Practical Guide to the NDIS: NDIS Provider Travel and ...



Practical Guide to the NDISNDIS provider travel and participant transportAuthor: Pascale Dreyer, NDS VictoriaContact: Stephanie Worsteling, NDIS National Adviser, with any enquiries at stephanie.worsteling@.auProvider travel and participant transport are different concepts. This practical guide explains the differences and notes specific rules and arrangements for both travel and transport under the National Disability Insurance Scheme (NDIS).The Practical Guides have been made available through Funding from the Victorian Government's NDIS Transition Support Package.About Provider travel: Provider travel describes scenarios when a provider is able to claim for worker time when travelling to deliver supports to a participant based on the NDIS Provider travel information. This guide will refer to provider travel as worker travel time.About participant transport: Participant transport refers to the transport supports used by participants, and may be funded in a participant’s NDIS plan to cover relevant costs. If delivering community access supports providers are able to claim, in addition to claiming for workers’ time, a contribution for additional transport costs (such as, cost of public transport or cost per km for car usage) if agreed to in advance by the participant.The Appendix provides practical examples related to travel and transport.Disclaimer: National Disability Services Limited (NDS) believes that the information contained in this publication is correct at the time of publishing. NDS does not accept any liability to any person for the information or advice (or the use of such information or advice) which is provided on in this guide or incorporated into it by reference. The information is provided on the basis that all persons undertake responsibility for assessing the relevance and accuracy of its content.?No responsibility is taken for any information or services that may appear on any linked websites.Provider TravelThere are a number of factors that determine whether a provider is able to claim for worker travel time, includingthe type of support being delivered,the location of the appointment, andwhere a worker’s journey starts and finishesProviders are able to claim worker travel time under certain circumstances when delivering the following supports:Personal careCommunity accessTherapeutic supportsEarly Childhood Early Intervention (ECEI) supportsTips for service providersProviders need to discuss worker travel time with participants prior to commencing services and must have the agreement of the participant in advance of claiming for associated costs.Service Agreements should specify how and when providers will claim worker travel time, tailored to each individual participant.When claiming worker travel time, providers need to keep accurate records for payment assurance purposes as the NDIA may audit providers at any time.For more information refer to the NDIS Provider Toolkit, Provider Payment and Assurance Program.When worker travel time cannot be claimedThere are a number of instances when worker travel time cannot be claimed. These scenarios include (but are not limited to) if a worker:Travels more than 20 minutes between appointments for personal care and community access supports, and therapeutic or ECEI supports in metro and other areas identified in the Modified Monash Model as being in MMM1?3 areas.Travels more than 45 minutes between appointments for personal care and community access supports, and therapeutic or ECEI supports in regional areas (MM?4 or 5)When travelling from the final appointment to the office if delivering personal care or community access supports Delivers supports outside the scope of NDIA’s provider travel policy (for example, for support coordination)Refer to the Appendix for specific examples.Claiming for worker travel timeWhen claiming for worker travel time, providers need to focus on where the service is delivered as this has implications for the maximum amount of time that a provider can claim for. Providers are able to claim up to 20 minutes of worker travel time if the appointment is delivered in a metro area, as determined by the Modified Monash Model (note, MMM1?3 includes large regional centers). If the appointment is in a regional area (MMM4 or 5) providers are able to claim up to 45 minutes of worker travel time. This means that if a provider is traveling from one metro area to another, they are only able to claim up to 20 minutes of travel time even if it takes 1 hour to get there.Providers are required to claim separately for worker travel time using the corresponding line item of the support delivered. This means that when claiming, providers will need to identify the claim type as ‘travel charges’ in either the bulk upload or individual payment request. For example if a provider delivers 2 hours of personal care supports and the worker has travelled 15 minutes to the appointment, the provider claims 2 hours of personal care supports as a standard claim, and claims 15 minutes separately as a travel charge.Ways to increase efficiencyProviders need to consider flexible ways of working to reduce worker travel time. To increase efficiency, providers may wish to consider:Meeting with the