Joint Standing Committee on the National Disability Insurance Scheme
Hear and Say Submission
Overview
Hear and Say remains committed to supporting the successful implementation of the National Disability Insurance Scheme (NDIS). As a service provider delivering early intervention, audiology and social skills development programs in support of children with hearing loss and their families, there are ongoing concerns regarding the impact of the NDIS on this cohort of clients and the potential for Hear and Say to deliver sustainable supports required to deliver the listening and spoken language outcomes sought by many parents of children who are deaf.
As continuing contributors to the Joint Standing Committee on the NDIS, Hear and Say (also a member of First Voice, the national body that advocates for world-class early intervention services that provide deaf children with listening and spoken language skills) is keen to provide further insight into the challenges facing customers of and, service providers under the NDIS.
The opportunity to invest in intensive early intervention in this cohort of children with hearing loss whose parents are seeking clear, natural speech and language for their children would significantly reduce any future and longstanding reliance on the NDIS as young adults / adults. The program run at Hear and Say and many other First Voice centres has objective research evidence to demonstrate longstanding outcomes that support the insurance / early investment model promoted by the NDIA however, this has not been supported throughout the implementation of the Scheme.
There are a number of overlaps in the issues as outlined Terms of Refence provided for this Inquiry however the following key issues are provided for information.
KEY ISSUES FOR CONSIDERATION
Communication
- Changes to the Hearing Pathway are not being adequately communicated with providers and/or families. It is difficult to support families to access the scheme when the pathway is unclear.
Funding levels
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Initial and subsequent plans are consistently inconsistent and are continuing to be, overall, underfunded. Planners will frequently make comment on service provision quotes and arbitrarily fund / not fund parts of these evidence-based programs.
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Paediatric hearing loss and the therapies associated with achieving age appropriate listening and spoken language outcomes for these children rely heavily on the involvement of parents, extended family and often the community. The practice of linking funding packages to levels of hearing loss does not recognize the wealth of research evidence supporting intensive early intervention and instead suggests that the greater the hearing loss the greater the therapies and supports required. This is completely inaccurate and is proving detrimental to children with hearing loss and the families seeking listening and spoken language outcomes for their child.
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The impact of unilateral hearing loss can be significantly reduced through the use of hearing technology and early, intensive (but not long-term) therapies however minimal funding levels approved by planners do not support the programs required to achieve optimal outcomes for these children with single-sided hearing loss.
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Children previously funded under the Better Start Scheme have not been eligible for the prioritised Hearing Pathway and thus plan and enrolment delays have occurred.
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A specific case where a family has two children approximately 2 years age difference with similar levels of hearing loss and similar therapeutic requirements have received completely different funding levels despite the same parent advocacy and program quotes provided to planners.
Planner Awareness / Education
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The field of paediatric hearing loss is so specialized that the experience of planners in this filed is extremely limited. There are significant inconsistencies in the application of the Hearing pathway and planner awareness / education regarding the impact of hearing loss and the neurological impact of delays to therapies that optimize hearing technologies
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Early Childhood Early Intervention (ECEI) partners have inconsistent or are unaware of changes or Hearing Pathway.
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Conflicting information is being provided regarding the access process for children with a Hearing Loss based on differing ECEI partners. This process is confusing and distressing for families and makes supporting them through the process difficult.
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NDIS planners take information provided and apply their own guidelines in order to put together approved plans often neglecting recommendations made by specialists or recognizing the services a family may already be accessing.
Review process - Ease / Timing / Scheduled Vs Unscheduled
- A specific case for a child with hearing loss / family enrolled one of our fortnightly programs has seen a plan be funded at approximately 50% of the quoted amount and although working with the family and their ECEI partner to start an unscheduled review, it has been our experience that unscheduled reviews can take up and at times over to 9 months with positive outcomes not assured.
Transactional / administrative overheads
- The significant overheads associated with providing initial support to families or transacting with plan managers / self-managed participants has placed substantial strain and financial burden on small to medium providers and at times means costly delays in cashflow or systems investment.
Self v Plan v Agency managed issues
- Families, particularly ESL families or families finding it difficult to navigate the Scheme, have at times been encouraged or have misunderstood the implications of different plan management options.
Impact of NDIS on program outcomes
- Under the NDIS, it is becoming increasingly clear that clinical programs, previously designed to achieve optimal outcomes for children with hearing loss are being compromised to fit funding models.
Summary
Hear and Syan and First Voice have done significant work in support of the Agency to achieve a referral pathway and funding levels appropriate to achieve optimal listening and spoken language outcomes for children with hearing loss that have a lifelong impact and will reduce the financial cost to the community required to support these children across their lifespan however disappointingly this has now been ignored and not incorporated into the Scheme implementation.
Hear and Say would be keen to have the opportunity to present to the Joint Committee further information and specific examples relating to the issues outlined as part of this submission if the opportunity was made available.
Date prepared: 6 September 2019