Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697629316225.pdf (Australia)
Emma Davidson MLA Minister for Disability Minister for Justice Health Minister for Mental Health Assistant Minister for Families and Community Services Member for Murrumbidgee Ms Bonnie Allan Committee Secretary Joint Standing Committee on the National Disability Insurance Scheme NDIS.Sen@aph.gov.au Dear Ms Allan Thank you for your invitation to provide a written submission to the Joint Standing Committee inquiry into the introduction of Independent Assessments.
Unfortunately, the ACT Government is unable to provide a formal submission to the inquiry, however I would like to take this opportunity to raise with you some areas of concern.

Additionally, as the Minister for Disability in the ACT, I would welcome the opportunity to be called as a witness to the hearings on this matter.

I understand that people with disability are concerned that the introduction of Independent Assessments would return Australia to a capped and rationed disability support system.
Although the National Disability Insurance Agency (NDIA) and the Australian Government have not stated this explicitly, the undercurrent of the NDIA consultations is that the use of Independent Assessments will reduce the costs of the National Disability Insurance Scheme (NDIS).

This claim, although denied by the Australian Government, is causing significant distress for people with disability.
As a social insurance scheme, it was understood that access to the NDIS was an entitlement and that investment in the scheme would reduce the long-term costs to the Australian economy.
The NDIA in its contribution to the NDIS Costs Productivity Commission Study Report 2107 suggests that the NDIS will reduce: • costs for the health system by between $140-$300 million each year (by reducing hospitalisations for people with disability and limiting the need for people with disability to remain in hospital due to a lack of more appropriate arrangements); ACT Legislative Assembly London Circuit, GPO Box 1020, Canberra ACT 2601 @emmadavidsonACT emmadavidsonACT @J emmadavidson +61 2 6205 1941 davidson@act.gov.au J 0 Independent AssessmentsSubmission 246 • justice system costs by between $350-$850 million each year (by reducing incarceration rates of those with mental disabilities); and • supported accommodation costs by between $1.2-$1.6 billion each year (as a result of the increased ability for people with disabilities to live independently).
Based on these findings, the ACT Government supports longer term investment into the NDIS and encourages a focus by the Australian Government on building and developing systems that realise the scheme’s benefits.

For some people with disability, access to the NDIS and a suitable funding plan can be challenging.
Free functional assessments would be invaluable for people with psychosocial disability, and especially those who experience economic disadvantage, who do not have a regular GP and who cannot afford to access allied health practitioners.

The ACT Government is concerned that people with psychosocial disability would be particularly disadvantaged by mandatory assessments and it is expected that they may disengage from the process resulting in the loss of valuable services and supports.
Those people in turn are likely to come to State and Territory services including public health services therefore increasing the cost to states and territories.

The NDIA has been unclear on how they will meet their obligation to support these people.

The ACT is committed to supporting the most vulnerable in our community but has also significantly financially contributed to the NDIS and it is our expectation that the NDIA delivers for the most vulnerable participants.
The ACT opposes any changes to the NDIS Act 2013 that diminishes the role of State and Territory Governments in defining and clarifying what constitutes reasonable and necessary supports.

The Tune Review recommended that all governments and the NDIA should clarify the definition of what kind of ‘reasonable and necessary’ supports should be funded under the NDIS.
The Disability Reform Council (now Disability Reform Ministers Meeting) has been identified as the most appropriate body to resolve the interface between the NDIS and ordinary living costs, including what supports the NDIS is not responsible for funding.
Consistent with its commitment to support this recommendation, the Australian Government should consider a consultative approach involving all jurisdictions, NDIS participants and the wider sector to provide greater clarity on reasonable and necessary supports under the NDIS.

Consultation should occur with a view to seeking consensus on what supports should be deemed as reasonable and necessary to support people with disability in pursuit of their goals.
The ACT Government considers the consultation undertaken by the NDIA on Independent Assessments has not been truly genuine.

The announcements made on the successful assessment panel the day after the consultation round occurred has not reassured people with disability that this is a true and genuine consultation.

The ACT Government call on the NDIA and the Commonwealth to have more meaningful consultations and address the concerns and questions of people with disability as a matter of priority.
Independent AssessmentsSubmission 246 I would like to also draw your attention to the significant concerns being expressed by disability advocates in the ACT in the enclosed correspondence.

The ACT shares their concerns and as a Human Rights jurisdiction has significant concerns that the NDIS’s fundamental principles of choice and control are being eroded.

Yours sincerely Emma Davidson MLA Minister for Disability Enc.
Letter to ACT Minister for Disability from disability sector organisations 23 March 2021Independent AssessmentsSubmission 246 1111 4 a 1f •1 advocacy / A.'-.

