I don’t think there’s an Allied Health Business Owner amongst us who can’t remember a time when operating within the NDIS didn’t involve wrestling with vague information and repeatedly changing processes in an attempt at compliance. The forecast for the remainder of the decade includes not just more of the same but MORE and MORE of the same but different. We are anticipating bigger fundamental shifts that will impact the market and disrupt business from pending legislation to the financial ledger.
The view will be either of the cloud or the silver lining, essentially it’s up to you.
We acknowledge that we see the clouds, but we are firmly focusing on the silver lining. Consider us storm chasers. Let us support you to sharpen your mindset for adapting and surfing the opportunity for what is ahead for Allied Health. Nacre Consulting members are already starting the shift and getting measurable results.
Perhaps it really is Power Call time.(Book here)
No Answers but What are the Questions?
The new legislation, National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024 refers to several new rules that are yet to be written.
The Bill has yet to be debated and is likely to be amended in some ways.
We still don’t know which of the 2023 NDIS Review (Working Together to Deliver the NDIS) and Disability Royal Commission into the Violence, Abuse, Neglect and Exploitation of People with Disability (2023) recommendations are going to be accepted by government nor the timeframes in years and cost in millions for implementation.
Let us also include the nervous wait for the news of the Annual Price Review.
The growing list of watch and wait must also include the questions to the answers regarding worker screening and provider registration.
As we reach for our NDIS crystal ball we have a hunch about the following.
EARLY CHILDHOOD
Different Funded Pathways
The possible outcome: less referrals of young children through the NDIS stream.
The much talked about issue of too many Australian children under the age of 8 years who have NDIS Plans has come to a head.
The likely outcome is that many children who were previously accessing NDIS Plans may at some stage going to be diverted to the mythical yet to be seen or proven Foundational Supports. These Foundational Supports will be the funding, staffing and operational responsibility of the state and territory governments.
Our thoughts: It’s time to rethink who your business serves and why.
Your future ideal clients are still out there, they may have a range of funding packages, they may need programs staffed, they may seek co-design support, they may know your future clients. Profile your teams individual and collective talents, leverage this. Deeply understand your vision, mission and values, set the north star and prepare to hallucinate on wildly innovative service delivery models. This demands you to think differently, plan differently and show up differently in the market. As we continue to say, same old is not going to cut it.
Key Worker Model
The possible outcome: Potentially clunky transition to serving our young people as Early Childhood services gear change, again, towards implementation of the Key Worker Model.
The evidence for best practice in Early Childhood Intervention is clear: the Key Worker Model, delivered within natural environments and focused on the capacity building of the circle of support who live around the child achieves best outcomes. This is how the NDIS Practice Standard for Early Childhood Supports Module has been written since 2018. The NDIS Review (2023) recommended that this model should be undertaken with more commitment in both the Foundational Supports programs (yet to be seen) and within the NDIS. While some experts openly say that this will be a slow, generational change, there’s a chance families will be rapidly directed to organisations who are already actively developing or who have a proven track record of implementing the Key Worker Model. It’s not like the NDIA haven’t responded to a policy change with the subtlety of a sledgehammer before without understanding the full implications (like waiting lists, relationships with families and kiddos, like specific expertise etc).
Our thoughts: Start reading about the Key Worker Model and best practice for Early Childhood Intervention. Read the NDIS Practice Standards for Early Childhood Intervention, they make the expectation for this model pretty clear. Strategize a medium-term plan for how your business will position itself to work within a Key Worker model, even if you only provide single discipline Allied Health Services.
NEEDS ASSESSMENTS
The possible outcome: A new model for the assessment of Participant need (yet to be written) will be introduced and is likely to be implemented by Allied Health Professionals.
The NDIS Review identifies significant inequity across accessing the scheme, eligibility criteria and the size and scope of the participants funded plan. The outcome is largely dependent on the Participants ability to fund assessments and reports to determine eligibility, self advocate their needs and to have the support of a strong and skilled team alongside them.
