Yesterday, the NDIS officially declared their lists of what participants can and can’t use their funding for. This has been a stressful time for participants and providers alike.
As someone who walked away from a business I loved because of the increasing difficulties of delivering support coordination in the NDIS environment, what I can see is that people in this role are about to become targets once again.
The guidelines around allowable supports have always been a bit hazy, creating confusion and loopholes—which have been taken advantage of by some providers, whether it be through wilful choice, or simply because the rules are open to such a wide spectrum of interpretation. Now, the government has decided they are tidying up the wild west of the NDIS, and they have provided us with some very clear (??) lists that let all of us know what can be purchased with NDIS funds, and what cannot.
This isn’t just a quick tweak. It’s a hard line being drawn on what’s allowed, and it’s going to affect a lot of participants and businesses that have built their services around those grey areas. Unfortunately, support coordinators will be the ones delivering some of the tough news, and it is going to be very hard at times. Many coordinators are already in free-fall burnout in many aspects, and this is just the icing on the cake.
A lot of providers are going to be very unhappy, participants are not only going to be confused, but they are also going to be angry and upset too. If there is an SC involved, they are going to be the one that everyone looks towards for answers.
For a long time now, the NDIS has allowed for a lot of leeway with providers and participants, and no real oversight of how supports are actually delivered. This has allowed us to get to where we are today. Thousands of businesses have jumped on board the NDIS juggernaut. Yesterday's announcement will signify the beginning of the end for some of those businesses and for others they will need to scramble quickly to survive.
Let's go through just a small, random selection of "Not NDIS supports" that I picked to add to my blog.
Gaming Therapy - A lot of participants who otherwise will not engage in the therapy process truly benefit from gaming therapy when it is delivered by an Allied Health Practitioner that understands its purpose and how to deliver it effectively. That is no more, there are no caveats or allowances. It is simply OUT. Gaming therapy is different to gaming groups which come under social and community core funding. They are not affected. According to this list, and my current understanding of the impacts of the "Not NDIS supports list" Gaming therapy cannot be delivered at all, NDIS funds cannot be used to purchase this support. Participants who are using this therapy will need to transition away from it before their current plan ends. SC are going to need to explain that to participants and ensure that the providers who deliver it also understand that a transition period must start as soon as possible, so that the participant is not left without support when their current plan runs out.
Equine Therapy - support when delivered by an accredited Allied Health practitioner who has evidence-based and outcome-based practices in place, should be allowed. However, with one line on the "Not and NDIS support" list, the NDIS has thrown an absolute spanner in the works:
(i) animal therapy, including puppy therapy and goat therapy;
Rather than use the opportunity to clarify what that means EXACTLY. They have chosen to specific two forms of therapy that seemingly incite public outrage and support. Nobody wants their tax money spent on goat therapy, I get that.
Yet they could have worded this exclusion to allow fully qualified and trained equine therapists to continue their important work, give clarity to participants and providers, and placate the public at the same time:
(1) animal therapy that is not delivered by a qualified Allied Health practitioner that is a current member of AHPRA
There NDIS I fixed it for you. Why is this so hard?
Next up is massage therapy that is not delivered by an Allied Health therapist. It is OUT. Not really anything new in the sense of most SCs knowing this was the case anyway, but nobody was stopping this. The proof in that is the sheer amount of massage therapists that are advertising online for NDIS participants and outlining how they will accept NDIS funding. There are float centres that are registered for the NDIS, so the NDIS really needs to clean its own closet very thoroughly before they keep dropping these new rules then expecting everyone else to deal with the fallout.
Massage providers are probably not all over the NDIS legislation and rules and probably are going to be very slow to fully understand that they cannot provide massage services to NDIS participants for much longer. SCs will often be the one having to inform them they will no longer get paid for their services. These conversations aren’t just going to be uncomfortable; they’re going to be really challenging and ongoing. As if the level of burnout for SC isn’t high right now, I feel like it will just get worse.
The fallout is going to be felt by everyone—participants, providers, and the support coordinators stuck in the middle.
I mentor SCs as part of my job, and one of the more common issues that arise is helping many of them understand that their job role does not include training providers (including independents, who are sometimes the worst offenders when it comes to this stuff) about NDIS processes or guidelines, or anything else. Many SC are full of empathy, and some unfortunately, are not aware of the parameters of their role so it can be difficult to help them draw a line and develop some strong boundaries in this area. Then there is this notion across the sector that everyone can; “Just call the SC” and they will fix any problem, if it is NDIS related. This attitude entrenched the very incorrect belief that SC are simultaneously the purveyors of all knowledge, but they are also the reason for all things going wrong. Support Coordinators are going to be squarely in the middle of this and this very correct advice that I give them about their role not including training and business advice to other providers is out the window apparently, because it seems that now SCs will need to help a lot of people on their business practices. And they will cop a lot of grief for it.
