July 1, 2019

COAG tackles NDIS health handball

COAG Disability Reform Council has brought common sense to funding some essential health related disability supports.

Funding necessary health related services

The Council of Australian Governments Disability Reform Council agreed on Friday to end some of the frustrating and difficult anomalies in NDIS packages that come from the refusal of the agency to fund many necessary supports and consumables deemed to be ‘health related’ rather than necessities for people with disabilities. The NDIA has declined to provide funding for many consumables and essential services for people with disabilities because they are health related. The NDIS legislation specifies that it will not fund services and supports which are provided by other systems, such as the health system, and that it does not fund medical treatment. The interpretation of this has resulted in many anomalies in funding decisions, and to the agency treating many essential supports as health related even though there is no mechanism for a participant to obtain funding in any other way.

The Council of Australian Governments, where the state and federal governments work out their financial and other legislative arrangements, has set up the COAG Disability Reform Council, to ensure that states and the federal government are working appropriately to make services for people with disability function effectively.
On Friday June 28, the Disability Reform Council met and agreed that the NDIS would fund a range of services not previously included in participant packages, many of which were anomalies in the system and were severe impediments for those who needed them.

Services to be funded include a range of assessments, supports and consumables for dysphagia, epilepsy, respiratory issues and incontinence.  The full list is below.

This is a major outbreak of common sense in how these services are funded, and removes at least some of the unnecessary obstacles to the NDIS actually providing services people with disability need.

Hospital Discharge Delay Action Plan

The Council also addressed the significant issue of people in hospitals who may be eligible for, or actually have NDIS plans but remaining in hospitals because of inability to access services.  The meeting communique states:

“The Council agreed the Hospital Discharge Delay Action Plan that will address NDIS related issues to promote timely discharge of NDIS participants from public hospitals, that Commonwealth and State and Territory agencies will work together to ensure the actions are implemented to the timescale”

Some participants are in the surreal situation of having funded supports in their plan, but they are stuck in hospitals because the supports are simply not avaialable.  Hopefully the action plan focuses on making sure that people actually have the services they need – discharging people who have funding but no services will not solve the problem.

More support for families of children with complex needs.

The Council announced additional focus on assisting families of children with complex needs living out of home:

“All governments committed to collaborating to act in the best interests of children and their families, to provide stable and supported arrangements for children living outside the family home, and effective early intervention support for families so that children are encouraged to live at home where possible.”

It is yet to be seen what this focus produces, but it is encouraging that there is recognition of the needs of families with children who have complex needs.

Additional health services to be funded by the NDIS

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 cathetersConsumables
  • 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