Everything about Health and NDIS is about to Change: Outcome of COAG's Meeting

The NDIS and Health services have been in an arm wrestle over who pays for particular supports pretty since much the Scheme’s inception. The tussle was leaving many Participants and their families in a horrible predicament, unsure of where funding for essential supports would be coming from and if they would be funded at all. It has also lead to many high profile cases at the Administrative Appeals Tribunal (AAT). But a curtain seems to have been drawn over all the fighting at last Friday’s meeting of COAG’s Disability Reform Council, with the states and Commonwealth government coming to a landmark agreement on funding responsibilities. As a result, the NDIS will soon be funding a range of new health-related supports.

 

What will the NDIS now be funding?

The NDIS will fund health-related supports if they are a regular part of the Participant’s life and a result of their disability. The examples they list include:

Dysphagia Supports

  • Development of oral eating and drinking care plans (OEDCP)

  • Swallowing therapy associated with dysphagia provided by an allied health professional 

Diabetic Management Supports

  • Development of diabetic management plan

  • Daily maintenance and care associated with diabetic management plan (where participant is unable to self-manage due to their disability)

Continence Supports

  • Catheter changes

  • Cleaning of catheters

  • Consumables

  • Assessments, plans and reviews

Wound and Pressure Care Supports

  • Wound care consumables (e.g. dressings)

  • Lymphoedema machines

  • Lymphoedema garments

Respiratory Supports

  • Tracheostomy changes

  • Tracheostomy clinical management

  • Tracheostomy equipment and consumables

  • Constant Positive Airway Pressure (CPAP) machine and consumables

  • Bi-level Positive Airway Pressure (BiPAP) machine and consumables

  • Air humidifier

  • Portable suction machine

  • Cough assist machine

  • Ventilator

Nutrition Supports

  • Percutaneous Endoscopic Gastrostomy (PEG) and HEN equipment (or similar) and consumables, excluding Food Formula

  • Thickeners and nutritional supplements

  • PEG stoma changes

  • Dietetic consultations

  • Development of nutritional meal plans

  • Development of meal time management plans

Podiatry and Foot Care Supports

  • Podiatry diagnosis and assessment and development of podiatry care plan 

Epilepsy Supports

  • Epilepsy seizure monitoring

  • Epilepsy monitoring through assistive technology

There are some pretty huge wins here for NDIS Participants. Many of these are supports that are essential to keeping people out of hospital and in the community. This agreement, therefore, will have the long-term double benefit of saving taxpayer money and, most importantly, improving the quality of people’s lives.

The above is not an exhaustive list of all health-related disability supports the NDIS will now be funding. The agreement suggests that if a support relates to a person’s disability, is a regular part of their daily life and meets the other reasonable and necessary criteria then it should now be funded by the Scheme.

The agreement also clarifies that if a person’s disability prevents them from self-managing health conditions, then the NDIS will fund these supports. This is in line with past Administrative Appeals Tribunal (AAT) decisions.

 

When will these changes come into effect?

Participants can access these supports through their NDIS Plan from 1 October 2019. So put that date in your calendars!

 

Health conditions that cause impairment

This is not so much a change as a clarification. There has been some confusion about whether people with health conditions that cause significant disability can access the NDIS. The agreement clarifies that the source of the disability does not impact a person’s eligibility.

 

Palliative Care

Palliative care is still listed as a health responsibility. However, the agreement clarifies that the NDIS will still fund supports that assist daily living for people with life ending conditions.

Did the DRC discuss anything else?

Yes! The Council agreed it was a priority to improve the quality of services delivered to children who can no longer live at their family home due to their complex disability support needs. The Council agreed to provide better quality supports to children already living out of home and early interventions to prevent other children needing to leave their family home. No further details have been provided at this stage.

There was also an agreement to implement the Hospital Discharge Delay Action Plan in all states and territories. The Plan aims to reduce the delays to hospital discharge that are occurring because people cannot access disability supports. Hopefully, a timeline for the rollout will be released soon.

The Government re-committed to its election promise to legislate an NDIS Participant Service Guarantee. This is designed to address the long (very, very, very long!) waiting times that people are facing when trying to access NDIS supports. People seeking SDA and assistive technology are said to be the first priority.

The Council also notes the NDIS Act will soon be reviewed. Consultations with people with disability, their families and providers will begin in the second half of 2019.

 

There are some massive wins for NDIS Participants and their families that have come out of this meeting. One can only imagine what a sheer relief it is going to be for people who have been struggling to get funding for essential supports. So go forth and share the news! We need to make sure that all Participants know that from 1 October they will be able to access a whole range of new supports.

You can read more about the DRC meeting here.