Over the last 4 years, since my daughter Nicky became an NDIS participant, I have become increasingly particular about what I look for in Allied Health support. I quickly realised that not all Allied Health providers and practitioners are the same. Currently, it seems many providers are so deluged with new NDIS participants that they are at risk of becoming complacent. However, as participants settle into the Scheme, we can expect the market to become increasingly sophisticated and demanding. Providers will have to make some conscious decisions about what supports they provide, how they provide them and who they provide them to.
I have changed providers several times for Nicky’s Allied Health support since her first plan. Through this process, I have finally settled on a list of the five things I look for in her Allied Health support.
Nicky’s NDIS Allied Health dollars are limited, so I need to spend every dollar wisely and purposefully. The money she has been allocated must last a whole year- if she has a minor change of circumstance, such as a growth spurt, I do not have the option of getting it adjusted. To meet all of Nicky’s Allied Health needs I could easily spend double her NDIS budget. To avoid this, I have no choice but to prioritise her greatest needs and consider what supports will have the most impact towards reaching her goals.
With this in mind, we decided that this year we would prioritise her goal of learning to communicate with an eye gaze device. Yet my previous Allied Health provider had allocated Nicky a Speech Pathologist who was a recent graduate with only limited and generalist experience. This did not suit our specialised needs. What Nicky required was a specialist with experience in supporting non-verbal communicating children learning to use eye gaze technology. Through a friend who uses an eye gaze device, I found the perfect person.
Participants have specialised needs, so consider specialising your services. You could choose to support a specific cohort of participants by age, disability-type or functional level. Or, alternatively, you could focus on a specific need such as non-verbal communication using assistive technology, home modifications, mobility-related therapy and equipment. Even if you choose not to specialise, be really specific about your support interests and strengths. In the end, you want participants and families to spread the word that you are someone who can help them meet their specific goals.
2. Local providers
Most therapy is best delivered in the community- at the participant’s home, school or workplace. This means travel is unavoidable. Our previous Allied Health providers were based about 20 minutes away. When I realised they would charge a travel fee for home and school visits, I felt like we were being penalised for the location of their head office. At a rate of $175 per hour of travel, and with Nicky’s limited Allied Health budget, I could not justify the cost. That’s why I have decided to only work with Allied Health providers within 10km of our home and Nicky’s school, or who chose not to charge for travel.
I would encourage providers to primarily target local clients or to choose not to charge travel for clients beyond 10kms. Travel charges are optional, yet few providers are choosing not to charge them. In fact, most have opted to charge the maximum they are allowed to. It might seem counterintuitive to not charge when you are entitled to, but competing on price could be what differentiates you. Participants have limited funds, so the price competition is real.
3. Continuity of support
One year, when working with a large Allied Health provider, we had a rotation of three different physios. The first two were recent graduates and, I kid you not, BOTH went to Brisbane to live with their boyfriends. Three physios in one year is disruptive in and of itself. But what really stuck in my craw was the cost of “getting to know Nicky” three times over draining our Allied Health budget. I sometimes like to joke that I only look for Allied Health practitioners who are middle-aged, born and raised in Newcastle, and have already had their kids. Underlying this totally non-PC banter is a real desire for continuity of support or the assurance that changes in staff will not disrupt Nicky’s progress.
Consider how to build continuity of support into your Allied Health team. Graduate practitioners will play an important role in meeting growing demand for NDIS Allied Health supports but they are a highly mobile segment of the workforce. An over-reliance on these practitioners may undermine your capacity to develop long-term relationships with participants and their family.
4. Word of mouth recommendations
I have never in my life chosen a provider because of an advertisement. My sole source of trusted advice, especially when it comes to Allied Health, is friends and family. Disability communities are often close-knit. We know each other through schools, clubs or online communities. And when the time comes to make a change in our supports, or the supports of our loved ones, that is where we go for advice.
Providers need to consider how to harness the power of word-of-mouth referral to build a customer-base of raving fans. The simplest way is to ask your clients to share your details with anyone they think could benefit from your supports. Some practitioners feel awkward making this request, but in truth participants and families love to support each other and if your services are exceptional, we take great pride in sharing them. Other methods include posting interesting, relevant and entertaining content for clients on social media. When we share it with our friends, it is effectively a third-party endorsement of your brand.
5. Direct relationships
People with disability and their families have a lot of people in their lives – and I’m not talking friends and family. I’m talking support workers, admin/rostering teams, therapists, specialists like neurologists, dietitians and endocrinologists, educators and their support staff. Sometimes it feels like a full-time job requesting, scheduling, confirming, reporting, paying for supports and juggling the various people that perform these tasks. My preference is to work with one person, the therapist, for all of these jobs, or to have them automated. Basically, we want fewer paid people in our lives.
My previous Allied Health provider sent a case-managery-type person to our house to discuss the service agreement. Then another person allocated us our practitioners and yet another was my point of contact to schedule an appointment with the practitioner. This was all before I even met the physio, OT or speechie. I am not even going to speculate how this model could be viable for the provider, but it was certainly a pain in the neck for me. Our new speech pathologist brought the service agreement with her on her first visit to meet Nicky. We filled it out in five minutes and moved on to the more important stuff. If I need an appointment I simply send her a text. The payment is processed directly after the appointment. It is easy for me and I expect it is pretty efficient for the provider too.
Providers need to have the confidence to empower clients and practitioners to autonomously manage their relationship using technology and light touch systems. What is more efficient for you is also less intrusive to participants and their families.
Providers need to be careful not to be lulled into a false sense of security by the deluge of new NDIS participants currently knocking on their doors. Allied Health is by far the fastest growing segment of NDIS providers. Increasingly, we are seeing providers in this space carving out their niche. As participants and their families become more particular about what they are looking for, it will only be providers that make conscious decisions about who they are and how they differentiate themselves that will thrive.