Deaf Services Queensland
Submission
The Provision of Hearing services1 for the NDIS for the
Joint Standing Committee on the NDIS
Background
Joint Standing Committee
The Joint Standing Committee on the NDIS is seeking submissions regarding how Deaf1 services are transitioned to and and delivered through the NDIS. Terms of Reference2 for the inquiry are as follows:
a) the eligibility criteria for determining access to, and service needs of, Deaf and hearing impaired people under the NDIS
b) delays in receiving services, with particular emphasis on early intervention services; c) the adequacy of funding for Deaf services under the NDIS d) the accessibility of Deaf services, including in rural and remote areas e) the principle of choice of Deaf service provider f) the liaison with key stakeholders in the design of NDIS Deaf services, particularly in the development of reference packages
g) investment in research and innovation in Deaf services; and h) any other related matters.
Deaf Services Queensland
Deaf Services Queensland is a not for profit organisation working with the community to enhance services and programs that benefit Deaf or hard-of-hearing adults and children across Queensland. Supports and services cover the entire lifespan from early intervention, lifestyle support, community engagement and development, education, interpreting and ageing well. Deaf Services Queensland is the prominent end-to-end service provider, advocate and leader for Deaf or hard-of-hearing
1 The term Deaf Services instead of Hearing services is used in this submission to recognise the needs of our community and that services are related to the needs of Deaf people not hearing people. 2 http://www.aph.gov.au/Parliamentary_Business/Committees/Joint/National_Disability_Insurance_Scheme/HearingServices
Brett Casey – Chief Executive Officer
community members across all ages with a focus on community and empowerment in Queensland. Deaf Services Queensland also provides Auslan interpreting onsite (face to face) and online (video remote interpreting - VRI) and also provide afterhours emergency interpreting services.
As the prominent end-to-end service provider in Queensland for Deaf people, a provider in the early NDIS launch site of Townsville and with over half of staff proficient in Auslan, Deaf services Queensland is well placed to make observations and share experiences relating to the NDIS and Deaf services implementation. This paper is informed by these observations with a focus on Queensland. Our submission to the Joint Standing Committee seeks to address each area of the inquiry.
Terminology
Deaf Australia operates a terminology policy that was adopted by members in 2010i. For the purposes of this paper Deaf Services Queensland adopts these definitions:
deaf: all Deaf and hard of hearing groups at once Deaf: culturally Deaf people who use Auslan and identify with the Deaf community hard of hearing: people whose primary communication mode is speech
An additional concept discussed in this paper is deafhood which is the process of actualising deaf identity.ii Auslan is Australian Sign Language which is the language of the Deaf community in Australiai.
Auslan
Willoughby (2013)iii reported from 2011 ABS census data that there were 9723 Auslan users. This figure represents a 124% increase from the 2001 census which was explained by several factors including, growing Auslan pride in the community and a census awareness campaign by Australia Deaf Societies. Queensland had a population of Auslan signers (n= 2221) which was only a few hundred less than NSW, thought to be explained by increase in children using Auslan at home due to QLD government policy implementation of transition to Auslan in Deaf education.
Other studies have estimated that there are around 15,000 people using Auslaniv. The census cannot be solely relied on as many deaf people with English as their second language may not have completed the census due to lower English literacy (English is a second language) and many may have missed the question about “speaking” a language other than English at home as it would have been perceived as not being relevant. Indeed, people may “speak” English at home but in reality it is not their preferred language. Addressing the Terms of Reference
a) Eligibility criteria Eligbility criteria for determining access to, and service needs of, deaf and hearing impaired people under the NDIS are currently defined according to the operational guides of the Early Child Early Intervention (ECEI) or Individual Funding Program (IFP) approach.
Early Childhood Early Intervention (ECEI)
Eligibility for the ECEI approach are as follows: 0-6 years Live in Australia and are an Australian citizen, or have paperwork that gives you permission to live here permanently Meet four early intervention requirements
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Identified disability or impairment that is likely to be permanent or a developmental delay
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ECEI will reduce future needs for supports in relation to disability
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ECEI will benefit the person through reducing impact of disability, preventing deterioration, improving functional capacity and strengthening supports
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Is NOT most appropriately funded through external systems The operational guidelines for access to early intervention supplies a list of permanent impairments that mean no further assessment is required. The relevant definitions to Deaf and hard of hearing in the guide are: Deafblindness confirmed by ophthalmologist and audiologist and assessed as resulting in permanent and severe to total impairment of visual function and hearing Deafness/hearing loss – a 45 decibels or greater hearing impairment in the better ear, based on a 4 frequency pure tone average (using 500, 1000, 2000 and 4000Hz)
Issues arising from ECEI eligibility criteria Children born in Australia with parents from NZ are NOT eligible for the scheme. At the age of 10 they become eligible for the scheme, meaning they missed a critical window of opportunity for early intervention to assist with language acquisition (whether by signing or speech or both) and other interventions for their disability. The aim of early intervention is to reduce the long term cost on the scheme. The automatic inclusion (no further assessment required) is useful; however, this did lead to a misunderstanding among parents that if their child was not in this decibel range then they would not be eligible for ECEI – even though children with less hearing loss benefit from early intervention in terms of speech and language development. The Auslan referral pathways for Deaf children has not been well understood by the Access Partners and NDIA planners. There is little understanding that even if a medical intervention such as cochlear is taken, parents may still choose an Auslan pathway to work in conjunction with this or parents may prefer an Auslan only pathway. Language acquisition through speech is seen as an allied health pathway whereas language acquisition through signing is not seen as an allied health pathway and less emphasis has been placed on the acquisition of Auslan as it is not an allied health service although it should be seen as an integral partway for deaf children. Mapped Auslan pathway early intervention approach is needed for planners, LAC’s or supports coordinators to assist families to make informed decisions for their children. Families should not be provided with an either or approach to Deafness early intervention, rather a range of options that suit them and their child’s needs.
