Australian Government - Department of Health - Office of Hearing Services
Hearing Services Program

Hearing Services Program NDIS Transition Plan

This document is a high level transition plan for the Department of Health and partner agencies responsible for supporting the transition of eligible hearing service clients to the National Disability Insurance Scheme (NDIS).

February 2016

Executive Summary

The purpose of this transition plan is to identify and describe the activities, dependencies and timeframes, that need to take place to effectively support the transition of eligible Hearing Services’ clients from the Hearing Services Program (the Program) to the National Disability Insurance Scheme (NDIS) by mid-2019.

As an interim approach, NDIS participants with supports for hearing loss identified in their plan will be referred to the Program to receive hearing services. These Program clients, and the associated funding, will transition to the NDIS by 2019-20.

This transition plan identifies the key objectives and the proposed strategies to ensure a smooth transition. The plan also identifies the roles and responsibilities between Department of Health (Health), Department of Social Services (DSS) and the National Disability Insurance Agency (NDIA).

The transition plan identifies the different stakeholders who are involved in the transition.

The scope of this transition plan includes identifying and implementing the activities that will enable

  • Program clients who will be eligible to move across to the NDIS to receive services,
  • Program clients who will not be eligible to move to the NDIS and how the Program will continue to support those clients e.g. clients over 65 years of age, and
  • Clarify responsibilities of stakeholder agencies for ensuring a successful transition.

Eleven (11) critical work-packages have been identified and validated with stakeholders as needing to be completed to ensure a successful transition. This Plan is a blueprint for identifying the broad actions required to complete the 11 work packages. It is expected that the plan will be refined over time.

Integrated transition blueprint

WP1

NDIS access

WP2

Paediatric

WP3

Quality and safeguards

WP4

Engagement and communication

WP5

Pricing of Services

 

WP6

Assistive hearing technology

 

WP7

Rural and remote access

WP8

Roles and boundaries

WP9

New arrangements for the Hearing Services Program

WP10

Legislation

WP11

Governance and risk monitoring

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Contents

Strategic Context

Hearing Services

As part of the introduction of the National Disability Insurance Scheme (NDIS) in 2013, the Australian Government agreed to transition existing Commonwealth programmes that provide support to people with disability to the NDIS. One of these programmes is the Australian Government Hearing Services Program (the Program), which will be transitioned in part to the NDIS by 2019-20.

This means that a portion of clients under 65 years of age currently receiving services through the Voucher Scheme or the Community Service Obligations (CSO) component of the Program will transfer to the NDIS.

The National Disability Insurance Scheme

The NDIS is a new, insurance based system of funding individually tailored support for people with disability.

This represents a significant change for individuals, providing them with control to choose the services that support their goals and providing them with a choice of provider in most situations (noting that support for participant outcomes is the primary consideration). It will also be a significant change for service providers currently receiving block funding who may need to change to a competitive fee for service market.

The transition of eligible hearing services clients will be a complex process which will need to be worked through in consultation with stakeholders.

Benefits of the NDIS

The NDIS will allow clients to have a smoother, more consistent disability support experience that is developed around their needs. This will see improved outcomes for people with hearing loss, through a holistic approach to care. The NDIS will allow the provision of government funded hearing services to more people.

Greater contestability for services will promote market efficiencies and supports innovation for service providers. The NDIS will allow service providers to capitalise on economies of scale, in particular where providers may choose to offer a coordinated delivery model to support a participant’s communication needs (e.g. hearing rehabilitation, assistive hearing technology, and speech therapy).

Transition design

Partners and stakeholders have had the opportunity to provide early input to the transition design process to ensure that those elements of the current system that work well for stakeholders are identified and not lost. The transition of eligible clients is a complex process with many moving parts, and it involves multiple Commonwealth agencies. A clear, early transition plan will minimise unintended consequences, including impacts on clients.

Collective effort

The transition process is based on a partnership approach with Health (as represented by the Office of Hearing Services), DSS (as the Commonwealth’s lead on NDIS policy and funding matters) and the NDIA (as the agency responsible for the operation of the NDIS). There is a complex set of decisions to be made that require multi-agency and sector input. There are many dependencies between decisions and areas of work. Clients should be encouraged to access the NDIS as it rolls out nationally to avoid any loss of services.

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Who is involved and how?

