Hayley's Journal - Deafness Forum Australia

A deep dive into current disability issues and the NDIS

Hayley Stone is Deafness Forum Australia’s Director of National Policy & Advocacy. Feel free to reach out to Hayley by email.

To everyone who is an NDIS participant, a family member, a carer, or ally, we urge you to keep yourself informed of changes being made to the Scheme after 3 October 2024.
- You can regularly visit the NDIS website
- You can also subscribe to the NDIS Newsletter
- To get emails about how you can give feedback on the changes, you can join Participant First

OCT 2024: The National Disability Insurance Agency introduced new rules on 3 October around the types of supports participants can and cannot access using their NDIS funding.
The new rules provide prescription on the specific types of supports participants can claim using NDIS funding, in the form of three lists:

a list of approved NDIS supports
a list of supports that are not NDIS supports
a replacement supports list

The lists were developed after consultation with the disability community and Disability Representative Organisations during a whirlwind couple of months.

Originally, the NDIA only proposed the first two lists. Smartphones and smart watches were on the ‘list of supports that are not NDIS supports’, together with any form of mainstream smart appliances.

Auslan interpreting could be funded by the NDIS, but only if there was no other way of accessing interpreting on the basis that the NDIS would only fund translation for ‘essential’ communications.

Deafness Forum Australia, together with Deaf Australia, Deafblind Australia, and Deaf Connect lobbied hard to demonstrate why these supports should be available to participants who are deaf and hard of hearing, highlighting the critical function that Smartphones and smartwatches have in modern society in supporting the communication needs of our communities.

We argued that limiting access to these devices would detrimentally affect NDIS participants’ abilities to communicate at school, work, and in the broader community and were critical, in many cases, to realising the full functionality of many newer models of cochlear and hearing aid technology. We also challenged the limits on Auslan interpreting, questioning how the NDIA intended to define essential and then realistically enforce this limitation.

While we were not able to get smartphones and smart-watches onto the approved supports list, which was our original goal, we were able to reach a compromise with the NDIA which resulted in the development of the third list of supports – the so-called ‘replacement supports list’.

Smartphones, iPads, smartwatches, and smart home appliances (for instance, home security systems) still won’t be assumed to be approved as NDIS-funded supports but participants who are Deaf or have hearing loss can make a separate application for these supports to be funded, subject to meeting certain criteria.

We also managed to get the NDIS to scrap the limits on Auslan interpreting, meaning that participants will be able to claim Auslan interpreting fees under the NDIS in any circumstance where they cannot otherwise access free interpreting.
These are collective wins, which came about as a direct result of the strong advocacy efforts of the hearing loss and Deaf communities, family, friends, advocacy organisations, and supporters.

Deafness Forum Australia would like to give special thanks to our brilliant NDIS Citizen Advisory Committee, who provided us with the vital information we needed to put a strong case to the NDIA on why these supports are critical and necessary.

We also thank the NDIA for listening to our concerns and taking steps to ensure that Australians with hearing loss on the NDIS will continue to have access to the supports they need, including agreeing to meet with us at the eleventh hour, as we fought against the clock to push for the necessary revisions.

SEP 2024: NDIS 2.0: Fear, Hope and All Things In-Between.

The National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024 has been passed by the Federal Parliament. It will become law on 3 October. This followed months of negotiations between the Federal Government, the Coalition, States, and Territories.

The news was later overshadowed to a degree by the announcement on 5 September that NDIS Minister Bill Shorten would retire from federal politics. He will remain the Minister for NDIS until February when he will take up a role as vice-chancellor of the University of Canberra.

On his plans for the NDIS in the coming months, Shorten said “I will use every minute left in this job to secure the future of the scheme and ensure it continues to empower with choice and control and give Australians with disability the chance to fulfill their potential”.

Bill’s Bill

The passing of the Bill surprised many, given the criticism it attracted in Parliament and the media. It was met with a range of emotions, including fear, anxiety, dismay, and hope.

The Government can now focus on the fine details of how the changes will operate – a process we expect to take several months at least.

It is an important time for the disability community as it collectively grapples with the broad swathe of changes, to understand what they will mean in a practical sense for both current participants and for those who apply for entry to the Scheme in the future. But at the same time, there are still so many unknowns.

The NDIS was always intended for people with disability with the highest support needs. It was designed to sit within a broader support system so that Australians with disability who were not eligible for the NDIS could still get their needs met. However, the reality is that these supports do not exist or are hard to find.

So, the State and Territory governments agreed to introduce what are called Foundational Supports. These, in theory, will fill any gaps in supports and services that the NDIS will no longer fund. They should provide critical support for those who don’t meet the new criteria for eligibility for the NDIS. However, the Federal Government, States, and Territories haven’t yet settled on their interpretation of what will be funded and delivered. We expect that the types of Foundational Support offered will vary based on state borders.

Current Individual Plans

The National Disability Insurance Agency (NDIA), the organisation that runs the NDIS, has assured us that participant plans will remain unchanged until they are due for scheduled reassessments. However, we have learned that some plan managers have been discussing the implications of the changes with participants and potentially factoring these changes into their decision-making. If this is true, they will be out of step with the NDIA’s commitment to ‘business as usual’ until the changes become law in the coming weeks.

What changes can participants and applicants expect to happen straight away?

Some changes to the Scheme will apply immediately, while others will only become effective after more details are worked out.

The Minister for the NDIS said that the Government will work in codesign with disability representative organisations and the broader disability community throughout this process. Our priority will be to ensure that the interests of people who are deaf or have hearing loss are prioritised, and that no one who is deaf or has hearing loss is worse off because of the reforms.

Changes we know will apply as soon as the Bill becomes law include:

Different pathways for entering the Scheme

If a person applies to the NDIS, the NDIA will tell them if they’ve met the disability requirements, the early intervention requirements, or both. This change will be effective as soon as the law commences.

It will no longer be assumed that a child will transfer to the NDIS once they reach the age cut-off

Unless the NDIA has determined that a child is eligible for the NDIS separately, a child who receives Early Intervention Support will not automatically transfer over to the mainstream NDIS once they are too old for this program.

We don’t know how this will work for children who are already on the Early Intervention Scheme and will try to learn more about this change and what families will need to do if their child requires ongoing support. If these children need to be reassessed, we’d want the process to be as straightforward as possible, and for the NDIA to fund any necessary reports or assessments.

Clear guidance on eligibility for the Scheme

There will be clearer information for potential participants and existing participants who have their eligibility reassessed on whether they meet the eligibility requirements for both the NDIS and Early Intervention Pathway. This change is supposed to make it easier for people to know whether to apply to the Scheme in the first place and is presumably aimed at preventing people from appealing decisions around eligibility. This is a change to watch, as it will come into effect as soon as the law commences, and could have negative consequences for existing participants, including children, who are currently receiving Early Intervention Supports.

Limits on making new access requests

Once the law commences, the processes of making access requests after a participant has been removed from the Scheme will change. The ex-participant will have to request a review of the decision and wait until the review is completed before reapplying for access to the Scheme. We’d want to know that the NDIA was committed to fast turnarounds for reviews to ensure that anyone who is removed from the Scheme can make an informed decision on their next steps as soon as possible.

Defined rules on supports

The NDIA will be stricter on the types of supports that participants will be able to receive under their plans, with a greater emphasis on ensuring the supports directly relate to their disability-related needs.

There will likely be increased scrutiny of participants’ supports both in the initial planning meeting and in subsequent plan reviews. Again, this is a rule that will apply as soon as the new law is in force and may have significant consequences for participants who have plan reviews soon.

The NDIA will have greater power to determine participants’ plan types

As soon as the law passes, the NDIA will have greater powers to determine participant’s plan types. If the NDIA considers that an individual who either self-manages or uses a plan manager will not spend their NDIS funds properly, the NDIA will have the power to switch the participant’s management type. This includes making the participant’s plan agency-managed.

Plans will have a total funding amount

New plans will have a total funding amount, and participants will be expected to keep within this prescribed limit and spend their funding in an approved timeframe.

Funding limits will not apply to existing plans, but participants will eventually be required to transfer over to new framework plans where funding limits will apply.

At this stage, we don’t know when participants will be required to transition over to these new plans, but the NDIA has made it explicit that this change will not occur retrospectively to people’s existing plans. We assume that this change will likely apply when a participant’s existing plan comes up for review, but this is only speculation at this stage.

We also don’t know how much time the participant will have to spend on their plan funds, and what happens if there is a reason why they can’t – for instance, if they can’t access a particular support because it’s not available in their area.

Some plan variations will be able to be made without needing to create a new plan

A glimmer of a silver lining is that once the new law commences, participants who have the new framework plans will be able to request variations to parts of their plans, including funding amounts and funding periods, without triggering the need to redo the plan altogether.

