Support Plans and Financial Help

Financial Help Info

Medicare

Chronic Disease Management (CDM) Plans

Mental Health Care Plans (MHP)

National Disability Insurance Scheme (NDIS)

When you discover the true cost of helping your child with a disability your first thoughts may be of despair. There are however a number of options for you to pursue. Spectrum Clarity can help you through the maze of options.

Planning the services and supports you need for your child within the context of your family plays an important role in focusing the intervention approach including what services are available in the mainstream setting and what specialist supports will be required. Developing a Plan is a requirement under the National Disability Insurance Scheme too.

Spectrum Clarity will undertake a full assessment so that we fully appreciate your family context and current participation in the community. However, we also want to know your future aspirations for your child within the context of the family. Some questions to think about are:

  • How your child would like their life to be in a few years and what they would like to change.
  • What your child, you or your family and friends can do achieve their goals and objectives.
  • What supports your child has to help them, including family, friends and other informal supports, as well as mainstream, community and disability supports.
  • What is stopping your child from achieving their objectives?

All the information gathered, taking into account any previous assessments (including diagnostic assessments) will inform the Plan and what specific interventions will be required. Spectrum Clarity Access Consultants will help guide you to identify service providers.

Who is Spectrum Clarity?

Spectrum Clarity is a team of professionals who are accredited Mental Health Social Workers with the Australian Association of Social Work (AASW). Our three social workers have a combined experience totalling 80+ years!

Who do we help?

The principal function of Spectrum Clarity is to help parents/carers access services efficiently and effectively for their child (ren) who are presenting with Developmental Delay and/or an Autism Spectrum Disorder including associated disorders. (We also work with young people up to the aged of 18 years with a particular focus on life transitions).

How do we help?

The early intervention and welfare service system is a very confusing and fragmented one with no real way of getting to the service(s) easily. Managing a household and the needs of other family members while trying to find information and support following a diagnosis of your child can cause additional anxiety and stress for you, as the parents. At Spectrum Clarity, our aim is to change that.

At Spectrum Clarity, the goal of our Access Consultants is to work collaboratively with you to identify the right mix and intensity of services and support suited to your specific goals for your child/young person. We will draw on our specialised early childhood knowledge to determine appropriate supports for your child and family, including information, emotional support and specialised early intervention supports.

What will we help you with?

We will work with you to develop a plan of supports. We will help you find those services and guide you in the decision making process to ‘demystify’ the system and reduce some of the stress and anxiety. We are a private ‘gateway’ Provider – independent from any service provider – so that we are not biased and hopefully guide well and in the best interests of your child and family to simply help you get on your way!

Medicare

Medicare provides a rebate on the cost of seeing a doctor, but doctors can write special plans that mean you can claim a Medicare rebate for seeing other allied health professionals such as some Social Workers.

Usually, Medicare will only refund a portion of the overall cost of services and this will leave you with a gap that you need to pay yourself. If you end up paying a lot for medical services in one year, you may reach the Medicare Safety Net. Reaching the Medicare Safety Net means you get a higher rebate for Medicare-subsidised services. Medicare will notify you if you reach the safety net.

The relevant Medicare plans related to use of services provided by Spectrum Clarity are:

  • The Chronic Disease Management Plan
  • The Better Access to Mental Health Plan

Medicare Better Start with Disability Initiative

The Better Start for Children with Disability Medicare items are early intervention services for children with a range of conditions such as Down’s Syndrome, Rett’s disorder, Fragile X Syndrome Visual Impairment and Hearing Impairment to name a few. These Medicare items are for eligible children have not accessed services under the Helping Children with Autism program.

Under this program, a child can be referred by a GP, specialist or consultant physician for the following allied health services:

  • Up to four diagnostic / assessment services from psychologists, speech pathologists, occupational therapists, audiologists, optometrists, orthoptists or physiotherapists to assist the referring practitioner with diagnosis or to contribute to a child’s treatment and management plan (for a child under 13 years of age)
  • Up to twenty treatment services from psychologists, speech pathologists, occupational therapists, audiologists, optometrists, orthoptists or physiotherapists (for a child under 15 years of age, providing treatment and management plan is in place before their 13th birthday).

