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  • Writer's pictureJacqui Grant

NDIS - What a month its been!

Connect and Grow Magazine - April 2024 - Edition 8




 

March has seen many changes and announcements that a team is reviewing all invoices, which delays payments.

 

The proposed new legislation, 'getting the NDIS back on track,' aims to replace the current NDIS Act 2013 and steer the NDIS towards a more effective and efficient future.

 

You can review the document: Getting the NDIS back on Track 

you will need to open this on a computer

 

Having read the document twice, I am still processing what it could all mean. I have also been reading other people's thoughts on the document, who are breaking it down and providing their interpretation.

 

The proposed new legislation, 'getting the NDIS back on track,' aims to replace the current NDIS Act 2013 and steer the NDIS towards a more effective and efficient future. If approved on June 20th, 2024, it will mean that more changes will come into effect, and these could start quickly. These changes could affect the availability and quality of services, the eligibility criteria for NDIS funding, and the overall experience of people living with a disability and service providers.

 

 

The proposed legislation talks about how NDIS funding will be flexible for most services; however, some people are concerned about the definition of those services. We have noticed that currently (2024), the NDIS is not working as it should for both the people living with a disability and for the providers.






What does it mean for me?

 

A question that both providers and people living with a disability are asking







How plans are written and implemented and how people can access NDIS funding and have a plan could be very different should this new legislation be approved and implemented.

For instance, the services that will be covered by NDIS funding will be defined by NDIS, and they may not all be the services currently paid for with NDIS funding. As we know, there have been discussions since December 2023 about the setup and implementation of foundational supports, so if a service is mainstream already, it could mean that services are accessed via the foundational support model instead of NDIS.


Exactly what it all looks like remains to be seen, all we can do is wait and see, not easy I know.

 

We have noticed that currently ( 2024), the NDIS is not working as it should for both the people living with a disability and for the providers.

 

Should the proposed legislation "Getting the NDIS back on track” be approved on June 20th, 2024, it will mean that more changes will come into effect and that these could start quickly, depending on the changes that they choose to start with and how the NDIS system is set up behind the scenes.

Things will have to be defined very clearly, and that could mean that there will be further changes to the legislation.


We have all seen issues with PACE and the introduction of the invoice assessment team to stop fraud; there are huge delays with payments, and some self-managed people are having trouble getting their details into the PACE so invoices can be approved.


With payment of invoices often delays or declined it is resulting in business' struggling to keep going, unable to pay their staff until the invoices are paid. We know that the "profit margin" for the sole trader or small business is not very big, as many business expenses are involved. The person with the NDIS plan may end up without support, especially if they have run out of funding.



All we can do is keep raising the issues and keeping the lines of communication open.

 

 



 

 

The proposed legislation talks about how NDIS funding will be flexible for most services; however, some people are concerned about the definition of those services. For example, the definition of a service provider could be that you can only use NDIS-registered providers. Another example is the definition of a support worker, which could include a minimum mandatory training qualification in disability. Now, these are only examples of what definitions could come into play; how it all turns out remains to be seen.

 


 

At this moment in time

What we are currently seeing is that the NDIA planners and people who run the NDIS online training and events run by NDIA are reminding people of what the criteria in place currently is and that the following is being reinforced in a multitude of ways:

 

  • No funding top-ups - this has always been the case; however, people have often gone to plan review the minute they run out of funding, claiming change of circumstance. However, the NDIA states that changes in circumstances are much more than simply overspending early on in planning funding. Therefore, we are seeing people needing support as they have spent all their funding too quickly and have yet to follow the plan budget.

 

  • NDIS does not pay for a holiday, and clearly defining STA/respite is for those who have been released from the hospital and require additional support and capacity building during that time; also, for high-intensity care needs, people with informal support need a break. As I was informed during a recent training for providers that NDIS runs regularly and anyone can attend, taking a person away for a weekend differs from what STA was designed for. Many providers have taken people away and invoiced this as STA. It is paid; what has then occurred is that the person has been left without ongoing support as they did not have STA in their plan, yes core funding, as it stands at the moment, is flexible; if the person runs out of funding early, they may not get a review for months and therefore go without ongoing support. In some instances, the provider has not been paid for the STA as it was never in the person's plan, and when the invoice was checked, that was identified; therefore, the NDIA declined the invoice, which then leaves the person with an NDIS plan with a big invoice to pay in some cases it is $10,000 and upwards.


It is important that a person who has an NDIS plan understands it and what it will and won't cover, especially as all invoices are being cross-checked with the person's plan.


While many people believe their plan is underfunded, the person is to work within the budget they have, as if they run out of funding, that could mean their next plan is NDIA managed due to what MAY be considered an abuse of funding.


If a person wants to access STA, they should check that there is enough funding in their plan and consider the consequences of choosing STA and depleting their funding so that they can make an informed decision.

