NDIS Provider UpdateSeptember 2016



NDIS Provider UpdateSeptember 2016Contents TOC \h \z \u \t "Heading 2,1" Resolving launch issues PAGEREF _Toc461102668 \h 2Claiming and payments strategy PAGEREF _Toc461102669 \h 2Participant Pathway PAGEREF _Toc461102670 \h 2Planning PAGEREF _Toc461102671 \h 3Assistive Technology (AT) PAGEREF _Toc461102672 \h 3What is Specialist Disability Accommodation (SDA)? PAGEREF _Toc461102673 \h 4Local Area Coordination (LAC) will be delivered with Partners PAGEREF _Toc461102674 \h 5Early Childhood Early Intervention Update PAGEREF _Toc461102675 \h 5Implementation PAGEREF _Toc461102676 \h 5Service Agreements PAGEREF _Toc461102677 \h 7My Place Portals PAGEREF _Toc461102678 \h 7Support Categories PAGEREF _Toc461102679 \h 8Service Bookings PAGEREF _Toc461102680 \h 10Payment Requests PAGEREF _Toc461102681 \h 11Support Materials PAGEREF _Toc461102682 \h 11Resolving launch issuesIssueGuidanceMigration issue: Incorrect or missing organisational details or registration profile i.e. service bookings, resulting in inability to claimFurther migration activity has been undertaken & is complete. Please access myplace and check your details. Advise your local NDIA site office if you are still experiencing issues. Update: New Quality and Safeguard (Q&S) working arrangements being finalised with each state/ territory that stipulate accreditation process. May differ from trial.Module 4 of the Provider Toolkit will be updated as relevant state(s) and Territories arrangements become availableChange: Support Clusters are now ‘Registration Groups’ with movement of supports to new list of 36 Registration GroupsModule 2 and 4 of the Provider Toolkit maps the registration requirements for each group.Change: Service bookings need to be in place before providing supports to a participant.“Fact sheet for existing providers” and Module 6 and 11 of the Provider Toolkit in relation to service bookings.Claiming and payments strategyA new strategy to continue to provide support for providers experiencing challenges with bulk claiming and payments has been introduced.A dedicated team has been established to assist with processing bulk claims or other claims.These arrangements will give providers additional support to help them finalise claims and support them to confidently use the new portal.The new strategy involves assisted claiming supported by a dedicated team instead of the current approach for advanced payments for providers being performed through the Regional Offices.Providers experiencing issues should contact 1800 800 110.Participant PathwayNDIA establishes contactFor persons currently receiving supports, NDIA will make phone contact to obtain consent to access the NDIS and collect information on the person’s name, date of birth and Customer Reference Number (CRN).EligibilityUsing the information collected the NDIA will assess eligibility to access the NDIS. Eligible people become participants of the NDIS.Pre-planningThe NDIA representative will make contact to collect the information required to develop a plan.PlanningThe plan is developed and approved by the NDIA. The plan may be handed over to a support coordinator at this point.Plan implementationSupport coordinator assists in plan implementation and building capacity to undertake future planning.PlanningInformation gathering has been progressing – LACs and NDIA planners Plans are being developed by NDIA planners Plans approvals are progressingTo ensure continuity of support for our participants plans that were due for review in June, July and August have been extended by 90 daysYou and your participants should discuss whether you need to update your service agreement in line with the new plan end dateNDIS PlanPart 1 – About meWhere I live and the people who support meMy daily LifePart 2 – My GoalsA number of goals including my longer term goals and aspirationsPart 3 – My supportsFamily and FriendsMy informal supportsServices and community groupsMy community and Mainstream supportsNDIS reasonable and necessary support budgetsThere can be up to 15 different support budgets - an example of one support budgetSupport AreaSupport CoordinationBudget$DetailsFunding for Support Coordinator to assist you to identify your goals and coordinate, liaise with service providers, mainstream and community supportsHow will the support be paidEither Provider / Participant / Plan managerAssistive Technology (AT)A new MOU is being finalised with Enable- NSW HealthEnable have processes re assessing and prescribingProvision of AT including refurbished stock, overview of customised equipment not delivered by Enable There will be budget allocations in plans and NDIA will make service booking for assessorA request for quote will be issued on receipt of assessment report – Enable prices are benchmarks for NSWWhat is Specialist Disability Accommodation (SDA)?Specialist?Disability?Accommodation (SDA) refers to accommodation for participants who require specialist