Secretariat Joint Standing Committee on the NDIS Parliament House Canberra ACT 2600

Dear Committee Members

I am writing to discuss the continuity of the PlayConnect Playgroup program. PlayConnect is a supported playgroup for children under five with Autism Spectrum Disorder, developmental delays or behavioral concerns and their families. The program is delivered by Playgroup Australia and our State and Territory Organisations in every jurisdiction.

PlayConnect provides a critical support to parents who often feel overwhelmed and lost in both responding to their child’s challenging behaviours and commencing a parenting journey that is not what they expected. They typically have no previous experience with the special needs system for young children and are not aware what options may be available to them.

The PlayConnect program delivers a three-tiered service model. It provides:

Safe, supported and appropriate play experiences and peer engagement opportunities for children within the target group;
A forum for parents, siblings and other caregivers to foster supportive social relationships with others who share similar experiences;
Access and connection to relevant information, community linkages and referrals.

Together these service elements bridge existing gaps within the disability sector and provides a critical support to vulnerable families. Children do not require a diagnosis to join PlayConnect and many commence playgroup aged around 18 months, well before a diagnosis, or access to any formal supports, is likely. They typically remain part of the playgroup until they commence school or other early childhood education. The program is provided as a free service to families and has been for many years. You can find more information about PlayConnect in the attached background documents.

PlayConnect is both a precursor to and compliments the services currently provided by the NDIS Early Childhood Early Intervention (ECEI) services. Many PlayConnect groups work collaboratively with their local partner organisation to support families while they await NDIS assessment and to identify families outside of the remit of the ECEI. In these instances, PlayConnect provides ongoing support for families deemed ineligible for an NDIS plan or otherwise outside of the NDIS system, bridging this vital gap. Typically, 60-70% of children participating in PlayConnect are without an NDIS plan.

Level 7, Wotso Building ABN 31 142 795 695 w playgroupaustralia.org.au 490 Northbourne Avenue t 02 6103 0173 Dickson ACT 2602

Playgroup Australia is funded by the Australian Government Department of Social Services. Visit www.dss.gov.au for more information.

PlayConnect also supports families with NDIS funding through social and community support, family capacity building, and peer-group learning and support. These outcomes are not typically funded within NDIS early intervention plans, which focus on individual therapy.

Playgroup Australia has been contracted by the Government to deliver PlayConnect through our state and territory playgroup organisations for over a decade. This contract was extended in March 2019, just prior to the announcement of the May election. At the time, the government indicated its intention to work with us to determine the most appropriate ongoing funding stream for PlayConnect.

We have continued to meet with both the Department of Social Services and the NDIA since this time to explore options for PlayConnect. Disappointingly, it has become apparent that PlayConnect does not fit within the current ILC funding streams and as such we are unable to submit an application for PlayConnect through these streams.

To summarise, as I’m sure you know, there are three funding streams:

The Individual Capacity Building stream. This is aimed at funding programs delivered by people with disability and their families for people with disability and their families. Playgroup Australia was not established as a Disability Peoples or Families organisation and it is therefore not appropriate for us to apply under this stream. In addition, the funding limits would not allow us to make an application for our current funding ($1.3m).
The Employment and Community access stream. This stream focusses on achieving employment and inclusion outcomes. As a playgroup for a specific cohort of families, PlayConnect does not meet the guidelines for this stream.
Mainstream capacity building. This stream is focussed on health services, again PlayConnect does not meet the required criteria.

We have identified the possibility of direct procurement as an alternative source of funding. The Strengthening Information, Linkages and Capacity Building (ILC) National Strategy towards 2022, released in December 2018, identifies an intention to refocus the ILC program including a refocus from ‘sole reliance on open and competitive grants’ to ‘a mix of funding models including targeted grants and procurement’. However, advice from NDIA officials is that there is no intention to implement alternative procurement in the near term.

