NDIA Accountability Project

Osteo and physio supports crucial for managing pain and mobility

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Submission 1722

Hi there,

I would like to give my thoughts on the proposed NDIS reforms and also some examples of how they will impact me as a disabled person on the NDIS.

The Bill is primarily aimed at reducing projected growth in NDIS expenditure and participant numbers, while strengthening fraud controls, provider regulation and governance arrangements.

  • We understand that a large amount of money goes on the NDIS and that this amount is growing, potentially being unsustainable. I would like to point out that money spend on participant funding is money that will not need to go into the public medical system later. Funding helps us manage our conditions so that we have less flares and crisis situations, meaning no or significantly less strain on the public health system.
  • Being disabled is expensive, as we have many costs that others don’t. These costs are compounded by the fact ther we often can’t work full time. As such, private or self-funded expenses like physio, support workers, assistive technology that gives us greater independence, are generally not accessable to us if we don’t receive the funding. When we have the correct funding and therefore the right supports we need to manage our conditions as well as possible, we have a greater capacity to work and participate in the community, adding to the country’s economy, as well as enjoying a better quality life.
  • I personally see an exercise physio every fortnight, and am trying to get funding to pay for my fortnightly osteo too, as I cannot afford this myself. These two supports significantly reduce my pain, increase my mobility, and allow me to safely strengthen my body, while also reducing the number of injuries and pain flares I get when I have tried to exercise myself or with a personal trainer. The 5 sessions Medicare subsidies a year are not a viable alternative to funding for this, as I use those 5 sessions by February and then still have the rest of the year to get through. If these supports are removed, or my funding is reduced meaning I need to see the exercise physio less frequently, my body will quickly decline again, pain will flare back up, and I’ll become a shell of the person I am currently.

Introducing a power for the Minister to reduce funding for specified groups of supports.

  • The groups of supports that are included in our plans are based on our individual needs. I understand that it’s easy to look at one category that costs more and conclude that it should be reduced. The result of this would simply be that participnts will miss out on what they need. If we look at the capacity building category, this is a ludicrous category to reduce. These supports are things like occupational therapy, speech therapy and physio. These give us greater independence, reduced pain and struggle, and helop us set ourselves up for a better

Submission 1722

life. This category also includes help to prepare for entering the workforce. It seems very counterintuitive to reduce this, if the government wants larger tax revenue.

  • The basic support category includes support workers, consumables and assistive technology. Not all of us need support workers, or could get by without them, but many rely on them to be able to function and live with dignity. Even if a person can technically do something themselves, it may use all of their energy for that day, leaving them unable to do anything else. Support workers are essential. Assistive technology is another thing that can be seen as a luxury, but it’s basic. I personally have days where I can’t walk, even though other days I can get around just fine. On my non-walking days, I use a walker to get around. This is not a solution for every situation, though. If I had funding available, I could purchase something like a saddle stool that I can’t otherwise afford, so that I could move around my home without walking, and still have my hands free to do things like cook myself dinner. This is also cheaper than having a support worker come over to cook for me, or using a meal delivery service regularly, as it’s a one off purchase that will continue to give me independence. This is just one example of how core supports are used.

Amending access and planning arrangements, including by defining functional capacity, limiting participant-requested plan reassessments, expanding the circumstances in which a person’s plan can be suspended, strengthening the link between supports and eligible impairments, changing reasonable and necessary support provisions, and allowing consideration of access to other service systems.

  • A short assessment by someone who doesn’t know us and that is possibly done over the phone, will not accurately show our function and needs. This is especially true for those who hide their struggles, or whose functioning fluctuates. I am a person who can look fine one day, and be unable to move another day. I can also pretend to be fine and mask a lot of my struggles, but that doesn’t mean I don’t struggle greatly and don’t require significant support to function well day-to-day. If a full functional capacity assessment is required, this will more accurately capture our functioning and needs, but is time consuming and expensive. I recently completed a full functional capacity assessment with an OT to be able to add further conditions to my plan. Luckily, I was able to use funding for this. The report took 10 hours of time with me, and another 10 hours of report writing time for the OT. These 20 hours cost around $4,000. We cannot afford this if it is required for acceptance to the NDIS. It also delays getting the supports we need. An alternative might be for our medical reports to continue to hold weight, and for planners to ask what supports we need, rather than giving us cookie-cutter plans based on the condition our plan is approved for. Participants go to great lengths to get their medical paperwork in order for application. This should continue to be enough. These medical reports also state what supports we need, with no additional assessments required.

Submission 1722

Everyone experiences their condition differently and has different needs. Cookie- cutter plans actually use money very inefficiently, as participants are sometimes given supports they don’t need, while missing out on others they do need. Please don’t add more barriers to the application process.

  • Participants already do not request plan changes unless there’s a good reason. This is a frustrating process, and we don’t want to draw attention to our plans in case we lose something we need. Trust that we are not wasting resources asking for unnecessary plan changes.
  • Suspending plans due to participants not being contactable is a very bad idea. I personally missed 2 phone calls from the NDIS a few weeks ago because I was in appointments. I could not return the call, as it came from a private number with no return contact details available. I was lucky that they tried me again while I was out, as I have very poor reception at home and may have missed a third call. It would have been very unfair if my plan was suspended due to me being uncontactable in this situation.

Strengthening fraud, compliance and regulatory arrangements, including by changing the definition of NDIS provider, introducing civil penalties, expanding information-gathering powers, imposing record-keeping requirements, changing claims timeframes and amending plan management arrangements.

  • Many businesses we use are not registered with the NDIS. They are registered with other industry appropriate bodies, proving that they are reputable businesses. Registering fo become an NDIS provider is a costly, time consuming, and resource heavy process, often taking 6 months and up to $5,000. Many businesses cannot accommodate this cost or disruption. As participants, we have built relationships with our current providers, and many of us have tried numerous providers over the years and use our current ones cause they’re actually helpful. We should not have to switch to NDIS registered providers just because of a change of rules. I have seen many other physios over the years, and none of them have been helpful cause they don’t understand my condition. I don’t want to go to a different physio just cause they might be registered, cause they won’t be helpful for me.
  • Records are required to be submitted before money is paid. There is no reason to require us to keep records after submitting them. This is simply an added burden. Many of us struggle with this type of administration and don’t have people to easily help us with it. Some of us may feel that further record keeping is just too difficult, and spend our own money that we don’t have instead. The paper trail between us and the NDIS or our plan managers should be sufficient.

Establishing a Ministerial pricing mechanism for NDIS supports and permitting automated administrative decision-making within the NDIS.

Submission 1722

  • It’s important that decisions continue to be made by human beings. Nuance is required, and mistakes often cannot be corrected. For the system to actually help participants, the human element is necessary.

Facilitating implementation of new framework planning arrangements and providing for transitional arrangements.

  • Situations can change quickly, as can health and functioning. Plans should be processed and implemented quickly, and be able to change quickly as needed, so that participants get the help they need, when they need it.

Thank you for taking the time to consider my concerns and experiences.