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Providers can play an important role in helping families of young children understand and access NDIS-funded supports. Here’s how.

David Kinnane · 15 November 2022 · Leave a Comment

The NDIS is meant to be easy to understand. In practice, many families find it confusing. 

Most – but not all – families know that the NDIS provides help to some young children with developmental delays and disabilities. But many families don’t know:

Most – but not all – families know that the NDIS provides help to some young children with developmental delays and disabilities. But many families don’t know:

  • whether their child might qualify for help; 
  • what kinds of help are available; or
  • where to start the process.

From the front lines, the system doesn’t always seem to provide children with fair access to help 

We’ve worked with many young children with developmental delays and disabilities over the years. Families who understand the NDIS rules seem to have a marked advantage over families who don’t. Some parents seem to get help for their children much more easily than others.  

For a long time, the system has appeared to advantage:

  • highly-educated parents;
  • parents with good communication skills – especially parents with good advocacy skills;
  • parents who can afford to pay private health professionals to write reports with formal diagnoses;
  • parents who speak English as their first language; and
  • parents in big cities with lots of options.

On the flip side, the system has at times seemed to disadvantage:

  • parents with limited formal education;
  • parents with communication disabilities and other challenges that make it hard for them to advocate for their children’s needs;
  • parents who cannot afford to pay for private health providers’ reports;
  • parents who do not speak English as a first language; and
  • parents in rural and remote locations.

This isn’t fair. 

The National Disability Insurance Agency (NDIA) knows about the problem: it has been working for a long time to make things fairer and more consistent. But providers can also play a part in helping to make things fairer and easier for families who would otherwise have difficulties accessing help.

What can providers do to help parents?

We can:

  • listen to parents’ concerns about their child’s development and take them seriously; 
  • summarise access rules for early intervention and tell parents whether support might be available; 
  • outline the kinds of help that the NDIS funds for young children; and
  • give practical advice to parents about how and when to get started in their efforts to get help. 

What, exactly, can providers say to parents?

This is what we tell families who are concerned about their young children’s development and may benefit from NDIS-funded help:

(A) You are the expert on your child 

If you are worried about your child’s development, trust your instincts. Don’t ‘wait and see’ what happens. Often the best help for a young child with developmental issues is early help from a team. Seek help early – even if you are not yet sure whether your child ‘will grow out of it’.

(B) Speak first with your health and early education professionals

  1. Often, the best place to start is speak with your child’s general practitioner about your concerns. 
  2. If you are already seeing another health professional, like a paediatrician, community nurse, speech pathologist, audiologist, occupational therapist, or psychologist, speak to them, too. 
  3. If your child is in childcare or preschool, speak with your child’s early educators, too.

(C) Don’t wait for an appointment, diagnosis, label, or report

  1. You don’t need a diagnosis to get help from the NDIS. 
  2. Waiting lists to see some health professionals are very long – even in the private sector.
  3. Waiting lists for experienced health professionals have always been a problem. But COVID-19 lockdowns and their effects, as well as sector-wide talent shortages, have made the problem worse.
  4. If you are in the process of waiting to see a health professional to obtain a diagnosis and/or recommendations to support your child, go through with the process at the same time as seeking help from the NDIS. Reports from health and other professionals can be very helpful later in the process, e.g. when considering whether a child is eligible for an NDIS Plan with funding.  
  5. Keep any health and education observations, reports and recommendations about your child in a consolidated file so you can find all the information you might need when you need it.

(D) To get informed, learn the basics about the NDIS approach to early intervention

The NDIA is working hard to improve early intervention. It now follows a national “early childhood approach”. Some of the terms used to describe the approach are a bit confusing – in part because of how the current laws are written. But the NDIS has made some helpful guidelines that try to explain their approach in plain English (see additional resources below). 

(E) Get in touch with one or more local “early childhood partners” 

  1. The NDIA doesn’t deliver the early childhood approach itself.
  2. Instead, the NDIA signs contracts with companies called “early childhood partners”. 
  3. Early childhood partners are funded by the NDIS. 
  4. According to the NDIS, early childhood partners offer “teams of professionals with experience and clinical expertise in working with young children with developmental delay or disability and their families”. 
  5. You can find your local early childhood partners here. You should see a search box that looks like this:
  1. Put your postcode or suburb name into this search box. For example, here are the first page of results we received when we searched for “North Strathfield” (where we are based):
  1. Look for search results that are marked “early childhood partner”. For example, on the first page of results above, Lifestart and the Cerebral Palsy Alliance are both identified as early childhood partners within 50kms of North Strathfield. We’re lucky: there are other options near us, too. 
  2. The search results list contact details for each early childhood partner. You can call or email them for an appointment to talk about your concerns and your child’s needs.