participant at the provider premises, if appropriateOrganising staff appointments according to the location of participants (to minimise travel time and distance between appointments)Helping participants to coordinate the timing of periodic appointments for therapeutic supports (particularly in remote and regional areas)Participant TransportProviders can recover transport costs (for example, costs associated with use of provider-owned vehicle) when ‘accompanying and/or transporting participants in the community’, as a part of delivering community access supports, or when delivering transport supports. For more information and examples, refer to the Appendix.Funding for transportWhere it is reasonable and necessary, a participant plan may include funding for transport. A participant is allocated transport funding if they cannot use public transport without substantial difficulty as a result of their disability. It is not intended to cover transport assistance for informal carers or parents to transport the participant to everyday commitments. For information about when transport funding is included in a participants plan, refer to the NDIA’s Operational Guideline: Transport. There are three benchmark levels of funding for adults who receive transport funding. For more information, refer to NDIA Factsheet: Participant Transport.Participants are able to use their transport funding flexibly to cover their transport costs. This may include (but is not limited to), paying for taxis or additional provider transport costs (for example, costs negotiated with the provider – these may be calculated by the amount of kilometres travelled). Support coordinators may need to assist participants to understand how their transport funding can be used.NDIS funded transport supportsParticipants can choose to manage their transport funding in four different ways. They can choose to have the NDIA manage their funding; choose a plan manager to manage their funding; self-manage the funding; or receive periodic payments (usually fortnightly or monthly) into their nominated bank account.If a participant receives transport supports or chooses to use their transport funding to pay any additional provider transport costs, providers will need to recover costs from the participant according to how their funding is managed. For example, providers will need to invoice the participant directly for the additional provider travel costs if a participant receives their transport funding as periodic payments into their nominated bank account. Providers should ensure that when claiming transport costs via the NDIA Provider Portal, they use the appropriate NDIS support line item (i.e. transport: 02_051_0108_1_1), and do not claim the transport costs using a different line item. Participants are also able to pay for any travel costs using their personal funds (derived from their own non-NDIS income).What if the participant wants to exercise choice and control of their Core supports to access more transport supports?Participants are able to use their Core supports flexibly across all support categories (including transport), except where a participant’s total transport funding is set up as periodic payments or if a participant has not been funded for transport supports.Participants can only use transport funding flexibly within Core supports if the participant’s transport funds are NDIA-managed, plan-managed, or self-managed. Participants may choose to have the NDIA manage some of their transport funds and receive the remainder as periodic payments. This would allow the participant to access their Core budget flexibly if they would like access to additional transport funding.Providers may consider working with participants to reduce their transport costs byBuilding participant capacity to use alternative transport options (for example, public transport, taxi services, uber, informal supports etc.)Encouraging participants to carpool if appropriateUsing existing transport assets to subsidise the overall transport costs (for example, using vehicles across different premises or service types when they are not in use)Appendix: Provider Travel and Participant Transport SummaryScenario 1Worker travels to provide personal care and community access (without participant in vehicle).When providers can recover costThe worker must be travelling from a workplace to provide support to a participantThe claim must be against the participant’s plan that the worker is traveling to (for example, the 2nd, 3rd, 4th, etc. plan)Travel cost cannot be recovered if: The worker is travelling between their home to the workplace; or from the workplace to their homeThe worker is traveling from the last appointment to the workplaceSupport time exceeds 4 hoursPaymentA provider must have the agreement of the participant in advance (i.e. the service agreement should specify the worker travel time that can be claimed.)Up to a maximum of 20 minutes travel time at the hourly rate for the relevant support line item in a metro area (MMM1-3)Up to a maximum of 45 minutes travel time at the hourly rate for the relevant support line item in a regional area (MMM4-5)Support categoryPersonal care or Community access supports (as appropriate). Guidance for scenario 1The term ‘workplace’ refers to an