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How will allied health NDIS providers survive? Some difficult choices ahead

David Kinnane · 12 July 2024 · Leave a Comment

If you are a private allied health business owner who works with NDIS participants – you should take a look at the Deloitte Access Economics report about NDIS price limits for therapy supports and the Ability Roundtable 2023-24 Annual Price Review Submission about Therapy Supports.  

Both are harrowing reads for occupational therapists, speech pathologists, physiotherapists, social workers, and other allied health businesses. They suggest that most of the bigger, NDIS-registered allied health therapy businesses operate at – or below – break-even point against NDIS price limits. For the 2024-25 financial year, the Ability Roundtable has projected a median loss (net margin) of -14.2% for larger registered providers of therapy supports.  

For registered and unregistered NDIS providers, the real costs of providing therapy supports to participants are often underestimated, including by many allied health business owners. Costs include:

  1. staff base wages and salary oncosts (e.g. annual leave, personal leave, public holiday leave, long service leave, and parental leave, superannuation, workers compensation insurance); 
  2. costs of supervision, training, professional development, and accreditation;
  3. non-billable (but necessary) activity costs, like non-billable client, travel and cancellation time;
  4. service delivery overheads, including occupancy costs (e.g. rent and electricity), motor vehicle fleet costs, specialised equipment, IT costs (e.g. laptops and software), and client consumables;
  5. non-service level staff costs (e.g. team leader and corporate governance costs);
  6. corporate overheads, e.g., IT, finance, human resources and recruitment, insurance, administration, marketing, quality control, and audit and legal expenses; and
  7. NDIS and other compliance costs. 

From Deloitte’s report, it appears that many of the bigger registered allied health businesses have a major structural business problem: high (and rising) fixed costs, a limited capacity to reduce variable costs without affecting service quality or access, a limited ability to increase staff productivity without increased turnover, and of course no room to move on prices. 

The Government’s decision to freeze NDIS therapy prices for another year increases financial pressures on allied health providers. To stay in business, allied health providers must (at least) break even. But we face several difficult choices and tradeoffs as we try to get there:

  1. We can’t lower wages without losing staff to higher paying opportunities, e.g. in the public sector.
  2. We can’t reduce new graduate and early career hiring and support without affecting the future of our professions (onboarding new graduates and building their caseloads requires significant investment and time, which affects average utilisation rates).
  3. We can’t ask frontline staff to see more clients without increasing staff burnout and turnover.
  4. We can’t cut corners on supervision, education and training without reducing the skills of our workforce and the quality of our therapy services.
  5. We can’t recalibrate staffing levels to match fluctuating client demand patterns (e.g. during school holiday periods) without reducing full-time employees and switching to casuals and contractors and reducing continuity of service to some participants.
  6. We can’t reduce investments in corporate governance controls without increasing business and client risks, including to safety.
  7. We can’t narrow our scope of services (e.g., switching to lower-cost supports or private client work outside the NDIS) without reducing NDIS participant access to our services.

For ethical reasons, many of these options and trade-offs are unacceptable for reputable allied health providers.

In the bleak business environment depicted in the Deloitte and the Ability Roundtable reports, it would be logical for:

  1. more registered NDIS allied health providers to deregister, continuing the trend described in the NDIA’s latest Annual Pricing Review;
  2. some allied health providers to downsize and to cut investments to reduce costs; 
  3. some allied health providers to cease working with participants with complex (higher cost) needs and to reduce (higher cost) in-community services to reduce losses; and 
  4. some allied health providers to pivot their businesses to focus on non-NDIS clients to reduce their exposure to NDIS price controls.

Unless allied health NDIS providers find new ways to increase productivity and to re-establish sustainable margins, we may end up with fewer registered allied health providers, fewer larger allied health employers, uneven levels of supervision, training and support for staff across the professions, and fewer options for some NDIS participants to access quality therapy supports. 