Independent Funding Program (IFP)
Eligibility for IFP is as follows: Under 65 years old
Live in Australia and are an Australian citizen, or have paperwork that gives you permission to live here permanently Meet disability requirements: o disability that is attributable to one or more intellectual, cognitive, neurological, sensory or physical impairments or to one or more impairments attributable to a psychiatric condition o impairment/s are, or are likely to be, permanent o impairment/s result in substantially reduced functional capacity o impairment/s affect their capacity for social or economic participation and o likely to require support under the NDIS for their lifetime
Issues arising out of IFP eligibility criteria These are not issues with eligibility as such, rather matters related to access and evidence of eligibility : It is unclear in the operational guides whether a decibel reading minimum is a criteria for inclusion or exclusion, in other words no adult Deaf person is defined under the NDIS even though it has been present since birth. There is no NDIA information in Auslan on the process for accessing the NDIS, there is Auslan on the pathway, about the NDIS and planning, not what they need to do to access it (e.g. Access Request Form, Audiology reports and so on). Contact with defined participants3 via phone and then follow up with a letter is an inaccessible method for Deaf people due to their unique language needs. Further, phone planning is also an unsuccessful method of engagement. As the practice in NDIA is people wait longer if they are not prepared to have a phone interview, this places Deaf people in an unfair and even discriminatory position with the planning and implementation process. Where planning has been made available NDIA have stated they would like the planning meeting to happen in Townsville not the persons residence of Ayr 90 km away so as to reduce interpreting cost4. NDIA planner’s failure to organise and book interpreters for planning conversation leaves the person at great disadvantage in planning for their future. Further we have had experience in Mackay when having the second meeting to hand over the plan to Deaf participant, NDIA are booking interpreters for the hand over but not paying for the interpreter. This has been charged retrospectively to the participants plan by the NDIA preferred provider –these hours were not included in the persons plan and perhaps the choice of provider is not that of the participants anyhow. Further we are aware that a planner advised a participant to “work out a way of communicating with coordinator so as to not use up interpreting hours”. This raises some serious issues about adequate service choice and control for Deaf participants (refer to terms of reference a, c and e). Requirement of audiology reports as evidence of permanent disability has not been consistently applied by planners. It is unclear under what circumstances an audiologist report is required. Previously people were told they did not require for ARF (access request form) and recently that has been over turned. There appears to be an assumption that adult deaf people have current Audiograms. Many Deaf people may not have had one completed since child hood and it is an expense for participants to bear for a document that the conditions in which an audiogram is required is not clear. For instance, why would you have an interpreter if you were not deaf? It may be a requirement for hearing aid technology, however, this should consistently form part of
3 Those participants already accessing support services funded by State Government disability services 4 NDIA has a preferred interpreter booking service, this has failed to consider VRI (Video remote interpreting) technology which makes distance and availability less of an issue.
the assessment for equipment component of support rather then something needed as evidence to enrol in the NDIS.
b) Delays in receiving services Staff in QLD regional office Townsville have noticed delays in receiving services after plans have been approved. There are several approaches to meeting the needs of Deaf people, although communication and language acquisition (be it English, Auslan or both) is important (Refer to Appendix A – Language Acquisition). Where only a medicalised approach is taken, children in particular, miss out on the opportunities to acquire and develop a life long language and the opportunity to connect with and be with their CALD community (Refer to Appendix B – Deafhood and CALD).
In our experience, delays in service are related to provider availability and limited awareness from relevant planner, LAC, support coordintor on possible pathways of support for a Deaf child or adult. Planners in particular have been unaware of the range of ways support can be provided to Deaf children and failure to recognise Auslan as an important aspects of a child’s development for long term independence. This results in a failure to refer to a range of options for service provision in the early intervention space.
Further, many planners have not understood the fundamental importance and need for an interpreter to be booked and attend a planning for a Deaf person. Not supplying an interpreter obviously creates issues of accessibility for Deaf people and phone planning is clearly a process that disavantages someone who is Deaf. Further, we are aware of planning meetings cancelled due to no interpreter. Deaf Services Queensland has already recommened Deaf Awareness Training (DAT) be rollled out Statewide to overcome this and a host of other issues associated with eligibiltiy, service delay and funding needs (Refer to Appendix C – Deaf Awareness Training). An example of limited Deaf awareness can be highlighted in something as simple as the naming of this submission as hearing services. This naming fails to recognise that services are related to the needs of Deaf people not hearing people. From a CALD perspective that would be similar to calling services for Aboriginal and Torres Strait Islanders a European service.
