Concerns about independent assessments impacting NDIS plans and funding

Valued lives Your Pathway, Your Journey

Introduction

Valued Lives is a peer-led organisation that supports disabled people, their families and supporters to lead the lives of their choosing. With a strong commitment to promoting social inclusion and empowering vulnerable people to have real choice, real control and a genuine voice in the design, planning and delivery of their own supports and services, Valued Lives, established in 2013, is a peer-led community organisation that continues to grow and develop through strong leadership from a user-led board of passionate individuals, families and supporters.

We are registered to provide supports and services through the National Disability Insurance Agency (NDIA) and Department of Communities (Disability Services) Western Australia and are a registered charity with the Australian Charities and Not- for-Profits Commission (ACNC).

Over the years Valued Lives Foundation has been involved with several NDIS initiatives. As a non-government provider of Local Area Coordination in WA, we then commenced delivery of capacity building strategies and support coordination when people transferred to the NDIS.

As members of the National Alliance of Capacity Building Organisations (NACBO) we have built solid partnerships with like-minded small grassroots organisations across Australia to build people’s knowledge, shift mindsets and strengthen values- based leadership so that vulnerable Australians are empowered to have full, meaningful and inclusive lives that are rich in relationships.

Valued Lives is an ILC grant recipient and in 2020 was awarded a two-year grant to continue the delivery of peer-led support to the WA community through the Peer-to- Peer Networks WA Project. Through the project we support disabled people to

• develop their confidence and capacity
• improve social connection and emotional support
• gain exposure to new ideas and leadership from peers
• improve their participation in community life

On Thursday, 18th of February 2021, the Peer-to-Peer Networks WA project hosted a community forum regarding proposed changes to the NDIS. This event was held as a follow-up to a webinar presented by the NDIA Community Engagement and Events team, held on the 13th of January 2021 via Microsoft Teams.

These forums were attended by 70 members of the community, all were people with a disability, their families and supporters.

The groups discussed the proposed changes to the scheme and the following themes were identified.

1. Regarding the accuracy of Independent Assessments

Overall, the forum attendees expressed concern that the introduction of independent assessments would have a negative impact on the quality of their NDIS plans and funding.

Many told us that they were fearful of an assessment done by someone who did not know them and may not have the specialist knowledge required to complete the assessment accurately. They also told us that they did not believe that the current proposed model would capture information about a person in all areas of their life, that important information would be missed and that some participants would present as having more capacity than they actually have, as a survival technique or learned redacted ehaviour. Forum attendees did not believe that tests administered by a stranger would capture this level of complexity that is the lived experience of a person with a disability. Forum attendees also expressed concern about how people with multiple or complex disabilities would be accurately assessed and that they did not believe that the current tools that exist were fit for this purpose.

Supporting Evidence for Community Concerns

Submission from Professor Bruce Bonyhady, Executive Chair and Director, Melbourne Disability Institute redacted:, tranquilizer or OCR artifact omitted - backtick wrapped as redaction/artifact

The current proposal to introduce IA seeks to apply a limited range of functional assessment tools to all disability types. As currently planned, the toolkit ignores agreed best functional assessment tools for segments of the NDIS population, such as the Gross Motor Function Test for people with cerebral palsy. This raises serious doubt about the likely accuracy of the current approach.

More broadly, the proposed approach to the implementation of IA seeks to rely on a single assessment in a pre-set time period. This is despite that fact that it is well- known that the most accurate assessments of disability are provided through multi- disciplinary teams observing the person with disability in multiple settings. It is difficult to understand why administrative ‘efficiency’ is being prioritised over accuracy, especially given that the accurate determination of both eligibility and reasonable and necessary supports are foundational to the success of the NDIS. Fairness and consistency can only be achieved through accurate, valid assessments and governments need both accurate and consistent assessments for funding to be predictable and sustainable.

Submission from Occupational Therapy Australia, February 2021

It is uncertain how the NDIA will use the data obtained in an IA to determine an applicant’s

eligibility for the scheme. OTA strongly believes the proposed tools and lack of scope for clinical reasoning mean that there will often not be enough information to make this decision. Certainly, no applicant should be excluded from the NDIS on the strength of an IA alone.

