Kevin Andrews (Menzies, Liberal Party) Share this | Link to this | Hansard source

On behalf of the Joint Standing Committee on the National Disability Insurance Scheme, I present the committee's report entitled Provision of services under the NDIS Early Childhood Early Intervention Approach.

Report made a parliamentary paper in accordance with standing order 39(e).

by leave—By 2019-20, it's expected that 47,000 of the 460,000 total NDIS participants with approved plans will be children aged between nought and six. The NDIA estimates that a further 59,000 children aged between nought and six may identify as having a developmental delay or disability but are not expected to need individualised funded supports.

The ECEI, Early Childhood Early Intervention, approach is designed to individually determine and facilitate the most appropriate support pathway for each child aged nought to six years with a disability or developmental delay, regardless of diagnosis, and their family.

The approach is intended to uphold the eligibility criteria of the NDIS, while helping to ensure that less severe cases are supported outside the scheme.

The committee recognises that the ECEI approach is in its infancy, however, it's concerned that the current access arrangements are potentially advantaging families who can afford to source expensive assessments and reports to expedite their child's access to the scheme.

Improvements to the ECEI

The committee acknowledges the efforts being made by the National Disability Insurance Agency to continually improve the operation and access to the ECEI pathway. However, the committee understands concerns regarding the eligibility criteria, and is of the view that unclear eligibility criteria increase risk of misinterpretation and conflicted understanding. The repeated confusion over whether one or more than one area of developmental delay determines access to the ECEI pathway illustrates that more work is required to clearly annunciate which children will be eligible for support. Publication of clearer guidance around all aspects of entry to the pathway would assist all stakeholders.

The NDIA has recently made significant improvements to the participant pathway, however the committee remains troubled by reports that planners have poor understanding of the needs of children that they are developing plans for. Planners should, at the least, have awareness of recommended intervention guidelines and therapies for the major disability cohorts, and demonstrate sensitivity in their communication with families.

Assessment tools

The committee is also concerned by reports that the PEDI-CAT tool is unsuited to assessing the functional capacity of children with a developmental delay, including those with autism spectrum disorder (ASD), yet it is being used by the agency and its partners to inform access and funding decisions and track children's developmental progress. The potential inaccuracy of the PEDI-CAT in determining a child's functional needs leads to broader concerns about whether the number of children with developmental delay accessing the NDIS and the level of the delay is correct.

The committee is concerned that some families have had to fully or partially fund assessment and diagnosis reports to ensure their child could access ECEI services and have adequately funded plans. As discussed in chapter 2 of the report, which has been tabled, there should be no need for families to provide these costly assessment and diagnosis reports at the time of lodging the access request for ECEI services with the NDIA or during the planning process.

As already indicated, the committee is concerned with the numerous reports of significantly underfunded plans for ECEI participants. The committee noted the funding shortfalls and inconsistencies in plans appear to particularly affect children with ASD and those with hearing impairments. The report explores evidence in relation to recurring funding shortfalls and plans with children with ASD. It appears that the level of funding granted in many plans does not meet participant needs and does not align with recommended evidence based practice guidelines. This is resulting in those children not accessing the right level of support and therapies to achieve optimal outcomes.

Alarmingly, the committee heard that NDIS funding levels are often lower than previous national funding models such as helping children with autism. It is concerning that some participants and their families are potentially worse off than under previous funding models. With almost 40 per cent of NDIS participants aged zero to six years having ASD as their primary disability, it is of paramount importance that the agency urgently addresses the issue of scope and level of funding in plans for children with this disability.

The committee also believes that approval of funding for assistive technology should be systematically and consistently based on the participant's individual needs to achieve optimal outcomes. The funding decision should not be based on minimising costs. As a result, the committee is concerned that some submitters suggested that participants were given inappropriate assistive technology equipment to reduce costs. The committee believes that access to supports for families and carers should be integral to the ECEI approach. The committee agrees that, to date, the role of siblings of children with disability has been overlooked within the framework of the NDIS and the early intervention approach. The committee believes the agency should consider the development of sibling-specific supports and how these could be integrated into the early intervention approach. Development of tailored programs should be considered and delivered through the ILCs.