Issues of service delay are obviously exacerbated through the tyranny of distance and limited options of specialist5 providers within certain locations. These are discussed in more detail under inquiry reference d) accessibility of Deaf services.
c) Adequacy of funding for Deaf services There are some obvious pricing and charging issues with regards to funding for Deaf services. In particular, in relation to interpreting (Refer to Appendix D – interpreting and the NDIS). The framework for interpreting under the NDIS will result in more individual funding however it moves the responsibility and burden from the system to the person; this is discussed in some detail in
5 In discussing specialist services, we are referring to providers who provide information and support through the method of communication required by the person and having staff who understand Deafhood. For example, Auslan communicating staff for drop in support, in home and community support workers. This is a unique point of difference from other non-specialist Deaf service providers.
Appendix D. From our learnings and experience with the NDIS and Deaf services in the ECEI and IFP space the following is some of the identified funding issues.
Interpreting and the NDIS A full analysis of the NDIS interpreting model as compared to the current approaches is offered in Appendix D by way of explanation. Interpreting hourly rate is not appropriately costed and does not consider the implications of best practice and award conditions for professional accredited interpreters: o Hourly rate is inadequate o Interpreters work a 2 hours minimum. This is reinforced with the Commonwealth Fair Work Act too. o Anything over 2 hours will require second interpreter to prevent physical and mental fatigue of the interpreter. o Captioning is quoted at the same as the interpreting hourly rate when industry standard it is nearly double the actual cost. It would be prudent to suggest that interpreting and captioning require very different resources and a complete different skill sets to implement. o Cost of travel is not adequate, particularly where supply of interpreters is limited. VRI (Video Remote Interpreting) can address some of these issues; however highly specialist deafblind interpreters for example will need to travel and will need to be face to face.
Further issues related to interpreting are noted in the Appendix D and are also addressed in the terms of reference a), however there are some additional observations we can offer. Firstly, there is confusion amongst NDIS offices in different locations and in particular the planners as to whether NABS (interpreting for medical appointments) and EAF (Interpreting relating to employment) are absorbed under NDIA or not. We have seen a discrepancy in decision making by planner as to whether to allocate NABS and EAF funding into the plan of the participant or not. This is placing a lot of angst amongst the community and the NDIA is not clear on the ruling of this. Additionally given the NDIS information on the NDIA website is very limited with Auslan this issue is exacerbated. This issue is further discussed in some detail in Appendix D.
Secondly we would argue that as a result of the interpreting issues and the model of interpreting deployment developed by the NDIA, Deaf people will actually be worse off in terms of accessing interpreters for their needs under this model as opposed to the current models of interpreting that actually exist. Medical interpreting under the Commonwealth funded NABS program is for all deaf people regardless of age and accessibly without eligibility criteria and or having to attend a planning meeting to discuss medical needs with a planner to receive an allocation of funding for medical interpreting needs. Currently interpreting for medical appointments the client and or medical centre can call and request an interpreter to attend at no charge of either (Refer Appendix D).
It is important for the reader and other government departments to understand that interpreting is about access to a service and not be seen as a support needs at the service. By way of analogy a wheelchair user need to have accessible ramps and or lifts in building to access the service they are seeking in the said building but the ramp or lift doesn’t form part of their care plan. By cashing in the NABS program to the NDIS means a deaf person has to go and predict and forecast their annual interpreting needs for medical appointments and the planner makes the decision as to whether this will be allocated or not (and we have seen some getting allocations and others not by the NDIS
planners) and could be based on historical data or not. However medical issues of individuals occur at any given time and are not scheduled appointments and or should not be seen or predicated over a year and be available at any given time as it is now with the current model. By requesting the Deaf individual to register with the NDIS and receive an IFP just to be able to access a GP is an onerous burden and one over and above that of their hearing peers are required to do. This impinges on the human rights of the Deaf individual.
Further whilst the Government is looking at the economic costs of funding the NDIS and cashing in current Commonwealth programs, we argue that this model of cashing in the NABS and EAF program will only increase the administrative and financial costs to the National Disability Insurance Scheme which is already under resourced to handle the intake numbers expected.
Funding tablets and data under the NDIS Although it has been difficult to get a firm stance from the NDIA, the funding of tablets has been in the main rejected in plans. A key strategy to making interpreting accessible is through VRI (Video Remote Interpreting), where the person has a tablet or similar device to use for interpreting. The other issue related to this is data to stream interpreting, this is a cost associated with support needs that should not be the burden of the individual.
It appears that the NDIA want services to provide and or develop innovative service solutions however are not keen to fund a participant in being able to access such innovation with technological devices even though this will keep the expenses down for the NDIA over the long term.
Funding equipment and technical aids under the NDIS At this stage we have had limited experience with the funding of equipment and technical aids (beyond tablets) for Deaf services. Initial concerns related to the caps that related to devices such as hearing aids, however, these caps were removed in the next iteration of the pricing and charging guide. It will be curious for us to notice how that applies in practice.
