Therapy and the NDIS: everything you need to know

Whether your child accesses the NDIS through the early childhood approach or they’re older and a ‘full’ participant, it’s highly likely that you will be requesting funds for therapy as part of your plan. So, what do you need to know about therapy and the NDIS? Read on as we cover off some of the basics for you…

HOW IS THERAPY REFERRED TO WITHIN THE NDIS?

Within your plan there are three main categories of supports (the ‘purpose’ of the support) funded through the NDIS – Core supports, Capital supports and Capacity Building supports. Therapy is considered a Capacity Building support – a support that enables a participant to build their skills and independence. In the Capacity Building section of your plan, supports are further broken down by category and therapy comes under the ‘Improved Daily Living’ category which is defined by the NDIS as follows: ‘Assessment, training or therapy to help increase your skills, independence and community participation. These services can be delivered in groups or individually. Confusingly, in the NDIS myplace portal Improved Daily Living is referred to as CB Daily Activity.

CAN I USE FUNDS FROM OTHER CAPACITY BUILDING SUPPORTS IF I DON’T HAVE ENOUGH IN MY IMPROVED DAILY LIVING CATEGORY?

Unlike Core support funding which is flexible and can be moved around the sub-categories, capacity building support funds cannot be moved from one support category to another. Funding can only be used to purchase approved individual supports that fall within that Capacity Building budget.

WHAT THERAPIES WILL NDIS FUND?

To be considered for NDIS funding a support must firstly be considered reasonable and necessary. In the context of therapy, to meet this criteria the NDIS will be looking for information that the support is related to your child’s disability and likely to work and benefit your child. It should represent value for money and importantly, be based on evidence. Evidence-based therapy is therapy that is proven to work in the wider community or based on scientific evidence and data.

WHO CAN PROVIDE THERAPY TO MY CHILD?

The NDIS empowers you to choose the best providerto help your child achieve their goals. They refer to any person, business or organisation that delivers funded services or products to a participant as a Service Provider.

Providers who are registered with the NDIS are called ‘NDIS registered providers’. They meet strict government quality and safety requirements. If your NDIS funding is NDIA-managed, you can only use NDIS registered providers to deliver your services.

Participants who self-manage or have a Plan Manager to manage their NDIS plan, can use NDIS registered providers and non-registered providers. (see our article on page 46 for more information on the different management options).

If your child is under seven you will most likely have worked with an Early Intervention provider to put your plan together. The NDIS has engaged Early Childhood Partners across Australia to deliver the ECEI approach. You can work with this provider to utilise the capacity building funds for therapy in your budget or you can also identify other providers either through the myplace portal (to find registered providers) or independently if you are self or plan managed.

HOW MUCH SHOULD I PAY FOR A THERAPY SESSION?

NDIS registered service providers are bound by the maximum limits of the NDIS price guide which can be accessed here – (https://www.ndis.gov.au/providers/price-guides-and-information). You are free to negotiate a lower rate with an individual provider if you are self or plan managed. If you are self-managed and using a non-NDIS registered provider you are free to pay any price you wish. The NDIS will set funding based on the price guide so if you do pay more then be aware that your funds may not go as far as you need them to.

HOW SHOULD I REQUEST FUNDING FOR THERAPY IN MY PLAN MEETING?

Your request for therapy hours for your child should be backed up by evidence-based reports from relevant professional therapists such as speech therapists, OTs, physiotherapists etc). Most importantly, the reports should be related to your plan goals and set out recommendations for how a particular therapy will help a participant to reach a goal or goals over a 12-month period along with the measures of success.

ADDITIONALLY, THE REPORTS SHOULD:

• Include a breakdown of how many hours of support are required to meet a goal within the plan’s 12-month period.

• Be in plain English and easy to read. An NDIS planner should be able to pick up a report and understand at the outset the content of a report and how this relates to the participant. Recommendations are one of the most important parts of a therapy report so a clearly labelled recommendations section will guide a planner to what is being proposed for the participant.

• Information should be included on how the diagnosis affects a child’s day (what can’t they currently do, what barriers are there that the therapy could overcome etc.) and how the therapy will work to address any issues with a focus on how the support is reasonable and necessary and provides value for money. The report should also state the risk of not providing the recommended supports.

• If a therapist has previously been working with a child (especially important for plan reviews) the report should include strategies that have previously been implemented and a history of outcomes. At an annual plan review the report should state progress made against goals (is the therapy working?), goals for the coming year and how strategies may differ from the previous year.

WHAT ELSE SHOULD I CONSIDER WHEN REQUESTING FUNDING FOR THERAPY?

Along with the funding you are requesting for therapy hours, you should also consider the funding you may require for ‘extras’ such as therapist travel time, report writing and equipment assessments and fittings which also come out of the same budget section.