Foundational Support - Supporting the role of OTs in an evolving disability system

All Australian governments are currently working on a range of reforms to support a sustainable service and support system for people with disability. As part of these reforms, governments are seeking to better balance the responsibilities of the National Disability Insurance Scheme (NDIS), mainstream supports such as those provided by the education system in schools and new services that will be provided in the form of foundational supports.

Foundational supports will encompass general supports such as information and advice, self-advocacy, peer supports, and capacity building. These will be available to all Australians. They will also include targeted supports that are more individualised and available to those that are not eligible for the NDIS. A key focus for foundational supports will be supports for children (early childhood supports) and for those needing psychosocial disability supports.

Why we're concerned

OTA welcomes the commitment to expanding the range of available disability supports to ensure all people with disability, and their families and carers, can access services. It is our view that occupational therapists are ideally placed to support expanded options across mainstream services as well as general and foundational supports and we’re eager to work with governments to design and implement reforms.

However, we have strong concerns that:

• The Commonwealth and National Disability Insurance Agency (NDIA) are implementing program and policy changes that mean children, people with psychosocial disability and other participants are losing funding without alternative systems being available to provide support. These changes are also impacting occupational therapists who are under pressure to help participants prove eligibility within short 28-day timeframes.
• Governments are not engaging with OTA and the sector as they design key reforms, despite the central role of occupational therapists in disability services.
• Reforms appear likely to preference large providers and commissioned services despite the fact that many of the most experienced professionals now work in private practice and there is little evidence that government is considering how to engage those professionals or support a transition to new systems.
• A focus on cost-cutting risks rolling back some of the most important developments and reforms in how people with disabilities are enabled to participate in their communities.

What is OTA doing to support the profession

OTA is working to ensure that we develop and articulate a clear vision for the role of occupational therapists within a future system of foundational supports. We are actively engaging with ministers, senior NDIA staff, and the departmental teams responsible for policy design to advocate for the profession in a reformed disability system. We are also working to develop clear proposals for how foundational supports can be designed to achieve the best outcomes for consumers, practitioners, and the sector.

OTA has established expert advisory groups for early childhood, and psychosocial disability that are working to review relevant frameworks and policies that will inform the design of foundational supports. These include the Best Practice Framework for Early Childhood Intervention, the National Framework for assessing children’s functional strengths and support needs in Australia, the Psychosocial Recovery-Oriented Framework, and proposals for a new early intervention pathway for psychosocial disability. We’re working to develop position statements outlining the role of occupational therapists within foundational supports and mainstream systems. These will support further engagement with all governments and participation in consultation opportunities.

Current consultation opportunities

The first round of consultation, undertaken on behalf of the Commonwealth Department of Social Services is now complete. The consultation focused on general supports and targeted supports for children with developmental delay and disability. A report is currently being developed for government by the team leading the consultation. A video outlining feedback to the consultation process is available here.

OTA made submissions to both the General Foundational Supports and Foundational Supports for Children consultations.

Due to narrow scope of consultation – and particularly the focus on the views of consumers, our submissions:

o take a high level approach,

o focus on roles and capabilities of OTs,

o identify the key areas for consideration under any strategy the Department develops.

For members seeking to keep up with consultation on foundational supports, please refer to the DSS Engage webpage. You can also sign up for email updates from DSS here.

The New South Wales government recently established a Select Committee on Foundational and Disability Supports for children and young people in NSW. The committee is seeking input from the community about supports in NSW with submissions accepted until March 31, 2015. More information about the Select Committee and consultation are available here.