OTA Government and Stakeholder Relations update - May 2023

22 May 2023

The OTA team has been working hard over the past fortnight, lobbying for improvements and driving change to get the best outcome for our members and the clients they work with. Read on for updates on:

• 2023-24 Federal Budget
• Disability
• Regulatory news
• Mental Health
• Aged Care
• Department of Veterans' Affairs
   

2023-24 Federal Budget

The latest federal budget includes more than $700m in spending to address issues with the NDIS and improvements that are expected better manage scheme costs and improve the NDIA. See our summary posted last week here for more information on the budget’s overall impact for OTs.

OTA attended a number of events over budget week and received some excellent insights into the governments planned spending. On Wednesday 10 May OTA attended a Department of Health and Aged Care Stakeholder briefing.  This included presentations from the Hon Mark Butler MP (Minister for Health and Aged Care), Hon Annika Wells MP (Minister for Aged Care), Ged Kearney MP (Assistant Minister for Health and Aged Care), the Hon Emma McBride MP (Assistant Minister for Mental Health and Suicide Prevention) and Senator the Hon Malarndirri McCarthy (Assistant Minister for Indigenous Health). This presentation broadly covered Medicare and Aged Care investments. 

On Thursday 11 May OTA attended the Australian Institute of Policy Science Post Budget briefing which featured addresses from both the Ministers for Health and Aged Care Mark Butler, and Annika Wells.  Both Ministers outlined some of the major spends under both portfolios and the forum saw some interesting comments from Annika Wells about the government’s intention to implement the remaining Age Care Royal Commission recommendations (currently 69 of 140 are underway) in the coming years. She also signalled her intent to work with a broad range of stakeholders on the new Age Care Taskforce that has been announced, and that Labor believes they have ‘turned the corner’ on inaction and underfunding of the aged care sector.

Disability

NDIS Review update

OTA has been engaging strongly with the Independent Review into the NDIS, and had made an initial submission in January 2023, highlighting the key issues that OTs experience working under the scheme that cause stress for OTs and poor outcomes for participants. We included over 20 recommendations for improvements. We also specifically highlighted our concerns about changing public perception of the scheme, due to recent media focus on provider costs and ‘padded bills’, and we recommended a focus of restoring public trust in the scheme if it is to continue to work in the best interests of participants and their carers.

You can read OTA’s submission by clicking here.

We are pleased that key elements of OTA’s submission have been recognised by the NDIS Review team and were picked up in the summary they recently published of what they have heard from stakeholders to date. Some of the key themes they have recognised include:

• The need to reduce red tape
• Better training for planners and Local Area Coordinators.
• NDIA staff and delegates needing to read reports and listen to recommendations from experts and health professionals.
• Providing greater transparency, communication and accountability during the planning process - including giving reasons for decisions
• They also picked up a key call in our submission that 'Staff working within the NDIS should have proper disability training and understand multiple aspects of disabilities.'

You can read more by clicking here.

OTA has also recently advocated for a significant price rise for the therapy supports NDIS item code, in the Annual NDIS Price Review, to better align this price with rising business costs, inflation, and the pressures that clinicians.

We are continuing to engage with the NDIS Review and will be providing further submissions on key elements of the scheme in coming months, alongside direct advocacy with the NDIA and other key decision makers at appropriate times.

MHA policy forum

OTA attended two MHA policy forums, in April and May.  The forum on 11 May featured a workshop with members from the NDIS Review team where some valuable insights were shared into the next steps of the review. The Review will shortly release more issues papers on pricing and payments, alternative commissioning and workforce challenges, upon which OTA will have the opportunity to respond.

Issues in the NDIS/psychosocial space were also flagged for further exploration by the Review including:

• implementing the Psychosocial Disability Recovery Orientated Framework
• codesigning fit for purpose assessment and planning tools/processes 
• reviewing their approach to SIL finding to consider the specific needs of participants with psychosocial disability and ability to have recovery and rehab elements in SIL plans
• support and information for families and carers
• reviewing pricing structures and how they impact on participant outcomes and incentives for good practice (they mentioned specifically in the roles for recovery coaches and other support workforce)
• better ways on working together for NDIA, providers and Mental Health services
• addressing the gap in tier 2 supports.

