Submission re: “National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track

No. 1) Bill 2024“

11/07/2024

Honourable senators,

I am a regional occupational therapist (OT), registered under Australia Health Practitioner Regulation Agency (AHPRA), who has been practicing for 3 years. Prior to that, I worked regionally as an allied health assistant (AHA) and in administration where I observed the rollout of NDIS regionally and supported participants as their AHA. I am a member of regional and national communities of practice, including the NDIS Occupational Therapy Community of Practice (NDIS OT CoP), which is comprised of over 10,000 OT’s; and a local Paediatric OT Community of Practice is comprised of 81 practicing OT’s. My workplace is made of a small allied health team (predominantly OT’s and Speech Pathologists) and a positive behaviour support team.

Please see the following concerns regarding current and potential risk of harm to NDIS participants and disabled persons seeking to access NDIS support. These concerns have been raised across myself and my colleagues, and OT’s among the communities of practice outlined above. Please consider these when reviewing submissions from 12th July 2024 onwards:

Co-design:

 -  The amendment made on 5th June 2024 require the Minister to have regard to the principle
   of co-design in subsection 4 (9A) of the NDIS Act when making legislative instruments
    establishing: how needs assessments will be conducted; and the method to be used in
    calculating a participant’s budget.

 -   This does not legally require the Minister to co-design these instruments, as the wording of
    this amendment only requires the Minister to ‘have regard to the value of co-design’.

 -    It is recommended that it is further amended to legally require co-design. This means that
   consultation with disabled peoples and disability representative organisations would ensure
   effectiveness from the beginning, and therefore be more effective ongoing and accessible.

The definition of ‘NDIS supports’

• The recent amendment on 5th June 2024 advised that the government will engage with the

disability community to develop rules that define ‘NDIS support’ which aims to ensure that it

is not inappropriately narrow in its terminology.

• It is recommended that evidence of consultation is completed and provided when determining the rules for ‘NDIS support’. Many allied health professionals who support NDIS

participants are familiar with the current and previous ‘reasonable and necessary’ criteria,

which guides decision making in conjunction with each discipline’s clinical expertise and reasoning, while adhering to their ethical and legal guidelines for practice. It is recommended

than the rules for ‘NDIS supports’ adhere to, and align with, a human rights approach to disability equity and justice. This means aligning with policies such as the United Nations Convention on the Rights of Persons with Disabilities.

Needs assessments

• The bill currently proposes that the needs assessment and budget-setting method would be limited to considering needs that stem from impairments that meet the disability or early intervention requirements for entry to the Scheme.

• This is significantly concerning due to the nature of interrelated disabilities and the inability for funding to accurately account for the impairment someone may experience that is compounded or changed by other factors. For example, a person with an autism diagnosis may present with significantly different challenges and disability support needs due to the lack of support for a range of intersections that person experiences (e.g. the person is First Nation Australian, a woman, lives in a remote and rural area). Therefore, this person is likely to require more supports due to a range of non-disability related intersections, however, they cannot be removed from this person, and equitable access to disability support means acknowledging that holistic and comprehensive support is needed.

• It is further proposed that significant consideration and co-design is implemented to support culturally responsive assessments, with both standardised and non-standardised options listed to ensure assessments are equitable for non-white participants. This is strongly

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encouraged due to the significant lack of standardised assessments developed by and for First

Nation Australian and/or CALD persons with disability.

This bill needs significant amendments, and ongoing consultation with disabled communities, individuals and organisations, as well as carers, advocates, disability services and providers, in particular allied health professionals who are held to ethical and best practice standards. Submissions provided by governing bodies and communities of practice should be highly regarded and considered.

Regards,

Marielle Turner Occupational Therapist