ABILITY SURF

Ability Surf - Occupational Therapy & Physiotherapy

Northern NSW

Submission to the Joint Standing Committee on the National Disability Insurance Scheme March 2021

ABILITY SURF

To the Joint Standing Committee on the National Disability Insurance Scheme,

I am writing to oppose the changes being proposed in regards to Independent Assessments to be carried out for participants of the NDIS.

As an Occupational Therapist who has worked in the disability sector for thirteen years, the changes proposed to the NDIS do not acknowledge a fair, reasonable and necessary approach to supporting people with a disability to access the NDIS.

The case I put forward is to highlight these significant barriers and limitations of Independent Assessors and the proposed changes:

• Whilst the Independent Assessors are classified as registered health professionals, all health professionals and their scope of practice and experience is significantly different. For example you cannot expect a Physiotherapist ‘Independent Assessor’ who works in Rehabilitation to ‘assess’ a person with a disability who may be severely Autistic and a non-verbal communicator. It is just not ethical or appropriate.
• It is not fair to expect any person to be ‘assessed’ based on their disability and function within a short space of time by someone who is unfamiliar to them and not take into consideration the therapeutic support and information their therapy support team has been providing. It appears as though the true uniqueness of a person with a disability is being completely disregarded by the NDIA if they are unable to see this view point. Furthermore, the stress and anxiety which would be placed on this individual and or their carer could be considered traumatic for many of the individuals.
• This leads me to the emotional and mental impact of being assessed solely by an Independent Assessor for a person with a disability. Many of the people who I support have significant challenges in their emotional regulation, anxiety, mental health, sensory processing disorders and regulation, inability to communicate verbally, inability to hold a conversation, inability to understand questions. These are some of the challenges they face on a daily basis. Many of these individuals also do not have people in their life who can advocate for them or may have some of these challenges themselves. Many of these people experience a flight/fright/freeze/fight reaction in their central nervous systems on a daily basis in which they are in a constant fear and anxiety state. I am deeply concerned that putting these people and/or their carer through an independent assessment would trigger these responses ten- fold and in actual fact be a traumatic experience for them. The expectations placed on them by someone they don’t know is unfair and not just. How is someone who cannot understand a question meant to respond? How is

someone who understands a question but cannot communicate meant to respond? How can you understand ABILITY SURF their function in daily activities like going to the toilet, eating, their social interactions and their emotional regulation if you cannot observe them and they are unable or cannot communicate to you whilst in this ‘assessment’ state?

• Whilst the NDIS was created to provide opportunities for people with a disability, it has most definitely come with a lot of stressor for carers and parents. The parents who are anxious at review time, are pro therapy reports with written goal outcomes to support them so they feel they have ‘someone that knows their child’ and feel supported. The changes to the NDIS with these proposed changes is moving away from its core founding principles- to provide reasonable and necessary supports to an individual. How can these be assessed as reasonable and necessary if you are not truly getting to know a person, but taking a snapshot of this person? It is imperative that a therapy team is able to provide written evidence and support of their therapeutic intervention during a person’s plan and to support ongoing challenges for that person. It can take months of building therapeutic rapport with some people with a disability for them to feel safe and secure, to trust you and to be able to have a conversation with you. How is it possible that this could be met within a few hours by an unfamiliar person?

I understand that for people with a disability to access into the NDIS it is difficult and expensive for them to have assessments and therapy reports. I would suggest that in this case an Independent Assessor could be a great alternative for this person and their family, if it is their choice. I would like to emphasise that I believe this is the only time this could be useful, ethical and reasonable.

It seems unfair and unjust that these changes are being made to the NDIS with little consideration for the huge, nationwide impact this could have on thousands of individuals with a disability. I would argue, that many people who would like to express their opinions on this are unable to. I am shocked to see 50 submissions to the joint council, when I have read hundreds of comments on the internet in a Facebook group for people who access the NDIS, outraged at this proposed change. My question would be, whether all possible avenues of collecting ‘voice’ have been obtained by the NDIA for NDIS participants? Have the rights, choice and control of people with a disability truly been acknowledged? Have there been attempts made by the NDIA in non-conventional ways to ensure these participants feel heard and to have their own say?

Sincerely,

Emma Bracken ABILITY SURF Occupational Therapist Ability Surf