Deaf Awareness Training
As existing funding paradigms phase out the NDIS steps in some gaps become apparent. Under the old EAF (Employee Assistance Fund) a range of supports and services were funded included Deaf awareness training for workplaces employing someone who is Deaf. An invaluable and important support service to an individual under the NDIS. Although, we have asked the question of the NDIS whether this could be funded under an individual’s plan this is still be tested and understood (Refer to Appendix C – Deaf Awareness Training and the NDIS). Further, individuals would need to understand its importance in achieving an employment goal when meeting with their planning
Information, Linkages and Capacity Building (ILC)
Although this scheme is yet to roll out, it has become a point of concern that Deaf people will inherently miss out under the ILC approach where there is not recognition of the need to communicate directly with a person in their native language. Mainstreaming of these services has benefits for the broader disability community in terms of connecting them locally, however Deaf people will always be Deaf and always require their communication needs to be met as a fundamental human right. Supplying interpreting for this support creates barriers such as lack of responsiveness (having to book and organise an interpreter to address walk in needs) and limited
insight of workforce that does not communicate in Auslan in terms of understanding the needs of deaf people in order to really build their resilience and capacity in addressing their own issues. Further understanding Deaf culture will be fundamental for appropriate support through the ILC.
d) Accessibility of Deaf services Accessibility of Deaf services, including in rural and remote areas is a significant area of concern for our community as the NDIS rolls out. Accessibility pertains to the area of communication for a Deaf person where people will require either access to captioning services or interpreting to access the NDIS, plan for their supports, implement their support AND as part of their individual plan. This makes communication accessibility a key issue throughout the entire NDIS pathway to the point of then accessing their needs under the NDIS plan. If the individual choose a deaf service such as Deaf Services Queensland the issue of communication is no longer an issue given that our organisation can communicate with the Deaf person in their own language.
However, specialised models of providing workforces that use Auslan are overlooked in rural area and this is compounded in indigenous and other CALD communities where people are also Deaf. Access is primarily about interpreting and is for the benefit of the public and private sector or community at large not just the Deaf person. Access to services that are not Deaf friendly will require additional interpreting hours and is not something the planners are aware of – another example of Deaf Awareness Training that is needed for NDIA staff (refere Appendix C). The key issues of accessibly we have identified and experienced in Queensland are noted below.
Workforce accessibility issues Limited Auslan communicating staff for in home or community support in rural and remote areas. This is a workforce issue and an issue of accessibility for a Deaf person who requires support. However, the high cost of delivery for the provider will increase inaccessibility.
In most places in Queensland there are NO locally available interpreters. Access to VRI can overcome this to some degree, however as noted earlier, by not funding tablets and data VRI also becomes inaccessible instead of being the most cost effective and accessible method for providing interpreting.
Service agreement planning As Deaf people require a face to face conversation for developing their plan and consequent service agreement with a provider, the cost of transport for initial assessment and meeting to make service partnership agreements are prohibitive in rural and remote areas. The benefit of a specialist service with bilingual staff is that an interpreter is not required at partnership agreement meetings as staff can communicate directly with a person in Auslan. Non-specialist providers would require an interpreter at each meeting with the participant which needs to be included in their individual plan.
ILC approach The ILC approach has been identified as being largely inaccessible in practice and principle for Deaf people as already noted under c) adequacy of funding.
Definitions of rural and remote Given the specialist nature of support required by Deaf people, issues of support overlap with issues of rural and remote delivery. For example, under the Modified Monash Modelv where areas are not considered remote by geography from our experience we would consider them remote due to the fact that no specialist services exist to provide support, creating an issue of remoteness. For example, where an interpreter does not live in a town, even if the town is not defined as remote the lack of interpreters makes it more remote.
e) Principle of choice of Deaf service provider The principle of choice for Deaf service provision is closely associated with the principle of inclusion. A fully inclusive community and society is an applauded principle and area of policy action in the National Disability Strategy 2010-2020 and one that Deaf Services Queensland supports. However, failure to recognise Deaf people have a “bona fide” cultureii presents an ongoing failure to honour Deafhood and Deaf identify. The NDIS and associated system changes for many deaf people fails to recognise that deaf people view inclusion as being and living in part of their own community. Whilst mainstream services and access to these services are equally important, many Deaf people prefer to mix with other Deaf people and attend deaf related events, in the same way people from different CALD groups often prefer to mix with those with similar cultural experiences. This is due to the barrier free communication environment that they participate in and the inherent cultural understanding of one another. This notion is complex for the required NDIS paradigm shift that is aimed at inclusion. Therefore, in discussing the principle of choice there needs to be a deep understanding of Deafhood as a CALD issue (Refer to Appendix B – Auslan recognised as a CALD commuity).
Deaf Services Queensland staff have noticed two key issues relating to choice of provider. Firstly, families and parents need to be offered a range of pathways and merging of pathways between a medicalised response (cochlear and English acquisition) and a Deaf culture response (Auslan acquisition). Many parents will select a cochlear repsonse with Auslan acquisiton as fundamentally the chochlear does not cure Deafness and when the processesors are removed or damagned the person is still Deaf. Secondly, it is our observation that people tend to stay with where they are receiving support, however, are they offered a range of options (for example, an Auslan pathway which has never been previously funded ) for support.