It was good to see the Review team has heard the calls from the sector, including OTA, for better fit for purpose processes and systems for participants with psychosocial disability, and the need for tier two supports to be considered in the overall picture.

Some of our members who have formed a MHOT community of practice team have also drawn on their deep networks and expertise to develop a submission in consultation with those with lived experience, for the NDIS Independent Review. We look forward to seeing this submission when it is finalised.

OTA will be providing another submission on the NDIS Quality and Safeguarding Framework in consultation with our NDIS NRG which has provided excellent input. We look forward to sharing this with you soon.

Response to public commentary about NDIS providers

OTA is strongly opposed to current commentary that suggests that OTs are not providing the very best service and support to their clients, and concerns that providers “padding their bills”.  We have highlighted our concerns in a letter to Bill Shorten earlier this year, and in our recent response on social media and our website to a story on the ABC AM program last week – read more here.

OTA is fully supportive of a sustainable NDIS and we welcome the government’s commitments to this end but we have consistently raised concerns about the excessive bureaucratic requirements mandated by the NDIA which take funds away from participants' plans and reduces the time available to support participants to achieve their goals. While OTA supports cracking down on fraud, we strongly challenge any suggestions that OTs are not working in the best interests of NDIA clients.

OTA has had some positive comments from the membership in response to this post but we are keen to hear the sentiments in the profession, and welcome feedback to policy@otaus.com.au.

Regulatory news

AHPRA new powers

There have been changes to the Health Practitioner Regulation National Law which came into effect on 15 May 2023, and give AHPRA and National Boards some new powers to take steps to protect the public. The changes will affect both registered and unregistered health practitioners, and include:

Public statements

Allowing AHPRA and National Boards to issue a public statement about a practitioner, if it if necessary to protect the public. This will enable AHPRA and the National Boards with a method to warn the general public about a serious risk from an individual – either a registered health practitioner or a person who does not hold registration but is providing a health service, while they take steps to assess and investigate a matter (for example a complaint). A threshold test will apply and AHPRA has confirmed that the power will only be exercised in extraordinary circumstances where it is reasonably believed to be necessary to warn the general public about a serious risk. Statements can also be withdrawn.

AHPRA has issued some FAQs about the new power and how it may be exercised, including some case study examples. Read more by clicking here.

Disciplining while registration is lapsed

Allow National Boards to take disciplinary action against practitioners who continue to practice or use a protected title after their registration has lapsed.

Information sharing

Allow National Boards to disclose information about a registered or unregistered provider who is the subject of a notification or investigation, to other registered health practitioners with whom the practitioner currently shares premises or to an entity that has a current ‘practice arrangement’ with the practitioner (e.g. employers).

Prohibition orders

Allow a prohibition order issued by a tribunal to impose restrictions on a practitioner’s provision of health services, in addition to the current ability to prohibit the provision of specified health services or the use of a title.

Read a full list of what is changing here.

Independent review of health practitioner regulatory settings

OTA recently made a submission to the Kruk review, which was established to review Australia’s regulatory settings for health professionals and consider ways to help ease health workforce shortages.

OTA’s submission made a number of suggestions to improve the process for internationally qualified OTs to obtain AHPRA registration, to reduce the administrative burden, long wait times and uncertainty for applicants, and recruiting employers.

The review has published an interim report which has recognised the shortage of occupational therapists and proposes a range of changes to make it easier for practitioners to relocate to Australia, including:

• Cutting red tape by removing duplications such as having to submit multiple criminal history checks while speeding up the allocation of Medicare provider numbers
• Removing duplication between regulators and agencies
• Enabling easier recognition of international qualifications from comparable health systems to fast-track some approvals
• Better recognition of overseas health practitioners’ experience and skills,
• Providing greater flexibility in demonstrating English language competency,
• Improving monitoring and publishing data outlining health workforce shortages, distribution and skills to better inform planning and policy
• Removing or suspending labour market testing requirements for employers sponsoring priority health practitioners on certain visas.

A final report is expected later in 2023. OTA will continue to update members as the review progresses. You can read more about the review here.

