Submission No 26
INQUIRY INTO FOUNDATIONAL AND DISABILITY SUPPORTS AVAILABLE FOR CHILDREN AND YOUNG PEOPLE IN NEW SOUTH WALES
Organisation: Northcott Disability Services Date Received: 24 April 2025
A submission to the Select Committee on Foundational and Disability Supports Available for Children and Young People in New South Wales
By Northcott Disability Services
Northcott Disability Services has a proud 95+ year history as a not-for-profit disability provider. Employing over 3000 staff and supporting over 35,000 people, Northcott operates across ACT, QLD and NSW. Operating as a registered provider and partner in the community, Northcott delivers clinical services, community-based services and programs, housing services and the NDIS early childhood approach.
Challenge: Timeline to deliver meaningful foundational supports
As highlighted in the “Foundational and disability supports available for children and young people in New South Wales” briefing paper, there have been repeated commitments to the ‘phased implementation’ of foundational supports throughout FY25-26, initially focussing on children 0-9 years of age. Whilst Northcott acknowledges of the enormity of system reform at this scale, we would also like to highlight the ongoing stress and anxiety felt by our clients and community throughout this period of change. It is imperative that, whilst phased, the initial roll out of foundational supports is sufficient to be deemed a meaningful level of support for children and families outside of the NDIS. Northcott also acknowledges that at the time of writing this response, April 2025, there is limited time and scope to develop new and robust systems of support for FY25-26.
Solution: Streamline existing services and support to present a cohesive
foundational supports framework
In line with section 4.2.2 (Difficulty navigating complex service systems) of the briefing paper, NSW can use this phased implementation of 0-9 foundational supports to begin repackaging existing services and supports under a streamlined framework of foundational supports. Simplifying the access to existing services, increasing the visibility of existing services and increasing the cohesiveness of existing services allows for the maximisation of existing resources and results in increasing the support received by children and families. This requires limited ramp up, training or hiring of staff. Conducting a state-wide review (if not yet completed) of existing services that fall into ‘general’ or ‘targeted’ foundational supports would allow for a more effective communication strategy to support this roll out. As an example, Northcott is currently an Early Childhood Partner in the Community across 5 service areas in NSW. With over 200 staff delivering “Early Supports” as part of the NDIS Early Childhood Approach, this could be included as a form of ‘targeted’ foundational support. Similarly, services and programs such as NECP, ISP, Brighter Beginnings etc can be pulled under a ‘general’ or ‘targeted’ banner.
Whilst this solution is not sufficient in isolation long-term, it allows time for the “$11.6 million investment over 2 years to develop and implement a foundational supports strategy” to occur.
Streamlining existing services into this model will also present the opportunity to ease the challenges and complexities of navigating multiple systems. It presents an opportunity to develop tech-solutions for single source of truth information (websites, app etc). Whilst this method of information delivery is not accessible or appropriate for all community groups, it will serve a large part of the community and there are other ways to present this simplified pathway of information where necessary.
Similarly, effective implementation of the keyworker model (outlined in more detail below) will allow the families keyworker to be the conveyor of information and have access to the digitised information relating to the new foundational supports offerings within their local community.
Challenge: Workforce shortages
As highlighted in section 5.2, the State of the Disability Sector Report 2024 sounded the alarm on significant workforce challenges within the sector. In short, organisations are turning away people with disability due to insufficient staffing numbers and that is exacerbated by insufficiently trained staff. It is worth noting that disability organisations identified this workforce shortage challenge in the existing environment wherein the vast majority of customers are NDIS participants. With the introduction of foundational supports and supports for all Australian’s with disability, the demand for these skills workers will increase. Despite 81% of responding organisations highlighting, they have had requests for supports they cannot provide, over 50% of organisations were not profitable in the same year. This indicates significant market failure that is not easy to correct.
