OT Unplugged: Community of Practice Insights

About OT Unplugged: Community of Practice Insights

A space for you to connect, reflect and stay up to date on OT practice and the evolving world of the NDIS.

Publisher

Sarah Collison, Nikki Cousins and Alyce Svensk

Category

health & fitness

Language

en

Explicit

No

First episode

15 Feb 2024

Latest episode

1 Oct 2026

Latest episodes

116 episodes in the feed.

1. 

   1 Oct 2026

   S10 Bonus Episode - The NDIS Funding Reset Is Here. Now What?

   The NDIS funding reset is here, and for OTs the implications go well beyond understanding the percentage reductions. There are questions about who will be affected, what happens when funding is reduced and what evidence may now need to be captured. The new Support Determination, High Support Needs safeguard and exclusions for certain supports have practical implications for OT assessment, reporting and service delivery. There is also the challenge of supporting participants and families through changes that may significantly affect their everyday supports. What does the funding reset mean in practice? From 1 October 2026, the funding reset applies to relevant new or reassessed plans, with a 50% reduction in accessible Social, Economic and Community Participation funding and a 10% reduction in Improved Daily Living. This could mean substantially less funding available for community participation and reduced therapy budgets. The changes are relevant across both adult and paediatric practice, including participants accessing Allied Health and community supports. The changes will be introduced progressively, with plan renewals also affected from 1 February 2027 and the reset intended to apply across participant plans by September 2027. What happens when the reduction creates a support gap? The High Support Needs safeguard provides a potential plan variation pathway where the funding reset creates a gap in a participant’s ability to safely receive 24-hour disability supports. Eligibility requires NDIS-funded disability supports across 24 hours and the relevant annual funding threshold to be met. The previously referenced 1:3 support ratio is not a separate eligibility criterion. The pathway does not simply reinstate the Social, Economic and Community Participation funding that has been reduced. Instead, a variation may provide additional Assistance with Daily Life or Home and Living funding to address the resulting gap in 24-hour supports. A significant concern remains for participants who require support across 24 hours but do not currently receive NDIS-funded disability supports across the full 24-hour period. This may include participants whose family members provide substantial support during currently unfunded hours. Which supports are protected from the 50% reset? Not all Social, Economic and Community Participation supports are subject to the 50% reduction. Excluded support subgroups include specialised supported employment, eligible high intensity supports and intensive and complex behaviour supports. For OTs, this makes accurately identifying and evidencing the type of support a participant requires particularly relevant. A participant may have needs consistent with high intensity supports while their existing plan has been built using standard support line items. High intensity support needs may include areas such as epilepsy and seizure support, complex bowel care, dysphagia support, diabetes management, enteral feeding and tracheostomy care. Appropriate evidence of the support required, including relevant management plans, may need to accompany these recommendations. Similarly, having a behaviour support plan does not automatically establish a need for intensive and complex behaviour supports. Functional evidence should clearly demonstrate the behaviours of concern, their impact on safety and wellbeing and the level of support required. Working differently with reduced funding For therapy, a 10% reduction does not necessarily mean simply reducing every service by 10%. Looking at the available funding across the full year may create more flexibility in how intervention is delivered. This could include changing session frequency or length, using blocks of intervention, incorporating telehealth or coaching where appropriate or prioritising particular aspects of a participant’s goals. Any changes still need to reflect the participant’s assessed needs and the potential impact of reduced intervention. There may also be efficiencies to find within OT practice. Streamlining assessment processes, reducing duplication in reports and improving templates may help make better use of available funding without compromising clinical reasoning or the evidence required. When you can’t change the outcome There is also a significant emotional impact for OTs navigating these reforms alongside participants and families. One client example involved achieving a positive outcome through the ART, only for the prospect of the new plan being affected by the funding reset to create another major challenge. This raises the issue of moral injury, particularly when clinicians can see the potential consequences of a system decision but have limited ability to change the outcome. Supervision, psychosocial safety and appropriate support for clinicians become increasingly relevant when OTs are having difficult conversations with participants and families while also managing their own response to changes outside their control. Key takeaways • The funding reset affects both community participation and therapy funding, with changes being introduced progressively • The High Support Needs safeguard may provide a plan variation pathway where the reduction creates a gap in safe 24-hour disability supports • Participants who need 24-hour support but do not receive NDIS-funded disability supports across the full 24 hours remain a significant concern • Some eligible high intensity and intensive and complex behaviour supports are excluded from the 50% reduction • OTs may need to strengthen how high intensity and complex support needs are identified and evidenced within Functional Capacity Assessments • Reduced therapy funding may require different approaches to service delivery and greater efficiency within OT practice • Supervision and psychosocial safety are increasingly relevant as OTs navigate the professional and emotional impact of these changes

2. 

   24 Sept 2026

   S10 E10 - Who Gets Left Out of the NDIS Safeguard?

