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Change to short notice cancellations under the NDIS Pricing Arrangements and Price Limits 2022-23

7 July 2022 By David Kinnane Leave a Comment

The National Disability Insurance Agency (“NDIA”) has published pricing arrangements for the National Disability Insurance Scheme (“NDIS”) in its NDIS Pricing Arrangements and Price Limits 2022-23 (“Pricing Arrangements”), which took effect on 1 July 2022.

Amongst other things, the NDIA has modified the definition of short notice cancellation in the Pricing Arrangements.

(1) Short Notice Cancellation

A short notice cancellation is defined in the Pricing Arrangements as when a NDIS participant:

  • doesn’t show up for a scheduled support within a reasonable time (e.g. in the event the NDIS participant should be attending a clinic where the NDIS provider is located); or
  • is not present at the agreed place within a reasonable time when the NDIS provider is travelling to deliver the support (e.g. in the event the NDIS provider provides the support at the NDIS participant’s home or a third party location),

and

  • has given less than seven clear days’ notice for a support.

This means an NDIS participant should give an NDIS provider at least seven clear days’ notice of the cancellation of a support.

The definition has been simplified from a two-tier system (two or five clear business days) notice, depending on the duration and cost of the support under the 2021-22 arrangements, to a single definition based on the number of days (rather than business days).

(2) Claiming for a Short Notice Cancellation

In the event of a short notice cancellation, an NDIS provider is able to claim 100% of the agreed fee associated with the support from the NDIS participant’s plan, provided that all of the following conditions are met:

  • the Pricing Arrangements set out that NDIS providers can claim for short notice cancellations in relation to the relevant support item; and
  • the proposed charges for the activities comply with the Pricing Arrangements; and
  • the service agreement between the NDIS provider and NDIS participant specifies that short notice cancellations can be claimed; and
  • the NDIS provider was not able to find alternative billable work for the relevant worker and was required to pay the worker for the time that would have been spent providing the support.

Takeaways

In order to claim for a short notice cancellation, NDIS providers should:

  • check that short notice cancellations can be claimed in relation to the relevant support item under the Pricing Arrangements;
  • ensure that their charges comply with the Pricing Arrangements;
  • check that the service agreement between them and an NDIS participant specifies that short notice cancellations can be claimed (and, if required, amend the service agreement with a variation signed by the NDIS participant and NDIS provider); and
  • be able to show that they could not find alternative billable work for the relevant worker and was required to pay the worker for the time that would have been spent providing the support.

The definition of short cancellation notice includes the concept of “within a reasonable time”. NDIS providers should consider what, in the circumstances of the provision of a particular support, is a reasonable time to wait when a NDIS participant does not show up for a support prior to making a claim for a short notice cancellation under the NDIS participant’s NDIS plan.

As good practice, NDIS providers should remind NDIS participants of the need to provide 7 clear days notice of a cancellation of a support (so as to not be impacted by short notice cancellations).

Our NDIS Service Agreement and NDIS Provider and Health Provider Booking and Cancellation Policy templates have been updated to respond to the changes to the Pricing Arrangements with respect to short notice cancellations.

NDIS Service Agreement Template
NDIS and Health Provider Booking and Cancellation Policy Template

Disclaimer: we have done our best to ensure that this article is correct as at the date of publication (7 July 2022). It may not reflect any changes to the Pricing Arrangements or other NDIS rules or guidelines after the date of publication. The article is intended to provide general information and is not legal advice. Formal legal and/or accounting advice should be sought for particular circumstances and transactions, or for matters arising from this article.

To infinity and beyond: how I learned to be optimistic about the NDIS

23 June 2020 By David Kinnane Leave a Comment

When I left full-time lawyering to become a speech pathologist, I promised myself that I would be more constructive, and less – well – judgmental. A good test of this resolve was watching the implementation of the National Disability Insurance Scheme (NDIS) in real time.

Yes, the NDIS has its problems

Starting in earnest with the enactment of the National Disability Insurance Scheme Act 2013 (Cth), the $22 billion roll-out of the National Disability Insurance Scheme marked a radical shift towards self-directed care for people with permanent and significant disabilities. It aims to enhance independence, choice and control by giving people with disabilities more choice about the type of help they receive, when they receive it, and who provides it.