Funding for PlayConnect ends on 30 June 2020. This program currently provides support to more than 400 children and their families, with clear indicators that, subject to funding, the program could grow significantly to support more vulnerable families. An end to funding will result in the discontinuation of this vital the program and create a significant gap for families with young children with ASD, developmental delays or behavioral concerns.

We welcome the opportunity to meet with you to discuss the future of this vital program moving forward. We also invite you to arrange to visit a PlayConnect group to better understand its important role.

Yours sincerely

Fiona May CEO Playgroup Australia 11 October 2019

Snapshot Report and Funding Considerations (October 2019)

Introduction

PlayConnect is a facilitated playgroup for families of children with Autism Spectrum Disorders (ASD), developmental delays or behavioural concerns. The PlayConnect program provides a supported space for children with ASD, developmental delays or behavioural concerns and their families to engage in developmentally appropriate peer-group play. These children often miss out on mainstream opportunities for peer-engagement, making the service provided by PlayConnect vital. However, PlayConnect is inherently more than this. The program is a whole family support that provides:

Safe, supported and appropriate play experiences and peer engagement opportunities for children within the target group;
A forum for parents, siblings and other caregivers to foster supportive social relationships with others who share similar experiences;
Access and connection to relevant information, community linkages and referrals.

PlayConnect is delivered by Playgroup Australia and is provided as a free service to families nationwide. The program sees the delivery of 42 PlayConnect playgroups across the country. These groups provide services to in excess of 414 children with ASD, developmental delays or behavioural concerns and their families on a weekly basis. This is almost triple the contractual obligations of the program and demonstrates both value for money and the importance of the program to participants.

This report summarises the most recent data on PlayConnect and explores pathways for future funding.

Background

The PlayConnect program

PlayConnect playgroups include the delivery of 42 groups nationally. Groups are delivered in all states and territories, across 18 metropolitan and 24 regional sites. The program caters for children from infancy to school-age (1-6 years) and their extended family units. Families typically begin attending PlayConnect when their child is between 18 months and 2 years of age, prior to entering into any formal diagnostic process, and continue to participate for approximately 2 years, before transitioning into formal education.

Most recent reporting data shows, between January and June 2019, the program was providing services to 414 children with ASD, developmental delays or behavioural concerns and supporting over 400 families and in excess of 120 siblings across the country. During this period, PlayConnect Playgroups were attended by 135 Culturally and Linguistically Diverse and 33 Indigenous families.

Of the 414 children participating in the program, 223 (54%) have a confirmed ASD diagnosis. The remaining 191 (46%) children are either undertaking assessment or have been found to not meet diagnostic criteria.

Only 152 children (37%) participating the PlayConnect program have an NDIS plan. The remaining 262 children (63%) are currently without NDIS funding support, either ineligible or awaiting assessment. Reporting figures from 2018 showed, at that time, only 30% of children participating PlayConnect had an NDIS plan. The slight increase reflects both the ongoing NDIS rollout as well as the progression of children within the PlayConnect network. However, it remains true that more than 60% of children attending PlayConnect groups have no access to NDIS funding.

This is a key target group of the PlayConnect program: children with ASD, developmental delays or behavioural concerns currently without an NDIS plan, and their families. This includes those waiting for NDIS assessment, those deemed ineligible for funding, or those otherwise outside of the NDIS system. Families with NDIS funding are also a core target group, with the program providing support through the provision of social and community support, capacity building, and peer-group learning and support for children, carers and siblings. These outcomes are not typically funded within NDIS early intervention plans, which tend to focus on individual therapy, and as such cannot be purchased by families with NDIS funding.

Current PlayConnect Service Reach

[Chart showing 414 Participants total: 152 with NDIS Plan, and 262 children currently without an NDIS plan / 414 children receiving services beyond the scope of NDIS funding]

Funding

The PlayConnect program has been funded since 2008, initially under the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) and later the Department of Social Services (DSS). During this time the program has supported thousands of families with children with ASD or ASD-like characteristics.