Solution:
Effective utilisation of existing resources
Whilst workforce shortages coupled with limited financial viability is not fixed via this solution, it is imperative that the existing quality staff organisations do employ are retained throughout this reform and change process. The disability sector cannot afford an exodus of staff to other sectors such as health or education. Through proper consultation with disability organisations, the NSW Government can lead the way in ensuring existing organisations and staff are adequately supported to pivot to meet the needs of the new disability support ecosystem. As an example, Northcott has over 200 highly qualified and trained early childhood staff supporting over 20,000 children at any one time and have a geographic footprint across large parts of NSW with long-term community presence and relationships. Through proper
consultation, Northcott is a strong position to pivot into the foundational support market and ensure continuity of service for children, families and communities.
Robust strategy to embed the keyworker model within early childhood
intervention.
Within the current NDIS-driven market, shortages are largely related to allied health professional (speech pathologists, occupational therapists etc). Whilst these professionals will always play a significant role in early intervention, the NDIS review highlighted the value of the keyworker model, which increases the population group to recruit from. In addition to supporting the workforce challenges present in the market, an effectively implemented keyworker model presents a cost-effective solution to ensure the delivery of best practice early intervention, which is another challenge further discussed in this response.
Challenge: Lack of clarity on commissioning framework
Whilst the briefing paper outlines previous efforts at consultation, both with community and disability organisations, there is still limited clarity on the commissioning framework that will fund foundational support services. This has a significant impact on workforce development and strategic planning.
Solution: Prioritisation of commissioning framework discussions and
decisions.
Northcott acknowledges the challenges of sequencing major reform and planning commissioning frameworks without an understanding of support provision is potentially futile, however would like to stress the importance of this piece of work to ensure business continuity and planning.
Challenge: Ensuring the delivery of early intervention follows best practice
principles.
Northcott acknowledges and agrees with the sentiment outlined in the briefing paper, wherein the conclusion is drawn that the NDIS has contributed to fragmented supports and a negative incentive structure discouraging best practice to increase financial viability. Northcott also recognises and has been heavily involved in the consultation process on the current PRECI led review of best practice in early intervention. It is worth noting, that whilst a best practice review is welcomed, the best practice guidelines published in 2015 are not being adhered to en masse in the community. So, whilst updating guidelines to reflect new information is important, it is imperative that these standards are enforced/incentivised at a systemic and structural level.
Solutions:
Accountability to Outcomes.
Both in the private sector and throughout the implementation of foundational supports, it is imperative that a robust outcome measurement process is introduced. Northcott is conscious of not overburdening individuals and organisations with administrative / regulatory requirements however we feel a shift towards outcomes over outputs is pivotal shift that is needed for the sustainability of the disability support ecosystem.
Dynamic Pricing/Funding.
As outlined in the challenge summary, the current NDIS funding model has resulted in fragmented services and increased the propensity of clinic-based therapy delivery to support financial viability. A way to counter this is through dynamic pricing, recognising that place-based best practice early intervention may be more costly and time consuming for an individual/organisation to deliver (applies to both specialised supports and delivery of foundational supports).
Keyworker Model
Northcott believes the most cost-effective delivery of best practice targeted foundational supports will be through effective implementation of the keyworker model. The principles of the keyworker model (individualised, place based, family centred, needs led & strengths based, family capacity building) closely align with core principles of early intervention best practice and meet the needs outlined in the NDIS review. An effective keyworker model not only provides support to the child in a cost-effective manner, it supports workforce shortages, builds the capacity of parents, carers and kin, empowers key people in the child’s life, occurs in natural settings and ensures integration across multiple services (education for example). A keyworker working under a targeted foundational support model will be required to maintain a working knowledge of other targeted & general foundational support offerings in their local area and can provide connection support to the families they support.
Example: a 4 year old child is identified as appropriate for the targeted foundational support pathway and are assigned a Northcott Keyworker. The keyworker works with the family in natural settings to both establish goals and engage in short term capacity building, resulting in parent/carer capacity building. It is noted throughout support that the parents would benefit from ongoing support and the keyworker connects them with a local triple P parenting program and peer support group. The keyworker ensures consistency of capacity building strategies through childcare upskilling and support.