But – truth told – the NDIS has had more than its fair share of problems.

Many criticisms are valid

Change is hard!

The rapid (just seven year) movement away from block funding to a national, personalised service model was always going to come with challenges; and the NDIS has not had a shortage of critics. Stakeholders, including service users, advocates, service providers, policymakers, researchers, lawyers, journalists and others, have at different times lambasted:

  • the scheme’s governance and regulatory architecture (e.g. Olney & Dickinson, 2019);
  • the inaccessibility and overall complexity of the scheme;
  • the NDIS portal and other IT systems, which frustrated participants and providers alike, and, in its first couple of years, sent some small providers to the wall (although the systems seem to be improving);
  • the difficulties users and providers face navigating the system;
  • poor communication between the National Disability Insurance Agency (NDIA), participants and providers, including difficulties getting reliable and accurate information (e.g. Warr et al., 2017);
  • the absence of ready markets for services in many areas, especially in remote places, leading to the under-use of funded (needed) services and supports;
  • the inefficiencies of the annual review process, including the need for extensive preparation and expert evidence, especially for participants looking to self-manage their funds (e.g. Olney & Dickinson, 2019);
  • the mismatch for some NDIS participants’ ad hoc needs caused by fluctuating health and the way supports are funded in advance; 
  • serious inequities, e.g.:
    • the frequent observation that assertive people with professional backgrounds or better advocacy skills (or people with access to others with good advocacy skills) tend to do better than those who are not as good at advocating for themselves (e.g. Warr et al., 2017); and
    • the fact that the system can be hard to access and navigate without access to the Internet; 
  • worries by some NDIS participants that unspent funds at the end of the year will result in fewer funds being allocated the next year (and the rush to spend funds that ensues to reduce this risk);
  • the limited evidence-base for some of the NDIA’s practices;
  • the training and knowledge deficiencies of some of its staff, including some staff who seem to lack an in-depth understanding of disabilities (e.g. Warr et al., 2017);
  • the administrative burden for NDIS participants, including using the portal to view plans, keep track of budgets, request payments and manage services (Warr et al., 2017);  
  • the red tape, and high administration and compliance costs for NDIS providers (e.g. Warr et al., 2017), which has resulted in many smaller providers de-registering from the NDIS;
  • the perception among many providers of low engagement with professionals involved in the sector, including limited understanding of the complexities involved in the provision of front line services, unrealistic pricing expectations (e.g. NDS, 2016, 2018);
  • the NDIA’s interpretation of tests for eligibility for the scheme or the meaning of “reasonable and necessary” supports  (e.g. Morton, 2018; O’Donovan, 2018; Victorian Legal Aid, 2018; Australian Legal Information Institute, 2019);
  • the NDIS’s interface with other “mainstream” services, and the “buck-passing” that happens, e.g. between the NDIA and state health authorities;
  • competing priorities, jurisdictional ambiguities, quasi-market shaping;
  • the fact that individuals and families rarely live their lives in the way in which government services are organised (e.g. Dickinson & Carey, 2017);
  • tensions between themes of giving participants choice and control in planning their care, and the reality of discretionary decision-making on the part of the scheme’s care planners about what is “reasonable and necessary support” in a given case (Olney & Dickinson, 2019);
  • service providers bearing the brunt of participants’ frustrations with the scheme (Olney & Dickinson, 2019);
  • serious forecasting errors:
    • estimating that there would be about 410,000 scheme participants, when the number will be closer to 500,000 by 2024-25;
    • thinking that people with Autism Spectrum Disorders would make up at most 18% of scheme participants, when the actual number of the past three years has been closer to 28-31% (e.g. Morton, 2020);
  • perceived and potential conflicts of interest, e.g. when plan managers are also providers;
  • fraud risks and sharp practices, which have arguably been overlooked or discounted until very recently; and
  • skill shortages, especially with highly-skilled, technical skill sets needed to provide specialised services to people with disabilities.

These are just some of the many criticisms of the scheme. On top of these issues, many continue to question the scheme’s long-term financial viability. Overall, many participants, providers and other stakeholders agree that there remains a significant gap between expectations (e.g. about participant choice and control) and the realities of navigating the NDIS.

