Assistive Technology

Submission 68

23 October 2018

Hon Kevin Andrews MP Chair Joint Standing Committee on the National Disability Insurance Scheme PO Box 6100 Parliament House Canberra ACT 2600

deeply concerned with the future of state and territory aids and equipment programs following the full-roll out of the NDIS.

Macular disease is the collective term used for eye diseases and conditions affecting the macula. The macula is the part of the retina at the back of the eye responsible for central vision. Macular disease is the leading cause of blindness and severe vision loss in Australia. It is estimated that there are approximately 8.5 million people at risk of macular disease and over 1.7 million Australians with some evidence of macular disease.$,2$

The two macular diseases which have the most significant impact on the Australian population are aged-related macular degeneration (AMD) and diabetic retinopathy. AMD alone accounts for 50% of blindness and primarily affects older Australians$; diabetic retinopathy is rising rapidly due to the massive increase in the prevalence of diabetes, where numbers are expected to at least double between 2004 and 2024.$$ Everyone with diabetes is at risk of developing diabetic retinopathy, which is the leading cause of preventable blindness among working-age Australians$$3$.

Due to the access requirements relating to vision loss, the vast majority of people with macular disease are ineligible for the NDIS. To become a NDIS participant, people with macular disease need to be legally blind before the age of 65 years old or have at least one of the genetic eye diseases listed in the NDIS Operational Guidelines.$$4$

As such, most people with macular disease have to depend on either the State and Territory aids and equipment programs or the aged care system for their low vision needs. This submission only discusses the State and Territory aids and equipment programs, as the aged care system is outside the inquiry’s terms of reference.$

Currently, accessibility to aids and equipment differs across all states and territories. State and Territory aids and equipment programs have different budgets, scope, eligibility requirements and levels of subsidy. Due to capped budgets, people may face considerable waiting periods for all but life-saving equipment, such as oxygen tanks. Some programs require no consumer co-payments but limit eligibility and scope, while others have broader eligibility and scope but require user co-payments. The provision of low vision aids and equipment is excluded from programs in Victoria, Tasmania, South Australia and Western Australia, but may be provided through other state-funded agencies at a different level of subsidy or at cost to the consumer. Some funded agencies may provide equipment loans or refurbished items.$$5$

Assistive Technology

Submission 68

There is a need to standardise the eligibility, access and co-payment requirements; and the types of aids and equipment provided by State and Territory programs. However, there is greater urgency for the States and Territories to provide certainty around the continuing existence of these programs following the full-rollout of the NDIS, given that they have effectively transferred their primary disability portfolio funding and responsibilities to the NDIS.

These issues have also been recently highlighted in the Legislated Review of Aged Care 20176, led by Mr David Tune AO PSM, with Recommendation 34 stating, “That the Australian, state and territory governments work together to resolve current issues with the provision of aids and equipment for older people”.

A national approach is needed to prevent waste and duplication of resources between the Commonwealth, State and Territory Governments. Leadership from the Commonwealth Government is required to ensure that State and Territory programs are equitable and consistent, aligned with Commonwealth funded programs and adequately funded. The focus of these programs must be on supporting the needs of all Australians with a disability, including those with vision loss from macular disease, regardless of which state or territory they live in.

The Foundation recommends that the Commonwealth, State and Territory Governments work together to ensure national equity and consistency of the provision of aids and equipment for all Australians with a disability.

Yours sincerely,

Dee Hopkins

Chief Executive Officer