The NDIA will be able to seek information to determine a participant’s ongoing eligibility for the scheme

Readers may recall that this was one aspect of the Scheme that we thought could be highly problematic. Clear parameters are absent for when this power could be applied. While the Government did agree to set some limitations on the powers of the NDIS CEO, we still don’t at this stage know what triggers would be to activate this power.

Under these new provisions, the CEO will be able to request that a participant provide additional information or be reassessed to determine their ongoing eligibility. Participants will generally have 90 days to provide this additional information. We understand that the NDIA will fund any additional reports or assessments requested and that participants will be able to obtain this information from their usual treating professionals.

A new claims and payments framework

When the law is enacted, a new claims and payments framework will apply to provide clarity on how claims should be made. This change will impact all participants and providers as soon as the law commences. We understand that for the first twelve months, the NDIA will honour all claims made for supports provided before the law came into effect.

A change that has been earmarked, but the details are still in limbo: The introduction of prescribed lists of NDIS supports and exclusions

One of the most controversial changes is the introduction of new, prescriptive lists that set out what participants can and cannot access with their plans. We’ve had an opportunity to review these lists and expressed our concern to the NDIA and the Department of Social Services that the lists fail to capture the essential support needs of our community members.

We are also concerned that there is no easy mechanism for participants to request supports that fall outside the lists, or to access supports that are expressly prohibited. There has been significant pushback on the lists from many sections of the disability community and Disability Representative Organisations, with calls for the NDIA to adopt a fairer, principles-based approach.

The NDIA appears to be listening and taking our concerns seriously. It will soon release a report of its findings from the recent public consultation on the draft lists, and we’ll be sure to provide a further update once we know more.

We hope that this information helps readers to understand where we are in terms of the Bill’s progression toward being formalised as an official Act of Parliament and what changes we can expect to happen once the new law commences in the coming weeks.

We know that many participants will be concerned about the changes and what they will mean for their existing funding and supports, and we’ll continue to keep you updated as we learn more.

What can we do right now?

Being in this ‘holding space’ is difficult and stressful, and we acknowledge how challenging this will be for many of you.

Deafness Forum Australia’s mission throughout the reform process is to ensure that no person who is deaf, or hearing impaired is worse off because of these reforms and we’ll advocate fiercely on behalf of our members.

You can support us in this process by participating in consultations and other calls for comment. We will be putting out requests for your contributions in the coming months. Your expertise and insights as Scheme participants are essential in illustrating the human impacts of the NDIS reform process.

SEP 2024: Australia’s Disability Strategy plays a crucial role in driving systemic improvements and cultural changes to create a more equitable and accessible society for all Australians.

Deafness Forum Australia was invited to contribute to improving the Strategy by providing feedback to a national review conducted in August and September.

How to engage all sectors of society in implementing Australia’s Disability Strategy?

The existing Strategy states: Australian, state, territory, and local governments, along with businesses, the community, and the non-government sector all play a role in supporting people with disability to enjoy their human rights on an equal basis with others[i]

However, currently, only Governments are required to be directly accountable to Australia’s Disability Strategy. The practical implication of this approach is that there is no assured consistency of rights for people with hearing loss in the community: a person may have access to a hearing loop at the train station but may not have access to equivalent support at the local shopping mall or theatre.

The Disability Discrimination Act is now 30 years old, and we’ve had two iterations of the Strategy. While there has been positive change across many aspects of public service delivery, there has been limited engagement with the Strategy in a voluntary capacity across the private sector.

The Australian Human Rights Commission has stated: Although a considerable amount of focus in the community has been given to highlighting what are discriminatory practices towards people with disability, less focus has been given by organisations, businesses and providers of goods and services as to how to promote equal opportunities for people with disability. This has meant the inclusion of people with disability has suffered.[ii]

Currently, the Strategy is constrained by both its design and implementation. Until we have a government that is prepared to expand accountability, people with disability will continue to be marginalised and subject to violence, abuse, neglect, and exploitation.

We strongly advocate for the Federal Government to expand the mandatory requirement for Disability Action Plans across all businesses and providers of goods and services as part of its review of the Strategy and would be open to a staged approach being taken.

Being accountable under the Strategy – having a Disability Action Plan – sends an important message to the community that businesses and providers of goods and services consider people with disability as being equal. While we consider that expanding responsibility for disability inclusion to the private sector is already well overdue, we would support a staged approach to such a process, in principle.

We note that a few companies listed on the Australian Securities Exchange have their own Disability Action Plans.

How can Australia’s Disability Strategy more effectively address all forms of equality and build a human rights approach based on the Convention on the Rights of Persons with Disability?

By its very nature, the Strategy lacks the power to enforce compliance. This has been a perennial problem since the Strategy’s inception. We have concluded that we need greater positive legislative accountability for disability inclusion across all levels of society.

Australia’s Disability Strategy cannot and should not be the primary tool for fulfilling Australia’s commitments under the Convention on the Rights of Persons with Disabilities. It is also unacceptable to expect people with disability to bear the onus of enforcing their rights. We need a better solution, with the capacity to achieve broadscale societal change in line with the expectations of the Strategy.

Australia’s Disability Strategy should sit beneath a new Federal Human Rights Act, to provide a practical framework for applying the legislative rights of people with disability in Australian society.

Australia is currently the only liberal democracy in the world that does not have a national act or charter of rights explaining people’s basic rights and how they can be protected.[iii] A Federal Human Rights Act has been endorsed by the Australian Human Rights Commission. More information on a national Human Rights Act can be found here.

How should the Strategy take action towards achieving inclusive education?

It will be vitally important to work in codesign to understand what inclusive education is, and how it could practically be achieved in the context of the public education system. Children with disability should be assured of a smooth transition through different levels of education and guaranteed an inclusive educational experience across all stages of their educational journey.

It is essential to create space for a thorough discussion on whether fully inclusive education – where all children with disability attend mainstream schools – is genuinely fair and equitable for everyone. There needs to be an acknowledgment that choice is important – families deserve the opportunity to choose what works best for them and most importantly, their child – and while they should be guaranteed an inclusive educational experience in the mainstream schooling system, the option to choose a specialised school should not be compromised or devalued as a legitimate choice for that family. Many people in our constituency, whose primary or only language is Australian Sign Language, are concerned about the idea of moving away from special schools, as an option for families of children who communicate primarily via Auslan. They fear that the unique Deaf education ecosystems, carefully cultivated in specialist schools for Deaf children, could be dismantled, forcing their children into mainstream settings without the necessary support to succeed. This issue calls for a genuinely inclusive codesign process with those most directly impacted.

Should there be a focus on identifying and supporting best practice approaches for accessible communications?

Information is empowerment. Accessible information and communications play a critical role in ensuring the safety, independence, and inclusion of people with disability. When appropriate information is provided in various formats, it empowers people with disability and people from non-English speaking backgrounds to make informed decisions about the services and supports that best meet their needs.

Under Australia’s Disability Strategy, there are no clear, enforceable requirements for promoting accessible information and communications beyond the Guiding Principles. Deafness Forum Australia, on behalf of its constituency and many other advocates, has raised this cause of significant concern, and it urgently needs to be addressed.

How should Australia’s Disability Strategy take action towards increasing leadership by people with disability?

People with disability should have equal opportunity to access the education and training they need to be qualified to apply for positions of leadership, and barriers need to be eliminated to allow them to compete for these roles on an equal basis with other candidates.

The Government needs to incentivise employers to address the barriers that exist at the organisational level which inhibit people with disability from aspiring to leadership positions.

It will be critical that any strategy to increase leadership by people with disability should have its effectiveness tracked across both public and private industries.

We note that a National Human Rights Act would create a positive obligation to address educational and employment barriers.

[i] Australian Government, Department of Social Services, Disability and Australia’s Disability Strategy 2021-2031, last updated 11 September 2023 < Disability and Australia’s Disability Strategy 2021–2031 | Department of Social Services, Australian Government (dss.gov.au)> accessed 4 September 2024.

[ii] Australian Human Rights Commission, Disability Action Plan Guide 2021 https://humanrights.gov.au/our-work/disability-rights/publications/disability-action-plan-guide-2021 accessed 4 September 2024.

[iii] Ibid, A National Human Rights Act for Australia, 7 March 2023 <A National Human Rights Act for Australia | Australian Human Rights Commission> accessed 4 September 2024.

SEP 2024: Our Response to the Aviation White Paper Policy Initiatives.

The Australian Government Aviation White Paper sets out long-term policies and actions to guide the next generation of growth and innovation in Australian aviation.

The Aviation White Paper is a report that lists 56 worthwhile new initiatives that the Australian Government will implement in partnership with industry, states and territories, and the community.

