Capacity building is a large part of the NDIS. Capacity building means improving someone’s ability to do more. This includes a wide range of different activities, from gaining more function, learning new skills, reducing the impact of a disability, to improving communication. These new skills are often learnt through various therapies funded through the NDIS, including occupational therapy, physiotherapy, speech pathology, and others.
Responsibilities when writing therapy reports
It is the therapists delivering the therapy for NDIS participants who are tasked with writing outcome/therapy reports, and these are used by the NDIS to determine what, and how much future support should be provided. If an outcome/therapy report is good, the NDIS participant would likely receive the funding requested in the report. However, if an outcome/therapy report is not clear, unfortunately the NDIS participant may miss out on funding.
As outcome/therapy reports are so important for NDIS participants, it is important for therapists to understand their responsibilities when writing them. It is also even more important for therapists to understand what the NDIS is looking for in a good report, and what will get the best outcome for the NDIS participant. This article will explain some of these factors.
- Why the NDIS requires a different approach (looking beyond a diagnosis)
In the past, therapists had to talk about the diagnosis and the disability of their clients, and they were then trusted to provide as much therapy as was allowed by government funding bodies. Things have changed with the NDIS, as every NDIS participant receives individualised funding, meaning the type and amount of therapy they receive can be very different.
In addition, the NDIS cares much less about someone’s disability diagnosis, and more about the functional impact of their disability and the functional benefit they will receive from therapy or assistive technology. As a result of this, therapy/outcome reports need to be very functionality oriented, and not rely purely on medical diagnosis.
- Link to goals
Goals are extremely important in the NDIS. All funding the NDIS participant receives needs to relate to their goals, which means the therapy/outcome reports written must also show clear links between what was recommended, and why it fits with the person’s goals. It is important to remember that every NDIS participant has individual goals, therefore when writing therapy/outcome reports, therapists cannot take the shortcut of having generic goals, as this will not lead to the reports being effective in helping to gain funding for the NDIS participant.
- Reasonable and necessary
Finally, as the NDIS is based upon the principles of reasonable and necessary, as well as value for money, therapists need to ensure that they provide clear justification as to why the NDIS participant needs the therapy and/or support that is being recommended. Reasonable means the therapist is asking for enough of the support, not too little but not too much. Necessary means the support asked for by the therapist has to relate to the person’s disability, and they only need it because they have the specific disability.
- The difference between outputs and outcomes
When writing outcome/therapy reports, it is very important to understand the difference between outputs and outcomes. This is because the NDIS is much more interested in outcomes than simply talking about outputs. Outputs are what you did, which could include things like how many therapy sessions you provided the NDIS participant during the year, what equipment you believe they need, or even the types of therapies you provided them. Outcomes are the result of what you did (or what you’re planning on doing), meaning the result of your outputs.
For example, with a new wheelchair (the output), my NDIS participant will be able to independently access the community with much less paid assistance. If as a therapist, you can link outcomes (both historical and expected future outcomes) to the individual goals of the NDIS participant, then the NDIS will be much more likely to fund the supports you request in your outcome/therapy report. This is because there is a clear link between what you are requesting, and what will happen for the NDIS participant as a result.
- Stay within your competence
Therapists have a high level of knowledge about their chosen profession. This is why the NDIS and the NDIS participant trusts them to use their expertise when writing a therapy/outcome report. Because of this, as therapists it is important to be honest and clear in your writing. In addition, it is important to make sure that what you are recommending is within your circle of competence, which means you do not recommend supports or services you do not fully understand.
For example, a speech pathologist should not be recommending what wheelchair an NDIS participant would require, as the NDIS participant would likely have somebody else better suited to recommend that type of equipment. By sticking with this principle, as therapists you can make sure that your professional opinions in your own discipline carry weight.
- Is the NDIS responsible?
Those writing outcome/therapy reports must understand how the NDIS interfaces with other areas of support available in the community. The NDIS is not solely responsible for providing all types of support to people disability, as other mainstream and community supports have a responsibility as well. Because of this, as a therapist you must understand what the NDIS should and shouldn’t be responsible for funding on behalf of your individual NDIS participant, and make sure you are not asking for funded supports from the NDIS which in reality are the responsibility of another area.
A common example of therapists asking for the wrong type of supports from the NDIS is within mental health. Those with mental health conditions may be able to access the NDIS if they have a psychosocial disability as a result, meaning their functional capacity is reduced, and they require support from others to undergo daily tasks. For example, the NDIS may fund community access for some NDIS participants with mental health conditions, in this hypothetical example it would be needed because the person requires support when they are out in their community (due to anxiety).
However, the NDIS would not and should not fund mental health related counselling and treatment for this person’s anxiety, as this is not related to their psychosocial disability. Instead, this type of treatment is the domain of the mental health system, and should be funded by this system. These boundary issues can be very confusing, which is why the job of a therapist is extremely important but also extremely challenging!
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