Community Affairs Legislation Committee

Parliament House Canberra ACT 2600

Dear Committee Members,

I am writing to provide my submission on the proposed changes to the NDIS Bill, which is due by Friday, 12th July. I have several concerns about the potential impacts of the proposed amendments on NDIS participants and the broader disability community. I have outlined my concerns below.

Stated Supports and Classes:

Presently, the NDIS assesses and supports participants based on their own, individual needs. In its original iteration, the scheme was designed to hand back choice and control for participants accessing supports, not limiting them to certain providers, limited supports, and taking away decisions in how their care is managed. Under the new bill, the proposal that participants and supports will be divided into classes with access restricted to specific supports within their class, is deeply troubling.

The Bill does not adequately describe what these classes will entail or how it will impact participant choice and control. Concerns that I have as a provider and as a sibling of a person with a disability include:

• Copy and paste plans for a disability instead of individualised support that looks at the person and their individual support needs
• Restrictions of which providers you can see for your supports.
  • Could this be stated down to a specific provider for a specific age class or disability class?
• Requirements for supports including conditions such as specific providers, processes, or locations, complicating access and reducing flexibility.
• Removing holistic participant supports all together by funding only 1 primary disability
• No clarity around what will now be considered a support
  • There is no documentation describing what is and isn’t considered a support and this leaves participants extremely vulnerable. The change in wording means that participants can end up being significantly more restricted in how they access supports that they need.
• Allocating funding “budgets” instead of funding supports.
  • The allocation of a pre-determined budget for a specific disability does not adequately address the significant differences in people with disabilities. As a provider I have several children with a diagnosis of autism spectrum disorder (ASD) Level 3. Every child has different support needs; some have food and sensory aversions whilst others eat a wide and varied diet. Some are minimally verbal, using Assistive Technology Supports, whilst others are developing verbal communication or have speech sound disorders secondary to apraxia.

The allocation of funding budgets significantly increases risk of debts from spending deemed non-compliant with supports criteria.

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also appears to have no clear appeals process for decisions made with regards to supports or debts. I have a great concern that participants could be hit with debts that they are unable to appeal, especially those made by algorithms (such as is described by the ‘funding budget’), undermining participant protections and leaving already vulnerable people, at significant risk. Without these debts then falling within the NDIS framework, there will be NO oversight into how providers reclaim debts from participants.

Further to this concern is the returned focus to a single disability or named: Primary Disability. Again, with reference to the variety and nuance of how a disability impacts a person, many disabled people do not have just one disability. There are numerous, well documented and researched co-occurring disabilities that interact with and impacts a disabled person’s functioning. For example, has a diagnosis of Down Syndrome, Intellectual Disability, ASD Level 2, ADHD, hypermobility, language disorder, apraxia, and anxiety. This Bill, again, does not adequately describe how or with what criteria, as person’s Primary Disability will be selected and fails to holistically consider the person. As we change over, transition to the new framework will be determined by the Minister, potentially leading to inequitable support access. The decision-making process is unclear for who will be selected to ‘trial’ the new system first. The focus on primary disability and foundational supports risks reverting to pre-NDIS systems, complicating responsibilities and funding clarity.

Needs Assessment (Section 32H):

The Needs Assessment is essentially a re-branded Independent Assessor process and once again, the Bill fails to identify how this new stipulation will be implemented or consider the impact on participants. The Bill lacks clarity on the qualifications and roles of assessors, the assessment process, and the use of automation in decision-making.

The Bill makes no specification on:

• The qualifications, experience or discretionary powers of the person completing the Needs Assessment.
• How the primary disability is selected and the exclusion of secondary disabilities from consideration, including how they interact with the ‘primary disability’.
• The tool that will be used to complete the Needs Assessment has not been named nor has what is it assessing been clarified or stated in the Bill. o As a Speech Pathologist, assessment is a core element of planning appropriate therapy and making recommendations specific to the person. I have multiple assessments looking at:  intelligibility,  language skills (both understanding and expressing),  written expression,  reading comprehension,  oral musculature control/strength/range of motion,  texture and food preferences,  chewing/swallowing/drinking skills,  assistive technology suitability  social skills  play skills

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A single tool (or handful of tools mentioned on the current NDIS Access Request Form) will not adequately determine a person’s support needs with any kind of specificity to that person.