While many of the initiatives will benefit people with disability, in our submission, we commented on those specifically targeted to them and, in particular, the people with hearing and dual hearing and vision challenges (and their families and supporters) that we represent.

Read Our Response to the Aviation White Paper Policy Initiatives SEP 2024.

AUG 2024: The legislation to reform the NDIS is in limbo. Both the Coalition and the Greens have criticised the Government’s handling of the consultation process. They argue that more time needs to be given for thorough consultation and that more extensive hearings and consultations are necessary before the Bill can be passed.

The Bill’s stalling reflects the ongoing debates and challenges in implementing significant changes to the NDIS. Some disability advocates are calling for the Bill to be scrapped, while others seek to delay its progress until the fine details are finalised. But how far should disability advocates go in pursuing completeness, and could it cause more harm than good?

A bill is a proposal for a new law or a change to an existing law. It is a draft law introduced into Parliament for consideration. An Act is the final, agreed-upon, and enacted law that can be enforced and applied in the Australian legal system.

In March, the Federal Government asked the Parliament to approve the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024. The Bill aims to fix the NDIS and put people with disability front and centre. This Bill proposes changes to the laws that govern how the NDIS will operate in the future. It addresses the scheme’s financial sustainability concerns and improves participant experiences within the NDIS. If and when the Parliament approves it, it will be supported by regulations – called Rules – that will set out the details of the law. We don’t know much about the Rules yet, which is a cause of concern among people with disability and their advocates.

In the best scenario, the Bill and the Regulations would have been available simultaneously for the community’s review and comment. That way, we could understand how the laws are intended to operate and provide recommendations based on that. However, the Rules have yet to be written. This disconnect between the Bill and the Rules makes understanding and critiquing the new Bill challenging. The disability community is split on how to move forward. But to be fair, it is not unusual for Governments to develop laws first and work on supporting regulations later.

In my early years as a legal professional, I learned that a good negotiation is one in which everyone walks away with something they can live with. I’ve applied this as a general life philosophy – the agreements that last are often those when there are no clear winners and losers but where everyone can agree that the outcome is ‘fair’. I tell this story because we’re at an important crossroads in the reform of the NDIS.

The progress of the Bill has been stalled, and the disability sector needs to make a collective decision. Do we fight for the ‘perfect’ NDIS Act? Or do we accept the concessions that the Government has already made in good faith and switch our focus to the substantive work around the development of the Rules that will guide the implementation of the new laws?

The level of engagement in co-design and consultation with the disability community in reviewing the NDIS is unusual. There was the Independent NDIS Review, the NDIS Roadshow Events, the NDIA’s establishment of the Disability Representative and Carer Organisations co-design working groups, and opportunities to provide comment on the Bill itself. I can’t think of a piece of public policy reform I’ve worked on where there has been more opportunity for community feedback, and it’s important not to forget the time and resources the Government has invested in consultation and co-design.

My thoughts on this matter have remained unchanged for some time. The bottom line for me is co-design. It empowers those most affected by decisions: it requires the Government to work with the disability community in equal partnership to shape the changes that will ultimately impact their lives.

If the Government commits to co-designing the Rules with Disability Representatives and Carer Organisations, we can be satisfied. Not every clause in the Bill needs to be perfectly drafted. Legislation is seldom perfect, but there are safeguards. All legislation is routinely reviewed as a matter of course, usually every five years, which means there will be ongoing opportunities to observe how the law operates in practice and to call for additional amendments.

But while we wait and second-guess every possible nuance, we risk undoing the good work we’ve already done. The question is, do we want to let perfect be the enemy of good?

I am not suggesting that we consider the Government’s approach to community engagement a privilege to be grateful for or that we shouldn’t stay firm on holding out for amendments to the new law where they matter. Co-design is participatory democracy in practice, and the NDIS Bill will ultimately be better legislation because of it.

We should consider the broader implications of delaying the Bill to perfect it when much of the concern is around speculation about how it might operate in conjunction with Rules that have yet to be written.

The Federal Government is still in negotiations with the States and Territories on many aspects of the changes, including when the States and Territories will have the power of veto on aspects of key decision-making and how foundational supports will be realised. These negotiations will need to be finalised before the Rules can be developed, and the Federal Government probably can’t do much to influence this timeline.

This is one of the reasons the Federal Government made it clear that the Rules won’t be drafted before the Bill is passed, and it has the prerogative to do this. If we push for the Bill to be deferred until the Rules are written, we may have to negotiate with a new Government, and there is no way of knowing how receptive it would be to pick up the co-design where the outgoing Government left off.

Substantial amendments have been made to the Bill since the Government first released it. The types of supports that participants will be able to access have expanded. The Government has also committed to defining the scope of the NDIS Chief Executive Officer’s new powers. All these changes are in direct response to disability community advocacy.

The Government has committed to mapping out an agenda for ongoing consultation and co-design with Disability Representative and Carer Organisations over the next two years, which includes developing co-design working groups in several key reform areas. It is doubtful that the Government would walk away from these commitments with a federal election possible before Christmas. However, a new government has nothing to lose, particularly if an unresolved NDIS bill is a problem it inherits. A new government could choose to work with or circumvent us, and how this plays out is currently being shaped.

If this were a negotiation, I’d be telling my client to take the wins they’ve already got, allow the Bill to get across the line, and put their efforts into working with the Government on the Rules. I’d advise them that the relationship costs of taking an inflexible position would be setting them up for grief in the future when the same public servants will be sitting at the negotiating table in years to come.

I would advise my client to return to their bottom line and consider what they can live with, what they can’t compromise on, and whether a delay is worth it in the long run.

The NDIS wasn’t built overnight and won’t be fixed overnight. We can work with the Government or delay the process. Ultimately, we need it fixed and fit for purpose.

JUL 2024: Well Begun, But Not All Done.

The Australian Government has announced its response to the Disability Royal Commission’s final report, released in September 2023. The Commission’s sweeping report, which includes 222 recommendations aimed at fostering a more inclusive and just society, has prompted a significant federal commitment to reform.

Despite a delayed response — initially due in March — the Government has now addressed 172 recommendations, endorsing 13 key proposals, such as bolstering the Disability Discrimination Act and updating Australia’s Disability Strategy. Additionally, the Government has agreed in principle to a further 117 recommendations, signaling broad support. Minister for the NDIS, Bill Shorten, emphasised the need for ongoing consultations to address these recommendations effectively.

You can read the Australian Government Response to the Final Report.

Among the noteworthy new commitments for our constituents are:

$12.3 Million to develop a national strategy for accessible information and communications, enhancing access to essential services and Auslan interpreters.
$19.6 Million to enhance disability responsiveness and capability within professional workforces, alongside grassroots initiatives to improve community attitudes toward disability.
Increased funding to support inclusive education, ensuring better outcomes for students with disabilities.

Minister for Social Services, Amanda Rishworth, affirmed the government’s strong commitment to the Royal Commission’s vision, saying it was “absolutely committed to the vision” for an Australian community that protects individuals with disability from violence, abuse, neglect, and exploitation.

The Government has made a good start, but much remains to be done. Disability advocacy organisations like Deafness Forum Australia must continue encouraging this government, and its successors, to fully implement these necessary changes.

JUN 2024: Australia’s State and Territory Health Ministers are considering options for regulating the audiology profession.

Occupational therapists, optometrists, osteopaths, pharmacists, physiotherapists and podiatrists are among the 16 professions regulated by an independent regulatory body. Yet, audiologists regulate themselves via their own peak body.

The group of Australia’s Health Ministers commissioned a consultation on a range of options with the aim of settling on the level of regulatory intervention necessary to ensure public health is prioritised. The consultation period has closed and we await the outcome of the review.

Our Recommendation

Deafness Forum Australia strongly supports the registration of the audiology profession under the National Registration and Accreditation Scheme.
And we recommend that it be expanded to cover national registration of both audiologists and audiometrists.

We wish to make it clear that we have great respect for the audiology profession and know that most practitioners work to high levels of professionalism and expertise. In our experience, the practitioners would value registration, affirming their deserved professional status. Being registered would provide a formal acknowledgment of an audiology practitioner’s qualifications and competence, facilitating professional credibility and recognition both within Australia and internationally. Registration would bring the status of the audiology profession as an industry up to the same level as other health qualifications, such as physiotherapy, optometry, nursing, and pharmacy, and would provide the public, (and employers) with a much-needed demarcation between audiology and audiometry as two distinct professions with different levels of skill and expertise.

The key test for determining whether to regulate is to assess the relative costs of regulation versus the risk of harm of not regulating. The reality is that 16 health professions are already regulated under the National Registration and Accreditation Scheme, with negligible adverse impacts to either practitioners or the public as consumers of these health services.