NDIS Providers: 5 basic things to know about the NDIS (Getting the NDIS Back on Track No. 1) Bill 2024

David Kinnane · 25 June 2024 · Leave a Comment

With today’s news, we don’t yet know the final form of the NDIS (Getting the NDIS Back on Track No.1) Bill 2024 or when it will be passed into law.

But, despite the uncertainty and lack of detail on many key points, NDIS providers (including unregistered providers) need to understand some basic concepts to prepare for the big changes ahead:

  • Providers should expect increased regulation, oversight, and enforcement action. The NDIS Quality and Safeguards Commission and the NDIS Commissioner will have expanded powers.
  • NDIS access rules will be clarified so that participants know whether they meet the disability requirements, the early intervention requirements, or both.
  • NDIS pathways will change. The NDIS will work differently for participants accessing early intervention supports compared with participants receiving disability supports for lifelong disabilities. (Future reforms will create a new early intervention pathway.)
  • Significant changes to NDIS supports, assessments, reports, and budgets:
    • “NDIS Supports” will replace “reasonable and necessary supports”, narrowing supports that will be funded by the NDIS.  
    • “Needs-based assessments” will replace diagnoses-based assessments, and produce “needs assessment reports”. 
    • The needs assessment report requirements will be developed in consultation with people with a disability, health and allied health technical professionals and governments. 
    • The “reasonable and necessary budget” will be determined by the needs assessment report and replace line-by-line “reasonable and necessary supports”.  
    • Reasonable and necessary budgets will be composed of “stated supports” (fixed budgets for things like assistive technology and supported independent living), “flexible funding” (e.g. for health or rehabilitations services), or both.
  • Provider boards and senior management must understand their NDIS compliance obligations and work with participants and others to improve their governance and leadership practices to enhance safety, quality, accountability, and responses to risk.

With thanks to the presenters at the Legalwise Seminars’ NDIS Law Intensive on 20 June 2024.

Do I need a diagnosis to get access to the NDIS?

David Kinnane · 30 November 2022 · Leave a Comment

We get asked this question a lot.

From a legal perspective, the answer is “no”. 

The Federal Court of Australia – most recently in an important case called National Disability Insurance Agency v Davis [2022] FCA 102 (the Davis case) – has been very clear:

  • The NDIS Act does not focus on the name of a person’s disability, nor the diagnosis given to a person. 
  • The NDIS Act is not concerned with what caused a person’s disability. 

Instead, the NDIS Act requires the National Disability Insurance Agency (NDIA) to look at impairments experienced by a person that may require ‘supports’ so that the person can participate in personal and community life. Anyone who meets the access criteria in the NDIS Act can be a participant – regardless of diagnosis, and regardless of whether their disability came about by birth, disease, injury or accident.

So why is everyone so focused on labels and diagnoses? 

An important question. To answer it, we’ll look, first, at early intervention; and then NDIS access, generally.

1. NDIS access for children under 7 years of age

In a previous article, we looked in detail at some practical issues facing families when trying to access early intervention supports funded by the NDIS. As a matter of law, it’s clear that you don’t need a formal diagnosis for your young child to access supports from the NDIS, a fact acknowledged by the NDIA.

However:

  • In clinical practice, we’ve observed that families who can afford to pay for formal assessments confirming certain types of diagnoses seem to have a much easier time accessing support from the NDIS than others. More specifically, the system seems to favour:
    • families who live in big cities with access to health professionals;
    • educated parents/carers who understand ‘the system’, can advocate for a diagnosis when interacting with health professionals;
    • wealthy parents/carers who can afford to pay one or more private medical professionals to write formal reports and/or who have the resources to challenge NDIA decisions (e.g. before the Administrative Appeals Tribunal or Federal Court of Australia); and 
    • people who speak English as their first language. 

This has contributed to what some commentators call a ‘two-tier access system’. It’s fundamentally unfair. The NDIA and the responsible Minister are both aware of the problem and are trying to fix it. But it’s the reality right now. 