housing solutions to assist with the delivery of supports that cater for their complete functional impairment and/or very high support needs. SDA may include specialist designs for people with very high needs or may have a location or features that make it feasible to provide supports for independent living. What changes?New approachThe NDIS is adopting a new approach to funding of SDA for people with a reasonable and necessary need for SDA supports under the Scheme.Individual funding Funding is linked to individual participants based on individual assessmentsIncreased choice and controlPeople who are assessed as requiring SDA will have greater flexibility and choice over their housing and the manner in which accommodation is provided.OpportunityThe funding approach affords greater opportunity for a range of ownership models including shared ownership arrangements. Specialist Disability Accommodation principlesSustainabilityBest whole of life outcomes with efficient whole of package costs, consistent with the insurance principles underpinning the NDIS and to support the most people possible based on value for money.InclusionTo assist participants to have the same housing opportunities, choices and responsibilities as the broader community through stimulating market supply. Some property forms do not achieve thisIndependenceMaximise independence and social and economic participation, consistent with the vision of the NDIS. Choice and controlTo allow participants their choice of providers of housing and of support services, and the way in which they will be provided.ContinuityProvide an orderly and managed transition of existing SDA into the NDIS. Over time, support a transition from historic accommodation options and service models to approaches that support independence and social and economic participation. InnovationTo encourage innovation and investment in new SDA.Which participants will be considered for SDA funding in their plan?Under continuity of support arrangements, existing residents of shared supported accommodation will have SDA in their first planThe NDIS is drafting Rules to that will determine if SDA is a reasonable and necessary support in a participants plan.The need for SDA will be discussed during the planning process.How many people are impacted?There will be approximately 460,000 NDIS Participants in total including approximately 200,000 who will require affordable housing. The estimate from the Productivity Commission and NDIA Actuary is approximately 28,000 NDIS participants will have a reasonable and necessary need for SDA. There will be two reference groups – Participants who have high support needs and require a specialist built form and Participants whose support needs can only be cost effectively met by SDA.Local Area Coordination (LAC) will be delivered with PartnersLocal Area Coordinators (LACs) support participants and their families to join in and contribute to the life of their community and assist with the planning process, plan implementation and community participation.LACs support participants through all steps of the NDIS pathway. LACs will also assist people not eligible for the NDIS to connect to relevant community resources and in building community accessibility and capacity.Partners in Community (LAC)Uniting and St Vincent de Paul NSW are delivering Local Area Coordinator services in NSW. Focus in Q1 is information gathering for participants living in group homes and in receipt of Community High support funding from NSW FACS.Followed by plan implementation for Q1 participants (except where funded support coordination included in plan).Commence information gathering with Q2 transitioning participants. Early Childhood Early Intervention UpdateEarly Childhood intervention best practice and evidence base underpins the NDIS ECEI approach.With the implementation of the ECEI Approach, the NDIA will have Early Childhood partners. They will be the first point of contact for families. The ECEI Partner will discuss with the family the most appropriate supports that will benefit the child. This includes information and referral to mainstream supports.For children who require more intensive support, the Early Childhood partner will work with the families of eligible participants to build budgets that reflect the child and family individual needs. Early Childhood Plans will state: ‘Provision of Early Childhood intervention supports to work together within the home and community settings, utilising relevant disciplines to support and advise the family in order to meet the plan goals and objectives’. Providers are to report progress towards outcomes and, where relevant, the Participant’s ongoing functional needs.Quotes will not be required – families will negotiate a service agreement; service bookings at the budget level will be established by the participant / provider.ImplementationFirst Plans and Support CoordinationFirst plans for people receiving support