The provision of hearing services under the National
Disability Insurance Scheme (NDIS)
Submission to
Joint Standing Committee on the
National Disability Insurance Scheme
Prepared by Key contact:
Royal Institute for Deaf and Blind Children Chris Rehn
Private Bag 29, RIDBC Chief Executive
Parramatta NSW 2124 P: 02 9871 0215 361 – 365 North Rocks Road, E: chris.rehn@ridbc.org.au
North Rocks NSW 2151
Content
Submission summary…………………………………………………………………………………………….. 3
About Royal Institute for Deaf and Blind Children ………………………………………………………. 4
Response to the Terms of Reference ………………………………………………………………………. 5
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Access and provision of supports and services for deaf and hard of hearing children, their families and carers ……………………………………………………………………………………… 5
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Access to the NDIS and reasonable and necessary supports for hearing impairment ……. …………………………………………………………………………………………………………………. 6
Submission by Royal Institute for Deaf and Blind Children Page 2
Submission summary
Royal Institute for Deaf and Blind Children (RIDBC) is pleased to make this submission to the Joint Standing Committee on the National Disability Insurance Scheme (NDIS) on the provision of hearing services under the NDIS. In this submission, RIDBC responds to the following:
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Access and provision of supports and services for deaf and hard of hearing children, their families and carers
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Access to the NDIS and reasonable and necessary supports for hearing impairment
RIDBC has the capacity to provide further information on a wider range of issues and would welcome the opportunity to provide any further information that may assist the Inquiry in regard to matters concerning the hearing health and wellbeing of Australians.
In summary, RIDBC submits that the Inquiry should consider and/or make the following recommendations:
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That the NDIA finalise and implement agreed evidence based Reference Packages for children with hearing impairment to determine the level of funded supports.
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That the criteria for hearing impairment for those 26 years of age or older remains as hearing impairment ≥ 45 decibels in the better ear, based on a 4 frequency pure tone average (using 500, 1000, 2000 and 40000Hz)
Submission by Royal Institute for Deaf and Blind Children Page 3
About Royal Institute for Deaf and Blind Children
Royal Institute for Deaf and Blind Children (RIDBC) is Australia’s largest non-government provider of therapy, education and cochlear implant services for children and adults with vision or hearing loss, their families, and the professionals that support them.
Our Mission is to provide quality and innovative services to achieve the best outcomes for current and future generations of Australians with vision and/or hearing loss.
We pride ourselves on working in collaboration with families, children and adults to tailor services that support and fit individual needs and life goals.
Services for children, adults, families and professionals:
Assessment and diagnostics Early intervention and early learning programs Specialist preschools, schools and school support Therapy and re/habilitation services Audiology and cochlear implant services Research, postgraduate and professional education.
SCIC Cochlear Implant Program, an RIDBC service, is Australia’s largest and most comprehensive cochlear implant program, setting new benchmarks and delivering the highest level of care and support at every stage of the cochlear implant journey.
RIDBC Renwick Centre conducts world-leading research and provides continuing professional education and postgraduate courses in a range of fields relating to the development and education of children with vision or hearing loss.
RIDBC services are provided to over 8,000 people from eighteen permanent sites across Australia, and by working remotely in rural and regional areas.
As a charity, RIDBC relies heavily on fundraising and community support to continue to make a difference in the lives of people with vision or hearing loss.
For more information about RIDBC, visit www.ridbc.org.au.
Submission by Royal Institute for Deaf and Blind Children Page 4
Response to the Terms of Reference
- Access and provision of supports and services for deaf and hard of hearing children, their families and carers
In the absence of developed reference packages for early intervention supports for children 0-6 with a hearing impairment determination of supports is through the Early Childhood Early Intervention (ECEI) approach. The use of the PEDI-CAT is inadequate to determine the supports required for a child with a hearing impairment. There is a significant difference between the PEDI-CAT rating and the child’s functional capacity. This has resulted in funded supports that are not reflective of evidence based practice for children with a hearing impairment.
In our experience almost all children with a hearing impairment receive a MILD rating on the PEDI-CAT. However, the hours indicated within the ECEI guidelines for this level are inadequate to support the evidence based intervention required for a child with a hearing impairment and address their speech and language milestones. The scope of supports provided to participants in their plans is highly variable despite similarities in needs and the substantial evidence available regarding the inputs required to achieve speech and language goals.
It is understood that the NDIA has drafted early childhood packages for children with hearing loss (0-6 years) to ensure reasonable and necessary early childhood intervention supports have a strong evidence base, leading to the best possible outcomes for the child. Furthermore, an actuarial modelling process has commenced to ensure that the outcome focus for this cohort are understood by all stakeholders. However, the timeframe for the release of the baseline reference packages is unknown. As such children who are yet to enter the Scheme continue to be supported by the provision of quality evidence based early intervention. As children transition to the NDIS and receive funding for a lower level of support Providers are having to fund the shortfall through charitable contributions or children are receiving less intervention.
For the purposes of ensuring the ongoing viability of high quality programs, decisions regarding service provision and funding should require that funded supports are consistent with international best practice and are demonstrably able to meet the needs of children with a hearing impairment.
Recommendation:
That the NDIA finalise and implement agreed evidence based Reference Packages for children with hearing impairment to determine the level of funded supports.
Submission by Royal Institute for Deaf and Blind Children Page 5
- Access to the NDIS and reasonable and necessary supports for hearing impairment
It is acknowledged that the NDIA has completed a review of the guidance for determining access to the NDIS and reasonable and necessary supports for hearing impairment. The approach for people aged 0-25 will allow for streamlined access to services and is consistent with existing arrangements whereby those identified with hearing loss receive audiological support from Australian Hearing, and are referred to specialist providers for early intervention. However, in the absence of appropriate evidence based reference packages the outcomes for their speech language and communication development will be poorer than in previous generations.
There is a significant variation with the access for adults aged 26 years and over who will only be accepted with a hearing impairment of ≥ 65 decibels in the better ear, based on a 4 frequency pure tone average. An adult with a hearing impairment of ≥ 45 decibels in the better ear will experience a reduced functional capacity to undertake relevant activities. However, to gain access to the NDIS they would need to have another permanent impairment. A hearing impairment of this level does require hearing aids in order to undertake communication, social interaction, learning and self-management activities. This cohort of hearing impaired adults may not be in a position to fund their required hearing aids and are not eligible for the Australian Government Hearing Services Program. For those of working age they may be unable to find employment as they are unable to fund the hearing supports they need.
Recommendation:
That the criteria for hearing impairment for those 26 years or older remains as hearing impairment ≥ 45 decibels in the better ear, based on a 4 frequency pure tone average (using 500, 1000, 2000 and 40000Hz).
Submission by Royal Institute for Deaf and Blind Children Page 6