OTA is also deeply concerned by the proposal that IAs may inform a participant’s current and future plan funding. The tools were not designed for this purpose and there is no evidence to support the assumption that they can be used as such. (This is expanded upon in OTA’s submission to the NDIA’s Planning Paper.)

Quotes from attendees.

redacted “The NDIS has underestimated the value of people who work alongside us, have walked on the journey with us and have taken time to build and develop relationships based on trust and mutual respect. These are the people that have kept us connected and resilient.

It is a very different feel to that which Western Australians living with disability have been accustomed to since the inception of the successful LAC programme introduced in the 1980’s, that has stood the test of time.

The LAC remit has always been to nurture local solutions and help people to access services where they are required. Services and assessment were the last thing that was considered, not the first. This approach was intended to ensure that mainstream services were accessible, accountable and available to everyone and access to services that should be available to everyone.

When the NDIA introduced LAC across Australia, this changed and relationship- based connection and pathways to community aimed at reducing the cost of formal supports required by the Scheme were usurped, as LAC’s were required to undertake assessment and planning roles on behalf of an agency that is overstretched.

The LAC role has been watered down beyond recognition, due to a poor understanding of the role. Now that the Scheme is under financial pressure action is being taken to implement independent assessments.

It would now seem that we are required to discuss our support needs with someone that we do not know, who has no relationship with us, may not know anything about our specific disability and does not take into consideration our family situations.

This person will be required to deliver a range of assessments on a computer, in front of us and write a report in 1-4 hours for the NDIA that will determine our funded supports. It is little wonder why people are scared and anxious regarding these changes.

This is not the solution to ensuring sustainability of the NDIS into the future and needs to be reconsidered. People living with a disability and their family members understand that there is limited funding to provide quality supports and services to the people that need assistance. Bring together some thought leaders and ask different questions and you will reap the rewards through a well-designed, co-design process”.

redacted Why are they defining the assessment process as a not reviewable process, how are they making an assessment for someone in 1 - 4 hrs., with never meeting them? Or without having access to the files they have?

redacted They need (the NDIA) to have a good understanding of the disability being assessed. I know you (the NDIA) said this will occur, but I am concerned that some therapists may say they understand something but don’t actually have a comprehensive understanding of complex disabilities.

redacted Assessors need to be skilled at navigating family situations, lots of families present a brave face in these meetings whilst things are falling apart in the background. Assessors need skills around complex mental health, what if the person is well on the day you meet them? Some disabilities will require multiple specialists to get a picture of a person’s life and sending a physio to assess someone with Autism is not only dangerous but negligent.

redacted How can someone do an assessment in a couple of hours, not on, it’s typical liberal BS.

redacted How can a “known you for years” therapist be substituted for some new university student meeting you for an hour or two? They can’t!

redacted Do we know what type of knowledge that the assessors will possess? For example will they be professionals or will it be a tick box approach. I would be very concerned, for example, if my son attended an assessment and just answered questions as he would say he can do everything (he has a profound intellectual disability)

redacted This reminds me of when we had interviews back in the day at school leaver time for the Post School Options. We had to paint the bleakest picture just to get the basics.

redacted My biggest fear. We need clarification as to WHO can come in the meeting with you.

redacted Will we get a chance to see copy or draft of the WHOLE or just a shortened version of your Independent Assessment before it goes to the NDIA planner?

redacted Working in the disability field for as long as I have, I really don’t have confidence in an assessor even if they have professional background. I am really not confident about the independent assessment and I wonder what the political agenda is? I would say it would not be client central.

redacted I prefer my own OT, who I work well with and who knows me.

redacted I feel this is such an erosion of basic human rights and taking away people’s choice and control.

redacted I have heard a few times that the reason they are doing this is to get rid of “sympathy bias” and providers who write reports that bring them business. I want to see the evidence that shows this, or at the very least, the evidence that shows this will lead to better outcomes like they claim. Because all our providers are registered with APHRA, meaning they have to abide by strict codes. So will the assessors, the only difference is that they won’t know us. All the peak therapist groups are saying it’s not good, so I don’t see how anyone who agrees to do this work is going to be ethical and skilled enough to do it well.

