As parents and therapists, Rachelle and Rosanna understand the profound impact that access to healthcare services can have on the development of children. However, navigating the funding options available for allied health services in Australia can often be a complex and overwhelming task. The following blog will outline funding options, including: NDIS, NDIS Early Intervention, Enhanced Primary Care plans (EPC’s), and privately paying for allied health services.
NDIS
NDIS funding refers to financial support provided by the National Disability Insurance Scheme (NDIS), which is a government-funded program in Australia. NDIS funding is allocated to eligible participants based on their individual needs, goals, and circumstances and is intended to cover various supports and services such as Occupational Therapy and Speech Pathology. Other services that a child may access include physiotherapy, psychology and social work services. Referral to the NDIS is appropriate for children aged nine years and older.
Watch this brief video to learn more about ‘What is the NDIS?’
Once funding has been allocated, the NDIS offers participants flexibility in managing their funding through various options. Choosing between these options depends on the individual’s preferences, capacity for financial management, and the level of control they want over their NDIS funds. The options are:
- NDIS self-managed
- NDIS plan-managed
- NDIA-managed
NDIS self-managed
The participant or parent is responsible for paying service providers directly. They keep track of invoices, receipts, and adhere to NDIS guidelines. Self-managed participants have a wide range of choices for service providers, including both NDIS-registered and non-registered service providers.
NDIS plan-managed
A plan manager is appointed by the participant or parent to manage the financial aspects on behalf of the participant. This includes paying invoices, tracking budgets, and ensuring compliance with NDIS rules. Plan-managed participants have a wide range of choices for service providers, including both NDIS-registered and non-registered service providers.
NDIA-managed
The National Disability Insurance Agency (NDIA) directly manages the funds on behalf of the participant, by overseeing the budget management including all financial transactions and paying service providers. NDIA-managed participants may only access NDIS-registered service providers.
BillyLids Therapy is currently able to accept NDIS participants who are self-managed, or plan managed. BillyLids is currently completing the NDIS registration process but until this auditing process is complete we are unable to accept NDIS-managed at this time.
NDIS Early Childhood Early Intervention (ECEI) for children under 7
NDIS early intervention refers to the support and services provided by the National Disability Insurance Scheme (NDIS) to children with developmental delays or disability under the age of 7. From their 7th birthday to aged 9 a child requires a formal diagnosis to access early intervention. From the age of 9, a child with a diagnosis can access the NDIS.
For children under the age of 7, no formal diagnosis is required but children need to show difficulties across two areas to access early intervention. The areas of need include:
Communication: supporting a child’s ability to effectively express themselves, understand others, and engage in meaningful interactions, including: speech development; language skills; Augmentative and Alternative Communication (AAC); social communication, early literacy skills, pragmatic skills, multimodal communication; and parent and caregiver education.
Socialising: interacting with peers, engaging in play, and understanding social cues.
Learning: supporting the development of a child’s thinking and problem-solving abilities.
Self-care: addressing developmental delays or disabilities that may impact a child’s self-care skills, including: personal hygiene; dressing and undressing: toileting skills; feeding and mealtime skills; mobility; sitting and transitioning to different positions; fine and gross motor skills; routine and schedule development; sensory processing; parent and caregiver education.
Early intervention focuses on identifying and addressing the needs of children as early as possible to promote their development and improve long-term outcomes. Watch this brief video to learn more about early childhood early intervention:
Your child, your family and early childhood intervention: Family Perspectives
Referral process
Families, parents and caregivers can self-refer to the NDIS Early Intervention program to initiate the process of accessing supports for their child. The first step is to contact your Local Area Coordinator (LAC).
Access to Early Childhood Early Intervention (ECEI) Services is provided by Local Area Coordinators. LACs play a crucial role in supporting individuals with disabilities and their families or carers in navigating the NDIS and accessing the necessary support and services. The key responsibilities of an NDIS LAC includes:
Information and Referral: providing information about the NDIS, its processes, and available supports, assisting families to determine eligibility for the NDIS and supporting the application process for NDIS access and eligibility assessments.
Access and Eligibility: determining eligibility for the NDIS and supporting the application process for NDIS access and eligibility assessments.
Planning and Goal Setting: collaborating with individuals to develop their NDIS plans by assisting families to identify personal goals and the necessary supports required to achieve them.
Plan Implementation: supporting the implementation of NDIS plans and ensuring that plans align with the individual’s needs and preferences.
Community Engagement: facilitating community partnerships to enhance access to services and opportunities.
Advocacy: advocating on behalf of individuals to ensure their needs and rights are understood and addressed; and assisting to resolve issues or challenges that may arise during the NDIS process.
