Submission on the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024

Name: Julie Smith

Profession: Psychotherapist (PACFA Clinical Reg # 27180) Internationally Certified Equine Interaction Professional - Mental Health

Date: 11th July 2024

Dear Senate Community Affairs Legislation Committee,

I am writing to express my serious concerns about the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024.

As a provider of a mental health service to a number of participants with a range of disabilities, i believe this Bill could have a detrimental impact on the lives of people with disability and undermine the original intent of the NDIS. I am also fearful lives will be lost.

Many of our clients come to us as a “last resort” after struggling with traditional room based therapies. They are not thriving and their capacity is low. By incorporating animals and nature many animal based therapies are able to provide goal-directed programs designed to support people with intellectual, physical, sensory, cognitive and psychosocial health conditions. Services are directed and/or delivered by a practitioner with specialized expertise within the scope of practice of their profession.

Our therapy is provided by trained and registered providers with the Psychotherapy and Counselling Federation of Australia (PACFA) and the Australian Counselling Association (ACA). Our animals are not “registered assistance animals” as there is no such registration for horses. However, our horses are trained by a professional weekly and assessed daily for suitability to work with clients. Our team have trained extensively with incorporating horses into our therapeutic work including international trainings to the USA and Europe to always provide the best care for all our clients.

Mental Health Treatment Plans are funded via Medicare and the primary goal is to provide “clinical treatment of clinically diagnosed mental health disorders” (Reference: Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS (Better Access). The conditions classified as mental disorders for the purposes of these services are informed by the World Health Organisation, 1996, Diagnostic and Management Guidelines for Mental Disorders in Primary Care: ICD-10 Chapter V Primary Care Version. Autism, ADHD and psychosocial disabilities are not included in this list.

It has been documented that “The NDIS will be responsible for supports that are not clinical in

nature and that focus on a person’s functional ability…. including supports to undertake activities of daily living and participation in the community and social and economic life.” (Reference: National Disability Insurance Scheme (supports for Participants) Rules 2013).

The clients we have supported vary yet all have been positively impacted by attending our Animal and Nature based programs. They are able to learn emotional regulation, tools that they can use at home and build their confidence which then translates to their everyday life and increasing their functional capacity in the outside world.

I am particularly worried about the following aspects of the Bill:

• The shift from ‘reasonable and necessary supports’ to ‘reasonable and necessary budgets’. I fear this change could lead to arbitrary limits on the supports people can access, rather than focusing on what each individual actually needs to live an ordinary life by their standards not by what is outlined by narrow majority.

• The tighter definition of what supports the NDIS will fund. I am concerned this definition is way too narrow and will exclude vital supports that people with disability rely on to participate in the community and pursue their goals. Often the supports that can have a big difference are ones that are not black and white.

• The increased powers for the NDIA to require people to undergo assessments or provide information, with the threat of plans being suspended or revoked for non-compliance. This fails to recognise the many barriers people with disability can face in engaging with bureaucratic processes, especially if they are experiencing a crisis or have complex needs. I have personally watched a number of clients be confined to their house due to external factors outside of their control. Without the help and support from their Care Teams (which include Support Coordinators, Support Workers, Registered Therapists and other Allied Health professionals), they would have disengaged from life and fallen through the cracks of society. They needed their Care Teams to support them in times of crisis with simple tasks that an able person takes for granted, such as getting food to eat.

• The provisions that allow the NDIA to prevent a person from self-managing their funding if they have made mistakes in the past.

  This seems to go against the principle of choice and control that is central to the NDIS.

• Recommendations Liaise with Animal Therapies Ltd (ATL) is the national peak body for the animal- assisted services sector. ATL represents a range of professionals and practitioners

Submission from Julie Smith

who work alongside animals as a key part of their service delivery. The type of service being delivered depends on the qualification of the person delivering it and includes fully insured psychologists, psychotherapists, occupational therapists, counsellors, speech therapists, teachers, educators and others working within the scope of their qualifications.

Liaising with ATL will allow for a greater understanding of how people are qualified and how the work they do is vital for the disability sector.

I am currently supporting a young person who has a range of diagnosis that was not safe in her own home and we have been helping her build capacity to try to access NDIS. This has nearly taken a year as she has not had the functional capacity to get all the reports, and go through all the processes that are required. She has been hospitalised for eating disorder as well as other mental health concerns. When she is having a depressive episode she can’t get out of bed and self-care is not a priority. She can go weeks without a shower and sometimes days without food. Someone like this deserves to lead a normal life but due to her circumstances requires support to make that happen.

Overall, I am deeply worried that this Bill represents a shift away from the original vision of the NDIS - to give people with disability choice and control over the supports they need to live, what they deem an ordinary life. It seems more focused on cutting costs than on improving outcomes for people with disability.

I strongly urge the Committee to recommend significant changes to this Bill. At a minimum, there must be thorough consultation with people with disability and our representative organisations to ensure any reforms genuinely meet the needs of the people the NDIS is intended to support.

The NDIS is too important to get wrong. We must take the time to get this right, with people with disability at the centre of the process.

Thank you for considering my submission. I do hope the Committee will take all submissions seriously in preparing its report. I would be happy to provide further information to the Committee if required.

Yours sincerely,

Julie Smith Psychotherapist (PACFA Clinical Reg # 27180) Certified Equine Interaction Professional - Mental Health