2. Concerns regarding the Assessments not being reviewable.

Attendees at both forums expressed significant concerns regarding information released in the consultation papers that Independent Assessments would not be a reviewable decision. In particular Page 23 of the Access and Eligibility policy that states:

Independent assessment results themselves will not be directly reviewable by the AAT. This is because independent assessments are not a decision the delegate makes under the NDIS Act. Instead, the delegate will request that an applicant has an independent assessment for the purposes of informing an access decision under the NDIS Act.

Disagreeing with the results of an otherwise sound and robust independent assessment is not sufficient for the NDIA to fund another assessment. Applicants can only seek a second assessment where the assessment was not consistent with the independent assessment framework, or if the applicant has had a significant change to their functional capacity or circumstances.

https://www.ndis.gov.au/community/have-your-say/access-and-eligibility-policy-independent-assessments

Given the numerous concerns regarding accuracy of the assessments themselves, attendees told us that they believe:

• Not providing a mechanism by which assessment results could be challenged or refuted would add significant additional stress to families who would bear the brunt of poor outcomes from the assessment.
• Not providing a mechanism by which assessment results could be challenged or refuted placed vulnerable people at risk through poor plan outcomes that would result from incorrect assessments.
• Not providing a mechanism whereby assessment results could be challenged or refuted gave no opportunity for people with disability or their families and supporters the opportunity to provide holistic, accurate information to assessors about all aspects of that person’s life.

• Not providing a mechanism whereby assessment results could be challenged or refuted was a violation of the rights of individuals outlined in the United Nations Conventions on the Rights of Persons with Disability

Supporting Evidence for Community Concerns:

Submission from Professor Brue Bonyhady, Executive Chair and Director, Melbourne Disability Institute:

Taken together, it is clear that there will be no exemptions from independent assessments, other than those determined by the NDIA. If a participant refuses an independent assessment, they will have no legal rights of appeal, because the AAT does not have jurisdiction where an access request has been withdrawn or the NDIA has not made a decision. This will place the participant in a legal ‘no-man’s land’. Therefore, there is a need for much more complete and transparent appeal processes. There must not be any diminution in the right of participants and those advocating for them to appeal to the AAT and IA itself should be reviewable.

Submission from National Disability Services

Our concerns with the planned changes include (but are not limited to):

Concerns about the way assessments will be carried out:

• Assessments will be carried out by outsourced private contractors using standardised tools in as little as three hours. Assessors will not be known to the person. As a result, it will be difficult to capture individual complexity or build a comprehensive and accurate picture of people’s needs and circumstances.
• Developing a complete and accurate understanding of the functional abilities of people with “invisible” or complex disabilities requires specialised skills and experience. We are not confident that the planned model takes this into account.
• People with disability from a Culturally or Linguistically Diverse (CALD) background, LGBTIQA people with disability, as well as First Nations applicants and participants also require specialised expertise and cultural competence from assessors. Again, we are not confident that the proposed model adequately addresses their needs in a culturally safe way.
• The results of the assessment cannot be challenged or appealed. In fact, people will not be given a copy of the full assessment report unless they apply to see it.
• These assessments are not genuinely independent but performed by an organisation/organisations contracted by the NDIA, creating a conflict of interest.
• Requiring people with disability to work with someone unknown to them will be difficult, even damaging, to those who have a history of trauma, abuse or violence.
• While a small number of people will be granted an exemption, it is not clear who or how this will occur.
• Once an assessment has started, risks may become clear and trauma may

occur. This may not have been obvious when the assessment started. It is not clear if or how support will then be provided.

• The process relies on additional people taking part in the assessment, such as a family member or carer. For some adults with a disability, this is not appropriate. Others may have no-one in their lives who can give accurate, reliable or independent information.
• The proposed use of telehealth facilities to undertake assessments with Participants in rural and remote areas may make it difficult for some people with disability to fully participate.

