NDIS Shake-Up: How will this affect you?
What can you do to prepare for the new NDIS world?
Just a few weeks into the new legislation changes and the NDIS is already a very different world for many in the disability community.
The NDIA are sending cease and desist letters to companies advertising NDIS holidays, some ‘therapists’ have had their entire caseload disappear overnight and poor Plan Managers have a few more days to get everything straight and communicate the ‘new world’ to their participants before they risk having a debt raised against them.
So while the NDIS is having its ‘glow up’ I’ve been thinking through a lot of the implications to us as parents and carers and how these changes will affect us and more importantly - what we can do do be prepared.
Why is this is important?
We have moved from a principles based approach to how funding can be spent, to a black and white list of ‘YES’ and ‘NO’ which leaves far less nuance and opportunity for interpretation. On the positive for the NDIA, this will 100000% save the NDIS a lot of money and provide avenues for the NDIA to raise debts against participants that spend outside the rules. On the negative for participants there is far less room for support to be specifically tailored for the unique individuals and the individual ways that their disability is disabling for them.
There are now supports and services described in the NDIS Price Guide (PAPL) that are also on the ‘Not an NDIS Support’ list. A classic example is Capacity Building - Increased Social and Community Participation: Community Participation Activities. The description on Pg 74 is as follows:
The cost of activities such as art classes, tuition, classes etc that are on the ‘Not an NDIS Support’ list. This is causing huge confusion for participants who have this specific category funded.
A response from the NDIA in a recent webinar I attended said:
“Most of the NDIA's guidance - including the price guide - are in the process of being updated to reflect new legislation. I appreciate that this is confusing. Where something is named as a support that is not an NDIS Support it can't be bought, even if it's in the price guide. We will work to have the price guide updated ASAP”
At the end of the day, the new NDIS Supports lists are legislation, and the NDIS Price Guide is not. So whatever is in the ‘Yes’ and ‘No’ Lists will override whatever information is in the NDIS Price Guide / PAPL.
Why is this happening and what will this mean for you??
According to the NDIS, this is happening because NDIS participants kept saying ‘we don’t know what we can and cannot spend our funding on’ (so its our fault okay?)
To stop random people who own horses calling themselves ‘Equine Therapists’ and people who buy paints and clay calling themselves ‘Art Therapists’ and charging $193.99 per hour under the ‘Other Professional’ line item when they are not appropriately qualified to do so.
To force childcare, OSH and school holiday programs to improve their accessibility, reduce segregation, stop discriminating against disabled children and fulfil their legal obligations to make themselves accessible to children living with disability.
To ensure that parent training is being delivered by appropriately qualified allied health professionals with the appropriate registrations and reduce spending on unregulated fields like ‘coaching’.
To clear up confusion where people aren’t sure if they can use less evidence based supports like alternative and wellness therapies and coaching.
To stop unscrupulous providers advertising holidays, health retreats and cruises to NDIS participants and enticing the use of funding with terminology like ‘NDIS Approved’
To force families to explore other community and mainstream options like Carer Gateway, In Home Care and the use of family and friends for babysitting, respite and support.
To reduce opportunities for families to use NDIS funding for education related costs like tutoring and push that responsibility back into the education system.
To reduce accidental misspending on items that are not considered disability related like entry fees to play centres, general parenting programs, recreational activities and childcare fees.
To push the costs of diagnostic screening and assessments back onto Medicare and the Health system.
To reduce the number of businesses that have been / are starting up purely to cash in on the NDIS dollar
To make plan managers more accountable (Yes CEO Rebecca Falkingham has said that Plan Managers are going to be the ones getting the fines!) Keep in mind the Plan Manager may have a clause in their Service Agreement that they will pass on any fines incurred to the participant / plan nominee.
Clarification that NDIS funding cannot be used to cover gap payments for Medicare-funded services and private health insurance claims.
My concerns:
Children and families will end up being in the middle of the NDIS and Education systems when schools fail to fulfil their legal obligations to make themselves accessible to children living with disability.
Disability Inclusion Support Funding systems are going to have a huge influx of applications and there is going to be a far greater requirement (demand) for childcare and kinder programs to make themselves genuinely accessible to children with disability.
Plan Managers become gate keepers to the extent that all creativity and innovation is removed from the scheme.
There will be a lot of upset business owners out there who have literally lost the vast majority of their income stream overnight. Some may get creative about what they put on their invoices and may be moving into the territory of fraud and deceptive conduct.
Doctors will be need to be more proactive in helping families understand how they can access medicare rebates for the diagnostic process, and other plans / rebates such as:
Helping Children with Autism Medicare Plan (Item 135 - referrals need to be written by a paediatrician or psychiatrist)
Better Start for Children with Disability Medicare Plan
*Note The above two care plans are undergoing changes being developed into Complex Neurodevelopmental Disorders Care Plans.
I have read the Easy Read version of these documents and am concerned that they are so simplified they cannot be relied upon in isolation.