With the national rollout of the National Disability Insurance Scheme (NDIS), the program had initially been marked for transition to the NDIS in 2019, which would have resulted in the cessation of the program. However, an extension of 12 months has been granted until mid-2020, with the intent of determining the most appropriate ongoing funding source. The program is currently funded at c$1.3 million per annum. Playgroup Australia is currently engaging with funding bodies and relevant stakeholders to explore future funding options for the program moving forward.

The PlayConnect Model

PlayConnect playgroups are designed around three core elements:

Developmentally appropriate play and peer engagement opportunities

PlayConnect playgroups are comprised of a series of play experiences and peer engagement opportunities for children with ASD, developmental delays or behavioural concerns. Owing to the challenges experienced by these children, play and peer engagement can be particularly challenging for children and parents alike. Sessions are purposefully planned to provide both children and caregivers with the opportunity to learn together through play in a safe, supportive environment that recognises and caters for individual. Activities within PlayConnect sessions are chosen to minimise these challenges or are modified to suit the developmental and social needs of children attending.
Peer support for parents, other carers and siblings

PlayConnect playgroups provide a forum for parents, siblings and other caregivers to foster supportive social relationships with others who share similar experiences. These networks provide an invaluable source of emotional and practical support for families across the challenging and often emotional journey of parenting a child with disability. In the case of parents, this peer support often extends to include informal mentoring, with more experienced parents within a group providing support and mentorship to newer members to build parenting confidence and capacity.
Community outcomes through the provision of information, community linkages and referrals

The PlayConnect program supports both formal and informal learning tailored to address these specific needs of parents, caregivers and families. PlayConnect facilitators work informally with families to identify their information and referral needs, and with community stakeholders to understand the local service and support landscape. Where possible, families are connected with services within the local community to meet their needs.

Collectively, these core elements provide responsive, individual support to whole families. The model is flexible to allow facilitators to respond to the needs of families and children and targeted opportunities for capacity building. While typical disability support services under the NDIS focus on the individual, PlayConnect extends this reach to encompass broader family networks. This is in line with the Principles outlined in Principles for High Quality Playgroups: Examples from research and Practice^i.

The value of PlayConnect

Evaluations of the PlayConnect program have consistently highlighted the value of the program, both at a program and consumer level. In 2014, La Trobe University conducted an independent evaluation of the program with several key findings:

PlayConnect was effective as a program. At a program level, the evaluation found that PlayConnect was an effective service model. The program had consistently delivered the goals and objectives specified in the funding and service agreement with the DSS “to provide play-based opportunities for parents and their young children with ASD to learn and socialise, and for parents to learn about their children’s needs, create informal social support networks, and engage in their communities”.

Additionally, the program was determined to be accessible to the target group with low barriers to accessibility. Of particular note, the evaluation highlighted the value of the following factors:
- no cost for participation
- no requirement for a formal referral or diagnostic requirement
- inclusion of extended families and
- flexible and responsive service delivery. Further, the program was successfully reaching those experiencing the highest levels of socio-economic disadvantage, and as such considered the most vulnerable and at risk.
The program was highly valued by families. A national survey of attending families found a vast majority of parents agreed, or strongly agreed that: they were satisfied with the quality of the program; that the program was a valuable community service; and that they would recommend the program to others. Parents particularly valued:
- the family support offered within the program
- opportunities for interaction with other children with ASD and
- the accessibility of groups.

Regular program reviews undertaken internally similarly reflect the value of the program to families and program facilitators. At a national level, parents consistently report participation in the program positively impacts their families in several ways:

Facilitates vital peer engagement and support both for children and broader families.
Greatly increases parental knowledge and understanding of ASD, associated behaviours, and support strategies and networks.
Significantly improves the capacity and confidence of families to support their children with ASD and ASD-like characteristics.
Improves capacity of families to manage stressors associated with raising a child with ASD, specifically reporting significant improvements in their ability to manage their stress and anxiety.