Quotes from forum attendees

redacted Needs to be published, that with the information assessments required, need to prior be reviewable to the assessment being held.

redacted Why, if you have your own assessments and reports, is this new assessment given more weight than reports from trusted therapists who know us well? This seems like a violation of our rights and places vulnerable people directly in harm’s way.

redacted What can you do if after seeing your Assessment and there are many items that are wrong? It appears nothing, this is totally not right and this goes against a basic human right!.

redacted Someone needs to be able to give feedback if they feel their assessor didn’t understand their condition.

redacted You need to listen to the participants, it’s their life!

redacted How many families will have the ability or resources to fight for a second assessment if the first one is incorrect and results in a poorly funded plan? They will be using those resources to support that person in place of funded supports.

3. Concerns that the Independent Assessments are mandatory.

Forum attendees felt that Independent Assessments should not be a mandatory process, particularly when a person’s disability, capacity or conditions were stable. They also told us that they believe that people who had no appropriate informal supports to assist them, were most at risk of being removed from the scheme or receiving plans not appropriate for their support needs.

Supporting Evidence for Community Concerns:

Submission from Villamanta Disability Rights Legal Service Inc:

Exemptions from Independent Assessments – as noted, the Tune Review recommended discretionary assessments, however, the proposed process would

make such assessments mandatory. The NDIA then proposes a process by which certain individuals can seek an exemption.

A discretionary assessment serves as a potential mechanism for individuals who cannot afford evidence of functional impairment to be assisted to access the scheme, it assists the disadvantaged and seeks to address issues of inequality.

In contrast, a mandatory process, under which those who are at risk form the process or for whom there are no informal supports to assist them can request an exemption, creates further inequality. The exemption process itself is inequitable as it requires those individuals who are most at risk, with the fewest supports and least capacity to do so, to undergo the highest level of interaction just to justify an exemption.

Even where individuals are able to request an exemption, under the proposed process it can be refused. The refusal is not a reviewable decision, leaving no appeal rights for those unwilling to subject themselves to a process they believe will be harmful. Again, an exemption process imposes the greatest burden on those individuals least likely to be able to cope with it and in itself has potential to do harm and cause undue stress. It is evident from the Tune Review and the Joint Standing Committee reports into the NDIS that many participants already experience high levels of stress, uncertainty and inconsistent decision making when interacting with the NDIA. There are a variety of potential alternative discretionary processes for Independent Assessments that should be explored first as part of a codesign process with people with disability and disability representative organisations instead of resorting to a mandatory exemption model.

Quotes from forum attendees:

redacted I think people should be able to opt out if they have already collected ample evidence of their own.

redacted I have a huge concern about the comment that an individual who does not qualify for an exemption will be considered to be withdrawing if they don’t do the assessment. This means people are forced to do this and that’s hugely traumatising.

redacted The proposal of the IAs is subverting the proper deference to us as the experts in our lives, it subverts us by asking us to submit to deficit-based assessments with strangers, it is not trauma-safe but further, it perpetuates the basic ableism where we are presumed to need another to validate us. I think that if we aspire to have fully fledged, independent lives then this cannot go through as compulsory.

4. Concerns about the process of the Independent Assessments.

During both forums, attendees told us that they had concerns about the process of how the assessments would be conducted. They told us that:

• The person should be visited multiple times in a number of areas, not just in their home where they were comfortable and might not demonstrate all the ways they need support.

• Simply asking a person whether they could complete certain tasks would not give a true picture of all the supports a person might need to complete said tasks.
• Not being able to provide feedback before the reports were submitted to the NDIA was unfair and potentially dangerous for vulnerable people.
• People were at risk if assessments were completed on a “good day” rather than evidence being gathered over time of both ‘good’ and ‘bad’ days.