Choice issues have also emerged in the interpreting space, where a preferred provider by the NDIS planning process has been identified and this can be charged against a persons plan in follow up meetings without the person adequately understanding this. This was discussed in terms of reference a – eligibility critiera.
An additional issue relating to choice of provider relates to specialist support. For example, if a person choose a mainstream service to deliver their supoort, if they do not have fluency in Auslan many more interpreting hours will need to be considered in the persons plan. This may significantly reduce the Deaf person’s options to choose from a range of providers.
e) Liaison with key stakeholders in the design of NDIS Deaf services, particularly in the development of reference packages
It is our opinion that consultation with stakeholders in the design of NDIS ‘hearing’ services has been virtually non-existent. We hope this submission process marks the beginning of much wider consultation. Deaf and hard of hearing community is not homogenous and has a wide range of opinions and perspectives on how services and supports should work. We feel particularly strongly that the voice of Auslan users have been largely ignored and misunderstood throughout NDIS design.
f) Investment in research and innovation in Deaf services
We have also seen little evidence if any of innovation in Deaf services. For example, the NDIA has selected a preferred provider for interpreting without consultation or tender which has failed to take innovation in Video Remote Interpreting (VRI). Further, failure to understand and use this technology has meant decision around equipment purchase like iPads and tablets has been overlooked as crucial for a Deaf person to access affordable and accessible interpreting (Refer Appendix D and E). However, we have noticed in recent plans Low Risk Assistive Technology up to $1000 has been included in plans, allowing Deaf people to purchase a tablet for VRI purposes.
In Australia there is no research available on the use of multiple models for children in language acquisition. For example, cochlear with Auslan as an effective method for both English and Auslan language development. Further studies have found that deaf children who have a cochlear and utilise a signed language do better academically than those who have a cochlear and only rely on the spoken language.
We are unaware of any research exploring the ways Deaf people would like to accessing interpreting, it is our experience that interpreting is viewed as a problem of the system and not the individual as discussed in Appendix D. However the NDIA should be aware and be concerned over the demand and supply of interpreting services and the workforce issues that are related to the implementation of the NDIS and the allocation of interpreting services within individual plans. The implementation of the NDIS has seen a rising allocation and expenditure on interpreting following IFPs however it has not seen an increase in the number of accredited interpreters within the industry therefore placing undue pressure on existing resources. The allocations are new allocations (apart from NABS and EAF) promoting the social and economic inclusion of deaf people.
There is also no Australian research on issues of inclusion and community connectedness for a Deaf person, particularly as it relates to a CALD perspective. There are this and numerous other research and innovation perspectives missing regarding the experience, needs and aspirations of Deaf people.
g) Other related matters The attached appendixes provide the opportunity for a deeper dive into issues relating to the NDIS and Deaf people. Other matters relating the NDIS that have been overlooked and are of importance include:
Deaf Culture and Awareness Training (DAT) for planners, LAC’s, community partners, ECEI access partners, supports coordinators, and eventually ILC funded programs is crucial if the needs of Deaf people are to be met. ILC and LAC approaches need to seriously consider the accessibility (or lack thereof) for Deaf people. Interpreting alone is not sufficient to genuinely meet the needs of Deaf people who use Auslan as their first language. Concepts of inclusion as they relate to the broader community do not relate to Deaf people and are more in line with CALD experiences of service inaccessibility. Interpreter access for planning meetings, plan agreement meetings and service agreements needs to be included outside of a person individual plan or identified clearly as such in their plan. The current preferred service provider for interpreting is unable to provider interpreters in some regions and does not use a secure platform for VRI.
Additional NDIS concerns: interfacing with NDIA
There are a number of additional concerns of the deaf community in regards to the interface with the NDIA. Deaf resources and support requires deaf awareness and knowledge to ensure people have their needs meet. Several key issues have already emerged:
There is a misconception that people who are deaf are highly proficient in English even where English is their second language. This is not always the case. For many deaf people, poor access to a strong foundational language and subsequent access education being limited results in missed opportunities to develop strong English skills. Presentation of information in English is often ineffectual. It should also be noted that there has only recently been a few scheduled videos in Auslan posted on the NDIA website over the last 6 months despite long standing advocacy to do so to the NDIA by Deaf organisations across Australia from the commencement of the trial and implementation of the NDIS website. Further, although Auslan translated they are conceptually difficult to understand for many Deaf people without practical examples and application to their own life. Information is best delivered by a native or proficient Auslan signer with comprehensive knowledge of the details of the NDIS as they relate to deaf people. Where a planner is not Auslan proficient, an interpreter will need to be present at any engagement with the NDIA, the planner or the LAC. The issue is not only the language as some Deaf people have had poor access to information over a long period of time, there is often gaps in their knowledge – this is why Deaf services have been established as they are today to assist in providing information and referral to minimise the gaps and ensure that the Deaf individual can enhance their quality of life and access goods and services that are relative to their need. The shift in the interpreting paradigm is not well understood by the Deaf community and people may fail to ask for the level of interpreting support they actually need (if they think to ask for
interpreting at all). This is a big concern as not having any idea how much to ask for is likely– e.g. in health and medical appointments, how can they know how many hours they ‘might’ need – and if they have children, how unpredictable their health needs can be. NB – the current NABS service also provides interpreters for Deaf parents to attend their children’s medical appointments. These type of missing gaps from our experience are not well understood by the NDIA planners. There is an assumption that cochlear implant is the solution to deafness as a medical deficit, once again this fails to recognise the human rights of Deaf individuals to a language that they can access with ease and also that deafhood is a cultural identity and not viewed as a medical deficit or even disability. Planners, Early Childhood Access Partners and LAC’s need a high degree of not only Deaf awareness but comprehension of all the different types of interventions and supports that may benefit a Deaf person or child. This requires high degree of knowledge specialisation. Current NDIA web-based information is largely inaccessible to Deaf community. Although there is Auslan translations about the NDIA they are lengthy and do not provide the practical and specific examples that a Deaf person with Auslan as their first language requires.