So should we give up?

Of course not!

The NDIS is publicly funded, so we should expect it to listen to criticism and be accountable to people with disabilities, service providers and other stakeholders – many of whom have very valid criticisms and complaints. But we also have to support the NDIS and to work with each other if we want it to survive. 

In scrutinising the NDIS’s performance, it’s worth remembering that disability services in Australia before the NDIS were underfunded, inflexible, fragmented, and, too often, focused on the system, rather than individuals with disabilities (e.g. Productivity Commission, 2011). Funding was complex, inefficient, opaque, with gaps and overlaps in State, Territory and Commonwealth responsibilities (Purcal et al., 2014). Far too many Australians with disabilities had a poor quality of life, including social exclusion, elevated risks of violence, low incomes and poor access to jobs (e.g. Kmjacki et al., 2016; OECD, 2009; Mithen et al., 2015). 

Many Australians with disabilities are faring better under the NDIS than under previous arrangements. But that is, of course, a low bar, and not everyone with a disability is enjoying more choice, control, better services, or a higher quality of life. Many challenges remain, including:

  • closing the gap between the lofty objectives of the scheme and the cold hard reality (e.g. Productivity Commission, 2017; Warr et al., 2017);
  • improving equity of access to the scheme and its outcomes;
  • maintaining the long-term financial viability of the scheme (and its bipartisan political support);
  • simplifying the administrative burdens of the scheme for participants and providers;
  • improve communication between stakeholders;
  • increasing training support to NDIS staff, its agents and providers;
  • increasing choice and control by supporting the markets for services (e.g. through seed funding); and
  • improving the quality, evidence-base, value-for-money and integrity of services provided, including through the NDIS Quality and Safeguards Commission, and its efforts.

The NDIA has always acknowledged that the implementation of the scheme would be a significant challenge and that problems would need to be solved and addressed through continuous improvement processes. To use a well-known simile, it’s like we’re falling from 37,000 feet and trying to build a plane before we land. 

The scheme’s sometimes rocky implementation is testing the patience of government, service providers, and, most importantly, people with disabilities and their networks.  More challenges – including many listed above – remain. But they will be easier to overcome if we work with each other constructively, giving most weight to the concerns, goals and lived experiences of people with disabilities.

Yes, I’m still a clear-eyed realist. No, I have no mellowed in my middle-age. But I’ve learned to be optimistic and to have high expectations about what the NDIS is and can achieve for participants and for Australian society as a whole.

When so much is at stake, what choice do we have but to support the NDIS and to work hard to improve it? 

Principal source: Olney, S., and Dickinson, H. (2019). Australia’s New National Disability Insurance Scheme: Implications for Policy and Practice. Policy Design and Practice, 2(3), 275-290.

NDIS Worker Screening Policy and Risk Management Plan Template for small NDIS providers

11 May 2020 By David Kinnane Leave a Comment

To protect participants, the NDIS (Practice Standards – Worker Screening) Rules 2018 (the Rules) require NDIS providers in all States and Territories (except Western Australian) to have a policy and processes in place to screen workers and other personnel.

Among other things, the Rules require that:

  • providers have a policy to protect people with a disability;
  • providers conduct risk assessment on each role to determine whether safety clearances (including checks for criminal offences and working with children checks) under the Rules are required;
  • certain workers and others personnel be screened, including key personnel and workers who have direct contact with NDIS participants;
  • providers take reasonable steps to make sure that people working with them under subcontracting arrangements have appropriate clearances for personnel who will be working with them; and
  • providers keep adequate records of role risk assessments, worker clearances and subcontractor contracts containing clearance-related clauses for other personnel, and that providers keep them for long enough so that the NDIS and others can check they are following the Rules.

This policy is drafted to help small providers to address the requirements of the Rules, including by establishing records to prove compliance with the Rules. It is drafted conservatively, with a “no clearance-no work” approach to protect small NDIS providers and participants.

Download the NDIS Worker Screening Policy and Risk Management Plan Template

What specific checks are required for worker clearance in each State?

Unfortunately, this is currently much more confusing than it should be.