These sentiments are also evident in the comments of parents themselves, with feedback including:

“Feeling you have a place where people understand, and your children feel accepted and appreciated for them. Having other parents to talk to about the day to day aspects of caring for the children, feeling others understand and feeling heard”

“I have felt relaxed and made some great friendships here. Having other parents to hear their experiences and advice has been so valuable.”

“It’s been a huge support for our family, something both boys really look forward to each week (and not stressful for me). It’s great being able to get some support.”

“The groups are an amazing idea to bring the community together. As a parent I felt like no one around me knew what I was going through when my son was diagnosed and now I have somewhere in my community with understanding people has made a world of difference to us!”

Playgroup Australia, PlayConnect, the NDIS and the ECEI Partners

Playgroup Australia and PlayConnect

Playgroup Australia is the leading voice for families and caregivers of children under age five. Our vision ‘creating a village through play’, aims to support learning through play and connection within communities. Playgroup Australia represents the state and territory playgroup organisations (STOs) that deliver support to more than 7500 community playgroups, attended by more than 110,000 Australian families. These playgroups reach into 80% of all Australian postcodes. In addition, member STOs provide a range of facilitated, drop-in, pop-up events and supported playgroups, including PlayConnect.

As outlined above, PlayConnect provides a vital support for families with young children with ASD, developmental delays or behavioural concerns. The program provides: a supported space for children with ASD or ASD-like characteristics to engage in peer-group play; fosters social support networks between families; builds linkages and connections to service pathways; provides a ‘soft- entry’ to the disability service sector, including the ECEI partner networks; builds capacity of families; and supports whole family units. For families with children with ASD, developmental delays or behavioural concerns, who often miss out on mainstream opportunities for peer-engagement, support and social engagement PlayConnect is a vital service.

NDIS Early Childhood Early Intervention approach

The NDIS Early Childhood Early Intervention approach aims to “assist families understand the potential role of the NDIS and to guide them to other appropriate supports and to offer independent advice on providers of support most suited to their needs”^ii. Within this remit, The NDIA appointed Early Childhood Partners focus, appropriately, on eligibility and planning for children that meet the NDIS criteria.

This is the fundamental distinction between the services provided by the ECEI partners and the PlayConnect program. The ECEI partners and the NDIS more broadly provide an undoubtedly important service, however they fail to act as a replacement in meeting the needs of PlayConnect participants in several key ways:

They lack the capacity to provide long term, sustained support to families.
Are unable to cater for the needs of whole families, focusing instead on the individual child’s NDIS eligibility and assessment processes.
Cannot support children who are determined to be ineligible for funding under the NDIS other than through short term advice or referral.
Early intervention plans primarily fund therapy provision and cannot be used to cover the cost of playgroup, or to replace the parent support elements of PlayConnect.

There continues to be a need for supports like PlayConnect alongside ECEI.

PlayConnect and current ILC funding opportunities

Past iterations of the ILC stream have not supported ongoing programs such as PlayConnect. As such, Playgroup Australia welcomed the December 2018 announcement of reforms to the ILC that indicated a both:

A shift from short term project funding to longer term program support, and
Competitive grants as the only procurement avenue for ILC activity, to a mix of funding models including targeted grants and procurement, and longer funding horizons.

We have closely followed the announcement of the current round of applications and the new program suite designed to deliver on ILC outcomes. Disappointingly, despite clear reforms, none of the three 2019 grant stream appear well suited to programs such as PlayConnect.

Individual Capacity Building Program

The Individual Capacity Building Program is aimed at “Enabling systematic, nationwide access to peer support, mentoring and other skills building for people with a disability, carers and families”. Certainly, peer support and mentoring for carers and families is a key element of the PlayConnect program, however, this stream is only open to DPOFOs.

While Playgroup Australia, and the Boards of the state and territory playgroup organizations include a strong representation of carers of children with disability, Playgroup Australia does not meet the intention of funding disability peoples organisation or family organisation eligibility requirements outlined in the funding guidelines.