Supporting Evidence for Community Concerns:

Submission from Disability Intermediaries Australia:

Making this process accessible will differ for each participant (NDIA, 2020), there are some things that DIA asserts contributes to accessibility. Multiple sessions within different environments are imperative, for example observations at home, in the community and at work. Support needs are likely to vary between environments and this helps to ensure a complete understanding of functional capacity. It is important that a participant clearly understands they can separate observations and an Independent Assessment doesn’t need to happen in one session at one location. Further, people with a disability must have the choice to have a support person in akttendance for all or part of the assessment where there is a pre-existing support relationship. Apart from contributing to transparency and promoting understanding of the participant of the Independent Assessment process, it needs to be understood that in many circumstances it can be difficult to build rapport that would allow for an accurate assessment of functional capacity. If a person with a disability is not comfortable, they will not present naturally and this will impact on an Independent Assessments judgement and ability to accurately assess a participant. This is one of many reasons that the NDIA must implement a review and dispute resolution process, to ensure appropriate mechanism for the Independent Assessment to be challenged and reviewed. Disability Intermediaries Australia Limited NDIA Access and Eligibility with Independent Assessments Paper Submission 15 DIA proposes that a national register of diverse Independent Assessors is established. Participants will find the Independent Assessment process much more accessible if they have access to, or can be supported by, to choose and access, a register of practitioners that can complete an independent assessment. Promoting true choice and control in this part of the process will naturally promote greater success, as a participant feels more in control, comfortable and can direct their choice based on expertise in diagnosis, cultural preferences, gender requirements etc. (Series, 2015).

Submission from Inclusion Australia:

The consultation papers do not detail safeguards for these changes that uphold people’s rights, recognise the risks and protect people with intellectual disability from disadvantage and harm. There is no evidence that NDIS has prioritised safeguards throughout the independent assessment process or understood the vulnerability of people completely reliant on informants, particularly for people who do not have any unpaid people in their lives. The lack of an appeal process profoundly underestimates the probability of unintended outcomes.

More about scheme sustainability than fairness, The Productivity Commission made it clear that the cost of the NDIS to government was NOT the actual cost to the economy. In fact, they said that because the aim of the NDIS was social and economic inclusion for people with disability, the NDIS would not be a cost but a benefit to Australian society and the economy over time. Inclusion Australia is very concerned that the real reasons NDIS wants to make these changes are less about fairness and flexibility and more about keeping costs down. Using independent assessments to push down costs carries risks to individuals, such as homelessness, congregate care and abuse. These, before too long, will create additional cost pressures for the NDIS. Independent assessments used in these ways are not only unfair, dangerous and risk a return to outdated and inhumane practices; they are a false economy and will harm the Scheme itself.

Quotes from forum attendees:

redacted We see no evidence of any mechanism to revisit the assessment with whomever the Assessor organisation is, if the original assessor did not have the required knowledge.

redacted As this is an assessment of function, the delivery needs to be completed in all areas of life of the PWD. If this is not done, then it is not a true assessment of function.

redacted We do not believe there are adequate safeguards in place to make sure assessments will be culturally appropriate? Especially in regional and remote areas.

redacted Will there be an opportunity to speak with the assessor privately (without the participant present) to safeguard the pride and dignity of the participant. We have recently been involved with SAT and have been impressed that automatically an independent person in the department was allocated to us so that family could have a say, which was a great way to prevent having to say “ the reality” in front of the person.

redacted We’ve had a lifetime of assessments already ….. will this be the last one?

redacted What about good and bad days? Our therapists that we work with regularly know what both of these look like. There is no way a person unknown to us can get this information accurately. It just feels like a cost saving measure by the NDIS that will ultimately strip us of the supports we need.

5. Statements regarding the impacts of Independent Assessments

Across the board, attendees at the forum expressed significant concern about the impact of the assessments on themselves and those they support. Most believed that the impacts would be negative in nature and that they would lose the significant gains made over the years as a result of their involvement in the NDIS. Those who were carers also expressed their concerns regarding the sustainability of the support they provided to their loved ones and on their ability to sustain their own levels of employment and wellbeing.

Supporting Evidence for Community Concerns

Submission from Carers Australia:

There is little in the information and consultation papers about the role of carers in relation to independent assessments, or about how carers will be factored into functional assessments. It appears that carers will continue to be included only insofar as they provide informal supports to the person with disability. Carers will not be assessed in their own right; that is, in terms of their capacity to provide care, or in terms of the supports they might need.

