NDIS slashes Brisbane woman's physical therapy hours, citing 'value for money' - ABC News & Headlines – Australian Broadcasting Corporation

April Coulson, 26, lost movement from the armpits down after bleeding onto her spinal cord in 2019.  (ABC News: Mark Leonardi)

April Coulson went to bed one night as an active, independent teenager and woke up unable to move from the armpits down.

A bleed on her spinal cord had left her paralysed.

"It was pretty terrifying," she says of that day seven years ago. "My strength and my ability to even sit up was completely gone."

April before her life changed forever when she woke up unable to move from the armpits down. (Supplied: April Coulson)

It would take two years before doctors were able to provide some answers into why the bleed occurred.

Scans revealed rare blood vessel malformations in other parts of her body, leading doctors to suspect a similar malformation had bled onto her spinal cord.

April, then 19, spent six months in hospital before returning to her parents' Brisbane home.

April Coulson's mother, Ann-Louise, says she was not sure if her daughter was going to make it. (Supplied: April Coulson)

"I was extremely dependent," she says of those early days after leaving hospital in a wheelchair.

She had to be strapped into the wheelchair.

Support workers funded through the National Disability Insurance Scheme (NDIS) helped her to shower, get dressed, and eat — daily activities she could no longer perform herself.

"I had to get carried in and out of bed, into a shower chair," April says.

April spent six months in hospital. (Supplied: April Coulson)

The NDIS also funded her wheelchair, a ramp into the bottom floor of her family home, and daily intensive therapy sessions, including exercise physiology, physiotherapy, and occupational therapy.

"In the very early stages, it was sometimes twice a day," she says.

"It was amazing. One of the whole reasons that I am where I am today was the support I was receiving."

In the first 18 months of being home, April says she developed three pressure sores, requiring her to "lie down on my side for a couple of weeks at a time".

April Coulson's mum Ann-Louise pushing her daughter in her wheelchair at their Brisbane home. (ABC News: Janelle Miles)

"Pressure sores are something that can leave someone with a spinal cord injury in a hospital bed for six months," she says.

"Once I got into that rhythm of continuous rehab, I've never had a pressure sore since."

With more therapy, April built her strength to the point she no longer had to be strapped into her wheelchair, and she was able to start driving a modified car.

Eventually, she transitioned into full-time employment and came off the disability support pension.

April Coulson was a healthy and active teenager until 2019 when she suffered a bleed into her spinal cord. Through rehabilitation, she's working full-time. (ABC News: Janelle Miles)

She has also reduced her support worker hours to just four hours a week to help with housework.

But acting against expert advice, the National Disability Insurance Agency (NDIA) — the body responsible for the NDIS — has recently slashed her therapy hours by two-thirds, suggesting unqualified support workers and family members can fill the void.

Her physical therapy hours have plummeted from six to two hours a week.

A request for funding to pay for a $5,000 replacement ramp, which has already been rebuilt to allow April to access the house, was also denied.

In a written internal review decision, an NDIA public servant ruled the extra therapy hours, and replacement ramp were not "value for money".

April Coulson using the ramp at her family's home in Brisbane.  (ABC News: Janelle Miles)

"It is expected the disability support workers have appropriate qualifications and training to complete the role they have been employed to complete and assist you in implement (sic) exercise routine," the delegate wrote.

April says using support workers would be unsafe.

"I'm already extremely injury prone with severe osteoporosis and other complications," she says.

"To put myself in the risk of someone who isn't qualified is just a danger to me."

April says she also does not have the specialised equipment at home required for her rehabilitation sessions.

April Coulson at home with her mum, Ann-Louise. (ABC News: Janelle Miles)

She says her therapists frequently use hoists and slings in her treatment, allowing her to get into an upright position.

"They'll have two qualified exercise physiologists on you at all times because there's such a risk for injury," April says.

"To try to replicate that at your home, you would need two support workers with … equipment that costs over $30,000 for a full hoist or sling. It just doesn't make sense.

"The really disheartening thing is I've had doctors, exercise physiologists, occupational therapists, and physiotherapists, all explain and write to the NDIA justifying why it's not safe.

"If they would even just have a conversation or even read the plethora of documents and reports that we provide to them, they would probably take a more reasonable approach."

April says the slashing of her therapy hours this year has meant losing some of the independence she's regained through her rehabilitation post injury.

So much so, she's worried she'll have to give up full-time work.

"I've experienced significant increase in my pain, my tightness, my fatigue, a much greater reliance on my parents, my sister, to help care for me," April says, when asked about the loss of physical therapy hours.

Dr Martin Laverty, one of the original architects of the National Disability Insurance Scheme. (ABC news: Ian Cutmore)

Dr Martin Laverty, one of the original architects of the NDIS, says he's very concerned by the cuts to participant plans being made against the evidence of health professionals.

"There's something very wrong with the way in which our assessment for people with disabilities is currently operating," he says.

"The National Disability Insurance Agency is pulling back on therapeutics, it's pulling back on active overnight support, it's changing the way in which people can access the community.

"If a health professional is providing a recommendation that a therapy is so important to April, and thousands like her, we should be funding those supports under the NDIS because that's why the scheme was set up in the first place."

Dr Laverty, the CEO of disability service provider Aruma, says the federal government plans to introduce a new support needs NDIS assessment tool in the next 18 months.

"The question is how do we ensure that between now and the replacement that's on the way we keep people safe?" he says.

"The system in place today is no longer fit for purpose. It's producing outcomes that mean people like April are missing out on the essential therapy and equipment aids that would help them live a normal, everyday life."

Dr Laverty has been one of the biggest supporters of the Albanese Government's recent NDIS changes, to ensure the scheme "is sustainable in the years ahead".

"But while ever it continues to put this pressure on April, her family, and thousands like her, it means the NDIS is not working the way we need it to," he says.

The NDIS Amendment (Securing the NDIS for Future Generations) Bill has been criticised as rushed and dangerous.  (ABC News: Patrick Stone)

In a statement, the NDIA did not comment on April's case.

But it said it reviewed "all submitted evidence, including from allied health professionals, when making decisions on an individuals (sic) funding allocation".

"While every request is considered, some requests may not be approved, as we are required to make decisions as to what is reasonable and necessary," a spokeswoman said.

April's mum Ann-Louise Coulson says she is "incredibly proud" of her daughter's determination in dealing with her disability.

"The first week, we weren't even sure she was going to make it," Ann-Louise says.

Ann-Louise Coulson says she's proud of her daughter, April, and how she has dealt with her disability.  (ABC news: Mark Leonardi)

Ann-Louise says April finished her university degree in hospital and completed her master's after coming home while working hard at her rehabilitation.

She says the family is grateful for the NDIS in helping April return "to be an independent and productive member of society".

But she is worried April is deteriorating with the reduction in therapy hours.

"It's like sitting in an economy class airline seat," Ann-Louise says. That's what it's like all day long and her body just gets so tight."

Without physical therapy, April seizes up, her spasticity gets "a bit out of control," her mother says.

April Coulson, 26, in the backyard of her parents' Brisbane home. (ABC news: Janelle Miles)

"She's just worked so hard. She works full-time and sometimes I think if she quit her job tomorrow and went back on the disability pension a lot more things would open up to her and that doesn't seem fair," she says.

"They're not rewarding her initiative and her discipline."

April is appealing the cuts to her plan at the Administrative Review Tribunal.