  • NDIS guidelines expressly privilege some types of diagnoses for determining access. For example, the NDIA has published:
    • a list of conditions that they deem are likely to result in a permanent impairment (an access requirement), including intellectual disability and Level 2 autism (Requiring substantial support) and Level 3 autism (Requiring very substantial report); and
    • a list of conditions that do not require further assessment for accessing the NDIS for early intervention for children under 7 years, including Global Developmental Delay. 

Good intentions, weird incentives, and unfair outcomes 

The NDIS guidelines and lists were no doubt intended to save families of children with significant, lifetime disabilities from having to jump through administrative hoops to qualify for clearly-warranted help. But, in practice, the lists have had unintended consequences. Inconsistently with the purpose of the NDIS Act:

  • many families, planners, providers, and stakeholders focus their time, money, and energy on medical assessments and diagnoses instead of on the functional needs and participation of children with developmental delays and disabilities;
  • the system creates a strong incentive for families to seek specific diagnoses of conditions that result in easier or automatic access to the NDIS, even if this involves some ‘diagnosis shopping’; and
  • some children who meet the legal requirements to become NDIS participants miss out on support because of bad advice and mistaken beliefs that they don’t have the ‘right’ diagnosis or label and are therefore ineligible.

Anecdotally, we’ve heard reports of some parents consulting up to five paediatricians to obtain a diagnosis of Level 2 or Level 3 autism for their child. This type of behaviour:

  • is not an option available to most families for financial reasons;
  • is a terrible waste of limited healthcare system resources in a system beset with long waitlists for paediatricians and other health professionals; and 
  • only makes sense in the context of the preferential access to NDIS funding that comes with the diagnosis.

2. NDIS access for children aged 7 years or older, teenagers, young adults, and adults

A. ‘Does my diagnosis qualify for NDIS access?’ is the wrong question

The idea that diagnosis should determine access to the NDIS is misguided. It’s legally incorrect. But it continues to dominate mainstream and social media commentary on the NDIS.

NDIS Guidelines have contributed to the confusion. The NDIA’s list of conditions that it deems likely to meet the disability requirements for access to the NDIS includes moderate, severe and profound intellectual disability, and Level 2 and Level 3 autism. Of course, most people with these conditions and/or the other conditions on the list should be entitled to NDIS support. But it’s understandable that people with other diagnoses and conditions would like to be added to ‘the list’.

Recently, we’ve seen a public debate about whether adults with ADHD should be able to access the NDIS. We’ve also seen well-intentioned disability and other advocates fighting for people with ‘their diagnosis’ to be ‘granted access’ to the NDIS, including advocates for adults with language disorders. Again, this is understandable in the current system – especially given that intellectual disability, autism, ADHD and language disorders are all subtypes of neurodevelopmental disorders (NDDs) that are known to have negative effects on people’s participation and functioning. It seems arbitrary to include some NDDs and not others – particularly in cases where they lead to similar functional impairments. 

The diagnosis debate is understandable, but harmful to the NDIS and people with disabilities. All the ‘noise’ about diagnosis-based access feeds into the unhelpful narrative about NDIS cost ‘blowouts’ and ‘unsustainability’. It obscures the great news about how transformative the NDIS is for many participants. It confuses potential participants, providers and taxpayers about who is entitled to access the NDIS, and why.

To counter some of this noise and confusion, let’s take look at the legal tests for access: 

B. NDIS access basics – the three requirements

To become an NDIS participant as a person aged 7 years or older, you need to meet the “access criteria” set out in the National Disability Insurance Scheme Act 2013 (Cth) (the NDIS Act).

Section 21 of the NDIS Act sets out the main rules. There are three kinds of requirements for access to the NDIS:

  • Age requirements. You need to be under 65 years of age when you make an access request to become a participant (see section 22); and
  • Residence requirements. You need to:
    • reside in Australia; AND 
    • be an Australian citizen, a holder of a permanent visa, OR a protected special category visa holder (section 23); and 
  • Disability requirements. These are set out in section 24, which is sometimes referred to as the “threshold provision”.

