Policy and Advocacy Disability Update October 2024

New NDIS Laws

The The National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Act 2024 (Amending Act) took effect on 3 October 2024. This introduces a range of major changes to the scheme, especially around needs assessment and planning. You can learn more about the changes by visiting the NDIS website.

Starting from 3 October, new NDIS budgets and funding periods will apply. If a plan is reviewed after 3 October 2024, new plans will have a total budget amount. This means participants will see a total amount for all supports in their plan. Current plans show line by line supports. New plans will be shown as a budget. This change makes clear the total funding available in a participant's plan and how long the funds need to last. Participants can’t spend more funding than what’s available in their plan. For now, all new plans created after 3 October 2024 will be 12 months. In the future, some plans will be longer than this.

List of NDIS Supports

As of 3 October, new guidance has been introduced to help NDIS participants better understand which supports are eligible for funding and which are not, providing clearer direction on how they can use their NDIS funding. The list will operate as temporary legislative guidance under the amended NDIS Act until a formal National Disability Insurance Agency (NDIA) Rule (a Ministerial determination) is made sometime in the future (no date has been advised).

OTA made a submission on the draft list in August calling for more clarity, the inclusion of specific references to OT services and prescriptions, and removal of some banned items/services. DSS has published a consultation report which captures feedback from stakeholders including OTA. Read the report here.

OTA welcomes the adoption of some of our recommended inclusions in the list. The draft shared with the community several weeks ago raised a great deal of concern and contained significant omissions and errors in terminology, some of which have now been addressed.

Government has advised that participants will have a grace period of 12 months to understand the new list and participants won't be penalised if they purchase a non-NDIS support if the support is worth less than $1,500.

What's included

OTA welcomes the clarification that occupational therapy services will be funded under early childhood intervention services and the provision on prostheses and orthoses, the provision of assistive products and equipment, disability-related health supports and of course therapy supports.

We also welcome an expanded definition of what constitutes therapy supports, and that this will include both maintenance and improvement of functional need. We are also pleased that psychosocial recovery supports will now specifically be referenced as permitted services.

We are pleased that there is specific inclusion of assessment services for the provision of assistive equipment for communication and information needs, recreation needs, household tasks, and personal care and safety, support planning and review, prostheses and orthoses and vehicle modifications. However, we have concerns about three significant omissions in the areas of home modifications, specialised driver training and personal mobility equipment which we will be seeking clarification on.

References to assistive products and services now refer to maintenance and repair costs, which is pleasing as the list was silent on this before now. We welcome removal of eating disorder treatment from the list of banned supports, given this can be an important disability related need for Autistic people.

What's not included

OTA is very concerned by certain omissions is the list and we will be seeking clarification urgently from NDIA and will update members in due course. We are concerned that the list doesn’t specifically refer to assessment of need in three areas of core OT practice, being:

Assessment of by a driver trained occupational therapist
Assessment for home modifications
Assessment, prescription, trial, or selection personal mobility equipment.

We are also concerned that the definition of therapy support services refers to ‘evidence-based therapies’. It is not clear how this will be established by the NDIA, and we hold concerns that participants or NDIA staff/delegates will not have the skills or training to make appropriate assessment on whether current and emerging evidence, innovative clinical practice and academic literature is sufficient to support specific types of intervention. OTA maintains that it should be within the specific remit of a qualified and registered Occupational Therapist to provide services that are informed by an appropriate evidence base.

Concerningly, some of our sensible suggestions like specific provision for backup power supply for disability specific equipment, funding for disability lymphedema and specialist sleep consultant services, and funding for costs for maintenance/repair of home modifications, and design and project management for home mods have not been adopted.

We are also concerned that specific exclusions for some types of therapy (e.g. gaming therapy, yoga therapy or wilderness therapy), may lead to confusion with evidence based clinical occupational therapy services via activity-based group therapy where the specific activity is used as an intervention in the development of broader goals or skills and is used to develop social emotion or functional capacity and outcomes.

We provided strong feedback that the blanket exclusion of standard household and garden items may exclude innovative, low-cost solutions that save the scheme money and increase independence, when prescribed by an occupational therapist for a disability specific need. We are disappointed that this has not been adopted. The new list enables a participant to apply to the NDIA CEO for a ‘Replacement support determination’ that will allow standard commercially available household items to be funded if there is an identified support need. NDIA is set to provide more information on the new process in the coming days. They recently advised stakeholders that the aim for the process will be to make it clear and simple, won’t require participants to get reports or assessments, won’t affect participant plans and will enable participants to self-service or get support from a specific NDIA team if needed.

Want to know more?

If you have specific questions about the NDIS Supports list that you would like clarified by the NDIA, email policy@otaus.com.au

Read the full NDIS Supports List here.

NDIS Psychosocial update

AHPA attends the NDIA’s National Mental Health Sector Reference Group (NMHSRG) which meets regularly to discuss issues and provide expert advice to the NDIA regarding the Psychosocial Stream of the NDIS. At the most recent September meeting they provided the following update:

Currently extensive lived experience consultation regarding the Psychosocial Early In Scheme Program to ensure that this is fit for purpose and achieves the aims it is working to achieve
The agency advised that no current participants are going to be moved to early intervention without consultation. It will be a voluntary process for existing participants with psychosocial disabilities and participants would only be referred into that program if they consented and if it was thought to be of benefit to them in their personal circumstances. As the Psychosocial Early in Scheme Program has not been formally developed yet, this is likely to be some way off yet.

Consultation on Foundational Supports

OTA attended a webinar on 20 September on the Government's consultation on General Foundational Supports. This was not a consultation session but provided high level information about General Foundational Supports and the consultation sessions planned. The Department has released a discussion paper and information sheets as well as dates for online consultation sessions. OTA will be attending one of these sessions on 11 October. The consultation period closes on 30 November. OTA is waiting for more information on the consultation on targeted foundational supports.

You can stay up to date with developments on Foundational Supports by signing up to the DSS Foundational Supports Newsletter.

OTA will continue to keep members updated.