by Yvette Brand
A $10 per hour cut in the National Disability Insurance Scheme fee schedule has forced a Warragul physiotherapist to assess the viability of servicing NDIS clients.

Helping people overcome their physical challenges inspired Through Life Physiotherapy owner Helen Lowe to become an NDIS provider in 2017. But, after a five year price freeze and now a $10 per hour cut, her Warragul based business may not sustain the expected $34,000 annual income loss.
"I love the NDIS, it has given so many people access to so many great services and support. I have lost count of how many children I've taught to crawl, walk, climb and swim...it gives me so much joy to see that," Helen said.
Come July 1, Helen will be forced to make some tough decisions - decisions that in her mind she cannot justify morally if it means reducing services to her 177 NDIS clients or impacting her 15 staff.
"I can personally take a $34,000 hit or I may risk my business going under but that's not morally right either," she said.
For Helen, the figures don't add up.
The National Disability Insurance Agency (NDIA) conducts an annual pricing review before the beginning of every new financial year.
The new rates announced this month for physiotherapists will see the hourly rate drop from $193.99 per hour to $183.99 per hour from July 1. Adjustments to other allied health services will be reduced $5 per hour with the per hour rate for dieticians and podiatrists dropping to $188.99; while psychology will increase $10 per hour to $232.99 per hour.
"As allied health workers we do what we do because we love it and we have a moral obligation to care for people so we don't make a fuss about the price.
"It's a fundamental error that they have based the new structure on," she said.
Helen said the new rates were based on an assessment that physiotherapists were over charging NDIS clients.
However, she said the pricing structure was based on a comparison to physiotherapy services for less complex clients being treated for a sore back or an arthritic shoulder; and, being charged $80 to $100 for a 20 or 30 minute appointment.
"It is still not nice living with those conditions but the appointments don't compare to the complexity of an NDIS appointment," she said.
Helen strongly believes the best service provision for their NDIS clients is delivered in their own environments.
For the 177 clients currently on their books, half of them aged under 17-years-old, it means her physiotherapists travel between Garfield and Traralgon and as far as Mirboo North and Poowong.
But travel costs also are about to be slashed by 50 per cent of the previous $193.99 per hour rate for staff while travelling.
It is a cost Helen said cannot be avoided in their service delivery.
"If they go to school, they need to learn to use the playground in their school, so we need to go to their school and home environment.
"For children with autism or neurodiversity needs, they can find changes in an environment distressing so trying to do therapy with those children who don't feel safe in their environment is not effective.
"And for adults who have had a stroke, we have to help them move around their own homes, or to cross the road.
"We have to get into the real world to do real world therapy.
"This isn't optional travel, it's not a luxury service, we have to see clients in their own environments," she said.
Helen said scheduling of appointments was done to ensure the most cost effective outcome for clients and time efficiency for staff.
She said reducing travel rebates meant if she continued to pay her staff award rates, she would go backwards $40 to $50 per hour they were travelling.
With July 1 fast approaching, Helen said she was scrambling for a solution.
"I could cease providing services to clients in their homes and schools but their lives are not easy, they are already difficult and I'd be asking them to do something that is more difficult.
"I could ask them (clients and families) to pay the difference but many of them are already on a pension so that's not a comfortable decision.
"Or I can risk my business going under but that's not morally right either for the 177 clients and 15 employees I have," she said.
Member for Monash Mary Aldred said she would be taking the matter up with Prime Minister Anthony Albanese and NDIS Minister Mark Butler this week.
Ms Aldred said regional communities would be disadvantaged.
She said the proposed cuts to NDIS providers under Federal Labor were deeply concerning.
"I am currently meeting with a number of local occupational therapists and allied health professionals from across Monash and will continued to do so.
"To often, government agencies take a cookie cutter approach to dealing with metro and regional communities, and this is a prime example.
"While I support reasonable steps to address wasteful spending, these cuts are not the way to do this.
"They will significantly disadvantage regional communities like ours," she said.