Interview with Chantelle Robards: Latest NDIS Changes Affecting Clinicians and Participants
The NDIS never stands still, and neither do the questions it raises for clinicians and participants. At this year’s Neurodivergent Clinician Symposium on 3rd and 4th September, our own NDIS expert, Chantelle Robards, took to the stage to unpack some of the most pressing changes facing the sector right now.
In her energetic session, Chantelle answered live questions from clinicians in the room — from invoicing and funding periods to plan manager processes and service agreements.
We’ve captured the Q&A here so you can catch up (or revisit) the key insights:
Introducing Chantelle Robards
1. Hi Chantelle, can you briefly introduce yourself and tell us about your work around the NDIS?
Chantelle describes her resume as ‘eclectic’ – and that about sums it up. A speech pathologist by trade, she spent two decades supporting kids with disabilities in a range of roles before moving onto tertiary Allied Health roles. Since the introduction of the NDIS in 2013, she has found herself as a strong advocate for Allied Health providers as she built her technical knowledge of the scheme and applied it to business operations and innovation, working in roles alongside many NDIS market providers in supporting their businesses. Her absolute goal is to support the successful growth of the market to ensure access to safe and quality supports for people with disabilities.
NDIS Reform & Participant Advocacy
2. There’s been a lot of changes in the NDIS space in the last year, and more to come, so I thought we might briefly touch on a few things to get a quick update (with links available via the QR code), and then talk about how we can advocate for our clients and what we can do to influence the changes that are being announced in the media. So, some of the latest concerns I’ve heard raised were around:
Participant Plan Reviews
a. NDIS participants’ plans being reviewed early without sufficient time to prepare, and having their plans cut drastically / NDIS plan reviewers not being transparent about the nature of a “quick phone chat” or “check in” actually being a review, and participants only realising when they’ve received their updated plan
The Participant Guarantee says that the Agency is supposed to start setting up the Plan Reassessment 56 days before the review date. The latest quarterly report says that they are only managing to meet that target 62% of the time. We all know that Plans are often rolled over early, a review is called early or one of those horrible ‘check in’ phone calls happens and then a new Plan turns up a few days later.
There are a few ways that we can support our Participants with Plan Reviews:
- We can track Plan dates – most of you are already doing this, some CRMs have this capability, if not a spreadsheet will do the trick.
- Prepare early -have your reports ready a month ahead of the end date on the Plan.
- Remember to have the conversation about what the following year looks like with your client BEFORE their Plan review date. This is essential to ensure that funding periods are set up in a way that’s practical and fits what needs to happen in the following year. Have this chat a month before the Plan review date and get the relevant information into the report.
- Coach your Participants about their right to reschedule their meeting. If they are called at a time that does not work for them to have that conversation they can ask to reschedule. There have been reports where the NDIA Rep has been insistent about the call occurring at that time – so good coaching is important to empower your Participants to say ‘not right now’ and organise another time
Impact of Reduced Provider Travel Rate.
b. Changes to the billing for travel, for example for home visits, and the impact this has on providers who can’t afford to carry those costs, and participants who aren’t able to do in-clinic or telehealth instead.
The changes to the way that travel is funded has had significant impact for many Participants who are unable to travel to clinic or for whom telehealth does not work.
While advocacy efforts around pricing continue, we have seen no sign to date that the Agency are going to make any changes to how they fund travel. We have to get to work to figure out what our businesses can manage and what we need to adjust.
We know that in many cases, especially where AT prescription is occurring and in situations where our clients are not comfortable outside of their own environment, travelling to where they are is essential if we are going to continue to support them.
Sadly, this means that some Participants are either going to go without or you are going to have to find a way to make it work.
Some strategies that you may like to evaluate against your business model:
- Grouping clients in geographical areas so that travel can be apportioned across several Participants.
- Ensuring that all the activities that you were allocating to travel are in fact travel. Remember that preparation and pack down are non face to face activities.
