2024-25 Federal Budget Delivered – OTA's full analysis

Published Friday 17 May, 2024

The 2024-25 Federal Budget was handed down on Tuesday 14 May 2024. OTA’s detailed commentary and analysis of what it will mean for occupational therapy is provided below.

In addition, you may also be interested in the following related commentary we provided earlier this week:

• Day-after Federal Budget Snapshot Analysis 
• OTA’s post-Federal-Budget activity: NDIS reform and MHA Policy Forum 
• OTA in the news media: OTA’s work advocating for paid student placement funding to be extended to occupational therapy students has gained traction with news media coverage. A summary is available here.

 

Detailed analysis and commentary of the 2024-25 Federal Budget

NDIS and disability support

The Government will provide $468.7 million over five years from 2024-25 (and $37.9 million per year ongoing) to ‘get the NDIS back on track’ and roll out recommendations of the Independent NDIS Review. Given that the Government has yet to provide an official response to the review – despite the NDIS reform progressing at full steam – how these funds have been allocated provides us with an insight of what may be to come. We also note that there is no mention of Government payment for initial assessments as has been previously suggested, so it is unclear how Government will progress on this.

The Budget did not say much on foundational supports although earlier in the year the Government committed $11.6 million for the Department of Social Servies to develop the Foundational Supports Strategy, which is due to be released later this year.  It’s expected that there will be more on this in next year’s Budget. OTA will continue to reiterate the importance of ensuring that foundational supports are in place before any changes to the scheme take effect.

Funding includes:

• $129.8 million over two years from 2023–24 for design and consultation work to respond to the findings of the Independent NDIS Review. OTA welcomes this funding and reiterates the importance of co-design and engaging stakeholders early in the design process. We will continue to strongly advocate to Government that co-design must include service providers like occupational therapists who deliver critical capacity-building services to people with disability.
• $45.5 million over four years from 2024-25 (and $13.3 million per year ongoing) to establish an NDIS Evidence Advisory Committee, to provide independent and transparent advice to Government on the efficacy and cost-benefits of types of supports funded by the NDIS. OTA calls for the inclusion of allied health representation on this committee, and in particular occupational therapists, who are well placed to provide this advice.
• $5.3 million in 2024-25 for the Independent Health and Aged Care Pricing Authority to work with the Department of Social Services and the NDIA to undertake initial work to reform NDIS pricing arrangements, including reviewing existing pricing approaches and developing a pricing data strategy. OTA will be advocating strongly to the IHACPA for more accurate provider pricing modelling and recognition of the financial challenges for OTs who have experienced a five-year price cap freeze, which is resulting in providers exiting from NDIS service provision. OTA will advocate for an increase in the price cap.
• $23.5 million over two years from 2024-25 for Services Australia to continue fraud investigation and response activities as part of the Fraud Fusion Taskforce.
• $20.0 million over two years from 2024-25 for initial design and consultation work on reforms to help participants and people with disability navigate services.
• $160.7 million over four years from 2024-25 (and $24.6 million per year ongoing) to upgrade the NDIS Quality and Safeguards Commission’s information technology systems, to better protect the safety of NDIS participants, reduce regulatory burden on NDIS providers, and improve cyber security.

 

Disability Employment Services Reform

The Government will provide $253.6 million over five years along with $19 million ongoing to reform employment services and supports for people with disability. Specifically, there is $227.6 million over five years from 2024-25 to implement a new specialist disability employment program to replace the existing Disability Employment Services program by 1 July 2025.

The new program will include a digital platform for providers and participants. Eligibility will also expand to include volunteers and people with less than 8 hours a week of work capacity. OTA will be watching this development closely, for both opportunities and risks.

Workforce

OT excluded from paid student placements 

In the face of unprecedented workforce shortages, it was disappointing to see occupational therapists and other registered allied health professionals were not included in the Commonwealth Prac Payments aimed to support students undertaking clinical placements for students. The Department of Health and Ageing has indicated that work is currently being conducted to determine how these payments will be expanded in the future, and OTA will be advocating strongly for occupational therapy to be included in any expansion.

Read more about OTA's extensive advocacy on this important issue here: 

• OTA's statement to members 
• OTA's advocacy on paid student placements in the news media.

 

National Allied Health Workforce Strategy 

OTA welcomes the allocation of $90.0 million over three years from 2023–24 to fund the implementation of the health-related recommendations of the Independent review of Australia’s regulatory settings relating to overseas health practitioners (the Kruk Review) to grow and support the health workforce. OTA provided a submission to this review. Emphasis was placed on the importance of prioritising allied health providers during implementation. One of the recommendations that came from the review was the development of a National Allied Health Workforce Strategy, which will likely dictate how Budget funding will be allocated moving forward. The Department of Health and Ageing has indicated that public consultation to inform this work will begin in the latter half of 2024. OTA will be looking out for this.

Ageing and Aged Care

OTA is disappointed with the lack of specific funding allocated to improving allied health services in aged care, despite the recommendations from the Royal Commission into Aged Care Quality and Safety.