APPENDIX A: Language Aquisition
Within the context of the framework of the NDIS in which supports are deemed reasonable and necessary, there will be a highly individualised approach with a high degree of personal choice and control over interpreter selection and language acquisition for Deaf people.
With the phasing out of various State and Commonwealth schemes in response to the NDIS there are several gaps that have emerged for the Deaf and hard-of-hearing community. In particular an additional emerging concern has been the structural changes and reforms to the mainstream setting that have previously provided specialist and transdisciplinary responses (recognised as best practice by the NDIS) to children who are Deaf or hard of hearing as well as meeting the National Minimum Standards of Practice: early intervention for children who are deaf or hard of hearing and their families. This has proved to be a best practice early intervention approach in a transdisciplinary family centred team and a very cost efficient model.
In response to the NDIS language emersion environments through various education settings have announced closures (including ECDP (Early Childhood Development Program) in QLD and Centre For Hearing Impaired (CHI) children situated at the Elizabeth Park Primary School grounds in South Australia) which would move Deaf children into expensive, non-Deaf-inclusive settings and where the key aspects of Article 24 of the UNCRPD are ignored. Children who are Deaf learn best when instructed by an Auslan speaking teacher and supported by Auslan speaking staff and peers rather than through an interpreter. Recent announcement of Auslan as a LOTE inclusion in the national curriculum although a pleasing development, does not address the language acquisition needs of Deaf children. Further it will take many years to come into any effective practice or process for Deaf students, let alone their peers.
Australia is a signatory to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). There are a number of articles within the convention that relate to a range of matters that impact on the Deaf and hard-of-hearing community. The right to education is a fundamental human right and Article 24 references the rights of people who are Deaf or hard-of-hearing to learn sign language early, develop linguistic identity as a deaf person and ensure that education of children who are deaf or deafblind are delivered in the languages and models of communication that matter to that individual. For these rights to occur, this article also recognises that teachers with the appropriate qualifications (such as sign) are employed and trained to work across all levels of the education system.
APPENDIX B: Auslan recognised as CALD community
Although deafness is defined as a disability under several legislative frameworks including disability discrimination across all jurisdictions and the NDIS Act, Deaf Services Queensland continues to advocate for Auslan being represented as a CALD (culturally and linguistically diverse) language group. The Deaf community see themselves as a linguistic minority group and not as a disabled group. As such, the basic services and needs for a deaf individual fall around the issue of communication access needs (interpreters etc) as opposed to individual support needs etc. (in home care). According to Dawkins (1991, p. 20)vi Auslan has been recognised by the Australian Government as a community group stating:
“It is now increasingly recognised that signing deaf people constitute a group like any other non-English speaking language group in Australia, with a distinct sub-culture recognised by shared history, social life and sense of identity, united and symbolised by fluency in Auslan, the principal means of communication within the Australian Deaf Community“
Deaf people who use Auslan as their first language thereby consider English as their second language and as such formulation of world views and general knowledge is via their understanding of the world though visual means and interactions with other deaf individuals rather than mass media.
Furthermore, it is our experience that Deaf individuals do not receive an adequate explanation on their care needs unless an active deaf organisation has provided such information or the person they are communicating within the Agency is familiar with Auslan or speaks through the use of an Auslan interpreter. Also, Deaf individuals with an additional disability who need to gain not just communication access but also individual support services will not receive adequate care and will experience communication difficulties with their carers where they are not a deaf specific service or interpreting is provided.
APPENDIX C: Deaf awareness training
Deaf Awareness Training is something that has been previously funded via EAF (Employee Assistant Fund) that will phase out as participants join the NDIS. There is currently no provision under NDIS to provide Deaf Awareness Training which is not only crucial in workplaces to help coworkers understand how to work with someone who is Deaf but also all releveant NDIA staff and allies to the scheme (planners, LACs, Community partners, ECEI access parters, ILC providers, support coordinators etc). This presents as a signficiant gap under the current scheme.
Deaf Service Queensland has provided Deaf Awareness Training (DAT) to employers and interested community groups for a number of years. Our early experiences in Townsville and Mackay have highlighted how important it is for planners to understand the unique needs of Deaf people and an awareness of Deaf culture. Our DAT covers the following areas:
Develop confidence when interacting with people who have a hearing loss Develop an understanding of the different types of deafness Awareness of the impacts of hearing loss Insight into the Deaf world, it’s community and culture Introduction to basic Auslan signs and learn the alphabet Understand the role and use of interpreters Awareness of support services available Develop a deepened understanding of how access can be improved Awareness about the role you can play in equality for people who live with a hearing loss
In the interests of representing our Deaf community, DSQ would like to see all planners and eventually LAC’s and partner organisations have some grounding in Deaf awareness. Without adequate understanding of the unique issues that Deaf people face they will continue to be at a disadvantage in the new system.