If you are lucky enough to live in an area with multiple early childhood partners, you may decide to talk to staff at a few before deciding which one to go with. Your healthcare providers may be able to assist you to find a partner that suits your needs.

In some places, your choice will be more limited. You may only have one option. In some rural and remote areas, you may have no early childhood partners at all. In this situation, you need to contact the NDIA directly to connect you with an ‘alternative option’.  

(F) Talk to the early childhood partner about your concerns and NDIS-funded support options that may be available for your child.

  1. Broadly, your early childhood partner will consider three main types of support for your child as part of the NDIS early childhood approach. 
  2. In the table below, we have made a (highly simplified) summary of the three main types of support that make up the “early childhood approach”. 
  1. Different kinds of supports may be offered at different times during your child’s development, depending on your child’s needs at the time and the rules for eligibility.  

(G) Don’t give up. If you need additional help to advocate for your child, ask for it.

Early childhood partners are funded to help you. You can also ask your healthcare and education professionals and providers for support. 

We can all work with families to help make the NDIS more accessible to young children who need it

For children with developmental concerns, delays, and disabilities, timely access to NDIS support can make a big difference to functional outcomes, and to the family’s quality of life. But not all families know about the NDIS and/or how to navigate the NDIS to access early intervention support.

Providers – including health and early education professionals – can help families to understand the system, and how to get started.

More resources:

  • NDIS fact sheets and videos about the early childhood approach: Help for your child younger than 7 
  • NDIS Guidelines on the early childhood approach 
  • NDIS Guidelines on early connections
  • NDIS Guidelines (general link for the most recent guidelines)
  • Section 25 of the NDIS Act 2013 (Early intervention requirements)
  • Part 6 of the NDIS (Becoming a Participant) Rules 2016 – When does a person meet the early intervention requirements?
  • “What is best practice in early childhood intervention – Reimagine Australia”
  • NDIS: List A: Conditions that are likely to meet the disability requirements
  • NDIS: List B: Conditions that are likely to result in a permanent impairment
  • NDIS: List C: What if you’re receiving disability support in Western Australia?
  • NDIS: List D: Permanent impairment/Early intervention, under 7 years. No further assessment required

NDIS participants deserve quality supports and services from small and medium-sized providers – including unregistered providers

David Kinnane · 7 November 2022 · Leave a Comment

Many small and medium providers of supports and services to NDIS participants are not highly profitable, with relatively high fixed costs, significant staffing shortages, limited operational resources, and sometimes long waitlists.

For cost, time, red tape, service delivery, and other reasons, many providers do not register with the NDIS Quality and Safeguards Commission.

Unregistered providers cannot offer supports and services to NDIS participants who have plans where the funds are managed by the NDIS.

Unregistered providers can offer and provide supports and services to NDIS participants who have plans that are:

  • self-managed: where the participant (or nominee) decides upon and engages supports and services themselves; or
  • plan managed: where the participant (or nominee) engages a registered plan manager to help them to plan, and manage funding for, services and supports for the participant.

Some exceptions exist, e.g., for specialist behaviour supports, and in situations involving potential regulated restrictive practices.

“Unregistered” does not mean “unregulated”. For example, when working with NDIS participants, unregistered providers of services must:

  • comply with the NDIS Code of Conduct; and
  • have systems to manage complaints from NDIS participants and others about the quality and safety of their services.

To protect participants, unregistered providers can benchmark their training and systems against registered provider requirements, e.g. by implementing codes of conduct, risk, incident, and emergency and disaster management  systems, conducting worker screening checks on staff, and by developing policies and procedures for issues like booking and cancellations, child safety, and waste management.  

Key source: NDIS Quality and Safeguards Commission, Unregistered Provider Obligations (Last update: 7 July 2022)

Click on the images below to review some of our popular NDIS templates:

NDIS Complaints Management
NDIS Risk Management System
NDIS Waste Management Policy and Procedures

NDIS basics for new small and medium-sized providers: what’s it all about?

David Kinnane · 31 October 2022 · Leave a Comment

For many small and medium-sized providers of supports and services to National Disability Insurance Scheme (NDIS) participants, the NDIS can be confusing – especially for new providers.

To understand the NDIS, you need to know a bit about the National Disability Insurance Scheme Act (2013) (the Act).

What is the NDIS trying to do?

Among other things, the objects of the Act are to:

  • give effect to some of Australia’s obligations under the Convention on the Rights of Persons with Disabilities;
  • provide ‘reasonable and necessary supports’, including early intervention supports, for participants;
  • enable participants to exercise choice and control in the pursuit of their goals and the planning and delivery of their supports;
  • promote the provision of high quality and innovative supports to enable participants to maximise independent lifestyles and full inclusion in the community; and
  • protect participants from experiencing harm arising from poor quality and unsafe supports or services provided under the scheme.