As a citizen representative peak in this space, we think the case for regulation is clear and urgent and consider that the existing self-regulation approach presents an unacceptably high level of risk to public health and safety. An independent regulatory body would provide a more robust and reliable regulatory framework, allowing for impartial oversight free from commercial conflicts of interests or industry pressures to dilute standards.

Independent registration facilitates effective monitoring and enforcement of standards through thorough audits, investigations, and penalties such as suspension or deregistration, mechanisms often weak under industry self-regulation. This structure not only boosts public confidence that professionals are held to high standards by a neutral entity, but also ensures more reliable compliance with best practices that safeguard consumers. It effectively reduces conflicts of interest, prevents the erosion of standards for commercial gains, and reinforces enforcement integrity, enhancing public trust in the profession.

An independent body provides impartial oversight and is free from commercial conflicts of interest, ensuring it can objectively establish and uphold standards that protect the public and maintain professional integrity. Such bodies are better equipped to implement stringent registration criteria, ethical codes, and disciplinary processes without succumbing to industry pressures to dilute these standards, providing a robust and reliable framework.

Independent registration facilitates effective monitoring and enforcement of standards through thorough audits, investigations, and penalties such as suspension or deregistration, mechanisms often weak under industry self-regulation. This structure not only boosts public confidence that professionals are held to high standards by a neutral entity but also ensures more reliable compliance with best practices that safeguard consumers. It effectively reduces conflicts of interest, prevents the erosion of standards for commercial gains, and reinforces enforcement integrity, enhancing public trust in the profession.

The hearing services industry is highly commercialised with a handful of large retail chains commanding most of the Australian market. The range of different schemes supports and sources of information for people to access hearing aids and hearing health services can make navigation of this market very difficult for people with hearing loss and their families.

In our experience, there are significant gaps in public knowledge about the differences between audiologists and audiometrists, as distinct practitioner subcategories within the audiology profession, which is not helped by businesses routinely describing audiology professionals as ‘clinicians’ or ‘hearing care experts’, or ‘audiology professionals’. People seeking hearing care often don’t know what type of professional they are seeing, or what types of services the practitioner treating them is trained to provide. This is a major cause for concern and complaint among our constituents.

We are concerned too about the commercialisation of the hearing health industry, its focus on selling devices and the pressures audiologists can experience through commercial partnerships between hearing care services and hearing aid manufacturers. There are inadequate consumer protections in place to ensure that audiologists are not compromised by these commercial partnerships – as can be seen through publicly reported instances where hearing device companies have offered commissions to audiologists for hearing aid fittings, or audiologists have had to work under sales targets and key performance indicators based on numbers of hearing aids sold.

We support action to ensure that the scope of service delivery performed by audiologists is aligned to nationally prescribed levels of knowledge, skills, and experience, and that professional qualifications mechanisms exist to manage underperforming audiologists, as well as those who engage in unethical business practices.

Deafness Forum Australia considers having a single organisation, independent of the profession, that has oversight or authority to investigate and consistently manage complaints and apply sanctions across the audiology profession to be essential to protect the community and enhance the reputation of the audiology profession.

MAY 2024: Reducing the growing cost of the National Disability Insurance Scheme has been applauded as one of the biggest savings of the 2024-25 Federal Budget, with the Albanese government promising to claw back savings of $14.4bn over the next four years.

How do we make sure the Government’s vision of ‘getting the NDIS back on track’ aligns with the hopes and aspirations of the community, when there’s an election looming, and Labor is on a fast-track agenda to rein in the Scheme?

The Federal Budget reinforced something we’ve known for some time – that the Albanese Government is extremely concerned with the rising cost of the NDIS and is determined to bring its costs down.
We can only imagine Labor has a complex relationship with the Scheme – like a birth parent who saw their child raised by someone else and has been left with an adolescent NDIS they believe now has some serious boundary issues.

We know that the stakes are high for the Government. In a fragile economy, with an election as early as the end of the year, Labor needs to be seen to be tightening its belt, and the NDIS is one of their key vulnerabilities. The conservative media knows it too, and has been playing it up for years, while the Coalition has remained quiet. Too quiet.
At the same time, the NDIS has positively changed the lives of tens of thousands of people with disability across Australia, giving many access to support and services they could never have dreamed of a decade ago.

Participants in the NDIS and their families, who fought long and hard for both the Scheme and the individual day-to-day benefits they receive, will tenaciously battle to keep those supports and services. Hence, Labor finds itself accountable both to the disability community and vulnerable to the sensitivities of the broader voters.

There’s no win here, except perhaps to move as quickly as possible to get the worst of it over, so the hurt is less raw when they call the election – certainly, this seems to be Labor’s approach to date.

And there’s another threat looming. While many are waiting for Labor’s formal response to the recommendations of last year’s Independent NDIS Review report to ‘get the scheme back on track’, it will be equally important to know the Coalition’s position. There is a risk that a different Government might not maintain the full five-year trajectory set out by the Independent NDIS Review to ‘get the scheme back on track’. The best way for Labor to protect the scheme is to lay down as much groundwork as possible to safeguard its vision before the election. It makes political sense for Labor to start up the machinations and get them to a point where the Coalition is as fiscally and reputationally tied to a particular path as it can be. But even so, there are no guarantees.

We can’t escape the fact that the NDIS is highly politicised and is likely to remain so for some time. Eventually, we can hope it will become, like Medicare and other social support mechanisms, simply another component of Australia’s social support infrastructure, considered so basic, so fundamental, that no one would ever challenge the investment.

Up until this point, we’re as much in a conundrum as Labor is. People with disability need to be heard across changes that will undoubtedly affect their lives, but it’s clear there’s limited time, and limited seats being offered at the consultation table.

We could push back on the Government’s approach, but we may well be setting ourselves up for more pain in the long run if we do. If we slow the pace of the work we may find the foundational building of the new Scheme being left to a new, potentially less engaged Government.

An advocacy sector representing the interests of many diverse cohorts needs to create efficiencies around how it engages with the Government on coming reforms to the NDIS and work smarter to advocate for a unified vision of an effective and equitable support system for all people with disability. We need to identify common priorities and set collective expectations for the Government around how it engages with people with disability, their families, and the Disability Representative Organisations that represent them. And we need to make sure any opportunities to participate in the reform process represent the best use of our collective time and resources. This means knowing which cohorts have the most to gain or lose on specific issues and giving the spotlight to those who need it when they need it, at a time when we are all feeling vulnerable and stretched. It also means making sure we’re united on the same basic goals and that our messaging is clear and consistent.

I need to be clear that I’m not suggesting that disability representative organisations stop prioritising the interests of those they represent for some ‘greater good’. They should always remain accountable to their memberships and put their interests first, but we need to break out of the silo culture we’ve been forced to occupy and start to look for common goals and work together to achieve them.

A key goal at this stage in the reform process should be making sure there is a legislative requirement for government to work in genuine codesign with disability representative organisations and the broader disability community across the five-year reform process. We also need to make it clear what codesign means and hold the Government firmly to account if it falls short of our expectations.

The pace of reform being pushed through, and limited opportunity for giving feedback also increases the value of network organisations: the pressure will be on these organisations to consult with their members and genuinely advocate across their collective interests.

Lastly, we need to collectively change public dialogue about the NDIS. We need to emphasise the positives of the scheme as a world first, which not only supports more than 649,000 participants, but is a critical component of the Australian service economy, creating tens of thousands of jobs and substantial economic activity, at a time when our economy lags.

If pre-federal election promises are to be made about the NDIS, we need to know that those promises will focus on building on the progress that the NDIS has already made towards supporting individuals with disability to participate equally in community, social, economic and daily life activities, and not on cuts that could take us backwards.

MAY 2024: A Federal Human Rights Act: a Crucial Step Towards Equality For All.

One of the key recommendations of the recent Disability Royal Commission into Violence, Abuse, Neglect and Exploitation of people with disability was to increase legal protections through a new federal Disability Rights Act.

Hayley Stone discusses why Australia’s formal recognition of human rights for people with disability is a critical step towards full equality.

But don’t we already have access to human rights in Australia?

Australia, as a signatory to various United Nations treaties and conventions including the Convention on the Rights of People with Disability, has international obligations to uphold the human rights of its citizens, but there is no legally enforceable national duty to consider people’s basic human rights in Australia.

Victoria, Queensland, and the ACT have state-based Human Rights Acts, but these only cover their residents – so it’s the luck of where you happen to live.

But what about federal anti-discrimination laws and other mechanisms?

Our Constitution protects some rights both expressly and implicitly, but its scope is very limited.

Australia has various federal anti-discrimination acts, which go some way towards ensuring that certain groups of people can get equal access in some areas, but the problem is that they are also limited in scope and the discriminating party can argue that there are extenuating circumstances why they shouldn’t be required to comply.

