Joint Standing Committee on the NDIS:

Inquiry into Assistive Technology

Assistive technology (aids and equipment) is of great benefit to many people with a disability. It can:

• boost personal independence;
• improve quality of life;
• assist with social inclusion; and
• reduce the need for personal supports.

Investment in assistive technology helps people to remain living at home, thereby delaying their need for costly residential support options, reducing hospital admissions and assisting carers in their critically important provision of informal support. It supports people with their education, training and employment. It helps give people with disability control over their lives.

Before the NDIS, state and territory governments ran their own equipment schemes. Eligibility criteria differed across the country, as did the equipment people could access and the amount of funding they received. Funding limits meant people frequently had to make a significant personal contribution in order to purchase the equipment (with a shortfall sometimes running into $1000s—a prohibitive amount for many). Waiting lists were often long.

These equipment schemes, however, did have some positive features. They included recycled equipment, which accelerated access to equipment for children whose needs were changing rapidly and for people with degenerative conditions for whom it made no sense to wait for a bespoke option.

Across the country, there was a network of Independent Living Centres. Staffed by therapists, they provided advice and allowed people to test equipment options (independent of a sales service). Similarly, there were specialist centres providing advice on computer access, speech generation, complex driving and environmental controls. These information and advice centres were invaluable.

The following comments are aimed at improving the access NDIS participants have to essential and often cost-effective assistive technology.

Provision of assistive technology under the NDIS

• Planning The provision of assistive technology has been problematic under the NDIS. Participants have endured long waiting periods, even to the point of having to repeat assessments or obtain new quotes because the existing assessments and quotes expired.

Problems start with planning. When a health professional’s opinion is sought, it is typically sought after a plan is in place, rather than prior to the plan’s development. As a consequence, the health professional can only assess the participant to provide what is already specified in the plan. If the professional believes that a different type of equipment is needed, the change can be made only by activating a plan review, which is a lengthy process.

Obtaining equipment, therefore, depends mostly on the participant being able to articulate their need well or a planner being astute enough to identify it - and, if the need is for complex equipment, including funds in the plan for assessment.

Currently, recommendations for multiple pieces of equipment each require the completion of a separate NDIS document. This is time-consuming and duplicates information.

Solutions

Particularly for complex assistive technology, plans should include adequate funding for health professionals to undertake assessments and to assist participants with set- up and training once the equipment is delivered.

Wherever practical, input from a health professional should be obtained prior to plan finalisation for people who would benefit from complex or multiple pieces of complex assistive technology. This should not be a full assessment but a health professional opinion as to whether a participant is likely to benefit from assistive technology and a recommendation on the level of assessment, set-up and training funding required.

Where multiple pieces of assistive technology are required, the administrative process should be streamlined by consolidating documentation and eliminating the duplication of information.

• Approvals NDS supports the NDIA’s changes that allow for funding for Level 1 and 2 items of assistive technology to be included in a participant’s core budget (up to the value of $1500). This decision is speeding up access to low-cost and low-risk aids and equipment. If, however, a participant needs assistance to make decisions on what to purchase, funding should be included in the capacity-building budget. This is uncommon.

Page 3

The process of assessment and approval for Level 3 and 4 equipment causes delays. Following assessment, relevant forms are completed, with the clinical justification explained. The forms are submitted to the NDIA which has them reviewed. (NDS understands that the NDIA provides the assessment forms to the organisation running the aids and equipment program in that state or territory). The reviewer considers the assessment report and the recommendations and the clinical justification and provides advice back to the NDIA. Frequently, the process to approve the equipment and quotation then stalls for what can be months. The delay can sometimes be so substantial that a new assessment or quote is required.

Participants and the disability service providers assisting them find the process to acquire assistive technology confusing, complex and difficult to track (commonly stating they struggle to obtain information about the status of their equipment request).

Solutions

If funding for Level 1 and 2 assistive technology is to be included in a participant’s plan, the planner should ascertain whether the participant will require formal assistance with those purchases. If the participant does, funding for assistance should be provided in the capacity-building budget.

To prevent long delays, the NDIA should set time-based performance indicators for processing assistive technology applications (and possibly, for the various steps they control).

Participants should be able to track the progress of their assistive technology requests through the MyPlace portal.

• Specialist advice As mentioned above, a strength of the aids and equipment programs administered by state and territory governments was the existence of information and advice services (often referred to as Independent Living Centres). In some jurisdictions there were also specialist centres providing advice on computer access, speech generation, complex driving and environmental controls.

Access to independent professional advice and testing of aids and equipment (outside a sales environment) is invaluable. Unfortunately, the state funding for these centres has ceased or is likely to cease (as funding is transferred to the NDIA). The NDIA, through its funding rounds for Information, Linkages and Capacity Building (ILC), has shown little inclination to enable these independent centres to continue. This is short-sighted.

Solutions

Make long-term funding available (not the short-term grants used in ILC commissioning) for a network of independent centres that can provide information and advice on assistive technology.

• Other The NDIS approach to providing individuals with the capacity to purchase equipment as part of a plan has impeded the development of options for people who need equipment urgently. They may be children whose support needs change rapidly as they develop, or people with degenerative conditions. Motor Neurone Disease Victoria has operated an equipment library to assist people who have support requirements that change regularly. They don’t need a bespoke electric wheelchair that would take many months to obtain; they need a wheelchair immediately. For these people, re-cycled equipment can be the most appropriate option.

Solution Work with the existing assistive technology programs to identify whether there is a role for loan or re-cycle schemes for some NDIS participants and how these could operate.

National Disability Services is the peak industry body for non-government disability services. It represents service providers across Australia in their work to deliver high-quality supports and life opportunities for people with disability. Its Australia-wide membership includes 1100 non-government organisations which support people with all forms of disability. Its members collectively provide the full range of disability services—from accommodation support, respite and therapy to community access and employment. NDS provides information and networking opportunities to its members and policy advice to State, Territory and Federal governments.