 

  • Plan Reviews: These take around five months to occur, and there are delays after the meeting in getting the plan. This can be very stressful for all parties involved, especially if the person with the NDIS plan is out of funding, which means no support to wait so long. When the meeting occurs, the planner will ask: "Why have you run out of funding?" Depending on the person's response, what happens next will be determined.

 

 Going to a plan review early before the plan finishes, does it require it be lodged as a change in circumstances if the only reason to request this is the person is out of funding, the NDIA and the person may decline it may be informed they have to wait longer, however, if there are other circumstances such as where the person requires additional supports for their safety then the supporting evidence can be submitted to support this change of circumstance request and the review.

 

There are many reasons for plan reviews, and the NDIA may highlight some of these, as well as the planner's identification of a complex situation. Every person is different, and their needs are different; it's essential to remember this.


  • Reasonable and Necessary - this has always been the basis on which the plans are developed. Is the service being requested reasonable? Is it necessary for the person to have this service, and how does it relate specifically to the disability? This is over and above Choice and Control. Choice and control come into play when it comes to choosing the service provider to provide the services in the plan or to choose to use a mainstream provider that they pay for themselves. The criteria are strict, as the aim of providing NDIS funding is to access services related to the disability; some things are considered unrelated to the disability.

 

  • Services payments are now taking, on average, 3- 10 days, and we see that invoices, including STA's invoices, are sometimes being declined. With the invoices for services now being checked against the person's NDIS plans, we see service providers not being paid for some services, leaving them in a situation that impacts their business and paying staff.

 

As mentioned above, with the new NDIA process for reviewing invoices, providers are sometimes not being paid for services and are unable to pay wages. Some participants who provide services wait over five months for their plan to be reviewed, leaving their businesses struggling financially. Some are choosing to leave the sector altogether.

 

  • The statement regarding reasonable and necessary in a person's plan refers to a person's informal support, which may include family, friends, community connections, and a church group. Formal health and education supports, such as GP, community health, and services, are also available. This statement is a blanket statement and is included in all plans; the list of people and service providers under this statement will be different for everyone. You can learn more about Reasonable and Necessary supports on the NDIS website:  https://www.ndis.gov.au/understanding/supports-funded-ndis/reasonable-and-necessary-supports

 

 

 

 


Providers are checked to ensure they meet the Consumer Law and the NDIS code of conduct, amongst other standards and legislation.

 

The NDIS plays a crucial role in this process, ensuring that all providers adhere to these regulations. If providers are found in breach of any of those, they may face significant fines. This comprehensive check applies to all providers, and these checks are being sparked by the recent changes in the implementation of the task force focused on reducing fraud.

 

Many businesses need to be set up correctly per business compliance in Australia, which is separate from the NDIS business expectation, except for NDIS registered providers; there is an overlap in that situation.

 

The NDIS states on its website that providers must all follow Australian consumer law. However, I am noticing more and more in social media groups that people are saying they only need an ABN and business insurance to provide services to those with an NDIS plan. They believe they need nothing else not the NDIS code of conduct, or Australian Consumer law at all or properly.

 

As part of working with people with an NDIS plan, there are these training modules that people are required to complete, which can be accessed here: https://training.ndiscommission.gov.au/

 

So, in a nutshell, if you are choosing to run a business as a service provider to people with disabilities, you are to set your business up to be a business, and that includes an incident management system, complaints management system, code of conduct, fair pricing, and risk management system. Also, there is evidence that a shift has occurred to support invoicing.

 

You also need to understand that as things change with legislation, this impacts your business, so understanding how to write your policies and procedures and use your documents will only positively serve you and help you to be on top of everything, which saves you money in the long run.

 

If you do not have your policies and procedures to be able to implement the following:

Incident Management system

Complaints Management System

Code of Conduct for Your Business

Compliance

We have put together a choice of two bundles that you can choose from:

Template Bundle - where you do have to do a lot of writing; however, it includes a lot of examples for you and prompts for $330 ( includes GST)

Comprehensive Bundle - a lot more work has been done for you, but there are still templates for you to adapt to suit your business. $1098.90 ( includes GST)


Business Compliance occurs when the business implements its documents, policies, and procedures daily, understands what its policies and procedures include, and ensures that they are tailored to the specific business and aligned with the legislations and laws.


Understanding the legislation yourself is important, which is why writing them yourself with the help of templates is a great way to ensure your business is meeting compliance.

 

Here is a link to help you understand what the proposed changes may mean for you as a provider and a person with a disability. 


Getting the NDIS back on Track - you can track its progress here.


 

We also have resources on our website:

If you have questions about your business, you can contact me to book a coaching session. Some fees apply for coaching services.

 

Book an introductory call about our services:

 



 

 

We also have a program called Connect, Grow, and Coach, where we meet once a month online.  It is $99 per month, or you pay upfront and save. It is for 12 months with the option to keep going. The program aims to support businesses as things shift and change in the sector so you can then support your staff and participants.




(c) 2024 Break Free Consultancy Connect and Grow Magazine


Disclaimer: All information is correct at publication and is subject to change. Please always check the NDIS website for the most currently information.

 

 

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