An additional problem is that anti-discrimination laws require a wrong first – and it’s then up to the individual who has been wronged to make a complaint to the Australian Human Rights Commission, which many can’t, or choose not to do, for various reasons. Even if a complaint is proven, the most the complainant might receive is some form of compensation or a letter of apology. There’s no way for the Australian Human Rights Commission to enforce compliance or compel broader systemic change.

So, what would be different with a Rights Act?

A National Human Rights Act would ensure that everyone’s rights were protected, all the time and would require people’s human rights to be considered in the development of any policies, laws, or practices at the time they are created as a positive duty of all decision-makers.

It would also, for the first time, articulate what people’s human rights are, and provide legal remedies to people when their rights are breached.

Australia is the only liberal democracy in the world that does not have a national act or charter of rights. Every Australian should be able to know what their rights are, as Australian citizens, and know that their rights will be protected irrespective of where, in Australia, they live.

Deafness Forum Australia supports the introduction of a Human Rights Act as crucial to realising the full rights and freedoms of the communities we represent. If you are interested in learning more about a Federal Human Rights Act, jump onto the Australian Human Rights Commission website.

MAY 2024: Design Guidelines for Access and Inclusion in Residential Development.

Deafness Forum Australia provided feedback to the Australian Human Rights Commission on its new guidelines for creating more inclusive and accessible homes.

Our feedback highlights the importance of designing homes that meet the unique needs of people with hearing loss, including those who communicate using Auslan.

Our submission discusses how people with hearing loss or deafness experience their environment differently, often relying more on visual and tactile cues for orientation and safety. The proposed design features aim to create comfortable and functional spaces for them, such as larger open-plan living areas, wide hallways, and visual or tactile alerts for safety threats like fires.

Additionally, our submission emphasises the importance of co-design, involving people with lived experience of disability in the design process. This approach ensures that homes meet basic needs and enhance the quality of life for people with hearing loss and others with disability.

APR 2024: The National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill (proposed law) is here.

It’s clear that the Government isn’t messing around with its plans to roll out major reforms to restore the original intention of the NDIS. But is the Government listening to the voices that matter at this critical stage, and how will it get buy-in if it doesn’t?

It’s been a hectic time in the disability policy space. On 26 March, we had the shock news that State and Territory Premiers had convened an urgent meeting to call on the Federal Government to reconsider its plans to introduce foundational supports until there was a guarantee that they’d be consulted before funding was committed to this new system of care.

The idea of ‘foundational supports’ is they can be accessed by people who are not eligible for the NDIS. There would be general foundational supports for all people with disability, and targeted supports for people with specific disability-related support needs.

The NDIS Independent Review, commissioned by the Government, recommended in its final report last December that state-coordinated foundational supports be created to reduce pressure on the NDIS as an ‘oasis in the desert’ for people with disability who had little to no support options outside the scheme.

The Independent Review report proposed that a multi-tiered system of support would allow a return to the original vision of the NDIS as a scheme to exclusively support those with permanent and significant disabilities, which would operate within a broad ecosystem of state-based supports and services for people that were not eligible to join the NDIS.

Originally, the States and Territories had agreed to work in partnership together with the Commonwealth to develop foundational supports, with 50% of necessary funding to come from the Federal Government. It appears that now the Federal Government is drawing up the finer details the Premiers are concerned that the new laws around foundational supports don’t require states and territories to be consulted on any funding changes, which could leave them out of pocket across other areas of spending.

While we didn’t expect the states and territories to take a collective stand against the government in such a public way, it was clear funding foundational supports was going to be a pressure point that needed to be managed carefully, which begs the question of why the Albanese government seems to have ridden roughshod over the States and Territories when determining whether they’d have a say in funding changes.

While Minister Shorten has given assurances that he wants people with disability, their families, disability representative organisations, and the States and Territories to all be involved in the transformation of the NDIS, it feels like the Government is intent on pushing through as many recommendations as possible, at the expense of the codesign and consultation which is critical for the success of the reforms.

As a case in point, the bold actions of the Premiers earlier this week didn’t stall Minister Shorten from tabling the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024 in Parliament the next day (27 March).

His speech in Parliament speech introducing the Bill is worth reading in full. Minister Shorten also spoke about the Bill in Question Time. In an op-ed, Minister Shorten said that the Bill is the next step of NDIS reforms that ensure the Scheme can continue to provide life-changing outcomes for future generations of Australians with disability and make sure every dollar in the Scheme gets to the participants for whom the scheme was designed.

He said that the Bill should give participants greater clarity on what they can spend their funds on and in what time period and that it will be clearer what’s ok to use NDIS funding for and what isn’t.

The Minister also advised that the Bill should make it clearer how long a plan is supposed to last and stop participants being encouraged to spend their plans too quickly by providers.

Shadow Disability Ministers Michael Sukkar and Senator Hollie Hughes have issued their own commentary on Getting the NDIS Back on Track Bill No. 1., saying that the Coalition will work constructively with the Government on this NDIS overhaul, but “it is concerning to see its failure to convince Labor premiers on these changes.”

“The new legislation has left many questions unanswered with key measures in the Bill failing to be finalised ahead of its release. This Bill, although participant-focused, fails to address provider fraud and price gouging which are two major issues contributing to cost blowout within the Scheme. If the legislation passes, it will take 12-18 months for the measures to become operational, putting further uncertainty on participants, families, carers, and providers.”

This Bill is one of a series of legislative reforms that roll out successive changes to the Scheme. Unfortunately, those hoping to understand how the changes will impact them won’t get a lot of clarity from reading the Bill itself.

While it gives us an understanding of the direction the Government is planning to take, much like a scaffold it doesn’t give much detail about any of the changes. We’re not going to get any nuts-and-bolts information about what the changes practically mean until the release of the Rules and other legislative instruments that accompany the legislation.

The Federal Government has assured us that the Rules will be developed in consultation with Disability Representative Organisations and people with disability but it will be critical that advocates make it clear that the sector doesn’t want more consultation – we need genuine co-design – and this will take time that the Government doesn’t seem to want to spend.

Here’s an initial taster of some of the changes in the new legislation. We will provide a follow-up article detailing further changes as we work through the legislation in more detail.

Access and Eligibility.

The Independent Review recommended that the NDIS place less emphasis on diagnosis and functional capacity as the mechanisms for determining eligibility, funding and supports. It recommended the scrapping of the Access List in preference of a uniform assessment process to determine eligibility based on self-reporting and strength-based interviews – and we now know that the Government is moving forward on this approach.

The Draft Bill sets up a new framework for determining eligibility and requires the National Disability Insurance Agency to provide participants with clear information about what they will need to demonstrate to meet the eligibility requirements.

We know that tools for determining eligibility will include self-reporting and will be strength-based, but the Bill doesn’t give any detail. The Bill does provide that if a child is approved for early intervention, a decision will also be made at the same time about whether they are also eligible for the NDIS, once they reach the age threshold, or whether they would be expected to receive ongoing support via the foundational supports system.

Changes to a ‘whole of person’ budget with more flexibility.

Under the new legislation, all participants will eventually transition to a reasonable and necessary framework plan with a ‘whole of person’ budget, as opposed to the current model where budgets are built around the specific supports that the participant is determined to need.

We understand that plans will be:

Flexible: meaning that the funds will not be tied to particular supports and can be used flexibly within a range of approved items, or
Specified: meaning they must be spent on particular supports, for example, assistive technology, or
A combination of flexible and specified.

There may be increased stipulations on how specified funding can be spent by participants, for instance that a support is provided by a specified person or class of persons, or that a particular process is followed as a condition of receiving the funding.

The Government plans to transition all participants onto reasonable and necessary framework plans across the next five years, but for anyone concerned about being transferred, there’s no indication that the process will start anytime soon since there’s still a significant amount of work to be done in setting up the framework.

The new legislation will tighten rules on overspending and inappropriate purchases, expressly providing that a NDIS participant who receives an amount for NDIS supports must spend that amount according to their plan.

We’ll need to carefully look through the rules that provide specific details on these changes to make sure there are no unanticipated negative impacts for participants, particularly those in areas with thin markets, or participants who exhaust their budgets through no fault of their own.

Another important change to funding and supports is that the National Disability Insurance Agency will consider the extent to which a participant can access services outside the NDIS (including foundational supports) and any lump sum compensation amounts they may have received when determining their plan.

While this makes sense in terms of the Scheme’s sustainability, it’s the first time we’ve seen limitations to funding and supports like this and we’ll have to see how it plays out in practice.

A new reasonable and necessary budget framework.

This change could be significant and may impact participants’ existing supports.

The Bill tightens up the types of supports participants will be able to access, in line with the original purpose of the NDIS as an insurance scheme, introducing new criteria to be demonstrated before a support will be approved.