The committee is concerned with widespread reports of delays in accessing and receiving services for ECEI participants with a plan. This can significantly impact on the successive therapies and the ability of participants to achieve optimal outcomes. Where delays can be attributed to staffing pressures in the agency, the committee is of the view that this needs to be urgently addressed by the NDIA.

The committee understands there can be significant additional costs to deliver services in rural and remote areas, including costs associated with travel. It noted that the new NDIA price guide introduced on 1 July this year incorporates a series of changes, including an increased price loading to apply for delivery of supporting to participants in remote and very remote parts of Australia. However, it appears that the issue of travel costs remains a significant cause of concern for many service providers.

The committee acknowledges the agency has made efforts to publish a range of early intervention related material on its website. However, it agrees with submitters that the quality of information currently available for families and carers could be and indeed should be improved. The agency should ensure that information on the website is logically presented. All information should be clearly dated, indicate if it has been superseded and identify related historical information. Information relevant to the early intervention approach should consolidate information from multiple sources and remove redundant and contradictory information.

The committee is also of the view that ECEI partners do not currently have the capacity or funding to conduct essential outreach and support services for vulnerable cohorts. The committee agrees with the Productivity Commission that adequately resourcing the information linkages and capacity building, ILC, is critical to ensure people with disability are connected with appropriate services.

The committee also is troubled by reports that there are Aboriginal and Torres Strait Islander families unable to use allocated funding because they are unsure how to access services. The committee considers that resources should be developed in co-design with people with disability, Aboriginal and Torres Strait Islander populations, and CALD communities to assist them to understand the scheme, and how to use their funds to access services.

The work undertaken by the agency in developing an Aboriginal and Torres Strait Islander engagement strategy is a positive step. However, it is imperative that the NDIA develop a specific strategy to ensure that culturally appropriate early-intervention services are delivered for this community by specialised staff.

Conclusion

In conclusion, the committee received a wealth of information and evidence throughout the inquiry and thanks all those submitters and witnesses who participated. As a result, the committee has made 20 recommendations, which aim to strengthen the effectiveness of the scheme and ensure that children can be appropriately supported and reach their full potential. I thank all members of the committee for their cooperative approach to this important social and economic issue for the nation, and I'd particularly like to thank the secretariat for their ongoing work on the NDIS inquiries.

Jenny Macklin (Jagajaga, Australian Labor Party, Shadow Minister for Disability and Carers (House)) Share this | Link to this | Hansard source

On this great day for equality, I'm very pleased to speak on this report that is about making sure that the National Disability Insurance Scheme delivers its primary purpose for people and, in this case, for small children with disability so that they can live a life that will give them every opportunity to be everything they want to be. All of us in this place want to make sure that the supports through the National Disability Insurance Scheme are delivered as early as possible to children with disability and developmental delay. This inquiry went to that purpose.

I endorse the remarks made by the member for Menzies, the chair of the committee, and I thank him and all the other members of the committee for the work that they've done and, of course, I thank all the people who made submissions and came to the hearings. The report makes a lot of important recommendations, which I won't go through at this late hour. The member for Menzies has done that, and I endorse his remarks. There were many concerns raised by parents and professionals—people like speech therapists and occupational therapists—about delay. Delay in access to services and early intervention is very serious for children with disability. It can mean the difference in a small child being able to deal with and overcome their disabilities or not. If they have to wait, as they are, for access to get into the National Disability Insurance Scheme, they're waiting for their plans to be finalised and they're then waiting for reviews to be done. As many of the submitters indicated, there is a lack of staff in the National Disability Insurance Agency, and many of the submitters highlighted that this is the result of the cap on staffing imposed by the government.

As the member for Menzies has said, there are many recommendations in the report. I commend them to the government and to the National Disability Insurance Agency. For the sake of the small children in Australia who are born with or develop a disability or early developmental delay, it is very, very important that these recommendations are implemented.

Kevin Andrews (Menzies, Liberal Party) Share this | Link to this | Hansard source

I move:

That the House take note of the report.

Tony Smith (Speaker) Share this | Link to this | Hansard source

The debate is adjourned and the resumption of the debate will be made an order of the day for the next day of sitting.