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Late last year, the NDIA caused a bit of a debacle when it announced plans to change the pricing structure for art and music therapy. If the changes had gone ahead, the price limit for these supports would have decreased from $193.99 to $67.56 per hour.
This news led to a significant backlash from art and music therapists, people with disability who use these supports and their families. In response, the NDIA commissioned an independent review into the pricing of art and music therapy. There will be no change to the price limits of art and music therapy until the after the outcome of the review.
There has been a blink-and-you'll-miss-it call out for submissions, which close on Friday.
If the events of last year prove anything, it’s that art and music therapy are supports that people care about. So we thought we’d take a close look at the independent review, the NDIS’s proposed changes, the role of art and music therapy and provide more information on the call out for submissions.
Background: the NDIA’s (paused or cancelled) proposal
The NDIA says it must ensure NDIS supports are evidence-based, good practice and likely to benefit the participant. To this end, the NDIA says it reviewed available research and found ‘insufficient evidence to conclude that art and music therapy are effective to maintain or improve functional capacity for most people with disability’. Unsurprisingly, art and music therapists disagree. Peak bodies Australian Music Therapy Association (AMTA) and Australian, New Zealand and Asian Creative Arts Therapies Association (ANZACATA) have criticised the NDIA for failing to consult with them in the research process, and for the lack of opportunity to review the NDIA’s evidence. To learn more, check out AMTA’s statement and ANZACATA’s statement.
Currently, art and music therapy can be billed at $193.99 an hour- the same rate as many other allied health therapies, including occupational therapy and speech pathology.
In November last year, the NDIA announced it would be changing its Operational Guidelines so that art and music therapy could not be purchased at therapy rates. Instead, it could be billed under Participation in Community, Social and Civic Activities, which has a price limit of $67.56.
The NDIA said the $193.99 rate could still be charged if:
- The support was stated in the participant’s plan.
- The therapy was provided in a group setting with at least 4 participants (in which case $193.99 would be the total amount, divided by the number of participants).
Just to be abundantly clear - the NDIA is not proceeding with any changes until after the findings of the independent review.
The independent review
The government is currently establishing an Expert Advisory Committee (EAC), which will give independent advice on support that is effective and evidence-based. The EAC (which is not to be confused with the other EAC - Every Australian Counts), would be perfect for a situation like this. However, awkwardly, it won’t be up and running until July 2025.
But the NDIA says it ‘recognises that there have been concerns raised by Music and Art Therapists and their representative organisations about this policy’ (a statement which forgets many people with disability also raised concerns). So, given the EAC won’t be up and running til July, the NDIA appointed Dr Stephen Duckett to conduct an independent review.
Dr Duckett is a health economist. He seems to be quite a big deal if his Wikipedia page is anything to go on - there’s even a section there dedicated to something called the ‘cookie controversy,’ which I’m sure was quite serious at the time but sounds objectively hilarious.
According to the Terms of Reference, the scope of the review will be to report on:
- The pricing arrangements for art and music therapy. Including benchmarking against other allied health professionals and qualifications.
- The NDIA’s review of art and music therapy to ‘provide advice about the consistent application of this evidence to requirements under the Act.’ The language is a bit fuzzy on whether a review of the adequacy of the NDIA’s evidence or if it’s meant to be used as a starting point. As part of this step, people will be given the opportunity to submit new evidence.
The independent review must consult with stakeholders and ensure that the views of people with disability are reflected in the recommendations.
The recommendations of the review must be delivered no later than 14 March 2025. Update: Since publishing this article, the deadline for the review final recommendations has been extended to 17 April.
But Dr Duckett must also meet with senior NDIA representatives every 3 weeks to keep them updated on the progress. What I wouldn’t give to be a fly on a wall in those meetings!
What is art and music therapy?
For those not so familiar, art and music therapy are allied health supports that help people navigate challenges and achieve mental, social and physical goals. Both supports can be an alternative outlet for exploring and processing emotions. This is often particularly beneficial to people unlikely to respond to traditional talk therapy, such as non-verbal communicators or people with cognitive or communicative disabilities.
Music therapy is also used to help people develop communication skills and improve their articulation. Working with an art or music therapist can help individuals develop fine motor control, hand-eye coordination, and spatial awareness.
Art and music therapy are self-regulated professions, and not registered professions under the Australian Health Practitioner Regulation Agency (AHPRA). This means that technically, anyone can call themselves an art or music therapist. Whereas if you tried to call yourself a nurse without the appropriate qualifications and registration, you would be in serious trouble.
But, the NDIS Quality and Safeguards Commission requires registered art therapists to be a member of ANZACATA and registered music therapists to be a member of the AMTA.
Both these organisations have minimum qualification requirements. With ANZACATA, this involves a two-years Masters with 750 hours of supervised placements. For AMTA, there are two AMTA accredited Masters programs, or applicants need to have done an equivalent international degree. Both peeks also have quality and safety standards for members.
Submissions
Dr Duckett sent a call out for submissions in the Participant First newsletter.
He is particularly interested in submissions which:
- Describe art and music therapy approaches for people with disability.
- Information on who is delivering art and music therapy, including qualifications and registrations.
- Evidence of how art and music therapy can improve disability function.
- Information about if it is 'possible or sensible' to distinguish between art and music activities and art and music therapy.
Submissions close Friday. People can attach any studies, reviews or evaluations to their submissions.
Send submissions to: [email protected].
Conclusion
The independent review will submit its final recommendations to the NDIA in mid-March. But there’s no guarantee when us mere members of the public will get to see the report.
But, for now, it’s business as usual for art and music therapists.
To learn more about the independent review, check out the NDIA’s statement.
Artwork by Thomas Weisner from Bayley Arts. Bayley Arts supports artists with a disability to create, exhibit and sell art. Learn more about Bayley Arts.