Under the new changes, a support will only be approved if:

It’s necessary to support the person to live and be included in the community, and to prevent isolation or segregation of the person from the community.
It will facilitate personal mobility of the person in the manner and at the time of the person’s choice.
It’s a support, mobility aid, device, assistive technology, live assistance, or some form of intermediary, which will facilitate personal mobility of the person.
It’s a health service that the person needs because of the person’s impairment or because of the interaction of the person’s impairment with various barriers.
The support is a habilitation or rehabilitation service.
It’s a service that will assist the person to access a health service or a habilitation or rehabilitation service.
It will minimise the prospects of the person acquiring a further impairment or prevent the person from acquiring a further impairment; or
The support is provided by way of sickness benefits.

The legislation also provides for an assessment tool (or tools) that will be used for determining a participant’s needs.

While it doesn’t state what tool or tools will be used, the explainer for the Bill states that any tools used will be evidence-based, highly technical, and developed in consultation with the disability sector and medical and professional experts, as well as relying on international learning and best practice.

While a consistent method for determining supports may lead to greater equality for participants, it’s concerning what these changes could mean when participants transfer over to the new framework.

We expect that existing plans will be reassessed based on the new tools and this could mean people lose some of the supports that they have grown to rely on if the supports don’t fit within the new criteria.

It will largely depend on how strictly the new provisions are interpreted by the NDIA – but there’s plenty of loaded language here, like ‘necessary’ and ‘needs’ and the focus on health services as opposed to services more broadly. It will be very interesting to see how the new framework interacts in practice with the choice and control of participants, as foundational principles of the Scheme.

We also note that mobility aids and devices, assistive technology, and live assistance all focus on physical impairment, so it will be important for disability representative organisations representing the interests of Deaf/deaf people or those who are hearing-impaired/hard of hearing to emphasise the importance of approving these types of supports to facilitate communication as well.

Changes to a ‘whole of person’ budget with more flexibility.

We understand that plans will be:

Flexible: meaning that the funds will not be tied to particular supports and can be used flexibly within a range of approved items, or
Specified: meaning they must be spent on particular supports, for example, assistive technology, or
A combination of flexible and specified.

There may be increased stipulations on how specified funding can be spent by participants, for instance, that a support is provided by a specified person or class of persons, or that a particular process is followed as a condition of receiving the funding.

The Government plans to transition all participants onto reasonable and necessary framework plans across the next five years, but for anyone concerned about being transferred over, there’s no indication that the process will start anytime soon since there’s still a significant amount of work to be done setting up the framework first.

The new legislation will tighten up rules on overspending and inappropriate purchases, expressly providing that a NDIS participant who receives an amount for NDIS supports must spend that amount per their plan.

The NDIS CEO will be able to request additional information from a participant, or another person, to confirm a participant’s status or request that they have an assessment to confirm their status as a participant.

This is a very significant change, and the introduction of these new powers is something that we will be considering very carefully.

Currently, the NDIS CEO doesn’t have any capacity to request additional information from a participant or request that a participant have an assessment or an examination to determine their status as a participant of the Scheme.

The new legislation will give the CEO or their delegate the power to do this, with the participant being able to choose which professional they use. While this is presented as a positive thing – to ensure that the CEO is making decisions based on the most up-to-date information about the participant, so the most appropriate supports can be provided – it can also be used to revoke a participant’s status as an NDIS participant, and we don’t yet know the circumstances in which the CEO might use such power.

As foundational supports are established, and ongoing eligibility for the NDIS is tightened to only those who have significant, and permanent disability there may come a point where this power is used as the basis to assess people’s ongoing eligibility for the Scheme. We’re speculating here, but it’s important to explore all possibilities.

These are only some of the changes that have been canvassed in the Bill – we’ll follow up with the rest of the changes in the next blog.

The next step is for the Bill to go to a Parliamentary Committee, which will allow disability representative organisations, and the disability community to provide feedback on the proposed changes and highlight any unintended consequences or elements of the Bill that create cause for concern.

It is important to keep in mind that any practical changes for participants are still some way off, and there is still scope for some change at this point.

Deafness Forum Australia will be providing feedback on the reforms, and as always, we welcome your thoughts and opinions.

MAR 2024: The Minister for the National Disability Insurance Scheme, Bill Shorten commenced a review of the NDIS in October 2022 with three main objectives in mind:

To put people with disability at the centre of the NDIS, restore trust, confidence, and pride in the NDIS, and ensure sustainability for future generations.

It had significant community engagement, receiving 4,000 submissions before releasing a final report on December 7, 2023, which detailed 26 recommendations and 139 supporting actions to get the scheme ‘back on track’.

While the federal, state, and territory governments have yet to formally respond to the Review’s recommendations, there have already been changes made to the Scheme since Minister Shorten took over the portfolio in June 2022. Some of this work started before or during the Review. Other actions have commenced as a direct consequence of the Review’s recommendations.

Here’s what we understand has already been done, or is in the works:

Legislative reform

All Australian Governments have committed to implementing legislative reform and making other necessary changes to support the NDIS Review’s vision of an expanded ecosystem of supports and services for people with disability. This includes legislative changes to both the National Disability Insurance Scheme Act and the introduction of a new Disability Services and Inclusion Act to replace the Disability Service Act 1986.

While we are yet to learn much in the way of details about the changes being planned to the National Disability Insurance Act, we know that the Government has had conversations with some Disability Representative Organisations on draft changes to the Act which have been flagged as going out to public consultation soon. When we have access to the changes, we’ll review them, and let you know what has been proposed.

The new Disability Services and Inclusion Act strengthens quality and safeguarding arrangements for people with disability who access services outside the NDIS. The new ACT introduces a mandatory code of conduct and certification for any person who receives Commonwealth funding to provide activities or programs to support people with disability.

The new Act also simplifies funding processes for these activities. We anticipate that the Disability Service and Inclusion Act will be the primary legislation governing foundational supports. We have provided further details later in this article.

Market reform

The NDIS marketplace has been a particular focus for the Minister, who has publicly called out fraud, overservicing of participants, and excessive pricing for NDIS clients amongst a broad range of concerns. The Australian Government has invested $10.2 million in funding for repairing the NDIS market and developing better ways to access and pay for supports.

In November 2022, a month after the Independent Review of the NDIS was announced, the Government established a Fraud Fusion Taskforce, jointly administered by Services Australia and the National Disability Insurance Agency. A key priority of the Taskforce is to support the safety of NDIS Participants and ensure that NDIS funding is utilised appropriately.

Another initiative, which was announced more recently is a new NDIS Provider and Worker Registration Taskforce, chaired by lawyer and disability advocate Natalie Wade. The purpose of the task force is to provide expert advice to the Government on how to move forward on the Review’s recommendations for increased regulation of NDIS service providers while balancing the need to preserve consumer choice and control and maintain a robust marketplace.

In addition to these welcome changes, we understand there are also positive legislative reforms on the cards to address the overcharging of NDIS participants by unscrupulous providers – and we look forward to reviewing the specific details of these changes in due course.

Foundational Supports

The Independent NDIS Review noted that supports for people with disability who were not participants in the NDIS either did not exist or were difficult to find.

The Review recommended the development of ‘foundational supports’ which could be accessed by people who were not eligible for the NDIS and spoke to the need for two different ‘streams’ of foundational supports – general foundational supports for all people with disability, and targeted supports for people with specific disability related support needs.

While the vision of a two-tiered system for foundational supports was the brainchild of the Review Panel, reestablishing state and territory-level supports for those excluded from the NDIS was already on the Federal Government agenda.

Eight months before the release of the Review’s final report, Minister Shorten stated:

“There needs to be investment in community-based programs – sports, recreation, education – and ensuring these programs are better integrated into the support mix for NDIS participants, because the NDIS in isolation can’t deliver independence, and because it was never conceived or promised to support every Australian with any disability.”

National Cabinet agreed in January this year that the Commonwealth, states, and territories will work together to co-fund and co-commission the establishment of foundational supports for Australians with a disability aged under 65 – we now know it’s not a matter of whether foundational supports will be introduced, but rather, when they will commence.

For those who are close to 65 or older this raises two key questions:

Will the Government recant on its decision to cap foundational supports to those over 65, and acknowledge that the distinction between disability supports and aged care is primarily an arbitrary one, and
Will those who have access to foundational supports prior to turning 65 be able to retain the foundational supports they have grown to rely on after they turn 65?

We predict that unless we push back strongly, foundational supports will become an extension on the inequalities that currently exist between the NDIS and Aged Care systems, and yet another example of older Australians being left behind.