OTA acknowledges the announcement of $2.2 billion to deliver aged care reforms and implement recommendations from the Royal Commission but again we note the absence of targeted funding for allied health services. We will continue to highlight to Government the crucial importance of implementing the allied health recommendations made by the Royal Commission, through activities such as the recent roundtable we held with the Inspector-General of Aged Care, other allied health providers and consumers.

We note the allocation of $110.9 million over four years from 2024-25 to increase the regulatory capability of the Aged Care Quality and Safety Commission and advocate for a portion of this funding to be used to support an increase in the Aged Care Quality and Safety Commission’s regulatory capabilities to be used to develop strategies to ensure sufficient allied health provision.

While recognising the $65.6 million allocated to attracting and retaining the aged care workforce and collecting more reliable data in existing aged care workforce programs, OTA seeks clarification on whether this funding includes support for allied health workers.

OTA welcomes the announced $531.4 million in funding to release an additional 24,100 Home Care Packages in 2024-25, but the Budget does not address the worsening shortages in the allied health workforce for home care.

The Government has also agreed to defer the commencement date of the new Aged Care Act to 1 July 2025.

Other funding includes:

• $21.6 million over three years from 2024-25 to extend the Home Care Workforce Support Program for an additional three years to facilitate the growth of the care and support workforce in thin markets
• $30.4 million over three years from 2024-25 to states and territories to continue to deliver the Specialist Dementia Care Program
• $11.8 million over three years from 2023–24 to implement the new Aged Care Act, including governance activities, program management and extension of the Aged Care Approvals Round
• $10.8 million over two years from 2024-25 to extend the Palliative Aged Care Outcomes Program and the Program of Experience in the Palliative Approach Program to continue to upskill the aged care and primary care workforce to further embed palliative care capacity in the aged care workforce

 

Mental health

While the Budget includes specific initiatives targeting primary mental health services and early intervention, there remains a need for broader mental health reform that addresses systemic issues and ensures access to comprehensive care for all individuals experiencing mental ill-health.

The Government will provide $888.1 million over 8 years from 2024-25 (and $139.8 million per year ongoing) to respond to the Better Access evaluation and to strengthen Australia's mental health and suicide prevention system.

The Government will provide $361 million over four years to expand the range of free mental health services, however the providers of these services are unclear in some cases. OTA supports the establishment of a new national early intervention service to provide individuals experiencing mild metal health issues or transient distress with free early support using evidence-based therapies. However, we have concerns around these services being delivered by ‘someone trained in evidence-based therapies’ and will seek assurance from Government that these services will be provided by qualified mental health providers, such as mental health occupational therapists.

The commitment of $71.7 million to fund Primary Health Networks (PHNs) to design and deliver multidisciplinary care for people with severe and complex needs in primary care settings is a step in the right direction. OTA has been informed that the PHNs will be commissioning or directly employing mental health workers to provide a range of clinical and non-clinical supports, including care coordination, navigation, case management, brief intervention, psychosocial support and social prescribing. OTA is pleased that occupational therapists will be recognised under this model of care.

OTA also acknowledges the allocation of $29.8 million to establish a network of 61 Medicare Mental Health Centres to provide individuals with complex needs free access to a psychologist or psychiatrist.

Other funding includes: 

• $29.9 million over four years from 2024-25 to uplift Head to Health services to expand access to free community based mental health services for adults with moderate to severe mental health needs
• $29.7 million over three years from 2024-25 to improve child and youth mental health services through uplifting workforce capability and co-designing new models of care
• $7.1 million over four years from 2024-25 to build and support the lived experience peer mental health workforce, through the establishment of a national professional association for peer workers, delivery of a workforce census and the exploration of further training pathways.

 

Primary care

OTA is disappointed that no progress has been made to progress the enablement of allied health roles in primary care and chronic disease prevention and management. However we do note the $23.1 million allocated to extending the continuous review of the Medicare Benefits Scheme and have been informed by the Department of Health and Aged Care that allied health items, in particular those related to chronic disease management, will be considered as part of this review. OTA has been engaging heavily with the Scope of Practice Review, the outcomes of which will be informing this work.

We note the provision of $227.0 million over three years to establish an additional 29 Medicare Urgent Care Clinics as a measure to alleviate the strain on hospital emergency departments. We also note that the primary focus of funding remains on general practice and call for an expansion of the allied health roles in these clinics.

Veterans

The Government will provide $194.4 million over four years from 2024-25 (and $20.6 million per year ongoing) to provide additional resourcing to meet increased service delivery pressures including claims processing, and modernise the digital capability of the Department of Veterans’ Affairs.

OTA hopes that this goes some way to improving the administrative challenges in dealing with the Department of Veterans’ Affairs, but is disappointed that no funds have gone towards paying providers a reasonable rate.

Funding includes:

• $186.0 million over four years from 2024-25 (and $20.6 million per year ongoing) to reduce the time taken to process claims, and respond to increased demand for downstream services, particularly the Veteran Access Network, Veteran Support Officers, complex case management, account processing, information access and mental health support
• $8.4 million over two years from 2024-25 to pilot an ICT solution to improve case management and workflow management capabilities in the Department of Veterans’ Affairs.

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