The Economic and Community Participation Program

The Economic and Community Participation Program has a primary focus on employee and employer readiness to increase the number of people with disability in the workforce and increased participation in mainstream community activities, particularly sport and recreation, arts and culture. The PlayConnect Program is not eligible for funding under this stream.

The Mainstream Capacity Building Program

The Mainstream Capacity Building Program focuses on health organisations and their capacity to appropriately engage people with disability. While PlayConnect has significant mental health and wellbeing impacts for families, it is not a health service, and as such does not align with this funding stream.

Situating PlayConnect

Clearly, the PlayConnect program does not align with any one current ILC stream. However, PlayConnect very clearly does align with several of the ILC Investment Objectives, including:

Building the capacity of people with disability, carers and families
Improving information linkages and referrals
Improving disability awareness and inclusion in the community.

This shows the PlayConnect program straddles several of the ILC program stream rather than fitting neatly within one. In addition, the funding limit or each off the rounds would not allow us to make an application for our current funding ($1.3m).

We have identified the possibility of direct procurement as an alternative source of funding. The Strengthening Information, Linkages and Capacity Building (ILC) National Strategy towards 2022, released in December 2018, identifies an intention to refocus the ILC program including a refocus from ‘sole reliance on open and competitive grants’ to ‘a mix of funding models including targeted grants and procurement’. However, advice from NDIA is that there is no intention to implement alternative procurement in the near term.

PlayConnect moving forwards

Recognising the particular funding and procurement issues around the program, Playgroup Australia looks forward to working with the NDIA and Department of Social Services to resolve future funding and sustain this vital family support program.

PlayConnect is a highly cost-effective program within the disability service sector, and a very low- cost program for Government. The current base funding of just c$1.3m pa enables more than 40 PlayConnect groups across Australia to provide support to over 400 families a year.

There is considerable potential to grow the PlayConnect program so that it can support more families. We have identified a range of sites where, with additional funding, new groups could be established to increase service available to families who otherwise sit on the margins of mainstream disability and support services. In addition, we are aware that the PlayConnect model can be readily adapted to support families with young children that have other (non-ASD) disabilities and that this style of support is not currently widely available for these families.

These families are largely sit outside of other formal support structures. The program uniquely bridges this gap between behaviours of concern, diagnosis and service delivery. Of the current families participating in PlayConnect, 63% do not have NDIS plans. If a suitable funding arrangement is not found these families will be without critical support, with the potential of increased education and support costs as the child enters school.

The PlayConnect program is highly valued by families and is an effective and cost efficient service. Playgroup Australia looks forward to working with Government to determine the most appropriate funding stream beyond June 2020.

Contacts

Fiona May CEO Playgroup Australia

Nicole Kee PlayConnect Program Manager Playgroup Australia

^i Commonwealth of Australia (Commerford, C., Y Hunter, C). (2017). Principles for high quality playgroups: Examples from research and practice. Melbourne, Australian Institute of Family Studies. Available online (29/07/2019) at: https://aifs.gov.au/cfca/publications/principles-high-quality-playgroups.

^ii ii NDIS. ECEI Partners in the community. Available online (13/08/2019) at: www.ndis.gov.au/understanding/what- ndis/whos-rolling-out-ndis/ecei-partners-community

Delivery Costs of PlayConnect

Viewed at both the individual and program levels, PlayConnect is a highly cost-effective service model when compared to other services.

PlayConnect Costings

From a whole of program perspective, the PlayConnect playgroups program was funded $2,563,470 (ex GST) for the two-year period 2017-2019, or $1,281,735 annually. Based on the 42 PlayConnect groups delivered around the country, this equates to $30,518 per group each year, including national and state administration costs. Over the course of 40 PlayConnect sessions annually, this equates to $763 for each PlayConnect session, and based on an average group size of 10 children, a cost of $76 per child per two- hour session, or $38 per hour.