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, WWDACT ~ Consumers 2nd March 2021 Emma Davidson MLA Minister for Disability Minister for Justice Health Minister for Mental Health Assistant Minister for Families and Community Services Dear Minister Davidson, NDIS Independent Assessments We write to highlight our significant concerns regarding the proposed introduction of independent assessments and related changes to the National Disability Insurance Scheme (NDIS).
These shared concerns reflect feedback from people with disabilities, advocates and others in our organisations and community.

While we acknowledge there have been issues in the implementation of the NDIS, we do not believe the proposed model of mandatory independent assessments is an adequate or preferred response to address these issues.

We hold significant concerns that the proposed model is an inefficient, heavy-handed and rushed initiative.
Introducing mandatory independent assessments to the NDIS has the potential to add considerable distress and trauma to the lives of people with disability and could cause further disadvantage to the most vulnerable of the current and prospective NDIS participants.

We provide below a summary of our concerns regarding the decision to introduce independent assessments and their proposed model of operation.
Lack of Consultation -The National Disability Insurance Agency (NOIA) has failed to meaningfully engage with people with disabilities and their representatives and has not adequately addressed the concerns raised since the announcement of the introduction of independent assessments was made.

In the first pilot of independent assessments only 28% (145 people) involved in the pilot completed the NOIA feedback survey.
Of those only 35 were NDIS participants, while the remaining 110 responses received were from carers.

This is an inadequate level of testing or consultation from which to rollout a policy that will affect 400,000 people.

Independent Assessments will be Mandatory-The assessment model will involve observation and use of standardised tools by an independent assessor not chosen by the individual.
The full assessment process will reportedly be limited to under 4 hours, and a participant's funding will be determined primarily on the basis of this assessment.

Independent assessments will be conducted repeatedly.

A participant who refuses to undergo an independent assessment, without being granted an exception, will be taken to have withdrawn their access request from the NDIS.
The proposed model of mandatory independent assessments will potentially cause significant distress to all current and prospective participants, but especially to those who have already and repeatedly proved their eligibility.

People with disability should not be subjected repeatedly to intrusive scrutiny and forced to crawl through hoops to prove their need.

Many people with disability have also already spent years working with health Independent AssessmentsSubmission 246 1111 4 a 1f •1 advocacy / A.'-.
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, WWDACT ~ Consumers professionals and other supports to determine and understand the impact of their disabilities, which results in a wealth of knowledge and expert opinion held by trusted professionals.
The prominence to be given to single independent assessments to determine functional impact devalues the expertise of health professionals and other supports, and disregards the importance of trust and ongoing relationships in developing an understanding of support needs.
Use of Independent Assessors -While the NOIA emphasises the importance of the independence of its assessors, the extent to which assessors can be considered independent is problematic, as they are contracted by the NOIA Other initiatives involving similarly 'independent' assessors contracted to provide assessments, such as Work Cover, provide a multitude of examples of questionable outcomes, complaints of bullying, unfair treatment and distress caused to those being assessed.
Appropriateness of Assessment -The contracted independent assessors will not be required to have specific disability knowledge or experience.
The NOIA has previously listed what they stated are the most appropriate health professionals to provide best practice standardised assessments, including professionals such as audiologists, neurologists, psychiatrists and Acquired Brain Injury health professionals; none of these have been included in the list of professionals who will conduct independent assessments.
The notion that a lone independent assessor, without knowledge or experience of the disability, barriers and stigmas faced, will have the ability to effectively comprehend and exhaustively capture the diverse experiences and full impact of various disabilities - and all in under 4 hours - is deeply problematic.

That the results of such an assessment will then be used to determine an individual's access to the daily supports needed to survive is alarming.
Disturbing disparities can occur between the opinions of an independent assessor and an individual's regular supports, as highlighted by the 2020 Administrative Appeals Tribunal decision in Ray v National Disability Insurance Agency, which demonstrated the risk involved with overly simplistic approaches to assessing disability.
Potential for Trauma -To require a person with disability to be observed by someone who is not known to or chosen by them, in order to justify their support needs, does not align with the principle of dignity of the individual.

Further, to have the level of disability support needed by an individual determined solely based on this limited interaction is inherently stressful for a person with disability.

The impact of the trauma and distress of such assessments must not be minimised.
Adverse mental health outcomes associated with stringent functional assessments, including increased suicide risk, have been recorded in other jurisdictions, such as in the United Kingdom when changes were made to assessments for the Disability Living Allowance and Personal Independence Payment.

