Looming price changes to national disability insurance worry providers

ABC NEWS (Australia)

Heartbreaking devastating and a kick in the guts. That's how providers in Canberra have described looming pricing changes to the national disability insurance scheme. Some practitioners are being forced to reduce their fees while others are staring down yet another year without a price increase. But the change that's proving the most difficult to understand is the drastic slashing of travel claims. A move advocates say will make it harder for people with the most complex needs to get the care they need.

Transcript

00:00This is one of Hayden Trainers rare trips into Canberra to see his team of physiotherapists.

00:10Usually, they come to him.

00:12Yeah, so we actually see Hayden once a week in Boorawa, so we have a physio that goes

00:16there once a week and on the alternate week we have an allied health assistant who goes

00:20out there and that just means, yeah, Laura doesn't have to come in, which I know is really

00:26hard for her.

00:27The now six-year-old was diagnosed with cerebral palsy after having a stroke at just three

00:32months old.

00:33For the last six years, he's been a right haemoplegic and faced struggles every day.

00:39Through therapy, Hayden has learnt to walk, dress himself and make his own breakfast.

00:45I think that he'd be completely crippled without all of this intervention that we've done.

00:50We were lucky enough to get streamlined onto the NDIS early.

00:54But new NDIS pricing for physiotherapy means Hayden's home visits are now in doubt.

01:00I think we're all feeling a bit down, a bit deflated, a bit undervalued at the moment

01:06and having to make lots of decisions, really tough decisions.

01:11The National Disability Insurance Agency reviews costs every year and has been hunting for

01:18savings for some time.

01:20This year, some price limits have been lowered to bring them in line with what Australians

01:25not utilising the scheme pay.

01:28From July 1st, physiotherapy will be capped at $184 per hour, a $10 drop.

01:36Dietitian and podiatrist appointments will be capped at $189, a $5 reduction.

01:43And claims for travel will be cut in half.

01:46Miss Caldo's considering overhauling how her clinic operates.

01:51We have to make a decision whether we continue to see children by travelling but then put our

01:57business at a huge financial risk or whether we say, no, sorry, we can't see these clients

02:03and that's an awful decision to be making.

02:05The thought of Hayden's home visits stopping is hard for his mum Laura to contemplate.

02:11It's devastating honestly, like it's just a real kick in the guts. We already have such

02:16a lack of services.

02:16One, two, three, three, three, three, three, three, three, three, four, three, four, three,

02:20John is five years old. He's very cheeky and he lives with a genetic condition called

02:26spinal muscular atrophy.

02:27It's a disorder that causes progressive muscle wasting and means John needs equipment to move,

02:35eat, even sleep.

02:37Occupational therapist Katerina Senga has picked and fitted every piece, a job that's required

02:44regular visits to John at home.

02:47It's more than critical, it's essential. Without having someone able to come to your house,

02:52your child will miss out.

02:54Occupational therapists are facing a seventh year of price freezing. Combined with the looming

03:00travel cuts, Miss Senga had to let her team of therapy assistants go.

03:05We literally had to make phone calls today and let them go.

03:08She is also considering charging a gap fee for out of clinic visits.

03:13For us, the gap fee would be that 50% that the NDIS has taken away.

03:18It's an extra cost John's mum isn't sure the family can afford.

03:23Having a gap fee would mean either we miss out, we can't afford it, therefore John misses out,

03:29or we would have to then prioritise something else that gets missed in order to pay for it.

03:35The NDIA says the changes to hourly rates are modest and ensure participants are paying prices

03:41that are fair and in line with industry standards.

03:44As for the halving of travel claims, the agency insists that's in direct response to feedback

03:50from participants who told them excessive claiming by therapy providers

03:56was draining their plans faster than expected.

03:59Michael Perusco believes it's time for the scheme's pricing to be done independently.

04:05Like aged care, like health, we think it makes a lot of sense for pricing in the NDIS

04:14to be independent. That ensures that people get the support they need

04:20and providers are compensated for the level of complexity of their work.

04:25He says the longer it takes, the bigger the exodus of providers from the sector.

04:29If that occurs, participants suffer and particularly those with the most complex needs

04:37who need the NDIS the most.

04:38Yes, it will look great to save a few billion dollars, but you're saving it on the back

04:43of the most vulnerable people that can't speak up.

04:45A prospect completely at odds with the scheme's very aim.

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