Stakeholder How they are involved
Program clients eligible for the NDIS Until the NDIS reaches full roll out the usual arrangements for the Voucher Scheme and the Community Service Obligations component of the Hearing Services Program will apply. At full roll out clients will generally have the option to choose a provider, or continue to receive services from their current provider. Clients may also be able to receive a broader range of benefits that they did not receive before based on an individualised plan.
Parents and carers of Program clients who can access the NDIS Parents and carers will need to become familiar with the new individualised planning and funding approach to hearing services under the NDIS.
Existing Program clients, including parents and carers who cannot access the NDIS because they do not meet the threshold for permanent hearing loss as a single disability These clients will continue to receive hearing services through the Program.
Existing and potential future CSO clients who do not have a permanent hearing loss (e.g. monitoring of children with transient hearing loss due to chronic ear infections) Responsibility for providing services to clients who do not have permanent hearing loss needs to be reviewed.
Service Providers who are currently unable to deliver CSO services Service providers will need to consider their capacity to deliver services to new client groups. Service providers do not currently need to register with the NDIA, unless they wish to provide services in addition to those available under the Program.
Future potential Hearing Services Program clients under 65 years who cannot access the NDIS. Access to the Hearing Services Program for people under 65 years who do not qualify for the NDIS will need to be reviewed.
Practitioner Professional Bodies (PPB), representing audiologists and audiometrists The PPBs will need to identify the scope for, and their role in, supporting the practitioner workforce.
Disability and hearing loss advocacy groups These groups need to have the capacity and capability to engage in consultation processes and represent the views of their membership (noting that many rely on voluntary support).
Organisations delivering services to rural and remote clients New models of service delivery may be required to ensure that there is no reduction in access to services.
Department of Health (Office of Hearing Services) Health will be responsible for leading on a range of transition work in addition to ensuring ongoing operational requirements for the Program.
Department of Social Services (DSS) DSS has lead policy responsibility to ensure there are no barriers to a successful transition.
National Disability Insurance Agency NDIA will be responsible for leading on several time-critical work packages while balancing other priorities.
Department of Human Services (DHS) DHS is responsible for providing input to aspects of changes required to the legislation governing Australian Hearing to allow delivery of hearing services via the NDIS.
Australian Hearing (AH) AH will operate in a more contestable environment for hearing services funded by the NDIS.
Service Providers of private clients Service Providers will need to ensure that their business model supports the potential change to their client base, as a portion of private clients are expected to be able to access the NDIS.

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Transition Goals and objectives

Goals

The goals of the NDIS transition plan are to ensure that

  • Program clients eligible for the NDIS are transferred without any disadvantage in terms of access to support to manage their hearing loss,
  • Existing clients of the Program continue to receive services, where they are not eligible for the NDIS, and
  • The Program continues to be efficient and sustainable.

Objectives

The six objectives define a set of supporting actions to ensure that these broader goals are accomplished. Together these objectives define the key steps to a successful transition.

1.        Deliver the benefits of the NDIS for NDIS participants

Program clients eligible to move to the NDIS are able to choose reasonable and necessary supports that suit their individual goals and preferences, and the provider of those supports where there is more than one option.

2.        Continuity of hearing services

Ensure continuity of services for Program clients, whether they stay in the Program or transfer to the NDIS. This will be achieved by ensuring

  • Service Providers are in a good position to provide consistent and regular services,
  • No current Program clients fall through the gaps in the transition process, and
  • There are clear options and no confusion about what clients need to do to continue to access services.

3.        Ensure quality and timeliness of hearing services are maintained

Confidence in the quality of services is maintained. Decisions are made regarding contestability and are based on evidence around market readiness. The sector takes responsibility for practice and clinical standards for service delivery as part of a strengthened service delivery framework for hearing services. The Practitioner Professional Bodies are supported to take a more effective national role. There is agreement on the scope of practice for clinicians. Service Providers are informed and supported with material to inform their clients. Newborn infants with hearing loss continue to access early treatment.

4.        Stakeholders are engaged and understand what is happening and are supported throughout transition

Stakeholders are engaged and kept informed throughout the transition process. Communication is clear and consistent from all relevant agencies. Clients and stakeholders know what is happening, when it is happening and what they need to do. Clients know where to go for help or questions and feel supported when they have concerns. They have clarity of where and who delivers services.

