OT Unplugged: Community of Practice Insights

Keeping Supports Steady: Psychosocial Disability and NDIS Changes   The NDIS is changing quickly and it can be hard to keep up. Many people with disability aren’t seeing the updates, yet the impacts are real. Here's a recap on what’s shifting and how OTs can respond. Psychosocial disability needs steady, long-term support Early intervention matters, but it won’t replace the NDIS for everyone. Many people with psychosocial disability have ongoing, fluctuating needs. They benefit from stable, wraparound supports across home, community, education and work. OTs understand everyday life. We translate goals into routines, coordinate teams and show how supports improve function. Our voice is essential in this debate. The information gap is real Policy moves fast. Participants often hear last. That isn’t co-design. Let’s keep updates simple, timely and accessible so people can make informed choices. What’s turning up in plans Therapists are seeing plans with sharp reductions or odd phasing that block setup and continuity. Example: a five-year plan with only 10 hours of capacity building released in quarter one, then nothing. Without clear reasons or a pathway to adjust, progress stalls. Another risk sits with people who rely on larger core budgets to live independently. If those budgets drop without alternatives, we’ll see more hospital presentations, housing stress and crisis care. Short-term cuts don’t save money if they shift costs elsewhere. Support needs assessments are delayed The Support Needs Assessment is now pushed to mid-2026. Decision rules are unclear in the meantime. Transparency helps everyone plan and keeps decisions accountable. Foundational supports and ‘Thriving Kids’ Early childhood changes sound promising but details are thin. If services outside the NDIS aren’t real, funded and available, families will miss out. OTs know what works for children and caregivers – our practical input should shape any new model. Pricing and the IHAPCA work Consultation feedback shows current pricing often fails to cover the true cost of quality services, especially in regional and remote areas. When prices don’t match delivery, access shrinks and innovation slows. Evidence-based pricing supports equity and a stable workforce. Art and music therapy Their evidence base has been recognised, yet recent price cuts send a poor signal to a highly trained, largely female workforce. When rates fall, participants lose access to skilled, consistent support. Section 10 and housing The transitional Section 10 rule has changed what’s considered mainstream versus reasonable and necessary. In practice, some people are being pushed toward costly home modifications when relocation would be safer, faster and cheaper. Permanent rules should weigh lifetime cost, safety and function – not just categories. What OTs can do right now • Strengthen assessments: Cover permanence, functional capacity and support needs in every report. Use the ICF and make your reasoning easy to follow.•   Log impacts: Track plan changes, delays and risks. Share trends through peer groups to support advocacy.•   Keep participants informed: Use plain-English updates, timelines and checklists for reassessments.•   Plan for continuity: If funding is phased, map what can start now, what needs bridging and what will stall.•   Back the ecosystem: Stand with allied health peers on pricing and access. A strong network helps participants most.    Key takeaways •   Psychosocial disability often needs lifelong, wraparound supports – early intervention alone won’t replace the NDIS.•   People with disability must be included and informed or reforms will miss the mark.•   Current plan structures are creating gaps in setup and continuity, with hidden risks in housing and core supports.•   Pricing should reflect real delivery costs to protect access, quality and workforce stability.

