Independent Assessments

Submission 348

to whom it may concern,

i want to relate a story of a planning meeting i attended with a client. This was a rollover from the\current plan with the disability services WA to NDIS as part of the integration of WA into the\national scheme. The meeting was with a contracted LAC as the client had a long standing\relationship with a current funding allowance. We were asking for more support to engage with the\community and attend training. The client had an established and well defined cognitive\impairment.

the lac asked the questions off the list without any attempt to define it or allow for the client to\provide information that provided real insight into her needs.. If I wasn’t there to prompt better\questions or follow up questions I doubt the client would have received any funding at all. I was able\to do this because we knew the client and knew the difference between her outward appearance of\competence to her actual needs.\two examples that stand out most clearly which I will attempt to repeat if not verbatim at least close
to the actual conversation: lac: do you have any trouble managing and budgeting
cient: oh no, im really good with my money and dont overspend \me: How much of your income do you keep to spend and how much do you give to your mother
cient: oh she gets most of it and i get to spend and budget with $20 per fortnight \ me: Who pays the rest of your bills then? \ cient: oh mum does and if i need extra for something we go and buy it together. Please note the original answer implied a competency that the client just did not have and would have provided an incorrect assessment about the clients ability. It was only because we had a good knowledge of the client’s actual situation due to having worked closely with her and her family for over 2 years that we were able to provide that extra insight.

lac: do you have any trouble getting out and about in the community
cient: i get out all the time and go lots of places
ac: Have you any problems taking public transport
cient: i prefer not to but i can take the bus if i need to..\me: it wasnt always like this remember? client: Oh yes I used to be frightened to leave the house even with MUM but working with
sUPPORT WORKER Ive gotten good at it and am looking to maybe do a tafe course \me: Do you go around by yourself?\ncient: oh no id be too frightened if Mum, CASE WORKER or COUSIN didnt come with me . cant
emember which buses to take or how to get places although i do know my way around the local shopping centre without help now.
again, the initial question did not in any way determine the clients actual competency in being able\nto navigate the public transport system or attend appointments or engage with the community without support. The anxiety the client experienced in even just thinking about becoming more independent would not have been determined at all.

These two instances were not the only times I asked supporting questions to flesh out the information the LAC was asking when designing the plan, but they were the most extreme in terms of the difference it made to the final result. The client did in fact gain two more hours a week to be supported to attend TAFE which is all that the client wanted.

Without the knowledge of the client and the fact that her outward appearance did not match her competencies and needs, due to her lack of insight, it would have been doubtful that would have eventuated and in fact would have been likely that the existing funding was reduced.

On a related note please can the Supporting evidence form and/or the Access request form be amended. Section 2.4 in the SEF and the section outlining current treatments in section F of the Access request form are misleading and inadequate. I have been supporting a number of people to try to access the NDIS. They have psycho - social, episodic or complex and co-morbid conditions. Most have had a request for further information and have been resent the SEF up to four times. Attending doctor’s reports are often not sufficient. I have determined that the NAT needs a list of all past and current treatments and if a normal treatment for the condition has not been tried (cortisone injections for Musculoskeletal or CBT for Trauma for example) they also need an outline from their treating professional as to why that was not determined suitable. (allergy to cortisone or CBT was trialled but not efficacious for example) None of this is outlined on the FORM or any guidelines. The very small space on the form gives an impression of brevity that is not reflected in the actual information required. Each condition can be expanded upon in a separate letter but if the Doctor or GP does not end each paragraph with the condition is treated, stabilised and not likely to improve (ending the letter with a blanket statement will not be sufficient) then the request for the SEF will just get sent out again until the participant either gives up in despair or possibly dies of frustration.

The extensive bureaucracy required of this process puts anyone not totally cognizant with the process, or perhaps not able to advocate for themselves fully due to cognitive impairments or CaLD backgrounds, at an almost insurmountable disadvantage.

I understand the need for clear medical input as the assessors are not alway diagnosticians or trained medical professionals, and that puts the agency at a disadvantage if the staff have to make decisions based on their impressions rather than clear guidelines. In fact their risk management is specifically designed to avoid the grey areas.

This is also possibly part of the push to have allied health professionals doing the assessments.

This is also possibly part of the push to have allied health professionals doing the assessments. However, as they too are not diagnosticians and/or medical professionals they will also not be able to make these determinations. If most of these don’t have extensive experience with the types of impairments and their effects on the participants daily life, then the problem of inconsistent and unsatisfactory plans will continue. Outsourcing this problem will lead to more liability, not less, higher levels of appeals, and will not reduce costs in any way. I suggest hiring people with life experience in the assessment and planning teams and providing them with resources, and adequate training, would be a better way to fix the problem.

Regards,