NDIA Accountability Project

Impacts on NDIS provider market and assessment processes

‹ PrevPage 1 of 4 · Source p. 1Next ›

Community Affairs Legislation Committee

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

Occupational Therapy Australia Submission

July 2024

Occupational Therapy Australia Limited ABN 27 025 075 008 | ACN 127 396 945 6 / 340 Gore St. Fitzroy VIC 3065 Ph +61 3 9415 2900 | Fax +61 3 9416 1421 | Email policy@otaus.com.au | Website www.otaus.com.au

Introduction

Occupational Therapy Australia (OTA) is the professional association and peak representative body for occupational therapists in Australia. There are over 30,000 registered occupational therapists working across government, non-government, private and community sectors in Australia, including more than 8,600 occupational therapy providers who deliver services to participants under the National Disability Insurance Scheme (NDIS).

OTA previously provided a submission to the Committee in April 2024 regarding the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024 (the Bill), prior to its amendment in the House of Representatives. We thank the Committee for the opportunity to provide an additional submission.

OTA has examined the Bill amendments adopted in the House of Representatives and proposed in the Senate. We have also examined the Committee’s Final Report, published on 20 June 2024. Following this examination, OTA continues to oppose the passage of the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024 (the Bill), even with recent amendments. The key points OTA outlined in our initial submission have not been addressed. We continue to hold concerns about the Bill as amended and restate some of our key issues below.

Uncertain NDIS reform pathway

OTA remains concerned that there has not been provision of adequate information by Government on their proposed disability reform agenda, and in response to the recent Independent Review of the NDIS, and the Disability Royal Commission. This includes information on proposed Foundational Supports, which Government has indicated will provide supports for persons who do not qualify for an individual NDIS plan. We are concerned that Government is yet to provide detail on the quality or extent of these supports which are anticipated to replace, in some cases, the supports provided by the NDIS, particularly for children. We look forward to the Committee’s examination of the positions of states and territories on this important issue.

Recommendation 1:

That passage of the NDIS Bill is paused until the Federal Government provides a fulsome response to the NDIS Review and Final Report of the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, so that participants, their families, advocates, and support providers can understand the proposed reforms as an entire reform proposal, and understand how these legislative changes will actually impact participants in terms of the services and supports they can access under new reforms.

Provision of economic modelling

OTA also believes that the Bill’s passage through Parliament should be supported by provision of sufficient information on the economic modelling that underpins the stated budgetary savings that are proposed through these legislative changes. It is critical that Parliament and key stakeholders have access to this key information to understand how the new NDIS processes and Rules proposed within the Bill will impact the provision of future NDIS services, and the effects this will have both on participants and the provider market.

Recommendation 2:

Before progressing the NDIS Bill, that Government provides the Committee and stakeholders with detail of the projected impacts of the proposed reforms, including:

Estimated impact on participants including:

  • projected changes in NDIS plan value (averaged per participant) due to introduction of new needs assessment process, changes to plan management type, plan length, and definition of NDIS Supports;
  • projected number of participants who will be diverted into early intervention pathways or foundational supports and the estimated efficacy of these supports in assisting people to build personal capacity, including social and economic participation.

Estimated impact on the NDIS provider market.

To provide protection to participants

we also contend that assessors should be independent of the NDIA in the performance of their functions. This would ensure that the assessment is conducted in line with the NDIS legislation, and is not constrained or impacted by direction from the NDIS that may have implications on the types of levels of support that are recommended due to budgetary or other constraints.

We also believe it is important that the legislation requires that a person will receive a copy of their full assessment report in an accessible format as soon as practicable after it is produced. The assessment should clearly state all of the person’s required supports, and where the assessment finds identified supports to be the responsibility of another system (for example health, education or other source), this should be clearly stated. It should also enable the participant to seek correction or amendment of the needs assessment, including the ability to request a new needs assessment, where it is identified that the assessment was not conducted in line with the correct process, where it was inappropriate for the participant and their circumstances, or where it resulted in inaccurate or inappropriate outcomes.

Recommendation 3:

The Committee recommends amendments to the Bill as outlined above, and particularly to: - Provide a definition of ‘assessment of support need’. - Require that needs assessments consider the whole-of-person, are appropriate for the participant’s life and circumstances, and appropriate for their specific type of disability/disabilities. - Specifically require that needs assessments are undertaken by appropriately skilled and qualified persons (for example an allied health professional), independent of the NDIA. - Specifically require provision of a copy of a full assessment report to be provided to a participant in an accessible format, that outlines all identified supports, and including specific review rights.

Broader NDIS market impacts

OTA remains concerned that the Bill enacts a range of changes to the NDIS that will result in wide scale impacts on the NDIS provider market, through restriction of specific NDIS supports, and creation of pathways to divert persons to early intervention services or Foundational Supports which will be engaged via Government block funding or tender arrangements.

This will be a significant departure from the individual choice and control model that the NDIS market has adapted to over the past 10 years and has the potential to massively disrupt the NDIS provider market, which is facing significant financial pressures. These pressures have been compounded through the NDIA’s recent Pricing Review Decision outcome, which saw a continuing freeze on the price cap for therapy supports. OTA’s members have advised that many are contemplating exiting from the NDIS service provision due to significant financial pressures, with almost one in four surveyed occupational therapists advising they are contemplating exiting NDIS service provision in the next three years due to financial pressures. The potential disruption proposed by this Bill, and the lack of clarity from Government regarding its reform agenda, compounds this pressure and we hold serious concerns for the NDIS provider market over the longer term.

Contact

Occupational Therapy Australia policy@otaus.com.au