Inquiry into the provision of assistive technology

Joint Standing Committee on the NDSI PO Box 6100 Parliament House Canberra ACT 2600 ndis.sen@aph.gov.au

Submission to inquiry

Carers NSW wishes to thank the Joint Standing Committee for the opportunity to provide a submission to its inquiry into the provision of assistive technology under the National Disability Insurance Scheme (NDIS). Our brief submission will focus on the transition to the NDIS in New South Wales (NSW) and how this has impacted on speed of equipment provision and the role of the National Disability Insurance Agency (NDIA) in approving equipment requests, with a particular focus on the impacts of these matters on carers.

A carer is any individual who provides care and support to a family member or friend who has a disability, mental illness, drug and/or alcohol dependency, chronic condition, terminal illness or who is frail. Carers NSW is the peak non-government organisation for carers in NSW. Our vision is an Australia that values and supports all carers, and our goals are to:

• Be a leading carer organisation in which carers have confidence
• Actively promote carer recognition and support
• Actively support carers to navigate a changing service landscape that will be characterised by ongoing policy reform
• Promote connected community experiences and opportunities for carers that are inclusive of diverse carer groups
• Lead and advocate for carer-specific and carer-inclusive policy making, research and service delivery
• Continue to be a quality-driven, responsive and carer-focused organisation.

Carers NSW conducted our biennial statewide Carer Survey between May and July 2018, elicting a total of 1,830 respondents, including 713 carers of NDIS participants. Drawing on data from an open response question on the NDIS from this survey, as well as case studies collected by the Carers NSW Policy Team, the following key issues have been identified by carers in NSW regarding assistive technology (AT):

• Requested AT not being included in the participant’s plan
• Funding for AT not adequate within the participant’s plan
• Lack of funding included in the participant’s plan for AT maintenance
• Lack of provision within the participant’s plan for emergency, after-hours repairs for funded AT

• Protracted approval processes for approved AT, especially for children, with AT often arriving so late that the size is no longer current
• Decisions being made regarding AT by NDIA representatives without the requisite skills that contradict specialist recommendations

Carers have explained to Carers NSW that difficulty accessing AT due to the above reasons can lead to serious consequences for participants, their families and carers. When a participant is not able to access appropriate AT in a timely manner, many carers are either forced to self-fund – which may not be possible or sustainable – or to fill the gap themselves, such as by lifting the person, which may place them at risk of injury. In some cases, the lack of appropriate equipment is also detrimental to the participant’s health or access to the community. Complications and delays in accessing AT have also caused many participants and carers considerable stress, due to the time involved in making follow up contact and prompting unscheduled reviews and administrative appeals.

Below are a number of direct quotes from respondents to the Carers NSW 2018 Carer Survey on the matters identified above:

  “We transitioned to the NDIS however our first plan did not allocate my husband any funds for
    assistive technology so he was worse off because he had no funds to maintain his equipment
   (power wheelchair, hoist etc.) when it broke down.”

   “The approval process for equipment that makes the individual and carer’s life easier and
  more independent is painful…Only after major complaints did my son’s wheelchair arrive – it
   had taken 8 months!”

    “Awaiting shower/commode chair and manual wheelchair which both have still not arrived
    despite plan commencing in July 2017. It has taken me to officially complain (after numerous
   back and forth emails and phone calls) to get anywhere. [We were] unable to get outside help
     to shower without equipment and in the meantime the child has grown and deteriorated in his
     mobility.”

    “Daughter’s wheelchair was almost 5 years old and in need of replacement when she was
   assessed for a plan. We had self-funded vehicle and home mods including ramp access, new
   bathroom, hoist and hospital bed. We had a reasonable and necessary expectation NDIS
   would fund a new wheelchair. First plan did not include any assistive technology despite OT
    report stating new wheelchair was required and shower chair was on loan and not entirely
    suitable…after 5 months the review was finally assessed and the wheelchair approved...In the
   meantime my daughter used a chair so small that she developed postural problems and could
    not be transported safely in the chair so we rarely left the home.”

   “Our difficulty has been in interpreting what has been provided for and the lack of speed in
    getting equipment scripted and approved. Some of which is necessary to allow myself as a
    carer to have assistance in the house (e.g. hoists).”

“Still waiting on hospital bed, wheelchair and shower chair since September 2017!”

“The process for assistive technology assessment, approval and supply is awful. It’s hard to take off the days needed to meet with OTs and to trial equipment. The decisions made by the Technical Advice Team at the NDIS regarding the suitability of the recommended equipment is ill informed…”

“The rollout of the NDIS has increased our workload substantially due to the timeframe per request e.g. equipment. We have had the minister involved on more than one occasion. The increased workload has placed a great strain on our family.”

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