NDIS extension to cover people with disabilities of all ages | External submission

Submission to the Exposure Draft National Disability Insurance Scheme

Bill 2012

25 January 2013

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Recommendations:

The NDIS be extended to cover people with disabilities of all ages.
People assessed as eligible for NDIS funding should have the option of continuing to remain with the NDIS as they age or move on to aged care services depending on which better meets their needs. People should not be pushed off the NDIS once they reach a certain age.
1. An independent, external and robust complaints mechanism should be

established so that conflicts of interest are removed and complaints are able to be dealt with independently and in a timely manner.

Recognition of the need for culturally appropriate disability services for CALD, LGBTI and indigenous Australians, for example, should be added to the Bill.

CPSA was founded in 1931 in response to pension cuts. CPSA is a non-profit, non-party political membership association which serves pensioners of all ages, superannuants and low-income retirees. The aim of CPSA is to improve the standard of living and well-being of

its members and  constituents. CPSA has approximately 140 Branches and  affiliated

organisations with a combined membership of over 29,000 people living in all parts of NSW.

CPSA welcomes the opportunity to make comment on the exposure draft of the National Disability Insurance Scheme Bill 2012.

Supporting people with disability as they age

CPSA is a strong supporter of a robust NDIS and welcomes legislation that should facilitate person centred support for people with disabilities and their carers.

CPSA is concerned, however, that people over 65 years of age will miss out on the support they need by being excluded from the NDIS. Older people need a similar insurance-based approach. Older Australians with a disability also need to see an improvement in the care and support services available to them. As the system currently stands there is no specified entitlement to aged care services for people who need it. Due to a lack of adequate funding and services, many people are simply unable to access the supports they need.

Recommendation 1: CPSA calls for the NDIS to be extended to cover people with disabilities of all ages.

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Although people generally require a greater level of assistance as they age, among people with a disability there is not necessarily a higher level of need for assistance once they reach 65 years of age. There are, however, differences in the types of assistance required by older people and people with disabilities.1 As a result it is inappropriate for older people with disabilities to be excluded from the NDIS and required to access aged care services which may be inappropriate for their needs or simply not meet them. This is currently the case where younger people are forced to live in nursing homes due to a lack of alternative support services available. The support services required by someone at 65 are likely to be drastically different to what may be required by someone over 85 and as such people should be able to meet their needs as required at the present time.

The source of assistance also differs between older people and younger people with disabilities. Although many people with high care needs live in households where they are assisted by co-resident informal carers, people over 65 are more likely to rely on a co resident informal carer as their primary source of assistance with daily activities. People with disability under the age of 65 are more likely to rely on formal non co-resident carers to assist with mobility and daily activities including housework, paperwork and transportation.

This difference in sources of assistance could have negative implications for the service

transition  for people with younger onset  disabilities. Ageing people with  disability are

statistically more likely to have more limited networks of informal carers and less likely to have a spouse carer. People who need assistance are half as likely as the rest of the population to be in couple families with their own children across all age groups between 15 and 64. They are also less likely to be in partner relationships (36 per cent versus 69 per cent), with or without children, than people who do not require assistance with daily activities. This makes social isolation more widespread, particularly for people who cannot readily access activities outside the home.

According to the latest ABS figures, while approximately 1.4 million people with a disability felt that their assistance needs were met, for 770,000 people requiring assistance, their needs were only partially met. For 50,000 Australians with disability, their needs were not met at all.2 There is therefore a significant cohort of people who have been waiting for adequate services for years and may be over the age of 65 once the NDIS comes into operation. CPSA understands that consultation groups were told that what was applied was the age at diagnosis or time when a disability was acquired rather than time of application; however this is omitted from the Bill.

The Productivity Commission recommended that for a person assessed as eligible for NDIS funding prior to 65 years of age that they have the option of continuing to receive the NDIS

1 Physical Disability Council of NSW (2011) The Impact of Ageing on the Needs of People with Physical Disability, p. 4. 2 Australian Bureau of Statistics (2009) Disability Ageing and Carers: persons with a disability, living in households, disability status-assistance needed, assistance received and extent to which needs met, table 16, cat no. 4330.0, Canberra. Page 3 of 4

entitlement or otherwise access aged care services, whichever best meets their needs. 3 CPSA upholds that having the option to retain NDIS funding and support services is crucial for maintaining meaningful participation and routines of people with disability. This will assist in facilitating healthy ageing by ensuring social ties are able to be maintained, risks of poor health are minimised and ensure that people with high care needs are able to avoid entering residential aged care facilities prematurely, or at all. CPSA fears that given the current standard of aged care services available to people in Australia and what is proposed in the Bill, there will be a dramatic reduction in care options available to people should they be required to move from NDIS services to aged care services.

Recommendation 2: People assessed as eligible for NDIS funding should have the option of continuing to remain with the NDIS as they age or move on to aged care services depending on which better meets their needs. People should not be pushed off the NDIS once they reach a certain age.

It is unclear to CPSA whether Section 22 (2) (b) which outlines that different ages and different dates may be applied to different areas in Australia will allow certain groups to access NDIS funding at an older age. CPSA believes this point needs to be clarified and not left up to the interpretation of the reader.

A need for an independent complaints process

CPSA is also concerned that provisions for a complaints process, external to service providers, is not outlined in the Bill. While Section 48 outlines that a NDIS participant may request the CEO of the Agency to conduct a review of their plan, the CEO can determine whether or not to conduct a review.

Recommendation 3: An independent, external and robust complaints mechanism should be established so that conflicts of interest are removed and complaints are able to be dealt with independently and in a timely manner.

Diversity amongst people with disability

Absent from the Bill is a recognition of diversity amongst people with disability beyond the differences in disabilities.

Recommendation 4: Recognition of the need for culturally appropriate disability services for CALD, LGBTI and indigenous Australians, for example, should be added to the Bill.

3 Australian Government, Productivity Commission (2011) Disability, Care and Support Inquiry. Page 4 of 4