NDIA Accountability Project

Increased Auslan interpreting funding for intellectual disability support

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My Brother has been a NDIS Participant since March 2019

Changes proposed in the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No 1.) Bill 2024 could significantly impact the funding he receives, how that funding is managed (currently managed by me – his Plan Nominee), his choice in how his funding is utilised as well as his choice in who provides his support.

Some specific concerns I have about the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No 1.) Bill 2024 are:

Does not take a Whole of Person Approach

My brother’s initial Plan expired at the beginning of the Covid pandemic, so the Plan was extended without a formal review (my understanding being for 12mths). Approx. 3mths later I received a new Plan in the mail. I had not been contacted to advise that a Formal Review was in progress. It had always been my intention at the 1st Plan Review to request additional funding for Auslan interpreting support so my brother could be more involved Socially and in the Community. Without being included in the decision-making process I was unable to advocate on his behalf.

When I spoke to the Planner, I was advised that the NDIS would only fund the ‘Primary Disability’ and that my brother had automatically transferred from Qld Disability Services to NDIS based on his intellectual impairment therefore that was the diagnosis on which his funding was calculated. To take into account that his hearing impairment exacerbated his intellectual impairment, Auslan interpreting funding was increased to the (NDIA) maximum of 80hrs.

80hrs of funding was sufficient to cover Auslan interpreting support when my brother attended Drs’, Specialists’ and Allied Health Provider appointments but not much more. Without additional Auslan interpreting support he was (as he had been for most of his life) still socially isolated.

At that time my brother was 54 and had never been assessed to determine his level of intellectual impairments or other diagnosis which I found was hampering efforts to support him. In November 2019 (after nearly 7 years) I located a psychologist willing to undertake assessments. Due to the complexity of behaviours my brother presented with, there was no one appropriate assessment tool available (there are several to utilise with children and young

  • adults but nothing for an older person). An Auslan Interpreter had to be present at each session to communicate the psychologist’s instructions.

The Psychologist’s report was finalised on 5 Jun 2020 and submitted to the Planner. The Psychologist’s report states that the results of the assessments were consistent with DSM-5 Diagnoses:

- Autism Spectrum Disorder with accompanying intellectual and language
  impairment, requiring considerable support,
- Moderate Intellectual Disability
- Attention Deficit Hyperactivity Disorder – combined presentation

Based on the ASD diagnosis my brother’s Plan was reassessed.

Clear review and appeal rights:

I am greatly concerned that the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No 1.) Bill 2024 extends CEO powers and limits participants’ ability to challenge decisions about their Plans, funding and needs assessments. The ability to challenge a NDIS decision (needs assessment) I believe should be a fundamental right of every Participant.

When my brother’s 2nd Plan did not include increased funding for interpreting hours, I requested an Internal Review. The Internal Reviewer stated the Planner had not made an error in relation to funding for Auslan interpreting as he had been provided with the maximum the Agency provided. I was not satisfied with this outcome so commenced AAT Proceedings. The ability to refer his case to the AAT resulted in an outcome (increase from 80hrs/year Auslan interpreting support to 12.5hrs/wk – 650hrs/yr) that now allows him to be more involved in his community through volunteering (his “work” - greatly increasing his self- esteam), better understanding of, and how to manage, his health through improved communication with his Medical Practitioners, Pharmacist & Allied Health providers. Socially, he is more engaged with his tenpin bowling teammates, and the frequency of misunderstandings with others has reduced dramatically. The increased funding has also allowed him to be supported to attend sporting events.

His Interpreters also assist him with weekly planning (discussing upcoming appointments, shopping list, budgeting) and have made themselves available via VRI to provide ad hoc support when he requires guidance or reassurance.

  • My brother’s current plan expires on 22 November 2024, so I am anticipating being contacted by a Planner in the next few weeks.

  • Whenever I think about this, I become very concerned. It is all too easy for a Planner to refer to his original primary diagnosis (intellectual impairment) and on that basis disregard his additional need for Auslan interpreting support. If that happened, and assuming no change to the status quo, the AAT pathway would be available to me to have the decision reviewed. However, if the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No 1.) Bill 2024 comes into effect prior to that date, there does not appear to be a clear pathway to have his needs reassessed and the Planner’s decision reviewed.

Broad Powers to Require Assessments

Given the time it took me to find someone prepared to work with my brother the ability to have these types of assessments redone would be nigh impossible. A recommendation from the original Psychologist was for him to attend regular sessions with another psychologist to work through strategies with him to reduce the impact of some of the challenges he was facing – again quite an ordeal finding someone prepared to do so. I do not know what her caseload is to know if she would be available to undertake further sessions with my brother in order to prepare a report if requested to do so at short notice.

Limits on Support and Spending

Under the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No 1.) Bill 2024 the NDIA has the power to determine how a Participant uses their funding either directly (through withdrawing funding for an activity) or indirectly by withdrawing up-front funding.

I am concerned that even if there is no reduction in funding for Auslan interpreting in my brother’s next plan the CEO had the ability to withdraw that funding anyway. Another concern is that the CEO has the power to direct that my brother’s funding for behaviour support can only be utilised to pay for him to attend consultations with a psychologist. The psychologist referred to above had 12 face-to-face sessions with him and advised that she could have weekly sessions with him for 3+yrs with little to no change to his insight and behaviour. In consultation with her, I made the decision that a better support outcome would be achieved by upskilling his Support Team (which includes me). We commenced fortnightly Zoom sessions with the psychologist in which we

  • Would discuss the challenges any of us had faced during the previous fortnight.

The psychologist would explain how the behaviours were typical of an adult with intellectual impairments or autism. We would then work through strategies to utilise in similar situations in the future.

I recently organised for my brother’s Support Team to attend a training session facilitated by Autism Qld which allowed us to gain a better understanding of Autism & Autistic behaviours and reflect on those which he exhibits. As it stands, the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No 1.) Bill 2024 the CEO would be able to remove the ability for funding to be spent this way even though it is the most effective way to provide my brother with the long-term support he requires.

My brother’s support requirements for Social & Community Access are not the same month by month. Currently Plan Funding is provided ‘up-front’ therefore the variability of his monthly funding requirement does not present an issue.

Under a hypothetical scenario of the NDIS ‘releasing’ 1/12th of annual funding monthly, by mid-year there would be insufficient funds available to pay for the supports my brother requires to participate in both his Tenpin Bowling League and to attend NRL games. From around Sep the monthly funding allocation would cover the cost of his supports and by year end he would have unspent funds. He does not have the capacity to understand a change like this and quite frankly this removes choice and control as to when and how he utilises his funding.

Ability to change how Participants Plans are Managed

I currently manage my brother’s Plan and the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No 1.) Bill 2024 has the potential to give the NDIA powers to remove that management option for my brother or for all participants. Unless there is reason to suspect funds are being misused, I do not believe a broadbrush approach to changing management options is appropriate. Raising debts in situations where people have genuinely claimed for items they believed were approved under their Plans is another area of concern for me.