David Kinnane

The Australian Government has kicked-off the consultation on Foundational Supports. As allied health NDIS providers, we’re following these developments closely because they have the potential to change our clients’ NDIS access and funding arrangements and, consequently, our service-delivery and general business models to support NDIS participants and others with disability.

On 20 September 2024, I attended a helpful webinar about one type of Foundational Supports called General Supports. I then reviewed the related General Supports Consultation Paper.

In this article, I’ll explain what the term “General Supports” means, and highlight my key takeaways for allied health providers from both the webinar and the consultation paper.

First, some context (because there is so much going on in the NDIS space!)

In 2023, the Independent Review into the NDIS recommended that governments fund and deliver foundational supports. They recommended that foundational supports would:

• be additional supports to those delivered through the National Disability Insurance Scheme (NDIS) or through mainstream services; and
• be available to all Australians with disability, whether they are NDIS participants or not; and 
• interconnect with existing mainstream services, like mainstream childcare and schools. 

More specifically, the Review recommended governments deliver foundational supports for people with disability into two areas:

• general supports to deliver access to trusted information and advice and build the capacity of all people with disability, including to fully participate in the community, and to make decisions and advocate on issues that impact them. General supports would also include information, advice and supports for families, carers and kin, and community organisations.
• targeted supports to operate between inclusive mainstream services (for example in areas like early childhood, schools and community mental health) and the specialist supports accessed through the NDIS. These supports would focus on helping certain groups of people that are not accessing or not eligible for support that is delivered through the NDIS, in areas where the need is greatest.

In December 2023, National Cabinet agreed to design and jointly fund Foundational Supports, where appropriate, through existing services, with a view to phasing them in over time. 

On 19 September 2024, the Government released their Disability Reform Roadmap for 2024 and 2025, stating that phased implementation of Foundational Supports will commence in 2025-2026. According to the consultation paper, the Australian Government expects that governments will agree a Foundational Support Strategy later this year (2024).

Key takeaways for allied health providers:

1. Narrow scope 

For service delivery and business planning purposes, allied health providers are most focused on what targeted supports may entail in the delivery of our services within mainstream and community settings. However, the consultation paper and webinar cover only general supports, with the consultation paper focusing mainly on information, advice and capacity building supports for people with disability. 

2. For many people with disability, the stakes and stress-levels are high 

This was made clear when the webinar hosts shared the contact details for Lifeline.

In a vacuum, everyone might think that general supports are a good idea (and they are). But consultation on foundational supports is taking place in parallel with major legislative changes to the NDIS to restore “the original intent of the NDIS to support people with permanent and significant disability within a broader range of supports” (page 21). The reforms are also being carried out to ensure that the NDIS is financially sustainable, with implications for both existing and future NDIS participants.

The webinar hosts were adamant that:

• the NDIS is here to stay;
• foundational supports (including general supports) are additional supports so that the NDIS isn’t the only lifeboat in the ocean; and
• any NDIS rule changes would not take effect until foundational supports are in place. 

The consultation paper also makes it clear that accessing General Supports should not preclude someone from accessing the NDIS or other supports in the community (page 6).

But, with the new NDIS Amendment Act due to commence on 3 October 2024, some people are understandably worried that new “sustainability measures” (like the new concept of “NDIS support”) will reduce support for some participants before alternative supports can be put in place. 

Time will tell. 

3. People with disability should lead the design of General Supports

According to the consultation paper, general supports will include:

• trusted information about disability, rights, and services;
• supports and tools that build the skills, capacity and independence of individuals to make and sustain social networks and community connections, to make decisions (including supported decisions) and to advocate on issues that impact them;
• information, advice and supports that empower and build the capacity of families, carers, and kin in supporting people with disability to participate and exercise choice and control over their own lives;
• assistance to find and access mainstream, community or disability-specific services and activities appropriate to needs and goals;
• information and advice that assist community organisations and non-government public services/activities to become more inclusive and responsive to the needs of people with disability (page 6).

Once implemented, these supports will be available nationally, will connect with other services, and tap into local community knowledge and networks. 

As multiple webinar speakers noted, each person with disability is the expert on what they need, and what works for them. Discussions about accessibility and inclusion often include sweeping generalisations about what we think people with disability need, e.g. “more visual supports”. But, as Jane Britt, senior consultant and advisor of The Social Deck, highlighted, different people need different things. For example, someone who is deaf and blind is not going to be helped by visual supports or maps, and would – obviously – prefer information to be presented in a way they can access and understand. When encountering an obstacle to participation, a person with disability might need information about their rights and who to contact to enforce them.