• How impact on functioning is being identified/calculated/reflected in the funding allocation
• Whether or not participants will be able to access this report
• Whether the report can be appealed or reviewed
• Whether there will be human oversight into how the tool is used or if it will function as an algorithm (much like Robodebt did) with no option to re-assess. The Bill’s wording as ‘highly technical’ does not provide any actual indication of how these assessments will be implemented
• Whether or not participants can provide their own evidence for consideration
• How a participant can review or appeal the decision if they feel that they have incorrectly assessed or not been provided with adequate supports

The rules around what an assessor must do are concerning:

• They must use the tool provided (even if they think it’s inappropriate)
• They must only assess the disability that meets access criteria (despite the likelihood of co-occurring disabilities and no nuance for how this impacts the person)
  • The assessor may assess the impact of other disabilities on functioning (but how? Who makes this decision?)

The Needs Assessment framework’s lack of detail prevents informed decision-making by the Senate and cannot be passed in its current form. It is deeply concerning that the Minister is expecting the Senate to pass a Bill into Law without specificity or clarity on what the Bill will actually mean or do. This Bill will only make people with disabilities more vulnerable and isolated than they already are.

Revocation of Supports:

The Bill fails to identify how the Revocation of Supports will be decided and what the process will be. At present, NDIS Letters can take more than 4 months to arrive on a participant’s doorstep (quite literally receiving letters dated up to 4 months ago) advising of decisions being made about their plans, funding, or supports. With NDIS LACs and ECEI Coordinators taking up to 8 months (an actual example from one of my clients seeking a review of their plan), I am concerned by the lack of clarity in this process and what will happen to participants. The Bill does not adequately describe how it will revoke funding, how this decision can be appealed, and what happens to a participant’s scheduled supports. If a participant has a Service Agreement with a 28-day notice period for termination, are they liable for the supports provided in those 28-days? What if the revocation is reversed? Will participants be reimbursed for the funds they spent on services whilst awaiting an appeal? This entire process leaves participants extremely vulnerable to debts and service disruptions. When most adult participants are accessing the Disability Pension and families with disabled children are already drowning in a cost-of-living crisis that isn’t going anywhere, this stipulation puts every participant accessing the scheme at significant risk.

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Furthermore, as a provider, my present waitlist for services is between 4-6 months. Participants requiring additional assessment, review, or information requested from the NDS may be facing a significant wait for these services, resulting in removal from the NDIS and placing the participant are significant risk without their supports. There are no indicated constraints on these powers and this very troubling. The timeframes of 90 days for revocation of eligibility and only 28 days for a new plan, are far too short and I hold significant concerns of what this means for participants. It could result in inappropriate assessments being completed by professionals without the required experience, further impacting the participant. The power this Bill will provide to the NDIS to compel participants to have assessments with unfamiliar, inexperienced, or inappropriate assessors will have a significant impact on participants, especially participants who require sameness, expected situations, and comfort to engage in assessment protocols. The outcomes for participants who can’t or won’t participate in these are far too severe.

Debts/Cancelled Claims/Review Rights

  The proposed NDIS Bill raises significant concerns about debts, cancelled claims, and review rights. It appears easier to incur debts from spending deemed non-compliant with access criteria than to have needs and assessments reviewed, particularly affecting those with multiple disabilities. The single disability framework overlooks the impact of additional diagnoses, limiting fair evaluations. The current Bill does not specifically indicate that participants will have a right and will be able to review decisions made by the NDSIS. Cancelled claims may result from insufficient context in support decisions, with minimal oversight or appeal rights, especially for algorithm-made decisions. This raises concerns about the treatment of debts incurred outside the NDIs framework and the overall fairness and transparency of the system.

Co-Design with Disability Community

   Co-design needs to be included into the legislation to ensure that future governments,

and this government, must develop the NDIS Bill and any following laws with consultation from the disability community. The Scheme is supposed to empower and support disabled Australians but is being written by policy writers and voted into law by politicians who have never experienced disability, have no formal qualifications to inform their decision making or will never have to experience the impact these decisions have on actual people. The co-design is crucial to ensuring that the Bill supports disabled Australians and doesn’t (as by their own admission on the existing bill) restrict human rights and vastly dimmish self-determination and autonomy for disabled people.

    In conclusion, the proposed bill raises significant issues reminiscent of the Robodebt

scheme, jeopardizing participant protections and creating a system that prioritizes cost-saving over necessary support. The current framework fails to ensure equitable and adequate support for all participants, infringing on their human rights. The Bill even directly admits that these reforms will place restrictions on human rights and that this is reasonable for sustainability. This reads: cost saving.

I urge the Committee to reconsider these changes and consult comprehensively with the disability community to develop a fair and effective NDIs framework.

Foundation First Speech Pathology

Sincerely,

Sarah Moran Director and Founder of Foundation First Speech Pathology Speech Pathologist (B.Sp.Path (Hons); CPSP; MSPA)