trials, and have been selected as the preferred supplier because of their reputation related to customer service and reliability with maintenance and repairs are being disregarded if a competitor’s quotation for the same equipment is of less cost.

b. whether current funding models support or hinder access to quality services;

The NDIS has provided an opportunity for people living with disability across WA to receive supports tailored specifically to individual needs through flexible funding arrangements which allow them greater choice over how they use these funds while still ensuring adequate levels of care from qualified providers within local communities where possible without compromising standards set by national guidelines regarding safety etcetera… However there remains some concerns around certain aspects such as:

• Inconsistent application rates between different regions due partly but mainly caused by lack sufficient resources allocated towards outreach initiatives aimed at reaching out those residing further away especially considering geographical challenges faced when trying connect remote locations together effectively thereby creating disparities among various groups affected differently depending upon location factors alone rather than actual need itself.
• Some stakeholders feel like existing frameworks might not fully account all potential barriers facing individuals seeking assistance particularly relating things like transportation costs associated traveling long distances just so one can obtain necessary items even though this could potentially lead into situations were someone ends up paying more overall despite initial savings made elsewhere during purchase phase only later realizing that extra expenses incurred afterwards outweighed any benefits gained initially thus making whole experience counterproductive instead beneficial outcome expected originally planned ahead time frame prior engagement commenced.

c. whether market based issues impact the accessibility, timeliness, diversity and availability of assistive technology;

Rural and remote NDIS participants are at a disadvantage with difficulties that are exponentially greater in WA given the vast size of the state and distances between towns where, and indeed if, services are located. The additional travel allowance for these areas often does not reflect the time requirements of the travel undertaken and there is the potential that service providers are unable to provide services, or alternatively are having to provide this service ‘in kind’ impacting their economic viability, which in turn influences their longevity in service provision to these areas. The risk is that there is no incentive for service providers to establish and maintain services to these regions which further disadvantages NDIS participants who live in regional and remote areas.

Trialling of equipment can present issues in metropolitan areas, with the NDIS AT process to demonstrate a number of alternatives have been considered and trialled. Undertaking this process can be time consuming when there is the potential to visit a number of suppliers, and/or make repeated visits to a participant’s home in order to make the most appropriate selection. Often the hours for health professionals allocated in participants plans do not adequately accommodate the hours required for trials. The issue of trialing assistive technology is further problematic in regional areas. Suppliers have a reluctance to meet the cost of freight to provide the equipment, in addition to the additional time that their equipment is not available to trial with others. There can also be difficulties with coordinating equipment availability to coincide with health professional and participant availability, necessitating additional visits and hours to complete trials.

There is also concern that suppliers who have taken the time to provide equipment and expertise to support participants AT trials, and have been selected as the preferred supplier because of their reputation related to customer service and reliability with maintenance and repairs are being disregarded if a competitor’s quotation for the same equipment is of less cost.

d. the role of the NDIA in approving equipment requests; Therapists have reported frustration and disappointment that assistive technology applications that have recommend equipment that addresses client need, and provided sound clinical reasoning are being queried and require additional input, research and use of client hours to further justify.

e. the role of current state and territory programs in the assistive technology process; Members have not provided comment on this aspect of the process.

f. whether the regulatory frameworks governing assistive technology are fit-for-purpose, The needs for health professionals’ involvement during planning stages within NDIS plans must ensure participant requirements get properly addressed while taking into consideration any limitations they may face functionally throughout entire duration involved.

WA Occupational Therapy Association

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plan to ensure that adequate hours are provided to appropriately assess, prescribe, report, implement, train and evaluate assistive technology.

Underestimate of hours required to complete assessment, prescription, set up and evaluation of assistive technology has a significant impact. On many occasions not all needs are able to addressed in a current plan period and AT prescription needs to be prioritised, leaving some needs unmet and barriers continue to remain for clients in terms of their participation, independence and quality of life.

documentation requirements in terms of the assistive technology application form are extensive and the time frames around the sourcing and provision of the information is not adequately reflected in the hours provided to complete the process requirements.

g. any other related matters.

Therapists have reported some concerns with the current plan to include level 2 assistive technology purchases in the $1500 aids of daily living allowance that is provided to NDIS participants. Certainly there have been issues with the cost of the application process at times equating to more than the cost of the item and it is likely that the formal written AT application for lower level AT may not be necessary, however health professional input can provide vital support and recommendations to make informed choices about assistive technology ensuring the best match and cost effectiveness with the most appropriate AT selected in the first instance. The ability of the NDIS participant to source allied health support for purchases of lower level equipment needs to be accommodated with hours allocated for this in plans. Additionally, risk can exist with the provision of inappropriate AT and set up and training is often required to ensure the safe use of assistive technology, including AT that is classified as lower level. Impartiality is a benefit of engaging a health professional in the process where as suppliers/retailers have a vested interest in promoting the products they supply whereas a health professional is concerned with feature matching of AT to address participation and independence of participants, not just an interest in supplying what is available through a retail outlet.

Dependent on participant case complexity and functional impact of their impairment, low level AT may present risk and this should be ameliorated through appropriate assessment prescription and implementation by a health professional.

Lynda Quigley Committee of Management WA Occupational Therapy Association.