- Draw a boundary around your base and determine how far you are willing to travel. Being clear about this will make it easier for your admin team when they are taking referral calls.
- For Participants who live further away, where a portion of the travel is likely to be occurring unfunded, you may decide that a longer session with the Participant will achieve better outcomes at a lower frequency and you will incur less of a loss if you take this approach.
Occupational Therapy and Psychology are not the same
c. Participants being told that having psychology and occupational therapy in a plan is “doubling up”, so not having psychology included in their plan because occupational therapy is “better value for money”. Also being told to get a mental health care plan for psychology, when autism is not a mental health condition
This old chestnut!
While not foolproof, the only avenue we have to combat this is to make it very clear in our reports that the support that each of us provides is very different, targets different goals and functional skills and most importantly to demonstrate the outcomes that the work we are doing is achieving. This may mean that we need to be talking to each other more explicitly at the time of Plan review and perhaps even submitting joint reports.
The Agency are falling on the ‘value for money’ argument more and more often – they are looking for any reason to reduce the overall value of Plans. You need to be able to demonstrate that the support needs to be delivered by you or someone like you and cannot be delivered elsewhere (including a mainstream option like Medicare). Spell it out clearly and give a examples where you can in EASY ENGLISH.
Art and Music Therapy Price Review
d. The place of music therapy and art therapy in the NDIS
We eagerly await the release of the Duckett report which the government has been told to release by 4.30pm Thursday 28th August – by Senate vote on Tuesday 26th August. This review was ordered by previous Minister Bill Shorten following a badly handled attempt to reduce the pricing for these supports to a completely offensive level.
The government have made no public announcement on what the future of Art and Music Therapy will look like within the NDIS and therefore it continues as business as usual.
Mandatory NDIS Provider Registration
e. Rumours that NDIS will force us to register to be able to continue providing supports, after many of us have dropped out due to high audit costs. (I checked with NDIS Quality & Safeguards and they have no plans to make therapists register. They said they only do what they’re legislated to do, and therapists are not one of the groups they are targeting)
Mandatory registration has been flagged since the 2023 NDIS Review.
The NDIS Provider Registration Taskforce (2024) recommended that graduated mandatory registration would indeed be on the Agenda, and the Minister raised this in his speech at the Press Club a couple of weeks ago.
The taskforce also said that registration would look different into the future, and the suggestions for Allied Health were for light touch approaches due to the governance already in place.
I would suggest that registration will in fact become mandatory at some point but it’s important that everyone understands that the process will be done gradually (Allied Health is not a priority), the process will look different to how it does now and the new requirements will have to be legislated before they are implemented. In other words – there is no panic around this.
Note: with the potential Thriving Kids reform ahead, I would just flag that IF supports are commissioned as a part of that, NDIS Registration may be looked upon favourably. Food for thought.
Quarterly Funding Periods
f. The delayed release of client funds to prevent overspending, but sometimes clients need the funds upfront, for example to pay for a functional capacity assessment
Funding periods are an unpleasant administrative challenge. 15% of Participants were not able to manage their budgets, and now 100% of Participants are stuck with funding periods.
The only option that we have here is to both cover funding periods in your Review report (after a thorough planning session with your Participant to figure out how those periods need to be loaded) and to strongly coach your Participant as to how to advocate for the right loading of funding periods during their meeting.
Look across the whole year with your Participant – is there an AT prescription likely sometime in there? Is there an intensive block? Are the family going to be away for any period across the year? Think all of these things through, and then make clear recommendations in your review report for where those funding periods need to be loaded. If the Plan still comes through with the funding periods not working for the year ahead, an S100 is your only option.
Supporting your client to budget is now an essential step in your onboarding process and needs to be carefully monitored across the year. Invoices from previous periods will not be paid unless sufficient funds have rolled over. Build a system to support you to do this efficiently, in a way that your Participants understand.
