Compensable Work for an AES

The aim of this web page is to provide a resource for practicing AES (or employers) who would like further information on how to work with clients who have access to compensable schemes to fund AES-run activities. This is an evolving resource which will be continually updated with more information over time.

What are Allied Health Assistants?

Allied Health Assistants (AHA) support the work of allied health professionals in various clinical and non-clinical tasks. This helps allied health professionals focus on their own work and allows for more care to be delivered to patients.

AHAs work across many disciplines including exercise physiology, dietetics, occupational therapy, physiotherapy, podiatry, social work and speech pathology. They may work in hospital settings in acute care, rehabilitation, aged care, mental health and in community care. An AHA works under the supervision and delegation of an allied health professional to assist with therapeutic and program related activities. The level and form of supervision that the allied health professional provides is dependent on the experience, skills and qualifications of the assistant and the service context.

An AES can be employed as an AHA to deliver exercise programs or health and well-being services which have been prescribed by an AEP or other allied health professionals such as physiotherapists. Employment opportunities as an AHA exist throughout state health organisations, however, the key area for AES for this through a compensable scheme is through the NDIS.

Allied Health Assistants and the National Disability Insurance Services

The National Disability Insurance Scheme (NDIS) is implemented by the National Disability Insurance Agency (NDIA). In regards to funding supports, the NDIA provides information and referrals, links to services and activities, and individualised plans which provide a support package for individuals and their carers.

Within the NDIS, AHA roles are also labelled Therapy Assistants (TAs). Two support levels of TAs are included in the NDIS Price Guide and Support Catalogue 2019–20 as outlined below (also see Table 1: item 0128):

1. Therapy Assistant (level 1): Allied health assistant working under the delegation of and direct supervision at all times of a therapist. The allied health assistant must be covered by the professional indemnity insurance of the supervising therapist (or the therapist’s employing provider).
2. Therapy Assistant (level 2): Allied health assistant working under the delegation and supervision of a therapist, where the therapist is satisfied that the allied health assistant is able to work independently without direct supervision at all times. The allied health assistant must be covered by the professional indemnity insurance of the supervising therapist (or the therapists’ employing the provider).

Employer requirements

Registration

The provider employing the TA will need to ensure the assistant meets requirements relating to the NDIS Practice Standards and deem them competent to complete the work they have been employed to do, this would be considered a business decision and the employing provider will be held responsible for decisions made on the matter.

Under the NDIS, the allied health professional will need to be registered to deliver supports in the Therapeutic Supports registration group to engage a TA. 

Providers can also apply billing arrangements for therapy assistants such as travel, cancellations and non-face-to-face time. Please refer to the NDIS Price Guide 2020-21 for guidance on non-face-to-face supports and billing.

Clinical Supervision Guidelines

1. AHA positions are to be clinically supervised by an allied health professional.
2. AHA positions will have a designated clinical supervisor.
3. Formal supervision sessions will be documented in accordance with local requirements.
4. Clinical supervision may be direct, indirect and/or remote.

GST notes for AHAs

If an AHA role is provided to a health service currently exempt from GST, then the AHA claim is also GST free. Where a health service is provided by an AHA on behalf of a health profession which is not yet recognised by the ATO, the billing for that service is not GST free.

NDIS and Telehealth services

AHAs are usually engaged in telehealth to support people living in rural and remote locations to access allied health professionals who would be located in a metropolitan or large regional centre. The allied health professional may use telehealth to supervise an allied health assistant who is locally based to the health consumer and can provide face-to-face assistance.

Some compensable schemes such as the NIDS considered telehealth as a business modality that can be used where appropriate and with the agreement from the participant. With the agreement of the participant and appropriate supervision of the treating allied health professional, an AHA/TA would be able to provide NDIS supports via telehealth.

Table 1. Overview of item numbers within the NDIS providing potential funding for Accredited Exercise Scientists (AES).

*This is not intended to be an exhaustive list; there may be other categories which an AES may utilise.

NDIS and Personal Training

AES are also eligible to register under the Exercise Physiology & Personal Well-being Activities registration group as a personal trainer. The NDIS Practice Standards: Verification Module - Required Documentation outlines that the required qualifications for personal trainers include personal training qualification, Certificate III, IV or Diploma in Fitness or equivalent. Further information on this can be found on the ESSA Member’s Lounge page: Understanding the NDIS. ESSA will provide accredited members with notification that an Exercise Science degree is of a higher level than a Certificate III or IV for submission to the NDIS.

For an overview of all the NDIS support purposes, categories and line items that NDIS registered providers can claim for, please see the Price Guide 2020-21 and Support Catalogue 2020-21. Please refer to the Support Catalogue for price limits pertaining to PTs and TAs.

NDIS Capacity Building – Increased Social & Community Participation and Skill Development & Training

Within the NDIS Price Guide and Support Catalogue, item numbers exist under the Capacity Building category. Specifically within increased social and community participation and skill development and training. This support category involves supports for participation in skills-based learning to develop independence in accessing the community (see table 1). Some examples listed by the NDIS as viable options to be funded are:

• Universal recreational activities: A limited number of lessons could be funded to enable a participant to try out an activity and test their capability and interest in further pursuing this activity – such as horse riding, art, dance or singing classes
• Funding to attend a “camp” or groups that build a person’s relationship skills and offer a range of activities and opportunities to explore wider interests.
• Other items or adjustments such as customised tools required because of the person’s disability could also be funded.

For further details please see page 39 of the NDIS Support Guide.

Carer respite funding

There are a number of funding programs which allow carers to access support to attend social activities or programs which help with their own health and well-being. Exercise sessions run by AES are eligible for these funds where the argument can be made that the program contributes to the health and wellness of the carer.

If you have a client who cares for someone they can find out more from the following organisations: NDIS, My Aged Care, Carers Australia, Commonwealth Carer Respite Centres and Live Better (QLD and NSW only).

Useful Links

For more information on the NDIS: www.ndis.gov.au/understanding
Understanding the price guide and funding supports: www.ndis.gov.au/providers/price-guides-and-pricing#priceguides
How to register as an NDIS Provider: www.ndiscommission.gov.au/providers/new-providers

Last updated 29 May 2020