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ARATA Response to Inquiry into National Disability Insurance Scheme Amendment Bill

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The Australian Rehabilitation and Assistive

Technology Association (ARATA) Response to the Community Affairs Legislation Committee Inquiry into the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024

17th May 2024

Prepared by

arata participation through technology

The Australian Rehabilitation and Assistive Technology Association (ARATA)

ARATA would like to acknowledge and thank the many ARATA members who contributed their knowledge and experience to inform this submission.

1 | Page ARATA submission to the Community Affairs Legislation Committee Inquiry

Table of Contents

  1. Background on the Australian Rehabilitation & Assistive Technology Association …………………….. 3

  2. ARATA’s Contribution to Advisory Input to the National Disability Insurance Agency ……………….. 3

  3. ARATA’s Preparation For This Response ……………………………………………………………………………………… 4

  4. Summary of ARATA’s Key Recommendations to the Community Affairs Legislation Committee Inquiry into the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024 ………………………………………………..…………………………………..…. 5

  5. Detailed Response from ARATA to the Community Affairs Legislation Committee Inquiry, Linked to Our Key Recommendations .…………………………………………………………………………………………………….. 6

2 | Page ARATA submission to the Community Affais Legislation Committee Inquiry

Background on the Australian Rehabilitation and Assistive Technology Association

The Australian Rehabilita7on and Assis7ve Technology Associa7on (ARATA) is the na7onal non-profit peak body represen7ng assis7ve technology stakeholders. ARATA works to advance access to rehabilita7on and assis7ve technologies, and promote prac7ces that ensure posi7ve outcomes from their use for people of all abili7es. ARATA includes a membership of both Na7onal Disability Insurance Scheme (NDIS) par7cipants and NDIS providers, as well as other assis7ve technology (AT) stakeholders across all experiences of individual AT use, the provision of AT advice (e.g. via health professionals), AT supply, product development, and AT research and educa7on in Australia and interna7onally. ARATA is run by a voluntary Board of Management that includes both NDIS par7cipants and NDIS providers. For details, including our cons7tu7on, see h8ps://www.arata.org.au/about-ARATA/mission/

ARATA provides a na7onal forum for informa7on sharing and liaison between people who are involved with the use, selec7on, customisa7on, supply, research and ongoing support of rehabilita7on and assis7ve technologies. Our Associa7on promotes, develops, and supports the na7onal rehabilita7on and assis7ve technology community of prac7ce as well as contribu7ng as a founding organisa7on to the Global Alliance of Assis7ve Technology Organiza7ons (GAATO) [1]. Through its membership, ARATA represents the interests and opinions of the full range of assis7ve technology stakeholders in Australia. ARATA advocates that roles for all AT stakeholders must be considered, centred around the goals and needs of people who use AT in their own lives, and their informal supporters – including family members – who may engage with the NDIS.

ARATA has made several previous submissions to the Australian Government regarding the NDIS, and invested in strategic projects to inform the Scheme development and enhance an effec7ve AT ecosystem. For a full list of previous submissions – see h8p://www.arata.org.au/educa7ion-resources/publica7ions/

2. ARATA’s Contribution to Advisory Input to the National Disability Insurance Agency

ARATA consults directly both via our Voluntary Board of Directors, as well as through the voice of shared membership of ARATA, with the NDIS Assis7ve Technology Market Policy & Innova7on,

Market Innovation & Employment Branch

and the Home and Living Branch within which NDIS- funded home modifications now site, at the National Disability Insurance Agency (NDIA). Members of our Board sit on various NDIS advisory committees. The ARATA President, Board and Strategic Executive Advisor liaises regularly with the NDIS Assistive Technology & Home Modification Teams. Both our Board and Members contribute to formal consultations and advisory committees convened by the Department of Social Services and/or the NDIA relating to the NDIS. ARATA also provides ad hoc information and commentary on drafted AT and/or home modifications guidance developed by the Agency as requested. This frequent and iterative engagement with a consistent team from the NDIA ensures timely AT sector consultation via the Board of ARATA and its diverse membership base, inclusive of both NDIS participants and NDIS providers as well as other AT stakeholders.

