23 August 2012
Vision Australia wants people who have low vision to be eligible for assessment to receive NDIS funded supports. Why?
Comparable functional needs - same outcomes
A person's functional need cannot be determined by a medical or clinical assessment alone. The outcomes achieved by various services and supports can be the same whilst the nature, intensity and frequency of such supports are different. Examples include:- Literacy aids - a person who is blind and uses a screen reader or a person who has low vision who uses a screen magnifier and portable CCTV, achieves the same outcome of being able to read and write. Remove the technology, both lose functional literacy
- Mobility aids - a person who is blind and uses a Seeing Eye Dog or a long cane and a person who has low vision and uses a long cane when outdoors, achieves the same outcome of mobility in the community. Remove the aids, both lose independent mobility.
- Adaptive technology training - a person who is blind and undertakes computer training for their screen reader over four terms and a person with low vision who trains for one term to use their screen magnifier, achieves the same outcome of proficient alternative literacy methods. Remove the training, both lose their access to literacy.
These comparisons play out across the spectrum of skills training for independence in the home, independence in the community, employment, education, sport and recreation, information access, and many more life stages and activities and a range of aids and equipment.
Reduced quantum of support - same outcomes for less
Our service profiles typically indicate that more vision means less cost, less intensity and less frequent support. We estimate an indicative ratio of 1:4 between people who are blind and those who have low vision across all 3 measurements. Therefore positive outcomes can be met for people with low vision at a reduced premium.
Proportionally small numbers
Our prevalence model estimates that there are about 333,000 people in Australia who are blind or have low vision in 2012. Considering that it is likely that the NDIS will only fund people under pension age, there are only 13,000 people who are blind and 129,000 people with low vision aged 0-64 years within this broader group. However, from market projections based on real service data, we anticipate that less than 30% or 3,900 people who are blind and 10% or 12,900 people who have low vision will seek to access NDIS funded support in any given year, which is only 4% of all those who will be funded by the NDIS.
Won't blow the budget
Based on this market segmentation, the total cost to the NDIS for vision related disability would be a maximum of $250 million or less than 2% of the NDIS operating budget. This is using the exaggerated dollar amount of $15,000 for each and every person, even though real life profiles indicate most will only seek to use about $4,000 in any given year. If the anticipated 1:4 blindness to low vision cost ratio plays out, the actual total cost is likely to be closer to $110 million or less than 1%.
The right social investment
Our analysis indicates that substantial returns to the community are derived from each dollar spent on blindness and low vision services. Using the Social Return on Investment methodology, we know that a minimum of $1.85 is returned by Orientation and Mobility training, $8.58 for disability employment services, and $12.40 for children and family services. These examples of returns exist despite serious limitations accurately quantifying social returns across the spectrum of community interactions and projecting these gains long term. Therefore we know that social spending is not dead money. Providing access to services and supports to all those that need them, makes good financial sense and is the right investment in our social capital.
Inclusive growth is the right approach for the nation
Making sure those with comparable needs are not left behind, is not just right for individuals and their communities but is also right for the nation. Inclusive growth theory recognises that to ensure a sustainable and stable economic growth pattern, countries must ensure to take direct actions to alleviate poverty and reduce inequality - lifting the base and reducing the gap is the way to drive growth.
Looking at the real and legitimate functional needs of some with low vision, the full and proper impact of the NDIS social investment must not be undermined by near sighted fiscal gains by harking back to outmoded assumptions of need based on medical criteria. To leave out people with low vision, is to choose a growth pattern that disengages a real proportion of the community from their potential social and economic contribution, and perpetuates the existing propensity for poverty and inequality within this group. Inclusive growth only works if everyone is counted.
The bottom line
"...Whenever we diminish equality of opportunity, we are not using one of our most valuable assets - our people - in the most productive way possible...." .
Joseph Stiglitz 2012, former Chief Economist of the World Bank
The National Disability Insurance Scheme provides a window of opportunity to start turning the tide and start providing the services and supports that individuals want, where and when they want them, and to facilitate meaningful inclusion in our community. But the scheme must be that link between support and access for everyone that needs it. It must not become a new site of exclusion and a new hub of division between people with disability.
A rigid approach to eligibility based on an estimation of need set at legal blindness, is not supported by the real functional needs and outcomes required by some people with low vision. Not supported by a need to contain numbers or minimise cost and not by concerns for prudent economic management.
Enabling access to NDIS funded support for both people who are blind and those who have low vision and who have an eligible presenting need, is essential under the nations own values of equality. It is essential for returns on social investment, and is absolutely essential for establishing a growth pattern that looks toward a future of sustainable prosperity for everyone.
Let's not forget people with low vision and let's not undo the promise of a National Disability Insurance Scheme that will improve the lives of all people with disability.