NDIS reform round-up: what OTs need to know now NDIS reforms are moving, but not always in straight lines. Here’s a clear, practice-first update based entirely on the issues raised in your discussion: consultation fatigue, the Evidence Advisory Committee, delays to the planning framework and support needs assessments, what impairment notices might mean, mandatory registration realities, audits in practice and the latest OTA pricing survey. Thriving kids: consultation fatigue, advocacy that still matters Clinics are feeling tapped out after repeated consultations and still-unreleased best practice guidelines. Yet advocacy remains important. A Senate inquiry into Thriving Kids was noted with limited specifics available. Given uncertainty, clinics should plan conservatively – avoid locking in long leases and keep service models flexible over the next two years. Evidence Advisory Committee: who’s on it and how it may work Expressions of interest for the NDIS Evidence Advisory Committee (EAC) have concluded with appointments described as largely academic. Subcommittees include assistive technology and capital, capacity building and therapy and economics. The first public consultation is expected “in the coming weeks”. Open questions remain about how EAC advice intersects with operations on the ground and with the Enduring Supports Rule process. Planning framework: delays, and unclear timing for impairment notices The new planning framework has been pushed back and support needs assessments are delayed. It’s unclear whether impairment notices are also delayed – timing wasn’t confirmed. Takeaway: keep documentation consistent, stay transparent in service agreements and avoid assumptions about start dates. Mandatory registration: what the consultation said and what to expect Consultation outcomes reflected familiar themes: registration costs and admin load, fairness for different provider sizes and locations and continuity of trusted supports. Priority areas flagged elsewhere remain supported independent living, support coordination and platform providers. Large-scale rollout faces capacity constraints – auditors are limited and processing times can already stretch towards a year. Expect staged change with grace periods to signal intent followed by a longer window to complete audits. Audits in practice: costs, process and realistic timelines Audits can be onsite or remote. Providers reported costs for auditor travel and accommodation for certification audits, document sampling across caseloads, client and staff interviews and close scrutiny of policies, records and safeguards. Experiences vary by auditor background and demand and timelines can extend beyond initial expectations. OTA pricing survey: pressure on viability and access From OTA’s recent survey of 600 OTs, key data points discussed were: 14% of providers expect to exit in the short term – estimated as 1,267 practices – potentially affecting up to 17,320 participants 39% don’t expect to remain profitable under current settings, 43% are unsure and 55% reported no profit in 2024–25 79% already have a waitlist; 52% report waits of 12 weeks or more Travel matters: 95% provide some travel, 56% travel daily, 98% say travel reimbursement is important to viability, 51% say it’s critical to deliver assessments and therapy in natural environments 85% exceed travel caps at least some of the time; 29% do so more than 70% of the time If caps remain, 92% plan to reduce travel and outreach, 63% to reduce regional and remote services, 33% to stop home and community visits and 24% to stop taking complex cases OTA’s asks discussed: reverse the travel cut, apply an immediate 7% uplift to OT hourly rates and co-design a fit-for-purpose allied health pricing model that properly accounts for travel, reports and multidisciplinary work. Business reality: profit as safety A modest profit buffer is a safeguard, not a luxury. It’s what allows services to ride policy pivots, delays and compliance costs. Until reforms settle, prefer flexible overheads over long commitments. Document processes now – it pays off later. What to do next Expect staggered change rather than a single switch Keep service agreements clear and documentation tight Model scenarios for travel, outreach and home visits Build a small profit buffer to cushion policy shifts Stay vocal in consultations, even when it feels thankless   https://www.ndiscommission.gov.au/about-us/ndis-commission-reform-hub/mandatory-registration#paragraph-id-107371      https://www.otaus.com.au/news/otas-survey-of-ots-shows-dire-consequences-of-ndis-pricing-decision  

Navigating complaints, compliance and safeguarding in the NDIS Working within the NDIS can be rewarding but it also comes with complex responsibilities. For allied health providers, support coordinators and practice owners, ensuring participant safety isn’t always straightforward. Even when the right steps are taken, reporting concerns can lead to frustrating delays, unexpected consequences and, in the most tragic cases, life-or-death outcomes. This article explores the realities of raising concerns in the NDIS – from understanding who to report to through to the emotional toll of speaking up when systems don’t respond as they should. When reporting doesn’t lead to action Many providers share the same difficult question: what happens when you do the right thing, report an issue, and no one follows up? Some have seen investigations stall until it was too late while others have been disengaged from service arrangements after raising concerns. The reality is that compliance processes can be slow and fragmented and providers who step forward often face unexpected risks. Who is responsible for what? One of the biggest challenges is knowing where to send a complaint. Different issues fall under different bodies: NDIA – for fraud, misuse of funds and suspicious claims NDIS Commission – for provider conduct, safeguarding and quality of care Police and state-based agencies – for criminal, abuse or neglect concerns (for example, the NSW Ageing & Disability Commission or the Office of the Children’s Guardian) Without clear pathways, providers can be left unsure about whether they’ve contacted the right authority and whether action will follow. Real-world impacts of system failures Case examples highlight the human cost of these gaps: Fraud and non-compliance reports going unaddressed Investigations dragging on until after a participant has died OTs and support coordinators being disengaged after raising red flags The heavy emotional toll of holding professional and ethical responsibilities without clear systemic support These stories show why reporting is both necessary and, at times, incredibly difficult. Why some providers hesitate to report It’s no surprise that many providers think twice before submitting a complaint.  The risks can feel personal and professional – from being removed from service arrangements to dealing with prolonged uncertainty to facing an overwhelming administrative burden. Yet not reporting also carries serious consequences. Building safeguards into your own practice The most effective approach is to put clear internal processes in place. This means: Having a set threshold for when a matter requires reporting Documenting everything – case notes, emails and conversations Submitting reports to multiple bodies where appropriate (more is more) Taking the emotion out of decision-making by following established procedures Knowing when and how to escalate concerns further – whether to the media, local MPs or Ministers’ offices – if systems fail to act Key takeaways There is no one-size-fits-all reporting pathway – knowing who to contact is crucial Delayed action can have devastating outcomes including loss of life Reporting can carry risks for providers but silence carries greater risks for participants Internal documentation is essential for accountability and protection Escalation beyond the NDIS is sometimes necessary when urgent risks are ignored If in doubt, report – it’s better to act and be safe than to remain silent Important contacts NDIS Fraud Reporting and Scams Helpline – 1800 650 717 | fraudreporting@ndis.gov.au  NDIS Commission – www.ndiscommission.gov.au  NSW Ageing & Disability Commission – www.ageingdisabilitycommission.nsw.gov.au  Office of the Children’s Guardian – for matters involving children (Each state and territory may have its own equivalent reporting bodies.) Final thoughts Reporting under the NDIS is rarely simple and providers often find themselves caught in grey areas between compliance, safeguarding and professional ethics. But having clear procedures, documenting thoroughly and knowing when and how to escalate can help protect both participants and providers. Above all, the message is clear: if you see something, report it. Even when the system feels slow or unresponsive, speaking up remains a crucial safeguard for the people we support.