  1. ARATA’s Preparation For This Response The following response is being submitted as part of the Community Affairs Legislation Committee Inquiry into the draft Bill. Specifically, the Committee has asked for views in relation to the proposed changes within the Bill. ARATA welcomes the opportunity to make this response and - in preparing it - we reviewed both the copy of the Bill, as well as the bill’s Explanatory Memorandum, which explains the Bill further. After the release of the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024 (referred to from here as ‘the Bill’) on 27th March 2024, ARATA’s Strategic Executive Advisor joined an online discussion with the CEO of the NDIA on that same day as ARATA is a member of the NDIS Industry Chief Executive Advisory Group. Our President and Strategic Executive Advisor also attended a webinar with the Department of Social Services on 4th April 2024. ARATA raised some early questions about this draft Bill with the Department of Social Services via email, particularly in relation to the lack of capacity to appeal an NDIS plan budget (this matter has been further highlighted in our response below). ARATA also convened a meeting of National Assistive Technology Alliance member organisations$ (for which ARATA provides a chairperson and Alliance administration) to discuss the draft Bill and Explanatory Memorandum, including shared

$ https://www.arata.org.au/access-&-funding/towards-a-national-assistive-technology-alliance/

perspec7ves and key points of difference. Finally, the ARATA Board and members also discussed this

drah Bill and Explanatory Memorandum.

More broadly, ARATA has undertaken member consultation, contributed written submissions, and presented at Senate and other Government Inquiries over many years now. This includes

contributions regarding general issues relating to the NDIS, proposed reforms and how they will impact both NDIS participant experiences and outcomes, as well as the provider market2. We

strongly encourage the Committee to refer back to recommendations made in our past submissions (some of which have also been referenced in the current submission), as well as the final reporting

from these various inquiries.

  1. Summary of ARATA’s Key Recommendations to the Community Affairs

Legislation Committee Inquiry into the National Disability Insurance Scheme

Amendment (Getting the NDIS Back on Track No. 1) Bill 2024

Below is a summary of ARATA’s key recommendations relating to the draft Bill and Explanatory Memorandum, which is followed by more detailed discussion of each recommendation (provided in Section 5 on page 6 of this response):

  • ARATA holds concerns about the transparency of various processes outlined, and proposes further clarity is required, in the Bill
  • The sector needs more detail about and revision of existing Bill drafting on the assessment process and planning framework
  • More detail on NDIS Budget setting, and appeal processes, is required
  • Evidence gaps exist to inform decision making on evidence-based support
  • Decision making regarding the streaming of NDIS participant ‘classes’ requires clarification in the Bill
  • The reliance in the Bill on use of ‘foundational supports’ as an alternative to NDIS-funded supports is problematic
  • People aged over 65 years of age who are NDIS participants need to be in focus
  • What constitutes an NDIS support, as listed in the Bill, is too narrow.

2 h#ps://www.arata.org.au/educa8on-resources/publica8ons/ 5 | P a g e ARATA submission to the Community Affairs Legisla7on Commi8ee Inquiry

Our response relating to each of these key recommendations will now be detailed in Section 5.

5. Detailed Response from ARATA to the Community Affairs Legislation Committee Inquiry, Linked to Our Key Recommendations

  • ARATA holds concerns about the transparency of various processes outlined, and proposes further clarity is required, in the Bill

This includes the powers the draft Bill which enable the CEO specific to restricting or declining funding. The lack of capacity to appeal a plan budget set was an issue ARATA has already addressed in writing directly with the Department of Social Services, and remains a concern in the current draft Bill. As it stands, the draft Bill appears to further limit access to right of review for NDIS participants. It is ARATA’s view that this further limitation should be addressed via Bill revision.

  • The sector needs more detail about and revision of existing Bill drafting on the assessment process and planning framework:

ARATA endorses the posi7on that NDIS access and planning processes must be fair and equitable for all Scheme applicants and par7cipants, regardless of individual circumstances. The assessment process referred to in the Bill however appears to align with the Independent Assessment processes detailed in the past, which ARATA – and many other stakeholders – provided extensive feedback on in previous submissions3,4,5. There is a lack of clarity in the Bill currently regarding how the new proposed assessment process will inform NDIS budget setting and what instrumentation will be used for budget setting, even though budget setting (both flexible and stated budgets) are strongly in focus in the Bill.

  • More detail on NDIS Budget setting, and appeal processes, is required:

ARATA has previously documented in various Government submissions the issue with variability in NDIS planners’ skills to undertake wholistic planning with Scheme participants6,7 – it can be for this

reason that NDIS plans and/or budgets are not structured to effectively meet the goals and needs of a participant, and thus require review. Limiting this right of review will pose risks to both NDIS

participant outcomes, and Scheme effectiveness.

  • Evidence gaps exist to inform decision making on evidence-based supports:

The Bill references that the Scheme will only invest in evidence-based supports; however, it there

has been a significant under-investment in disability research over decades which means that evidence gaps do exist. A blanket decline of funding of supports for NDIS participants where there is

only limited published evidence in the past (e.g. assistance animals, beyond vision guide dogs) has

led to restricted options for effective supports.