Mental Health

Victorian mental health and wellbeing - Access Policy and Triage Guidelines

OTA has engaged in multiple workshops facilitated by KPMG, on behalf of the Victorian Department of Health, to support the development of a mental health and wellbeing access policy and triage guidelines. OTA provided feedback about the OTA mental health strategy, specifically focusing on the workforce support and OTA mental health capability framework.  

Suicide Prevention Competency Framework for the health sector

OTA attended a number of workshops facilitated by Suicide Prevention Australia to support the development of the National Suicide Prevention Competency Framework for the health sector. OTA provided feedback and contributed detail regarding OTA mental health capability framework.

State and Territory compensation schemes

OTA has been engaging with and consulting across the states and territories to ensure OTs mental health capabilities are recognised and correctly remunerated. We have been in regular discussions with schemes in South Australia, Queensland and Victoria.

24th Annual International Mental Health Conference 

OTA will be presenting on the Mental Health Strategy, Capability Framework and Endorsement Program at the 24th Annual International Mental Health Conference, 7-9 June 2023 on the Gold Coast. The conference brings together a diverse global community of mental health professionals to share innovations and address challenges facing the sector to improve the quality of mental health care for everyone. 

Aged Care

NACA Roundup

OTA was pleased to attend the National Aged Care Alliance in Melbourne on 18 and 19 May.  Government and Stakeholder Relations General Manager Alissa Fotiades and Chief Occupational Therapist Erin Garner attended Day One where they heard updates from the First Nations and Workforce NACA strategic priority groups and received updates from the Interim Inspector General of Aged Care, Ian Yates on the progress of this new position. 

Day Two was attended by General Manager of Government and Stakeholder Relations Alex Eather and Professional Practice Aged Care Advisor Christina Wyatt.  They heard from the Care Economy Taskforce on their work addressing aged care workforce, reform updates and budget announcements from the Department of Health and Aged Care, details on data quality initiatives within the Aged Care Quality and Safety Commission and work underway by the Independent Hospital and Aged Care Pricing Authority to develop aged care pricing.

Other engagement in the aged care sector

OTA has been engaging heavily in the aged care sector recently as it continues to be an area of reform. Here is an overview:

• The government is proposing some legislative updates to increase reporting responsibilities for providers.  The exposure draft can be found here. OTA provided a response recommending the legislation requires providers to supply information pertaining to therapy services delivered as reflected under Schedule 1 Part 2 of the Quality of Care Principles.  This information is helpful in building a clearer picture of allied health service utilisation and cost in aged care.
• OTA submitted a response to the new standard Psychotropic Medicines in Cognitive Disability or Impairment Clinical Care Standard calling on a stronger focus for non-pharmacological strategies and emphasising the expertise of occupational therapists in delivering interventions that support a non-pharmacological approaches to managing symptoms of cognitive disability or impairment.
• The Department of Health and Aged Care has launched the new Quality Indicators for residential aged care.  From 1 April 2023 six new quality indicators will be included as part of the National Aged Care Mandatory Quality Indicator Program.  Plans to extend these indicators into home based aged care have been put on hold pending ongoing reforms.  OTA attended a webinar launching the new indicators on the 15 May 2023.  You can watch a recording of that webinar here.

Department of Veterans’ Affairs

Review of Veterans’ Compensation Legislation

OTA recently made a submission to the current review of Veterans’ Compensation Legislation. The review is in response to Recommendation 1 of the Interim Report of the Royal Commission into Defence and Veteran Suicide, that government “simplify and harmonise” the three current compensation schemes.

The review proposes to establish a single new Act (based on the current Military Rehabilitation and Compensation Act), which will see all new Defence and DVA compensation claims lodged under the new Act from 1 July 2025. The intent is to make the claims process easier and simpler, without reducing any entitlements. All existing claims would be grandparented (i.e benefits and entitlements would continue to be administered under their existing arrangements, with no reduction or cessation in entitlements).

OTA made a submission supporting changes that will make it simpler and easier for veterans to access their entitlements, and also called for a commitments and specific changes to ensure that occupational therapy supports can be easily accessed under any new legislation. OTA will continue to update members as the review progresses.