Early Intervention for autism - KPMG report - September 2014

The ACT Government engaged KPMG to conduct a program of market soundings, focus groups and research activities to inform options available for transitioning Early Intervention small education groups to the community sector.

Through June and July KPMG:

  • Facilitated an Early Intervention and Therapy Forum with approximately 200 attendees;
  • Interviewed 31 providers;
  • Interviewed 5 peak body organisations;
  • Carried out 14 family focus groups with 64 participants; and
  • Produced reports on best practice in early intervention and advice to Government on transitioning services.

The Early childhood intervention – an overview of best practice report [PDF 600KB]
The Early Intervention Services transition report – Final report summary [PDF 328KB]

*Please note the ACT is committed to improving the accessibility of web content.  To provide feedback or request an accessible version please contact us at ndis@act.gov.au or phone (02) 6207 1086.

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Summary of findings

The market soundings suggest there is significant interest from the market in providing early intervention services in the ACT, tempered by concerns related to the timescale which may prevent some organisations being able to mobilise and establish services.  Providers indicated a preparedness to work with Government to address risks associated with transitioning early intervention services in the ACT, such as community acceptance of new models, access to workforce and impact of NDIS pricing. 

Families generally recounted positive experiences with the existing early intervention services, focussing on the quality of staff and small staff to child ratios.  Parents expressed a clear preference for not for profit providers and high quality experienced staff.  Parents indicated a preference for more flexible hours and collocation and links to education.  Parents also raised concerns regarding the timeframe and confusion about ‘next steps’.

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Considerations

KPMG consider ACT Government can manage the risks identified in the report through:

  • A clear and detailed communication of the Government’s transition plan for services;
  • Procurement or bulk purchasing services involving a robust pre-procurement approach;
  • Encourage providers to add value through integrated service models that build on the existing early intervention services, considering the extent to which this will be accepted;
  • Require providers to demonstrate how they will maintain links with schools and therapy services.
  • Work collaboratively with providers to address risks associated with access to workforce, financial sustainability, links to mainstream and local services, knowledge and experience,
  • A transitional approach to the development of contemporary models within a defined timeframe;
  • Work 1:1 with existing service users through the transition; and
  • Commitment to continue to work with families to co-design services.

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What is early intervention?

Early intervention refers to services that support children with a disability or developmental delay so they can get the best start in life. Such services help optimise the child’s development and ability to participate in family and community life.

Intervening early in the lives of children with a disability or developmental delay can lead to better outcomes for the child, and their families, over the long term.

Children with a disability or developmental delay may be eligible for the National Disability Insurance Scheme (NDIS).

How does the ACT Government deliver early intervention services?

The Education and Training Directorate currently provides small group programs for children with developmental delay or disability and individualised support for children with sensory impairments.

Therapy ACT, which operates as part of the Community Services Directorate, also offers a range of support services including physiotherapy, occupational therapy, speech pathology, social work and psychology, which are provided to people of all ages with delays in development and developmental disabilities.

The ACT Government will transition early intervention group programs to the community sector by the end of December 2014 to ensure there are more options available to families as the NDIS gets up and running.

Therapy ACT services will be transitioned to the community sector by the end of December 2016, but it will continue to provide these services until then.

Why is the ACT Government moving away from the providing early intervention services?

To ensure the success of the NDIS in the ACT, the ACT Government has announced it will gradually transition specialist disability services to the community sector.

Transition of early intervention and therapy services to the community sector will allow participants in the NDIS to have a greater choice of integrated and family-centred support for children with a developmental delay or disability and their families and carers.

All the funding that the Government has provided for these services will flow to families through their NDIS packages, so that they have increased choice and control over the reasonable and necessary services provided by the non government sector.

What does this mean for children in early intervention programs?

In 2014 there will be no changes to programs, and the vast majority of children in early intervention programs in 2014 will transition through normal processes to preschool or school, including specialist schools, in 2015.

From 2015 children with a developmental delay or disability will be able to access new specialist early intervention supports and services through the NDIS, which will be delivered by community organisations.

To help streamline the process, children below school age will be able to transition to the NDIS between July and December 2014 so their plan can be finalised before the start of 2015.

Will children eligible for the NDIS have to go through an assessment process again?

The National Disability Insurance Agency, which administers the NDIS, will use information from assessments provided by Allied Health or medical specialists to help determine eligibility for the scheme and also to plan future supports.

If you have not yet received a letter from Therapy ACT or the National Disability Insurance Agency you can contact the Agency directly on 1800 800 110 or visit one of their two locations:

  • 212 Northbourne Avenue, Braddon
  • One Human Services Gateway, 153 Emu Bank, Belconnen

Will children going to ACT schools still get the same support they are now?

Services within ACT Government schools will not change as a result of the NDIS.

The Education and Training Directorate currently provides additional resources to schools to support children with developmental delays and disabilities access and participate in preschool. This support will continue.

Families of children who are eligible to access the NDIS will meet with a planner to discuss the necessary and reasonable supports that their child requires. Each package will be individualised for each child. All children will be able to access mainstream services such as early childhood education and care, preschool and school.

The government will transition early intervention services to new providers. Will these providers be ready by 2015?

No child currently accessing early intervention services or who requires services will be left without support. All current supports will continue until a participant has an approved plan with the NDIA.

