Hearing services under the NDIS: Eligibility, funding, and provider choice

The Provision of Hearing Services under the NDIS

Submission

January 2017

ABOUT US

The Deaf Society of NSW (trading as the Deaf Society) was established in 1913 and is a company limited by guarantee. We are a not-for-profit, bi-lingual, bi-cultural, community-centred organisation which exists to achieve equity for deaf people. Our services include employment services, Auslan interpreting, education and training, independent living skills, advocacy, community development and community services. We work in partnership with the Deaf Community to enhance the quality of life of deaf people, strengthen the community and bring about change to ensure fundamental rights and freedoms.

RECOMMENDATIONS

That choice and control in relation to choice of audiologists and equipment providers be strengthened.
That requirements for new audiologist reports be relaxed for people who are already profoundly deaf.
That Auslan be included in research objectives relating to early intervention and supports for people with hearing loss.
That Auslan learning be adequately funded in support packages.
That Auslan interpreting is automatically allocated to all deaf people who uses Auslan to access services, medical appointments and NDIS meetings.
That the appeal process for disputing what in the packages especially for Auslan interpreting should be reduced from three months to maximum of four weeks.

OUR RESPONSE

The Deaf Society greatly appreciates the opportunity to comment on hearing services provided under the NDIS. The comments below reflect our experience working directly with NDIS participants.

THE ELIGIBILITY CRITERIA FOR DETERMINING ACCESS TO, AND SERVICE NEEDS OF, DEAF AND HARD OF

HEARING PEOPLE UNDER THE NDIS

It is excellent that the NDIS is not means tested, as this enables much better access to hearing aids and batteries as was previously the case.

There have been some frustrations with the practical elements of planning and providing evidence as part of proving eligibility, for example:

Profoundly deaf people having to provide recent information / evidence of their hearing loss, when the old information is very unlikely to have changed. Getting new evidence costs both time and money.
We have heard of a deaf person being denied an interpreter for a planning meeting. The deaf person was asked to write back and forth with the planner. The planner needed to be shown the relevant section of the NDIA “Operational Guideline – Planning and Assessment – The Planning and Assessment Conversation” before they would book an interpreter.
We have been told of situations where the LAC in the planning session has asked the deaf person to choose either hearing aids or interpreters. In some cases the LAC has allowed both when the deaf person explained why they need both and in another case the LAC forced them to choose.

Provision of Hearing Services under the NDIS 2 January 2017

We know of a situation where a deaf person was asked to provide evidence that they used interpreters for social and personal events as the deaf person was asking for a review of the amount of interpreting funds in their plan. Consideration needs to be given to the fact that many deaf people won’t have this evidence as they have never been able to afford personal funds for these types of events.

THE ADEQUACY OF FUNDING FOR HEARING SERVICES UNDER THE NDIS

We cannot comment on the scheme-wide situation, but we do have anecdotal evidence that funding is not always adequate for individuals. For example:

In terms of assistive technology, some people are being granted what they have requested and others are being asked to submit a quote from an occupational therapist. Some are being given funding for the occupational therapist assessment and others are not. This appears to vary.
We know, for example, of one person who has $750 for assistive devices in her plan and another who has $1900. Both plan to use those funds for new hearing aids. It is not clear why one has more than the other. The first person has decided that the hearing aids she wants will cost $5000. So there is a clear difference between the funds provided and what she needs.
We know of a case where a deaf person was asked to get three quotes from an Audiologist with an occupational therapist report, but the deaf person had to pay for the report each time. The LAC advised that person to get the OT report from one Audiologist and use it for obtaining the 3 quotes. However, when they went to the other audiologists after getting the first occupational therapist report they wanted to do their own report in order to prepare their quote and the deaf person had to pay for that in each instance. This was after the plan had been approved and consideration was not given to these extra costs in the planning meeting.

THE PRINCIPLE OF CHOICE OF HEARING SERVICE PROVIDER

The NDIS support the principle of choice in theory and generally in practice. However, there have been some cases where this principle has not been upheld as consistently as might be hoped.