Shift of children to Foundational Supports
g. The biggest one at the moment is the government saying NDIS was never intended for “people with mild to moderate autism” which is awful language and not reflective of the language used in the Autistic community or even the DSM criteria. They’re using this to justify shifting autistic kids away from the NDIS towards “foundational supports” which don’t seem to be very concrete at this stage, other than that they are to be delivered by the States.
I think there’s a range of things to be considering with the Thriving Kids announcement.
The government are looking for ways to try to reduce the NDIS budget and have identified the increase in the number of kids with autism as a key cohort for them to target. They are proposing doing this by diverting most of the early childhood group to what they are calling Thriving Kids, which will sit outside of the NDIS and be designed and run by both the Commonwealth and the States and Territories.
So first, this relies on an agreement being reached between the States and Territories and the Commonwealth which has not yet happened.
Everything the Minister spoke to in his address to the National Press Club was hypothetical. Will funding go to programs like Inklings and Playgroup? Will supports be delivered in schools and day care centres? Will there be new Medicare line items for fee for service work? Maybe. Maybe not.
The only thing we know for sure right now is that they have come up with a name for the program.
For those of you who are running businesses focusing on children, if this policy shift occurs it will impact your business. It is important that you are alert, that you are running some risk filters across your caseload and waiting list and referral trends; that you are building relationships with your local schools and day care centres; that you are diversifying your income wherever you can. These are win – win activities. Your business will benefit whether Thriving Kids becomes a thing or not.
Make sure that you are connected with communities where you can access changes in a timely way. Facebook and LinkedIn are the noisiest places for this – our Facebook page Allied Health Business Brilliance is a good option and there are many others.
Advocating With and For NDIS Participants
3. Okay, so in terms of advocacy, I’d like to ask:
a. How much of the above can participants challenge, for example, through review of a reviewable decision or a change of circumstances review
The Minister suggested that there were more legislative changes ahead that would encompass eligibility for the early childhood stream and this will give us an idea about how appeals will be handled. Remember the Minister has said that children already on the NDIS, and those who join between now and 2027 will remain on the Scheme until reassessed at the usual time. So technically the changes should affect children who have not been born yet, or who have not been identified as having developmental challenges until after July 2027.
b. Thinking more broadly, what can we do as service providers to try to influence the NDIS to allow more actual choice and control for participants, and to have individualised supports rather than manualised programs for early intervention?
First, communicate with the Peaks loudly and often. They need to be at the table on this issue.
The next best thing that you can do is to join one of the grassroots advocacy efforts that are occurring and are led by people with disability. It is important that we back them as to ‘nothing about us without us’; they have powerful lived experience voices, and their message resonates with the public far more than that of providers who have been painted as the bad element of the NDIS by the media for years.
Another strategy, something that everyone should be doing anyway, is to be collecting clear outcomes that provide evidence for the support that you are providing. Include these outcomes in your reports; store them, save them – imagine if we were all doing that and we found a way to collect them on a large scale. It’s much harder for government to argue with data.
Leadership without the panic right now is key. If you are posting content publicly, be informative and calm. Our Participants are super anxious right now and we have very little to tell them.
Finally, communicate clearly with your team and Participants about what’s going on and coach them to advocate for themselves too.
Support For Business Owners.
4. Finally, for those who may be thinking about the potential impact of these changes on their businesses, what supports and online communities are available for therapists?
At Nacre Consulting, we help Allied Health Business Owners in a variety of ways.
You’re invited to join our Allied Health Business Brilliance Facebook Community — a supportive, solutions-focused space for Allied Health Business Owners.
Join the group here.
Keep in touch on LinkedIn where we share fresh ideas, insights and conversations.
Follow us here.
And don’t miss our weekly Newsflash — packed with business updates, industry news, tips and trade secrets to help you stay across the issues that matter. Email us at smile@nacre.com.au to receive our news.
Outside of our own channels at Nacre Consulting, there are a range of Facebook groups that provide grassroots support and information; Disability Representative Organisations such as Every Australian Counts and Australian Neurodiverse Parents Association are a great start.
If you need a hand with the business side of things at any time, you know where we are – www.nacre.com.au