A range of organisations have already expressed an interest in providing early intervention services from 2015, including Northcott, Yooralla, the Cerebral Palsy Alliance and House With No Steps. And a number of organisations have received NDIS Sector Development funding to help develop services such as early intervention.
On 13 September 2014 there will be an Early Intervention and Therapy Expo for people to find out more about who will be offering these types of services and how they can connect with them under the NDIS.

KPMG, a leading advisory service, has also been engaged to talk to families, peak bodies and service providers about what they want early intervention services to look like, and to develop new programs that families will be able to choose. A summary of the KPMG report will be available soon.

What happens if the new market does not meet demand?

The ACT has been given $12.5 million in sector development funding from the Commonwealth Government to help our service providers make the transition from block-funding to an individualised funding model. Service providers have already done a lot of work to assess their preparedness for the NDIS and understand what they need to do to ensure they can deliver the services people will want under the NDIS.

The ACT Government has also allocated $1.4 million of that funding to 40 organisations in the ACT to ensure they get professional assistance to make any changes they need to as a result of the NDIS. Some organisations might use this funding to develop new service offers, overhaul their IT systems or streamline their admin processes. This includes organisations wanting to expand into the early intervention space.

We are already seeing organisations express interest in delivering early intervention and therapy services here in the ACT, and we are working with them to develop services that people will want. Currently more than $2 million is invested in the early intervention programs that the Education and Training Directorate will transition to community providers. Already Northcott, Yooralla, House With No Steps and the Cerebral Palsy Alliance have informed us they would like to offer early intervention services.

The National Disability Insurance Agency is also investing in sector development with the aim of supporting small providers through the NDIS two-year trial period.

The NDIS will mean we will see disability funding double in the ACT over the next few years, to $342 million by 2019-20. The difference in the future will be that the market will need to give prominence to relationships between services and people with disabilities, rather than with government.

What should Therapy ACT clients know about the NDIS?

The NDIS has now commenced in the ACT. NDIS funding will enable reasonable and necessary supports to be purchased by people who are ACT residents and meet the participant eligibility guidelines for Early Intervention or Disability. Some Therapy ACT clients will be eligible to receive funding for supports such as therapy services from the NDIS.

My child doesn’t have a disability – why do I need to know about the NDIS?

The NDIS not only provides funding for people with a diagnosed disability, it also provides early intervention packages for some children with developmental delays in one or more area, such as delays in communication or mobility skills. Information on the eligibility criteria for the NDIS is available on the NDIS website.

Therapy ACT clients who have a developmental delay or disability and who are potentially eligible for the NDIS, will be considered for the scheme according to a predetermined timetable. This timetable identifies which age groups will be transferred to the scheme at which times, which is referred to as phasing. More information about the phasing schedule may be found on the NDIS website.

Therapy ACT clients currently receiving services may receive a letter from the National Disability Insurance Agency (NDIA). If it is their turn to phase into the NDIS, the letter will include an Access Request Form which may be completed by people who would like to be considered for the Scheme. Alternatively clients may choose to initiate contact with the NDIA directly. For more information please visit www.ndis.gov.au/act or call 1800 800 110.

What happens when Therapy ACT current clients enter the NDIS?

Current clients will continue to receive their services from Therapy ACT as planned in the goal setting consultations which are held with clients and their therapist/s.

Therapy ACT clients meeting the eligibility requirements for the NDIS and phasing into the Scheme become “NDIS participants”. Participants will have a Planning Conversation with the NDIA and develop a plan. This plan will identify reasonable and necessary supports for current areas of need.

If Therapy ACT services are among the services identified in the plan these services can continue to be provided by Therapy ACT as Therapy ACT is an NDIS registered service provider.

NDIS participants will be given a participant number which can be shared with Therapy ACT so therapy services can be linked with the participant’s plan.

Some clients will complete their Access Request Forms and/ or meet with the NDIA and find they are not considered to meet the requirements for participation in the NDIS. These clients may continue to receive Therapy ACT services as previously arranged.

What if I (or my child) is on the waiting list at Therapy ACT?

People on Therapy ACT waiting lists and people who are not current Therapy ACT clients may approach the NDIA to arrange a planning conversation. For more information please visit www.ndis.gov.au or call 1800 800 110.

In addition to Therapy ACT, the range of Allied Health service providers in the ACT has begun to grow and will continue to do so. NDIS participants who identify the need for therapy services in their plan will receive assistance from the NDIS to choose a service provider.

How long will Therapy ACT services continue?

Therapy ACT services will continue until December 2016 and over the next two years Therapy ACT will continue to receive referrals as usual. New clients may access therapy services via Drop-In Clinics or by phoning the Therapy ACT Intake line on 6205 1246. Usual service demands and waiting times are expected to apply during this period.

Beyond 2016 some services such as Drop-In Clinics for speech pathology and physiotherapy, intake and referral services and diagnostic assessments will continue to be provided by the ACT Government. However other therapy services currently provided by Therapy ACT will be provided by private and non-government providers.

What will happen to Therapy ACT staff?

Therapy ACT staff are aware of the changes to ACT Government services that are now underway. Staff are receiving assistance to look at options, to plan and prepare for future career moves. It is anticipated some staff will join non-government organisations or private practices and will continue to see clients, including clients who receive funding from the NDIS. Some staff will pursue other government positions, including positions in other Directorates, for example ACT Health, or with the Commonwealth Government, such as taking up positions at the National Disability Insurance Agency.

from http://www.communityservices.act.gov.au/disability_act/national_disability_insurance_scheme/early-intervention