Submission regarding the Proposed Changes to the National Disability Insurance Scheme
to whom it may concern,
i am writing regarding the proposed changes to the scheme as outlined in the following consultation papers:
- Access and Eligibility policy with Independent Assessments
- Planning Policy for Personalised Budgets and Plan Flexibility
the views expressed here today are my own, and reflect my personal thoughts and experience. i am the mother of a young man with a disability, and supporters of others in my community. I am also a person with a disability.
i have also been part of the disability sector in a professional capacity for more than 17 years. during this time i have witnessed, and supported the enormous change that the introduction of the ndis has brought to the disability landscape in our country. we, as australians, were world leaders in the introduction of meaningful change that enabled participants to finally gain access to the supports and services they need to live a life of their choosing.
at least, that was the case when we as a nation embarked on this journey in 2013. Today, the same cannot be said, despite the assurances of the minister and current and previous ceo’s of the national disability insurance agency.
in recent times the federal government and the ndia have made much of the information presented in the tune review and the productivity commision reports, in particular the recommendation for independent assessments. however, the tune review clearly states that:
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- This change in approach will require extensive consultation with participants, the disability sector, service providers and the NDIA workforce. fundamentally, however, the success of the program will largely be dependent on: a. The willingness of prospective participants and participants to work with ndia approved functional assessors b. Those assessors providing truly independent functional capacity assessments, so they are not perceived as agents of the ndia or a tool designed to cut supports from participants.
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- The NDIS Act should be amended to support the use of functional capacity assessments as proposed above. However, there are a number of key protections that need to be embedded as this approach rolls out, including: a. Participants having the right to choose which ndia-approved provider in their area undertakes the functional capacity assessment b. Participants having the right to challenge the results of the functional capacity assessment, including the ability to undertake a second assessment or seek some form of arbitration if, for whatever reason, they are unsatisfied with the assessment c. The ndia-approved providers being subject to uniform accreditation requirements that are designed and implemented jointly by the ndia and appropriate disability representative organisations
d. The NDIA providing clear and accessible publicly available information, including on the NDIS website, on the functional capacity assessments being used by the NDIA and the available panel of providers.
The consultation paper released by the NDIA and subsequent community engagement sessions have clearly shown that the assessments will be mandatory, non reviewable and conducted by an organisation contracted and funded by the NDIA.
I firmly believe that the contracting of these organisations by the NDIA cements them as agents of the NDIA in much the same way as the Partners in the Community program does, and that their ability to operate independently is significantly compromised as they are reliant on funding from the agency and paid on a volume basis. Furthermore, I believe the awarding of the contracts, prior to the completion of the pilots and community consultation warrants investigation. There is evidence that a number of the companies awarded the contract are subsidiaries of larger companies, who acquired these organization within the last 18 months. Additionally, two of the parent companies are operating in redacted or had prior knowledge of redacted this program becoming part of the NDIS landscape. How can we, as participants and families be satisfied that these assessments truly are independent?
Secondly, the Agency has stated that the assessments will be mandatory, and not reviewable. I believe this is a violation of the rights of disabled people under the United Nations Convention on the Rights of Persons with a Disability. Specifically principle 1: Respect for inherent dignity, individual autonomy including the freedom to make one’s own choices, and independence of persons. In current practice, it often is only through multiple conversations, revisions and appointments that quality, accurate assessments and reports are completed. The proposal put forward by the Agency does not accommodate this, and the removal of any right to appeal eliminates any safeguards for the participants.
The Committee will no doubt receive numerous submissions from the various peak bodies of Allied Health providers as to the accuracy, and safety of the provision of assessments from individuals unknown to the participant. There are grave concerns about the methodology and practice of completing these assessments, and in their current detailed form, I believe the conduction of these assessments will place many of the Allied Health professionals at risk of being in breach of their professional codes of conduct.
Furthermore, the Agency has provided no information as to how participants: will be matched with the appropriate professional with the skills and knowledge to complete the assessment will receive an accurate assessment when they have multiple, or more complex disabilities who normally require multiple therapists to build a picture of their support needs can now receive the same level of accuracy when an assessment is conducted by one individual, unknown to them, and without specialist knowledge of their disability. Current Proposed Assessment Tools
The Agency has not provided any transparent information as to how the proposed assessment tools will be used to develop a personalised budget for participants. In fact, these tools were never designed for this use, and any adjustments made to them will eliminate their validity. Furthermore, there is an assessment that is designed for this purpose, the I-CAN (V6) that would provide an accurate picture of the support needs of individuals, is fit for purpose and widely accepted by the
Independent Assessments Submission 307 - Attachment 1
The Allied Health community. Yet the agency has chosen not to use this assessment, and one would ask the question – is this because the agency fears that, should participants have access to a purpose- buit, industry standard tool, their plans are likely to be funded in a way which more accurately meets their needs?
Professor Bruce Bonyhady, widely known as the original architect of the scheme notes in his submission entitled “An analysis of the NDIA’s proposed approach to independent assessments – A response to the National Disability Insurance Agency (NDIA) Consultation” that:
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 or 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 acurate 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.
Again, I believe the Committee will receive multiple submissions from Allied Health governing bodies outlining their concerns regarding the current proposed use of these tools.
