Last week, we attended two, lengthy webinars hosted by the team at The Social Deck, on behalf of the Department of Social Services, about Foundational Supports, including Targeted Foundational Supports. Our key takeaways for allied health providers of paediatric services are as follows*:
State of play:
- Consultation period ends on 5 December 2024. Soon!
- Weirdly, negotiations between governments are happening completely separately from community stakeholder consultations.
- No update on the status of negotiations between the states and the Federal government, who will share the costs, 50:50.
General impressions:
- Lots of stressed attendees. (Lifeline number shared!)
- Frequent reminders from convenors that “we won’t be able to answer some of the specific questions about how foundational supports might work in the future” because they depend on what governments may decide to do.
- Lots of very good ideas, but not clear how they could all work together in the real world. (One participant described the session as an “idea salad”, which I borrowed for the title.)
- Private practitioners appeared to be under-represented in discussions, perhaps because the webinars occurred:
- in the middle of working days; and
- so close to the calendar year-end.
General themes:
Targeted Foundational Supports should:
- include early recognition and assessment of needs;
- be family-centred and holistic;
- be consistent and continuous;
- include disability-led organisations; and
- include robust quality, safety and accountability controls.
Attendee concerns, including about:
- NDIS changes and children falling through the “cracks” right now;
- allied health workforce readiness, including training pathways and supervision;
- gaps between evidence-based practices and front line realities;
- how to ensure consistency and continuity of services;
- how best to engage families and deliver family-centred care; and
- how supports will work in rural and remote areas and for CALD populations.
Services delivery preferences:
General – but not unanimous – preferences for:
- a move away from one-to-one, clinic-based therapy;
- transdisciplinary and multidisciplinary teams;
- service delivery in naturalistic settings using existing (public) infrastructure;
- systems that promote longer-term relationships between families and professionals;
- a movement away from medical models of care; and
- key workers and allied health assistants having significant roles in the new system.
Many big questions remain:
- Who will be eligible to deliver targeted supports and how will they be registered/certified?
- Who will employ, train, and supervise them?
- How (if at all) will allied health professionals access some settings, e.g. in states like NSW without a long history of integrated health/education service delivery?
- Who will oversee and audit services, including outcomes?
- How will services be funded? (Fee for service, block funding, fees for outcomes?)
- What intensity of support is envisaged? (The consultation paper appears to envisage low intensity supports.)
- Will recipients have any choice and control?
- How (if at all) will upcoming elections affect the proposals, including their timing?
Lots of questions. Few answers.
Read more:
Foundational Supports | Department of Social Services
* Any errors of interpretation are – as always – completely our own.
We’d like to thank Mel Butcher and the rest of the team at The Social Deck for the work they are doing under enormous time pressures.
Leave a Reply