They could have made this so much more simple! For example saying:
Category: Therapeutic Supports (for example Improved Daily Living)
NDIS funding can only be spent on therapeutic supports when the service provider has a minimum bachelor degree in the relevant field and is registered with their peak body or regulatory authority such as AHPRA.It literally is not rocket science.
My tips to prepare and safeguard:
Get clear about the purposes of the support you are spending NDIS funding on. If it is a therapeutic support then it will most likely have to be provided by a registered and qualified allied health professional. It it is core support then ensure they way you are spending your funding is not replacing what all parents have to do for their children regardless of disability.
Educate yourself on what ‘Reasonable Adjustments’ are according to Disability Discrimination legislation. A reasonable adjustment means doing something to assist a child with disability so they can participate in activities just like other children. All businesses and organisations have a legal obligation to make reasonable adjustments to support inclusion and ensure that they are not discriminating against children with disability. Simply stating that a child cannot attend kinder or childcare because of their disability is no longer going to be a reason for the NDIA to provide that support instead. The Australian Children's Education & Care Quality Authority has provided lots of resources and fact sheets on this topic. And if you’re thinking about a career change I’d suggest Education Advocates are going to be in high demand!
Start thinking about community and mainstream (non NDIS) supports that can compliment the support that the NDIS is providing. Childcare and school holiday programs are on the ‘Not and NDIS Support’ list. That means stating that your child needs childcare and OSH funding over the school holidays is going to be a big fat ‘no’. (See below comments). Sometimes there are genuine reasons where support should be funded in school holidays though, but it comes down to the way this is evidenced. If you need Childcare during school holidays and don’t think that a mainstream service will be able to let your child’s support needs due to their disability, you can explore the In Home Care program funded by the Child Care Subsidy. I imagine the In Home Care program is preparing for a deluge of applications soon!
Foundational Supports are in consultation now. The access criteria will change in the next 12 months. Some participants are going to be exited from the scheme and will need to reply on these instead. Start to educate yourself about and advocate for genuine co-design for these supports.
Record storage: It has already become a requirement to provide a support description when making a claim for reimbursement. Some participants are being asked to upload an invoice and some are not.
The next step, I believe is that soon it will also be a requirement to upload an invoice or receipt for all claims. So start thinking about the tech you need to have electronic copies of everything. It may be as simple as taking a photo of a receipt and uploading it. Some businesses and supermarkets now also offer e-receipts. This may make the claiming process more difficult if you’re using to claiming via the My NDIS App on your cellphone but don’t have the capacity to get receipts from your phone files and folders into the App.
Use the next 12 months to get the evdience for supports you need ‘stated’ into your next NDIS plan.
Start thinking about any Replacement Supports you might need that are on the ‘No’ list and how you could make a request to get them funded.
Keep ringing the 1800 NCC number for advice because they are collating that information to feed back to the NDIS about where more clarity is needed. Also - be nice to them (it’s not their fault).
Don’t rely on any advice from LAC, support coordinator, plan manager etc unless you get it in writing. If they refuse to put their guidance in writing make a complaint about lack of accessibility.
The NDIS are running educational webinars for participants. The chat sections at these events are equal parts lit and heartbreaking.
Support workers, school holidays, childcare and Parental Responsibility
Typically support workers are funded to provide capacity building support to help children develop independence (ie require less support later in life which is the purpose of the scheme). But families are attempting to use them in ways that replace what all parents need to do for their children… such as driving them to and from school.
There is now an item on the “Not an NDIS Support” list in the category of Travel and transport related stating that “Transport for children as part of their reasonable care and support provided by families or carers” is a no go!
Now think about the category this is in. They are not saying a support worker cannot transport a child during the course of providing support to a child, for example to attend an event in the community. But they are saying that support workers are not ‘transport providers’ aka taxi drivers for kids.
All parents need to get their child to and from school (getting to school is not a disability related support need) and children don’t drive themselves anywhere, they need a parent to drive them - so potentially paying a support worker to drive a child to school is not a disability related support need and replaces the care and support that all parents typically need to provide for their kids.
I’m also well aware that support workers may be on shift for respite purposes and yes there are times where driving a child somewhere is disability related. Or a shift might incorporate two different purposes - both capacity building and respite. So there is definitely nuance here.
Final point -
These are transitional arrangements and the permanent rules that will come into effect in July 2025. As above you still have opportunities to advocate and provide feedback via your Federal member.
Yes I have second hand embarrassment at the way this has all gone down. It’s last minute homework vibes for sure. But the NDIA do seem to be acknowledging that it’s a bit of a sh*tshow right now and keep reinforcing that they will take an educational approach rather than punitive measures for the next 12 months.
Still… if you feel like the NDIA think it’s cheaper to medicate your child into submission (or oblivion) than it is to fund the support they (and their families) need, please know that you’re not alone.
If you need support in navigating this hugely complex and every changing system, get in touch. We are here to walk the path with you and take some of the overwhelm and confusion away.
Until next time,
x Anna