In an effort to standardise this the new legislation proposes to introduce a Needs Assessment that will be delivered consistently for all Participants, the results of which will support their Plan budget development. Important to note – the Participants Needs Assessment will be a critical step in the formation of the Plan.
Our thoughts: Shades of Independent Assessments again here but the intention is good. If this Needs Assessment gets over the line workforce constraints will mean there will be demand for Allied Health Professionals to deliver this work. Ramp up your workforce retention strategies, read up as required, be ready and systemised then watch and wait.
FOUNDATIONAL SUPPORTS
The possible outcome: a range of supports that are currently being provided under the NDIS will be provided within state and territory based services. This includes some psychosocial supports and some Early Childhood supports.
Foundational Supports are being established in an effort to provide both better supports for people with disabilities who are not eligible to access the NDIS as well as divert some other people who have previously been made eligible but may not be in the future. We have no visibility over how they will be implemented, contracting, block funding something else? it’s all guess work right now.
As we wait with our business fortunes and client outcomes in hand we witness the financial push and shove between the federal and state governments. Gosh for a moment a while back we thought that this may have been sorted and that they were all play nice for the right reasons.
Our thoughts: as we mentioned before, be ready for less referrals of young children with NDIS Plans; be familiar with Key Worker Model and how your business can be a part of it. If you haven’t diversified your income away from the NDIS as yet – now is the time to start planning for it. Reimagine your services and get in front of schools, day care centres, preschools and other mainstream service environments where young children are likely to be identified as needing support.
FLEXIBLE BUDGETS
The possible outcome: Participants will be able to spend their budget in whatever way they like, whether the money be allocated to Core or Capacity Building (with occasional stated item exceptions).
Understandably, Participants have long wanted to spend their Plan funds however they like, and have been frustrated when they have had budget left in one part of the plan but are unable to spend it on a support that they really need. The whole budget concept will fix that problem for them which is wonderful. However expect disruption to the market with less assumptions being able to be made about how much of the budget will be allocated to one specific support. Expect also the guidance some Participants may require to grasp and implement the changes and the risk associated with the provision of this advice. If you were a parent of a small child and wanted to return to work and all you needed to make this happen was an hour of support before and after school – would you choose therapy or a support worker?
Our thoughts: Your Allied Health Businesses will be looking more like a standard small business in almost any other sector where there are no guarantees that a customer will return once they walk out the door. Get to work on delighting your clients, capturing and proving life changing outcomes, deeply understanding their journey and lifetime value with your business. Proven outcomes, established reputation and sophisticated marketing will help you stand out head and shoulders in the market.
NAVIGATORS
The possible outcome: Support Coordination will be shifted to a block funded role called ‘Navigator’. These Navigators will be available to anyone with a disability – NDIS funded or not.
Great Support Coordination is worth its weight in gold. Poor Support Coordination involves lack of choice and control, budgets spent with little in return and even rumours of kickbacks from providers in return for referrals. Support Coordination is also available to the minority of Participants and almost never for families with young children. The new Navigator role is intended to be applied broadly across the sector, be based in local organisations and be able to connect people with disabilities to appropriate supports.
Our thoughts: For some of you, these will be your key referral pathways that are about to be disrupted. It’s time to work on those referral partnerships – who knows your future clients?
It might be cloudy, but the sun still shines.
Changes we don’t know about and don’t understand when we do find out are clearly the clouds. Government policy shifts that; embrace risk taking and seize opportunity to deliver a better holistic outcome for participants. This is the silver lining and shining sun. As we said at the start of this article, there is much to come during the next few months and some of these assumptions may turn out to be off the mark. Regardless, our intention is to share what we think about and provide suggestions for what you may wish to consider in regard to future proofing your Allied Health Business.
For more specific, and targeted support on your change adventure, our incredible tribe, coaching and resources are all waiting for you.
Book a call with us here to see whether we are a swipe right for your business 😊