APPENDIX D: Interpreting and the
NDIS
Current approaches to interpreting
In Australia the interpreting paradigm has largely been one that considers interpreting the need of the service providers and or settings rather than the need of the person, that is, it is an issue of accessibility not individual need. A similar comparison would be wheelchair accessible public buildings. There is no public expectation that an individual who happens to need a wheelchair accessible ramp would have to individually apply for funding, pick suppliers and organise installation of an appropriate regulation ramp. Indeed, the opposite approach is enshrined in legislation where it is mandatory for new buildings to have wheel chair accessible ramps and amenities.
Prior to the NDIS, interpreting has generally been the responsibility of the public and private sector on a user’s pay system (service provider, Government etc.) and not the responsibility of the individual. The following table provides a brief summary of some of the different approaches to interpreting currently adopted in Australia. This list is by no means exhaustive and is used to highlight the current approach.
Table 1. Pre-NDIS interpreting approaches
Service Approach
Centrelink National tender to one service to provide through VRI – Video
Remote Interpreting (Auslan Connections6)
Federal Courts National tender to one service to provide through VRI – Video
Remote Interpreting (Auslan Connections)
Private and medical health National Tender to one service to provide (NABS – National
appointments (GP, Specialists, Allied Auslan Interpreting Booking Service7)
Health, Health Educators, Indigenous
Health Liaison etc.)
State funded Disability Services (QLD) State tender to one service to provide (SWITC8 ) it is our understanding that no other jurisdictions has an interpreting service specifically for disability NGOs as this one in Queensland and administered by SWITC. Mainstream services (Health, This varies from jurisdiction to jurisdiction however, it is Education, Police etc) common for State government departments to source and pay
6 Auslan Connections: Auslan Connections a joint venture of Deaf Services Queensland and VicDeaf provides specialist interpreting services including onsite and online and captioning across Australia with all profits reinvested in programs supporting the Deaf and hard of hearing community 7 NABS – National Auslan Interpreting Booking Service: funded by the Australian Government to provide interpreters FREE of charge to people who use sign language to communicate and would like to book an interpreter for private health care appointments. 8 SWITC - Support With Interpreting, Translating and Communication: operated by Deaf Services Queensland this service provides Non government organisation that have a client requiring an interpreter in any language (Auslan or CALD) to access interpreters free of charge. SWITC also includes translations to any language, live captioning, brail translation and interpreting for Indigenous languages.
Service Approach
for interpreting as required Employment (in workplace settings) National gateway to access workplace modification program including Auslan interpreting is the National EAF (Employment Assistant Fund) 9. For any interpreting required the deaf person must apply and register to be pre-approved and an allocation is provided of only up to $6,000 per annum. This system also requires the deaf person and or their employer to book and pay for the interpreter upfront and then claim reimbursement post appointment. The downfall here is where small businesses employing deaf people do not have the sufficient cash flow to participate in the reimbursement process and as such many deaf people continue to miss out or unable to access assistance in the workplace for communication. Weddings, Funerals and important life Individuals fund themselves or philanthropic support from events local Deaf Societies
Strengths and weaknesses There are several strengths and weaknesses within the current approaches to interpreting:
Strengths Weaknesses
Responsibility rests with system not Unless accessing a disability funded service
individuals. in QLD there is no access to interpreting for
Singular focuses allow for responsive social and community participation outside
interpreting with emphasis on need and of government services.
expertise (specialisation). Mainstream systems such as Health and
Efficient collection of resources to book, education regularly fail to provide (or
source and supply interpreters to meet attempt to provide) interpreting although as needs. policy dictates and legislative measures are
Clear pathways as to interpreting coverage in place in which they are required to do so.
and providers of interpreting. Limited choice of providers or individual
interpreters. Potential for fragmentation as a system
9 EAF – Employment Assistance Fund: The EAF gives financial help to eligible people with disability and mental health condition and employers to buy work related modifications and services. This fund includes Auslan interpreting and deafness awareness training. EAF is administered by JobAccess
Interpreting and legal obligations
Australia is a signatory to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD)10. There are a number of articles within the convention that relate to a range of matters that impact on the Deaf and hard-of-hearing community. Specifically, Articles 9 and 21 which describes areas that impact for people who require access to interpreters.
Article 9 – Accessibility Reference is made to the right to access information and communication including electronic services and emergency services in urban and rural areas. This article notes that State parties should ensure that stakeholders are provided training on accessibility issues and that “professional sign language interpreters” are provided to assist accessibility for those people that require interpreters.