Review and Feedback: assisting with plan reviews to ensure ongoing relevance and effectiveness; and seeking feedback from individuals and using it to improve the NDIS processes and services.
Cultural Competence: recognising and respecting the cultural diversity and specific needs of individuals and communities; and ensuring that NDIS supports are culturally sensitive and appropriate.
LACs are typically employed by partner organisations contracted by the National Disability Insurance Agency (NDIA), which oversees the NDIS. If your family lives in South East Queensland, you can start the NDIS process for your child by contacting:
Gold Coast : Uniting Care
UnitingCare provides various health and community services, including delivering supports under the National Disability Insurance Scheme (NDIS).
Visit the Uniting Care Online Enquiry form
Uniting Care Phone: 1800-543-354
Visit the Uniting Care Website
Brisbane, Logan City, Redland City, Brisbane City or Moreton Bay regions: Benevolent Society
The Benevolent Society is a not-for-profit organisation, providing a range of community services, including disability support services.
The Benevolent Society online NDIS Early Childhood Approach Referral: (Queensland only): Visit the Benevolent Society Referral Form here
The Benevolent Society Phone: 1800-236-762
Visit the Benevolent Society Website
Medicare – Enhanced Primary Care Plans [EPC]
The Enhanced Primary Care Plan (EPC), also known as the Chronic Disease Management (CDM) Plan, is an initiative in Australia that allows general practitioners (GPs) to coordinate and provide multidisciplinary care for patients. An EPC promotes coordinated care by involving multiple healthcare professionals in the child’s treatment and management. Allied health professionals work in collaboration with the child’s GP and other healthcare providers to ensure a comprehensive and integrated approach to care.
Once your doctor assesses your eligibility, they can establish an EPC plan for your child, granting them access to up to five subsidised visits to allied health practitioners, such as Speech Pathologists and Occupational Therapists, per calendar year. The GP develops the plan in collaboration with the family or caregivers, outlining the specific allied health services deemed beneficial for the child’s health management. All BillyLids therapists have medicare provider numbers and are able to see children with EPCs.
Please note that an EPC is not a ‘referral’ for allied health services. It is a specific medicare form completed by your GP. The rebate is approximately $50.00 and you can claim that through Medicare. At BillyLids Therapy you will be required to pay the full fee at the time of your appointment and claim the rebate from Medicare.
Referral Form for Individual Allied Health Services under Medicare for patients with a chronic medical condition and complex care needs:
Visit the Individual Allied health Services Referral Form
Privately paying
Privately paying for allied health services refers to individuals or families covering the costs of these services directly.
Accessing therapy at BillyLids Therapy
BillyLids Therapy is an allied health private practice with clinics at Nerang on the Gold Coast; and Newmarket in Brisbane. Additionally, our therapists are able to deliver services in the community, including at home, daycares and schools with prior arrangement and school consent. Our allied health services include: Occupational Therapy and Speech Pathology. We are dedicated to helping children under the age of 10 with developmental delays, disorders, and disabilities. Parents are able to self-refer their children to BillyLids services.
BillyLids practices with a family-centred approach and we enjoy collaborating closely with parents, family members and the extended support team. Our clinic is specifically designed to engage young children, recognising the unique needs and dynamics that come with providing therapy services to this age group. We understand that creating an environment that is both welcoming and stimulating is crucial for fostering a positive therapeutic experience. From vibrant and child-friendly decor and design to age-appropriate toys, resources and interactive learning spaces, every aspect of our clinic is carefully curated to make children feel comfortable, safe, and excited about their time here.
Funding options at BillyLids Therapy
BillyLids Therapy is able to accept clients who are: NDIS self-managed, NDIS plan managed, medicare clients who have Enhanced Primary Care plans (EPC), or privately paying families. If you have any questions about funding options for your child, please feel free to contact our team via the contact us button, or call our clinic on 1300-4-BILLY [24559].
Links to further information
NDIS – National Disability Insurance Scheme
NDIS – Early Intervention for children under 7
What is Early Childhood Intervention?
NDIS Early Intervention Approach
How the NDIS works with young children and their families
NDIS Early Intervention Approach
What does the NDIS Early Intervention Approach look like?
NDIS Partners
Medicare – Enhanced Primary Care Plans (EPC)
Information for medical practitioners and allied health professionals providing services to patients with chronic diseases.
Chronic disease individual allied health services Medicare items.
Medicare – Enhanced Primary Care Plan (EPC) referral form
Referral Form for Individual Allied Health Services under Medicare for patients with a chronic medical condition and complex care needs.