Community Consultations
The report released on 26th of March by the NDIA regarding community consultations, the agency outlined the various methods by which they had engaged in community consultations. I personally arrended multiple sessions, including one that was externally conducted via the Participant First Engagement team. The sessions I attended were delivered in an online format.
it is my experience that the Agency did NOT conduct genuine feedback and consultation sessions, as much of the information that was presented to attendees was done so as non-negotiable, or already determined. More than once attendees were told to “make a submission”, their concerns glossed over or ignored. Additionally, the Agency has not been clear in the use of language during these sessions. For example, the question “how can we assure participants that their plan budgets are at the right level?” Should the Agency not be focussing on ensuring accuracy, rather than trying to convince us to accept what we are given?
Secondly, i question the validity and intent of these consultation sessions, given that the tenders for those process, and subsequent awarding of those tenders took place prior to the closing of the inquiry period. Myself, and most of my community, have no faith that the Agency has any intention to consider our safety, wellbeing or voice in this matter, given these actions.
Impact of Proposed Changes
i, and many of my peers, firmly believe that the introduction of changes in their current format will have a hugely detrimental effect on lives of people with disability throughout Australia. They are clearly designed to cut costs, and eliminate participants from scheme.
Independent Assessments Submission 307 - Attachment 1
The risk of losing any of the gains they have made under the scheme, and of falling back to reliance on state based schemes, many of which are now grossly underfunded or non existent.
The threat is real; people will die as a result of removal from the scheme, or insufficient funding of the required supports. In fact, the impacts of the proposed changes are already being felt across the community. We are seeing ourselves once again pushed into the category of ‘leaners’ not ‘lifters’, of rorting the systems, taking more than we need.
My family is at significant risk of losing any gains we have made over the past three years since our son gained access to the scheme. He is likely to fall into the category of those for whom access will be revoked. Not because of the impact of his disability, which is significant. Not because he has reached those lofty insurance-based principles of no longer needing supports, because he hasn’t. But simply because, after a lifetime of bullying and abuse experienced in education, social and workplace settings, he has learnt to hide the impact of his disabilities. He will acquiesce. He will tell you he’s ok.
He will mask in order to survive.
What an assessor will see in a one off visit is a young man who has friends, is attending school, and working a small amount of hours.
What an assessor will not see in a one off visit, is the hours it takes for him to build trust with friends, workplaces, school and providers; not just once but repeatedly.
What an assessor will not see is that he is underemployed due to the struggles he has navigating the workplace and experiencing workplace bullying.
What an assessor will not see are the hours of informal support provided at home to help him manage his daily life and emotions.
What an assessor will not see is the cumulative trauma experienced through a lifetime of rejection by society, and the narrative that he is somehow less than his peers.
And why should they? Isn’t this the point of the scheme: To celebrate what he can do, has achieved, and is striving for? Why is he, and many others like him, at risk of having to once again present themselves as less than, as pitiable and helpless just to receive the supports they need to survive? Where in these proposed changes is there commentary about provision of supports to maintain success? Why should he be subjected to this flagrant breach of his human rights?
This is a narrative further perpetrated by the Minister, Stuart Robert, in multiple interviews in mainstream media. He has used inflammatory half-truths to convince the wider public that these changes are necessary to protect taxpayer funds, but the examples he has used – such as the purchasing of yachts and sex workers (prostitutes) - are simply false and easily dismissed with the slightest investigation.
He should be sanctioned for the manner in which he has portrayed some of the most vulnerable people in our country; and I also believe he has allowed his religious beliefs to permeate his Ministerial activities, to the detriment of many.
Further consideration should be made to the wider impact of these changes on informal support networks of disabled people. If inadequate supports are built around an individual, parents’ and carers’ ability to continue working will be significantly impacted. In my professional life, I will lose approximately 50% of my staff if they or their loved ones are forced to change their work due to
Submission from Inclusion Australia
The submission from Inclusion Australia entitled “Inclusion Australia submission on NDIS Independent Assessments February 2021” stated:
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 is 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.
“If the process is to save money, then I fear the pool of support agencies prepared to take on high support needs clients will diminish and drive a move to the reinstitutionalisation of this population.” Trevor R Parmenter AM |Professor Emeritus |Sydney Medical School | Faculty of Medicine and Health | University of Sydney
I believe that the introduction of the changes in their current proposed format will have significant detrimental effect on people working within the sector, such as support workers and staff within service provider organisations. There will also be a detrimental affect on the ability of disabled people to access employment opportunities. For example, in the Microenterprise and Customised employment space, we have repeatedly seen participants lose access to the reasonable and necessary supports they need due to inadequate conversion of therapy reports into support budgets. This has resulted in loss of support to run small businesses, to continue in employment and loss of social and community participation opportunities facilitated through microenterprise development.
Working Together to Move Forward
Myself, and many others agree that significant work needs to be done to improve equity within this scheme. We agree that in some areas, standardised decision making will be hugely beneficial.
None of us are opposed to making our scheme fairer or clearer. All we are asking is that we are included in the design and delivery of any changes. And not tokenistically as has happened here.
Meaningfully. Transparently. Equally.
Many of us believe that, done well, Independent Assessments could have a hugely positive impact on the scheme. But the reality is, these changes are not going to deliver any of the stated outcomes.
Instead, they will eliminate any safeguards we have that protect our human rights, and place large numbers of us in danger. They will deliver large chunks of taxpayers funds directly into the hands of corporations ill equipped to work with people with disability.
Lets Go Back To The Drawing Board
Pursue delivery on the promise of a world class National Disability Insurance Scheme (NDIS), which should be accessible to all Australian citizens.