Submission from Professor Brue Bonyhady, Executive Chair and Director, Melbourne Disability Institute:

Under IA, the assessment processes will, inevitably, focus on what people with disability cannot do. It is a deficit-based approach. It will inevitably lead to participants and their advocates identifying every impairment in order to increase the likelihood of a sufficient resource allocation. As a result, it could have the unintended consequence of potentially undermining the sustainability of the scheme. It is also likely to generate inequity, as those who are better educated or more knowledgeable about the underlying assumptions of the questions will be more successful in detailing their impairments in a particular way. The proposed introduction of IA represents a totally top-down approach to planning. It begins with a participant’s impairments, rather than their goals and aspirations. It puts people in boxes before they have had a chance to outline what they would like to achieve or the ways in which they hope their lives change. It could mean that aspirations like leaving home or increased independence will need to be traded off against essential supports or that funding to support these activities will be lost if not used. It is also unclear how environmental factors, such as sustainable informal supports (not informal supports) will be included in IA. This is counter to everything that people with disability and their families and carers hoped for in the creation of the NDIS and fundamentally undermines the principles on which it was founded.

Quotes from forum attendees

redacted You will need to provide resources for participants to think longer term, we are used to planning for 1 to 2 years, families may not be prepared to consider longer plans

redacted Do the NDIS realise the anxiety this is causing people?

redacted What scares me is my Dad is 63 in 2 months and slowly deteriorating, how will I know he will be ok? I myself am on the (Autism) spectrum and have extreme anxiety about every interaction I have. Particularly with authority and I don’t think I am going to get a good outcome, because I am going to shut down around strangers.

redacted Last time my nonverbal son had an independent assessment with Centrelink and they realised he couldn’t speak. I said to the assessor you are assessing him not me, so talk to him. I was in there 5 minutes, papers stamped and out of there!

redacted If a person is doing well because they have adequate supports, will the NDIS look to reduce funding/supports, meaning people are at risk of crisis.

redacted It would be good to have clearly stated, the contact details of the assessor and what the process is (at our last NDIS assessment we were told that we couldn’t contact the planner directly).

redacted What is the reason is for this change? It feels like a cost cutting exercise against vulnerable people.

redacted I have three people that I support, the stress factor is incredible. How will they identify any additional supports required if they have not yet met the participant?

redacted I am concerned that the assessors will not have the ability to capture the complexities of the disability. I also believe the participants are at risk because they will have difficulties in understanding the questions being asked. The tools being used are not appropriate for this task!

redacted You are denying us our Humans rights, by not giving us a choice. This system is already very stressful, causing physical and mental reactions. The introduction of this process will only make this worse. It is disgusting that there is no appeal process in place for the Assessments if they are wrong.

redacted The ways the plans are changing it makes me extremely worried about the impact to me being able to continue working. The IA could potentially not give an accurate picture of my daughter’s disability needs. If she does not get the appropriate funding it all falls on me to give her the best quality of life with no funding support. That impacts my ability to work, and I may have to give up my job.

redacted The capacity to review an independent assessment is the only safeguard to ensure people aren’t left in dire situations (not enough funding to cover basic needs) should their assessor not gel with them, they feel too scared or anxious to disclose their actual support needs, they don’t have insight or understanding of their own support needs, the assessor doesn’t understand them well, the assessor has poor skills and little experience.

I am a supporter for someone who is very astute, usually has excellent verbal skills but currently has not and hasn’t showered in over a month, as he doesn’t want to admit he can’t do it. He is too embarrassed to ask support for help with personal care tasks. I didn’t even know until over 18 months of knowing him, as he does not disclose easily and appears so capable. How would an assessor capture that? No time to build rapport or trust.

redacted The same allied health professionals doing the independent assessments… currently doing the functional assessments… both have the same qualifications and professional registrations (including adhering to ethical standards), yet one is considered more valid than the other and only one has a long history of understanding the individual and their capacity. The other Independent Assessor’s sole purpose is to tick boxes… they both have the same conflict in that they’re both being paid by NDIS.

redacted The scheme is returning to a deficit-based model rather than capacity building… which weirdly goes against their insurance principles, and the UN CRPD. Also, over assessment of PwD, their treating professionals will need to do some of these

assessments to develop a baseline to work from - why not use those baseline assessments instead of expecting it to be repeated and costing more money??

redacted What about people with fatigue-based disability - yes, I can wash dishes today… but the effort might stop me from doing anything else except sleep for the next 48hours!