How does it work?

The Act’s objects are achieved through:

  • the NDIS, which follows an insurance-based approach, informed by actuarial analysis, to the funding of supports for participants;
  • the National Disability Insurance Agency (NDIA), which delivers the scheme;
  • a national framework that regulates:
    • registered NDIS providers and their services and supports; and
    • services and supports provided to participants by unregistered providers; and
  • the NDIS Quality and Safeguards Commission and the Office of the NDIS Quality and Safeguards Commissioner, which oversee:
    • the quality of safety of services and supports provided to participants;
    • NDIS providers;
    • allegations of misuse and fraud; and
    • the NDIS worker screening database.

Source: sections 3, 4, and 8 of the National Disability Insurance Scheme Act 2013 (Cth), as amended.

Click on the images below to review some of our popular NDIS templates:

NDIS Complaints Management
NDIS Incident Management
NDIS Emergency and Disaster Management Plan Framework

How to navigate conflict with other people

David Kinnane · 27 October 2022 · Leave a Comment

Interpersonal conflicts are common. They can make us worry and react in regrettable ways that make us feel bad about ourselves. Sometimes, we withdraw from relationships, which is also not good for us.

Conflict with people can lead to lots of bad outcomes: reduced focus and creativity, worse decision making, and unhappy relationships.

None of us is perfect when it comes to relationships. When you are in conflict with someone else, there are several strategies you can use to find a healthy way forward:

  • Remember your perspective is just one amongst many. Sometimes, we forget that we all have different viewpoints and values and think that our view is correct and all other views are uninformed, irrational or biased. Thus is not always true – not everyone sees things that same way and that’s okay.
  • Be aware everyone is biased (including you!). We sometimes assume that other people’s behaviour is due to their personality, when it might just be due to their situation. Ask someone you trust to help you reflect on the ways you might be seeing the situation unfairly.
  • Avoid black and white thinking. Sometimes, when we disagree with others, we start to think that the other person is an opponent or even enemy! Rather than thinking it’s ‘you versus them’, focus on the decision or situation instead and try to make progress on it. Think of yourself and the other person as sitting on opposite sides of a seesaw and work together to find a balance.
  • Know your goals: Avoid drama and stay focused on your goals, e.g. you want a healthy relationship that will last into the future, and you want to feel less angry/frustrated after interactions. Make a list of your goals and circle the most important ones. You don’t need to be best friends with the other person – focus first on having a functional, respectful relationship.
  • Don’t gossip or look for drama: It’s perfectly fine to seek help with sorting out your feelings and to check in with others. But choose who you speak with carefully and look for people who are constructive and who will challenge your perspective – people who will help you solve the specific problem.
  • Experiment: There is no one way to solve interpersonal conflicts. Your strategy will depend on the situation and the people involved. Experiment and see what happens: e.g. decide that for two weeks you will listen to the other person, and not interrupt, and focus on what they are saying (rather than how they say it). Try to summarise what the other person is saying, and check you have understood them. Try to interrupt your conflict patterns of the past.
  • Stay curious: People are complex! Try to learn more about the other person. Do not approach conversations with aggression or defensiveness, but with creativity and with genuine questions about them. Think about a future when you have overcome the conflict.
  • Don’t give up: With good faith efforts and hard work, you can resolve most interpersonal conflicts.

Key source: Gallo, A. (2022) How to Navigate Conflict with a Coworker, Harvard Business Review, September/October.

What’s going on with NDIS AAT appeals?

admin · 21 September 2022 · Leave a Comment

Yesterday, we listened in on the “What’s going on with NDIS AAT Appeals?” livestream hosted by Every Australian Counts and Disability Advocacy Network Australia. The livestream was a conversation about NDIS participant appeals of National Disability Insurance Agency (NDIA) decisions to the Administrative Appeals Tribunal (AAT). Conversation participants included the Minister for the NDIS Bill Shorten, NDIA Chief Counsel Matt Swainson, NDIS advocates, and NDIS participants.

At the start of the conversation, non-Government participants were asked to sum up the AAT appeals process in one word. Here is a screenshot of the wordcloud (about 110 responses): 

As part of the new Labor Government, Minister Shorten was keen to highlight that he does not support an adversarial approach with NDIS participants, and has told the NDIA that they are now “in a different world”. He acknowledged that there was a need to rebuild trust and fix problems with the NDIS. According to the Minister, under the previous Coalition Government:

  • external reviews of NDIA planning decisions increased by 400%;
  • appeals of NDIA decisions as a percentage of NDIS participants more than doubled;
  • the NDIA received about 250 enquiries per month from participants experiencing problems with the system – this increased to 1,250 enquiries per month when the Labor Government took over; and
  • there were 4,501 active NDIS appeal cases in the AAT by the time of the last election. 

