Association staff have analysed the NDIS Review Final Report and have prepared the following FAQs to address key issues that may impact the profession.
About the independent review
The Independent Review of the NDIS (the Review) was established in October 2022 to review NDIS design, operation and sustainability. The Review Panel consulted with people with disability, the NDIS workforce and the public regarding all aspects of the scheme. Speech Pathology Australia responded to all four issues papers put out by the Review between November 2022 and August 2023 with separate submissions on the primary issues within the NDIS for speech pathologists; pricing and payments; the NDIS Quality and Safeguarding Framework and the What We Have Heard Report.
When was the Review report finalised?
The report was handed down to Minister Shorten on 31 October and then was passed to the National Cabinet and therefore was not released to the public until 7 December. The report makes a range of recommendations, with implementation planned to be gradually rolled out in consultation with the sector across the next five years.
What changes has the Review recommended for planning?
The Review recommends dissolving the concept of a 'primary' disability, with a focus on the functional needs of the participant. There will be a corresponding emphasis on long term planning, whereby if the person's needs and disability do not change, they do not need to be reviewed for several years. They wish to lessen the burden and stress upon participants of yearly reviews. Planning will take into account information from a new assessment process conducted by the NDIA, in conjunction with information from the participant and their family, as well as reports from health professionals.
Are they bringing back independent assessments?
No, the Review Panel have assured the sector that the new use of assessments is not a repeat of independent assessments. Key differences include the provision of extensive training to assessors; provision of adequate time to get to know the participant and their needs; and there will be no set categories for people with disability to fit into. The Review also acknowledged that an assessment is only one part of the information that will be used in the planning process. They have not yet decided upon what tools will be used, but Speech Pathology Australia provided specific feedback that they must be fit for purpose, communication accessible, in addition to considering the communication needs of the participant.
Will I have to be registered to provide NDIS supports?
Yes, but not immediately. What has been recommended by the Review is the development of a new system with different levels of regulation required for different providers, but ALL providers will have to be registered in some way. In addition, they plan for the entire disability sector to be regulated through worker screening to improve safeguarding for people with disability. Speech Pathology Australia has and will continue to advocate strongly for recognition of pre-existing robust regulation and governance of speech pathologists through the CPSP certification process to limit the burden on the profession. We will monitor this aspect of implementation very carefully and communicate any changes or requirements to members as soon as further details are released. The NDIS Review Panel have said that they plan to work with peak bodies and the sector more generally regarding this transition.
Can I continue to work only with self-managed participants?
The Review has proposed that the different types of financial management effectively be dissolved, including plan management, with a new digital payment system that would allow participants to pay in close to real time for their supports (see Action 10.5). Reimbursements will be phased out. It appears that all participants will essentially become self-managed with no link to registration requirements, as all providers will be registered in some capacity.
Are early intervention supports being taken out of the NDIS?
No, they wish for there to be more services for children who are delayed in their development to be available in the community through childcares and health and education settings. As part of this, they want to expand developmental checks (see Action 2.13). They have discussed that these foundational supports will function alongside the NDIS, not replace it.
How is the early intervention pathway changing?
It appears that early childhood intervention partners will be replaced by Navigators in terms of accessing the NDIS and then Lead Practitioners (see Action 6.5), who will have an allied health background. They wish to implement a key worker model using these Lead Practitioners who will support the family around the child and work with them to develop a plan for supports for the child. The Lead Practitioners will be commissioned by the NDIA but work for other organisations. They will lead the provision of supports for the child, working with other providers and the child's education or other community setting/s in a wholistic manner. There will be an expectation that all early intervention supports are based upon best practice evidence, although it is currently unclear as to how this will be defined and implemented. Speech Pathology Australia will be working very closely with the NDIA and relevant parties to advocate strongly for the profession and highlight the benefits of the essential services that speech pathologists provide for young children.
What is a navigator?
These are going to be replacing the role of local area coordinators, but in keeping with their original intention, to help all people with disability to link in with supports, even if they do not qualify for the NDIS. They will also take up a lot of support coordinator work regarding navigating and coordinating supports but will not be paid from within people's individual plans. At this stage it is suggested that they will not be NDIA staff directly but employed predominantly by other non-government organisations with contracts commissioned by the NDIA.
What about provider panels?
This is proposed to be a form of commissioning to ensure that there are allied health supports available in thin markets and rural communities where participants are struggling to access services. These provider panels would aim to use existing providers and be reviewed every three years (See Action 13.2). There is limited detail regarding the process of determining provider panels within the report and Speech Pathology Australia will be seeking further information regarding these proposed arrangements. The NDIS Review has also recommended that specific commissioning processes are implemented for Aboriginal and Torres Strait Islander Communities (See Action 14.1).
Is this the same as preferred providers for capital supports?
No. Preferred providers for capital supports is suggested to be related to those companies who provide the equipment itself (See Action 11.2). The Association will be seeking further clarification regarding this aspect of the report as to its implications for members who provide AAC supports and assessments.
Will they be implementing outcomes-based pricing?
The Review Panel took on board feedback from the sector (including the submissions by Speech Pathology Australia) and is not currently planning to introduce outcomes-based pricing for therapy services. They have indicated that they do wish to measure outcomes, and establish data sets, including creating an evidence committee to report on what supports are reasonable and necessary. The Review Panel wants better data to be gathered and shared about outcomes across the NDIS. Note that they are planning to look at an enrolment payment regarding shared living supports that may contain an outcome-based aspect. In terms of pricing more generally, they have recommended a transfer of responsibility for recommendations around price setting away from the NDIA to the Independent Health and Aged Care Pricing Authority (IHACPA). Again, Speech Pathology Australia will monitor this aspect of implementation very closely.