NDIA Accountability Project

Assistive Technology Provision in Western Australia

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Assistive Technology

Submission 69

Government of Western Australia

Department of Communities

Issue: Joint Standing Committee on the National Disability Insurance Scheme - Parliamentary Inquiry into Assistive Technology

The Joint Standing Committee on the National Disability Insurance Scheme (the Committee) is undertaking an inquiry into the implementation, performance and governance of the National Disability Insurance Scheme (NDIS). Subsequently, the Committee is inquiring into and reporting on the provision of assistive technology with particular reference to: a. the transition to the NDIS and how this has impacted on speed of equipment provision b. whether the estimated demand for equipment to be sourced through the assistive technology process in each roll-out area was accurate c. whether market-based issues impact the accessibility, timeliness, diversity and availability of assistive technology d. the role of the National Disability Insurance Agency (NDIA) in approving equipment requests e. the role of current State and Territory programs in the assistive technology process f. whether the regulatory frameworks governing assistive technology are fit-for-purpose g. any other related matters.

Submission - Western Australian Government From 1 July 2018, the NDIA assumed responsibility for the delivery of the NDIS in Western Australia (WA). The NDIS will be implemented on a geographic basis by the NDIA and will be fully rolled-out across WA by 2020, in accordance with the Bilateral Agreement between the Commonwealth and WA. a. The transition to the NDIS and how this has impacted on speed of equipment provision:

  • For patients with complex or rapidly changing needs, the NDIA have been unable to execute plans at the pace required. WA s Department of Health (Health) has needed to bridge this gap. This is particularly the case with rapidly degenerating conditions. b. Whether the estimated demand for equipment to be sourced through the assistive technology process in each roll-out area was accurate:
  • No comments can be provided at this time. c. Whether market-based issues impact the accessibility, timeliness, diversity and availaoility of assistive technology:
  • Learnings from the State s Community Aids and Equipment Program (CAEP) and the WA NDIS trials (State-administered) have identified the following issues: o National distributors and suppliers are predominately located on the east coast, leading to impacts on costs, availability and timeliness, o There are several areas of known thin or limited markets due to a lack of community expertise in prescribing of equipment, o Maintenance, repairs and trialling of diverse assistive technology are impacted by local availability limitations - this issue may also affect participants experiences.
  • In WA’s regional and remote areas, accessibility, timeliness, diversity and availability are further impacted by: o distance and associated costs i.e. transport significantly raises costs o limited choice of prescribers and suppliers influence pricing, supply and choice

Assistive Technology

Submission 69

e. The role of current State and Territory programs in the assistive technology process:

  • Learnings from each jurisdiction s programs could be used to inform the development of an agile localised approach to assessment, provision, supply (and pricing) and drive market/sector development.
  • WA does not have a State-wide program similar to EnableNSW and Victoria s State-wide Equipment Program and instead only provides equipment for defined categories and the disability cohort.

f. Whether the regulatory frameworks governing assistive technology are fit-for-purpose:

  • Currently there is no nationally consistent credentialing system in place that establishes the required level of skills and competence for prescribers.
  • The introduction of a credentialing framework would: o lead to improved assistive technology prescriptions o decrease the cost and time associated with incorrect or inefficient prescriptions o deliver optimal outcomes with more rigorous safeguarding and improved experience, while retaining choice and control for participants.

a. General considerations regarding funding models:

  • There may need to be additional loadings, which are required to address increased costs.

b. Transition challenges within service sectors:

  • Many of the CAEP s services are currently transitioning to the NDIS and the aged care sector. However, gaps in service provision have been identified as a large number of the existing cohort are not NDIS eligible.

d. The role of the NDIA in approving equipment requests:

  • There is a need to consider instances where equipment funded by health services post-discharge is later replaced by NDIA-funded equipment, including: o the suitability of the equipment (e.g. equipment at discharge may serve an interim purpose rather than prescribed equipment to address long-term functional impacts) o the length of equipment loans from health services before NDIA-funded equipment is available and the cost/inventory implications for health services.
  • Another consideration is funding for maintenance and repair of equipment.

g. Any other related matters

  • There is the potential for the Commonwealth to develop a national procurement strategy, to improve pricing due to demand and volume.
  • In key areas of State Government service provision, such as health, transport, education and housing, there is a natural tension between reasonable and necessary supports under the NDIS and the obligation to make reasonable adjustments under the Disability Discrimination Act 1992. These concepts are frequently difficult to delineate.