NDIA Accountability Project

Impact of NDIS reforms on occupational therapy services

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Driving Well

OCCUPATIONAL THERAPY

12/07/2024

Committee Secretary Department of the Senate PO Box 6100 Parliament House CANBERRA ACT 2600 AUSTRALIA

Dear Committee,

As an employee at Driving Well Occupational Therapy, I am writing to you to express my concern about the planned reforms to the National Disability Insurance Scheme (NDIS), as articulated in The National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024.

As an allied health professional, I ask for your support in making sure proposed reforms do not pass into law. These reforms pose many risks to people with disabilities in Australia. Changes to the NDIS Act, for example, that amend or remove government responsibility to provide access to reasonable and necessary disability supports, will disadvantage many disabled Australians and prove more expensive in the long term as disability needs are neglected.

At a minimum, the primary legislation should be updated to include:

  • A definition of ‘assessment of support need’.
  • Clarification that assessors will be qualified allied health professionals working within their scope of practice.
  • Assurance that assessors will be independent in the performance of their functions.
  • Guarantee that the assessment of need will be carried out in good faith, irrespective of the cost of identified support needs.
  • Clear statements in the assessment report when identified supports are the responsibility of another system (health, education), and assurance that these systems must have the capacity to meet the identified need.

  1. Inclusion of ‘whole of person’ support needs, not limited to a single impairment(s).
  2. Provision of a copy of the full assessment report to the participant.
  3. The right to at least one replacement assessment and additional assessments if prior ones were found to be flawed.
  4. Inclusion of a review date in the assessment report.

Let’s learn from existing legislation in other jurisdictions. In Ireland, there is a legislated Assessment of Need contained in the Disability Act (2005). The Disability Act 2005 sets out the details of the Independent Assessment of Need:

  • An assessment officer shall be independent in the performance of his or her functions.
  • An assessment under this section shall be carried out without regard to the cost of, or the capacity to provide, any service identified in the assessment as being appropriate to meet the needs of the applicant concerned.
  • An assessment officer shall prepare a written report of the results of the assessment and furnish a copy of the report to the applicant and relevant parties.
  • A report shall set out the findings of the assessment officer, including determinations about the applicant’s disability, the nature and extent of the disability, the health and education needs occasioned by the disability, and the period within which a review of the assessment should be carried out.

I want to highlight the vital work that occupational therapists do every day and the impact that follows as a result. For example, the image on Mr. Shorten’s Facebook page, dated 16th May 2024, shows him talking with a woman in a manual wheelchair. Though I do not know her, I can imagine the steps she took to be able to talk with Mr. Shorten, such as using a custom bed, transfer techniques, adapted environments, and driving modifications—all of which involve occupational therapists.

Occupational therapists working within the NDIS have spent the last decade serving Australians in every aspect of their daily lives, helping them live their best lives. Recent and proposed changes to the NDIS threaten our ability to do our job and create impact for our clients. Constant barriers and criticism are significant threats to our ability to serve Australians effectively.

I implore all stakeholders—business owners, clinicians, students, academics, researchers, team leaders, department heads, board members, OTA team, and Senator Jordan—to LISTEN and do everything in their power to allow occupational therapists to do our job. Don’t waste this opportunity; the world is watching, and history has its eyes on you.

When things get tough, I remember how privileged I am to change people’s lives:

  • Peter returned to driving with an electric spinner knob after a stroke.
  • Katie became independent with community access after finally receiving her vehicle modifications.
  • Levi gained his Provisional license and plans to become an electrician after specialized driving lessons.

The Participant Service Guarantee is currently on pause.

There are unprecedented delays in plan reassessments, impacting access to supports and causing enormous distress for participants and families.

I am concerned these issues will only worsen if the changes outlined in the Bill proceed. More work must be done to ensure the scaffolding contained in the Bill is solid enough to set up an optimal NDIS 2.0 before dissolving the current legislative framework through Bill ratification.

I am writing to ask you to STOP the changes to the NDIS Act (2013) until due diligence around Commonwealth government responsibility to disabled people has occurred. The Bill’s current state, which refers to undefined and non-existent supports, is absolutely ludicrous.

Thank you for your attention to this matter.

Yours sincerely,

Driver Trained Occupational Therapist