C. Disability requirements: commonly disputed issues

Often, the main issue for potential participants is whether they meet the disability requirements. 

The disability requirements are complicated, cumulative, and include a number of separate requirements that must be met before a person can become an NDIS participant (participant). You can read them in full here.

Common issues in disputes between the NDIA and applicants include whether the person:

  • has a disability that is attributable to one or more intellectual, cognitive, neurological, sensory, or physical impairments;
  • has impairments that are likely to be “permanent”;
  • has impairments that result in “substantially reduced functional capacity” to undertake one or more of the six activities set out in section 24(1)(c) of the Act, namely:
    • communication;
    • social interaction;
    • learning;
    • mobility;
    • self-care; and/or
    • self-management; 
  • has impairments that affect the person’s capacity for social or economic participation; and
  • is likely to require support from the NDIS for the person’s lifetime.

D. What do the Courts say about access to the NDIS? 

In the Davis case, Justice Debra Mortimer considered the disability requirements in detail*. She made several important observations and comments about the disability requirements and NDIS access, generally. These comments are helpful for understanding who should get access to the NDIS, and why. 

Our key takeaways, paraphrased from Davis, are as follows:

  • The NDIS is focused on assisting people with disability to live with dignity, with as much autonomy as possible, and with the ability to enjoy access to community and social engagement commensurate with people who do not live with disabilities. 
  • The NDIS is not means tested. Access doesn’t depend on how much money you or your family have (or don’t have).
  • Not everyone with a disability gets access to the NDIS.
    • The scheme is directed at providing lifelong support to people with enduring needs.
    • Access to the NDIS is reserved for a subcategory of people with disabilities and is determined by the access criteria. 
    • There are many people with disabilities who will not qualify as participants of the NDIS. This was a conscious policy decision, not an accident.
  • The intention of the NDIS is that, once a person meets the access requirements, the person will (generally) remain supported through their lifetime.
  • The link between “disability” and “impairment” is not explained in the NDIS Act. The disability requirements revolve around the severity and permanency of the effects of impairments experienced by a person to justify the funding of “reasonable and necessary supports” (as later assessed under the NDIS Act).
  • The concept of “impairment” enables the assessment of:
    • the severity and permanency of the person’s condition, and
    • the effects of that condition through:
      • evidence of the person; and
      • medical and clinical evidence.
  • The assessment of the severity and permanency of the person’s condition and its effects should focus on the effects of impairments on a person’s functioning. The assessment must be functional, practical and detailed. The assessment must be focused on what a person can and cannot do.
  • In clinical practice and litigation, people sometimes use the terms “impairment”, “disability”, “condition” and “diagnosis” interchangeably. But, for the purposes of the disability requirements, these terms are not synonyms. For example:
    • the focus of the disability requirements is whether a person has one or more impairments, and whether those impairments are permanent (i.e. enduring); and
    • whether a person’s disability is attributable to those impairments.
  • The NDIS Act does not focus on the name of a person’s disability, nor the diagnosis given to a person. Instead, the Act focuses on identifying the impairments experienced by a person that may require supports so that the person can participate in all aspects of personal and community life. 
  • The term “permanent” is not defined in the NDIS Act. However, there are “access rules” that have been made for the purposes of the NDIS Act called the National Disability Insurance Scheme (Becoming a Participant) Rules 2016 (Cth) (the Rules). Rules 5.4-5.7 provide as follows:

5.4 An impairment is, or is likely to be, permanent (see paragraph 5.l(b)) only if there are no known, available and appropriate evidence-based clinical, medical or other treatments that would be likely to remedy the impairment. 

5.5 An impairment may be permanent notwithstanding that the severity of its impact on the functional capacity of the person may fluctuate or there are prospects that the severity of the impact of the impairment on the person’s functional capacity, including their psychosocial functioning, may improve. 

5.6 An impairment may require medical treatment and review before a determination can be made about whether the impairment is permanent or likely to be permanent. The impairment is, or is likely to be, permanent only if the impairment does not require further medical treatment or review in order for its permanency or likely permanency to be demonstrated (even though the impairment may continue to be treated and reviewed after this has been demonstrated). 