Challenge: Poor integration between education supports and the NDIS.
Northcott acknowledges and agrees with the challenges outlined within the briefing paper. Northcott works extensively with schools throughout NSW and note ongoing
confusion around funding parameters and responsibility and vastly different experiences in terms of how to work with schools, access to schools etc.
Solution:
Review of APTOS
Whilst the intention and principles are sound, the APTOS has been in effect for nearly a decade and confusion has not abated. It is clear further work needs to be done on clarifying funding responsibilities.
Collaboration with Department of Education
The promise of foundational supports is one of an integrated and inclusive society wherein all people with disability in Australia receive the right support at the right time in the right place. This cannot happen without deep departmental collaboration. There needs to be a clear and effective ‘ways of working’ established between department of education and the disability sector that promotes best practice and collaboration in these environments.
Challenge: The current NDIS approach to early intervention for
developmental delay is not working as intended.
Northcott is the largest early childhood partner in the community in NSW and partially agrees with the position of the briefing paper. Northcott agrees the developmental delay pathway is not functioning as intended however we believe the issue more complex than “partners have prioritised NDIS access requests and planning over their information, linkages and capacity-building role”. Drawing information from point 4.2.1 (lack of accessible supports outside the NDIS) and figure which highlights that 93% of disability support is received through individualised NDIS packages and that Non-NDIS disability contributions at the government level accounted for <$2B whilst NDIS contributions exceeded $29B. As iterated throughout the NDIS review, this has resulted in a black hole effect outside of the NDIS (or, the “only lifeboat in the ocean”). So whilst yes, the developmental delay pathway is not functioning as intended, it is worth noting that partners are not engaging in their linkages role effectively due to a lack of supports to link to, not through de-prioritisation. Similalrly, the capacity building of the partner role occurs through the early supports pathway. Partners receive approximately 17 hours per child to provide early supports, inclusive of travel, resources, professional development, documentation etc. It is simply not funded to the degree it needs to be to be a viable alternative to an individualised NDIS package (the average individual package for a child 0-6 years in 2020 was ~$24,000 which equates to close to 125 hours of support).
Solution
Adequately fund partners to deliver capacity building supports.
Whether this is through the current PITC model or a transition to foundational supports model, it is imperative that capacity building supports are adequately funded. As highlighted above, the developmental delay pathway has not performed as intended and the majority of children are receiving individualised funding packages at an average cost $24,000 (125 hours of support). Northcott believes that with more adequate funding (above the 17 hours now provided), we are equipped to provide cost effective capacity building supports, reducing the reliance on individualised packages.
Rebuilding mainstream and community supports.
This solution is well discussed and one of the primary themes of the NDIS review, but it’s worth stating again that there is no use in funding a “linkage” or “connector” or “navigator” role if there are no services to link people to.
Call to action:
Northcott Disability Services is prepared and eager to work with the NSW Government to support the establishment and implementation of robust foundational supports, offering a particular expertise in the early years space.
The reality is, we NEED to start somewhere. The Northcott early childhood team currently has a significant footprint across NSW, over 200 trained and qualified staff, supporting over 20,000 children between the ages of 0-9. We have the staffing, systems, processes and critical mass of participants to engage in meaningful trials and pilots.
As an example, Northcott is the current early childhood partner in the Hunter New England region (and 4 others). Hunter New England has the highest number of children supported through the NDIS and the partner in the community program. We support the region with ~70 frontline staff, and multiple offices throughout the region. It is unique in the sense it encompasses both metropolitan areas such as Newcastle as well as rural and remote suburbs. This presents a unique opportunity to pilot a foundational supports ecosystem that meets the needs of diverse communities.
Northcott is ready and willing to engage in meaningful discourse, co-design, implementation and evaluation of foundational support solutions that support our communities.
For further information or discussions, please contact
Nic Andrews – Early Years Strategist