Speak Out October 2020 DIGITAL EDITION FINAL

Ask SPA NDIS and ethical decision making Scenario 1: I have a client I have been seeing

therefore participants and members would need to be aware of the risk of using this item for communication and then being audited/ the use of funds questioned. Providers may be penalised, and self managed participants no longer allowed to self manage their funds. The NDIA will have allocated a certain amount of funds to therapy (including SP) and that is the allocation, they expect therapy to be arranged according to the amount of funds available. If the allocation of funds for speech pathology is not sufficient, the participant or family can ask for a plan review. Participants would also need to be clear that taking money from the core section may mean that they are limiting their funds to pay for core supports (such as assistance with daily living tasks), and that they will not hypothetically have additional funds added in to their plan for these core supports, as they would be expected to budget. Participants may need to prioritise funds for what they see as being essential. When communicating with participants, speech pathologists have an ethical obligation to provide information that is accurate and objective. The onus of responsibility lies on the individual speech pathologist to understand what can and cannot be done, rather than relying on others. Ensuring that we both understand these limits and act within them protects everyone involved. This might result in you needing to have a conversation with the participant or their significant others, that is difficult, but this too is an ethically appropriate choice, as it reflects the values of professionalism and integrity and responsiveness, as well as the principles of autonomy and justice and fairness. Scenario 2: My client’s parent has heard from their plan manager that they can get a new iPad through the extended low cost low risk AT process for telehealth so they have asked me to buy them a top of the range iPad pro and a pencil and a printer to help with school work. They have been told they are entitled to this, but we have been doing the online sessions on their laptop and it’s been working well. What should I do?

for some time around their communication, and they have run out of funds in their capacity building budget for speech therapy. The support co-ordinator has said this is ok, I can keep seeing them and we can just use funds from their core budget, because the client has choice and control over how they use their budget, is that right? A: While the client does have choice and control over their supports, and within some budgets, at present there is limited flexibility across budgets. For instance, now that core budgets are completely flexible, a participant can choose to have additional home support, ‘borrowing’ funds from their unspent consumables budget. It is important to note that if the client uses up all of their funding in their core supports, they may not be able to get any additional funds without a plan review, and may not be able to receive additional funds at all if those supports were appropriately funded, but this money was used for something else. Additionally, many of the core support categories would not be able to be used by speech pathologists, as they are only for specific professionals. For example, items under the ‘Development of Daily life skills’ with a 0117 number can only be accessed by Disability Support Workers, Aboriginal Health Workers and Welfare Workers. At present the only core support items that can be claimed for speech pathology supports are 01_741_0128_1_3 (for over 7s) and 01_740_0118_1_3 (for early childhood), but these can only be used for disability related health supports (e.g dysphagia supports). There is no core item for communication supports, only the regular therapy items under capacity building. As per page 49 of the price guide: “These Disability-Related Health Supports provide care, other than nursing care, to respond to the disability-related health needs of a participant where that care is not the usual responsibility of the health system.” The NDIA’s official stance is that these are for disability related health services ONLY,

Ethics

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October 2020 | Speak Out