To date, the Commonwealth has invested $11.6 million over two years to develop and implement a Foundational Supports Strategy, to be directly informed by the disability community, families, carers, and researchers. We know that the NDIS Review recommended that the Foundational Supports Strategy should be developed with an advisory group of disability representative organisations and people with lived experience of disability, and we anticipate that the Government will follow through on this recommendation. Having said this, we’re yet to learn if such a group has been set up, and if not, what organisations and people with lived experience will be invited to the ‘table’. This is particularly relevant to advocates for people who are Deaf or hearing challenged since the Government has previously explicitly highlighted people with hearing loss as a cohort that is anticipated to benefit from targeted foundational supports.

The Government has advised that plans for the Strategy will be put to the National Cabinet for consideration in the latter part of this year.

Improving effectiveness.

In the 2023-24 Federal Budget, the government committed a massive $910 million over 4 years to improve the effectiveness and delivery of the NDIS. Of this amount $429.5 million has been committed to building workforce capacity and

systems, $54.6 million for reforming the processes around determining budgets, $3.6 million has been earmarked for foundational work on the development of a best-practice system of early childhood supports and $49.7 million has been put towards improved home and living options.

Since October 2023, the NDIA has been slowly rolling out a new computer system to improve delivery of the NDIS, which will apply to both participants and providers. The NDIA released a new Supported Decision-Making Policy to empower participants to make decisions around applying for the NDIS, goal setting, and using plan supports.

To say that it is a busy time in the evolution of the NDIS is an understatement. To my mind, this makes sense – the Albanese Government has a limited timeframe to make as many foundational changes as possible before the next federal election and a vested interest in the NDIS as a Labor-driven scheme. The challenge is getting the balance right – if the Government wants to put people with disability back at the centre of the NDIS, and restore trust, confidence, and pride in the Scheme, people with disability must have an investment and ownership in its evolution – and this can only come through genuine consultation and co-design. These processes take time.

Another reflection is the extent to which the Review appears to have provided legitimacy for decisions already made by Government – it’s as if Government has drafted up a plan and laid the foundations, with the Review then providing the scaffolding and materials to realise that plan.

While we don’t see this as a negative, given the strong investment the government has in the NDIS as a cornerstone of our social support system, and noting that the Review was explicit from the beginning in advising that it would not wait to make recommendations for change, it indicates that this is not simply Government responding to the disability community. There is a broader political agenda here, and a little bit of scepticism will be a good thing across the sector as we get into the nuts and bolts planning.

Deafness Forum Australia has direct links to the National Disability Agency, aka NDIA (the government body that manages the NDIS) through sector co-design and stakeholder manager meetings which we’ve used to promote the interests of our constituents. In addition to these activities, over the last three months, we’ve provided the NDIA with a report on our NDIS Independent Review Survey, contributed to a joint position paper collated by the Australian Federation of Disability Organisations on preliminary concerns with the review’s recommendations, and provided feedback on the NDIA’s draft Agency strategy.

We will continue to advocate the interests of our stakeholders and inform you of any new information as it becomes available to share.

Are you aware of any other changes to the NDIS we’ve missed? Do you have thoughts that you’d like to share? Please feel free to reach out to me directly by email.

FEB 2024: How will people who receive funded aged care services live active, self-determined, and meaningful lives while we still medicalise age-related disability and persist in defining support for older people as ‘care’?

Over the past few years, we’ve had the opportunity to spotlight the multitude of problems in our disability and aged care sectors. Older Australians, those with disabilities, and their supporters have shared harrowing stories – of abuse, exploitation, violence, and neglect, forcing governments to address the dysfunctionality of the support structures that should provide people with additional support needs decent quality of life.

When we think about caring for older people, we think of things like help with showering, home modifications, or support to perform basic daily tasks like cooking or cleaning. We might think about assistive technology, wheelchairs, walkers, and hearing aids. But there’s no association with independence or autonomy.

This view reflects the medicalised model of disability, which links a disability diagnosis to an individual’s physical or cognitive condition. It focuses on the diagnosis, cure, or management of a person’s limitations. Under the medicalised model, a person can be fixed, or at least supported to manage more effectively in society, through targeted support.

Unfortunately, what so often happens is that the individual is lost in the focus on their physical or cognitive limitations. There is little to no scope for the individual to have any choice and control – because they can either do something, or they can’t – with an emphasis on the can’t. As a person’s physical or cognitive limitations increase, so do their supports.

It’s a model that focuses on the reduction of the individual into various deficits to be assessed, and then responded to, through some type of intervention.

It’s not unusual for people with disability who are over 65 years of age to tell me that they wish they could access the National Disability Insurance Scheme instead of the Aged Care Scheme, and I’ve come to understand that a great part of what they are comparing between the two schemes, either consciously or not, is how disability is firstly conceptualised and then addressed in a practical sense to funding and supports.

What makes the National Disability Insurance Scheme so unique in an Australian context – indeed, worldwide, is that the NDIS is a social support scheme founded on a social model of disability. This contemporary approach rejects the idea that the person is the ‘problem’. It recognises that disability is an inherent part of the human condition and that the person with disability is limited not by their characteristics, but instead by external factors that we all have a responsibility to address. These external factors can be physical, attitudinal, or legal.

In recognising the equal value of the individual with disability, the social model acknowledges that that person should have access to the same rights as anyone else, including freedom of expression, self-determination, and decision-making – as seen in the phrase that has become synonymous with the promotion of the NDIS ‘choice and control’ and this is why a NDIS participant can, in theory, make decisions about the individual supports they want to align with their personal goals.

The Royal Commission into Aged Care Quality and Safety was established in October 2018 to inquire into the quality of aged care services in Australia, including whether these services met the needs of older people and their families.

The Commission presented its final report in 2021, giving 148 recommendations on improving aged care services. The commission’s first recommendation was that the Government review the Aged Care Act and create a new Act to provide for a system of aged care that allows older Australians to live active, self-determined, and meaningful lives.

The Commission emphasised that the Act should give older Australians the same rights of social participation as other members of society, allow them to make decisions about their care, pursue physical, social, emotional, and intellectual development opportunities and be active and engaged members of their communities, irrespective of age, or level of physical or cognitive capacity – in essence, to bring the Act in line with the social model of disability.

And to the Federal Government’s credit, the draft of the new act does include provisions that should strengthen the rights of older Australians, including a clear statement that the Act is intended to give effect to Australia’s obligations under the International Covenant on Economic, Social and Cultural Rights and the Convention on the Rights of Persons with Disabilities.

But I have doubts that the Act will fully comply with the Royal Commission’s aspirations, so long as we continue to conceptualise our support for older Australians as ‘care’.

To be clear, we certainly do need to provide basic care for any older Australians who require it. All older Australians should have access to basic home and care supports, but what about supports that facilitate aging well, or that support older people to realise personal goals around community participation, capacity building, or learning?

Should older Australians be able to access exercise classes and physiotherapy under the Aged Care Scheme as preventative measures to age better? Should they be supported to participate in community activities that we know will keep them psychologically and cognitively fit and active longer? Paid employment or volunteer work?

What about support and funding to do courses and training if this would support them to live happy, socially connected lives? I believe all these activities should be accessible under our Aged Care Scheme, simply based on common sense –because we know that happy, engaged individuals live healthier.

But there is no way these activities would be defined as ‘care’, and that’s the limitation of our current Aged Care Scheme. The scheme’s basic framing doesn’t facilitate a holistic view of support for older Australians that includes the right to realise their rights as citizens and members of the community in the same way that their NDIS counterparts do, and while this remains the case, it will continue to minimise the Act’s capacity as an instrument to realise the rights of older people in line with our domestic and international obligations.

So, how would we go about addressing this? For a start, we need to go back to basics and reconceptualize the whole scheme to broaden the scope of supports and services available to support older Australians. We’d need to revisit the types of support available to individuals dependent on their individual needs.

It is also important to redefine the portfolio to support the needs – not just care- of older Australians and separate it from the health portfolio to ensure the distinction between the two portfolios doesn’t become blurred.

We also need to change community attitudes around aging. People are living and working longer. They’re working into their 60s or 70s, participating in the volunteer workforce, and often balancing informal caring commitments to older or younger relatives, but as a society, we’ve been slow to adjust our attitudes and expectations around what aging now looks like, and what we should be able to expect in terms of support as we age. The Hon. Bill Shorten, once said to me (and I paraphrase) that the Aged Care Act was great for its time – until we had the NDIS. The reform of the Aged Care Act is a once-in-a-lifetime chance to redefine how we, as a society, support our Elders, both now and into the future.

By acting on the lessons learned from the National Disability Insurance Scheme and integrating a social model of disability, we can reimagine ageing not as a decline to be managed but as a phase of life rich with potential. The reform of the Aged Care Act offers hope for a future where aging is celebrated as a vibrant part of the human experience, ensuring that our elders are respected, valued, and empowered to live good lives. We can take this opportunity to redefine the narrative of ageing in Australia to one of dignity and respect. For everyone of us, no matter their age, it’s personal.