The Government has announced that a national system will be rolled out to help with checks, which will allow worker screening across all States and Territories (except Western Australia). The timetable originally envisaged that this would be done by 30 June 2020, but is is not clear whether this will be achieved, especially in light of current events.

Until the new system is rolled out, the specific checks that must be completed vary from State to State and are not portable (for example, a NSW check doesn’t satisfy the Victorian requirements, and vice versa). This means that workers who work across different States currently require separate clearances in each State.

This policy template is drafted neutrally so that it can be used both during the transition period and after the roll out of the national register.

For compliance purposes, the specific checks required for workers in each State and Territory are summarised here.

To help providers, we will update this information (and if necessary the policy template) as the national roll out occurs.

Download the NDIS Worker Screening Policy and Risk Management Plan Template

New NDIS Risk Management template: another quality (but inexpensive) NDIS template for small organisations

20 April 2020 By David Kinnane Leave a Comment

When I stopped practising law full-time to become an allied health professional, lots of people – understandably – had questions. Some colleagues asked me straight out: why throw away more than 15 years of legal and compliance experience to work in a completely different field?

I never looked at it that way. Beneath the surface, both professions are about people, good communication, and building trust; about doing the work for clients, and striving to get better every day. About being an ethical professional in an imperfect world. 

Both professions – law and speech pathology – give me enormous joy: an opportunity to use my skills to push myself out of my comfort zone, and to help others to achieve their goals. 

Every now and then my two skill-sets intersect in interesting ways. A good example is my recent NDIS template writing:

  • as a lawyer, I know how to read the legislation;
  • as a speech pathologist, I know how to translate legislation, guidelines and rules into readable policies; and
  • as a small speech pathology practice owner, I know that our resources are limited, that few of us are in practice to make millions, and that margins are tight.

With my wife (and fellow lawyer), we started Speechies in Business way back in 2015 to support Australian speech pathologists in private practice with high quality, inexpensive templates, precedents and other resources. 

In 2018, we started hearing from Australian Occupational Therapists, Physiotherapists, Dietitians, Podiatrists, Chiropractors, and Exercise Physiologists asking whether our templates could be used to support their practices, despite our speech-related name! They could. 

In 2019, we heard from NDIS providers of all kinds to see whether we could support them with template documents to help with NDIS compliance, NDIS verification, and NDIS audits. 

Initially, we were reluctant to do so – we wanted to focus on helping speech pathologists and other allied health professionals. But we kept hearing horror stories: about small NDIS providers being quoted thousands of dollars for basic templates – money they could use to invest in themselves to help their clients.

So, accidentally, we’ve become known for producing quality, inexpensive resources for small NDIS providers. And after literally hundreds of requests, we’re thrilled to launch a major new addition to our growing NDIS Template Library: The NDIS Risk Management System. Click on the button below to check it out

NDIS RISK MANAGEMENT SYSTEM TEMPLATE

We hope you find it useful!

Related resources:

  • NDIS Incident Management and Reportable Incidents System Policy and Procedures
  • NDIS Complaints Management and Resolution System Policy Document and Complaint and Feedback Form

NDIS Providers: New Complaints Management and Resolution System – Policy Template now available!

11 August 2019 By David Kinnane Leave a Comment

We’ve had quite a few requests for this one!

So, last week, we sat down with the National Disability Insurance Scheme (Complaints Management and Resolution) Rules 2018 and drafted a policy template designed to help you meet its requirements.

Having such a policy is a condition of registration – and something NDIS providers can expect to be asked for as part of verification or certification.

The template policy is designed to form part of your compliance system to support NDIS participants and other people to make complaints about supports and services.

We’ve used a plain English, accessible writing style, and included a complaints form, too.  We’ve also made both documents available in PDF and Word versions so you can use and adapt for your needs.

Download the NDIS Complaints Policy

By way of thanks, we’ve given a free copy of this policy template to those of you who suggested we write it.  If you can’t find a template, policy or resource, please get in touch and we will add it to our to-do list!

We’ve also just launched the policy document that will comply with the requirements of the NDIS (Incident Management and Reportable Incidents) Rules 2018.

Image: httpss://tinyurl.com/y2fu576o

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