Or yes, I can tie my own shoes, but it takes me an hour which means I have to get up 10 hours before I need to leave home if I don’t have support!!

People with the same diagnosis/ disability don’t have the same support needs, even if their capacity is the same, their goals and lifestyle will be different, necessitating different funding.

redacted The questions I have are regarding the assessment process for individuals with complex intellectual needs who are also living on their own under ILO. It is for most in this situation, a complex situation and is vastly different to people who are living with family or people who have the intellectual capacity to have clear insight into their needs. I think that the questions I have may also be relevant to those living with significant mental health conditions.

I am concerned about the knowledge of the assessors and the brevity of the assessment that seems to be solely done by one person without the input of others, such as a functional assessment done by an OT chosen primarily because they have the relevant knowledge and understand the way the individual person wants to live. I think this could be compared with assessments done for older people who have dementia and if the assessor lacks knowledge and just solely asks the person what they can do and what they need help with, then this is not going to be an accurate reflection due to the lack of insight .

Another concern is, if we aren’t allowed to have a full functional assessment done by a qualified therapist who best suits a person’s needs (in our case this would be an OT), then many things would not be picked up. A good example of this is in our functional assessment an OT went out with our family member and accompanied him whilst they negotiated both busy roads and very quiet roads. The functional assessment showed that our family member has not got the capacity to judge traffic and hence cannot cross anything other than quiet roads safely. Where a person wants to be out and about by themselves, then this has a huge bearing upon what sort of support they will need and indeed on the very location of their home. This cannot ever be picked up in an independent assessment done in an office unless the assessor solely just asks the person or their support person or family this specific question.

I also note that it is stated that it is going to be allied health professionals who are to do the assessments. My worry is that this will not be at all sustainable because there is already a great shortage of allied health professionals as it stands now and that this will be morphed into the future, into inexperienced people fulfilling this vital gatekeeping role.

Conclusion

Valued Lives wishes to acknowledge the generous contribution of disabled people, their families and supporters in WA and elsewhere who have given their input and feedback to the consultation process and this submission. We also acknowledge the contribution of disability service organisations and disability advocacy groups across Australia in the development of this submission.

As a peer led organisation, we strongly support changes to the National Disability Insurance Scheme that will address issues of inequity and barriers to meaningful outcomes to the individuals we work alongside. However, we do not support the proposed changes in their current format and formally request that the National Disability Insurance Agency halt the planned rollout of these changes and begin transparent and meaningful consultation with our community.

We, like so many other organisations across the country, strongly believe in the potential of a mature scheme. We ask the NDIA to go back to the drawing board and would be pleased to assist in an inclusive, evidence-based process to design a scheme that is equitable, consistent and sustainable for all.

References:

1: “An analysis of the NDIA’s proposed approach to Independent Assessments – A response to the National Disability Insurance Agency (NDIA) Consultation” Professor Bruce Bonyhady AM, Executive Chair and Director, Melbourne Disability Institute, February 2021

2: “Consultation Paper: Access and Eligibility Policy with Independent Assessments” Occupational Therapy Australia, February 2021

3: “Submission: Independent Assessment & Planning Policy and Plan Flexibility” National Disability Services, February 2021

4: “Response to Consultation on Proposed NDIS Reforms: Access and Indpependent Assessments” Villamanta Disability Rights Legal Service, February 2021

5: “Access and Eligibility with Independent Assessments Discussion Paper” Disability Intermediaries Australia, February 2021

6: “Submission on Independent Assessments” Inclusion Australia, February 2021

7: “Carers Australia submission to the National Disability Insurance Agency – Consultation papers Access and Eligibility Policy with independent assessments and Planning Policy for Personalised Budgets and Plan Flexibility” Carers Australia, February 2021