Impact of transition to an individualised funding model on allied health support of participation opportunities

Abstract

Introduction The National Disability Insurance Scheme is the new consumer-controlled funding system for people with disability in Australia, and is expected to enhance participation outcomes of people with disability. This research explored participation opportunities for people with disability during the formative period of transition to the scheme, through stakeholder accounts of changes in allied health service contexts. Materials and methods Qualitative data were generated during interviews, workshops and meetings with industry, policy, practice and education stakeholders involved in scheme services. Inductive coding explored key themes within the data. The International Classification of Functioning model was then applied as a deductive coding framework to illuminate how the scheme was perceived to be impacting participation opportunities for recipients of scheme funding. Results and discussion Using the International Classification of Functioning helped us illuminate whether changes resulting from scheme transition posed participation opportunities or barriers for scheme recipients. Research participants often framed these changes negatively, even when examples suggested that changes had removed participation barriers for scheme recipients. Some participants viewed changes as obstructing equitable and quality professional practice. We explore potential opportunities to resolve tensions that also optimise the participation outcomes of individuals who receive services through individualised funding. IMPLICATIONS FOR REHABILITATION The introduction of individualised funding has removed barriers to participation for many National Disability Insurance Scheme recipients. Efforts must be made to build the trust of stakeholders involved in National Disability Insurance Scheme service provision regarding how fee-for-service funding can lead to good participation outcomes for scheme recipients. Transparency around the shared processes of clinical governance and equitable service access operating in Australia’s individualized disability funding scheme are suggested to build trust. A visible commitment to maintaining a broad range of services is also indicated to build trust for stakeholders involved in the scheme.