JAN 2024: Deafness Forum Australia analysed the Independent Review of the National Disability Insurance Scheme’s Final Report, examining and contemplating its extensive findings and recommendations.

The NDIS was established in 2013 as a collaborative funding effort by the Federal Government and state and territory governments. Its primary objective is to provide necessary and reasonable supports for eligible individuals with disability.

In 2022, the Government initiated an independent review with the express aim of realigning the NDIS with its core mission: placing individuals with disability at the forefront. The review aimed to rebuild trust, confidence, and pride in the NDIS.

The review’s final report was published in the weeks before Christmas 2023. Titled “Working together to deliver the NDIS,” the report outlined 26 key recommendations and 139 specific actions to enhance the scheme over the next half-decade.

Like many organisations in the disability advocacy sector, Deafness Forum Australia was concerned about what the report might mean for the future of the NDIS and its participants – especially given ongoing public concerns around higher-than-predicted participants and the increasing costs associated with the Scheme.

While the review calls for significant readjustment to how the NDIS operates, there were no obvious red flags. The review’s 26 recommendations and 139 integrated actions provide a detailed blueprint for reducing cost projections, addressing many pain points of the Scheme while also expanding supports to cover people under 65 who currently fall through the cracks.

The recommendations go beyond the NDIS, calling for a well-coordinated, national effort towards designing, operating, and governing a new disability support ecosystem, and call for a massive investment in resources and services over the next five years, in addition to a shifting of responsibilities back to States and Territories for a new category of supports.

But nothing has been decided yet.

While states and territories have expressed commitment, in principle, to the reforms, we anticipate some pushback once planning gets underway. At the same time, the proposed five-year rollout would extend into the tenure of a new government, so it’s vitally important to have the solid commitment of the Opposition.

We’ve put together a summary of the review’s significant recommendations, with our initial thoughts.

1. A new model for disability support.

The report has recommended replacing Tier 1 and 2 supports with an expanded range of foundational supports that would be available to people with disability under 65, irrespective of whether they are participants of the NDIS or not.

Targeted foundational supports would be for people with specific, but less intense, disability support needs, and would include things like aids and equipment, and home maintenance services.

General foundational supports would include services like peer support, information, and advice, as well as disability employment services.

What’s good about this model is that it will potentially expand the supports available to people with disability who are ineligible for the NDIS, but there’s limited information on precisely what supports would fit under the ‘foundational’ umbrella or whether this will mean that participants of the NDIS will have their supports split across foundational supports and their individualised plans, which could be challenging to navigate.

We also don’t know whether NDIS participants might be expected to transition off the Scheme if the supports they need can be accessed as foundational supports. It also doesn’t appear that foundational supports will be available for people aged 65 years and older – a missed opportunity for the review to address the inequity between the NDIS and Aged Care.

Another issue is that the proposed model transfers significant responsibility back onto states and territories to administer and provide funding for foundational supports. While this isn’t a new idea, we know that many state-funded services have been eroded over the past decade. Significant work will be required to rebuild those services to achieve the interconnected disability support ecosystem necessary for this recommendation to work in practice.

2. Introduction of systems navigators.

Another recommendation is the introduction of navigators to support all people with disability under 65 years of age to access the support and services they need. The expectation is that navigators will have consistent training and national oversight but will be locally based to ensure they understand local communities. Systems navigators would be available to all people with disability under 65 years of age.

If a person with disability wanted to apply for the NDIS, the navigator would assist them in understanding the scheme and support them through the application process. Once a budget and plan have been set, the navigator could support the participant in accessing services in their local communities.

As we all know, the complexity of the disability support landscape is a significant barrier to people with disability getting access to the supports they need when they need them.

Navigators are used effectively in several other public service contexts, including healthcare and could significantly improve the experience of people with disability interacting across various elements of both the NDIS and the broader disability support ‘ecosystem’, but we need the right people for this vital role.

Navigators need to be unbiased and impartial. Service providers or entities affiliated with service providers should be excluded from providing navigation services to ensure that people with disability are appropriately referred, based on their preferences and requirements. We’ve also recommended that any navigator scheme be extended to support people with disability aged 65 years and older.

3. A new system for determining NDIS eligibility, funding and supports.

The review has proposed that the NDIS place less emphasis on diagnosis and functional capacity as the mechanisms for determining eligibility, funding and supports.

The recommendations propose scrapping the Access List in preference of a uniform assessment process to determine eligibility based on applicants’ needs. The assessment would be based on self-reporting and strength-based interviews. The same assessor who conducts the assessment would support a successful applicant to plan their budget and supports.

It’s clear that the proposed assessment model is not a rebranding of the independent assessment model that was fiercely opposed in 2021. The proposed model doesn’t work to an algorithm, it doesn’t use the same diagnostic tools and looks to have scope for assessors to seek supporting information from an applicant’s treating professionals.

If the new assessment model is adopted and implemented well, we anticipate that it should address current inequities around evidence

requirements for people with different types of disabilities, while ensuring people continue to receive customised supports.

If the new assessment model is confirmed, we will need to be assured that the tools are evidence-based, that the assessors have the skills and training necessary to administer the assessments, and that people with disability have the time and supports necessary to fully articulate their needs.

4. Continuum of supports for children and young people with disability.

Addressing the needs of children and young people with disabilities and their families was a key priority in the review. The report recommends additional screening processes to identify children with disabilities and developmental delays as soon as possible through general community screening, and a continuum of supports for children and young people with disability, irrespective of whether they are NDIS participants or not, to the age of 21,

Changes would include expanding the early intervention program to age 9, new supports and services for children and young people aged 9-21 to prepare for key life transition points, including secondary school and employment, and targeted funding for a capacity-building program for parents and caregivers.

Children would be assessed via a whole-of-person needs-based assessment and monitored to track how well supports were working.

While we welcome these changes in principle, we’ve requested more details. We want to know how the impacts of supports would be assessed in practice and whether there is scope to optimise the universally available child development check for screening. We also need to be confident that needs-based assessments are evidence-based, age-appropriate, and conducted by people with the right skills and expertise.

Any capacity building programs for parents and caregivers, must be developed in co-design with people with disability and be identity affirming. We’d also recommend the development of a national database to track lifetime progress against measured outcomes, with scope for interventions as needed, to ensure that all Australian children with disability can reach their full potential.

5. Enhanced access to assistive technology supports.

The review noted that access to assistive technology for people outside the NDIS is underfunded, fragmented, and complex, with an estimated 108 different schemes to access assistive technology outside the NDIS.

The review has called for the Department of Social Services, with States and Territories, to develop a nationally consistent approach for delivering aids and equipment outside the NDIS with a focus on improved planning and coordination of aids and equipment between the NDIS, Health, and Aged Care.

While we would welcome a centralised, national program to link people with disability to the aids and technology they need, further detail is necessary to understand how such a scheme would be funded and coordinated.

6. A digitalised market with increased quality and safeguarding mechanisms to protect consumers.

The report proposes significant changes across the market, including introducing a new pricing and payments framework, a complete transition to electronic payments, and developing a centralised online platform to help participants find service providers in their local area.

The review panel also recommends that the National Disability Supports Quality and Safeguards Commission actively monitor the market to identify and respond to poor service

delivery and introduce a new graduated risk-proportionate regulatory framework.

Under the proposed framework, all disability service providers must be enrolled or registered with the National Disability Supports Quality and Safeguards Commission. Providers would have graduated regulatory obligations increasing depending on the risk associated with the services the provider is delivering. There would be minimal ‘red tape’ for service providers who provide low-risk services.

These recommendations represent a good balance between providing regulatory safeguards for consumers and facilitating their choice and control by encouraging a robust, diverse marketplace. We can anticipate that these reforms would reduce fraud, price gouging, and over-servicing.

So, what comes next?

It’s now a matter of wait and see how many recommendations are picked up and the response from the Australian Government, States, and Territories to the five-year implementation target. Until then, we’ve been told by the NDIA that participants should expect things to be business as usual.

Our key priorities across the implementation of the reforms will be making sure Governments and the NDIA commit to genuine co-design with people who require hearing and speech supports and people whose first language is Auslan. We’re aiming to influence and and inform decision-making around the practical implementation of the changes and will continue to advocate for increased supports for those who are deaf or hard of hearing who are over 65 years of age.

We’ll keep you informed as we learn more about changes and will be reaching out for your thoughts and input over the next few months once we know the plan for the NDIS moving forward. In the meantime, there are some resources on the recommendations, including fact sheets on key topics and an easy-read version of the final report, on the NDIS Review website.

Hayley’s Journal