Submission 2552
I would like my submission to be confidential (Name withheld) as I do not want my personal details, which include my name, to be released to the public and accessible to the public on the internet.
I am both an NDIS participant and a registered Occupational Therapist currently working part time as a Sole Trader. I work with children and families, and with their Educators in clinic, at childcare or kindergarten, and at school.
My concern relates to the part of the bill that will reduce social, civic and community participation supports by 50 per cent and capacity building and participation supports by 10 per cent.
As an NDIS participant who is unable to obtain employment directly as a result of my disabilities, and have had to resort to working as a Sole Trader, so that I am able to schedule my work around my needs, I rely on funding for social, civic and community participation so that I am able to access client’s homes, childcare centres and schools to complete Functional Capacity Assessments, provide education, complete observations in a child’s natural environment and provide recommendations, as I am unable to drive. The proposed 50 per cent reduction to social, civic and community participation supports will have a significant impact on me and will result in reduced job opportunities for me as I will be unable to attend professional development opportunities in person, as many of them are held at locations which are inaccessible by public transport, or finish late in the day where I am too fatigued to transport myself home, or don’t feel safe using public transport at night time, and unable to see clients who live or attend childcare or school in areas which are not accessible by public transport, meaning that I will have a reduced caseload and risk not meeting the required amount of client contact and continued professional development hours per year to maintain my registration as an Occupational Therapist with AHPRA, therefore denying me the opportunity to contribute to society. Having access to funding for social, civic and community participation has enabled me to join social groups which is the only social contact I have outside of the home and also contribute to the community through volunteer opportunities which has had a positive impact on my mental health. These funding cuts will mean that I am unable to participate in any groups related to my interests as these groups are either not in areas which are serviced by public transport or occur during the evening where I feel unsafe to travel home by public transport, and will deny me of the opportunity to socialise as I will be unable to access these groups as I have no other way of getting to and from them, and this will result in social isolation and inability to participate in my community, and will result in a decline in my mental health. This will place a burden on public and community mental health services.
The proposed funding cuts to social, civic and community participation also assume that participants only access the community for social or lifestyle activities and not for essential life activities such as attending therapy appointments. If I do not have enough
Submission 2552
access to funding for social, civic and community participation then I will be unable to attend my therapy appointments or be forced to find another therapy provider, as the current therapist that I see is not in a location which is accessible by public transport, and this will mean having to start from the beginning again and having to repeat my whole story again to a new therapist which will result in re-traumatisation for me.
Autism is a lifelong, Neurodevelopmental disability which results in the ongoing need for supports throughout life. By reducing capacity building and participation supports, this will result in me being unable to access therapy when required, particularly when I may be navigating challenging circumstances, or a significant change in my life, which will result in a decline in my mental health and reliance on community and public health systems. Without access to NDIS funding for capacity building and participation supports I will be unable to afford the cost of private therapy.
Section 4.3 Permanence, Appropriate Treatment and Bodily Autonomy of the bill will tighten access criteria and requires participants to undertake “all appropriate treatment” before impairments may be considered permanent. This does not take into consideration the harmful side effects of medications or treatments, or trauma that these treatments may cause which will result in further disability. This also does not take into consideration the cost of accessing treatments or specialists to obtain the required documentation to be able to access the NDIS. People should not be denied access to the NDIS and be forced to live with no supports because they are unable to afford treatments, or to see specialists to provide evidence of disability.
As an Occupational Therapist cutting capacity building and participation supports by 10 per cent will reduce the frequency that I am able to offer therapy services to my clients who require weekly Occupational Therapy sessions to be able to work towards their goals. This will reduce their choice and control over their services as there will be less funding to utilise and therefore they will be forced to choose one allied health service over the other, or have to reduce the number of therapy sessions to allow for funding to be utilised for parent education sessions or consultation with Educators for example. I am also very concerned about the use of algorithms and standardised tools being utilised in decision making and to assess people’s eligibility for the NDIS as these standardised assessment tools do not accurately reflect the impact of a person’s disability on their daily living. Just because someone scores a particular number in a particular life domain, this does not mean that their disability does not have a significant impact on their daily lives and that they don’t require supports. These assessment tools do not consider conditions which result in fluctuating capacity such
as Postural Orthostatic Tachycardia Syndrome (POTS), Chronic Fatigue Syndrome
(CFS), Ehlers Danlos Syndrome (EDS), autoimmune disease and Psychosocial disability. When assessing a participant’s eligibility for the NDIS and the supports which they need, it is important that this assessment is completed by qualified allied health
Submission 2552
professionals including Occupational Therapists, who are able to talk to the individual either seeking access to the NDIS, or seeking a review of their current NDIS Plan and find out further information to determine what areas the supports are needed in. We have completed four years of training at university to be able to assess people’s level of function and provide recommendations for support based on this, therefore the assessment should not be delivered by non-allied health professionals who are employed by the NDIA.
All participants should be able to view a draft of the support needs assessment (SNA) report, and if they are not happy with their budget, they should not have to undertake another SNA. Individual supports should also be allowed to be reviewed rather than having to complete another SNA.
I am also concerned about the additional costs for Occupational Therapists who are Sole Traders to register as NDIS registered providers. If we are all required to become registered NDIS Providers to continue providing Occupational Therapy services to our clients, then this will result in a lack of continuity of care for my clients and their families who have already established good rapport and connection with me, as Sole Traders like myself will be unable to afford the costs associated with registration as an NDIS registered provider.
I would like Parliament to change the Bill to ensure that there are no reductions to participants access to Occupational Therapy, capacity building supports or community participation supports, and that participant’s needs are assessed individually by a qualified allied health professional, not utilising standardised assessments administered by employees of the NDIA. People like myself who live with a disability, require ongoing access to community participation and capacity building supports in order to be able to participate in our communities and lead fulfilling lives.