It’s obvious, but needs to be said: different people have different needs and goals. But, as leading disability advocate Dr George Taleporos noted, common themes underpinning the consultation paper include empowering people to live independently and autonomously, to exercise choice and control, to live with dignity, to understand their rights, to self-advocate, and to participate, and to increase peer and other networks to to reduce isolation, and eliminate abuse and neglect. 

Importantly, for allied health providers, people with disability should be able to access our services that are relevant to their needs and goals.

4. The design of General Supports will not start with a blank slate

A wide range of services and supports already exists, including the Information Linkages and Capacity Building (ILC) program, the Partners in the Community program, and the Disability Gateway.

For communities, workplaces, and schools who want to take action to be more inclusive, other resources are also available, e.g. via this helpful list of inclusion resources on the International Day of People with Disability website.

In the consultation paper, there’s not a lot of detail about the perceived deficiencies of the existing systems and resources. But it is apparent from the Independent Review recommendations, that, as things stand, we can do better. For example, the consultation paper writers note that, at present, “there are limited supports focused on early intervention, prevention or low intensity support needs for certain groups of people with disability that are not accessing or not eligible for support through the NDIS” (page 22).

General supports may include reforming some of these existing programs and services. But they are also likely to include additional programs beyond supports delivered through or in partnership with the NDIS. 

5. Allied health providers shouldn’t wait to make their services more inclusive and accessible

As providers, we all need to work harder with people with disability (including our clients) to ensure our allied health services are inclusive and accessible to everyone, including people with disability and their families, carers and kin. We also need to understand the rights of people with disability; and to train our staff so that they understand people’s disability rights, too. 

If we have knowledge gaps, we need to educate ourselves about the rights of people with disability. We should also share resources and best practices with each other to avoid reinventing wheels. 

General supports may help us to do this. But lots of good information and resources exist to improve our understanding of disability rights and to get good ideas to improve the accessibility of our services (including here and here and here). 

We all have a role to play in helping people with disability to access the allied health services they need, when they need them, and in a way that:

• works for them;
• respects their legal rights; and
• reflects their goals. 

This includes:

• providing people with disability and others with accessible information about our team and services. We may need to provide this information in multiple ways, e.g. on our websites, via digital apps, through online chat and phone services, with links to quality information and resources about disability and childhood development relevant to our clients and services (see, e.g., page 9); 
• increasing our focus on providing services within local community settings to help build the capacity of community organisations like sports groups and arts groups to support people with disability (see, e.g., page 13); and
• connecting people with disability to trustworthy information, tools, resources and other services as general supports progressively roll out.

We can all improve accessibility, and we can start work now. As allied health providers, we should lead the way by example.

6. Help your team get up to speed on core concepts

Appendix A of the consultation paper (pages 17-23) includes a very helpful glossary of terms relevant to Foundational Supports and the NDIS. While most allied health providers will be familiar with most terms, it’s a potentially helpful tool for training staff. It’s also a helpful reminder that we all need to be mindful of the language we use, even when fiercely debating the pros and cons of potential reforms.

7. Caveat: everything is subject to intergovernmental agreement

Page 3 of the consultation paper includes an important note for service providers:

“Any future funding opportunities will be promoted via normal procurement/commissioning and grant round mechanisms and will take into account transitional arrangements associated with reforms to existing programs. As the concepts in this paper have not yet been agreed by governments, they have no status within the provider market and should not be relied upon.” (Our emphasis.)

8. Get involved!

The consultation period closes on 30 November 2024. This is the first consultation on Foundational Supports, and may have knock-on effects to consultations for other supports, including Targeted Supports. You can give feedback in lots of ways, including via the DSS Engage website and/or by filling in an online questionnaire.

Key source:

Foundational Supports | engage.dss.gov.au

Our related articles:

Will NDIS reforms and foundational supports trigger the end for many paediatric allied health clinics?

NDIS “ins and outs” for participants seeking “mixed” disability, health and education supports: mind the gaps between NDIS and mainstream services

Paediatric allied health providers: let’s tackle our NDIS worries by improving our services, bit-by-bit, and monitoring general reform trends

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