Speak Out April 2018

NDIA Independent Pricing Review Members will be aware that the NDIA recently released the Independent Pricing Review (IPR) report that was produced by the McKinsey group. A number of the recommendations from the report have raised concerns, including the proposed tiered structure of pricing, premised on the complexity of participants, and the arbitrary assignment of intervention type as physical verses psychological. The concerns raised by Speech Pathology Australia members are consistent with the concerns of the Association and that of other allied health peak bodies. Issues raised include: • The logistical and philosophical problems assigning a level of complexity to participants, and the resultant potential for the individual payment and overall incomes for providers to drop significantly, • Significant concerns regarding the financial viability of allied health organisations and businesses to remain registered and continue to take on NDIS clients, • The resultant impact on the available workforce should providers choose to deregister and no longer provide services to NDIS participants, • The potential for participants who are deemed to be "less complex" to be disadvantaged in a tiered market, • The difficulties around defining "complexity"of participant using a holistic approach related to physical capability which doesn't reflect the range and variability of issues considered by providers in the sector, • The lack of consultation with the disability sector (including the peak bodies) regarding these proposed changes. Strong advocacy with the NDIA has been occurring on many fronts by professional peak bodies including Speech Pathology Australia, as well as collaborative approaches through Allied Health Professions Australia (AHPA). Actions taken include correspondence with the NDIA CEO, Rob de Luca, and the Assistant Minister for Disability, Hon Jane Prentice. Contact has also been made with the NDIA Board and key NDIA staff and meetings convened. Following these advocacy approaches, there has been a renewed process of consultation with provider and participant groups, with McKinsey and Co. inviting consultation around the implementation process and to understand any impacts this may have on the sector. SPA and other peak bodies, including AHPA, have registered for these consultations and are urging the following: • Consultation with professions about determining complexity, • Consultation with professions about determining process for judging participant complexity, • Consultation with professions about pricing levels for tiers. SPA members have been highly responsive to our requests for data and feedback, with this information informing our response on the financial modelling and implications for market failure/weakness if the recommendations were to be introduced. Information for members is being disseminated through member Facebook groups, as well as updates included on the SPA Website NDIS page. Updates on NDIS A RANGE OF NDIA/NDIS MATTERS CONTINUE TO BE HIGHLIGHTED AS AREAS OF ADVOCACY FOR SPEECH PATHOLOGY AUSTRALIA. UPDATES ON A RANGE OF THESE SPECIFIC ISSUES CAN BE FOUND ON SPA’S WEBSITE, NDIS NEWS PAGE.

National Quality and Safeguarding Framework (NQSF) The NDIS National Quality and Safeguarding Framework is being introduced nationally with an initial roll out in South Australia and New South Wales as of the 1 July. See also further details on this can be found on page 10 of this issue’s Speak Out. Dysphagia Assessment and Mealtime Support Plans The Association has reviewed its advocacy around the provision of funding for speech pathology support for oral eating and drinking. This follows information that Minister Jane Prentice had informed a NSW advocacy group that the NDIS "had not changed its position" that dysphagia assessment and development of oral eating and drinking care plans were preventative health and should therefore be funded by Health. The Minister's communication appeared to indicate that COAG had made a decision. In previous correspondence and meetings with SPA, State and Federal Ministries for Health and Disabilities, the Association had received indications that there was support for SPA's position (that funding for these supports should continue to be the responsbility of the NDIS) and that the matter was currently before the COAG Disability Reform Council as part of broader discussions on the interface between disability and other mainstream services. AT / Home Modification design processes The National Disability Insurance Agency (NDIA) facilitated two workshops in March 2018 to review the initial planning of the Assistive Technology (AT) and Home Modification (HM) redesign. NDIA invited representation through Allied Health Professions Australia, and both SPA and the Dieticians Association of Australia (DAA) were included as representatives on the Reference Group. The NDIA released the project report on Friday March 23rd, with feedback requested by Wednesday April 4th. It is unclear whether the NDIA plans to use this process in the provision of Augmentative and Alternative Communication Assistive Technology. The proposed process includes changes to the pre-planning stage in the participant pathway, where participants will be supported to identify what level (if any) of AT and/or HM supports they may require in their plan, including through the addition of ‘guiding’ questions to the Participant Planning booklet. The redesign also recommends the introduction of a specialised AT and HM assessor panel whose role will be to complete an assessment in the pre-planning stage to identify the reasonable and necessary supports related to AT and HM. A small group of members who are involved in provision of AAC AT was convened and provided substantial feedback about the proposed system and its workability in the provision of AAC AT.

Cathy Olsson National Advisor, Disability

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April 2018 www.speechpathologyaustralia.org.au

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