We have heard that participants must make the purchase through http://www.enable.health.nsw.gov.au/home/about_enablensw or if they want to purchase elsewhere the cost must be equivalent to Enable.
We have heard of a case where a deaf person had used a same audiologist for years but was required to get a report from an occupational therapist and three quotes as well. There was no independent occupational therapist so the report would have to have been obtained from an audiologist. However, normally the audiologist will give a report only if you use their service. If NDIA decide that a deaf person needs to go to a new audiologist due to the costs, this is not supporting choice and control. Deaf people generally do not want to change audiologists because the equipment is cheaper elsewhere. In many cases, they would prefer to stay with the audiologist they have.
We know of another situation where a deaf person had to get 3 quotes for hearing aids. Those quotes were given to the NDIA to approve. There is every chance that the NDIA will approve the cheapest quote that may not necessarily be the choice of the deaf person.
We know of another situation where a deaf person went to their Audiologist to get the occupational therapist report. The Audiologist refused to give it to them directly and only wanted to send it to the LAC directly. Deaf people have a right to access information about their disability.

Provision of Hearing Services under the NDIS 3 January 2017

INVESTMENT IN RESEARCH AND INNOVATION IN HEARING SERVICES

We would very much like to see more research into the benefits of using Auslan in early intervention and disability support programs. Current research trends in Australia (see for example the Research Objectives here) seem to ignore Auslan as a plausible intervention. This is out of line with international trends, especially in Northern Europe, where signed languages are a mainstream part of early intervention and disability support programs.

Auslan is not always adequately provided for in early intervention. We know of packages for young children where Auslan learning has been provided for, but consideration needs to be given to an amount that does in fact allow for the acquisition of language. One hour per week, for example, is not enough to adequately acquire a language. It would be good for NDIA staff to have an understanding of what kind of time is required to acquire a language, both for parents and children.

We are also concerned by the variation observed in NSW and ACT in allocated hours and funding for interpreting for NDIS participants for their medical appointments. It noted that in some cases, there was no provision of medical interpreting in the package even though the clients provided information/evidence of previous medical appointments and hours of medical interpreting. On the NDIA website it has stated that:

“ The NDIS provides funding for support for participants with hearing loss and use of Auslan to access interpreting and translation services in activities of daily life. The Scheme provides choice and control for participants over how they use those services. This can include the provision of Auslan interpreting for medical appointments. Auslan users cannot access both the NDIS and the National Auslan Booking and Payment System (NABS) – once a NABS client joins the NDIS, their interpreting needs will be covered as part of their plan. Participants can choose the provider they prefer, including Wesley Mission Brisbane, which delivers the Commonwealth’s NABS. People can continue to use the NABS until their NDIS plan is in place. The NABS remains funded to deliver a full range of Auslan interpreting services at medical appointments until clients move into the NDIS. The NDIA is working hard to ensure NDIS plans include appropriate allocations for interpreting and translation supports. “ https://www.ndis.gov.au/people-disability/what-help-can-i-get

Here are two examples of the variation of allocated funding for Auslan interpreting for medical/health related appointments:

A Deaf person who had a meeting with their local area coordinator, received 40 hours of medical interpreting as a result of providing evidence that they required medical treatment every two weeks with appointments longer than one hour in duration.
Some NDIS participants in NSW did not receive any funding for medical interpreting. In some cases, they were told that their other approved hours for interpreting needed to be accessed in the event that medical interpreting was required.

The Deaf Society asserts that some participants are worse off than before they entered the Scheme because of inconsistency in assessments and allocation of funding. It noted that the process for disputing funding takes up to three months and this has created higher level of stress for the participants as they are heavily reliant on access to information during appointments in relation to their or their children’s health.

Provision of Hearing Services under the NDIS                  4                                                 January 2017

CONTACT

Leonie Jackson

Chief Executive Officer

Deaf Society of New South Wales

ph. (02) 8833 3600 fax. (02) 8833 3699

Provision of Hearing Services under the NDIS                  5                                                 January 2017