5.        Cooperative and strong partnerships with key implementers

Health, NDIA and DSS form a strong partnership and are clear about their roles, responsibilities and accountabilities. Agencies share common goals and understanding of the transition process. Matching policy to practice is driving consistency during transition.

6.        Strong and willing participation in Transition Planning

The transition to the NDIS is planned through genuine and meaningful consultation that allows all stakeholders to participate in transition planning with confidence. Feedback is integrated into the transition process so that people accessing the NDIS can shape their future experience. The transition plan incorporates a rich understanding of the possible impacts of the transition on the hearing services system. Clients feel comfortable to access the NDIS, in order to access hearing services and their access is supported and managed.

There is effective monitoring, governance and oversight, and clear communication with stakeholders.

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Overview of work-packages to transition Program clients to the NDIS

Work-package 1: NDIS access (eligibility)

Who will be eligible for the NDIS and who will be eligible for support under the Program?

This work package is about defining clearly what the eligibility criteria are for clients, including CSO clients up to 7 years of age (early intervention criteria) and those aged 7 to under 65 years.

Work-package 2: Paediatric referral pathway and data collection

What assurance is there that the responsive referral pathway, as it is now, will continue? How will the collection of national clinical data be retained?

It is important that the effectiveness of the referral pathway is preserved.  A system will need to be developed to ensure registered providers of paediatric services have (and maintain) appropriate skills, objective trusted information is available for parents and there are no roadblocks to ensure speedy referral or access to services. If Australian Hearing is no longer the sole provider for hearing services for younger children, clinical data on this cohort will become fragmented.  This work package is to consider national collection strategies and management of data.

Work-package 3: Quality, safeguards and client outcomes

How can we ensure that the services that clients receive are high quality and provided by practitioners with appropriate experience?

This package is about assurance for stakeholders that Program outcomes are maintained in the transfer to the NDIS, and there is an appropriate ongoing measurement of client outcomes, in particular for CSO client groups. It also includes the level of service standards, workforce training and expertise. This could be through, for example, a service delivery framework for hearing services including client outcomes to be achieved, systems and processes to support the identified outcomes and standards for required competencies and ongoing maintenance of expertise of hearing practitioners (audiologists and audiometrists).

Work-package 4: Engagement and communication strategy

How will stakeholders be kept informed and engaged to continue engagement?

The communication strategy will outline how Health will engage stakeholders and provide them with information about the transition of Program clients to the NDIS. It will ensure that stakeholders are aware of the transition process and how it will impact them, including what their responsibilities are. Stakeholders’ issues and concerns will be identified to be incorporated into the transition planning.

Work-package 5: Pricing of services and funding transfer

How much will service providers be paid for hearing services under NDIS? How will the change from block funding for CSO to fee for service be managed?

The pricing model needs to be carefully developed to ensure equity of payment for \ comparable services delivered under the NDIS and the Hearing Services Program, where appropriate, and ensure no market instability or distortion through Government funding.

The interim arrangement for referral of NDIS participants to the Program for services will cease by 2019-20, at which time funding for NDIS participants who will no longer be eligible for the Program will transfer to the NDIS. The transfer of funds from the Program to the NDIS will depend on clear eligibility criteria which can be applied to Hearing Services Program clients and modelling of services delivered to those clients.

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Work-package 6: Supply of assistive hearing technology (AHT)

How will devices be supplied in a way which supports the sustainability of the NDIS while also providing client choice of an appropriate range of hearing devices? What hearing supports will be available under NDIS? How will NDIS clients get access to new devices or upgrades to existing technology?

This work package considers how hearing devices (hearing aids, processors for implantable devices and alternative listening devices) will be supplied in a cost effective manner to NDIS and Hearing Services Program clients, including funding of devices as technology improves.

The hearing related supports that will be funded under the NDIS need to be evidence based, including the need to replace existing supports as new technology or new models of existing technology become available. Guidance for NDIS planners will be important to find the right balance between an individualised approach through the NDIA and consistency of supports and services.

Work-package 7: Rural and remote access

What arrangements will be put in place to ensure that NDIS clients in rural and remote areas have access to hearing services and that these are delivered to a nationally consistent standard?

This package involves developing strategies to ensure that rural and remote clients do not lose access to hearing services during the transition process. This work will be informed by the experience in rural and remote NDIS trial sites.