In this episode, we dive into two big conversations every occupational therapist, and anyone in the disability space, needs to hear. First, we reflect on the reality of career uncertainty in OT. Whether you're in private practice, working for yourself, or exploring other sectors, we talk about the importance of backup plans, transferable skills, and why it’s okay to reassess your path without guilt or panic. You’ll hear honest reflections on transitioning between roles, recalibrating expectations, and staying grounded while thinking about “what’s next?” From there, we shift gears to the recently released NDIS Ministerial Brief, obtained under Freedom of Information. We unpack: The upcoming Notice of Impairment rollout (and the red flags it’s raising) The move from function-based to support-needs-based planning Concerns around simplified plans and what they might mean for funding The confusion around new support needs assessment tools Pilot plans for navigator roles and early intervention pathways The NDIS’ updated debt recovery approach and examples of flagged claims What OTs and AT suppliers need to know, especially around maintenance claims We also reflect on what these reforms mean for participants, practitioners, and the broader workforce as we all brace for the next wave of change. Tune in to stay informed, feel less alone in the chaos, and share a few laughs along the way. Links & Resources: NDIS Ministerial Brief (PDF) – available in the OT Facebook group file section Debt Recovery Summary on the NDIS website - https://www.ndis.gov.au/about-us/improving-integrity-and-preventing-fraud/recovering-funds-owed-ndia  

This week on OT Unplugged, Sarah, Nikki, and Alyce swap Oodie stories (pandas vs. champagne avocados), laugh about missing wine bottles and Lego office décor, and then get serious about something far less cozy — the way NDIS policy shifts often reach providers first through the media rather than direct communication. In this episode, we explore: The Numbers Game: What the latest NDIS quarterly report reveals — more than 739,000 participants on the scheme and growth well above original forecasts. Children and the Scheme: Why kids under 15 continue to dominate new entrants, and what this means for families with limited alternatives outside the NDIS. Foundational Supports on Shaky Ground: Reports suggest state governments are backing away from foundational supports, leaving families and providers with even more uncertainty. Big Announcements, Little Warning: The upcoming productivity summit and what it signals for future scheme reforms — from eligibility pathways to funding constraints. Diversifying Beyond the NDIS: Why pivoting to Medicare, private, aged care, and DVA isn’t straightforward, and the pitfalls for OTs stepping into new systems without proper guidance. The “Goal” Debate: Do we expect too much from participants to frame their lives in NDIS goals? A candid chat about capacity building, maintaining skills, and what really matters. Plus a few extras: The eternal debate: Oodies, Squiddy hoodies, or dressing gowns? Sarah’s victory in finally evicting a Wallabies jersey from her office (although they did win, apparently). Our upcoming Perth workshops in September with OT Services Group — and an open invite to dinner if you’re local! Links & Resources: Subscribe to the Verve OT Learning Newsletter  for weekly NDIS updates and training opportunities - https://www.verveotlearning.com.au/subscribe  AFR article on foundational supports and state negotiations - https://www.afr.com/politics/federal/ndis-black-hole-risk-as-states-back-away-from-savings-measures-20250815-p5mna7 Intro to Aged Care for OTs webinar resource - https://www.wayforwardot.com/courses