office, where a participant may be located at the time, or a participant’s home.Providers must claim travel time separately from the standard claim. Providers will need to identify the claim type as worker travel time.The amount must reflect the actual travel time. For example, if travel time is 10 minutes, only 10 minutes can be claimed. The maximum that can be claimed is 20 minutes or 45 minutes, depending on where the support is delivered.Providers need to consider how they are rostering shifts with participants to mitigate the risk that some participants may bear the cost of provider travel more than others.Providers are able to share the cost of travel among the scheduled participants in regional, remote and very remote areas, as long as it is agreed with the participants in advance. For example, if a worker travels two hours between four participants to provide services in a regional area, each participant will be charged 30 minutes of worker travel time, regardless of the actual travel time between participants.Scenario 2Accompanying and/or transporting participants in the community (with the participant present in the vehicle)When can providers recover costWhen the provider incurs an additional cost, in addition to worker’s time or when delivering transport supports.PaymentNegotiated between the participant and provider (i.e. the service agreement should specify how the transport costs will be claimed).Support categoryCore Supports (i.e. transport funding, including periodic payments) or participant contribution using non-NDIS funds.Guidance for scenario 2Providers may choose to calculate the additional transport cost by the amount of kilometers travelled. Refer to the relevant employee awards for guidance when negotiating the additional cost.A worker’s time can be claimed at the hourly rate for the relevant support line item for the total time that the worker is transporting or accompanying the participant in the community, in addition to the incurred transport cost (for example the kilometres). Worker time cannot be claimed when the provider is purely transporting the participant to from one location to another (i.e. is not also delivering other disability supports).If the provider is transporting two or more participants on the same trip, the individual charge should be calculated according to the group ratio (for example, 2 staff to 10 participants).Some participants may require assistance from support workers when accessing transport supports. In these circumstances providers are able to support participants while they are receiving transport supports, where it is reasonable and necessary.Scenario 3Travel to provide therapeutic or Early Childhood Early Intervention (ECEI) supports.When can providers recover costThe worker must be travelling to an appointment provide support to a participantThe provider is able to claim for time spent travelling to the first appointment, and from the last appointment back to the workplaceWorker travel time must be claimed against the participant’s plan that the worker is travelling to (for example, the 2nd, 3rd, 4th, etc. plan)PaymentUp to a maximum of 20 minutes travel time at the hourly rate for the relevant support line item in a metro area (MMM1-3)Up to a maximum of 45 minutes travel time at the hourly rate for the relevant support line item in a regional area (MMM4-5)Support categoryImproved Daily LivingGuidance for scenario 3The term ‘workplace’ refers to an office, where a participant may be located at the time, or a participant’s home.Providers must charge travel time separately from the standard claim. Providers will need to identify the claim type as worker travel time.The amount must reflect the actual travel time. For example, if travel time is 10 minutes, only 10 minutes can be billed. The maximum that can be billed is 20 minutes of travel time.Providers need to consider how they are rostering shifts with participants to mitigate the risk that some participants may bear the cost of provider travel more than others.Providers are able to share the cost of travel among the scheduled participants in regional, remote and very remote areas, as long as it is agreed with the participants in advance. For example, if a therapist travels two hours for a round trip to provide services to four participants in a regional area, each participant will be charged 30 minutes of worker travel time, regardless of the actual travel time between participants.Scenario 4Remote or very remote travel.When can providers recover costServices are delivered in remote or very remote regions. For more information regarding geographical locations refer to the Modified Monash Model.ChargeSubject to relevant loading or agreement with the NDIA and provider. This is a quotable item.Support categoryCore or Capacity Building Supports (depending on the types of supports delivered).Guidance for scenario 4Prices in remote and very remote areas are respectively 20 percent and 25 percent higher than supports delivered in other areas. If local area providers are not available in remote or very remote areas, the NDIA may enter into agreements with other providers to provide supports, for example, those in thin markets.End of document. ................
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