Work-package 8: Roles and boundaries

What are the roles and responsibilities of State/Territory governments and Commonwealth agencies, for example broader hearing loss education?

Current arrangements for CSO funding supports broader hearing loss education, prevention, monitoring and school based liaison activities delivered by Australian Hearing. Clarification of roles and boundaries will be required to cover the end to end process for hearing services: education, screening, prevention, monitoring, diagnosis and assessment/rehabilitation.

Work-package 9: New arrangements for the Program

What will happen to those Program clients that will not get services through the NDIS?

It will be necessary to review the arrangements for the Program to ensure continuity of services for existing clients under 65 years who are not eligible for the NDIS. There is also an opportunity to improve the current system, including leveraging the arrangements used by the NDIA to deliver the NDIS.

Work-package 10: Legislation changes

What legislation amendments will be necessary to support transition?

Two primary Acts and a range of subordinate legislation will need to be changed to support the transfer of clients to the NDIS and to allow Australian Hearing to deliver services to NDIS clients (who are not Program clients). The continued need for a Memorandum of Agreement between the Office of Hearing Services and Australian Hearing will be reviewed.

Work-package 11: Governance and monitoring emerging risks

The transition of clients to the NDIS requires action from multiple government agencies. To ensure that the transition is smooth and consistent for clients, service providers and other stakeholders, responsibilities and ongoing communication between agencies need to be clear. This includes leadership, support and oversight, management of risk and continued engagement and focus on the Program.

The Department of Social Services (DSS) has established a Hearing Services-NDIS Transition Governance Group (Governance Group) with representatives from DSS, Office of Hearing Services (Health), the NDIA and the Department of Human Services (DHS). The Governance Group will facilitate decision making where this is necessary to ensure that there is no slippage to key transition milestones. The Governance Group will brief respective Ministers and their offices and keep them informed at key stages of transition.

The Governance Group is responsible for leading, developing and implementing the NDIS Transition Plan. This includes the required arrangements for decision making and accountability.

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Transition Dependencies and Priorities

The work-packages will be delivered mindful of a number of dependencies

  1. Key decisions by DSS and NDIA regarding NDIS implementation. Most of the-work-packages are dependent on key decisions by DSS and or NDIA, in consultation with Health.
  2. Integrated picture of transition across each work-package to ensure the end to end user experience will work. Users include clients and families, service providers, NDIA planners, and other key actors in the service delivery of hearing services and NDIS.

The key priorities for transition of Program clients to the NDIS are mapped in the implementation timeline.

Accountability, Responsibility and Timelines

Each work-package has clear accountability and responsibility as follows

Work Package Lead responsibility Input Indicative timeframes
  1. NDIS access (eligibility)
NDIA Health, DSS First half 2016
  1. Paediatric referral pathway and data collection
NDIA with advice from expert referral group Health, DSS First half 2016
  1. NDIS Quality, Safeguards and client outcomes, as underpinned by sector driven improvements and standards for hearing services

DSS

Key Sector Stakeholders[1]

Health

Health, NDIA

Ongoing to 2019-20

Industry endorsed certification scheme in place by
2019-20

 

  1. Engagement and communication
Joint Health/NDIA/DSS   Ongoing
  1. Pricing of services and funding transfer
Joint Health / NDIA   Review of hearing services and items 2016
  1. Supply of assistive hearing technology (AHT)
Joint Health / NDIA   Consultation in 2016-2017
  1. Rural and Remote Access
Joint Health/NDIA   2017-2019
  1. Roles and boundaries
Health NDIA, DSS 2017-2018
  1. New Arrangements for the Program, including IT and processes
Health DHS as required on aspects of Australian Hearing legislation 2016 - 2017
  1. Legislation changes
Health DHS as required on aspects of Australian Hearing legislation 2017-2018
  1. Governance and monitoring emerging risks
Joint Health/DSS/NDIA/DHS   Ongoing

The design and delivery of each work-package is a sequenced, and in parts overlapping, series of activities. The order and phasing of work packages and milestones has been mapped on the Implementation timeline. It is expected that this blueprint for implementation activities will be refined as further detail is clarified.

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[1] As represented by hearing service providers, the clinical workforce, hearing loss advocacy groups, relevant research bodies and higher education institutions offering recognised programs for audiologists and audiometrists.

 

NDIS Transition Plan (PDF 170 KB)

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