Article 21 - Freedom of expression and opinion and access to information This article is about freedoms to express opinion and obtain information via communication of choice, including with access to the use of sign language and deafblind interpretation. Further this article urges private entities, mass media as well as State parties to make information accessible.10
As provided for in the National Disability Insurance Act 2013 (Cth) s3(1)(a)vii the objects are in conjunction with other laws, give effects to Australian obligations under the Convention on the Rights of persons with Disabilities. Considering the issue above, due consideration needs be given to effect the specific provision in the convention relating to disability and which supports the independence and social and economic participation of people with disabilities.
Many existing schemes that provide interpreting will cease to operate for those who transition to the NDIS, specifically this includes NABS, EAF and SWITC. Main stream services (government, public sector) and the private sector systems will still be required to provide interpreting to ensure that the UNCRPD obligations and other Commonwealth laws are not breached.
What is the NDIS approach to interpreting?
The following is a list of items that apply to interpreting according to the NDIS pricing guideviii italicised notations reflect Deaf Services Queensland translation into practice. It is important to note that if someone uses Auslan they would require an interpreter for all aspects of life where the other people do not use Auslan.
Telephone or video interpreting Auslan or signed English training Interpreting and translating
10 The UNCRPD committees report on Australian Compliance to the UNCRPD, delivered to the Australian government, recommends that the Australian government in 2013 recognise Australian Sign language (Auslan) as one of the national languages of Australia and develop the use of other accessible format of communication by allocating adequate funding for their development, promotion and use in accordance with articles 24 (3) and 29(B) of the convention (paragraph 41 of the concluding observations on the initial report of Australia 24 October 2013).
Strengths and weakness of NDIS approach
Strengths Weaknesses
Choice and control of allocating interpreting There may not be a large choice of providers.
to various goals that are being pursued. There will be supply and demand gaps in
A more competitive market and competitive locating interpreters.
pricing. The highly individualistic model actually
May create opportunities for more defies human rights convention to develop
innovative approaches such as VRI (Video linguistic identity as a deaf person (Article Remote Interpreting) which, where a good 24). This is hard to do in isolation from Deaf connection can be maintained under the community.
NBN improves community participation for Highly individualistic interpreting model is
Deaf individuals that live in rural and remote expensive and inefficient to respond.
regions. It puts the onus on the Deaf individual who
Greater access for whole of life responses. up until now had access to interpreting
That is, the NDIS will cover costs for services which either they could book or the interpreting that otherwise are not currently service provider book, to now source and available – e.g. communication needs for secure and pay for their own interpreting Deaf children at child care centres – this is a services through an NDIS package. Deaf mainstream service and the centre may people will now need to register with the claim unjustifiable hardships as a defence to NDIS just to visit a local GP.
not providing access to interpreters. Now It puts people who are deaf into a disability
the Commonwealth will pay for this access paradigm that they do not see themselves as which was initially was the onus of the part of. This is because the responsibility and provider. burden of interpreting has become the persons not the systems Preordained plans with providers will reduce flexibility for participations (they will basically still have to go with one provider to get interpreting) The hourly rate does not recognise award requirements of working two hours minimum or that if a long session, additional interpreters will be required.
Deaf Services Queensland: considerations relating to the position of interpreting and the NDIS
Consider the retention of block funding approach for specialist health appointment interpreting.
Increase access to more than one provider who can actually supply this (increases individual
choice and control and retains efficiency). The current system does not fail the deaf community
or health sector. Interpreting can be booked as easy as a text message sent by the deaf
individual or the local GP, specialist or allied health profession to the agency to request the
interpreter. An interpreter will be then organised by the provider who will then show up at the
appointment. No further action is required by the deaf individual or health profession to engage
an interpreter here. Having to pre-plan for interpreting appointments for potential medical appointments and
associated organising of the appointment through a provider and undertake service agreement
only serves to place undue burden on the Deaf individual as well as the overall NDIS system. Mandatory requirement for an interpreter to be provided by NDIA for planning meetings with
Deaf people. We have already experienced deaf people being refused an interpreter at this point
of the planning process. An unacceptable outcome. Interpreting can be by choice of the
individual – onsite or online (VRI)
References
i Deaf Australia Inc, 2016. Terminology. Accessed from: http://www.deafau.org.au/info/terminology.php
ii Ladd, P. (2003). Understanding deaf culture: In search of deafhood. Multilingual Matters.
iii Willoughby, L. (2013). The distribution of Queensland sign language users [electronic resource] : analysis from the 2001, 2006 and 2011
census. Deaf Services Queensland
iv Trevor, A. (2004). W(h)ither the Deaf Community? Population, Genetics, and the Future of Australian Sign Language Johnston, American Annals of the Deaf, Volume 148, Number 5, , pp. 358-375 (Article) Published by Gallaudet University Press DOI: 10.1353/aad.2004.0004
v Modified Monash Model, http://www.health.gov.au/internet/main/publishing.nsf/content/modified-monash-model
vi Dawkins, J (1991). Australia’s Language: The Australian Language and Literacy Policy. Australian Government Printing Service: Canberra
vii Commonwealth of Australia, National Disability Insurance Act, 2013 s3(1)(a)
viii NDIA Price Guide Vic/NSW/TAS/QLD (effective 1 August 2015). Released 31 July, updated to included QLD in title. https://myplace.ndis.gov.au/ndisstorefront/html/sites/default/files/VICNSWTASQLD-PriceGuide2015.pdf