Chronic Disease Management (CDM) Plans

The CDM items are for GPs to manage the health care of people with chronic or terminal medical conditions, including those requiring multi-disciplinary, team-based care from a GP and at least two other health or care providers. There is no list of eligible conditions. However, these items are designed for patients who require a structured approach to their care and to enable GPs to plan and coordinate the care of patients with complex conditions requiring ongoing care from a multidisciplinary team.

The CDM Plan provides 5 sessions with an Allied Health Professional per calendar year. All Spectrum Clarity Access Consultants are eligible for this item as we are Medicare Accredited Mental Health Social Workers.

It should be noted that people with Autism Spectrum Disorders (ASD’s) are eligible for the CDM as ASD is a Chronic Condition. This means that there is $4250 worth of dental treatment if the doctor writing the referral feels that the chronic condition (ASD) is causing the dental problems. Problems such as teeth grinding, eating non-edible items, refusing to brush teeth, etc., could be attributed to the child’s ASD. The total payment is available across two consecutive years, and only covers treatment delivered in a dental chair (i.e. it does not cover procedures given under general anaesthetic). Not all dentists accept this referral, so will require you checking with your dentist first.

Mental Health Care Plans (MHP)

The Better Access to Mental Health Care Plan is an option available for anybody (people with an ASD, parents, siblings, carers, etc.) who feels that their overall wellbeing and mental health is at risk.

We know that having a child with a Developmental Delay and/or ASD results in family members who are feeling sad, confused, depressed or anxious about the diagnosis should see their GP and/or paediatrician to discuss other professionals who may be able to support them, such as a Medicare approved Mental Health Social Worker.

Medicare rebates are available for up to 10 individual services and 10 group services per calendar year. All Spectrum Clarity Access Consultants are eligible for this item as we are Medicare Accredited Mental Health Social Workers.

National Disability Insurance Scheme (NDIS)

The National Disability Insurance Scheme (NDIS) is a new way for people to get disability support, including early intervention. This new approach is about focusing on individuals rather than a ‘one size fits all’ approach. The NDIS is gradually being rolled out across Australia. When the roll out is complete, programs such as Early Childhood Intervention Services, (ECIS), the Helping Children with Autism (HCWA) and the Better Start initiative for Children with Disability will no longer exist. Rather, all children with developmental delay or disability and their families will be required to request service through the NDIS.

The NDIS envisages that families will access services via an Access Partner (such as Spectrum Clarity). The Access Partner will draw on their specialised early childhood knowledge to determine appropriate supports for the child and family, including information, emotional support and specialised early intervention supports. If a child requires more early intervention support that cannot be provided through a more universal platform (i.e. mainstream settings), the Access Partner will work the family to develop a plan of supports and each family will be able to choose a provider(s) to best meet their child and their own needs. Spectrum Clarity is a Registered NDIS Provider for Support Coordination/Connection.

Below is an illustration from the NDIS in how they hope the Early Intervention roll out will work.

NDIS Eligibility

There are a number of steps that a family must take in order to confirm eligibility with the NDIS, as well as obtain the ‘reasonable and necessary supports’ that a family has identified. The NDIS has placed a number of criteria around what are ‘reasonable and necessary supports’. The NDIS will ensure that a Plan is written and will then discuss what will be funded and to what value range. The NDIA Planner will also discuss with you how you would like to manage the funds. Options include:

  • Self-managed. You choose to manage the funding for your child’s support.
  • Registered Plan Management Provider. This management provider can find and organise support, pay the providers, take care of the paperwork and work with your selected service providers to decide how much and when your child gets support.
  • NDIA Managed. The NDIA manages the funding and you choose the service providers you want from the registered provider list on the NDIS website, and you organise the support your child needs directly with them. The NDIA then pays the providers directly.

At Spectrum Clarity, our goal is to make access to the service system as easy as possible, hence, our titles ‘Access Consultants’. In addition, from our own experience in using services, we know that supporting parents will be critical so that service providers remain focused on outcomes using evidence based interventions, and within the price regime agreed. At Spectrum Clarity, we are a Registered Plan Management/Support Coordination Provider with the NDIS to enable us to fulfil this function.