   From 1 October, new NDIS funding changes will affect how some participants can access funding for social, community and civic participation. The detail OTs have been waiting for around the safeguard for participants with high support needs has now been released. The guidance provides a pathway for some participants whose funding reset leaves them without enough funding to maintain their 24-hour disability supports. But the eligibility criteria create a significant gap: needing 24-hour support is not necessarily enough. The participant must already receive 24-hour funded NDIS supports. Who qualifies as a high support needs participant? To access the new safeguard pathway, participants must meet specific criteria relating to their existing plan funding and support arrangements. The guidance describes a high support needs participant as someone with a relevant total budget of at least $215,000 before the funding reset, who receives 24-hour funded NDIS supports for needs arising directly from their disability and receives those funded supports at a shared ratio of at least 1:3. The wording around funded NDIS supports is particularly significant because it determines who can access the safeguard when their funding is reduced. Required support and funded support are not the same thing A participant may require support 24 hours a day without currently receiving 24 hours of formal NDIS-funded support. Consider someone who cannot safely be left alone but lives with family. Support workers may assist with personal care in the morning, the participant may attend a day program and family may provide support during evenings and overnight. Their disability-related need for support exists across the full 24 hours. The difference is that some of those hours are currently being provided by parents, partners or other informal supports rather than funded through the NDIS. Under the new criteria, this distinction will determine whether the participant has access to the safeguard. The bad news? The above mentioned participants will not. What happens if they don’t meet the criteria? If community participation funding is reduced, participants relying partly on informal supports will find themselves in a difficult position. They won't meet the High Support Needs criteria because they do not currently receive 24-hour funded NDIS supports, even though they cannot safely be left without support. The funding reduction itself also does not necessarily represent a significant and ongoing change in functional capacity, support needs or circumstances that would provide another straightforward pathway to an unscheduled plan reassessment. This leaves an important question about what happens when formal community supports are reduced and family is already providing the support required during the remaining hours. There are no clear answers to this. For eligible participants, what does the safeguard actually provide? The guidance provides an example of a participant whose social and community participation budget reduces from $150,000 to $75,000, leaving insufficient funding to maintain their previous 24-hour support arrangements. Through the safeguard pathway, additional funding may be added to daily living supports to address the resulting support gap at home. However, this does not necessarily restore the participant’s previous level of community participation. Instead, funding may be redirected towards the support required while the participant remains at home. The safeguard therefore addresses a potential gap in 24-hour support, but it does not necessarily replace the community participation opportunities lost through the funding reduction. The variation process could create another support gap Timing creates a separate practical issue for participants who do qualify for the safeguard. Participants have 90 days to request the variation. The Agency then has 21 days to determine whether the participant meets the High Support Needs definition. If they do, they have a further 21 days before a decision is made about varying the plan. This creates the possibility of a gap between reduced funding taking effect and additional daily living funding becoming available. For participants receiving SIL supports through monthly funding periods, this could also create practical difficulties for providers expected to maintain safe support arrangements while the variation is being considered. The importance of early identification of participant criteria Given the above timeframes and high risk to participant safety and well-being, timely provision of reporting to evidence eligibilty for the High Needs Support Safeguard is essential. To aid Occupational Therapists in preparing reporting to address this, we have created an editable template to either insert into their current FCA reporting or provide as an addendum report. Access the framework template here: INSERT LINK Key takeaways for OTs • The High Support Needs safeguard has specific eligibility criteria, including requirements around 24-hour funded NDIS supports • Requiring 24-hour support and receiving 24-hour funded support are not the same thing • Participants relying on family to provide part of their 24-hour support may fall outside the safeguard pathway • For eligible participants, the safeguard may redirect funding towards daily living support rather than restoring previous community participation funding • OT reporting should clearly distinguish actual disability-related support needs from the amount of formal support currently funded • The timing of the variation process may create additional challenges for participants and providers while decisions are being made Links High Support Needs Safeguard Info, released 22rd September 2026: https://www.health.gov.au/resources/publications/ndis-funding-changes-high-support-needs-safeguards?language=en (https://www.health.gov.au/resources/publications/ndis-funding-changes-high-support-needs-safeguards?language=en) High Support Needs Safeguard Info, released 23rd September 2026: https://www.health.gov.au/our-work/ndis-legislation-changes/amendments/funding-changes-for-ndis-supports?language=en&fbclid=IwdGRleAUgLjRwZG9mBWZkaWQWUO88wjK41vlh4a2RhNo7m1ODdX5SmWV4dG4DYWVtAjExAHNydGMGYXBwX2lkCjY2Mjg1NjgzNzkAAR71jgOkSuL5QanyhR8LgE-8ZBblHA27CnQkyxSwU4kKG_E7uzTQhDmeiySy9w_aem_aV9hx-NIV-kXaE_OlzzaEQ (https://www.health.gov.au/our-work/ndis-legislation-changes/amendments/funding-changes-for-ndis-supports?language=en&fbclid=IwdGRleAUgLjRwZG9mBWZkaWQWUO88wjK41vlh4a2RhNo7m1ODdX5SmWV4dG4DYWVtAjExAHNydGMGYXBwX2lkCjY2Mjg1NjgzNzkAAR71jgOkSuL5QanyhR8LgE-8ZBblHA27CnQkyxSwU4kKG_E7uzTQhDmeiySy9w_aem_aV9hx-NIV-kXaE_OlzzaEQ)

3. 