In Australia, Centrelink and Job Access participants have also had negative experiences with outsourced functional capacity assessments.
Of greatest concern is the fact that standardised assessments performed by independent assessors without specific disability knowledge risk disadvantaging the most vulnerable: those who are isolated or have experienced trauma, people with multiple, complex and fluctuating disabilities, people with intellectual and psychosocial disabilities, CALO and Aboriginal and Torres Strait Islander peoples.

Independent AssessmentsSubmission 246 1111 4 a 1f •1 advocacy / A.'-.
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, WWDACT ~ Consumers Lack of Transparency - There is a significant lack of transparency in the decision-making process.

It has not been made clear when or whether an individual will be provided the full results of their assessment, meaning that an individual may be unaware of the information being used in planning and deciding their funding.
There is also little recourse for individuals who do not agree with an assessment, as the NOIA states that results will not be a 'reviewable decision'.
Going Beyond the Recommendations - Despite referencing recommendations from the Productivity Commission's 2011 Inquiry and the 2019 Review of the NOIS Act (the Tune Review), the proposed scope of independent assessments goes beyond those recommendations, and the NOIA has failed to implement key protections emphasised in the Tune Review during the development and rollout of the trials.
The Tune Review recommendation on assessments was very cautious and included key protections such as allowing participants to exercise more choice over which providers completed their assessment, as well as options for participants to challenge the results and seek arbitration.

The Tune Review also stated that any consideration of independent assessments would require extensive consultation with participants, the disability sector, service providers and the NOIA workforce, this has not happened.
The proposed changes do not align with the intent of the Tune Review, nor do they adequately reflect the kind of reform to the NDIS that is desired by people with disability and their families.
Justifications for the Changes - The NOIA has stated that these changes will resolve inconsistencies in the NOIS by introducing standardised assessments of functional capacity, addressing concerns of bias among health professionals, and reducing the impact of socio-economic inequities on access and planning processes.
The introduction of independent assessments will substantially reduce choice and control for many people with disabilities, and it is questionable how much impact the assessments will have in reducing socio-economic barriers.
Given that independent assessments will not provide recommendations for supports, and that prospective participants will still be required to provide evidence of their disability and its permanence, participants are still likely to face financial burden related to sourcing further assessments.

Very little evidence has been offered to show why the NOIA would outsource assessments away from an individual's own trusted health professionals.
While the NOIA has cited sympathy bias as a 'potential' risk, it has not produced any evidence that supports the existence or impact of such bias in NOIS supports.

The introduction of independent assessments is a concerning move away from a social model of disability to a medical model, and significantly removes control from people with disability, and their trusted supports, who are the experts in their own support needs.
The decision to introduce independent assessments and the proposed model highlights the need for the NOIA to work in partnership with people with disability to co-design reforms that adequately address needs, do not negatively impact participants nor undermine trust and confidence in the NOIS.
If the NOIA proceeded with the proposed mandatory independent assessments, we would expect that people with disability would face increased difficulty accessing the scheme and negative consequences due to inadequate provision of disability supports.

We urge the ACT Government to support the protection of choice and control in the NOIS, and to fight to prevent the erosion of the human rights of people with disabilities.
We implore the ACT Government to take every opportunity to make the strongest Independent AssessmentsSubmission 246 1111 4 a 1f •1 advocacy / A.'-.

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, WWDACT ~ Consumers representations possible for the NOIA to pause these reforms and engage in a genuine dialogue with people with disability and their representative organisations, as a funding partner in the NDIS and the launch site for the entire scheme.
We welcome the opportunity for further consultation with you and your office.

Sincerely, Nicolas Lawler Chief Executive Officer Advocacy for Inclusion President People with Disabilities ACT Inc. Wendy Prowse Chief Executive Officer ADACAS w: www.advocacyforinclusion.org 11 11 4 a 1f •1 advoca cy / A.'-.

for inclusion Dr Emma Campbell Chief Executive Officer ACTCOSS w actcoss.org.au rltii(Qff.4.\ Kerrie Langford Head of Employment and ACT Manager National Disability Services w : www.
pwdact.org.au People with Disa bi I ities ACT Inc http://www.adacas.org.au ADACAS A D V O C A C Y Kat Reed Chief Executive Officer Women with Disabilities ACT Alan Thomas President Health Care Consumers' Association Inc W www.wwdact.org.au $ 't' Women with Disabilities ACT Leith Felton-Taylor Executive Officer (A/g) Mental Health Community Coalition ACT A ('HealthCare Consumers Dalane Drexler Executive Officer ACT Mental Health Consumer Network Web: www.nds.org.au National Disability Services w: www.mhccact.org.au ~ ~~~~~,~;:l~~ It -1 ACT Mental Health Consumer Network Independent AssessmentsSubmission 246