He described internal NDIA reviews as opaque and unaccountable and has sought to decrease the number of decisions going to appeal to the AAT since the election. As at 19 September 2022, the number of active cases before the AAT has apparently dropped by 10% and is now “under 4000”.

Alternative Dispute Resolution to deal with Legacy Cases

The Minister said he wanted to introduce an alternative dispute mechanism in an attempt to decrease the backlog of cases at the AAT. According to the Minister, the model would include:

  • the creation of an ‘Oversight Committee’ to look at legacy cases and chaired by former Federal Disability Discrimination Commissioner Graeme Innes and include members from the disability sector including advocates; 
  • the appointment by the Oversight Committee of independent expert reviewers to “blitz” the thousands of cases currently before the AAT. The experts would seek to resolve outstanding cases and make offers to participants; 
  • the following features of the proposed alternative dispute resolution (ADR): 
    • entirely voluntary for NDIS participants to use; 
    • run concurrently with the AAT appeal process – so participants would not be disadvantaged or lose access to (or their queue spot in) the AAT appeals process; 
    • access for participants to a 1800 number if they had questions about the ADR, with NDIS advocates providing assistance via the hotline; 
    • participants could accept or reject the decision of the ADR; and
    • NDIS participants would have an opportunity to consult with lawyers, if an offer was made, so they could obtain advice; and
  • a trial/pilot scheme of 15-20 matters and then the reviewers tackling 2000+ cases before Christmas 2022.

Changing processes

In addition, the Minister would like to undertake a review of NDIA processes to create a less adversarial, more efficient process including:

  • improving the initial planning process for participants;
  • greater transparency of internal review of NDIA decisions;
  • the provision of written reasons for NDIA decisions; 
  • providing model litigant rules in all cases; and
  • a recognition there has been an overuse of external lawyers, which has created an unfair “David and Goliath sort of struggle” for NDIS participants.

In response to a question about the ongoing nature of the ADR, the Minister indicated he wanted to streamline the system so:

  1. a lot more of the planning decisions are made in-house at the NDIA;
  2. there is greater communication between NDIS planners and participants;
  3. there is continuity between an NDIS planner and an NDIS participant and their family;
  4. there is availability of a decision review by the NDIA; and 
  5. if a participant is unhappy about the outcome of an internal review, access to an experienced independent mediator via the ADR.

The Minister said he did not want the NDIA to “lawyer-up” or for the process to become a process of attrition for NDIS participants. The focus should be on resolution, not playing games. He wanted to resolve matters in the interests of the participants, with support from advocates.

Settled positions

In response to a question about NDIS participants needing to go repeatedly to the AAT to have NDIA decisions overturned, in circumstances where supports had previously been funded, Matt Swainson said that the NDIA general principle would be that if the NDIA had agreed to a position, or if the evidence showed that the AAT had made a ruling on a particular support, then the ruling should be the position of the NDIA, and should remain in place without the need for the participant to seek support from the AAT (subject to where circumstances may have changed).

Guidelines

In response to a question about if it was going to be necessary for the NDIA to speak with participants during the internal review process (as was not the case under the previous Government), Matt Swainson said that operational guidelines may need to be changed so that NDIA staff must speak with participants (and/or advocates) prior to making decisions following an internal review, however he understood that NDIA staff were now contacting participants prior to making making a decision.

Whilst the Minister acknowledged that all NDIS participants are unique individuals, he advocated for the NDIA to publish clearer guidelines and previous decisions so as to make it easier for NDIS participants and planners, and not have NDIS participants needing to re-argue over things that were common sense and common claims. 

Training

A question was asked about the skills and knowledge of NDIA staff with the questioner citing an example of NDIA staff not knowing about a particular decision of the Federal Court and not understanding about the validity of the decision.

Matt Swainson acknowledged that training of NDIA staff was a “big piece of the puzzle” and committed to further training of NDIA staff. He acknowledged that a lack of training was a problem and publishing guidelines about how AAT or Federal Court decisions will be applied is needed.

Conclusion

The Minister acknowledged that people had been let down by the NDIA. He stressed that the Government couldn’t change everything immediately, however he wanted to work with the disability sector and build trust. 

Conversation participants were asked to provide some feedback at the end of the one-hour conversation about how they felt about the discussion. Here is a screenshot of the responses:

We look forward to reading more about the formation of the Oversight Committee, the ADR process for legacy cases, better training (and retention) of NDIA staff, and respectful outcomes for NDIS participants.

The recording of the livestream is available via the Every Australian Counts Facebook page at: https://www.facebook.com/everyaustraliancounts/videos/782013843134082

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