coordination will be focused on meeting a participant’s immediate needs.It is expected that Support Coordination will assist the participant to implement and monitor their plan as well as:Working with the participant to develop their goals prior to second plan and the supports required to achieve them. Building current capacity and encouraging participants to explore different supports.Linking the participant with mainstream and community supports.Role of Support CoordinationPrimary roles of Support CoordinatorSupport implementation and identify options for all supports in the plan, including informal, mainstream and community, as well as funded supports.Strengthen and enhance the participant’s abilities to coordinate supports and participate in the community, reach decisions and develop agreements with support providers.Ensure mainstream services meet their obligations (i.e. housing, education, justice, health).Build capacity of the participant to achieve greater independence, self-direct supports in the longer term and understand funding flexibility.Be available – to ensure new support arrangements endure and in times of ‘crisis’.Provide NDIA with reports on outcomes and success indicators within agreed reporting frequency.Allocation of Support CoordinatorOn plan approval, NDIA will contact the participant for preferred support coordinator;If not nominated, NDIA will allocate (random selector).NDIA sends a copy of the Participant Plan and a Request for Service and completes Service Booking.Support Coordinator meets with participant within 5 working days.Support Coordination - Request for ServiceA request for service covers:Participant details (name, NDIS #, plan start date, contact details, preferred contact person).Information on what support is required. Can include barriers, immediate connections required and other informal and mainstream connections.Reporting requirements, progress report.Terms of Business/ Conflict of InterestCompliance with this requirement is achieved by:Explicit policies in place to manage any conflicts.Maintaining records that demonstrate potential or real conflicts are managed appropriately for each participant.Records of options discussed with participants, promoting choice and control.Ensuring all participants are treated equally and preferential treatment is not given to any participant.NDIA can request evidence of compliance at any time.The Participant experienceParticipant (and/or supporter) meets with the Support Coordinator or LAC.Support Coordinator or LAC assists participant to understand plan.Support Coordinator or LAC assists participant to implement plan - choose service provider, negotiate service agreements and completing service bookings.Support Coordinator or LAC engages with the participant and their family on other options to be considered as the year progresses and development of plans for year two.Support Coordinator or LAC is contact person for participant in any discussions re plan.Service AgreementsThings that participants are recommended to be in their Service Agreement include:The supports provided under the Service Agreement.The cost of those supports.How, when and where the participant would like their supports to be provided.How long the participant needs the supports to be provided.When and how the Service Agreement will be reviewed.How any problems or issues that may arise will be dealt with.The participant’s responsibilities under the Service Agreement– such as letting their provider know if they cannot make an appointment.Their provider’s responsibilities under the Service Agreement – such as working with the participant to deliver their supports in the right way.How the participant or their provider may change or end the Service Agreement.My Place PortalsSystem overviewThe move from trial to full scheme transition represents a unique period for the NDIS. The Full Scheme rollout of NDIS will commence from 1 July 2016 with the aim to support approximately 460,000 Participants. To support the growth of the NDIS, we require a scalable and resilient information technology (IT) System to ensure people with disability continue to get the support they need.The NDIA was supported by an interim ICT system managed by the Department of Social Services (Seibel). It was designed to support around 30,000 participants for the duration of the NDIS trial period.Participant PortalThe participant portal menu options are:My Payment RequestsMy PlanMy Contact DetailsMy AppointmentsProvider FinderMy MessagesEventsMy Document UploadProducts and ServicesMyGov InboxMy Service BookingProvider PortalThe provider portal menu options are:ProfileInboxRegistration DetailsOutlet ManagementService BookingPayment RequestQuotationsProducts and ServicesReferralsMessagesFind a ProviderUpload EvidenceSupport CategoriesList of Support CategoriesThe NDIA Price Guide is arranged into 15 categories that align to the purpose of the funded supports and the NDIA Outcomes