NDIA Accountability Project

Concerns regarding independent assessor capacity to understand psychosocial disability

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Coalition for Appropriate Supported Accommodation

for People with Disabilities PO Box 3263 Marrickville Metro NSW 2204 •

SUBMISSION TO THE PARLIAMENTARY INQUIRY INTO INDEPENDENT ASSESSMENTS UNDER THE NDIS

My name is Myree Harris OAM RSJ, convenor of CASA, the Coalition for Appropriate Supported Accommodation for people with disabilities in NSW. CASA has 20 members from disability organisations, NGOs, charities and peak bodies. I was one of the four people who founded it in 1995.

CASA is active in advocacy, especially for residents of what are now called Assisted Boarding Houses in NSW, for people with disabilities. CASA was instrumental in bringing about the $66.23 million ($53 million recurrent) Boarding House Reform Program in 1998. Services provided by this program continued until the NDIS rolled out in 2018. CASA advocated for 17 years for new legislation to replace the YACs Act 1973. The 2012 Boarding Houses Act NSW was the result. A review of the Act is now taking place. CASA also advocates on issues such as homelessness and an increase in social and affordable housing. It promotes the Housing First approach as a means of dending street homelessness.

I am also Public Officer and Coordinator of Gethsemane Community Inc, a community house for a small group of men and women who have mental illness (psychosocial disability). Gethsemane aims to provide four residents with the security of a residential tenancy agreement and a safe and secure home in which they can learn living skills and become independent. Since 1990, Gethsemane Community has been home to over 60 people, 75% of whom went on to independent living.

I would like to address one particular term of reference:

THE APPROPRIATENESS OF INDEPENDENT ASSESSMENTS FOR PEOPLE WITH PARTICULAR DISABILITY TYPES, INCLUDING PSYCHOSOCIAL DISABILITY.

As the live-in voluntary coordinator of Gethsemane Community since 1990 and as a CASA advocate since 1995, I have met many men and women with psychosocial disability. An independent assessor, meeting some of them, may conclude, erroneously, that their disability does not affect their capacity and functioning in society.

  •   is a 48 year old woman who has a lovely smile, a delightful manner, and speaks animatedly. She has lots of ideas about work she would like to do, and activities in which she could be involved. There is no immediate indication of her many psychiatric hospitalisations across NSW and her current large doses of psychotropic medication. Her quite severe short-term memory loss is not immediately apparent. Her lack of ability to self-organise may not be seen. It is only with secure housing that her multiple physical issues could be addressed. Caseworkers had never been able to contact her to make appointments, as she would lose her mobile phone or forget to charge it. Without support she would forget to take medication or think she had already taken it. She has thrived as an NDIS participant, taking courses at Buckingham House, a service for people with mental illness, and going to the beach. Carers keep track of her medical appointments and take her to them. She has re-established some family contacts. I am concerned that an independent assessor may believe that L's disability does not impact on her capacity or function.

  •   is a 55 year old man who has wandered Australia for 20 years, living in caravans. He spent a year street homeless in a Sydney suburb. He has mental illness, intellectual disability and brain damage. None of this is immediately apparent. When interviewed, he maintains he is independent and doesn't need support. However, he would happily stay in

bed all day unless prompted to get up and shower. He is unwilling to buy clothes, despite having substantial savings. He lacks the capacity to plan activities and organise himself to do them. His mental illness has been stabilised by medication prescribed by the local mental health team. His application for NDIS has been made recently. This could provide companionship and encourage him to take part in activities he enjoys such as fishing, going to the beach and riding the ferry to Manly. He could be encouraged to go to Exercise Physiotherapy. A carer could take him to medical appointments. I have some concern that an independent assessor may think ’s disability does not impact on his capacity or function.

CASA has a particular concern for the residents of what are now called Assisted Boarding Houses (ABHs) in NSW. These facilities are for people with disabilities. There is a screening tool to monitor entry so that people with high level needs do not enter inappropriately. The Boarding Houses Act 2012 Part 4 contains·the regulations pertaining to them. The Monitoring and Compliance Team from the Department of Communities and Justice ensures that standards and regulations are met.

  • There are 17 Assisted Boarding Houses, in NSW, accommodating 244 men and women.
  • 203 residents have an NDIS plan.
  • 18 residents have Continuity of Support
  • 23 have neither

In terms of this Parliamentary Inquiry, CASA’s particular concern is for the 203 residents with an NDISplan.

A high percentage of residents of ABHs have psychosocial disability (mental illness). Others have intellectual disability or brain damage. 60% have no family contact. Most have no friends or contacts outside the facility. Most have a history of institutionalisation. Some have been in ABHs (formerly Licensed Boarding Houses) for up to 25 years. Most have little awareness of their needs and even less capacity to articulate them.

Board and lodging at an ABH ranges from 79% to 96% of the Disability Support Pension. As a result, residents have very little personal money. They cannot afford new clothes or shoes. If they smoke, that uses just about all the money they have. They cannot go a movie or to the swimming pool and cannot afford haircuts.

The NDIS has been a lifeline for residents who have a plan. They can go out into the community and enjoy activities we take for granted. They have someone to talk to and with whom they can enjoy activities. They can start to get some idea what life is like outside a boarding house. Some may begin to work towards transitioning to a more independent style of living. They can express concerns safely and privately.

CASA is concerned that an independent assessor may have no idea of the world from which these residents come. Most residents would be unable to answer the questions without the support of an advocate. Though an advocate or support person can be present, I am unsure who will provide this support. People with Disabilities Australia is funded to provide individual advocacy but could not cover all residents who will need this support. If residents lose funding, they return to spending day after day sitting around a backyard. This is no kind of life for anyone, especially people who have experienced poverty, deprivation and social isolation for most of their lives.

ADDRESSING SOME OF THESE ISSUES

  • Request that independent assessors who work with people who have psychosocial disability have experience in this field.

  • Ensure that an individual advocate is available to support a resident of an ABH before any appointment with an independent assessor is made. Make this a requirement for any interview to take place. Ensure that the resident knows the advocate and is known by this person, so that effective representation of the resident’s situation and needs can be made. Ensure that the advocate understands the culture of an Assisted Boarding House and the kind of life the resident experiences there. In preparatory meetings, the advocate could ask the resident what he/she most values from the support and outings with NDIS workers and assist the resident to express what is important to him/her.