JOINT STANDING COMMITTEE ON THE
NATIONAL DISABILITY INSURANCE
SCHEME
INQUIRY INTO THE PROVISION OF
HEARING SERVICES UNDER THE NDIS
AUSTRALIAN GOVERNMENT
DEPARTMENT OF SOCIAL SERVICES
SUBMISSION
JANUARY 2017
Background / Context
There are 17 Commonwealth programs that are transitioning funds (in full or in part) to the National Disability Insurance Scheme (NDIS). At full scheme implementation in 2019-20, the funds from these programs are expected to contribute approximately 10 per cent (around $1.1 billion per year) of the Commonwealth’s total contribution to the NDIS. The funds are being transitioned in the form of cash paid to the National Disability Insurance Agency (NDIA), or through in-kind services delivered to NDIS participants.
Scope of this submission
Of the 17 Commonwealth programs, there are four which provide services and supports to people who are deaf or hearing impaired. These are:
- Hearing Services Program
- National Auslan Interpreter Booking and Payment Service
- Remote Hearing and Vision Services for Children, and
- Better Start for Children with Disability. The Hearing Services Program is managed by the Department of Health and the subject of a separate submission by that department.
The National Auslan Interpreter Booking and Payment Service, Remote Hearing and Vision
Services for Children and Better Start for Children with Disability programs are managed by the Department of Social Services (DSS).
This submission provides details of these three programs and addresses the terms of reference below, specifically as they relate to these programs:
b. delays in receiving services, with particular emphasis on early intervention services;
d. the accessibility of hearing services, including in rural and remote areas; and e. the principle of choice of hearing service provider. Program descriptions
National Auslan Interpreter Booking and Payment Services
The National Auslan Interpreter Booking and Payment Service (NABS) aims to facilitate communication between people who are deaf or hearing impaired and private medical practitioners by providing Auslan interpreters for private medical appointments that attract a Medicare rebate. The program seeks to provide this service to clients outside the public and private hospital systems; however, the exception to this is that all sign language interpreting services to deaf Indigenous people are provide free of charge for both public and private health care appointments. Funds for clients under 65 years will be transitioned to the NDIS.
Wesley Mission Queensland is the sole provider of this program. Based on historical data, it is estimated that 80 per cent of NABS clients are aged less than 65 years. A total of 27,415 NABS appointments were conducted in 2015-16, of which approximately 21,932 were for clients aged less than 65 years.
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NABS remains a demand-driven program. Wesley Mission Queensland has implemented a process to identify NDIS participants at the time of booking, and encourages potentially eligible clients residing in NDIS areas to register for the scheme, where appropriate. DSS continues to work closely with Wesley Mission Queensland and the NDIA, to support transition of NABS clients and services to the NDIS.
NDIS participants who are deaf and use Auslan to communicate may have Auslan interpreting as a ‘reasonable and necessary’ support in their plan. Depending on the participant’s goals, Auslan interpreting may be funded for a range of purposes. NABS currently only fund interpreting for private medical appointments.
Under the NABS program, Auslan interpreters are paid in accordance with their agreement with Wesley Mission Queensland. Under the NDIS, Wesley Mission Queensland, or other organisations delivering interpreting services will be paid in accordance with the NDIS price guide.
Remote Hearing and Vision Services for Children
The Remote Hearing and Vision Services for Children (RHVSC) program is targeted at children, up to and including 18 years of age, with permanent and significant hearing and/or vision impairment and their families in outer regional and remote locations across Australia, including Indigenous communities. It is a small program currently providing services to less than 60 children. The service provides technology, training, resources and where applicable communication services to enable eligible children and their families to access educational and specialist allied health services via remote service delivery methods. It is expected most participants of the program will be eligible for the NDIS.
The Royal Institute for Deaf and Blind Children is the sole provider of this program.
The RHVCS program is block-funded. The provider is paid a set amount to deliver services for clients. Under the NDIS, the provider will claim a fee for the service in accordance with the NDIS price guide.
Better Start for Children with Disability
The Better Start for Children with Disability (Better Start) program aims to assist eligible children with developmental disabilities to access funding for early treatment, diagnostic and management services.
Under Better Start, children under the age of six with an eligible diagnosis can access early intervention funding of up to $12,000 (a maximum of $6,000 per financial year). The funding is used to pay for services and therapies from a panel of registered services providers. Funding must be spent prior to the child’s seventh birthday.
To access Better Start, families must register their child prior to their sixth birthday. The Department has established a Registration and Information Service managed by Carers Australia to assist families wanting to access Better Start.
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Eligibility criteria for Better Start includes an eligible diagnosis of hearing impairment that results in: a permanent hearing loss of 40 decibels or greater in the better ear, across four frequencies (the four frequency average hearing loss represents the average of hearing thresholds at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz); or permanent conductive hearing loss and auditory neuropathy in both ears; or
- deafblindness. It is expected that most children in the Better Start program with a primary disability of hearing impairment or deafblindness will be eligible for the NDIS.
Better Start funding is transitioning into the NDIS as it rolls out. Children registered under Better Start continue to draw upon their funding until their individual NDIS Plan is in place. There are currently more than 5,900 children receiving services under the program, of which more than 1,500 have a primary disability of hearing impairment or deafblindness.
Allied health providers delivering services under Better Start must charge fees that represent value for money. DSS publishes the early intervention fee schedule for each provider on the DSS website. Under the NDIS, early intervention providers will be required to charge for services according to the NDIS price guide.
Statements addressing terms of reference
b. delays in receiving services, with particular emphasis on early intervention services People who are deaf or hearing impaired, and currently receive services and supports through Commonwealth programs which have funding transitioning to the NDIS, will continue to receive services under the program until they are registered with the NDIS and have a plan in place. They will then receive the services under their plan.
DSS is working closely with the NDIA to streamline the intake process for clients of Commonwealth programs. This work has included DSS, or the service provider, providing client details to the NDIA. This enables the NDIA to contact the client when the scheme is commencing in a region, or is commencing for an age cohort, and it is ready to accept the client’s access request.
These measures will ensure clients in receipt of hearing services under Commonwealth programs will not experience gaps or delays in services during transition to full scheme.
d. the accessibility of hearing services, including in rural and remote areas Better Start, RHVSC and NABS provide national coverage and have strategies in place to ensure access to services for people in rural and remote areas. It is expected that the workforce for these programs will continue to deliver services under the NDIS.
Wesley Mission Queensland is required to have strategies in place to ensure access to NABS for deaf Auslan users living in regional and remote areas. The RHVSC targets children up to and including 18 years of age and their families living in regional and remote areas. The two providers of these programs are registered with the NDIA to continue providing services under the NDIS.
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There are currently over 250 providers of Better Start operating in outer regional, remote and very remote areas. It should be noted that these providers deliver a range of supports, and not all will currently be delivering services for children with hearing loss.
e. the principle of choice of hearing service provider Two of the DSS programs delivering hearing services, NABS and RHVSC, are delivered by sole service providers. When clients of these programs transition to the NDIS, they will be able to choose their service provider from those registered with the NDIA. If clients elect to manage their own funds, they may choose from a broader range of providers than just those registered with the NDIA.
There are close to 3,000 providers registered to deliver early intervention services under the Better Start program. Families can choose their Better Start provider from these providers. When clients transition to the NDIS, they will be able to choose their provider from those registered with the NDIA. If clients elect to manage their own funds, they may choose from a broader range of providers than just those registered with the NDIA.
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