5.7 If an impairment is of a degenerative nature, the impairment is, or is likely to be, permanent if medical or other treatment would not, or would be unlikely to, improve the condition. 

  • The term “permanent”, for the purposes of the disability requirements, means the impairment or impairments are “enduring” or of an “enduring nature”. It does not mean “irreversible”. It does not mean “cannot be improved”, e.g. with therapy or medicine. The effects of a permanent impairment may fluctuate. 
  • In other words, the question for the NDIA is whether the impairment(s) experienced by the person has or have an enduring quality so as to require supports funded under the NDIS on an ongoing basis.
  • The rules about whether an impairment results in substantially reduced functional capacity of the person to undertake one or more of the relevant activities (communication, social interaction, learning, mobility, self-care and/or self-management) are set out in Rule 5.8: 

5.8 An impairment results in substantially reduced functional capacity of a person to undertake one or more of the relevant activities-communication, social interaction, learning, mobility, self-care, self-management… if its result is that:

(a) the person is unable to participate effectively or completely in the activity, or to perform tasks or actions required to undertake or participate effectively or completely in the activity, without assistive technology, equipment ( other than commonly used items such as glasses) or home modifications; or

(b) the person usually requires assistance (including physical assistance, guidance, supervision or prompting) from other people to participate in the activity or to perform tasks or actions required to undertake or participate in the activity; or

(c) the person is unable to participate in the activity or to perform tasks or actions required to undertake or participate in the activity, even with assistive technology, equipment, home modifications or assistance from another person.

Bottom line

Not everyone is entitled to access the NDIS. This is a feature of the scheme, not a bug. 

Access rules are essential for the NDIS to work fairly and as intended. But the rules and processes must be transparent, fair, and applied consistently.  

The current system includes incentives that are not aligned with the NDIS Act and its policy objectives, and lead to unfair outcomes. Access to the NDIS should not depend on where you live, your family’s cultural and language background or socioeconomic status, your ability to advocate for your rights, or your capacity to understand the rules and to navigate ‘the system’. 

Similarly, access should not depend on your diagnosis or label. Instead, access should be assessed by reference to whether you have a disability attributable to enduring impairments that substantially reduce your functional capacity, and capacity for social and economic participation. 

Fair access to the NDIS for people with disabilities is far too important an issue for us to get side-tracked on debates about medical diagnoses and labels. As Justice Mortimer noted in Davis, questions about access – and about the operation of the NDIS Act generally – should be approached with a reasonable degree of common sense, given the purpose of the NDIS, and the fact that its operations affect people, families and carers already facing great challenges in their daily lives. 

*Justice Mortimer was also the presiding judge in a very important earlier case called Mulligan v NDIA [2015] FCA 544 (Mulligan). Both Davis and Mulligan were appeals from the Administrative Appeals Tribunal (which hears disputes about NDIS access in the first instance).

Disclaimer: we have done our best to ensure that this article is correct as at the date of publication (30 November 2022). It may not reflect any changes to the NDIS Act, NDIS rules or guidelines after the date of publication. The article is intended to provide general information and is not legal advice. Formal legal or other advice should be sought for particular circumstances or for matters arising from this article.

Related articles:

  • Providers can play an important role in helping families of young children understand and access NDIS-funded supports. Here’s how.
  • NDIS participants deserve quality supports and services from small and medium-sized providers – including unregistered providers
  • NDIS basics for new small and medium-sized providers: what’s it all about?

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)

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  • Child Safety Code of Conduct and Policy Child Safety Code of Conduct and Policy $65.00 including GST
  • NDIS Complaints Management NDIS Complaints Management and Resolution System Policy Document and Complaint and Feedback Form $65.00 including GST
  • Social Media Policy Social Media Policy $30.00 including GST
  • NDIS Risk Management System NDIS Risk Management System Template $75.00 including GST
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