   17 Sept 2026

   S10 E9 - Sliding Doors: The Moments That Shape an OT Career

   Some moments in your OT career stay with you. A decision, a client or even a comment from someone else can change the direction of your career or the way you think about your role. This week, Sarah, Alyce and Nikki share some of their own ‘sliding doors’ moments, from career decisions that changed their direction to clinical experiences that reshaped how they understood their role as OTs. They also unpack recent NDIS developments around students on placement, functional capacity and changes approaching from 1 October. The career decisions that change everything Sometimes a career-defining decision starts with realising it is time to leave. Sarah reflects on the workplace experience that ultimately gave her the push to step away from a role she once thought she would never leave and start Verve OT. Alyce shares turning points of her own, including professional development that challenged the way she thought about clinical intervention and a period away from Occupational Therapy that ultimately led her back to the profession and into building her own practice. Looking back, neither could have known exactly where those decisions would lead. Sometimes it is only years later that you can see how one choice changed the trajectory of your career. When you can’t change the outcome Nikki shares the story of a man with rapidly progressing motor neurone disease who desperately wanted to leave hospital and return home. After considerable work to organise equipment and make his discharge possible, he made it home on a Friday afternoon and died the following day. At first, Nikki felt that everything they had done had made no difference. Her manager helped her see it differently: they could not change the fact that he was dying, but they had changed his experience by helping him spend that final time at home. That moment changed Nikki’s understanding of what making a difference can look like and influenced her later work in palliative and end-of-life care. It also highlights the role good supervision can play in helping OTs process difficult experiences and make sense of what they mean for their practice. The small things can be the big things Not every meaningful OT outcome looks impressive on paper. Nikki shares how one family still considers a simple toilet rail one of the most valuable things she has done for them, despite years of other intervention. Sarah recalls a client telling her that the biggest thing she had provided through a home modification process wasn’t the modification itself. It was hope that life might become easier. These moments are a reminder that OTs don’t always know which part of their work will matter most to someone. Particularly as service systems and funding models change, recognising these smaller wins can help keep the focus on what can make a meaningful difference for the person in front of us. Can you bill for students on placement under the NDIS? New NDIS guidance has raised fresh questions about students on placement. Earlier guidance stated that allied health students could deliver specific supports under supervision but that their work could not be directly claimed because placements were unpaid educational opportunities. The current NDIS guidance says allied health students and provisional psychologists can provide services under the supervision of a qualified allied health provider, with participant agreement. It also says service agreements should outline how the arrangement could provide greater flexibility, such as a lower hourly rate or additional service hours. What remains less clear is exactly how those services should be billed. The wording appears to have shifted again, but there is still enough ambiguity that providers will need to consider how they interpret and apply the guidance in practice. A changing definition of functional capacity A recent SDA matter prompted questions about how the amended definition of functional capacity is already being applied under the NDIS. The definition considers a person’s ability to undertake an activity without assistance from other people or assistive technology, with particular provisions around commonly used AT and assistance for children. This raises questions about what the definition could mean when considering the functional impact of disability. There is still more to unpack about how this will be applied in practice, particularly for OTs completing functional capacity assessments. It is an area to watch as further information becomes available. What’s changing from 1 October? There is plenty for allied health providers to have on their radar as 1 October approaches, including changes to classifications under the Health Professionals and Support Services Award and the upcoming ban on card surcharges. Thriving Kids activity is also expected to begin in New South Wales, although there are still questions around exactly how and when service pathways will roll out. For NDIS providers, there is also uncertainty around upcoming support determinations and what the high needs pathway will look like. With several changes happening at once, OTs and business owners will need to stay across further guidance as it becomes available. Key takeaways • Career-defining moments can come from unexpected decisions, challenges and clinical experiences • Good supervision can help OTs reflect on difficult experiences and shape their future practice • Small interventions can have a significant impact, even when they seem simple from an OT perspective • NDIS guidance around students on placement has changed again, but questions remain about how services can be billed • Changes to the definition of functional capacity may have implications for OTs completing functional capacity assessments • Several changes are approaching from 1 October, including award classifications, card surcharges and NDIS support determinations Links Guide to working as an allied health provider: https://www.ndis.gov.au/providers/working-participants/allied-health-professionals/guide-working-allied-health-provider (https://www.ndis.gov.au/providers/working-participants/allied-health-professionals/guide-working-allied-health-provider)

Reach and audience

Public platform figures. Ratings count people who left a rating, not total listeners.

Spotify

4.9 / 5

49 ratings

Podcast Authority Score: 51 / 100

A composite of feed quality, social presence, YouTube performance and engagement. Read the methodology.

Quality

68

Social presence

0

YouTube

0

Engagement

82

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