Introduction

The Independent Living Centre Australia (ILCA) greatly appreciates the opportunity to respond to the Draft Productivity Commission Report on Disability Care and Support.

The ILCA is a “network of the Independent Living Centres around Australia” and our mission is “to be recognised as the leading collective, impartial voice for Assistive Technology”.
The state and territory members of the ILCA provide a unique Australia wide perspective into the effective uptake and barriers to access and utilisation of Assistive Technology solutions to improve quality of life for people living with a disability.
The membership of the ILCA is composed of the CEOs/Managers of each of the State based ILCs and we have been fortunate to be involved in many of the initial submissions through various memberships. 

As a collective with a particular investment in the areas of Assistive Technology (AT) and the provision of Information about AT we are pleased that report reflects on the importance of both these issues in the context of a persons participation in a variety of (WHO ICF 2001) life domains and shifting decision making to the individual. 

Assistive Technology Definition:
“ Any device, system or design, whether acquired commercially or off the shelf, modified or customised, that allows an individual to perform a task that they would otherwise be unable to do, or increase the ease and safety with which a task can be performed.”
Independent Living Centre Australia

Areas for Comment

1. Assistive Technology: (Hard and Soft Technology)

In an “outcomes based framework” where AT is considered as an enabler of participation a systemic change such as a National Disability Insurance Scheme can be designed to be flexible and responsive, by ensuring that AT is not limited by existing lists or practices. Rather an AT device should be considered as a component of an “AT solution”. This means that inclusion of emerging technologies such as integrated devices that allow a person to mobilise or communicate and control their own access to their environment need to be able to be funded and not limited by artificial “lists”.
An “AT solutions” based model moves the focus from AT to the person. Supporting the individual’s needs & abilities, is as important as the specific device.

The hard technology such as the equipment is diverse and changing and this is essential in an arena where no two people will have the same situations or needs. The ability of the prescriber and those people involved in supporting a person to ensure all the soft technology is available (trial, setup, support and review) will ensure best outcomes.
ILCA Recommendation
Our concern is that the report does not articulate clearly or in detail the importance of AT both hard and soft. We believe that successful implementation of an NDIS scheme is reliant on this issue being fully understood and addressed.

2. Personal support:
The focus on the person and their goals and aspirations is essential in achieving real change for individuals and families in a continuous and whole of life approach. Personal support will be very different for each person and should facilitate independence and be a factor that can change in unison within an AT solution.

The ILCA appreciates the complexity at describing a system by which people would access personal support. In terms of the importance personal support has within the application and maintenance of an AT solution we believe that the system should not be overly complex and add too many layers that would impede a person’s ability to navigate it.

3. Inclusive environments:
The third component of an AT solution that incorporates all the enablers required for a person to have control and choice is the creation of inclusive environments at the personal as well as at the community level of engagement and participation.

Universal design is recognised as essential in achieving a barrier free environment and the availability of emerging technologies and design creates an opportunity for people to control, their environment and to be able to perform the tasks and activities that they require to participate fully.

ILCA Recommendation
AT solutions should be promoted and demonstrated in integrated, inclusive environments and that this is supported by education and training in all aspects of Assistive Technology. 

4. Information Provision:

Underpinning a holistic approach to a model which has the person at the centre is the importance of a well developed and integrated pathways for a best practice model in AT.

It is important to acknowledge that for people, particularly those with complex needs that this is a continuous cycle, which is able to address development and changing needs.

Literature suggests that the rate of abandonment of Assistive Technology is quite high and is attributable to many reasons including inappropriate prescription (including cultural aspects), client’s satisfaction and not being involved in the choice, client’s inability to maintain (or access maintenance for) the Assistive Technology, as well as many other factors. 

While the ILCA applauds the new initiatives to allow client autonomy, it is important that clients have the necessary expert information available about Assistive Technology in order to make an informed choice. It is also very important that health providers be given the opportunity to develop their knowledge and skills and keep abreast of changes in the ever expanding area of Assistive Technology.

As the leading providers of Information, advice and education about Assistive Technology in Australia the ILCA is very pleased to see the inclusion of the 3 Tiers of the NDIS and in particular Tier 2 (Information, referral and web services). We believe that this will be a necessary step to further reduce the rate of abandonment of Assistive Technology which will in effect increase the cost effectiveness of the program and have better long-term health outcomes for the clients.

ILCA Recommendation
That within the information tier provision be made to adequately address Assistive Technology in an impartial, person centred manner and responsive to the rapidly changing technological environment       
That equal importance is given to the provision of AT information as it will be to assessment and referral process.