Vision Australia raises NDIS amendment fears before Senate committee

Vision Australia representatives have appeared before the Community Affairs References Committee in the Federal Senate to raise concerns the organisation has regarding NDIS Amendment (Securing the NDIS for Future Generations) Bill. 

The Bill intends to strengthen the NDIS, however Vision Australia’s Chief Mission Officer Chris Edwards and NDIS & Aged Care Funding Specialist Lead Caitlin McMorrow put forward to the committee a number of concerns held by Vision Australia about the impacts the Bill would have on individual participants, including those who are blind or have low vision. 

“Vision Australia acknowledges the importance of ensuring that the NDIS is financially sustainable for future generations of Australians with permanent and significant disability,” Chris said

“We also acknowledge the challenges that are presented by the unanticipated growth of the scheme. It is necessary, however, that the policy reforms that this Bill seeks to implement are not applied to the detriment of some disability cohorts or individuals, whether intentionally or otherwise,” he said.

“We remain concerned that some of the reforms proposed in this Bill will further undermine equity, fairness and consistency within the Scheme, rather than improving it.”

Vision Australia’s concerns centre on three key issues. 

1. The challenges of using Support Determinations as a mechanism to address inconsistency of NDIS funding; 
2. The risks of simultaneously reducing both community access and therapy supports; and
3. Unforeseen consequences of proposed changes to criteria for plan reassessments and reasonable and necessary supports.

Full address by Vision Australia NDIS & Aged Care Funding Specialist Lead Caitlin McMorrow

Even with the amendments that have thus far been agreed, this Bill confers significant powers on the Minister to influence the Scheme at an operational level. If I could turn firstly to the issue of Support determinations. We do not consider that the use of support determinations as proposed in the Bill is an appropriate mechanism for correcting over funding in certain groups of supports. 

There has been long-standing and systemic inconsistency in NDIS planning decisions, but this cannot be addressed by enforcing over simplified and universal reductions in support. It is a financial control measure that lacks procedural fairness and would unduly expose many participants to the risks of isolation and psychological harm. Using our client cohort as an example, while there are some people with vision impairment who currently receive extensive funding for community participation, we also have many clients who receive three hours a week or less, to assist with basic essential tasks such as shopping. 

A universal 50% reduction in funding will disproportionately affect those participants with limited funding. A participant whose funding is reduced from 40 hours to 20 may arguably still participate in the community, if not to the degree that they would ideally wish. A participant whose funding is reduced from 3 hours to 1.5 hours per week will likely find it impossible to access the community or complete basic tasks in any meaningful way. 

It is not reasonable to assume that every Scheme participant has been grossly overfunded, given that many have plans that have remained stable and consistent for several years. It would be more equitable and effective to review supports for those participants whose plan values have increased extensively over time, rather than penalising every participant for the inconsistency of Scheme decision-making as a whole. 

Finally on the topic of Support determinations, we do not support the provisions in Section 33 of the Bill, which allow the Minister to determine maximum funding amounts, worker ratios or intensities for certain types of support. This requires operational knowledge of disability supports that decision-makers at this level of Government simply do not have. If these provisions are included, there must be a legislated commitment for the Minister to engage in constructive and transparent dialogue with both participants and service providers, before wide-ranging changes to supports are made.

If I could turn now to the second but related issue of reductions in capacity building supports. In view of the intention to reduce social and community participation funding, we are of the view that it is counterproductive to simultaneously reduce investment in therapy services. The reality is that over the last ten years, the NDIS has facilitated a level of dependency on community access supports. If these are reduced, many participants will now be required to develop additional compensatory skills to address the shortfall caused by reductions in funding. Therapy supports are a crucial mechanism in achieving this, because they enable participants to build capacity and build long-term independence.

Referring to the final issue of plan assessment and reasonable and necessary criteria, I would like to say that in general, we support strengthened criteria around unscheduled plan reassessments, which would now be based on a significant change in functional capacity, living arrangements or the participant’s environmental circumstances. It is unclear, however, as to how these new criteria might impact high-cost assistive technology purchases that typically occur outside of the usual planning cycle.

For example, when vision impaired participants seek funding for a dog guide, this process typically triggers an unscheduled reassessment of their current plan, because the identification of a suitable match and retirement of their existing dog cannot be timed to coincide with their plan renewal date. Currently this is not problematic because an unscheduled plan assessment can occur for any reason, however, it must be ensured that these new criteria do not unintentionally preclude a participant from accessing funding for high-cost assistive technology such as dog guides at the time when it is needed. We would like to see failure or deterioration of high-cost assistive technology added as an additional criterion under Section 48 which would justify a plan reassessment.

We are also broadly supportive of a clearer definition of reasonable and necessary supports. In our work with participants, we continue to find that there is an expectation gap between the supports that people want and those which the NDIS can reasonably fund. Many participants still struggle to understand how the Scheme differentiates between day to day living costs that are related to their disability, and those which are not. There should be equity and consistency in what is considered reasonable and necessary for participants with the same or similar needs and the Bill makes some progress in achieving this. We do, however, have grave concerns regarding the effective and beneficial considerations that are proposed additions to Section 34.

We do not agree with the principle that the CEO may decide that a support is not effective and beneficial due to a lack of peer reviewed evidence, even where there is other evidence that the support is beneficial either generally, or for a specific participant. This provision has the potential to severely disadvantage small disability cohorts such as those with vision impairment, who constitute less than 3% of Scheme participants overall. Peer reviewed evidence is often limited due to the size of this cohort and the specialised technologies and therapeutic supports that they access. We therefore suggest the drafting of this section should be amended to ensure that research, evidence of individual participant outcomes and the overall effectiveness of the support are considered with equal weight.