Participants are going to be upset, and rightfully so. For many of them, services they’ve depended on for years will now be out of reach, at least through their NDIS funding. They’ll likely feel blindsided, confused, and even betrayed by the system. And unfortunately, some of that frustration is going to land squarely on the shoulders of support coordinators. But here’s where it gets tricky: as a support coordinator, it’s your job to help participants navigate the system, but not at the expense of the rules. You’ve got to find a balance between empathy and clarity, which means sticking to the new guidelines, even when it’s hard.
You can have opinions on the changes, and that is more than natural; I have opinions. I am just trying to stick to reality here. Support Coordinators cannot work based on idealism. Your work needs to be informed by the legislation and guidelines of the job you work in. You should be caring and empathetic, but your job is not to tell people what they want to hear, or to protect them from negative situations, just because you want to feel good about yourself. That is not life.
Support coordinators have always had to juggle a lot of moving parts: the participant’s needs, the NDIS’s rules (however confusing), and the emotional labour of supporting people who are often navigating tough circumstances. But now, the rules are stricter, and your role is going to require a lot more of that difficult but honest communication.
So, how do you manage this? Participants are going to have a lot of questions, and some people may not fully grasp why these changes are happening. It’s your job to understand the changes to the best of your ability and explain things as clearly as possible, without promising things that cannot be delivered. Set boundaries, manage expectations, and be upfront about what can and can’t be done under the new rules. You are not doing anybody any favours by tying to make things look better than they are. Master the art of hard conversations, and how to do them in a way that doesn’t leave room for confusion. It is especially important to be honest with participants who may have been misled by other providers; don’t add to that by avoiding the truth or dressing it up. Honesty and clarity can be done with kindness and empathy.
When you go home at night, park it. This is not your fault; yes you may end up losing a few participants because there are always going to be people around who will promise the world to participants. You cannot win against that, so don't try to. Unfortunately, the people who feel like you are not doing a good job, are the ones who may end up with the dishonest SCs and you need to try and keep that out of your head when you can.
For support coordinators, the best thing you can do is stay up to date on the changes, be ready to understand the nuances and be honest that sometimes the changes are either still unclear, or they don’t make much sense to you either. You don’t have to know everything, but the more you do know, the more you can help to manage the pressure that will undoubtedly fall on you.
Your role is probably going to feel less like one that helps people live a better life, and more like one where you are the captain of a plane during some serious turbulence, unfortunately.
It is important to remember, you’re not the one making the rules—you’re just helping people understand them. SCs are going to find that some people are going to question their knowledge, because they are not going to like what they hear. Some participants and providers are going to ignore you. Some of them will challenge you. Providers in particular who have been delivering supports that are now clearly “out” are going to be stressed out and that might get directed to you.
Keep the new legislation handy. Understand how it applies, and do your best to interpret it correctly, or seek support to do so. In my opinion, there are still some grey areas that are going to be exploited by providers who are trying to work out what to do with themselves.
The reality is that a lot of providers that have relied on the NDIS to fund their services are going to struggle. Many won’t make it. And while this shake-up will cause stress and frustration, some of the changes are needed. You cannot take all of that on your shoulders. Some good people will get caught up in this too. It is lovely to care, but you need to wake up each day and focus on your role and yourself. You cannot take the world's problems on your shoulders alone.
I want to be very clear that I feel the way the NDIS goes about the things they do, is often harmful to everyone involved. I am honestly just a girl from the country who wasted her youth and is now trying to make something of my life in middle age, but every day I see the NDIS release something new into the media I shake my head and wonder how those 30 high paid boffins in the government departments that make these decisions are so....dumb at this.
Be kind to yourself: people might look to you for answers, but you can only give them so much. The NDIS has a responsibility to be crystal clear, that is not your fault. Don't try and be everything to everyone, it is natural and normal, and allowed that you say: "I am also struggling to keep up with how these decisions all work, the NDIS has not been clear on this, and it's really difficult for everyone to follow, I am trying my best to get you the correct information, but right now, everything is a bit chaotic and seems to be changing daily. I am so sorry for how that is affecting you."
What else can you do?