Submission: NDIS Back on Track Bill

As a registered and experienced Occupational Therapist of 18 years, I formally request that the OT Community of Practice submission to this Amendment be considered and actioned in full, particularly around ELIGIBILITY and ASSESSMENT - including:

NDIS Bill Amendments are needed to ensure fair NDIS Assessments. At a minimum, the primary legislation should be updated to include:

• A definition of ‘assessment of support need’.
• Clarify that assessors will be qualified allied health professionals working within scope of practice.
• The assessors will be independent in the performance of their functions
• That assessment of need will be carried out in good faith, irrespective of the cost of identified support needs.
• Where the assessment finds identified supports to be the responsibility of another system (health, education), this is clearly stated in the assessment report and that these systems must have capacity to meet the identified need.
• The assessment will include ‘whole of person’ support needs, not limited to a single impairment ($)
• A copy of the full assessment report will be provided to the participant.
• The right to at least one replacement assessment; and additional assessments if priors were found to be flawed.
• The assessment report will include a review date.

We can do better than this in Australia - 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. hhttps://lnkd.in/gDtYXEDM

Disability Act 2005, Section 8: Independent Assessment of Need* (*extract)

(4) An assessment officer shall be independent in the performance of his or her functions.

(5) 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.

(6) Where an assessment officer carries out or arranges for the carrying out of an assessment under this Part, he or she shall prepare a report in writing of the results of the assessment and shall furnish a copy of the report to the applicant, the Executive, and, if appropriate, a person referred to in section 9 (2) and the chief executive officer of the Council.

(7) A report under subsection (6) (referred to in this Act as “an assessment report”) shall set out the findings of the assessment officer concerned together with determinations in relation to the following— (a) whether the applicant has a disability, b) in case the determination is that the applicant has a disability— (i) a statement of the nature and extent of the disability, (ii) a statement of the health and education needs (if any) occasioned to the person by the disability, (iv) a statement of the period within which a review of the assessment should be carried out.

Around ELIGIBILITY and ACCESS:

1)  Participants' rights to appeal a decision relating to their budget and support,
  must be upheld by the new Bill.
2) The terms 'Classes of participants' and 'classes of supports' will need to be
   defined in the primary legislation, to clarify their intended meaning and purpose.
3) We recommend all circumstances and process through which a participant's plan
  can be revoked, be included in the primary legislation, not the Rules (Section
   30A,1).
4)  Any classification system introduced to the NDIS and identified by the Bill must
  be scrutinised by independent review and considered through the lens of
    Australia’s obligations under UNCRPD.
5)  Principles, key features and expectations of the new NDIS Assessment of Support
 Need must be detailed in the primary legislation. Following extensive co-design,
   further details on assessment process must be listed as Category A Rules
6) The new 'assessment of support need' would need to be extensively trialled,
   piloted and evaluated prior to rollout across the Scheme, to ensure fitness for
   purpose. This would include current and new assessments that may be utilised for
    this purpose. Assessment processes must be proven to be equitable for all people
   with disability.

Key NDIS Review Recommendations

7. Key NDIS Review recommendations, including the need for assessments to be completed by skilled allied health assessors working within scope of practice; the requirement for support needs assessor to consider information provided by treating professionals; and the need for an extended time period in which to complete assessments, should, be accepted and confirmed within Category A Rules.

8. A detailed policy-risk assessment must be completed prior to introducing mandatory assessments. A co-designed trauma-informed framework would need to be developed and implemented alongside the introduction of new mandatory assessment processes, to reduce risk of participant harm.

9. Given the proposed centrality of the assessment of support needs and the multi functions it will hold for the effective working of the NDIS, exceptionally high standards of quality and oversight are required. We recommend dedicated processes to ensure ongoing quality, and independent and rigorous standards and governance.

10. A dedicated allied health role should be added to the Independent Advisory Council for this purpose, and the primary legislation should be updated to enable this role. This role would further be held accountable to the Australian Chief Allied Health Officer.

Further – on the so-called FOUNDATIONAL SUPPORTS:

1. We require clarity of what and who is providing these supports PRIOR to kicking many thousands of disabled individuals off the scheme and having their own individualised package.

2. We require that the draft Rules detailing the intended structure and nature of new early intervention pathways should be drafted and made publicly available, prior to changing the primary legislation.

3. We do NOT want to see a return to early 2000’s where block-funded, mostly not-for-profits ruined the lives of many children and families of children with complex disabilities, let alone those with more simpler developmental delays – I should know, those were my early days of my OT career, and frankly, it was horrifying to me, the band-aid solutions, the seeing a child once every six months if we were lucky. The broken equipment and minimal funding available to replace this for general growth purposes. It was terrifying. I think I would rather pack bags at woolworths, than go back to those sorts of conditions.

This is what we need to ensure for the safety and integrity of support provision to our vulnerable.

Registered Occupational Therapist.