Framework.CoreOutcomes Framework DomainSupport Category (Plan Budgets)Daily LivingAssistance with Daily Life (1)Social & Community ParticipationTransport (2)Consumables (3)Assistance with Social & Community Participation (4)CapitalOutcomes Framework DomainSupport Category (Plan Budgets)Daily LivingAssistive Technology (5)HomeHome (6)Capacity BuildingOutcomes Framework DomainSupport Category (Plan Budgets)Choice and ControlCoordination of Supports (7)HomeImproved Living Arrangements (8)Social and Community ParticipationIncreased Social and Community Participation (9)WorkFinding and Keeping a Job (10)RelationshipsImproved Relationships (11)Health & WellbeingImproved Health & Wellbeing (12)Lifelong LearningImproved Learning (13)Choice and ControlImproved Life Choices (14)Daily LivingImproved Daily Living Skills (15)Support PurposeCore Supports1 – 3. Assistance with Daily LivingAssistance with self-care activities: Establishment FeeStandard needs High Intensity needsOvernightAssistance with daily life:Live-in carer/in home supportPersonal domestic activitiesHouse / yard maintenanceHouse cleaning/linenPreparation / delivery of mealsSupported independent living:Lower needsStandard needsHigher needsAssistance in Shared Living Arrangementsshort term accommodation alternative familyindividual living - complex needsTransporttransport allowancespecialised (school/work/community)Consumablesinterpreting and translatingcontinencehome enteral nutrition (HEN) 4. Assistance with Social and Community ParticipationCommunity and social activity costsassist access community and centre based activitiesactivity fees- camps, OOSH, coursesProviders should not claim payment for: Expenses related to recreational pursuits (tickets or sporting club fees) The cost of entry for a paid support worker to attend a social or recreational eventCapital Supports5. Assistive TechnologyWheelchairsProstheticsVehicle Modifications6. HomeHome ModificationsSpecialist Disability Accommodation (SDA) Capacity Building Supports7. Coordination of SupportsSupport ConnectionSupport CoordinationSpecialist Support Coordination8. Improved living arrangementsAssistance with accommodation /tenancy9. Increased social / community participationInnovative Community Activity FeesCommunity Participation/Volunteer support Activity Fees10. Finding and Keeping a JobEmployment related assessment and counsellingSupported employment (ADE) Employment support to find and retain workSchool Leaver Employment Supports11. Improved RelationshipsSocial Skills DevelopmentBehaviour Support12. Improved Health and Well-beingPhysical well-being activitiesDietetics13. Improved LearningTransition through school and to further education14. Improved Life ChoicesPlan Management (Financial and service intermediary)Financial Intermediary15. Improved Daily LivingTherapy Assessment and ServicesTraining for carers/parentsSkills DevelopmentMultidisciplinary Team InterventionEarly Childhood Intervention Driver TrainingService BookingsThe Role of the LAC or Support CoordinatorEnsure the development of a Service Agreement with chosen provider(s).Ensure provider has a completed Service Agreement prior to a Service Booking being created.Support participant to access Myplace – the participant portalSupport participant to create a Service Booking.Creating a Service Booking requires assisting a participant within their portalGenerating a Service BookingThe Portal allows you to Add Service Bookings and View Service BookingsWhen adding a service booking it is possible to click on a button to find providersOnce a provider has been selected the following information must be added:Service Booking TypeService Booking Start DateService Booking End DateThe Find Plan button must be clickedPayment RequestsClick on “Create a Payment”This opens the Payment Requests menu with these three options:Create a paymentView a Payment RequestBulk Payment Request UploadThe information you’ll need to submit a Payment Request are:Participant nameParticipant NDIS numberDates of supportSupport item categorySupport item numberSupport item quantity and priceNote that many pages also feature a “Return to Home” button on the bottom left-hand corner, in addition to being able to click on the myplace logoClick on “Create a Payment”Note that many pages also feature a “Return to Home” button on the bottom left-hand corner, in addition to being able to click on the myplace logo.Support MaterialsA range of support materials is available on the provider section of the NDIS website and in the Provider Toolkit can assist you work within myplace. We’ll be updating these materials as we receive feedback, to ensure they best meet provider needs, so please check the website regularly.Step-by-Step Guides:PRODA account creationFirst time logging into myplace (existing providers)Provider Portal Registrationmyplace Step-by-Step GuideOther resourcesFrequently Asked Questions ................
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