October 3rd marked the starting day for the implementation of the amended NDIS Act. At our recent Quarterly Accelerator Conference, the incredible Todd Winther pulled the Amendment apart specifically for Allied Health, giving attendees insight into how important reporting from AHPs will be in the future. While we do our very best to meet the new medical model criteria and evidence to give you the information that you say that you need, the puzzling stories coming from the eligibility process, the re-assessment process and the planning process has the entire sector hyperventilating.
The Ordeal of Writing Deficit Focused Reports
At the recent Allied Health Awards, our colleague and advocate Dr Libby Calloway gave an incredible speech where she repeatedly quoted Gandhi, “Find yourself by losing yourself in service to others”. I reflected heavily on that in the ensuing days because this encapsulates how most of the Allied Health Professionals that I have worked with over too many years to count approach their work. In fact, it could be argued that we do this to the detriment of our own wellbeing.
Within just a couple of weeks, I am already feeling the weight of trauma that many AHPs are experiencing by having to write deficit-based reports in order to meet the criteria for what the NDIA now require to approve access and funding for Plans. We said goodbye to this style of reporting years ago (with the exception of the Education system but we all know that their approach to disability is hideously prehistoric) and being forced to return to it carries an emotional burden not only for the people about whom the report is being written, but also for the person who is writing the report.
We are supporting our members through the change and we strongly suggest that all AHPs consider their processes for how they have conversations with families about how these reports need to look from here forward. AHP’s should also ensure that there is some ability for families to understand that you are very aware of the persons strengths, skills and experiences even though you dare not mention them within NDIS documentation. We also recommend that you have some systems in place to support your team and yourself.
What Change Management Process
As could have been predicted, there seems to be a complete absence of change management plan across the broader sector for implementing the new rules. Interpretation of the legislation and rules is inconsistent at best and absent at worst. Most stakeholders seem to be erring on the side of caution which is heavily based on guesswork. Of course, the people who pay the price for this are the Participants; the people who bear the brunt of the fall out are their support network, their supporting professionals and providers.
The stories coming from Planners, Access, Re-Assessment and even Plan Managers and Support Coordinators as everyone interprets the new legislation and rules in their own way are hair curling.
In just a few weeks we have seen:
- Access for a child who has a severe disability denied because she seemed to be improving.
- So much fear around use of Short-Term Accommodation that referrals have all but stopped.
- Foundational Supports listed within a child’s plan (their paediatrician and similar) even though Foundational Supports are not scheduled to launch until July 2025.
- Disabilities claimed to be not ‘permanent’ because the Participants skills had improved. Leaving this one right here.
- Disabilities deemed to be not ‘permanent’ because it was felt that there were more interventions that could be tried (which might cure them?) .
- Plan Managers declining payments based on the draft Supports List.
- Payment for items previously approved and included in a Plan being subsequently revoked based on the new Supports List.
- Support Coordinators asking to vet reports before they are sent as they are so concerned about how they will be interpreted.
- 6-year-old re-assessments happening ‘on steroids’ with nowhere to send the kids who are being declined for full scheme eligibility as Foundational Supports are not yet in place. More hard conversations here.
- Therapists being told that they must have prior approval to use Capacity Building funds to complete Assistive Technology prescription (approval by who? How? How many forms, phone calls and emails will that be?)
And so it goes on.
‘Wedding Tax’ Anyone?
The constant rhetoric around how providers charge out under the NDIS has been focused on them stripping plans out and overcharging. I am sure that there are a number of sharks out there who need to be rapidly removed from the Scheme.
Having said that, here we have yet again an environment where hours and hours of unpaid time are being spent trying to navigate and support Participants through the beginnings of this reform process which is likely to be ongoing for the next few years. Businesses can only soak so much of that up before some of the cost needs to be passed to the consumer; that is how business works. The alternative is that we will see more providers close their doors.
We hold out breaths once again for the predictable backlash.
Up Next
We expect the next tranche of legislation to include Registration and Needs Assessments at a minimum. Resilience and self-care through what’s ahead for your whole teams is going to be at the top of your priority list.
Breathe, Focus, Move Forward
I wish that there was a magic answer that I could give you here, but I predict that this will be the status quo for the coming year or so.
If there was ever a time for the community to support each other through this, it is now.
I would suggest that:
- Ensure that you are connected to an Allied Health Community in some form. You are always welcome at Allied Health Business Brilliance, our public facing Facebook Group. This is where breaking news and any training that we offer to support the process will be posted.
- Ensure that you have processes in place to support your teams have these difficult and confronting conversations with families and Participants about the nature of the written NDIS related documentation from now on.
- Make sure that you and your team have opportunities to debrief and have self-care strategies well in place. Nacre members, here is your reminder that Dr Linda Wilson joins our Wednesday morning Coaching Zones to provide support to this part of your business.
- Stay on top of NDIS news where you can.
- Support is always available here at Nacre Consulting. Give us a call if you would like a chat about how we can help you manoeuvre this test of resilience.