Annual Program Funding	$1,281,735
Annual cost per group (42 groups)	$30,518
Weekly running cost (40 weekly sessions)	$763
Hourly cost per family per week (av. 10 children per group)	$38

NDIS Relative Costings

Relative to individual and group therapy services: Under current NDIS pricing guidelines, individual therapy may be costed between $193.99 and $224.62 per hour, dependant on jurisdiction and therapy type. Early intervention therapy groups with a ratio of 1:4 (therapist to participants) may be costed between $64.92 and $74.67. Based on these guidelines, a two-hour early intervention session may be charge at between $449.24 and $129.84 per child.

By comparison, PlayConnect groups are offered free of charge to families. Participants are provided with the opportunity to engage in facilitated group interaction for a two-hour period each week, 40 weeks a year, at no cost. In real terms this translates to a saving of between $17,970 and $5,194 for each family annually. At a whole of program level, based on an average of 400 families attending PlayConnect this represents a total cost saving for families of between $7,187,840 and $2,077,440.

NDIS costings	Individual therapy	Early Intervention Group (4:1)
Hourly cost	$225	$65
40 weekly 2-hour sessions	$17,970	$5,194
400 Participants	$7,187,840	$2,077,440

While PlayConnect facilitators are not typically allied-health clinicians providing therapeutic intervention, Playgroup Australia facilitators are trained ASD providers, supported by extensive PlayConnect resources which ensures, that while they may not have specific allied health qualifications, they are trained to provide high quality group facilitation and support to families. In addition, they are supported by a suite of program of resources, play activities and ASD supports to provide developmentally appropriate activities during playgroup.

Again, referring to the NIDS pricing guide, ‘training for carers in matters related to caring for a person with disability’ (a core component of the PlayConnect program) is priced at $58.52 per hour. Arguably, PlayConnect provides two hours of parent training and support each week, 40 weeks a year. For each family this alone represents $4,682 of service. From a program perspective, based on 400 attending families this translates to $1,872,640 worth of parental training and support within the PlayConnect program each year.

Stream	Individual therapy	Early Intervention Group (4:1)
Individual focus	$7,187,840	$2,077,440
Family and Carer Training	$1,872,640	$1,872,640
Total relative NDIS Cost	$9,060,480	$3,950,080

Drawing on these figures, conservative estimates suggest the program provides between approximately $4 and $9 million value for the $1.3 million funded by Government. This equates to the equivalent of $123.44 to $283.14 per hour respectively, compared to $38 per hour for PlayConnect program delivery. However, while PlayConnect presents this financial potential value, it is useful to consider this figure in context.

It is appropriate to note that many PlayConnect participants are without an NDIS plan. In June 2019, only included 37% of program participants had an NDIS plan. The remaining participants are either awaiting NDIS review, have been found not to meet the requirement for an NDIS plan, or are otherwise outside the NDIS. For these families, PlayConnect provides an important source of support and connection that would otherwise be unavailable.

Furthermore, for those participants with an NDIS plan, PlayConnect does not, nor does it intend to, replace therapy. Rather, in addition to the funding under NDIS individual plans, PlayConnect provides a supported peer and play engagement opportunity for children with ASD or ASD-like characteristics and their families. PlayConnect builds the capacity and confidence of both children and carers, which in turn allows them to maximise the benefit of their NDIS funding packages. Additionally, in locations where there are significant waiting lists for families to access therapists, PlayConnect provides accessible early intervention to bridge the gap and support families until appropriate therapy becomes available.

Finally, while the financial value of PlayConnect is clear at both a program and individual level, this still significantly underestimates the true value of PlayConnect. This costing fails to capture the value of the program beyond these child peer-to-peer interactions and parental capacity building. That is, the value of the program for whole families, including the provision of social support, community linkages and connections, as well as the value of the program as a ‘soft-entry’ point to the disability service sector and therapeutic services. This value cannot be underestimated.

Playgroup Australia August 2019