  • Decision making regarding the streaming of NDIS participant ‘classes’ requires clarification in the

Bill:

The draft Bill introduces a new terminology of participant ‘classes’, but this terminology is not defined. In the draft Bill, there is a focus on streaming of ‘classes’ of participants into an early

intervention pathway and ARATA anticipates this may primarily be children under 9 years of age, as well as people of all ages who experience psychosocial disability. There is a lack of transparency

currently about which ‘NDIS participant classes’ are in focus, and this requires clarification. If ARATA’s assumptions are correct, this streaming of these two participant cohorts into early

intervention may impact both NDIS participant outcomes and Scheme impacts, given that some of these people will have ongoing significant and permanent disability (and therefore associated

support goals and needs) across the domains of core, capital and capacity building supports and

thus would benefit from Scheme entry.

  • The reliance in the Bill on use of ‘foundational supports’ as an alternative to NDIS-funded supports is problematic:

The draft Bill refers to use of ‘foundational supports’ as an alternative to NDIS-funded supports. At this point in time, however, foundational supports that exist in the community for people with

disability and their families to access have been significantly depleted as States have disinvested from foundational supports for people with disability (e.g. as an example in the area of assistive

technology noted previously by ARATA in government submissions, there have been closures of all state-based Independent Living Centres that used to offer independent assistive technology product and service advice8). Following, new information, linkage and capacity building initiatives like assistive technology peer-mentoring have no funding sources currently, and ARATA has written to government about this previously9.

Existing state-based disability resources have been directed via bilateral agreements into the NDIS.

This focus in the draft Bill on foundational supports is viewed as a risk given these types of supports are currently limited or - in some areas or for some NDIS participants - do not exist.

  • People aged over 65 years of age who are NDIS participants need to be in focus:

The issue of equity of support for NDIS participants with significant and permanent disability aged over 65 years, inclusive of those NDIS participants who are ageing into older adulthood with

disability after Scheme entry, remains an issue and is not considered in the current Bill. Some member organisational experiences that these people are being encouraged to move off the Scheme when they reach the age of 65 years, and this is inequitable. Any revisions to the Bill should clarify the capacity for continuity of NDIS supports (or otherwise) once a person reaches 65 years of

redacted h#ps://www.arata.org.au/public/33/files/Publica8ons/ARATA%20Response%20to%20NDIS%20RFI%20SPC1263%20Early %20Childhood%20AT%20Approach%20submission%20SUBMITTED.pdf redacted h#ps://www.arata.org.au/public/33/files/Publica8ons/NATA%20JSC%20General%20Issues%20submission%20SUBMITTE D%20APRIL%202022%20FINAL.pdf

More broadly, ARATA has supported work to examine AT equity in Australia, including for those people aged over 65 years who do not get NDIS access10.

  • What constitutes a support that can be funded by the NDIS, as listed in the draft Bill, is too narrow:

Whilst ARATA agrees that NDIS participants and providers will benefit from the provision of clear guidance on what supports can be accessed through the NDIS, the draft Bill and Explanatory Memorandum outlines a narrow list of what will now be deemed to constitute an NDIS-funded support. Specific to assistive technology, this list does not address all the classes of assistive products that a Scheme participant may require to address their identified goals and disability-related support needs. Whilst the draft states the Government aims to “allow NDIS rules to be made that narrow the scope of these constitutionally valid supports to those that are appropriately funded by the NDIS” the current draft Bill risks impacting NDIS participant outcomes that can be achieved, unless this section of the Bill is revised and expanded.

The current draft of excluded items – including a blanket reference to exclusion of ‘household appliances and whitegoods’ – also does not overlay cultural safety for Aboriginal and Torres Strait Islander NDIS participants, or consideration of remote and very remote issues that link directly to NDIS participants’ disability-related support needs11. More consideration of cultural safety, and how the Bill may support or impact that – particularly for Indigenous Scheme participants – will require close consideration and community consultation.

In conclusion, ARATA appreciates the opportunity to provide this submission. We invite the Committee to contact our Association if further information is required, using the contact details listed below.

Associate Professor Libby Callaway Strategic Executive Advisor The Australian Rehabilitation and Assistive Technology Association (ARATA) Phone: Email:

10 h#ps://www.arata.org.au/public/33/files/Publica8ons/2022%20AT%20Equity%20Studies%20Report%20(revised).pdf 11 h#ps://www.ilaustralia.org.au/docs/default-source/research-and-projects/2024-liveup-be#er-prac8ce-guide-for-culturally-safe-informa8on-about-assis8ve-products-final.pdf?sfvrsn=6371d2cd_1 9 | P a g e ARATA submission to the Community Affairs Legisla7ion Commi8ee Inquiry